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HomeMy WebLinkAbout0020 ROSEMARY LANE - Health 20 Rosemary Lane Centerville A 147 007023 a No. 4210 1/3 ORA Pendaflex' 1000 . 007 -b 23 Commonwealth of Massachusetts - W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address K*1 Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page: City/Town State Zip Code Date of Inspection ka �ry 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. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain Q Company Name 8 Johns path Company Address B S Yarmouth MA 02664 City/Town State Zip Code 508-364-9587 S113522 Telephone Number License Number B.-Certification 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 ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority ,./'.•ram r-.....__._._..... - 6122/17 Inspector's Signature Date The system inspector shall 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 to the buyer, if applicable, and the approving authority. ****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. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 �o vs Corr monwealth of Massachusetts W Title 5 Official_ inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 20-Rosemary Ln _ Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) 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: System contains a 1500 gl septic tank as well as a concrete distribution box and 2 500 GI leaching chambers. B) 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage-Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a , wM 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 . page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ 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 ❑ ND (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): C) 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. 1. System will pass unless Board of Health determines in accordance with 31.0 CMR 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 a salt marsh t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Forte Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 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. 3. Other: D) 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 El ® 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 '/2 day flow 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No El ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: 1 ❑ ® , 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 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.] 0 ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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:.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 D. 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 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 has 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Supsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City[Town State Zip Code Date of Inspection C. Checklist 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 ❑ ® 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 rovid❑ ® Y ( p ) 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)). D. System Information 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): 330 t5ins•3/13 - Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln M Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No 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)): 213 GPID Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date 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 Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every .Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 5/15 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is Centerville Ma 02632 6/22/17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (coat.) Approximate age of all components, date installed (if known) and source of information: 2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): System is vented at the roof Septic Tank(locate on site plan): Depth below grade: 2 feet , Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene El other(explain) 1500 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 t Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection Do System Information (cost.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 24" " Scum thickness 3 j Distance from top of scum to top of outlet tee or baffle 42" Distance from bottom of scum to bottom of outlet tee or baffle 11 Sludge stick How were dimensions determined? Tape Measure 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 (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 t5ins•3/13 Tjtle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of i7 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Fore Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y° 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6122/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert level and at normal level 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.): 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. Soil Absorption System (SAS) (locate on site plan, excavation.not required): If SAS.not located, explain why: tins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System^Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® 2 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.): No signs of failure 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts P W Title 5 Official Inspection Farr Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City(fown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Rosemary Ln Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection .D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 10+ 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: 9/2/03 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: Test hole data on plans Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 i • I lei s-4v ' III 3 i ' e 11' 1 1 TOWN OF BARNSTABLE LOCATION , SEWAGE#j�Clr��? `✓.�� ;.;�; VILLAGE ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. y.,- SEPTIC TANK CAPACITY LEACHING FACILITY: (type) NO.OF.BEDROO BUILDER ORWN $ _)t. PERMITDATE: :) COMPLIANCE DATE: Separation Distance Between the: i Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility j�r Private Water Supply Well and Leachin Facility Feet i g . ty (If any wells exist on site or within 200 feet of leaching facility) Edge,of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by 6�111/1p1 cry j, tSS Feet p `s Commonwealth of Massachusetts W Title 5 Official Inspection Fora, _ Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 20 Rosemary Ln 1M Property Address Eric Setterlund Owner Owner's Name information is required for every Centerville Ma 02632 6/22/17 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information— Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 1 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOW_ N OF BARNSTABLE ® L✓ ACV LOCATION ,;', 0 I� Se�� SEWAGE # VILLAGE e -f-f�olll ASSESSOR'S MAP & LOT 1"I - 'G "D2.3 INSTALLER'S NAME&PHONE NO. a4lelk ee-M r„FAL y?`a•r- SEPTIC TANK CAPACITY ), coo Gel LEACHING FACILITY: (type) 5 00 G'e- �da�Sr �-?� (size) 13 X-2 V NO.OF BEDROOMS BUILDER 0 0 �Swre PERMTTDATE: 9 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 i within 300.feet of leaching facility) Feet :Furnished by / U�" k �✓ ! .t .¢ , f �//��� f� ���' iy� o ��� ��G �. ,:f�. ;�X. :,.. t.-a s ,��:� . .. ... � �� � b No. 6 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for Zigozal bpotem Construction Permit Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) D Complete System F7 dividual Components Location Address or Lot No. poee� Owner's Name,Address and Tel.No. Assessor's Map/Parcel , Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ���®��1�`� l 3 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 //® gallons per day. Calculated daily flow 33o gallons. Plan Date R /,5``11'3 Number of s eets Revision Date Title I Y- �Ct/Q 4' ® ZD Xesewyv Size of Septic Tank /®©ep Q' Type of S.A.S. — ® Description of Soil, a",[;t- f Nature of Repairs or Alterations(Answer when applicable) 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 not to place the system in operation until a Certifi- cate of Compliance has been issued by thip Board o e Signe ® Date vl wl Application Approved by _ Date Application Disapproved for the following reasons' Permit No. Date Issued �j r � No. D Jb � Fee 6"o _�/THE COMMONWEALTH OF MASSACHUSETTS.— „ Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zlpprtcation for Migogal *p.5tem Construction Permit 1 • 1- Application for a Permit to Construct( )Repair(V,/)Upgrade( )Abandon( ) El Complete System .vIF"b' dividual Components Location Address or Lot No. Owner's Name, and Tel.No. G�Oser�a'r T-p S ale- le Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms ,� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building_`P��°5,W�_-_�//'&No.of Persons Showers( ) Cafeteria( ) Other Fixtures Y Design Flow //i% gallons per day. Calculated daily flow 330 gallons. Plan Date R'— /5-- l Number of s eets / Revision Date Title S/ ' Y- 5 e 4ti:p pe'. q q, D y Size of Septic Tank _Type of S.A.S. Description of Soil, Nature of Repairs or Alterations(Answer when applicable) 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 not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of—Health. / Signe 2&/ _ Date d\ 79/0*%°r13 Application Approved by Date �I Application Disapproved for the following reasons Permit No. "" Date Issued w THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( Upgraded( ) Abandoned( )by--- 1 �iJ`� /0/d �O 19 5�, at 4 5 t/ L- o _ !1 Ile has den constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. , _ ated Installer Designer The issuance of s trmit shall not be construed as a guarantee that the s stem , >fu./c ion '� ed. Date / p��3 g Inspector y 7 � --------------------------------------- - No. '3 / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mitpo5al *pgtem Conotruction Permit Permission is hereby granted to Construct( )Repair( 1l)Upgrade(_ )Abandon( ) System located at V Z0, C-ell le/l//,Ile. 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:Construction 1 ust be co pleted within three years of the date of this ;ermit /j Date: -/ Approved by a-✓ ),q > >7 t > TOWN OF•BARNSTABLE LOCATION o?O Pf®j/,e `7 L✓ SEWAGE# -:�9570 3 VOK VILLAGE ASSESSOR'S MAP& LOT LI — C '02-3 INSTALLER'S NAME*PHONE NO. 26" SEPTIC TANK CAPACITY G-'L LEACHING FACILITY: (type) S OG 61 �-Z) (size) J3 y'r Xy i. NO.OF BEDROOMS 3 BUILDER O O c/BUILDER PERMTTDATE: 9 COMPLIANCE DATE: °I—1() 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 i- within 300.feet of 1 aching facility) Feet Furnished by ssDc- I I:OT NO. : _ADDRESS: -vd� OWNERS NAME: MY SEWAGE PERMIT NO. : NEW: REPAIR: DATE ISSUED:„ DATE INSTALLED: a I.1-lqs INSTALLERS NAME: L� I ,e INSTALLATION OF: WATER TABLE: FINAL INSPECTION BY� �//� DRAWING OF INSTALLATION ON REVERSE SIDE: 3f qA � e a or f , it � 00 No.. ..... ✓ Fss.............`..'... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiou for Diripwml Works Tomitrurtion 11amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...................... .... tS 'e 4- ....... ............................. ------------...........--........--------• �� cation-:�ddress or Lot No. .............. ��r�.__. l. .!?, Owner Address Installer Address � r UType of Building Size Lot..�3F.__._...Sq. feet .< Dwelling No. of Bedrooms................A--------------------------EX ansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons---------------------------. Showers ( ) — Cafeteria ( ) 04 d Other fixtures ------------------- -----------------------------------------------------------------------•------•••-'-----•-------------------------•-•••-•--.--'•- W Design Flow....................... .....�. __gallons per person per day. Total daily flow......3? .......gallons. WSeptic Tank—Liquid capacity/O.v.IL-gallons Length-.X7:A.... Width__-_Z.... Diameter:-. Depth.--` :,F..... x Disposal Trench-- No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No.-_--------_ l.._ Diameter...../_./..--------- Depth below inlet......¢.......... Total leaching area....?��3�...sq. ft. Z Other Distribution box (tom Dosing tank ( ) aPercolation Test Results Performed .................... Date_/Z.'.1F.. j.;C.......... . Test Pit No. 144_..14:SR.z..minutes per inch Depth of Test Pit----/4t_......... Depth to ground water...... 44 Test Pit No. 2......`'......_minutes per inch Depth of Test Pit----!AT:......... Depth to ground water..... 1:4 _ ---------------- ------------------------------••...__............ -•-...-••••'---------------••'-•......................................................... 0 Description of Soil.....1 �5....... hr' r --- ti_ ________________ V ...................................................................................................................................................................:............--------•-••-'•--....... 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 TITLE 5 of the State Environmenta Code—The undersigned further agrees not to place the system in operation until a Certificate of ComplAP *94 issu by t board of health. Signed . . . . <- .... .- ...... .......--...... ............--........A lication A roved B PP PP Y ..... .-...Application Disapproved for the following rear ..... .......................................................... . .... ........ ....................--........ .. . . ......-- ...-.....-.-..... . ... .......-------------- - Date Permit No. q.q. ... ........ .................... ... Issued ............ .e ........... � Iz-1 7-01- D�3 ;e FEB.... A_...00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / C/ TOWN OF BARNSTABLE . xt � �-- Apli iratiaitt for Diaipwiul Waarks Ta t6trnrtiont -IJ.erntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...................... .....� 4�_ _ !e jv L , ! . z 3 ........----••.................................... cation-Address /"— or Lot No. Owner - Address •----•.............•--•-----•-----••------•_...---••-•--•-•..................••.......••. ................................................................................................. Installer Address � Type of Building Size Lot__?� ........Sq. feet Dwelling—No. of Bedrooms------------_3_ ___-___-_ -.__Expansion Attic Garbage Grinder_ _________ a ( ) Other—Type of Building ____________________________ No. of persons___----__._...__..__-______ Showers ( ) — Cafeteria ( ) dOther fixtures ...............................................--------------------------------------------- -------------------------------------W Design Flow................................. ��_.gallons per person per day. Total daily flow-----330...._............._...._._..gallons. WSeptic Tank—Liquid capacityfr��2_.gallons Length__'_G__.. Width_-4:_:�.... Diameter... Depth_5_:9..... x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No---------------?_--- Diameter-----/I.......... Depth below inlet......¢.......... Total leaching area...�33....sq. ft. Z Other Distribution box (#--) Dosing tank ( ) ; W Percolation Test Results. Performed by.-A:/.k._--- ...................... DateZZ.-_I::...F, ............. Test Pit No. 1 SS._Z..minutes per inch Depth of Test Pit.... -7............. Depth to ground water.__-". ........... fs, Test Pit No. 2................minutes per inch Depth of Test Pit....!2-_......... Depth to ground water..... �+ _ ----•------•-----------------------•----•-..._..-----------------------•--------•---........--••--•---...............-•---...-•----•••••.......---........... DDescription of Soil.....7 4,5....... --•---•-------------------------------------------------•----•----- V .....-••••-----•--•••------------------•-•••----•••......--•---•-----•-----•-•••••-•---•.....--•---•••---••--•----•---••••••-•-----------••-•--•----•••••-•••--•••--•-•--..._-••---...-•-••....._•-•-•• W ..••------------------------------------------------------------ -------------------------------------------------------------------------------•--------------•----------------••-•--•-•---•-••.... U Nature 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 TITLE 5 of the State Environmenta, Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance..�Ias been issu d by tbo board of health. Signed ........... ................ Q ..,......... _.ti .......: J.................................. ....../........ ., Application Approved By ... .... .... ......(/!. /..!. ...... 3 �! ... .e� �.../.... Application Disapproved for the following rearb r: . ............................... .- .. ... . ....................--- ............. ...........................................................................................� .. .... te.................. Permit No. q_tf f � _. Issued ........... /.. X........ Da e THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (fQrtIfirate of (gomplinure THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by - _......--- M- - .................. ............................ ................... ... .......... at 1.1�>. ............ `- .-.f� ..of TI"rL t N/ ,/ ------------------------- - has been installed in accordance with the provisions he S� to E vironmental Code as described in the application for Disposal Works Construction Permit N�. .. �' .. t� r��....... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. Ins DATE._ ..."' ......... ;............... ectcrr . .. ............. -/. P �2 i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE /� No.- i FEE, ..................... Ewposal Works Tlanstrudian vrrntit Permissionis hereby granted---------------------------------------••----------------------------------------------------------.--.--------�------------.--••---.-•--- to Construct (,�- ors R.gpair (�,)�any�Individual Sewage Disposal System n �/ 0 , at No...__._�1�j/ /�( 'S.= 1 1 ,� ) � Y t � --1::�n/`✓-1!.l_-�?./�-_�!-N„'? .............. _.__._.....�._;✓f..___..__ `- Street ��i l as shown on the application for Disposal Works Construction Permit No.-.._-P��/.� ated........................................... ... ............ a q v__ ( /Board of Health DATE............ ------------------•-•-----•----•--•••-- v FORM 36508 HOBBS&WARREN.INC..PUBLISHERS � J I o� l C,/9.. /S. M l I 40.0 I I • 3 .4 STK 39.•�8 i � 39.3 , /58.83 : 13 89 ' _ � I ' J. rt0%3e1ytG/rL� 23 I p L : ans rp 737 I. 40 / wide H l00%. ; PltoAuS'FP= Is K P 1 oao ty , c 10' . -+.;.. A , 401 }j i i I i' I .Cat 2 la cs 1 0 , j f J`, r pao •i,Le No ScG,lz No.beAoogil, 2 3 t E ;s }U .bi4po �jt1 air �auxated �AW 330 GNA*l4]� _ i 1+ eae�cue ;1 233 a --- 1�n0 ;� t, �`' - n � � '1 -I, u � acit �F4/ c � ff' 'Sketch Ran an o .C'ncgn�d++ in CejlteAv t e, l,iq a j 702 �.a►m�. ('fCt�;lrady ! t ,����{�Ji,�fi i{ Zo t. 23 a, ahown ova .C.C.#4 1�,l S ;A ah -'__a i I . � -CeucrX.tov». ate opt an a�.�utxP_,d' datum; Vic.:te---A 77 Ze-170_av 17ec� - ' � iI , 11-30 j . date I12-14-9a { At Cape' <r�uz�;eehrnc Idc a,z tins, 1.1q 0260'1 I Beat O t #P-8 3 32 Made 12=8-9�1 W t. Ed 3 �' No wane% encoun to tc Pe&c. .te,. 2 nun. pew 3q9 q.o.� ! "'.yam!h�I ,and , i I a' ltv_ Z TOWN OF BARNSTABLE LOCATION Lal 3dt�'4p/ ,�iy/' SEWAG E # `.VILLAGE > ASSESSOR'S MAP & LOT f,.? t Ii�;STALLER'S NAME & PHONE NO. ` '2 S/ Qt ASEPTIC TANK CAPACIT"I 1 G o c, � LEACHING FACILITY:(type) (Size) "NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER CAR OWNER DATE PERMIT ISSUED.: DATE COLIPLIANCE ISSUED: / C ` VARIANCE GRANTED: Yes No 4d 3� 3 y `// 1.s... No � ..... Flcs........... ... ....a' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..._.. ......oF G- .�...............---•---•---•--------•...............•---- Ap4diration for Digpviial Works Tonotrurtiun Permit Application is hereby made for a Permit to Construct (✓�or Repair ( ) an Individual Sewage Disposal System at: ....... ...•-•- .in Address }or tmoo• ....... L L :- -___-------••-•--•-------•••---_••• . � .L:.Y.:....»....».»..... Owner .......-^----•-••--••--•...................Ad-ress p�qq ......... V,1:1... ....... ...-•-•-•--------•..................... •----.....----•--......................... Installer Address UType of Building Size Lot... U.......Sq. feet .-� Dwelling=No. of Bedrooms .................................Expansion Attic ( ) Garbage Grinder ( ) `•� Other—Type T e of Building ..... No. of persons............................ Showers a YP g .........:............• P ( ) — Cafeteria ( ) 04 Other fixtures Design Flow............!�_.........................gallons per ier day. Total daily flow....... ............._.__.._....gallons. Septic Tank—Liquid capacity/A gallons Length._ __.4t.___. Width:.. _.� .. er:............... Depth..�'�. '. xW Disposal Trench—No.._...... .. Width................... Total Length Total leaching area....................sq. ft. �"r-•-••- 3 Seepage Pit No...... Diameter.......J ...... Depth below inlet......b.......... Total leaching area_,14.�..3.sq. ft. Z Other Distribution box (� Dosing tank- - ) -2 _�� Z�_$S Percolation Test Results Performed bDate ` �� �. Y•--....Z::- -�.�.:�?� ii....-•--•-•-•....... ._..----•................� ......._.. Test Pit No. 1......y L-_-minutes per inch Depth of Test Pit.... Depth to ground water..... 44 Test Pit No. 2.....LY..minutes per inch �Dep h of 'hest Pit.....�s� Depth to ground w ter......N1.1-44... Ux :tn Zo.t.S..oDesch C?il:.: .�...a....'.`.�........,j :o.: .`..'. r1- :. ....�.f t ^_�........ ... x •••--•-•-----•--...----•---•--•-----•.---....-•--•-..---.•-•-•••....••--•--•-•-----.....•------•---•---.---.-•••---•-•--•--.--=--•••------=------•..................................................... U Nature 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 SIT:LZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issuedby the board of health. Signedggx / ....................... �,,�.. ... .......... _.... .D. a Application Approved BY..... �.. .....n`.........................••-••---••-•----......•-- ........ � {. Date Application Disapproved for the following reasons:........................................:..........................................................:.....:..:... •••........•................•--••••••----•-------•--------------------...-••-•----------........----.._......:........--••----------------------------........---•------........_----.....____•••••-_•-- Date Permit No��r 7Z....._..._» Issued............................... ....................... ^ Date No..—�... --- 2 '` Fps.............. THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH OF......... .....................................................................-. 'Appliration for Digpusttl Murky Tonstrurtion thrmit Application is hereby made for a Permit to Construct (✓)tor Repair ( ) an Individual Sewage Disposal System at: 1 11_ Location-Address or Lot No. ...... .. ........ ...- ...... ..._......rt_..................... ..... �rl n J .. .roc ......... .......... �j..` /.)--r ti�n�'y I,_ � h+S Al W 1 .. I Owner •� Adddress .. 4 a ..................... ... ............... ............................•---....-•--••--...... ....................................-••....._...................-••-............--................ Installer Address Type of Building Size Lot...f.�,. .7: 1•........ feet U 1.4 Dwelling—No. of Bedrooms......-S.................................Expansion Attic ( ) Garbage Grinder ( ) e �W Other—T yp of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ............................................t....... W Design Flow...... �.�.6........ gallons perlpe sr on pi r day Total daily flow...... ?d........................gallons. W� Septic Tank—Liquid capacityX�u.gallons Length..K'r 6."_. Width:.�.1./e)". Diameter ..... Depth.. ._�..� x Disposal Trench—No. ........ ..... Width.................... Total Length..........._...... Total leaching area....................sq. ft. 3 Seepage Pit No......6Z�° ..... Diameter....... �..... Depth below inlet.....r°.......... Total leaching area.2��t I9.sq. ft. Z Other Distribution box (✓) Dosing tank a Percolation Test Results Performed by ........•.......................••........ ...•-••................ Date. .. '.............. Test Pit No. I......! I....minutes per inch Depth of Test Pit.... .... Depth to ground water...... 44 Test Pit No. 2.....L.k...minutes per inch Depth of Test Pit..... r�_.`. Depth to ground water......61!?:�t�.... ••••••............••.........,.. s �:....... ---•--•----•................ ..................................... O Description of Soil........... ().:1:^t - V ..............................1 '-'.:-: r :�n,� F ,� �a::.� ?�t�" �SCs' . _c-� c..oj...)-P i t .. ......� ....._ .... . .. 7.. .............................ac ^F-- -.r. VW ..............................................................................................................................a...................................................................._.... Nature 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 TITUf- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .........................................................,:...--••-•--------.................--- .... ..................... v Date Application Approved By.............. :�..n � d��y ...-..--• .............-----•.. /�.......................... r Date Application Disapproved for the following reasons:............•:...---•--•--------------------........--------.....-----------.................................... ...-•.......................••------..._...........................................-----....------...................................-------••-----•-••....••--••-••-••••••-•••-•• - ......---•• Date — Permit No �'C: - - -`'............. Issued_....................................................... _..�;•_:.;. ,..,..,.. .,..�_..,_. _.....-__,r„ ,-.. .r ._... .,.a Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ................OF..... ...1 ..... Trrtif irate of Tonwhanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( 4-)-or Repaired ( ) by.......... YZ .......................................•-................. .. ........_.. .......•----•--•.......-•••••-•--................•••-•....................••.... Installer at...........................................��k ` fit(? r✓� �l ow)............._..........._.: _.... has been installed in accordance with the provisions of TITLE, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.... '�'�_' •.''?�'7:.____...... dated.....7... . ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......... -:.j.:._ ...'........ ................. Inspector.................................................................................... 1 7 — t THE COMMONWEALTH OF MASSACHUSETTS "V BOARD OF HEALTH -� ......�::.......... oF....�'a�:.:�....C:7 ...�....................................••... ............. ......................... Fn.....�......'�'........ Disposal Works Tontrurtion ramit Permission is hereby granted.....�i� -- .----•...................••••....:•••-••.....•••--•-•-•.................................................--••••.......... to Construct (—) or Repair_.( ) an Individual Sewage Disposal System at No........ .......3 L n C. ` ................... ............................................................ Street as shown on the application for Disposal Works Construction Permit Nok _...'1'2-Dated......1.I.�� _ c c . ........................... ..................... ......... .:i ................................... C/DATE..... Board of Health (....-- s� -•---••--./•--•-•---•.............................. i SECTION - SEWAGENo-rE BctJcH r�A2oz EL: 42.54 -Top OF c•B. @ S.,E. co�Lt�E� Gd± SovYV{ OF I I 1t�� Ems• OF k?oSEMARY LA. r /01 -SEPTIC TANK - I - "D"BOX -.. - LEACH PIT I TOP OF FAO/N� I 0� "2"OF i/sTO Vz.. WASHED STONE SEI 00 IN- OUT• - IN- OUT. IN- C_SEPTIC v TANK 1 � N / ,r I T P r. I I ' _•.)- �- ELEV. ELEV. ELEV." ELEV.e)oto?I r }: I / ELEV. ELEV. f P �2'_ oF�/4.. i,�2. _L_0T. \ti 21,t _.:LO-T Z . 44 WASHED STONE s z 12 �, .. � N _0� F-L. TEST HOLE LOG F_�+Ob , 1"KI C,0A0, y s-3'� O, TH-61Z'. G2_70., Ill-1�►1'�lfi2, "II-?11-8Co q� TEST BY TZ.�AIRIIANK,Q•E. TEST DATE WITNESS BEDROOM HOUSE i t@��� 2 �I'C, DESIGN �"T.H. # 1 T.H. # 2 r 0 ,q5 ELEV. ELEV.L}t!p S NO \\ „ DISPOSER DISPOSER ss� 2 _" PERC RATE MIN/IN. 4 a.z ,. 135 �1- L_C> s `4-o FLOW RATE 330 (GAL./DAY) 3 3 0 CLLAIIJ SEPTIC TANK330 x (1,5)= 9 9 515,436± S•- . MED. �E I REQ'D SEPTIC TANK SIZE / 00 0 I :tit_" SAND EW)R� LEACH FACILITY — - _ SIDE WALL 1$6.4 (2.5) = 4`71.0 G/D. �� 100. 00 BOTTOM .. _ ,,f (. .® ) _ ? G/D. 5 TO :Ai f56 3?•2 / it USE: 0 LEACHING IT I NO WATER ENCOUNTERED I ' e��• muA � � 4VT,-,MEts t-k NOTES (UNLESS OTHERWt�IJSIf NOTED) 1. DATUM(MSL)+TAKEN FROM__-L_Y_'_1_L_1C -_-______QUADRANGLE MAP ----------•---AVAILABLE Of 2.MUNICIPAL WATER_______ �,S____.._______ 3.PIPE PITCH:Ve"PER FOOT 4.DESIGN LOADING FOR ALL PRECAST UNITS: AASHO 44 O ARNE H. G 5.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. �S J, - � OJAu► SEWAGE 6.PIPE JOINTS SHALL BE MADE WATER TIGHT cQ,a CIVIL 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS.. STATE ENVIRONMENTAL CODE TITLE 5 NO. 30792 SITE PLAN Ado 9 C T i�N LOCUS: G G OF �fS ALA ---- - % P� ass9� C. .lc' 411,4 REG. L ENGINEER O� ARNE yG H. REF: dGiVn cape en, gineeting L N PREPARED FOR: CIVIL ENGINEERS I � t LAND SURVEYORS BOARD OF HEALTH on main SL RE KQ{q���i R. ^01 SCALE I'�__ "i�+�RIVSZ-i4L,sLE ! J. Yar...a�►. CONTOURS (EXISTING)------------- gppROVED DATE I MA. r � DATE (PROPOSED)—0-0-0-'O— ) I NOT TO s ALE TEST t 10LE LOCH f fi�0 ��� N G 9 LAYER OF 3/8"PEASTONE DATE: h-05-094 P-8332 r EL.= .42.0 FIRST PIPE LENOTM OVER 3/4"—I I/V'DOUBLE TEST BY: ALL GAPE ENGI NEER NG ro �E SET LEVEL WITNESS: E.CARRY J �¢ TOP FOUNDATION WASHED STONE Locus 0 EL= FOR MIN 2 PER(,RATE: <2 MIN./IN. g FINISH GRADE EL= 4OOf Rzosmwy L,# r— a, 40.1 d' a b 4!1 PVO LOAM LOAM `Q SCH AOPVG „ PVG TOP @ EL. 36.7 & & 40 a SU�SOI L SUpS01 L Ul 3G00 ^°�x�°�'°°° 35, 15" 38.E 18" _ pOTTOM @ EL. 3�}00 2 INSTALL&AS BAr ;N0UrLr_TTEE DIST. f5OX (EXI5TINO) 261- 0 7.1' SEPARATION ,.:.., 1000 TANOK MEDIUM MEDIUM LOOAT�ION MAP (EXI5TINO) SAND SAND BOTTOM OF TEST HOLE Cp? EL. 26.9 15G" 27.1 I 15/v" NO WATER ENOOUNT ERED DD31 CAN PATA DAI_Y FLOW: (3)BEDROOMS x 10 OPP=330 GPD SE``'T 6 TAN\:330 GPI? x200%=(oh0 OPP US[::EX6TINO h00 GALLON PRECAST 6EPT6 TANK LD'hl I NG FAO(L IT"Y: USE : (2)5,20 GALLON PRECAST DRYWELLS LINED WITH k' OF DOUBLE WASHED STONE AP f O SIIPEWALL: 7G x 2 x 0.7-4 = 112.5 O N RAL NOTE�3 BOTTOM: 13' x 25 x 0.74 = UO.5 LOT 23 TOTAL: 353"O GPD l CONTRACTOR TO BE RESPONSIBLE FOR THE LOOAT ONOF ALL UTILITIES, ABOVE AND UNDERGROUND,PR OR TO ANY EX(AVAT ON OR WON STRUOT ON. I59�3 2. SEPTr,SYSTEM TO BE INSTALLED IN WOMPLIANOE WITH 3r OMR 15,00.TITLE V + 3. THr3 PLAN F,NOT TO BE USED FOR PROPERTY LINT^DETE2MINATION it ALL DIGTURf.ED AREAS TO BE LO&\�=D AND�3EEDED �I 1 ij 40 5. CONTRACTOR TO PROVIDE 2.4 HOUR NOT6E FOR ANY REgUIRED INSPECTbN5 Ij /o. EXISTING LEACH PIT TO BE PUMPED DRY AND REMOUI=P, A.-ONO WITH ANY !I CONTAMINATED SOILS, AND REPLA.WEP WITH CLEAN SA'c I.-'. IP �S EXr:5TINO LEACH Pr" TO>,E PLUPEP DRY AND REMOVED �.� 41.0 \ `\ Ex67INC7 \ \ \ SEPTr,TANK EXG7IN6TREE—_/ \ TO tyE RELOCATED ` 1 T VVAOE PLAN LOCATION: ZO RO5EMARY LN., OENTERVILLE, MA PREPARED 1=0R: I OM & L I NPA 5 WEET �i SCALE: DRAWN BY: i OF �1 / I„ T MW sTEVE �� % `jNoFrr" .: J013 NUMBER: DATE: SHEET: v ��UM A / o DANIEL - PLC 03 (0) 08—i5-2003 5P oOP CIVIL N,, FE�Slo��Q Q. 326 6C � WELLER & A 06- I AT _ SS�oNn 1645 FALMOUTH RP SUITE 46 GENTERVILLE, MA 02-632- o-(5-0,3 TEL.: (505) 775-0735 N FAX: (505) 775-0754 PROFE5510NAL ENGINEERS & LAND SURVEYORS 1