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0039 ROSEMARY LANE - Health
39 Rosemary Lane, Centerville 1111 o s . UPC 12543 No.�. 53LOR ��ros1•CONs'�` HASTINGS, MN Town of Barnstable Barnstable . Regulatory Services Department AlFfteficaCitv IARNSfA13M 9 "�: ,�� Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2847 8339 December 20, 2016 Tina Newman 86 Statice Lane Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 39 Rosemary Lane, Hyannis, MA was inspected on 11/30/2016 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching pit or cesspool with high liquid level,<12" below inlet (per Town Code 360-9.1). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF T . E BOARD OF HEALTH Thomas McKean, R.S.; CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\39 Rosemary Lane Centerville.doc . A Town of Barnstable a.xivsrAat.E, + #,�� Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA*02601 Office: 508-8624644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) _ An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground ❑Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation of a driveway due to H-10 components, etc) -%Leachin it or cesspool with high liquid level <12" below inlet(per Town Code g P P g � §360-9.1) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:ISEPTICIDEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts a Title 5 Official Inspection Form ` �� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 39 Rosemary Ln m Property Address Tina Rogers ' Owner Owner's Name ---�- information is required for every Centerville MA 02632 11-30-16 page, City/Town State Zip Code Date of Inspection W 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. A. General Information S141;t M6�3 1., Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 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 16.340 of Title 5 (310 CMR 15.000).The system: ' ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evalua ' by the Local Approving Authority 11-30-16 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-3/13 Title 5 Official Inspection Form,Subsurface Sewage Disposal System•Page 1 of 17 �Q� �S c Commonwealth of Massachusetts ,a Title 5 Official Inspection Form j ' , 1A Subsurface Sewage Disposal System Form Not for Voluntary Assessments QY: 39 Rosemary Ln Property Address ` Tina Rogers Owner - Owner's Name information is required for every Centerville MA 02632 '11-30-16 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: 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 exfltration 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 :below (Explain ) t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 1 } Commonwealth of Massachusetts 1a=1 Title 5 Official Inspection Form wSubsurface Sewage Disposal System Form -Not for Voluntary Assessments 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 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): n . ❑ 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 310 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 1 r Commonwealth of Massachusetts .a=1 Title 5 Official Inspection Form ' ,1. Subsurface Sewage Disposal System Form Not for Voluntary Assessments o% 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 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 ® ❑ 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 1/2 day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 4 Commonwealth of Massachusetts a Title 5 Official Inspection Form f;II Subsurface Sewage Disposal System Form Not for Voluntary Assessments 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or ❑ ® tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public 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.] f ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 1 0,000g pd. ® ❑ 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 r. 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 •a=1 f Title 5 Official Inspection Form J-1 Subsurface Sewage Disposal System Form Not for Voluntary Assessments �! 39 Rosemary Ln l J" Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 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) 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 „ Commonwealth of Massachusetts 1a=1 Title 5 Official Inspection Form r3 lit �11.1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 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 Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d : 9 , ( Y 9 (gP )) Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 2016 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 7 Commonwealth of Massachusetts a=1 Title 5 Official Inspection Form " I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 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: Owner--pumped 2014 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance 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) I ❑ 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 . t Commonwealth of Massachusetts Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ` pI 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1988 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18"feet 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.): Good condition. Septic Tank(locate on site plan): Depth below grade: 12"feet Material of construction: ' ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" t5ins-3/13 Title 5 Official Inspection Form;Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form f A Subsurface Sewage Disposal System Form Not for Voluntary Assessments 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 page. City/Town State Zip code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" • 1" Scum thickness Distance from top of scum to top of outlet tee or baffle 6 11 Distance from bottom of scum to bottom of outlet tee or baffle _ 15" How were dimensions determined? 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.): Tank is in good condition with baffles installed and no sign of leakage. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts a=1 f Title 5 Official Inspection Form �N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 0 4$!„% 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts a=1 f Title 5 official Inspection Form �� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments `,_e;!✓ 39 Rosemary Ln L J' Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 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 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.): Water at working level with stain lines above inlet invert. Pump Chamber(locate on site plan): Pumps in workingorder: ❑ 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: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form �� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: ,. A Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit holding water at 6" below inlet invert with stain lines above inlet invert. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System r Page 13 of 17 r Commonwealth of Massachusetts 1a=1 Title 5 Official Inspection Form WW,I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Jzr✓ 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 page. City/Town 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 :a f Title 5 Official Inspection Form �. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments }!g% 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 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 f - e)3 1,10 rw e r � CIO t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts fz,, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments �a_�{_,✓ 39 Rosemary Ln Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope p ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 6 Official Inspection Form:Subsurface Sewage Disposal System.Page 16 of 17 Commonwealth of Massachusetts :a µ Title 5 Official Inspection Form ' IfE I Subsurface Sewage Disposal System Form Not for Voluntary Assessments 39 Rosemary Ln t J" Property Address Tina Rogers Owner Owner's Name information is required for every Centerville MA 02632 11-30-16 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 ' TOWN OF BARNSTABLE _ �LOCATION �.c SEWAGE# b 'S 3 VILLAG E<JL/ f V 0 /N� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �.�✓,� � r ��iZ,Qc�P'' SEPTIC TANK CAPACITY LEACHING FACILITY:(type), DCA4 a (size) NO.OF BEDROOMS OWNER PERMIT DATE: Z COMPLIANCE DATE: d 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 existw#hin 300 feet of leaching facility) � Feet FURNISHED BY ( 0 1 A-L - No. Ro lk _Y53 Fee :4 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitatlon for Disposal 6pstem Construction permit M Application for a Permit to Construct( ) Repair(Upgrade Abandon( ) ❑Complete System Individual CompoAts t—o Location Address or Lot No. -/q✓'� ,�,,r� Owner's Name,Address,and Tel.No. `%,117 /Aez of a Assessor's Map arcel N3 Installer's e,Address,and Tel.No.�,;'A'& ,� D t � Designer's Name,Address,and Tel.N�o�._�av��/CQv$hsal •, P �2 ��/:4 /IZ�/� p° /� JC�.CO _ 'r'-.S�//� '17� Ly�6� Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) � � gpd Design flow provided � gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank �`� /O00 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �21 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 Certificate of Compliance has been issued by this Board of Health. _I 7 Signe 4�7�__ Cam/ Date % _' A" Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. .^ Fee IOo P THE COMMON;.,'TOWN OF MASSACHUSETTS Entered in computer: L/" PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4plication for MispoSal 6pstetn Construction Permit ti i Application for a Permit to Construct( ) Repair((l�Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No.-3? Owner's Name,Address,and Tel.No.—;'/// /7l Q;/2 Assessor's Map/Parcel Installer's Dame,Address,and Tel.No Designer's Name,Address,and Tel. ,�l�a %5S_G -1r (b 0,'263<� Type of Building: I. Dwelling No.of Bedrooms 3 Lot Size S�jG sq.ft. Garbage Grinder( ) { r Other Type of Building e 15 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 37361-1 gpd Design flow provided � d gpd Plan Date Number of sheets ;t. Revision Date Title �l Size of Septic Tank /D6`0 Type of S.A.S. w Description of Soil Nature of Repairs or Alterations(Answer when applicable) /J�l� 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 Certificate of _Compliance has been issued by this Board of Health. Signe Date h" Application Approved by Date Application Disapproved by u Date for the following reasons Permit No. � (!� Date Issued / - - - - - ---- - - ----------------------------------------- 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 -g _ /D p" at v ) has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No dated Installer Designer #bedrooms Approved desi flow gpd The issuance of th' pe it shall not be construed as a guarantee that the system wi 1 cti n as designed. Date 1 Inspector ----------------/------------------------------------------------------------------------------------------------------------------------ No. SJ�t� �I- 3 Fee r!JG THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Vermit Permission is hereby granted to Const u (( ) Repair( ) Upgrade. ) Abandon( ) System located at V`- , `o and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be comp 6ted within three years of the date of this pe it. Date � �`Iph Approved by r Town of Barnstable Regulatory Services ti Richard V. Scali, Director ` BARNSTABLE,MASS. Public Health Division qj •i639 �0 ArE1639 Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 LL(( Fax: 508-790-6304 Date: Sewage Permit# ssessor's Map/Parcel I1I-7 7-4 Installer & Designer Certification Form Designer: �)OLv1i D. (60 Yqqwf Installer: 2 Address: lS5 Ge-fTO- R-/dCr kA S61v+ti Address: C W-h4m O U 3 S' /�,>��11 ���ly���as issued a permit to install a On ate (installer) septic system at F-C'se mcil'y Lqne— based on a design drawn by (address) C�06V40wv dated (designer) certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank.. Stripout (if required) was inspected and the soils were found satisfactory. r I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils, were found satisfactory. __I,--T—certify that the system referenced above was constructed i c':: e with the terms of the I/A approval letters (i`pplicable). moo`' DAVID yGN � D. t,oz, 0 A2 0��4', �� COUGHANOWR N (Installer's Signature No. 1093 C/STE��O SgN1TAR\ (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice formsWes ignercert ifi cation form.doc LEGEND � nF 0 T SEPTIC COMPONENTS D UV 0 © .� M � 2 c ,�a T-E�a Vv W=NJ EXISTING LS 1 GAL I SEPTIC TANK FAI EXISTING ANIF LEACH PIT/CESSPOOL "A Q � �-� DISTRIBUTION BOX❑o n pOSEEM TEST PIT 6.00 ft EDGE OF PAY,EMENT 51 94.00 ft 50 a 12 in / OAK rn v o G Tcn ���IM1 ®® 0 DOOR �Uv� GARA�� GARB R 0 SLAB oN 01 F o ` ATE 1 OWED l� � l�D57 16 in � THIS IS A PINE - / O COLOR O PLAN USE COLOR PLAN ONLY FOR INSTALLATION 20 in FULL DETAIL IS BEST PINE 50 VIEWED IN FULL COLOR 1 24 in / PROPOSED SOIL ® 0 PINE 18 in PINE ABSORPTION 2 49 SYSTEM -SEE DETAIL ON BACK 24 in ® PINE / - 1 L 0 T 4 1 U T#L 0 T§CAS 5o1 8 in AREA = 15000 Sf+- / 1 PINE LAND COURT PLAN 41445—A WATER LINE 48 WATER GATE 0 ASSR MAP 147 PCL 7-4 GAS LINE —G G /tYP) ELECTRIC AND EXIS DUF MINGRADING / TELECOM LINES CONT PROPOSED 49 _ 48 100 00 ft pL A N OQ eP�NSjP%E GIS D% SCALE: I in = 20 ft ELEVATION I 0 20 40 T 52. 83 o 10 20 Op OF FOUNDP�\0 THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM DEPICTED ON IT. FOR ANY OTHER CHANGES TO THE PROPERTY INCLUDING PRINT ON 8—1/2 x 14 in SHOUPLACEMLD CONSULTENT OF WITH A MASSACHUSETTSS. SHEDS. FENCES OREG SI ERED LAND OSURVEEYORR PAPER FOR PROPER SCALE NOT _ N Mgss �tN Of SEWAGE DISPOSAL SCAOLE � )AVID 9`yGs o�P DAVID S9�yGJ �y SYSTEM PLAN D. D. -TO SERVE EXISTING DWELLING COUGHANOWR H COUGHANOWR N 005��P �O�oP���C No. 1093 No. 461 - ( T I N A M. NEWMAN -lOPR �� OWNER(S) OF RECORD 39 ROSEMARY LANE oJ��P Iss Gea Ryder Rd s CENTERVILLE, MA y PROPERTY ADDRESS CENTERVILLE. MA Chatham, MA 02633 -FOR SURVEYOR'S CERTIFICATION REFER TO 'CERTIFIED PLOT PLAN' DOVIdCOU@HotmalLCom DATE DECEMBER 14. 2016 DATED ZBI TT Y JOHN WEE RLS VENT L O ` U S M A P ON FILE WITH THE BARNSABLEBUILDNG DEPART —4122 A BCDE9P / UOL TEST LOGDATE: DECEMBER 13. 2016 PERC# 15231 � SOIL EVALUATOR: DAVID D. COUGHANOWR, ASE #461 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD WITNESSED BY: DAVID STANTON. HEALTH DEPT. SEP.TIE TANK: 330 GPD X 2 DAYS = 660 GALLONS TEST PIT 1 NO GROUNDWATER ENCOUNTERED USE EXISTING 1000 GALLON SEPTIC TANK IF IN PERC AT 62 in - 2 MIN/INCH IN C SOILS SOUND STRUCTURAL CONDITION. IF NOT. INSTALL ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER NEW 1500 GALLON SEPTIC TANK. INCHES HORIZON TEXTURE (MUNSELL) MOTTLES 50.50 0-6 Ap LOAMY SAND 10 YR 3/3 NONE FRIABLE DISTRIBUTION BOX: INSTALL UNIT DEPICTED BELOW. 47 67 6-34 Bw LOAMY SAND 10 YR 4/6 NONE FRIABLE SOIL ABSORBTION SYSTEM: 34-138 C MEDIUM SAND 10 YR 5/6 NONE LOOSE THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE 39.00 SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES TEST PIT 2 NO GROUNDWATER ENCOUNTERED PER INCH = 0.74 GALLONS PER DAY PER SQUARE FOOT. 2 MIN/INCH IN C SOILS THE 24 ft x 12.5 ft x 2 ft LEACHING GALLERY ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER DEPICTED BELOW CAN LEACH: INCHES HORIZON TEXTURE (MUNSELL) MOTTLES 50.65 0-8 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE BOTTOM AREA = (24 x 12.5) = 300 sq. ft. 8-36 Bw LOAMY SAND 10 YR 4I6 NONE FRIABLE SIDEWALL AREA = (24+24+12.5+12.5)x2 =146 so. ft. 47.65 TOTAL AREA = 446 s ft. 36-138 C MEDIUM SAND 10 YR 5l4 NONE LOOSE q• 39.15 FLOW CAPACITY = 0.74 x 446 = 330.04 gal/day 9 y INSTALL A 24 ft x 12.5 ft x 2 ft GALLERY AS CONFIGURED I i BELOW. FLOW CAPACITY = 330.04 gal/day WHICH EXCEEDS 1 GALLON SEF�'T 1 C TANK THE 330 gal/day REQUIRED FOR A THREE BEDROBE PUMPED DRY AT TIME OF OM DESIGN. s � � SOIL A = SOf'? PT101�1 ANDKEXAMINED FOR STRUCTURALN EGRITY.A NSTA�N S Y S T E ll/1 NEW PVC OUTLET TEE EQUIPPED WITH A GAS BAFFLE. ®. • . REPLACE WITH A NEW , 1 in 1500. GALLON TANK DUNWELL 24.0 ft TAPER IF CRACKED, ROTTED r IT co OR OTHERWISE m y -' COMPROMISED. m� „ w 0 ® ® Ln 0 ° NOT N I r, c TO -- _ - LQ r� SCALE STONE 3.5 ft 8.5 ft 8.5 ft 3.5 ft 0 8 Ft-6 jl n A f� - N - i - _ 500 GALLO DRYWELL INLET OUTLET DIMENSIONS & DETAIL INSTALL ONE INSPECTION COVER COVER RISER TO WITHIN THREE USE INCHES OF FINAL GRADE & INDICATE LOCATION f110 DROP H-10 ON AS-BUILT --► FLOW LINE UNIT FROM = BUILDI - i� DBOX 33 8 inQUID GASEVEL BAFFLE 102 in b in STONE BASE /F NEW CROSS SECTION VIEW SEPARATION BETWEEN INLET & OUTLET INSTALL AN APPROVED GEOTEXTILE TEES NO LESS THAN LIQUID DEPTH FABRIC OVER STONE CROSS SECTION VIEW 24 USE ES /•• 28 - EFFEC V -1/2�n GRAVEL,DSTR - UTION Box • 12 in DPTHA • A :• • RUN in E AND DETAIL •• BEFORE DOWN— _ 46 in 58 in 46 in ` 150 in 12 in - - MIN H -INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE —� STARTING WORK. —> Lo FROM < < -ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC n1 TANK Lq LO TO O CODE (310 CMR 15). O oz ^ SAS -INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. -ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION \� b in STONE BASE E OF LOW FLOW FIXTURES & APPLIANCES. AND PERIODIC 21 ;n 2� CROSS SECTION VIEW PUMPING OF THE SEPTIC TANK. -SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. F L 0W p R Oo F LAi � TOP OF FOUNDATION RAISE COVERS TO WITHIN ALL PIPE T() BE SCH. 40 PVC EL = 52.83 +- 6 in OF FINAL GRADE AND TO PITCH AT 1/8 in/ft MIN 50.50 - D—BO 3' — USE H-20 MAX EXIST �� TEE 47.75 EXISTING 1000 GALLON ° 0000b PRECAST a$P01a° DRYWELL oo61 00 SEP= TAT 48.83 47.13 °oo 00 ° o EXISTING REFER TO DETAIL BOX 6 In SOL Q° BSSORPT N + 47.30 STONE w 47.00 _ BASE SYSTEM REFER TO EXISTING e in STONE easE IF NEW q ft 5-12 ft DETAIL BOX 45.00 Lo NO GROUNDWATER BELOW MOTTLING OBSERVED _ 39.00 SEWAGE DISPOSAL SYSTEM PLAN11139 ROSEMARY LANE CENTERVILLE, MA DECEMBER 13, 2015 I ETE-4122 PG 2/2 k Town of Barnstable Barnstable Regulatory Services Department I j BARNS OU& I MASS .1639 Public Health Division i639 ,0$` m Fb " 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 1 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2847 8339 December 20, 2016 I�1 L Tina Newman 86 Statice Lane Hyannis, MA 02601 ' ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located ato39'Rosemary_Lane,.Hy uis MA was inspected on 11/30/2016 by Shawn Mcelroy, certified Title V Sep —c Spector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching pit or cesspool with high liquid level, <12" below inlet(per Town Code 360-9.1). You are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF T E BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\39 Rosemary Lane Centerville.doc Is Town of•Barnstable P# SZ3 I ''�"►'� Department of Regulatory Services Public Health Division Date MA82 i639 200 Main Street,Hyannis MA 02601 • rEa n+xt� n Date Scheduled ( Time I ' ✓"'. Fee Pd._f Ja 1 V 7S�oil Suitability Assessment for Sew e ,Di posal Performed-By: Q I y'0 �r711 h G�Jd WY % `Tb►Wltnessod By: +/�1 IIV. j LOCATION&.GENERAL INFORMATION Locallon Address Owner's Name - 'i p w vy h 3� *Ros ' rlWPr L� ; h'� CeP14,P'vl Q � Address 5 tl �2�5e vw4t r Lh. Assessor's 1`Ma /Parcel: (,�_' - CZ°w y "l`Y! 1P P -t Engineer's Name . I7°i�ivl Cc..s;hcin•Cwr NEW CONSTRUCTION REPAIR Telephone# 1�-p Land Use �S iGt2h/1 t qI Slopes(96) D Surface Stones h� Distances from: Open Water Body 0+ ft Possible Wet Area 0.0 f ft Drinking Water Well �W+ ft Dralhage Way �N t ft Property Line Q f ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pare tests,locate wetlands-in proximity to holes) • �0 5 2v�nq�.� �.q h� 00 ff GbD 100,00 Ft ' Parent material(geologic) ��� laGa D�fi W�S i1 Depth to Bedrock Depth to Groundwater. Standing Water In Hole:_ h H L� Weeping Pram Pit Fnoa V1 0 X e Estimated Seasonal High Groundwater more- .t-h 9 h 1 h �t o m 5 0 v fci ce DETERMINATION FOR SEASONALUIGH WATER TABLE Method Used: M0 t:' (1 A% h8ne q{ (3$Depth Observed standing in obs.hole: In, Depth to soil mottles: Ia.' Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Welt-# Reading Date: Index Wall level Adj faster, Adj.Groundwater-Level PERCOLATION TEST Date 13116 nme It Observation Hole# / Time at 9" l/q Depth of Pero Time at 6" Start Pro-soak Time @ to.. 10 Timo(9"41) in End Pre-soak I O 2 Rate Min./Inch 2m P 1 Site Sultabillty Assessment: Sitd'Passed V Site Failed: Additional Testing Needed(YIN) original: Public Health Division Observation Hole Data To Be Completed on Back--- ***If percolation testis to be conducted within 100' of wetland,you must first notify the Barnstable Consefvation Division at least one(1) week prior to beginning. Q:\SEPTIGIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soli Horizon Soil Texture Sdil Color Soil. Other Surface(In.) (USDA) (Munsell) Mottling (Stnucture,Stoned;Boulders. Consistency,%'Oravol) `- 0 -6 Lea toy? 313 t�owp- �riablP 6 -34 w Lo4m SAY( to"�2 4-16 �)oW'� " hl0 34'-G8 C Mcxt�vw► 5 �� oea osp , DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sol]Color Soil Other t Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, A Loam S��c LO ` R 3/z o�j Rl• 13L�? '3 -36 w Loco 4- A NONE- FfZI A'T3LL - 139 G M 10 cZ 5 Now LODse •- DEEP OBSERVATION HOLE LOG Bole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.. Consistency. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(In.) (USDA) (Munsell) Mottling (Structure,S;olles;Boulders. . o . � I Flood Insurance Rate Map: / Above 500 year Mood boundary No— Yes Within 500 year boundary No V, Yes Within 100 year flood boundary No.,•;_ Yes,,. .._ depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the area proposedfor the soil aosoiption'syatem? L'e S If not,what is the depth of naturally occurring pervious material? — Certi._flcatlon I p q I certify that on NQJ _l.6 I S (date)I have,passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,a ertise n experience describeedd/in 10 CNM 15.017. Signature Date DPC t3 , 2-0 1 G Q;13BPTIDPBRCPORM.DOC T UUht ARNST Lt /►'1R>• L h SEWAGE :ASSESSOnIS 1V1AP Si;L Gx II�STrt. tt'S NAIdI��.1'�EQNE ISO CT- NK CAPAC r J oo LF.l�C�ritG 1�1�C11t,1TX: (typa) �� i rso O BSOROOMS -� Rl1dITI3A►`S �GP/di'°1tIRaI�1( IRATE'.,,._., 5epatanttistflataastvreen too' Maximum�l)u�tec►Grpuratlwatet Table to ti�g}3attorrt of Leaching Fruticy .--- f'�'', Ive Wets Supply Udallticl leci6unga6rtaty . exty�ial9s exSs a i eltcs ae`'wlthw-200€eet'of 166CWr4g Fqc l►ty� . F�.ctgTact c cy� Jeti ►d and leaching 1F�cl�Ity(lk try wetlands exist vitf�iii 3Q0 f6 Furelsh4d tay; �..� L' U ` �3 , ,ca - 33 ° 4 TOWN OF BARNSTABLE LOCATI tt SEWAGE 'ASSESSOR'S MAP Cz LOT�� INSTALLER'S NAME Ct PHONE NO. f r SEPTIC TANK CAPACITY. e1 LEACHING FACILITY:(type) l c s /r (size) _ ; �. NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER_ ®BUILDER OR OWNER Vf DATE P` RMI'T ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No f fQ40 q l �Y No....CIS.... 5��2 FEs.....2-1............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....fi-- ------- - -----•----......OF............ ..:, ...... ...p....-------•--....... Appliratiun for Uiipu i al Works Tonutrurtiou Famit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at 2 ... r-e� L EP-/�"'�''....... ----•-•---.. ...-•--•-....•-----•......................•-^----.. ._.. ot No Owner ,p f Address ' Installer Address d Type of Building Size Lot-__ _Cl.'�.Sq. feet U Dwelling—No. of Bedrooms-_.---`-*�% -------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------•--•---•--•---------•---......---••---•••--•-•......---------------------•--------•--•---------•-•-•------------ W Design Flow............................................gallons per person per day. Total daily flow......... -- .0........._.........._gallons. WSeptic Tank—Liquid capacityP11:00._gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area —-V-mil.-_'?sq. ft. Seepage Pit No.------- ---- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank Percolation Test Results Performed b ............ ............................. Date....... .. Test Pit No. �1 /r.__ -.minutes per inch Depth of Test Pit.... ..L. .' . Depth to ground water----______ _ 44 Test Pit No. �minutesper inch Depth of Test Pit.................... Depth to ground water.-.--_------ RS -•---•--•-•--•----------•---•-•••----••---•---••••••--------------••...----------------•---•--------......................................................... O Description of Soil.............•..._._ ✓ f^� ---------------------- (� 'E. - W UNature of Repairs or Alterations—Answer when applicable............................................................................................... --------•-----------------------•---------------------------------------------------------------------•----••------------•--------•---------------------------...---------------------- ............. Agreement: The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with the provisions of' TT4.,W. p 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...................................................................................... ---....................... Date Application Approved By...........�--:f7n3--- ------- . ............................... ....._...y.-./5- Date Application Disapproved for the following reasons---------------•----------------------------------------------------------------•-------------------------...---- .....-••....•--•-•-••.-•-•----------------•----------••-•---•----•----•---------•--•----•-----...........••----••--•--•--•-•......•--------••-------•••-----------•-------------•-•-••-•--•••--------_.. GG Date PermitNo...... .... .................... Issued....................................................... Datc THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............................. Trr#ifirtttr of Toutpliatta THIS IS TP CERTIFY, That the I dividual Sewage Disposal System constructed ( ) or Repaired ( ) by......................... C-0., z <: ..... // // staller 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.._._..__.�_�---_�C_-- Y..... dated---..-___-_.--_--______-_----------------•--. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. `\ DATE..................•--•-••--------...........-•-•--------------•---•-..... Inspector.... 1 . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTpH�,, ......../..f.91(.:...............OF............... tr �"�'�f.............._.. ............ FEE....:.... ........ Disposal Works Tongtrnrtion Vprrmit Permission is hereby granted........... ......44-.r r'....... ........ .. . to Construct ( kX or Repair ( ) an Individual Sewage Dispo al System atNo..........J_nz::._--...... -� 9v c L --------y .- � ---------------••------.......... Street ¢ as shown on the application for Disposal Works Construction P m' No.Z6_Z_ , ted.._.. ---47.................... . � -----..---- • --• • . . -----............. DATE..........�-- ....................... Board ealth FORM 1255 HO BS & WARREN. INC.. PUBLISHERS AsBui-lt Page 1 of 2 39 TOWN OF BARNSTABLE LOCA'1'ldI4 r,' SEWAGE #_�J •.j.s' ' VILLAGE,-V, ASSESSOR'S MAP & LOT INSTALLER'S iQAME r. PliO27E NO., ;G>/r�y `SEPTIC TANK CAPACITY �C[•(; v � �i LEACHING FACILITY:(rype) //'r t i.s /• 7/ (size) ENO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER /V,'C��,�c. S /`�'i�ItN S F� +rn,,_J DATE PERMIT ISSUED: cf -/5 - y DATE COUPLIANCE ISSUED: VARIANCE GRANTED: Yes No +f Sri 1:T �3 ,3 r' http://issgl2/intranet/propdata/prebuilt.aspx?mappar=147007004&seq=1 12/2/2016 V d l.� COMMONWEALTH OF MASSACHUSETTS r r;" EXECUTIVE OFFICE OF ENVIRONMENTAL IRS >) DEPARTMENT OF EIVVIROI�'MENTAL PR CUP 8 ONE WINTER STREET. BOSTON. NIA 02108 611-292..50 rplyyyo 199� yet H�VSt48t f `AJ A DY CORE W'iLLl.4N' F.WELDE y Secretan Govemo: ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner PART A CERTIFICATION Property Address: 39 1fv_se.0"44r_7 1v14,e.� 6'"_Te,-v/J1 jWd'dress of Owner: Date of Inspection: ��s 9 7 (If different) Name of Inspector: 70h" / IX& I am a DEP approved system ins ctqr pursuant to Section 15.340 of Title 5 (310 CMR 15.090) Company Name: zipi", Ag�fr [/(L-e SorLii Mailing Address: 51, /Y�l4rf os "- 013E Telephone Number: ', !�47 X• V2 9-9S-9S- 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 inspection. The inspection was pe-formed based on my training and experience in the proper function and `. maintenance of on-site sewage disposal systems. The system: _, Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fail Inspector's Signature: Date: —S 97 The System Inspectors all submit a copy of this inspection rep)t to the Approving Authority within thirty (30) days of completing tktis 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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A) SYSTEM PASSES: have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: 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. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty(20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97)' Pay 1 of 10 DEP on the World Wide Web: http:Uwww.mapnet.state.me.usldep IL Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r. PART A wn ti CERTIFICATION (continued) Property Address: 5 /Tv31✓N�+v 4ofH-e (f_% Owner: X".5 Az«/� '7/iaS rGHh !��iirra> �/z�f f.r Date of Inspection: B] SYSTEM CONDITIONALLY-PASSES (continued) ,, F - Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but SO feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation.not valid). 3) OTHER (revised 04/25/97) Page 2 of 10 . cti SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 3� /�a j•t h,ury�Grro f �)p��yi� /�,/�v, Owner: Ai.sI' /Qrcil7f'y'Tress> Jai, �Nuv�.00, Tstis-re e Date of Inspection: D) SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 chwed SAS or cesspool. Static liquid level in the distribution boa 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 112 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. 1 Any pon ion 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. EJ LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater trealwent program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART B NCHHECKLIST �c S'r , �cr�,i' C�dr/err//��� /. w, Property Address: .3�' !mac r Owner: )use f,Gul{, ji.sS7 Tau. /y/lrriv�v Tr�+s/p e' Date of Inspection: Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Yes No JZ _ Pumping information was provided by the owner, occupant, or Board of Health. 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. P� _ As built plans have been obtained and examined. Note if they are not available with N/A. i✓ _ The facility or dwelling was inspected for signs of sewage back-up. 611, _ The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. ✓/ _ All system components, ex;4+4ing/the Soil Absorption System, have been located on the site. 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. / The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. _ Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)) (revised 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C p SYSTEM INFORMATION Property Address: o�-�t-��v� �r Owner: ,[�,sj Rea //us�� VIJc*h Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: 3 30 ,;.p.d./bedroom for S.A.S. Number of bedrooms: 3 Number of current residents: Alv-r< Garbage grinder (yes or no):_jv Laundry connected to system (yes or no): � Seasonal use tyes or no): Al c, Water meter readings, if available (last two (2) year usage (gpd): s OC/� /�S��f�U0 J Sump Pump (yes or no):A10 Last date of occupancy: COMMERCIAUINDUSTRIAL: Type of establishment: Design flow: >;allons/day Grease trap present:. (yes or no)_ Industrial Waste Holding Tank present: (ves or no)� Non-sanitary waste discharged to the Title i system: (yes or no)_ Water meter readings, if available' ' r Last,date of occupancy: OTHER: (Describe) VL'asf date of.occupant),: GENERAL INFORMATION PUMPING RECORDS and source of information: Ally, e System pumped as part of inspection: (yes or no)4e.> If yes, volume pumped: — —gallons Reason for pumping C:/�� 5 t• , �v�k 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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: �.do-W iri4i,.y Lcfyr Owner: �GS R14/t' /�_ Date of Inspection: /rHs y-S- 91-7 _. BUILDING SEWER: (Locate on site plan) i Depth below grade:_; Material of construction: _ cast iron 40 PVC L other (explain) Distance from private water supply well or suction hr- Diameter �i. '/ Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction: oncrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: D />-L Sludge depth: it Distance from top of sludge to bottom of outlet tee or baffle: 2� Scum thickness: Distance from top of scum to top of outlet tee orbaffle: .b Distance from bottom of scum to bottom of outlet tee or baffle: 6 How dimensions were determined: rW 11r I AIO Jti-rv"} ;7,.:�5 Comments: (recommendation for pumping, condition of ini t and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) dir, GREASE TRAP: (locate on site plan) 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: (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, etc.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: % /`Lo3rir�--,A��„ih Owner: T/s✓rS/mod Date of Inspection: TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or 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/da� Alarm level. Alarm in working order_ Yes; _ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:f, (locate on site plan) Depth of liquid level above outlet invert: a � Comments: (note if level and distribution is equal, evidences of solids carryover, evidence of leaka a into or ou/t of box, etc.) /, �b S/CY✓Js [+ 7 .!d/�!� t�Y%✓ �i ��U t�.�. -_AP, G`C"'{S PUMP CHAMBER:_ (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.) (revised 04/25/97) Pag• 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: '3'1 A0Sl j�W�`y` ��'N Cyr 1�I�`��Ae.1M,1 Owner: �GS��f'G�/y /��-✓S J`N� �Ci/ >v'D /`HS/e' Date of Inspection: 9-3 SOIL ABSORPTION SYSTEM (SAS): (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, number: leaching chambers, number:__ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydjaulic failure, level of 1 pondin , conditio of vegetation, etc.) /)�G C ,�/ 19 J �/rX Lr 4/ F P4 C 4 �- CESSPOOLS: _ (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 (cesspool must be pumped as part of inspection) 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.) (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: y/ToSc':7�z��� �►.� LPM Ile A&. Owner: 4 •5t oval'] �S'N� Date of Inspection: p, SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 0olFF ,30 (revised 04/25/97) Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: C / rosrAr�,yI �aH� Owner: &Sf Date of Inspection: ltN3 t t Depth to Groundwater 17 Feet Please indicate all the methods used to determine High Groundwater Elevation: ��Obtained from Design Plans on record yObservation of Site (Abutting property, observation hole, basement sump etc.) 1/ Determine it from local conditions heck with local Board of health Check FEMA Maps Check pumping records _Check local excavators, installers ~ Use USGS Data Describe in your own words how you established the High Groundwater Elevation. Must be completed) ��vH �Ci�, TIA•� e /r �'z d7 T ��f. rh : / !i f // ����' -- /;, dU /h/S L.c jl .y ,p2/i/i!1 y+ t:. i %7 /6�ity yvs,/1/. �Ovv cya' J� �- ��w .jc � Iry J r.�`� �Y /v�l.t v► �.! C'a r� l p c:k s �J � �Cj 'c�'-. �S- � hv)ieS�GLV .VHJ I.LYLc Ir°ye? ' �y y , ...►— ��; C c✓! vet L �% (roviaad 04/25/97) Page 10 of 10 ) SECTION - SEWAGE NOTE: BENCH MARK EL.= 42.54 TOP OF C.B. @ S.E. CORNER LOT 1 = 1601; SOUTH OF INTER. OF ROSE- MARY LA. AND NYE RD. -SEPTIC TANK - - "D"BOX - ( O - LEACH --c TOP OF FDN (MSL)* —"2"OF 1/8TO Ur" WASHED STONE 1 R05EArzy A,x -ANC A&, _ _ L _ 60 L IN• M'T IN- OJT- --- -- 1 . IN• i i `I GC• G jc) �2C SEPTIC �}(r .0�. ! TANK �� y ELEV. ELEV. ELEV. I I IA ELEV. fIM� �S•qo 45'73 _9 cz 6 �` ELEV. ELEV. ELEV. OF 3IY"•hh" �•� WASHED STONE LET "� G1' �'� LOT 114 1 'p j,% TEST HOLE LOG P 403 G LP FAIR13^14y, ,P.E. 'toM r--, (tFAN I J' � TEST BY R. ! L_OT 4 _' 'I z/8/65 WITNESS BEDROOM HOUSE TEST DATE DESIGN d T.H. * 1 T.H. ,r 2 frL t 8 \ 15, Q ELEV. ELEV. / NO L ' 1„PAM. L.�gG Ln M .40.5 `2 DISPOSER DISPOSER r - ii, 2g• , '. 24" PERC RATE MIN/IN. .S `E 38.5 FLOW RATE 3;j0(GAL�DAv) 330 ccE Salvo SEPTIC TANKS 50 X 11•54= 49 5 I / 60" S+crY 35 REO'D SEPTIC TANK SIZE 1 000 1 Mir. Sq►�G 78 34:0 _ sec•. LEACH FACILITY — NL Inev. SIDE WALL hu'E, = tb5...�� (2.5 ) _ 4`71.2 G/D. FNe BOTTOM .102, 11 t� _ '7£�•S ( I.o ) 78.5 G/D. -}`�l Salvo �� TOTAL Z�•-j.o S �• = 5 9.`7 G/=' 4� 47 '�'h•35•S ts� 2'1S USE: N F— LEACHING t"�IT N t7 1 C� E_T'r. Tt�t�. . x. t-1>� -? - WATER ENCOUNTERED _ NOTES: (UNLESS OTHERWISE.NOTED) 1.DATUM(MSL)+TAKEN FROM HYA IVAJI S QUADRANGLE MAP OF 2.MUNICIPAL WATER /S -----AVAILABLE. 3.PIPE PITCH:4.••PER FOOT 1(� /O 44 y ; 4.DESIGN LOADING FOR ALL PRECAST UNITS:AASHO.- Z3 p ARNE H.. S.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(2)FT. OJALA =4k S 6WA G,IE 6.PIPE JOINTS SHALL BE MADE WATER TIGHT' p� 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. w CIVIL SITE CLAN u 7 STATE ENVIRONMENTAL CODE TITLES N0.3O 9 Z Locus:. GoT 9 ;Pa r'/_lrdlk5/ LASE OF M(JS\ '� AfA V/L/_� R L ENGINEERI j ARN.E G^ LC? I.J . � { H. REF: t I • q; r.l.•'� e Q down cape ell 80efing ,yo a`, E PREPARED FOR: CIVIL "ENGINEERS LAND SURVEYORS BOARD OF HEALTH �� REG.~ �IA(ZVE' R .. SCALE (EXISTING)- -------- t3ARN5TA�'LE :�- CONTOURS I" 40' (PROPOSED):0-0-0-4- APPROVED DATE MA W;. DATE