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Home My WebLink About0503 PRINCE HINCKLEY ROAD - Health 503 PRINCE HINCKLEY ROAD CENTERVILLE A= 170 -214 7 C No. Fee " _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppfitation for Misposal 6pstrm Construction permit Application for a Permit to Construct( ) Repair('Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. r.33 f r,ri9C j,1 /e" Owner's Name,Address,and Tel.No. pi Assessor's Map/ParcelJ,9 Z/�/ ' p�- li re.v* O Installer's Name,Address,and Tel No. F? Designer's Name,Address,and Tel.No. cJ E�G�t►n � J.n�� /Cep,e J/ lit, re 5e/0',9-i L Type of Building: Dwelling No.of Bedrooms -� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �� gpd Design flow provided S gpd Plan Date Z f 5 umber of sheets Revision Date Title f Size of Septic Tank z G�JC S '�": 5 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �/� i� .� K ata �1�� •%� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code agd.net,to"place the s� operation until a Certificate of Compliance has been issued by this Board of Health,- ed Application Approved by e Application Disapproved by Date for the following reasons - Permit No. c= "vJ �" Date Issued a' A{ No. C�_ � "' � `•-�- -, `� Fee ro THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application for ]Di!�-tlosal *pstrm Construction Permit Application for a Permit to Construct( ,) Repair(-Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.s"CJ? f/,r ne- Owner's Name,Address,and Tel.No. D � Assessor's Map/Parcel / y ^, �"` .,d�h �rc,,,,, a Installer's Name,Address,and Tel.No. 36 Designer's Name,Address,and Tel.No. a a ac, k, 'eJ >/ Cr. fie e fit Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building U2e !� No.of Persons Showers( ) Cafeteria( ) Other Fixtures v Design Flow(min.required) 7 3c� _ gpd Design flow provided 3�S gpd Plan Date 12 (?a/9r Amber of sheets Revision Date Title Size of Septic Tank )l IYI� c S Type of S.A.S. 2 Soo Description of Soil ----Nature of Repairs or Alterations(Answer when applicable) &0 /,,61 e4 r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and�pEi -to-alace the system in operation until a Certificate of Compliance has been issued by this Board of Healt - S gned ` D tteo Application Approved by TNate' Application Disapproved by Date for the following reasons Permit No. Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CEERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(/� Upgraded( ) Abandoned( .)by J,� ; Gc c�rt , S�u�..�r a.,/t (�✓�t.�lrr^� at S6 3 / .P� c If �;, Al AI- has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NoDK_66�- oZ dated Q Installer ,`�h ,o� () ;� '�-� d.�i-D Designer -All 6 "e';,2 Ke #bedrooms Approved design flo 3 y and The issuance of this permit shall not be construed as a guarantee that the system will cbn I as designe . Date I�A(1 Inspector v jor"" ---------------------7-------7-------------------------------------------7--------------------------------------------------------------- No. Fee — THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS �iS�l08at �pstetn onstruction J)ermit Permission is hereby granted to Construct( ) Repair( L,,f Upgrade( ) Abandon( ) System located at �O�r�/��r�L�i.C�•' -e%C �'e e and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be c pleted within three years of the date of this permit. Date Approved Town of Barnstable • �"`E Inspectional Services • • Public Health Division HnxzvsrnBM M^S' Thomas McKean,Director Eon° 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Sewage Permit## Assessor's MapWarcel Designer: l �ko— /GOA,-( Installer: Zo_lf? Address: Plntc Address: GA 4fV1 MA- 1 On 113 )-o was issued a permit to install a (date) (installer) septic system at 5D 3 T based on a design drawn by (a ress dated (designer) _ I Y that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. ,.----� ,� nth of I certify that the system referenced above was constructe lrba the terms of the I1A approval le rs licable) 0 J� Scott A. dy 0 McGann (Installer's Signature) #1224 y e d S ar��'�s (Designer' Signature) (Affix Design Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. WoMdeptAHEALTMSEWER connecASEPTIODesigner Certification Form Rev&14-13.DOC TOWN /OF BARNSTABLE LOCATION 2 C A 0-0—C-7 - VILLAGE ASSESSOR'S MAP&PA`RCEL/1 C4 1 INSTALLER'S NAME&PHONE NO. CU�!�Lt_z A d J /�+�M SEPTIC TANK CAPACITY G� G S LEACHING FACILITY:(type) 2 S NO.OF BEDROOMS OWNER Cj rG& o PERMIT DATE: 1-3 2 0Z O COMPLIANCE DATE: �—C ��y Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY I C L< 2 c 3r' 7 - A e. 3 C� I 2 Town of Barnstable Inspectional Services Department anxrrsrASM 1639.M� Public Health Division if°tea 200 Main Street, Hyannis MA 02601 Office: 508-8624644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 1074 November 18, 2019 GRAMOLINI, JOHN J 503 PRINCE HINCKLEY ROAD CENTERVILLE, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 503 Prince Hinckley Road, Centerville, MA was inspected on 10/15/2019 by Chad Hathaway, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360-20 h). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE B ARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of.Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\503 Prince Hinckley Road Centerville.doc t • ��THE t� " Town of Barnstable nnx�vsraei.s. MASS Inspectional Services Department .or f0 µy'l A Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 316 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) Veaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is Centerville required for every ✓ Ma 02632 10-15-19 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information c 1#7 on the computer, use only the tab Chad hathaway key to move your Name of Inspector cursor-do not H PS use the return Company Name key. r� Company Address Forestdale Ma 02644 t Cityrrown State Zip Code 7e 774 274 2581 12866 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails 10-15-19 Inspector's Sign re Date The system inspector shall su It a copy)this inspection report to the Approving Authority(Board of Health or DEP)within 30 ys off c rx�pleting this inspection. If the system has a design flow of 10,000 gpd or greater, the ins c of r and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts r= Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: This inspection is not a guaranteeand applies no warrantyof the described septic components in this report including but not limited to piping structual intergrity of components and life exspectancy of leaching and described components. This inspection is to describe conditions witnessed at time of inspection only. Regular tank maintenance and water conservation can prolong life of septic systems Information on care and do's and don't's can be found at town health dept or mass.gov 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �a 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. CityTrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ® Y ❑ N FIND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or.obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. City[Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6° below invert or available volume is less than %day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than.50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section CA Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form �- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 .page_ Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): min. 330 Description: Number of current residents: unknown Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: unknown Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 1985 Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): Depth below grade: 1.5' feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line. 24'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): no signs of leaks or poor venting t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 1 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) concrete 1000 gal h10 tank with riser on inlet and outlet If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8'x5' Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 22" Scum thickness less then 1" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? tape and sludge judge- Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): baffles in place. slight concrete decay present. 1/2 aggregate exsposed on ceiling of tank. Concrete thickness of ceiling to be 2 1/4" inches. no visable cracks or visable leaks t5insp.doc•rev.M6/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form IQ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete . ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 cam, Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System form-Not for Voluntary Assessments . J� 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): ' Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): need replacement heavy decay t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form l w Subsurface Sewage Disposal System Form-Not for Voluntary Assessments J� 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 6'x6' ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments v 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit dug up Pit full to invert with black sewerage staining to top of leach pit with black sewerage in cover seam. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .� 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts rM - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately LJ I 37 G O y3 3� 5U LlY v a o a � C) ices t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 20'+feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: town GIS mapping lot el. 48' low in area wetlands seth parker and Ames way el. 26.12' bottom of leaching pit 9' below grade Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 503 Prince Hinckley Road Property Address Gramolini Owner Owner's Name information is required for every Centerville Ma 02632 10-15-19 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 • INVOICE Chad Hathaway D.E.P Title 5 Inspector P.O Box 151 Forestdale Ma.02644 774 274 2581 521 HPSIONCAPE YAHOO.COM INVOICE#t DATE:10/15/19/19 Title 5 Inspections—Voluntary Septic Inspections—Risers—Pipe and D Box Repairs System locating-Well Sampling—Pump Chamber repairs—Camera Inspections TO:GRAMOLINI 503 Prince Hinckley Road Centerville DESCRIPTION HOURS RATE AMOUNT Septic inspection 350.00 Paid in full C/C card 10-16-19 TOTAL 350.00 All work is to be completed in a workmanship like manner according to standard industry practices.Any changes or deviation to above specifications described above by consumer may result in added labor and or material costs.All payments are due upon completion of work.. Payments over 30 days Late will result in interest charges at the maximum legal amount by law. Authorizing Signature agrees to terms described above. Authorized Signature: Date: Printed Name Date: Please make checks payable to Chad Hathaway THANK YOU FOR YOUR BUSINESS! T ION SEWAGE PE RMIT NQ. c- �3 PILL E. VT INSTALLER'S NAME ADDRESS It lei e U I L D E R OR OWNER DATE PERMIT ISSUED 2 DATE COMPLIANCE ISSUED ., ' .� � � k� � � c� � a fT , �� No.... ............................_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ........ ...................OF.......... .A.R.Q_S... ............ ApplirFation for Uhipmal Worka Tomitrnrtiun Primit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. U�e� - � _._._.�o.►.�..1?- . I - Mvc sC� f� --------------------------......................`.......... . wne a -- � % --------•- _-______•••-•---•--------------- Installer Address Type of Building Size Lot.....Z/__->l_�..Z_._Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------- --------- ----------------- ------•--- W Design Flow............ per person per day. Total daily flow..__._.__��- _____._.___________gallons. P: Septic Tank—Liquid'capacity`01 gallons Length.`7_t':P..... Width................ Diameter________________ Depth................ W Disposal Trench—No_____________________ Width,______-_-_°_______ Total Length..........__ ______ Total leaching area....................sq. ft. x Seepage Pit No...........1-------- Diameter......... _._.__ Depth below inlet____..�6?__________ Total leaching area_?-�' _.,�_-'_sq. ft. Z Other Distribution box (V ) Dosing tank ( ) Percolation Test Results Performed ___________________ Date__._kR_/__r '_� Test Pit No. 1_.__LZ__minutes per inch Depth of Test Pit.....1.7!n........ Depth to ground water____:.""______________. Test Pit No. 2............_...minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------•-•--•-- .... 0 Description of Soil------_-----•- �f' ---- h --5_ _SJ-�-L' Z------�------ ...._ �., ------------------- UNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ --------------------------------------••-•-•••-•-•••-•-•----------•-•--•--•--•----••-•••---------•-•--•------••-•------------...---•••----••--•---•-------------------------•••---•-••-.....••--••-•••- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code— The dersigned further agrees not to place the system in op ration until a' tiff�to Compliance has bee ed t e b of health. Signed J) r •' _ r � / Date application Approved By.....-----•-•-----•----•------------------••--•---•- --.....--•---•-----•----- ........................................ Date Application Disapproved for the following reasons--------------------------------------------------•-•---._.----•-------------------------------------...-----•--- e + ! / Date PermitNo...........................--- ----------------------- Issued--------- -1--.-7 ...I............... ate No.....t Fxs.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I f?:�_ v......... ....OF........... Appliration for Bisp.aial Workg Tnmitrnrtinn amit Application is hereby made for a Permit to Construct ( k� or Repair ( ) an Individual Sewage Disposal System at: t..�.` T�lcz4�jc_......---. f.._..�%All?........ ----r- .r t�Location-Address _ Lot ;vo. ram, ---•----. is -�� a_�`.:./.._.� � �...( ..--•- f�=N IU.t. -fires IM �i,5 .._..... er !! `- . -. __.. ......---- Installer Address U Type of Building y Size Lot_ _ _ -_-Sq. feet �., Dwelling—No. of Bedrooms........... ..........................._-_____Expansion Attic ( } Garbage Grinder ( ) PL4 Other—Type of Building ____________________________ No. of persons____________________________ Showers ( ) — Cafeteria ( ) p-I Other fixtures ....•--••---•••-•-•-----•-----•--- --- --- W Design Flow-___-_______ .......................gallons per person per day. Total daily flow..__._.__.�3_,?1,�-_.__.____________.gallons. WSeptic Tank—Liquid capacity_16Uvgallons Length:l<P__._ Width................ Diameter................ Depth................. x Disposal Trench—No_____________________ Width.................... Total Length______.____...___.__ Total leaching area....................sq. ft. Seepage Pit No.........._.l-------- Diameter--------®.._.._ Depth below inlet....../......... Total leaching areaZ�!�_ sq. ft. Z Other Distribution box (N/) Dosing tank ( ) '-' Percolation Test Results Performed __________________ Date.....1_!?_J._! Test Pit No. 1 ___�z.minutes per inch Depth of Test Pit.....1._2r__._........ Depth to ground water....."_______________ fT Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •--------•---••---....--••-•------•--•------•---•----------------------------_-......----•-•-•---......................................................... 0 Description of Soil .'':-•. !'.1-----•-J��----- l�''�--Z� !•----- '��.......... ",4 / W UNature of Repairs or Alterations—Answer when applicable----------------_.............................................................................. --------------------------------------------------•---------------------••---••--••-•--•----•_._...----••••------•-----•--•----••--•------•----••••-----------•--------•-•--••-----•-••-----••-•••-••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1E 5 of the State Sanitary Code— The uridersigned further agrees not to place the system in operation until a Certificate of Compliance has been-is ed 1b,'F tl b of health. f l Signed. _- v_'-o__..` ) r----�'`._............................... r z�� -� r Date ApplicationApproved By••-••---•-•-•---••-•----•••---••••---_..................-......................................... ........................................ -Date Application Disapproved for the following reasons--------------------•-----------------------------------•-----------------------•---------------------.........._ ----------------------------••---•------...----------------------•-------------------...-----•••----••••-••••••••----••••-•-••------------------...................................................... Date Permit No........------................. ---------------- Issued............------- -?- ---4=---------- ate THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / .. _ .. ............OF..... ° :: 1.-.TT:: `4........................ TwWrtifiratr of Tomplianrr THIS IS C IF , That the Individual Sewage Dis osal System constructed ( or Repaired ( ) by.............. t '.` 't an.__ , z7 �_t"� -.- ............ i r J �� nstaller � s� � � f �� 1F� -- ------ at..__.. ___ - �___� /�rx e'___ ,_ ?. -}.__ _ __i_ G '� __. it!_=_ -'+r S ��____. �. ................... ____ has been installed n accordance with the provisions of T171 >of 1 he State Sanitary Code as desc bed m the application for Disposal Works Construction Permit No._______ ��__ ,�'____ dated _-11L-_'_ `�_ ----------- THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED A,i A GUAR TEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......... -•�--- :5------------------------- Inspector-------f-= '--- - ------ ---- - ---•- E V THE COMMONWEALTH OF MASSACHUSETTS BOARD/,,OF HEALTH "'. •�. .` ..._.. ._:....__.............................. No....... j ./� FEE........................ Miposat Works TWInatrurtion' amit Permission is reby granted °f .. �� ' ? ' !�-----•------------------------------------------ to Construcl I or Repair ( ") an Individual Sewage D posal System ' ; ,C treet ------------------------------------------------------------------------------ • as shown on the application for Disposal Works Construction Permit No _______________•___ Dated----------................................ Board of Health DATE......:............................................................. 5 FORM 1255%HOBBS &,WARREN, INC., PUBLISHERS T t;= SITE PL A N SHEET I OF 2 fSCALE: ►- r=A H..BrAal J. 4 I ) `� vih , fox loop Griq,L, p o 3 N4_ �� PlZc p, 3 �12 RJL. 4 4R i_.aY 7 Zs - j I I 1 I ' i i \ Of R4 a WILLIAM M. '�� Pis �7 O ' W ► 0 E 1Pf",ICA .., NO, IIl FOR I � L� REGISTERED L AND SURVEYOR ZONE iZG G�ciu-r�Ru �L_l_v— I M/�•4�ph . PLAN REF. DATE BENCH MART( DATUM � ��'-"'"tip � WM. M. WARWICK 8 ASSOC., INC. DOMESTIC WATER SOURCE. 8OX 80/ - NOR TH FA L MOUTH FLOOD ZONE i*-J - +-� A►�- L� tlGl MASS. 02556 - (6I7) 563 -2638- It LEACkING ®ASIN SECTION NOT TO SCALE Sheet 9 o f z EARTH FILL BRICK AND MORTAR COURSES AS REOD• rO BRING COVER TO GRADE B INLET � FLOW I 2=S8 r0!IF"WASHED PEASrONF FREE OF IRONS, 1 PIPE FINES AND DUST IN PLACE T. 6 `- '• �14" TO /%2 N WASHED CRUSHED STONE FREE OF OPEN/NC WITH 4%g" IRONS, FINES AND DUSr /N PLACE 7 OUTER D/Ah1E7ER AND l314„INSIDE , D/AMfTER I ••'' • CONCRETE E E TOBE4 PS I SI 28 S 2. REINFORCED WITH 6%6" NO. 6 GA. W.W.M. 4 3. 2'.AND 4` SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS 4101, �-- -s'0" --j—2' --I 4. NUMBER OF PITS REQUIRED ®rJ 1= MIN. I` EFFECTIVE DIAMETER NOTE: EXCAVATE TO ELEVATION 37O OR (Ivor ro Excm i T1MEs EFFEcrIvE oEprH) LOWER AS REQUIRED TO REMOVE ALL - = w.4rER (ABLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. L•1"cL h2 5 /g STD. L r WGT. c./.MY COVER �l•9 �•. 0.9 500 '��1 4`C./.PIPE 4"B/T.FIBER P/P£ TIGHT JOINT OUrLEr LEVEL DWELLING t (FLOW LINE _ TO FIRST ✓olNT - -�4;. ,-• 'f�•� ,v i 14 �}7 rl O O 11 00 11 5 Z 110 00 to C./. rEE 7 3 1e000�00 it i i t7,72 sm PRECAST CONC. 47 /ST. BOX TO BE ' 1 0 0O 00 It GAL,SEPTIC TAN �--- �700 i 1 000 00 01 i I INSTALLED ON,LEVEL, I goo 00 0,1 STABLE BASE 'SEPr'C TANK ro BE t r 1 0 0.0 00 0 1 INSTALL D N LEVEL ! 1 100100 1 1 ; STABLE BASE. i t 1 0 0 0 0 0 0 0 1 1 i11000 00 0 1 � , LEACH/NO BASIN 1 e O I 0 0 0 1 BASE TO B£L EVEL 1 8 0 0 0 1 SOIL AND PERC. DATA TEST-PIT NO. P- 0,7 TEST PIT NO. 2 PERC. RATE MIN. /IN. O„ . To��SuP�ivlL TEST BY : }3�uGg I-Ep L Gva25 cam WITNESSED BY: _eOrJ 6-LF G L��4►J r-I�� TEST PIT GR. EL. v DATE: Iz' �' DESIGN DATA GENERAL NOTES BEDROOMS 3 NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL Jo�jC- SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL GAILY EFFL. GPD, PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK love GAL ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE 2 5 TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, SIDEWALL AREA GAL./SQ.FT, MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY 11 1977. LEACHING..REQUIRE_D ' I SQ.FT. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING -AREA OF HEALTH. z Q.FT. "-:; AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES 'A" / FT. UNLESS INDICATED OTHERWISE. °F Af �s SEWAGE DISPOSA L SYS TEM MARTIN E. MORAN Lo� P1211JGG w11 ►�c k.� �PF yz3aailp � fi �Y CZy is.,� -00-f V 1 LI.E M,&,5`7. ` w SCALE AS INDICATED DATE--- e A- (o Z Z • WM. M. WARWICIK 8 ASSOC., INC. BOX 801 -NORTH FAL M041 rH ` MASS. 02556 - (6I7) 563 -2638 PROFESSIONAL ENGINEER CONSTRUCTION NOTES CENTERVILLE, MA RAISE MIN. 20" DIAMETER COVER RAISE MIN, 20" DIAMETER COVER 1.) ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE, TITLE 5 (310 CMR 15.000): EL=50.5± To WITHIN 6" OF FINISH GRADE TO WITHIN 6" OF FINISH GRADE \o STANDARD REQUIREMENTS FOR THE SITING, CONSTRUCTION, INSPECTION, UPGRADE, AND EXPANSION OF ON-SITE SEWAGE TREATMENT AND DISPOSAL SYSTEMS AND FOR THE TRANSPORT 49.7± 49.5± EL=48.0± o �i AND DISPOSAL OF SEPTAGE, AND THE LOCAL BOARD OF HEALTH REGULATIONS. �`\X \�/ �/ \ \�/ \/ / /\\/��/ Locus 1 _y of -c aS 2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE IS POTENTIAL FOR \��\� \��\� \��\\� /'i;��\� H,nckle ° a� c� °9 VEHICLES OR HEAVY EQUIPMENT TO PASS OVER IT SHALL BE DESIGNED To WITHSTAND AN H-20 K '` Y� c c� LOADING. IF UNDER AN IMPERVIOUS SURFACE, SYSTEM SHALL BE VENTED TO THE ATMOSPHERE. ° 2 x c 'A � N c O > Y O Cn 3.) TO MINIMIZE UNEVEN SETTLING, SEPTIC TANKS AND D-BOX SHALL BE INSTALLED ON A STABLE 47.9± '�`' N ;n v Qo MECHANICALLY-COMPACTED BASE ON SIX INCHES OF CRUSHED STONE. "' GEOTEXTILE o ml 4.) COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK, THE DISTRIBUTION BOX, AND 47,5± 0 45.6 FABRIC THE SOIL ABSORPTION SYSTEM SHALL BE RAISED TO WITHIN 6" OF FINAL GRADE. LEACHING Existing ��pS Way FIELDS, TRENCHES, AND OTHER SOIL ABSORPTION SYSTEMS WITHOUT ACCESS MANHOLES SHALL 4 d HAVE AT LEAST ONE (1) INSPECTION PORT CONSISTING OF PERFORATED 4" PVC PIPE PLACED 46.5± U C oC \ VERTICALLY TO THE BOTTOM OF THE SOIL ABSORPTION SYSTEM WITH A CAP,' TIED WITH MAGNETIC 46 7± `v Existin 45.67 45.5 f 36 ptb� MARKING TAPE, ACCESSIBLE TO WITHIN 3" OF FINAL GRADE. g 45.1 3/4" to to t Z Existing N iv 1-1/2 STONE ~f 't 5.) PIPING SHALL CONSIST OF 4" SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL BE LAID ON A s GAS BAFFLE DB-3 H-20 (Double wash) MINIMUM CONTINUOUS GRADE OF NOT LESS THAN 2% FROM THE BUILDING TO THE SEPTIC TANK, AND NOT LESS THAN 1% OTHERWISE. D-BOX TWO (2) 500 GALLON H10 PRECAST 6.) DISTRIBUTION LINES FOR THE SOIL ABSORPTION SYSTEM SHALL BE 4" DIAMETER SCHEDULE 40 43.1 CONCRETE LEACH CHAMBERS WITH 4' OF d PVC (OR EQUIVALENT) LAID AT 0.005 FT/FT. UNLESS OTHERWISE NOTED. LINES SHALL BE CAPPED EXISTING STONE ON ENDS AND 4" ON SIDES AT END OR AS NOTED. 1,000 GALLON T 22'+ - -12^±--� 51' 7.) LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO (2) FEET BEFORE SEPTIC TANK LEACH CHAMBERS SITE LOCUS PITCHING TO THE SOIL ABSORPTION SYSTEM. DISTRIBUTION BOX SHALL BE WATER TESTED TO (To Remain) (END VIEW) NOT TO SCALE ASSURE EVEN DISTRIBUTION. 8.) GROUT To BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE STRUCTURES FLOW PROFILE EL=3$.0 Bottom ,Test Hole IN ORDER TO PROVIDE A WATERTIGHT SEAL. 9.) HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF THE SEWAGE NOT TO SCALE DISPOSAL FIELD DURING THE COURSE OF CONSTRUCTION OF THE SYSTEM. 10.) IN ACCORDANCE WITH 310 CMR 15.221. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING TAPE. 1.) Assessor's Map 170 Parcel 214 11.) THERE ARE NO KNOWN WELLS WITHIN 150' OF THE PROPOSED SOIL ABSORPTION SYSTEM. 2.) Book 31361 Page 75 12.) FROM THE DATE OF THE INSTALLATION OF THE SOIL ABSORPTION SYSTEM UNTIL RECEIPT OF 3.) PL. Bk. 386 Page 93 THE CERTIFICATE OF COMPLIANCE, THE PERIMETER SHALL BE STAKED AND FLAGGED TO PREVENT 4.) This property is in a Wellhead USE OF THE AREA THAT MAY CAUSE DAMAGE TO THE SYSTEM. Protection District 13.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLESS / 5.) This property is not in the Flood Zone CONSTRUCTED AS SHOWN ON PLAN, ANY CHANGES SHALL BE APPROVED IN WRITING BY THE h �� 14.) THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENT OF THE / J BOARD OF HEALTH AND THE DESIGNER. THE DESIGNER SHALL CERTIFY IN WRITING THAT THE SEWAGE DISPOSAL SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS OF THE PERMIT Map 170 /Parcel 213 AND THE APPROVED PLANS. 48 HOURS ADVANCE NOTICE 1S REQUESTED. `,p` 15.) LOCATION OF UTILITIES IS APPROXIMATE AND CONTRACTOR SHALL BE RESPONSIBLE FOR DETERMINING THE LOCATION OF ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF ANY WORK. THIS INCLUDES, BUT IS NOT LIMITED TO, REQUESTS TO DIGSAFE, �� / /�oye /! w >s°o. I SYSTEM DESIGN CALCULATIONS ANY PRIVATE UTILITY COMPANIES, AND THE LOCAL WATER DEPARTMENT, �,16. / 1 48\\ SEWAGE DESIGN FLOW- THREE BEDROOM DWELLING ® 110 GPD/BEDROOM = 330 GPD 16.) CONTRACTOR SHALL VERIFY THAT ALL WASTELINES ARE CONNECTED BY WATER TESTING WITHIN THE DWELLING PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS. / w \ /p (MINIMUM DESIGN REQUIRED 330 GPD) 17.) CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF ANY / l �\ Q SEWAGE DESIGN FLOW PROVIDED: TWO (2) 500 GALLON CHAMBERS SEPTIC SYSTEM COMPONENTS. 9 .- Lot 8 _ --- Gard e Q WITH 4' STONE ON THE ENDS AND 4 STONE ON THE SIDES 18.) TEST HOLES COMPLETED PER STATE ENVIRONMENTAL CODE, TITLE 5. SOILS CAN BE 22,332± Sq. Ft. �- \ Vt 25.0 x 12.83 + 2 2 VARIABLE AND TEST HOLE DATA IS NO GUARANTEE OF SOIL CONDITIONS IN OTHER AREAS. IF ,�\ = �( ) ( 5.0 + 12.83) (2) x .74 = 349 GPD PROVIDED SOILS DIFFER FROM THOSE SHOWN IN THE SOILS LOGS, DESIGN ENGINEER IS TO INSPECT THE a / CAS.ram X 349 'GPD PROVIDED > 330 GPD REQUIRED SOILS PRIOR TO PROCEEDING WITH INSTALLATION OF ANY SEPTIC COMPONENTS. y°�� Qok #503 19.) EXISTING+SEPTIC-COMPONENTS TO BE LOCATED, PUMPED DRY, FILLED WITH CLEAN SAND AND may, �e < 3 Bedroom SEPTIC TANK CAPACITY REQUIRED: 330 GPD X 200 = 660, (MINIMUM} ABANDONED IN PLACE OR REMOVED AS REQUIRED. AREA TO BE COMPACTED TO MINIMIZE SETTLING. TOF EL = 50.5 / SEPTIC TANK CAPACITY PROVIDED: 1,000 GALLON SEPTIC TANK (EXISTING) \ Deck 48 a \ GO \ Holly l see 9 Note ST # / O Tree 0 48 TEST HOLE LOGS Wooded Area ` a Floor Plan Rhododen`n (01 ti` �` / Garage Test Hole 1 (EL=48.0±) o ✓ yo To Corner Block aotlo N.T.S. o O DB TB�L = 49.6 Family Depth Elev. Layer Soil Class Soil Color H ` Pees oTP �' / 84� _ TP Mop 170 0"-9" 47.2 A Loamy Sand 10YR 3/1 °6"w `'s • a Parcel 215 Living �' �" `~ ° '',•�.,o o`O Kitchen Bath 9"-28' 45.7 B Loamy Sand 1OYR 5/6 SAS, 28"-120" 38.0 C Medium Sand 2.5Y 6/3 fining <P Beroo d1 Mop 170 �' Parcel 057007 r _46 Bath Bedr o 6.4S Bedroo 46 j #3 Test Hole 2 (EL=48.0±) Depth Elev. Layer Soil Class Soil Color Mop 170 0"-9" 47.2 A Loamy Sand 1OYR 3/1 Parcel 057008 4 Note: 9"-28" 45.7 Y Sand 10YR B Loam 5 6 �ea1th vt was 'This pion is only valid for current regulations and may / 28"-120" 38.0 C Medium Sand 2.5Y 6/3 ofi spa not be suitable for future regulation changes that may occur. Scott A. N o McGann c'r I CERTIFY THAT I AM CURRENTLY APPROVED BY THE DEPARTMENT OF U #1224 y ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMR 15.017 TO CONDUCT ,� Proposed Sewage Disposal System DATE OF TESTING: 12/10/19 SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED 4* BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE SOIL EVALUATOR: SCOTT MCGANN DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY THAT THE RESULTS OF MY WITNESS: DAVID STANTON, BARNSTABLE BOH SOIL EVALUATION AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM, `�are r, ri, 503 Prince Hinckley Road Centerville, MA SOIL EVALUATION, AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM, PERCOLATION RATE: LESS THAN 2 MIN/INCH ARE ACCURATE AND IN CORDANCE WITH 310 CMR 15.100 THROUGH 15.107 Prepared b P Y: PERC IN C LAYER (55" Deep) Prepared for: All Ca p NO GROUNDWATER ENCOUNTERED GRAPHIC SCALE Cape Septic LLC SCOTT CGANN, CE D SOIL EVALUATOR John Gramolini 618 Route 28 30 0 15 30 60 120 503 Prince Hinkley Road West Yarmouth, MA 02673 Centerville, MA (508) 771-4200 allcopeseptic@gm oil,com ( IN FEET } 1 inch = 30 ft. Date: 12/16/1 Sheet 1 ofTJBy- MA Check: SM Project No. AC-210