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HomeMy WebLinkAbout0024 SEABURY LANE - Health 24 SEABURY LANE,CENTERVILLE A=208-077 i /// �aEcvaEac J ny^ No 63LOR HASTINGS,tjN (31-7-r COMMON"rEALT14 OF MASSAmusETTS E1.ECU'1'IVE Or-FTCE OF EIMl�ONMENl'-A1..AF..:IkzitS - ..--- DEPARTMENT OF ENVIRONME,v/A.L PROTECTION PARCEL LOT TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: ' e,#.ey4y i. / Owner's Name: h�& r^ A&r,5 Owner's Address: Date of Inspection: Name of Inspector:(please print)� ? Jd - ll Q Company Name: Pt1MW-5 4da6 d ",og Mailing Address: bM Y 9. t-yA,yST .4.:. Telephone Number: o > CERTIFICATION STATEMENT L I certify that I.have personally inspected the sewage disposal system at this address and that the inform tion repo&d below is true,accurate and complete as of the time of the inspection.The inspection was performed b d on my-, I training and experience in the proper function and.maintenance of on site sewage disposal systems.1 a a DEIi� rn approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The Passes Conditionally Conditionally Passes Needs Further Evaluation by the Local.Approving Authority Fails Inspector's Signature: _ _ Date: S `f The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DE]')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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system wit]perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Pagc 2 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM"INSPECTION FORM: . PART A CERTIFICATION(continued) Property Address: t y w 441 A- Owner• c Dare of Inspection: Inspection Summary: Check A,%C,D or E t 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements.if"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or cxftl,tration 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. VI D explain: Observation of sewage backup or break out or Nigh static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced. ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval,of the Board of Health): broken pipc(s)arc replaced obstruction is removed ND explain: Title 5 Inspection Form 611 5/2000 2 • Page 3 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 5 C."Oey / CZA)s-e.n v. t t+e Ym 4 Owner. Sig r.tl e r- t r1+!&JX Date of Inspection: C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board ofHealth 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 1.5,303(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 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 I.of public water supply. — The system:has a septic tank and SAS and.the SAS is within 50 feel 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 cohlbrm bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered..A copy of the analysis must be attached to this firm. 3. Other: Title 5 Inspection Form 6/15/2000 Page 4 of l 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A. CERTIFICATION(continued) Property Address: 4q ILAJ, _ Owner: Date of Inspection: -/-— D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No —VI—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'/:day flow ✓' Required pumping more than 4 times in the last year DL dine 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 1.00 feet of a surface water supply or tributary to a surface __A'ater 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 1.00 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.[This system passes if the well water analysis, performed.at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal 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.] YO(YcslNo)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)5,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria;cwater e systems in addition to the criteria above) yes no _ the system.is 0. a surface drinking water supply _ the system is eet o tributary to a surface drinking water supply the system is a nitrogen s itive area(Interim Wellhead Protection Area_ IWPA)or a mapped Zane II of a p supply welt I:f 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 31.0 CMR 1.5.304.The system owner should contact the appropriate regional office of the Department. Title 5 Inspection Form 6/15/2000 4 u Page 5 of 11. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY,ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: aq 5fdj:: may L O Owner: 1��"Jfe4 t t- wy Gh Date of Cnspection: Check,if the following have been done.You most 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 r Has the system received normal flows in the previous two week period. ✓B.ave 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?(Ifthey were not available note as NIA) —v""-_ Was the facility or dwelling inspected for signs of sewage back up Was the site inspeeted for signs of break our' 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 ,�b'a"'lflles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum 11 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: Yes ,xw 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(3)(b)) Title 5 Inspection Form 6/15/2000 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: .2� �lfl y� L•.fl l���yi 11 Owner. .Al if +9st✓'t1 _ Date of Inspection: -S-- FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 1.5.203(far example: I I0 gpd x#of bedrooms): Number of current:residents 7 Does residence have a garbage grinder(yes or.no): ALC Is laundry on a separate sewage system(yes or no):AW [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): Last date of occupancy: bKvJ COMMERCIAJI NDUSTRIAL Type of establishment: _ Design flow(based on 31.0 CMR 1 03):�apd Basis of design fla (seats! /sgft,etc.): Grease trap present es ar n _ Industrial waste holds g present(yes or no): Non-sanitary waste dis arged to the Tittle 5 system(yes or no): Water meter readin ,if vaiiable: Last date of occ ancy/use., OTHER(describe): GENERAL INFORMATION Pumpiol Records Source of information:. OtO0,0V Was system pumped as part of the.inspection(yes or no):.�j 0 If yes,volume pumped: gallons--How was quantity pumped.determined? Reason for pumping: TYP F 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/A.lternative technology.Attach a copy of the current operation and maintenance contract(to he obtained from system owner) _Tight tank. ,.,_,_.Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): A—to Title 5 Inspection Dorm 6/15/2000 6 v Page 7 of l l OFFICIAL INSPECTION FORM:—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: -t k( S,e.,4-R_Q RI Owner: A +-L/ .+c/}t G h 4r5 e Date of.Inspection: ^'/`7-0 y BUILDING SEWER.(locate on site plan) �t Depth below grade: Materials of construction:_cast iron t-!'40 PVC iother(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK (locate on site plan) 1 Depth below grade: ►tir /" Material of construction: +/concrete--metal—fiberglass___polyethylene other(explain) If tank is metal list age:_ is age confirmed by a Certificate ofCompliancc(yes or no):_(attach a copy of certificate) Dimensions: (e Q Sludge depth: 2� Distance from top of sludge to bottom of outlet tee or baffle: 3 r ' _ Scum thickness: I "I Distance from top of scum to top of outlet tee or baffle: /0<i Distance from bottom of scum to bottom of outlet tee or baffle: Flow were dimensions determined: 11 r:$vA-'( •/` car- Gc'A'`e 4a 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: Material of construction: concrete,metal_fiberglass---polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scXto � t tee or baffle: Distance from bottom.o of outlet tee or baffle: Date of:last pumping:Comments(on pumpinns,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet in rt.evidence of leakage,etc.): Title 5 Inspection[corm 6/1.5/2000 7 r Page 8 of I.1 OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM.INFORMATION(continued) Property Address: 12( LN Owner: Date of inspection: 7 TIGHT or HOLDING TAN)L (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: 1. c<t3 gallons Design Flow: !4VP galionslday Alarm present(yes or no): Alarm level; Alarm in working order(yes or no): Date of last pumping: !wA y4A,64F— Comments(condition of alarm.and float switches,etc.): DISTRIBUTION BOX:y" (if present must be opened)(locatc on site putt) Depth of liquid level alcove outlet invert: 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.): L d O Gam' 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.): Title 5 Inspection Form 6/15/2000 8 Page 9of11 OFFICIAL INSPECTION FORM-NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:c2- e.4�euZx CA/ '--gd 7- �wi/lf1r 11-V-4 Owner: Date of Inspection: r5"/-7—� Y SOIL ABSORPTION SYSTEM.(SAS):-, ate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: , R 5 .t "' s "c• ]caching fields,number,dimensions: Zt2 :Zj/-klrX#-/rX5 overflow cesspool,number. . innovativelaltemative system Type/name of technology- Comments omments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.).- CESSPOOLS: (cesspool must be pumped as part of inspeetion)(locate on site plan) Number and configuration: Depth -top of liquid to' let invert:_ Depth of solids layer Depth of scum layer Dimensions of cesspool: Materials of constru ' Indication of groundwater ir►flow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (Locate on site plan) Materials of construction: N n Dimensions: Depth of solids: Comments(note conditi of il,signs of hydraulic failure,level of ponding,condition.of vegetation,etc.): Title 5 Inspection Form 6/1 SI2000 9 Page 10 of 11 OFFICIAL INSPECTION FOEM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address• � •e Owner: Date of Insp m. SX E TCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least,two pmnanent reference landmarks or bencbmark&Locate all wells witbin 100 feet locate where public water supply enters the building. , o LZ i r S I page I of I l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART C SYSTEM INFORMATION(continued) Property Address: ,�r�clRy 1,0 Owner..Sh e&—,e X Date of Inspection: SITE EXAM: Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: served 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: Title 5 Inspection Form 6/15/2000 i l TOWN OF BARNSTABLE LOCATION ,L�.���4' /� SEWAGE # VII.LAGE ASSESSOR'S MAP & LOT IQ$ • d 7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY. ' G LEACHING FACILITY: (type) 1tf ilZ '.� (size).17 _Q0 X�1 NO. OF BEDROOMS ._— BUILDER OR OWNER PERMITDATE: T-.) I - 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 within 300 feet of leaching facility) Feet Furnished by r u i LrjC'IL } TOWN OF BARNSTABLE LOCATION i SEWAGE # VII.LAGE ASSESSOR'S MAP & LOT 10$ 7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1 LEACHING FACEL TY: (type) f c,( TwO (size) 9b)6_218 NO.OF BEDROOM BUILDER OR OWNER �Cf"i�' 1� 1y1 PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet i. Private Water Supply Welland Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by �' La IL i No. iVJ U �Vo Fee i-HE COMMONWEALTH OF MASSACHUSETTS Entered in computer: f PUBLIC HEALTH DIVISION - TOWN OF BAR NST"' LE;'MASSACHUSETTS es 0(pprtcation for Zt!6poeal *pgtem Construction 3permit Application for a Permit to Construct( )Repair( )Upgrade( _ Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2 /[-�� Owner's Name,Addres and Tel.No. sctl�- cellfw Assessor's Map/Parcel hfa e/l Se �� ��st9�✓ Installer's Name,Address,and Tel.No. !JlVIW �C? Designer's Name,A dress and Tel.No. L!2 o c(A. MlXsra VS In.;a ►'t,z OJT to - nx,�2 cam, 9-5q r'?Qcri atq r=,Q q5V/ Type of Building: q1 0�4 Dwelling No.of Bedrooms Lot Size 14 7� sq.ft. Garbage Grinder( ) Other Type of Building FIT�t/R— No.of Persons Showers Cafeteria( ) Other Fixtures Design Flow 4(31�,4 llf�/� 0 gallons per day. Calculated daily flow gallons. Plan Date ✓ t" 17#1 I9'K Number of sheets Revision Date Title Size of Septic Tank 1500 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 4m& re,,V �Rs �c� y anci 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 nviro ental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue y th4 ar of 9 Signe Date 1 Application Approved by Date Application Disapproved for the following reasons Permit No. _113061 Date Issued THE COMM N) f4k COMMONWEALTH OF MASVS CHUSETTS Entered in computer: b�r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLt";�IAASSACHUSETTS 01pplication for Digaal 6pgtem' Co'nztruction Permit Application for a Permit to Construct( )Repair(` )Upgrade( bandon( ) O Complete System ❑Individual Components , Location Address or Lot No. � � /LQ } Owner's Name,Addres d Tel.No. J( UY✓lll� � C e�-lr �, I CR , oZ.�3Z 11Cc r� ��y,Jr: Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,A dress and Tel.No. a o lA&TOP CIA. MWS rocs l�r'rt_ ga(G - ca/ �rzj c�c ,r we q�n��s'f8 939 rncc,', rnr� �5 / Type of Building: Q';� Dwelling No.of Bedrooms� �£! Lot Size //a 7W sq. ft. Garbage Grinder( ) Other Type of Building (hk,�YQ No.of Persons L7 Showers(2•) Cafeteria( ) Other Fixtures Design Flow 9 gallons per day. Calculated daily flow '7" gallons. Plan Date fTI..C./ Number of sheets Revision-Date Title Size of Septic Tank /5UU &t9C- .U-7� ) Type of S.A.S. Description of Soil rt 7 Nature ofiepairs or Alterations(Answer when applicable) v # Q 1 4 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 t nviron ntal Code and not to place the system in operation until,a Certifi- cate of Compliance has been issue y thik, ar of - Signe Date Application Approved by _ °. Date Application Disapproved for the following reasons r _ 7 Permit No. !2 Date Issued J 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 at has been constructed i accordance with the provisions of Title 5 and the for Disposal System Construction Permit N. �1 -:f-y-,5T dated 2.. Installer .4 Designer _ArAl O_/c The issuance of this permits all n t be construed a a guarantee that the system will function as designed. Date - a .. Inspector r C --------------------------------------- No. 6 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 33i5po5ar *p5tem Construction Permit Permission is hereby granted to Coustruct�( )Repair( )Upgrade( andon( ) System located at 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 must be completed within three years of the date of this permit. Date: Approved by v a TROY WILLIAMS _ SEPTIC INSPECTIONS Certified by MA Department of Environmental Protection (508) 385-1300 19 Hummel Drive South Dennis,MA 02660 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION COPY ONE WINTER"STREET. BOSTON, MA 02108 617-292.5500 WILLIAM F.WELD TRUDY CORE Govcmor Secretan ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Govcmor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissionct PART A CERTIFICATION Property Address: y S�``S r 7 Ce , �'ff Address of Owner: A.) is e leyES+- � Date of Inspection: (If different) Name of Inspector: Troy W i 1 1 i a m S I am a DEP approved s ter inspector pursuant to Section 15.340 of Title 5 (310 CMR 1S.000) / S Cam.. i, C✓a k Company Name: Troy Wirl iams Septic Inspections MailingAddress: 5 , `� ,, AA- Telephone �9 Himmel DrivPa South Dennis ,D MA 02660 'off< < y Telephone Number: _(F�^3 8 5-13 0 0 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 performed 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 Approvirig Authority _ Fails Inspector's Signature: J /t.—,,, G✓,� Date: 0Q oZ The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 repon 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, 8, C, or D: A] SYSTEM PASSES: I 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: BI SYSTEM CONDITIONALLY PASSES: A///� One or more system components as described in the'Conditional Pass' section need to be replaced or repaired. The system,upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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. - t revi.ad 0�/Js/f7) page I of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 24 Seabury Lane,Centerville,MA Owner: Estate of Stanley Buckler Date of Inspection: February 12, 1998 B) SYSTEM CONDITIONALLY PASSES (continued) 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, IX 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 50 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) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: 24 Seabury Lane, Centerville,MA Date of Inspection: Estate of Stanley Buckler February 12, 1998 DJ SYSTEM FAILS: 11)1,q You must indicate ei;,.er "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 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 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. 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. 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. El 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 treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (rwim*d 04/25/97) page 3 or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST 24 Seabury Lane, Centerville,MA Property Address: Estate of Stanley Buckler Owner: February 12, 1998 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 Pumping information was provided by the owner, occupant, or Board of Health. ��PO 4A C_ ) .A/— 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. _ Nit As built plans have been obtained and examined. Note if they are.not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components,,excluding the Soil Absorption System, have been located on the site. IV /9 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)) (zwis.d 04/25/97) Paq• 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 24 Seabury Lane, Centerville,MA Owner: Estate of Stanley Buckler Date of Inspection: February 12, 1998 RESIDENTIAL: FLOW.CONDITIONS Design flow:o22 0 e.p.d./bedroom for S.A.S. Number of bedrooms: 02 Number of current residents: d Garbage grinder (yes or no): /Vo Laundry connected to system (yes or no): Seasonal use (yes or no): A/o Water meter readings, if available (last two (2) year usage (gpd): Sump Pump (yes or no): A/u Last date of occupancy: 17 Q_c 9(7 COMMERCIAUINDUSTRIAL: Type of establishment: Design flow:_ izallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no) Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING^/RECORDS and source of information: T L 0. l o- L / ti �� s 7u S �4 l✓ /J�a 4-, System'pumped as part of inspection: (yes or no) ,Vcl If yes, volume pumped: gallons 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) 1/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: r, 5 ', 4 / 4, �, t I4 c�.rjo ,r ()v<,�/o c �ssr-,e/ whs ,4 s4 //mod 2c / �j6G S Sewage odors detected when arriving at the site: (yes or no)-/—Vu (revim•d 04/25/97) Page S or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 24 Seabury Lane, Centerville,MA Owner: Estate of Stanley Buckler Date of Inspection: February 12, 1998 BUILDING SEWER: (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC_other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: YI/9 (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: Comments: (recommendation foe pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) GREASE TRAP: /V/4 (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.) (rwiud 04/25/97) Page 6 0! 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 24 Seabury Lane,Centerville,MA Owner: Estate of Stanley Buckler Date of Inspection:February 12, 1998 TIGHT OR HOLDING TANK: /047(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/day 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: IV14 (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of.leakage into or out of box, etc.) PUMP CHAMBER:,�V/l (locate on site plan) Pumps in working order: (Yes or No) Alamu in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) ., Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: 24 Seabury Lane,Centerville,MA Date of Inspection: Estate of Stanley Buckler February 12, 1998 SOIL ABSORPTION SYSTEM (SAS): (locate on si te to 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, si ns of hydraulic failure, level of ponding, condition of vegetation, etc.) _K .S >a vh CESSPOOLS: (locate on site plan) Number and configuration:_ Qh t rat c-ys -C d f Depth-top of liquid to inlet invert: 4/- 5' Depth of solids layer: _Z Depth of scum layer: /oti/E Dimensions of cesspool: Materials of construction:_ Indication of groundwater: nla /F inflow (cesspool must be pumped as part of inspection) y �' O e-1 Comments: (note- condition of soil, signs of hydraulic failur�Iclof pondi , condition of�vegetat�ionetc,) li w S s o7C ✓ u ✓ �• ` 6 � /lnS� Lc z ✓1 . 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.) (ravimad 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 24 Seabury Lane, Centerville,MA Owner: Estate of Stanley Buckler Date of Inspection: February 12, 1998 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) L T a o�A,V"f ; . Lc-s sp"b (revised 04/25/97) a Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 24 Seabury Lane, Centerville,MA Owner: Estate of Stanley Buckler Date of Inspection: February 12, 1998 Depth to Groundwater — Feet adjusted high groundwater level Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check 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) i �.J h /_ c> C�Fig 4 of I �j 5/�z>✓ . c� w c. �cd ) i (revised 04/25/17) _ Page .10 of 10 4� PAR L � 5 PARTRIDGE �A WAY 7�IDG'� Y Cus a 8 - 2 3 25 ' N8 3.9 � , 4 O0 �,o ° ASSESSORS o r j '7 k MAP 208- 77 11 O ti EKED.US MAP 18662/31 PROPOSED ~ PLAN REF122/97, 236/75 & 195/1 GARAGE/STUDIO` SETBACKS. 20-10-10 i // EXISTING SHED FLOOD ZONE. "C" r ` ` p TO BE REMO vED FLOOD PANAL.• 250001-0008-D oR�°, DA TED. 712192 ' LOT 1 PLOT PLAN OF LAND 0 ' ASSESSORS LOCATED AT.• CID ; ` i / ° MAP ,208 14 7 24 SEAB UR Y LANE �j ' STOOP CENTER VILLE, MA , 'ti THE SEPTIC SYSTEM PREPARED FOR: t, WAS DRAWN FROM THE J LE TOWN OF BARNSTABLE NANCY SEPTIC INSTALLERS CARD MAY 24, 2006 BULKHEAD. C*J N84 000 ,2 REV 0 IY 1O0 00 , _ REV- REV- ASSESSORS YANKEE LAND SURVEYORS MAP 208- 78 & CONSULTANTS GRAPHIC SCALE LOT 2 =. P.O. BOX 265 �Y\1<.� - �``�� UNIT 1, 40 INDUSTRY ROAD ASSESSORS MARSTONS MILLS, MA 02648 MAP 208- 76 v TEL- 508-428-0055 FAX 508-420-5553 1 inch = 20 ft. SHEET 1 OF .1 JOB ,¢!' 54034 LM ' I II 2ol 4 - 0 OF —oll — -- ►�'—`III q U 115 rl Try w, 8� F 1� , I I i I GF_I. • I _ I i 1 i o "POVYSt2 PLA�4 I I GAPe-,-a _► Glc C� 1�8��a I1, �n I - I � 1 2- � 2 _.�j 2 -O� �- -3 �• -3 �I �I� 21-10 21-� '�}' j�A�U1zY ��� G>✓1.1-T�vll.t�IN(A.o2Co32 SCALE: AS MCrMV APPROVED BY: DRAWN BY MAJ 51_OII j 1�1 _OII G I_, Cjll DATE: 2/I gIO&> REVISED 25�A'o — - ---s�--- 21_��► M1GH �1 -.11M oti1 I A A }a1T>10 + INTF--�tc�t2��► �. P 1.1i' { �� II= I � DRAWING NUMBER 02. � s10 51-OII s 000 -2�-g ��-3j1 �`-� 21_�u I jr/11�1fU� W !L� I Vol ===�1 �N- 1t45 , N , n �,ti A 1 2Nb �l.Dol2�Npit� �ry1;12 R Y�"=11- o" 01 j W 3 UQ. — — -- -- �� tf) .] mi 1 i � I I r ► 2►t �' /�t� I u 2A ��,Nourey �N� G�Nr�V1►�.�, � ®�Ca�2 -9 -`� -3 _ � _� I SCALE: �!7 �� APPROVED BY: DRAWN BY HAJ DATE: 2 21/0�0 REVISED C1 OCO 4 1+ . i li ! M I GH1�>✓1. � �M�t��tJ �!A ��'ilYl✓G'il,UtL>v + 2 - o HaKS)�,5HDr-, 1,.A � G�fyT�;2ti'tl�L 1 lv(A. �a� ?75.42/d i II t / DRAWING NUMBER T- 2—mt2 P1� . �'fu�3lc7 P 1 T.O.F. AT EL. 49.55 SEPTIC- PRO IT TEST HOLE LOGS ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NC" TO SCALE) / 18x5 ACCES:3 COVER (WATERTIGHT) TO ENGINEER:_ ARNE OJALA 18x2 MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE GLEN E. HARRINGTON PON 2% SLOPE REQUIRED OVER SYSTEM 49.5 WITNESS: (EXIST.) RUt'. PIPE LEVEL 2" DOUBLE WASHED PEASTONE DATE: 5�7/98 C NTE VI 47.47 FOR FIRST 2' <2 MIN./INCH INE T PROPOSED 1500 3.0 PERC. RATE = GALLON SEPTIC 46 90 46.63 TOP OF PERC. AT 39" 47.15 TANK (H- 10 ) 1 9145 46.58 ��0 46.41 CLASS SOILS P# 46.21 0 45.63T ( 2 % SLOPE) �6" CRUSHED STONE OR MECHANICAL - I 2 ELEV, SITE COMPACTION. (15.221 [21) ELEV.Q Q DEPTH OF FLOW = 4' ( 1 % SLOPE) ( 1 % SLOPE) 0" 47.3 0" 48.8 TEE SIZES: INLET DEPTH = 10 3/4" TO 1 1/2" DOUBLE.-WASHED STONE A A OUTLET DEPTH = 19" - SANDY LOAM SANDY LOAM 8.3 10 YR 4/3 10 YR 4/3 LEAC;-iING 10" 10" OX FOUNDATION- 15.5 SEPTIC TANK 32 - D' B 19.5' max B B FACIi ITY LOAMY LOAMY SAND SAND 37.3' BEgcH 36„ 44.3 36' 45.3 10 YR 5/4 10 YR 5/4 GRP` 1 39" c1 c1 LOCUS MAP 1 -2083' PERC. M-c M-c 57 SAND SAND 2.5Y6/6 2.5Y6/6 PARTR DGE Area = 11,447 sq.ft± WAY 0.26 Acres± SETBACKS: FRONT = SIDE - ----------------- �--------------- --------- -- ---- REAR = 73.25' (Obc 100 PLAN 122 P 97 REC:7/25/55 , -23 33--____' 10.0 FLOOD ZONE. C h� 1 2048 future 120" NO 37.3 120" NO 38.8 POST / drive I WATER WATER NOTES: ! LIGHT 19 97 r / rn 23 94 ASSUMED FROM HTANNIS QUAD MAP SEPTIC DESIGN: (GARBAGE DISPOSER Is NOT ALLOWED1 . DATUM IS_ 4 110 - 440 2. MUNICIPAL WATER IS AVAILABLE / L �00_ uture garage Ut51GPJ FLuvV: __ BEDROOMS ( GPD) - GPD� USE A 440 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 0 2200 4H-. SEPTIC TANK: 440 GPD (_2 _) = 880 GALLONS . DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO 10 ��` � 23.1 5. PIPE JOINTS TO BE MADE WATERTIGHT. W . USE A 1500_ GALLON SEPTIC TANK 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. C�l r 10.7 10.00 LEACHING: ENVIRONMENTAL CODE TITLE V. % 18" MAPLE TREES 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE w� 36' CROWNS SIDES: ______________ (___) _ ___- GPD USED FOR LOT LINE STAKING. 10.0 0 f cv 19 HOUSEG _^ BOTTOM: 28x22_ ------- (_74) _ _616 GPD 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. r o � >> TF = 4955' TOTAL: 616 _ S.F. 455_ GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED CP USE 12 INFILTRATORS WITH 4 OF STONE BETWEEN FROM BOARD OF HEALTH. CESSPOOL AND 2' AT SIDES; 1' AT SOUTH END; VARIABLE TO NORTH BENCHMARK: `' COVER FOUND -- 10. CESSPOOLS TO BE PUMPED AND FILLED WITH CLEAN SAND OR TOP OF CONCRETE PROPOSED BY PROBE as REMOVED AS NECESSARY. 33.4 �'-, ADDITION 33,10 _ LEGEND BOUND PAVED _- 48 : ELEV 48.53' - DRIVE r, = 100.0 PROPOSED SPOT ELEVATION (ASSUMED) ! SHED CP UPGRADE SI TE AND SEWAGE PLAN JTo BE O 100x0 EXISTING SPOT ELEVATION r ,�/ MOVED CESSPOOL OF 215 1887 covER FOUND 2 4 SEA B UR Y LANE r' 7.81 BY PROBE 4� 100 PROPOSED CONTOUR r-'".- 100,00' - 100 - - EXISTING CONTOUR IN THE TOWN OF: �-� CENTER VILLE, MASS. _47 J EXISTING TREE POLE LANNY - PREPARED FOR: LANNY & SHELLEY CHASE BOARD OF HEALTH 20 0 20 40 60 Feet MA APPROVED DATE SCALE: 1 " = 2O'DATE: AUGUST 17, 1998 off 508-362-4541 fox 508 362-9880 down cape engineering, inc. `�H Of Mrs ot'I� ARNE • CIVIL ENGINEERS ; H. Cw -+ z, Mk LAND SURVEYORS Na�2& �� son 939 main st. yarmouth, ma 02675 s gf�Is JP JOB# 98- > 60 ARNE H. OJALA,�P.E., P.L.S. DATE