HomeMy WebLinkAbout0041 ROLLING HITCH ROAD - Health 41 Rolling Hitch Road
Centerville F
A = 192 067
=14aECVCIFpco2.
UPC 10259
No. H163OR
HASTINGS.MN
TOWN OF BARNSTABLE .�
LOCATION !Z/ di D L L /N (� %7'C/1 R p SEWAGE # 3 01-
VILLAGE C C Alf C R V L L P ASSESSOR'S MAP & LOT 192-0i 7
INSTALLER'S NAME&PHONE NO. 44 A C 0,14 tie K -i,5 0! �✓
SEPTIC TANK CAPACITY Z(1 6t� 0-1-P
LEACHING FACILITY: (type) . (size) / �S
i
NO. OF BEDROOMS
BUILDER OR OWNER o J/In j
PERMITDATE: COMPLIANCE DATE: (�
.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
F
1 •.4
y
cp' ` A
s
LOCATION SEWAGE PERMIT NO.
VILLAGE p _
INSTALLER'S NAME i ADDRESS'
B U I L D E R OR OWNER
S ,,zY, 91dv¢ lC
DA T E PERMIT ISSUED
DATE COMPLIANCE ISSUED
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No. Fee• 5� 0.Vt,,l
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pprtcation for Migaaf *pgtem Comaruction pertnit
Application for a Permit to Construct( )RepairXX)Upgrade( )Abandon( ) El Complete System El Individual Components
Location Address or Lot No41 Rolling Hitch Road Owner's Name,Address and Tel.No.
�entery lg,Mass. John J. Collins
ssessor s ap azce .r
Installer's Name,Address,and Tel.No.5 0 8—7 7 5—13 3 8 IDesigner's Name,Address and Tel.No.5 0 H—2 7 3—0 3 7 7
J.P.Macomber & Son Inc. JC Engineering 5 Round Hill BLD
Box 66 Centerville,Mass. 02632 Fast Wareham,Mass, 02632
Type of Building:
DwellingXX No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow ti gallons per day. Calculated daily flow 3) "' 3 0 j �� gallons.
Plan Date Number of sheets Revision6ate
Title
Size of Septic Tank f Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)Add i nq t 500 a l l o n leaching
chambers packed in 4 ' of 115" stone. 'X13,'X2 '
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 E vironmental Code d not to place the system in operation until a Certifi-
cate of Compliance has been iss by thi B d
Signe Date 1 0
Application Approved Date
Application Disapprove or the following reaso
Permit No. Date Issued
NO. .r i _ � Fee$5 0.0 0 i
'^ Entered in computer:
THE COMMONWEALTH OF MASSACHUSETTS
"4 i r Y I
UBtICtHEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01pprication for Migooal *pgtem Construction Permit
Application for a Permit to Construct( )Repair'(X)Upgrade( )Abandon( ) El Complete System ❑Individual Components
Location Address or Lot No.41 Rolling,, Hitch Road Owner's Name,Address and Tel.No.
Centy Ile,mass. /� John J. Collins
ssessor s ap arcel.
Installer's Name,Address,and Tel.No.5 0 8—7 7 5-3 3 3 8 Designer'same,Address and Tel.No.5 0 8—2 7 3—0 3 7 7
J.P.Macomber & Son Inc. JC Engineering 5 Round Hill BLD
Box 66 Centerville,Mass.02632 East- Warehani Mass.02632
Type of Building:
f.,9•
DwellingXX No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 3 5 0.9 gallons per day. Calculated daily flow 3 X 1 10=3 3 0 gallons.
IPlan Date t Number of sheets Revision Date j
Title i
Size of Septic Tank Type of S.A.S.
Description of Soil '
Nature of Repairs or Alterations(Answer when applicable)Adding two 500 gallon leaching
chambers packed in 4 ' of 1�" stone. 25'X13'X2' j
Date last inspected:
FF" Agreement:
-ff0
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 E vronmental Code And not to place the system in operation until a Certifi-
cate of Compliance has been iss -d by this B e YwIl" Ah
Signe /• Date 1 /8 .0 2
Application Approved 1 J / a Date
Application Disapproved'or the following reaso s'
V.
Permit No. rY Date Issued
———— \-- -- ———-- ------ --------
THE COMMONWEALTH OF MASSACHUSETTS 1
ill
LE, MASSACHUSETTS BARNSTAB
i
M .Certificate of Compliance
THIS IS TO CERTIFY;that the On-site Sewage Disposal System Constructed( )Repaired}(XX)Upgraded( )
Abandoned( )by J.R.Macomber & Son Inc.
at 41 Rollina Hitch Road Centerville.Mass. has bee constructed in accordance
with the provisions of Title 5.and the for Disposal System Construction Permit No. 1 sated
Installer ,T P.ManomhP_r & Ron Tnc__ Designer JC -nc;ineering �,
The issuance of this permit shall not be construed as a guarantee that the system will function a' dIesigned. r
Date A 1 n Inspector (4 )_ �In1 ►.i n�" } -
i
—�— ----------------------------
No.® Fee'$5 0.0 0
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
lwizpool *p!5tem Construction Permit
Permission is hereby granted to Construct( )Repair(�X�rUpgrade( )Abandon
System located at 41 Rolloing, Hitch Road Centerville,Mass.
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided: Constructio4 mu f be co leted within three years of the date of tt permi .�
Date: I Approved b i l ?
TOWN OF BARNSTABLE '
LOCATION / , ' d SEWAGE #
VILLAGE C C�✓'y"e�' 1/f L 1 P ASSESSOR'S MAP & LOT �92-D. 7
INSTALLER'S NAME&PHONE NO. / 44 A C O 14 e X
SEPTIC TANK CAF ACITY c l_
LEACHING FACILITY: (type)�— PM ul eL/5 (size) / �� Xsf
NO. OF BEDROOMS
BUILDER OR OWNER a I'In j
PERMITDATE: COMPLIANCE DATE: (�
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
F
.a
COMMONWEALTH OF NLkSSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTIO�e�
C
SV�y` �004
-- SEP r
350 MAIN STREET (N� WEST YARMOUTH,MA N�
508-775-2800
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner's Name: 41 ROLLING
G HI cA'LED INSPECTION
Owner's Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Date of Inspection AUGUST 28,2002
Name of Inspector:(please print) JAMES D. SEARS MAP V Z
Company Name: A&B Canco
Mailing Address: 350 Main Street PARCEL
West Yannouth,MA 02673
Telephone Number: 508-775-2800 LoT -
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information
reported below is true,accurate and complete as of the time of the inspection. The inspection was
performed based on my training and experience in the proper function and maintenance of on site sewage
disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310
CMR 15.000). The system:
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
X ails
Inspector's Signature: Date:
The system inspector shal submit a copy of this inspection report to the Approving Authority(Board of
Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a
design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the
appropriate regional office of the DEP. The original should be sent to the system owner and copies sent tot
he buyer,if applicable,and the approving authority.
Notes and Comments
""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.
Title 5 Inspection Form 6/15/2000 1
Page 2 of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes: N/A
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:
B. System Conditionally Passes: N/A
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.
Answer yes,no or not determined(Y,N,ND)in the 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 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.
ND explain:
_ 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
Obstruction is removed
Distribution box is leveled or replaced
ND explain:
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
Obstruction is removed
ND explain:
Title 5 Inspection Form 6/15/2000 2
Page 3 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(CONTINUED)
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS JOHN
Date of Inspection: AUGUST 28,2002
C. Further Evaluation is Required by the Board of Health: N/A
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.
1. System will pass unless Board of Health determines in accordance with 310 CNIR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health safety and the environment:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or salt marsh
2. 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 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 coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility
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.
3. Other:
Title 5 Inspection Form 6/15/2000 3
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(CONTINUED)
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
D. System Failure Criteria applicable to all systems: X
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded
or clogged SAS or cesspool
X Static liquid level in the distribution box.above outlet invert due to an overloaded or clogged SAS or
cesspool
X Liquid depth in pit is less than 6"below invert or available volume is less than'h day flow
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
X Any portion of the SAS,cesspool or privy is below high ground water elevation
N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a
surface water supply
N/A Any portion of a cesspool or privy is within a Zone 1 of a public well
N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well
N/A 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 coliform bacteria and volatile organic
compounds indicates that the well is free from pollution from that facility and the presence of
ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm,provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.)
YES (Yes/No)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.
E. Large Systems: N/A
To be considered a large system the system must service a facility with a design flow of 10,000 gpd to
15,000 gpd.
You must indicate either"yes"or"no to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
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 11 of a public water supply well.
If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes"in Section D above the large system is failed. The owner or operator of any large system considered a significant
threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The
system owner should contact the appropriate regional office of the Department.
Title 5 Inspection Form 6/15/2000 4
Page 5 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
Check if the following have been done. You must indicate"yes"or"no"as to each of the following
Yes No
X Pumping information was provided by the owner,occupant,or Board of Health
X Were any of the system components pumped out in the previous two weeks?
X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
X Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X Was the facility or dwelling inspected for signs of sewage back up?
X Was the site inspected for signs of break out?
X Were all system components,excluding the SAS,located on site?
X 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
X 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)has been determined based on:
Yes No
X Existing information. For example,a plan at the Board of Health.
X 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(3)(b)]
Title 5 Inspection Form 6/15/2000 5
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
FLOW CONDITIONS
RESIDENTIAL
Number of Bedrooms(design): 4 Number of bedrooms(actual): 4
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms: 440
Number of current residents: 2
Does residence have a garbage grinder(yes or no): NO
Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required]
Laundry system inspected(yes or no): YES
Seasonal use(yes or no): NO
Water meter readings,if available(last 2 years usage(gpd)): 2000 71,000/2001 150,000
Sump pump(yes or no) NO
Last date of occupancy: PRESENT
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203):
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: N/A
Was system pumped as part of the inspection(yes or no): . NO
If yes,volume pumped: gallons—How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
X 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)
Tight tank Attach copy of the DEP approval'
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
UNKNOWN
Were sewage odors detected when arriving at the site(yes or no): NO
Title 5 Inspection Form 6/15/2000 6
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
BUILDING SEWER(locate on site plan): N/A
Depth below grade:
Materials of construction: Cast iron _ 40 PVC _ other(explain)
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK(locate onsite plan): X
Depth below grade: 14"
Material of construction: X Concrete metal fiberglass polyethylene
other(explain)
If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of
certificate)
Dimensions: 1,000 GALLON
Sludge depth: 2"
Distance from top of sludge to the bottom of outlet tee or baffle: 28"
Scum thickness: 0"
Distance from top of scum to top of outlet tee or baffle: 12"
Distance from bottom of scum to bottom of outlet tee or baffle: 18"
How were dimensions determined: ASBUILT AND TAPE
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as
related to outlet invert,evidence of leakage,etc.):
MAIN TANK AT WORKING LEVEL.TANK AND COVERS 14"BELOW GRADE.OUTLET BAFFLE.
GREASE TRAP(located on site plan) N/A
Depth below grade:
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:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as
related to outlet invert,evidence of leakage,etc.):
Title 5 Inspection Form 6/15/2000 7
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
TIGHT or HOLDING TANK: N/A (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/day
Alarm present(yes or no)
Alarm level: Alarm in working order(yes or no):
Date of last pumping
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: X (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.,):
DISTRIBUTION BOX IS 16"X16",T BELOW GRADE.ONE LINE IN,ONE LINE OUT.BOX IS SOLID.
PUMP CHAMBER: N/A (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Title 5 Inspection Form 6/15/2000 8
Page 9 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required)
If SAS not located explain why:
Type
X leaching pits,number: 1
leaching chambers,number:
leaching galleries,number
leaching trenches,number,length
leaching fields,number,dimensions:
overflow cesspool,number:
innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of
vegetation,etc.)
LEACHING IS ONE 1,500 GALLON PRE CAST PIT.PIT IS 44"BELOW GRADE WITH COVER AT 16".PIT
IS FULL TO INLET LINE.LEACHING IS FAILED.
CESSPOOLS: N/A (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 or no):
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation etc.):
PRIVY: N/A (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.)
Title 5 Inspection Form 6/15/2000 9
Page 9 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch 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.
I'
agL
vi
Title 5 Inspection Fonn 6/15/2000 10
Page 1 1 of 1 l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 41 ROLLING HITCH ROAD
CENTERVILLE,MA 02632
Owner: COLLINS,JOHN
Date of Inspection: AUGUST 28,2002
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to groundwater 47.9 feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
Observation site(abutting property/observation hole within l50 feet of SAS)
Checked with local Board of Health-explain:
Checked with local excavators,installers-(attach documentation
X Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
USGS WELL DATA
USGS WELL SDW 252 AT 47.9
ZONE B
ADJUSTED AT 44.9
S
/}
3V
IT
Title 5 Inspection Form 6/15/2000 11
JOSEPH P. MACOMBER & SON, INC.
P.O.BOX 66
CENTERVILLE.MA 02632-0066
775-3338 775-6412
August 9, 2002
John Collins
41 Rolling Hitch Road
Centerville Ma, 02632
Dear Sir:
In regards to your letter received on 8/9/02. 1 agree that we were
out at your property and pumped for you every 2 years for maintanance
purposes. Everything at that time was working properly. Septic is still working
properly at this time but the water in the leaching pit was less than 3"from the pipe.
With new Title`5 regulations we by law have to fail a septic system that has water
in,leaching.pit-that is lessjhan`6"from pipe.
I believe that that septic system has done very well to last 16 years.
• With regular maintanance pumping most people are lucky to get 10 or more
years from a leaching pit.
We are an honest company, we do not take advantage of people .
We have been in the septic business since 1928 this is a family run business.
If you are still aprehensive about this please feel free to call office. We will
gladly explain all state requirements and laws to you to explain why your septic
failed.
CC copy sent to Board.Of Health
Sinter IY �"x4'u
eph P Macomber. &Son Inc.-L .
<,
Joseph P. Macomber Jr. (owner) {
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001
s
V
r
August 7, 2002
John J. Collins
41 Rolling Hitch Road
Centerville, MA 02632
Joseph P. Macomber&Son, Inc.
P. O. Box 66
Centerville, MA 02632
Dear Sir,
Enclosed is a check for services rendered for a Title V septic system inspection.
My wife and I, along with several professional persons with whom we conferred
about your results, are extremely skeptical of your findings.
Less than seven years ago when we bought this house, your company did the
Title V on this property and it passed with no problem. Since then, we have had
the septic system cleaned every two years by your company as recommended.
by you. (See enclosure with copy of canceled checks). Never once did anyone .
ever mention that there might be a problem.
We were asked by you in a telephone conversation if we wanted an estimate on
"fixing" our system. You.have got to be kiddingl We have not one ounce of
confidence in you or anyone in your company. We trusted you and thought you
were doing your job. With only two of us living in this house, we have major
concerns with your report and question its validity. We will be getting a second
opinion and will not be having any further business dealings with your company.
Very truly yours,
John J. Collins
x Board of Health
'NSPECTION
DATE: 7/17/02
PROPERTY ADDRESS: 41-Rollinghitch Road
-- --------------------
_ 41_Rollinq Hitch Roa_d____
__entParyille,-Ma.-U-622---
On the above date, I inspected the septic system at the above
This system consists of the following: RECEI ED
1 . 1-1000 gallon septic tank . JUL 2 5 2002
2 . 1-1000 gallon precast leaching pit .
3 . 1-Distribution box . TOWN OFBAPNSTABLE
HEALTH DEPT.
Based on my inspection, I certify the following conditions:
4 . Thi^ is a title five septic system . ( 78 Code )
5 . The septic system is in hydraulic failure .
6 . The tank is structurally sound .
7 . A_ new leaching area needs to be installed . � 1
8 . Waste water is 3" below the invert pipe of the
leaching pit .
SIGNATUR t
Name:- J.-P. -Macomber-jr.
-- -- ------- -------
Corripany:Joseeh P .— Macomber &_ Son, Inc.
Address: Box 66
-- Cen_t_erv_ille_,_L4a-_Q2632-0066
Phone: 508-775-3338
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY
JOSEPH P. MACOMBER & SON, INC.
Tan ks-Cesspools-Leachflelds
Pumped & Installed
Town Sewer Connections
P.O. Box 66 Centerville, MA 02632-0066
775-3338 775-6412
Page 2 of I 1
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 41 Rnl 1 i n� Hi tr`1� Road
centeriiLP., ma 0 632
Owner: dew—C®lllag
Date of Inspection: 7Tl r 0.2
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes: .( NO )
Yes lhaY4 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:
The leaching it is in hydraulic failure . A new leaching
area needs to be installe Waste water
pipe . _.
B. System Conditionally Passes:
NO 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.
Answer yes, no or not determined (Y,N,ND) in the for the following statements. If"not determined" please
explain.
NO. 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
I 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.
ND explain:
NO 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
obstruction is removed
distribution box is leveled or replaced
ND explain:
NO 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
obstruction is removed
ND explain:
2
Page 3 of I I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Propern Address: 41 Rolling Hitch Road
Cpntprvillp, Ma_ 02632
Owner: jnhn rr)l 1 in--,
Date of Inspection: 7111 102
C. Further Evaluation is Required by the Board of Health:
NO Conditions exist which require funher evaluation by the Board of Health in order to determine if the system
is failing to protect public health, safety or the environment.
I. S,Nstem will pass unless Board of Health determines in accordance with 310 CMR 15,303(l)(b) that the
system is not functioning in a manner wbich will protect public bealtb, safety and the environment:
D Cesspool or privy is within 50 feet of a surface water
,ND Cesspool or privy is witbin 50 feet of a bordering vegetated wetland or a salt marsh
2. 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:
g0 The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a
surface water supple or rributary to a surface water supply.
The system has a septic tank and SAS and the SAS is within a Zone I of a public water supple.
NO The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
NO The system has a septic tank and SAS and the SAS is less than )00 fei but 50 feet or more from a
private \+ater supple well Method used to determine distance Visua
"This system asses if the well water analysis, erformed at a DE certified
P y , p P c n fled laboratory, for coltform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facilir)• 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 artached to this form.
3. Other:
N0NR_
I
3
i
Page : of I I
OFFICIA-L INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 41 Rolling Hitch Road
CRntervillpi Ma, 02632
Owoer: J hn �czllins
Date of lospeetion: „ 7 1 7/02
D System Failure Criteria applicable to ell systems:
You must vsdicatc "ycs" or "no" to each of the following for all inspections:
Ycs No
Back-up of sewage into (aciliry or system component due to overloaded or clogged SAS or cesspool
Discharge or ponoLng of effluent to the surface of the ground or surface waters due to an overloadee or
/Clogged SAS or cesspool
_ _ Stauc liquid level Lnn he dismbuuon box above outlet inven due to an overloaded or clogged SAS or
cesspool f—J zJ
Liquid depth in�¢ee1 is less Ulan 6" below invcn or available volume is less than ''A day now
cluvcd pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number
of times pumpcda ..
Any ponion of the SAS, cesspool or privy is below high ground water elevation.
Any ponion of cesspool or privy is within 100 feet of a surface water supply or rributary to a surfacc
/water supply
v Any ponion of a cesspool or privy is within a Zone I of a public well.
/any ponion of a cesspool or privy is within 50 feet of a private water supply well.
j/ an) ponion of a cesspool or privy is less than 100 feet but greater than 50 feet.bom a private water
supple well with no acceptable water quality analysis. iTbis system passes If the well water analysis.
pert,rmco at a DEP centried laboratory, for coliform bacteria and volatile organic compounds
indicalcs that the well is free from pollution from that facility 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 aoalysis must be attached to this forma
YES (l cs'No) The system fails. I have determined that one or more of the above failure criteria exist as
• dcScr?bcd in )10 CMR 15 )0), therefore the system fails. The system owner should contact trsc Boar-
Health to determine what will be necessary to conact the failure
E Large Systems:
To Of considered a large system the system must serve a facility wlth a design now of 10,000 gpd to 15,000
Va.
You must indicate either "ycs" or "no" to each of the following:
The following criteria apply to large systems in addition to the criteria above)
rs no
!/the system is within 400 feet of a surface drinking water supply
_ e system is within 200 feet of a tributary to a surface drinking water supply
G c system is located in a nitrogen sensitive area (Interim Wellhead Protection Area — IWPA) or a mappee
Lone If of a public water supply well
you rave answered "yes" to any question in Section E the system is considered a significant threat, or answered
cs" in Section D above the large system has failed. The owner or operator of any large system considered a
s en:fjcant Uveat under Section E of failed under Section D shall upgrade the system in accordance with 3 10 C.MR
;04 The system pwner should contact the appropriate regional oMce of the Department.
4
Page S of I I
OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 41 Rr)1 1 i ng Iji_tch s' Road
Qnt�xui-11-, Ma 02632
Owner: T��� ^^llins
Date of Inspection: -, i, 1 in
Check if the following have been done. You must indicate "yes"or"no"as to each of the following:
Yes No
_ Pumping information was provided by the owner, occupant, or Board of Health
— 7kere 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 pan 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 ?
z _ Was the faciliry 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:
Yes no
Existing information. For example, a plan at the Board of Health.
_t1_ Determined in the field (if any of the failure criteria related to Pan C is at issue approximation of distance
is unacceptable) (310 CMR 15.302(3)(b)j
S
Page 6 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 41 Rnl i na Hitch Road
C'pntPYVi l l P., Ma. 02632
Owner; .Jahn r'nl1 ins
Date of Inspection; 7/1 7T02
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): Number of bedrooms(actual):
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # or 6—rooms):
Number of current residents: 4
Does residence have a garbage grinder (yes or no): 41d
Is laundry on a separate sewage system (yes or no):�O (if yes separate inspection required)
Laundry system inspected (yes or no): /(/0
Seasonal use: (yes or no):A
Water meter readings, if available (last 2 years usage (gpd)): 2000-87 , 000 gal lons=238 . 36 GPD
Sump pump(yes or no)Ak'14*
, gallons=410 . 96 GPD
Last date of occupancy:
COMM ERCLAL .NDUSTRIAL
Type of establishment:
Design now (based on 310 CMR 15.203): gpd
Basis of design flow(se ats/persons/sgft,etc.):
Grease trap present (yes or no): d&
Industrial waste holding tank present (yes or no):
Non-sanitary waste discharged to the Title 5 system (yes or no):
Water meter readings, if available:
Last date of occupancy/use:
OTHER (describe):
GENERAL INFORMATION
Pumping Records
Source of informationNone available
Was system pumped as pan of the inspection (yes or no):
_
If yes, volume pumped; gallons&/ &
s quaatiry mpeddet rminedReason for pumping: w
TYQE 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 Erom system owner)
!!gOTight tank ." Attach a copy of the DEP approval
Other(describe):
Approxi nate age of all com onents, date installed (if known) and source of information:
Were sewage odors detected when arriving at the site (yes or no):otk)
6 J'
I
Page 7 of 1 I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 41 Rol 1 i ng Hi tche Road
rentervi_ 1 1 P f—Ma. 02632
Owner: Tnhn Collins
Date of Inspection: 7/1 7/n?
BUILDING SEWER(locate on site plan)
J/
Depth below grade: //
Materials of construction: ast iron 1/40 PVC&othef(explain):
Distance from private water supply well or suction line:Comments (on condition ofjoints, venting, evidence of leakage, etc.):
Joints appear tight . No evidence of leakage The system is vented through
he house vents .
SEPTIC TANK: (locate on site plan) /6vOq044,
�/
Depth below grade:
Material of construction: concrete,(metai4Afiberglass/f&polyethylene
Z)other(explain)
If tank is metal list age: Is age confirmed by a Certificate of Compliance (yes or no)/l� (attach a copy of
certificate)
Dimensions:
Sludge depth: n
Distance from top of sludge to bonom of outlet tee or baffle:
Scum thickness: _ 0
Distance from top of scum to top of outlet tee or baffle: G'
Distance from bottom of scum to bottom of outlet tee or baffle:
How were dimensions determined:Pumped at time of inspection .
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
Pumn the sentir tank every 2=3 years Inlet & outlet tees
Ar_e in nlara Tha tank is structurally Snund and shows no ✓
evidence of leakage .
GREASE TRAPlocate on site plan)
Depth below grade:,
Material of construction:"f)Aconcrete metal *iberglassj&polye thy]enr,,&other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of sc uto bottom of outlet tee or baffle: —�
Date of last pumping:
.Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
Grease trap is not present .
7
Page 8 of I I
OFFICIAL, INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 41 Rolling Hitch Road
rinni-p x7i 'l l A _Ma. 02632
Owner: Tnhn
Date of Inspection: 7 f 1 7 f 02
TIGHT or HOLDING TANKt (tank must be pumped at time of inspect ion)(locate on site plan)
Depth below grade: A
Material of construction concrete J11h metalA,�&_fiberglass,&j Polyethylene�(//� other(explain):
Dimensions
Capacity: 4ja gallons
Desien Flo" gallons/day
Alarm present (yes or no):
Alarm level: i)a
v„ Alarm in working order(yes or no):
Date of last pumping:
Comments (condition of alarm and float switches, etc.):
light or o ing an s are nor present .
DISTRJBUTION BOX: if present must be o ened)(locate on site plan)
P P )
Depth of liquid level above outlet invert: Ith
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.):
Distribution box has one lateral . There is evidence of solids
carry over . No evidence of leakage into or out of t e ox .
PUMP CHAMBERI,ha�locate on site plan)
Pumps in working order (yes or no): / 7 v
Alarms in working order (yes or no):7D�
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Pump chamber is not present .-
8 �.
I
Paae 9 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 41 Rol 1 i na Hitch Road
C'Anteryilla., Ma. 02632
Owner: .Inhn rol ling
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, excavation not required)
1-1000 gallon precast leaching pit . ( 6 ' X9 ' )
If SAS not located explain why:
Located ; See page 10
kleaching pits, number:
X leaching chambers, number: Q
dU leaching galleries, number:
leaching rrenches, number, length:
leaching fields, number, dimensions:
overflow cesspool, number: d _
innovative/alternative system Type/name of technology:�ir�� y�
Comments (note condition of soil, signs of hydraulic failure, le
etc.): vel of ponding, damp soil, condition of vegetation,
Loamy sand to medium fine sand .The leaching pit is in
hydra 1 ai 111 as e wa er is .
Soils are damp , Vegetation is normal . A new e
to be installed .
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 laver:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or no): �i
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):
-CesspQolS are not present
PRIVY4Q��locate on site plan)
Materials of construction: _ 4W
Dimensions:
Depth of solids:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):
Privy is nnresent
9
Pig( )0 of I I
OFFICLA.1_ INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORI,j
PART C
SYSTEM INFORMATION (continvcd)
Properr� ndd/t11: 41 Rolling Hitch Road
rPnteri7i11 ,- , Ma. 02632
OxOtr:
oil( of n)pcclioo: 2
SKrTCH OF SEWACE DISPOSAL SYSTBM
Pio.ioc 11kmh o( Ihc )<witc dispolll lymm including tics to it Icw two permancnt rcrcrcncc 1Ljcrn6/x1
ocncrmvkl lo<I c III Nclh -Ithln 100 (cc1. Loccic whctc pvblic wilcr Iupply CAW$ the bvildin6.
�I rd �x
r- 1
F Io
,Page 11 of 11
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 41 Rolling Hitch Road
Centerville, Ma. 02632
Owner: John Collins
Date of Inspection: 7117, 02
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water IQ "feet
Please indicate (check) all methods used to determine the high ground water elevation:
Obtained from system�d' tansonrecord If checked, date of design plan reviewed:S Observed site(abuttie bservation hole within 150 feet of SAS)
Ald Checked with local Health-explain: 1414
Checked with local excavators, installers- (attach documentation)
Accessed USGS database-explain: h t t p : //t own . bar n s t a b l e . ma us .
You must describe how you established the higgh ground water elevation:
Used ; Gahrety & Miller Model . 12/16/94 Ground water elevations above
sea eve
Used ; USGS ; Observation well data . June 1992
Used; USGS:; Technical bulletin . 92-000-1 Plate #2 X—nnu-al ranges o
ground tIgprig1e vat ions .
Leaching
/ r
Pit op 'eet
Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method
Therefore, the vertical separation distance between the bottom �y j
of the leaching pit and the adjusted groundwater table is
feet.
ll
WAj 0
`,'r.nr. -nr►�•.-r- '+r.-mr•nn-rrrnr..rnr.mr.:•.n-r-rsnr:•rm-mrn nc-�ir*.a�rcr.mn .rmrr•,.--ir—r-..-•.r- .F
1 TOWN OF Barnstable WARD OF HEALTH
0 ^SUOSIJRFACR 9FHA(;E f)1SfUSAL SYSRT M INSI'FCTION FORM - PART D .- CERTIFICATION
-TYPE OR PRINT CLEARLY'-
PROPERTY INSPECTED
STREET ADDRESS 41 Rollinghitch Road Centerville ,Mass .
ASSESSORS MAP , BLOCK AND PARCEL #
OWNER' s NAME John Collins
PART D - CERTIFICATION r
NAME OF INSPECTOR Joseph P .Macomber Jr .
COMPANY NAME J. P.Macomber & Son Int!"
COMPANY ADDRESS Box 66 Centerville Mass . 02632
S t r 0 9 t Town or City 3ta.9 iIP
COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 J 790 _ 1578
rf
CERTIFICATION STATEMENT
D
I certify that I have personally inspected the sewage disposal, system at
his address and that the inrorination reported is true , accurate , and
omplete as of the time of .-inspection , The inspection was performed and any
ecommendations regarding upgrade , maintenance , and repair are' consistent
with my training and experience in the proper function and maintenance of on-
site sewage disposal systems ,
Check one ;
System PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
hOR1th or the environment as defined in 310 CMR 16 - 303 . Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form ,
_1j/Sy3tem FAILED*
The inspection which I have con�cicted has found that the system fails to
Protect the 1)ttblic health and the environment in accordance with Title
5 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection form ,
Inspector Signature 164 Date
Xnecopy of t1lis - rt,ification must be provided to the OWNER, the BUYER
re applicable ) and the DOARD OF HEAL'1'll .
* If the inspection FAILED , thZe owner or"'oporator shall upgrade ' the ayetem
within one year of the date of the inspection , unless allowed or required
otherwise as provided in 310 CFIR 15 . 3o5 .
partd . doc
I
c -Q
k�ivEOJUL
2 ,j 1995 DATE:_1/.U/95
. PROPER a AD :_4.1 ® lling Hitch Road
terville
Mass .
On the above date, I inspected the septic system at the above address.
This system consists of the following:
1 . 1-1000 gallon septic tang .
2 . 1-distribution box .
3 . 1-1000 gallon leaching pit .
Based on my Insertion, I certify the following conditions:
1 . This is a title five septic system. ( 78 Code )
2 . The septic system. i.s in proper working order at the
3 . Present time .
4. Sprinkler line runs over inlet cover of the septic tank .
5 . This should be moved .
6. Septic tank should also be pumped .
7. The septic tank should be pumped once a year due to the
garbage disposal that is present .
SIGNATURE':
Name: ' J_P.4Macomber Jr -
--- -------
Company: -- --------
_J: P:M-amer.
-----, er.
ao b SQn_;In,'� : � {.
T 4�.6 3
Phone:__ 500-175-33 8 ,(
-- ---------------= J
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY
nfl
i
JOSEPH P. MACOMBER & SON, INC.
ftm
Tanks-Cesspools-LeachfieIds
Pumped & Installed
Town Sewer Connections
P.Q. Box 66 Centerville, MA 02632-0066
775-3338 775-6412
• 1
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ,FORM
Address of nrc� erty 41 Rolling Hitch Road Centerville
Owner' s name Unknown
Date of Inspection 7/18/95
PART A
CHECKLIST
Check if the following have been done:
X1XX pumping information was requested of the owner, occupant, and Board of
Health.
XXXX None of the system components have been pumped for at least two weeks
and the system has been receiving normal flow rates during that
period.. Large volumes of water have not been introduced into the
system recently .or as part of this inspection.
XXXX As built plans have been obtained and examined. Note if they are not
available with N/A.
XXXX . The facility or dwelling was inspected for signs of sewage back—up.
XXXX The site was inspected for signs of breakout..
XXXX All components,system onents excluding the SAS, have been located on the
Y p 9
site.
XXXX The septic tank manholes were uncovered, opened, and the interior of
the septic tank was inspected for condition of baffles or tees,
material of construction, dimensions, depth of liquid, depth of
sludge, depth of scum.
XXXX The size and location of the SAS on the site has been determined based
on existing information or approximated by non-intrusive methods.
XXXX The facility owner (and occupants, if different from owner) were
provided with information on the proper maintenance %of SSDS.'
8
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION
FLOW CONDITIONS
If residential
L number of bedrooms
Q_ number of current residents
YES_ garbage grinder, yes or no'
YES laundry connected to system, yes or no
N0 seasonal use, yes or no
If nonresidential, calculated flow:
1993-36 , 000 • g'allons GPD=98 . 63
Water meter readings, if available: 1994-58, 000 gallons=GPD=158. 90
Sprinkler system is present .
Unknown Last date of occupancy
GENERAL INFORMATION
Pumping records and source of information:
_ Nn System pumped as part of inspection, yes or no
if yes, volume pumped
Reason for pumping:
Type of system
YES Septic tank/distribution box/soil absorption system
Single cesspool
Overflow cesspool
Privy
NO Shared system (yes or no) (if yes, attach previous inspection
records, if any) '
Other (explain)
Approximate age .of all components. Date installed, if known. Source of
information:
10 years .old
``Icy Sewage odors detected when arriving at the site, yes or no
9
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION ^-:ntinued
SEPTIC TANKXXXX
(locate on site plan)
depth below grade: 14"
material of construction xXXX concrete metal FRP other(explain)
dimensions: L=3 ' 6`' W-4 ' 10" H-5 ' 7"
-X4,LX sludge depth
XXXX, distance from top of sludge to bottom of outlet tee or baffle
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
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles,
depth of liquid level in relation to outlet. invert, structural integrity,
evidence of leakage, recommendat0}oT for Tt: : _:1ris, etc.
Septic tankpu; y�e once a year , ar age dis�5osa prese t . Structural
senticttank fine ;No leakgFe ; inlet water 54" Outlet 51 ; No repairs
npp,lp" lor the septic tank
DISTRIBUTION BOX: XXXX
(locate on site plan)
NO depth of liquid level above invert
Comments:
.(note if level and distribution is equal , c,.•-' --?ence of solids carryover,
evidence of leakage into or out of box, ;endton for r airs, etc. )
Box is level with no solids carry over ;N6 sins o eakage . �
repairs needed or the distribution Box . -"-
PUMP CHAMBER: NONE
(locate on site plan)
, NONE pumps in working order, yes or no
Comments:
(note condition .of pump chamber, condition - pumps and appurtenances, •
recommendations for maintenance or repairs- , :. : c. )
NONE
10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ,
PART B
SYSTEM INFORMATION continued
SOIL ABSORPTION SYSTEM (SAS) : XXXX
( locate on site plan, if possible; excavation not required, but may be
approximated by non-intrusive methods)
If not determined to be present, explain:
Type.
leaching pits and number 1-6 ' x7 ' Leachinp Pit
leaching chambers and number Packed in stone .
leaching galleries and number
leaching trenches , number, length
leaching fields, number, dimensions
overflow cesspool , number
Comments :
(note condition of soil , signs of hydraulic failure, level of ponding,
condition of vegetation, rfego5meni4tiafns for maintenance or repairs,etc. )
Sand & Gravel ; o signs o y rau is allure or pon ing ;
Ve$atat; nn nnrmal Leach pit cover must Ee raised . Pit cover
inches down.
CESSPOOLS (locate on site plan) :
number and configuration
depth-top of liquid to inlet invert NONE
depth of solids layer
depth of scum layer
dimensions of cesspool.
materials of construction
indication of groundwater
inflow (cesspool must be pumped as
part of inspection)
Comments :
(note condition of soil , signs of hydraulic failure, level of ponding,
condition of vegetation, recommendations for maintenance or repairs, etc. )
NONE
PRIVY :
(locate on site plan)
materials of construction NONE
dimensions
depth of solids
Comments :
(note condition of soil , signs of. hydraulic failure, level of ponding,
condition of vegetation, recommendations for maintenance or repairs, etc. ) .
i
i
• 11
f
�. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION •FORM
PART B
SYSTEM INFORMATION continued
SKETCH OF ,SEWAGE L_SPOSAL .SYSTEMS i
f-•— 5::;'.. }. a »,S,yr .. F`
include -ties to at least two permanent references landmarks or benchmarks .
locate all wells within 1001 Town Watgr
1 �N `r �� ,
{
I .
DEPTH TO GROUNDWATER
20 '+ depth to groundwater
method of determination or. approximation:
Testhole dug prior to ins a a no
Tian eft -fle Rased Of uoni +-b 9/1Rfg5
12
SUBSURFACE SEWAGE DISPOSAL SYSTEM 'INSPECTION FORM
PART C
FAILURE CRITERIA
Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of
determination in all instances. If "not . determined", explain why not)
NO Backup of sewage into facility?
O Discharge or ponding of effluent to the surface. of the ground or
surface waters?
NO Static liquid level in the distribution box above outlet invert?
P
ILiquid depth in 9�ysypyool <611 a. below invert or available volume< 1 2 day
y
NO Required pumping 4 times or more in the last year?
number of times pumped
Nn Septic tank is metal? cracked? structurally unsound? substantial
' infiltration? substantial exfiltration? tank failure imminent? l
l
Is any portion of the SAS, cesspool or privy:
NO below the high groundwater elevation?
NO within 50 feet of a surface water?
N_ wit supply?
hin100feet of a surface water supply or tributary to a surface
Up within a Zone I of a public well?
NO within 50 .feet of a bordering vegetated wetland or salt marsh-
(cesspools and .privies only, not the SAS) ?
NO within 50 feet of a private water supply well?
NO less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis? If the well
has been analyzed to be acceptable, attach co
for coliform bacteria, volatile organic compoundsf well water anal,
and nitrate nitrogen..
- Water ..,�..:. �.�.�
Cori�ervation
SAVE Tips
ME! , .
CHECK FOR LEAKS
Water Loss in Gallons Due to Leaks
Leak
this Loss Per Day . Loss Per Month
Size
120 3,600
• 300 10,800
693 ' 20,790
1,200 36,000
1,920 57,600
3,096• 92,880
0 4,296 ` .128,980
® 6,640 199,200.
6,9.84 '• 200,520
8,424 252,720
9,888 296,640
® 11,324 339,720
12,720 381,600
14,952 448,560
yv-s_-vsr..xtr=rrr.»t.-=zar.�za�-rr�tati:•mmso�:vs-rr�.trss.y rsrccca cxsxsasr.-ur.�rra-sv .. .asrtanr:arsz=x�ma:ax:nst.�L=�_s;
+f TOWN OF Barnstable BOARD OF HEALTH
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION
�1ttST.CLaPt 1:r:TST.i.S.�..T.'R3.-�R'SfiC7¢ TiG-tV�ETII �CiiY-151f7t:.II@ �. Sri R+iRZ.T'1.Y.riRiiTlLlflalSRJ-:CLtt.'i-1`.13 r?i:.
—TYPE OR PRINT CLEARLY—
PROPERTY INSPECTED
STREET ADDRUS �t��1Zo 1 i no Hi _rb Rnarl C'Pnt_e_rvi] 1 P _Tvta�G
ASSESSORS MAP, BLOCK AND PARCEL # 197-67
OWNER' s NAME _ Arthur* Carev
PART D - CERTIFICATION
NAME OF INSPECTOR J P Macomber Jr
COMPANY NAME J.P.Macomber & Son Inc.
COMPANY ADDRESS Box 66 Cen.terville,Mass . 02632-0066
Street Town or City State gip
COMPANY TELEPHONE (508 . ) 775 - 3338 FAX ( 508 ) 790 _ 1578
t�
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at
this address and that the information reported is true , accurate , and
complete as of the time of inspection . The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on-
site sewage disposal systems .
Check one:
XXXXX System PASSED
The inspection which h
P c I have conducted has not found any information
which indicates that , the system fails to adequately protect public
health or the environment as defined in 310 CMR 15 . 303 . Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form.
System FAILED*
The inspection which , I have conducted has found that the system fails to
protect the public health and the environment in accordance with Title
5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection form.
'/: t
Inspector Signature _ - Date 7/20/95
One copy of this certification must be provided to the OWNER, the BUYER
( where applicable ) and the BOARD OF HEALTH.
* If the inspection FAILED, the owner or operator shall upgrade the system
within one year of the date of the inspection, unless allowed or required
otherwise as provided in 310 CMR 15 . 305 .
partd.doc
Ccmmonwecan ct Masscc^seas
Execurive Office cr EnvironmenTCl hrfc,s
Department of
Environmental Protection
Water Pollution Control Tecnnlccl Asswance and Training Sections
wlYism F.Weid
Trudy core
S"r• y.coo►
Thomas&Powen
aarg Cairn.wonw
06/12/95
ATTN: Joseph P. Macomber, Jr.
Joseph Macomber and Son
PO Box 66
Centerville, MA 02632-
Dear Joseph P. Macomber, Jr. ,
I am pleased to inform you that you have attended training, met
the experience qualifications, and have passed the Title 5 System
Inspector exam, pursuant to 310 CMR 15.340. The passing grade for
the exam was 39/52 or 75%.
This is an official notification that you are a Certified Department
of Environmental Protection System Inspector pursuant to 310 CMR 15.340.
You will receive a System Inspector certificate at a later date.
If you have any futher questions, please write to me at the following
address:
Kimball Simpson
D.E.P. Training Center
50 Route 20
Millbury, MA 01527
Thank you very much for your time and consideration in this matter.
Sincerely,
Kimball T. Simpson,
DEP Training Center Director
(2 4 0 5) Routs 20 a Millbury, MA 01527 • FAX 508-755.92M • Telephone 508-756-7281
TOP OF FOUNDATION 101 .6'
5"DIA. OUTLET(S) FINISH GRADE OVER CHAMBERS = 99.51-100.01 GENERAL NOTES
/ =
REMOVABLE COVER SLOPE @ 2% MIN. OVER SYSTEM
FINISH GRADE OVER D-BOX= 99.8' 4" SCHEDULE 40 PVC MIN SLOPE 1% 3/4"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE
1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION
FINISH GRADE @ FND. EL.= 101 .0' FINISH GRADE OVER TANK EL.= 100.01 2" OF 1/8"TO 1/2" DOUBLE WASHED STONE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE
ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES.
20"MIN.ACCESS COVER 12"LN. ' PLACE RISERS ON ALL CHAMBERS
TOP OF SAS = 98.23(TYPICAL FOR 3) 36"MAX. 36"MAX. TO 6" OF FINISHED GRADE 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD
EXISTING 4" /// + 97.401 36"MIAX.
BREAKOUT EL = 97.90' OF HEALTH AND THE DESIGN ENGINEER.
PIPE 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL
2" DROP MIN. PROVIDE WATERTIGHT BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED.
V- --
E" 3"DROP MAX. 3„ 9„ µ JOINTS (TYP.) o 0 0 0 0 0 0
4" PVC IN FROMO 4. TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN
14" ---97.921 SEPTIC TANK 4"PVC OUT TO o 000 00 O �� o0o ELEVATION = 97.90'FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS
LEACHING FACILITY ao o o A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF
oo THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
OUTLET TEE 97.67� MIN. 97,50' 2 0 0o p 0 0 0 �0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
48' o 0 0 L� 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
11.4' 22"ZABEL FILTER 6" CRUSHED STONE
OVER MECHANICALLY
(APPROX.) MODEL#A1801 HIP COMPACTED BASE 14 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED
l (GAS BAFFLE ON 8•5 I 4' 4' PRIOR TO BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND
BOTTOM) 5 33.5' 4 9 READY FOR INSPECTION. SYSTEM IS NOT TO BE BACK FILLED
OUTLET DISTRIBUTION BOX �P•) WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH.
TO BE INSTALLED ON A LEVEL STABLE , GROUND WATER ELEV.= < 88.70 12.9'
1 BASE. FIRST TWO FEET OF OUTLET 95.40
EXISTING 1000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 3 - 500 GAL. CHAMBERS 5'MIN.
LENGTH 9� WIDTH r� DEPTH �2 8. ELEVATIONS BASED ON ASSUMED DATUM OF 100.0'MSL OBTAINED
CROSS SECTION VIEW TYPICAL CHAMBER PROFILE CHAMBER END VIEW FROM NAIL IN UTILITY POLE AS SHOWN ON PLAN.
SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL CHAMBER DETAILS 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
NOT TO SCALE NOT TO SCALE NOT TO SCALE THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE
AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY
DISCREPANCIES TO THE DESIGN ENGINEER.
! `� ? �► TEST PIT DATA
�w 'N f ' � } ` ` 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE
y STRUCTURES SHALL BE MADE WATERTIGHT.
INSPECTOR:
•i,�� , � �F'a`rr. l�r�� fi� *r z��r�� '� t, '�Pc f i:y
SOIL EVALUATOR: Samuel Philos Jensen 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR
ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN
+► DATE: October 2. 2002
j
SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
1 N. x6N� A 9 r4s 914`'aJ u tirr: PIT
TEST #: 1
} � 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS
ELEV TOP = 99.70'
LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH
a
a ' CASE THEY SHALL WITHSTAND H-20 LOADING.
�� ELEV WATER= 11 BGS
CQ
° ' r PERC RATE = < 2 Min/In (Assumed) 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT DUST AND
M V. ��# �� tiz; J
M h i 1, z AFy
W.
FINES.
T f P 1A n m!1'v
1 - Cer a 41$J..7 �,,I�, ai11 ,•i° iIF F't -IM MF AYE -.
1 � DEPTH OF PERC= 56"-74"
" k 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND
IL
TEXTURAL CLASS: 1 UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES
o Y, OF LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN
^ w„ d . A ' � COARSE SAND FREE FROM CLAY FINES OR OTHER UNSUITABLE MATERIAL IN
� '
ACCORDANCE WITH 310 CMR 15.255(3).
0
99.70
iiYl
f My M 14Y 4 FILL 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES
s. " k FOUND IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
� ,� � �S 12„ � 98.70'
�,r, in f , , , ' +k 7ti ,
ay,� .MI O-A y
y� I IIIJ ti I�� � {� .�. } � , 1 yt„, 5r P h,r
q. ' Sand
L(, a Is,N,yy g a ' • r ti ,: r;; ► Loam 16. PROPOSED PROJECT IS LOCATED WITHIN:
c �0Jµ+" � + 18' 98.20 ASSESSORS MAP 192 PARCEL 67
II � will � "I� y�rq 11 r$ f.
I I M II M I"d6.
B Sandy Loam
e► '� w' . ! ,: 26" 97.53'
Loamy Sand 17. OWNER OF RECORD: JOHN J. AND PHYLLIS M. COLLINS
IG ♦ �. a ,a,
ADDRESS: 1 41 ROLLING HITCH ROAD
" �" * �,,•��� �� '� �,, `fi, -, � 5-1�J% Gravel _
36" 96.70' CENTEhVILLE, MA 02632
�, �► 'r x � :M* 56" - Loamy Sand
�, „br Y ,
r.
,
15-25% Gravbl 18 PLAN REFERENCE: LAND COURT PLAN 33723A
MAP 1 92 �' :�► **' + ' * • "� del; 85 hf-C Sand 91.62'
QO 00o PARCEL E7 �' n 1'" C_3 L.oY 5/4 19• ALL DISTURBED AREAS,.9HALL BE RESTORED TO ORIGINAL CONDITION.
p O
5-10/° Gravel
5� �O ti No Groundwater or
17 988 SQ. FT. ± 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
s�9' LOCUS PLAN Weeping Observed FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
132" 88.70 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
�'` SCALE: 1" = 1000'
EXISTING 1000
t GALLON SEPTIC -��f � `,,,
DESIGN DATA LEGEND
TANK --�\ ..,�... �- ;,
�..
EXISTING
� �• � E x:.ISTi�IG ; EXISTING SPOT GRADES
x '0
DISTRIBUTION CB (FND) '~RiVEIPJAY GARAGE
BOX TO BE / 0 EXISTING CONTOUR
j REMOVED --�- 101 -
i NUMBER OF BEDROOMS (ASSESSORS) 3 50 PROPOSED SPOT GRADES
NUMBER OF BEDROOMS (DESIGN) 4 PROPOSED CONTOUR
O � �_ NUMBER OF PERSONS 2
1 � 10;�A P �•
INSTALL THREE 500-GAL 33.`' 0 11.4' 1 DESIGN FLOW 110 GAUDAY/BEDROOM E/T/C EXISTING ELECTRIC, PHONE AND CABLE UTILITIES
INFILTRATION CHAMBERS G RDEN EXISTING 4
- BEDROOM
TOTAL DESIGN FLOW 440 GAUDAY
DWELLING GAS EXISTING GAS LINE
IE
G ;J ile -~~ 'ev' - - - EXISTING WATER LINE
o = T.O.F. = 101.6'
`" o 25-Q' DESIGN FLOW X 200% = 880 GAUDAY
Q `° 13 3 8" OAK ,
r
TP 1 DECK USE 1000 GALLON SEPTIC TANK TEST PIT LOCATION
(EXISTING TANK) EXISTING 1000 GALLON SEPTIC TANK
♦ `>,rt ' 99x70 , - 20 OAK FO�8' OAK ---�
♦ INSTALL 3- 500 GAL. CHAMBERS
4"SOLID SCHEDULE 40 PVC PIPE
DISTRIBUTION BOX ' 12" OAK DISTRIBUTION BOX
SIDEWALL CAPACITY
N (L+W) (2 SIDES) (2' HIGH) (.74 GPD/S.F.) = GAUDAY
SEXISTING LEACHING PIT ' ti (33.5' + 12.9') (2) (2') ( .74 GPD/S.F.) = 137.3 GAUDAY L_u J 500 GAL. LEACHING CHAMBER
TO BE PUMPED AND CB (FND) 132. {K
FILLED WITH CLEAN SAND Ro` �7
BOTTOM CAPACITY
7'1 7
9 15" OAK 1 1/13/03 JLC JLC NUMBER OF BEDROOMS
HED (LENGTH x WIDTH) (.74 GPD/S.F.) = GAUDAY
(33.5'x 12.9') (.74 GPD/S.F.) = 319.8 GAUDAY REV. DATE BY APP'D. DESCRIPTION
sA �Gs PROPOSED SEPTIC SYSTEM UPGRADE
� TOTALS:
PREPARED FOR:
TOTAL NUMBER OF CHAMBERS JOHN J. & PHYLLIS M. COLLINS
` TOTAL LEACHING AREA 617.8 SQ. FT.
QO10� ` W /
CB (FND) TOTAL LEACHING CAPACITY 457.1 GAL./DAY LOCATED AT
o&�`� 41 ROLLING HITCH ROAD
- vv
-9 CENTERVILLE, MA 02632
B.M. SCALE: 1 INCH = 20 FT. DATE: OCTOBER 16, 2002
Nail in U.P. t 0 10 20 40 80 FEET
Elev. = 100.0' a+�'TH of��c^
0 JOHN L. yw PREPARED BY:
Assumed CHURCHILL
�R. JC ENGINEERING, INC.
CIVIL
N 41807 5 ROUNDHILL BLVD.
- EAST WAREHAM, MA 02538
SITE PLAN- 508.273.0377
SCALE: 1"=20' 1 f 3/03 Drawn By: JLC Designed By: JLC Checked By: JLC JOB No.312
PLM