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HomeMy WebLinkAbout0042 SKUNKNET ROAD - Health ( 42 SKUNKNE% RD, CCN%6R VILLC'' �A= 192-049 ___ �j�.x_.•iru.:cn�b 1: �.:••�i�11 .: .::,lV4iJRr 'rf'17E7L`!'_",,.84�19All.l�.w °TM r, �, , .,rr.��rcl ^.,."'P�F'��'*ra';i"""rR""ra4�".1 't�,��r,+ Town of Harnetsble F;M a I �`/ �,p�rat et �SenkN • f Pnblla "DfvhUan 1 . . !Od'li1a681wR li!►+�1bt�l o16D1 ' Drez 6ieduted May 6 ,,.�°!° zrw Sog Sadtabilky ASSesSMen t for Stw_ aga DUPOR d �1�che�l Qimenlel. iCS i CSC tHlbrwd�e audd u,, ska,��•, R.S rl V��T • JWlCaA'"ON&dk7NftALDjftM& ON LmftbonAdanom �Z SKv,��tn�F Poac1 owAM►.". 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SWAM No. Fee Y THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: UBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes \ Rpplication for Did oaf *Vztem CowarUCtion Permit Application for a Permit to Construct( ) Repair(✓S Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.. ��K /- ��l/_ Owner's/Name,AI ddress,and Tel.No. Assessor's Map/Parcel 97 _ 4�9 yL Sku n j«,,e9 ��/ �n Hale noL Z(o3 Z Installer's Name,Address,and-Tel.No. fUff q78 Designer's Name,Address and Tel.No. 314 0?3 U 3 77 G'4pwiek 4%.4L,.pn1rf 'C C t,z"rv" . yfv? B S &nn thyq £'�/ 0 Cl713If Type of Building: Dwelling No.of Bedrooms 3 Lot Size l 1-;31 z sq. ft. Garbage Grinder (• ) Other Type of Building 0 Q S No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33 D gpd Design flow provided gpd Plan Date S - 7 - /d Number of sheets Revision Date Title Size of Septic Tank 1 600 4"S6,I Type of S.A.S. �(?11�(fSS �t �(, C/�. 1��¢,,•�.. Description of Soil Set 1 kar. Nature of Repairs or Alterations(Answer when applicable) CX,s°kt't s2 _., y cp(, i_b L2) S jC1,) DCOA (- CC i 4 A--% lL ion f/4�c. �i('tl C Date last inspected: :Zoo, 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 Boar f Health. a Signe 0 to V Application Approved by to Application Disapproved by: Date for the following reasons Permit No. Date Issued' No. / ' { '{ t Fee �' "'P Entered in computer: THE COMMONWEALTH OF MASS�►CHUSETTS r =PyUBLIC HEALTH DIVISIO - TOWN OF BARNSTABLE, MASSACHUSETTS Yes N ❑ t Application for aiqoaY �&p!5tent COTC$truCtlOu Permit Application for a Permit to Construct( ) Repair(- Upgrade( ) Abandon O ❑Complete System ❑Individual Components Location Address or Lot No. �}p �� /�/ Owner's Name,Address,and Tel.No. z YiC4 /c .1e I4 �� I A ,dcl sor 1 Assessor's Map/Parcel /9Z - V 9 3 �/Z Skc+)11-oat- ��/ fir, �x t k �(k f 1iC f el L(o j G Installer's Name,Address,and-Tel.No. lu4 e/T 8 V/dZ o Designer's Name,Address and Tel.No. 23 U 3 77 JC C n.Ge rill. � U-71 3f Type of Building: Dwelling No.of Bedrooms Lot Size 11,3 I Z sq. ft. Garbage Grinder ( ) Other Type of Building {2 c S No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided !/& • S gpd Plan Date j - /d Number of sheets Revision Date Title Size of Septic Tank !�OU Type of S.A.S. TZSl�R e5 S ! 2C 3�. f L (d +^ Description of Soil - h Nature of Repairs or Alterations(Answer when applicable) � ,y r ` 11/t vac. ; v4A,,,, N-)-i?jam rr C ! +� �.Z.) � �-wua tK.) '��!Gr -�. 1�0 IIC --P.�:"�► �Z 1 �i Y1� 1/�-J`C �t / '* Date last inspected: 7ZQ 1 J Agreement: i 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 Boa;O of Health. /y Signe //Y1.4 0 Date j - () v Application Approved by a, `Date i r -Application Disapproved by: � � � 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 ( ) /� 4 Abandoned( )by 5 at L/ -Z S(c d 4 U has been constructe i acc rdattce� with the provisions of Title 5 and the for Disposal System Construction Permit No. — _ 7* dated Installer V r�e.,,Pf,V I Designer , , #bedrooms s Approved design flow n (o• gpd The issuance of t is permit shall not be construed as a guarantee that the system w 1,1 t'7 s desig d. Date/ � �(} Inspector - � No. � � r �� - Fee l THE COMMONWEALTH OF MASSACHUSETTS �y PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Ti5po5al *pttemc Construction permit Permission is hereby granted to Construct ( ) Repair Upgrade ( ) Abandon ( ) System located at e 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 ust D c'mp jetted within three years of the date of this per m'! Date 1 ,/ Approved by f "("own of Barnstable Regulatory Services a, Thomas F. Cr'eiler,Director BASNg[AB1E. : Public Health Division Thomas McKean,Director 200 Malin street, Hyannis, MA 02601 Office S09•862.46+14 Mte: ✓ _��" I C� _ Sewage PermitM ?0(0 r l Assessor's Mal)/F arcel Installer & Desii vier Certification Form Ucsigner: ..;SC �wE�1� trier�rir� T"t c. Installer: Gci . Cu,k*de_ Gr)I' Address: 21_5y C�cInbeAlC-)L iiv�L� Address: © q 3o-c ?lob has} We+r �►m 1 was issued a permit to •nstall a (date) ('installer) Septic Wstelrt at q Z.. 8basted On [3 design ,�, ____....._._._�W..•_...._._.__...._....----....... -----__..-. -_-...� drawn 1 , SC _L�, cneec( _�....C�nG._ dated )1 �1> cto _ (designer) ...... _.__._. v I certify that the septic system referenced above was installed substantially aecordin the design, which may include minor approved changes such as lateral relocation of distributior, bO% and/or septic tank. Stripout (if required) was insplxted and the Were found satisfactory, 1 cerlity that the septic systern referenced above was installed with major change, greater than 10' lateral relocation of the SAS or any vertical relocation of any comhOl . c,f the septic system) but in accordance with State & 1.,ocal Regulatic)ns. Plan revisi ;:. certified as-guilt by designer to follow. Stripout (if req n 'pected and the were found satisfiletory. CHL IiCr+I.L dR I� _..._�Tii Caller's sign u•N) - --- Ci..L i No 41A^% wrr esi�;ner s Signatur 71ii; esi e s" PLEASE RETURN 'I Cl BARNS'TA13I,E I'C)13LIC H +ALTE DIVISION, CERTIFI(�;�; ! OF COMPLIANCE WILL NOT BE ISSUED UNTIL 130 THIS"1�401UW AND M;t BUILT CARD ARE DECEIVED BY THE BARNSTAH1,17. PUBLIC HLAL'I'I �1,6.j'... THANK Yf.)I!. •-----8�•. 1 +111.:Irnr•.r.;ir,•grcliillili:n:uul f.: .+,L+i IP1 A J 99 G1 9J 7. R 0 Q °1W T?I-4-4NT-iw-inr WA 1AC: 90 P1I07-RT-J-HW TOWNi OF BARNSTABLE LOCATION 117- SEWAGE 01 O — 13 VILLAGE �2� Ul��� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. c4egaa tfis yo4 SEPTIC TANK CAPACITY \SQ p \ I b LEACHING FACILITY.(type) iZ f-,�--rr, 31p 1 to (size) LO) 3 30 NO.OF BEDROOMS .3 ` OWNER a ft rae,,r S Ulm PERMIT DATE'. 1 Z o Zd(o COMPLIANCE DATE: I '_ ZO(i) Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A,& r/ 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) 0 Feet FURNISHED BY (?AatP.r.�l t'GL C AZ lq,Z 33 3q,� �1 13y 34,U %3f 4 3-5 e3 43,0 cq 30,n TOWN OF BARNSTABLE LOCATION 40 SEWAGE # Vi:,LAGE cx,c�',rf�vr4-1-E ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 2 G LS( GS (size) NO.OF BEDROOMS _3 WUHL-MR OR OWNER PERMITDATE: - COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility �d.S� 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 leachin facility Feet Furnished by I 8uL K/i�ii o ate. po I?cN 1 S as G iz y�pvvL,S M 19 2 0 PC- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION 42 Skunknet Road Property Address:Centerville,Ma Address of Owner: (if different) Date of Inspection:02-15-2000 c't_i I to Inspected by: James Holler I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.09dIVE0 p, Company Name:Holler&Son Construction LLC E Mailing Address:P.O.Box 702,Marstons Mills,Ma 02648 F E B 16 2000 + Telephone: (508)420-0280 TOWN OFBARNSTABLE HEALTH DEPT. CERTIFICATION STATEMENT Ab 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 traim'rtg+ u` and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ®_Passes_ Conditionally Passgs nNeeds Further Evaluation by the Local Approving Authority ❑Fails s� Inspectors Signat&i �hredcsystern Date: The system inspector sopy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the syste 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: ®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: 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 exfiltratio or tank failure is imminent. The system will ass inspection if the � y r >x existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (Continued) Property Address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of Inspection:02-15-2000 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 leveled 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 1 of a public water supply well. ❑The system has a septic tank and soil absorption system and the SAS is with 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 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of Inspection:02-15-2000 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 15.304.determine what will be necessary to correct the failure.. 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''/z 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 with 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 with 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. E) 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. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of Inspection:02-15-2000 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. ® ❑ 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. ® ❑ 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. ® ❑ 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 or 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 BOH. ❑ ® 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)] SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of Inspection:02-15-2000 FLOW CONDITIONS RESIDENTIAL Design flow: 110 gpd/bedroom for SAS Number of bedrooms 3 Number of current residents:2 Garbage Grinder:No Laundry connected to system:Yes Seasonal use-No Water meter readings,if available (last 2 years usage in gpd):N/A Sump pump:No Last date of occupancy:Current COMMERCIAL /INDUSTRIAL Type of establishment Design flow: gpd Grease trap present: Industrial Waste holding tank present: Non-sanitary waste discharged to the Title 5 system Water meter readings,if available Last date of occupancy OTHER:(describe) GENERAL INFORMATION PUMPING RECORDS and source Homeowner,not pumped since new System,pumped as part of inspection No Volume pumped: Reason for pumping: TYPE OF SYSTEM ®Septic tank/distribution box/soil absorption system ❑Single cesspool ❑Overflow cesspool ❑Privy ❑Shared system(y/n)(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:4 Years,BOH records Sewer odors detected when arriving at the site:No SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (Continued) Property Address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of inspection:02-15-2000 BUILDING SEWER (Locate on site plan) Depth below grade 16 inches Material of construction❑Cast Iron®40 PVC❑other Distance from private water supply well or suction lineN/A Diameter 4 inch Comments.,(condition of joints,venting,evidence of leakage,etc.) Good condition SEPTIC TANK (locate on site plan) Depth below grade 12 inches Material of construction®concrete[]metal❑Fiberglass❑Polyethylene[]other If metal list age is age confirmed by certificate of compliance Dimensions: 1500 Gallon j Sludge depth:21 inches Distance from top of sludge to bottom of tee or baffle 19 inches Scum thickness 2 inches Distance from top of scum to top of outlet tee or baffle 1 inch Comments:Septic tank should be pumped within the next 6 to 12 months GREASE TRAP (locate on site plan) Depth below grade Material of construction❑concrete❑metal❑Fiberglass❑Polyethylene❑other Dimensions Scum thickness Distance from top of scum to top 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 leak,etc.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (Continued) Property Address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of Inspection:02-15-2000 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: GPD Alarm level: Alarm working?❑yes❑no Date of previous pumping Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert:Level Comments(note if level,and distribution is equal,evidence of leaks or solids canyover,etc.) distribution appears equal,Dbox is level,no solids noted 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,pumps,and appurtenances,etc.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(Continued) Property Address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of Inspection:02-15-2000 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: Perforated pipe 2 trench system not uncovered as it is too invasive Type; leaching pits,number leaching chambers,number leaching galleries,number leaching trenches,number&length 2,length unknown leaching fields,number&dimensions overflow cesspool,number: Alternative system: Name of technology Comments:(note condition of soil,signs of hydraulic failure,ponding,vegetation,etc.) 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 Material of construction Indication of ground water inflow(must be pumped as part of inspection) Comments:(note condition of soil,signs of hydraulic failure,ponding,and vegetation,etc.) PRIVY❑ (locate on site plan) Materials of construction: Dimensions Depth of solids Comments:(note condition of soil,signs of hydraulic failure,ponding,vegetation etc.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(Continued) Property Address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of Inspection:02-15-2000 SKETCH OF SEWAGE DISPOSAL SYSTEM Include ties to at least two permanent references,or benchmarks,locate wells within 100'and where public water supply enters house. G4 A U � Q 2 � 2-9 2 33�b 1 34-t Z 3p-o a M SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (Continued) Property Address:42 Skunknet Road,Centerville,Ma Owner:Don&Phyllis Tremble Date of Inspection:02-15-2000 Depth to Groundwater y""feet Please indicate all the methods used to determine High Groundwater Elevation: ❑ observed from design plans on record ❑ observation of site(abutting property,observation hole,basement sump) ❑ 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 works how you established the High Groundwater Elevation. (Must be completed) uses � sg � 3 31. 3 Al � 7-2b� G2oVa,�D�►�-r 1 s,3 , �usTw�rJT 2-:7 �---- No p CERTIFIED SFPTTC SYSTEM REPORT �` l 1995 _ LOCATION 26 SKUNKNETT RD . CENTERVILLE, MA 02632 MAP 192 PARCEL 049 LOT 4 PREPARED FOR SRT.T.F.R MR. & MRS. PETER P . LUCHINI 26 SKUNKNETT RD . CENTERVILLE, MA 02632 BUYER MR. & MRS. TRIMBLE 32 VALLERA RD . SARATOGA SPRINGS , NY 12866 PREPARED BY HILLIARD HILLER P .O . BOX 250 CENTERVILLE, MA 02632 508-778-1472 f a � � Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection W 11lam F.Weld Go�.mor Trudy Coxe , s.u.t.ry.� David B.Struhs commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: aG c/LA/fk/Lv Address of Owner: Date of Inspection: d- (If different) Name of Inspector: y/LWj�,ZQ h'&GG, 4 Company Name, Address and Telephone Number: Pp /jvX aS 1-4Z ��c .�,e v.?c3. CERTIFICATION STATEMENT 9 0? 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 Approving Authority Y"'Fails Inspector's Signature: Date: 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 report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner ano copies sem to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, 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. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. 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,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 8/15/95) 1 One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500 A CJ Printed on Recvded Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 2 G s h�.vk.�GTT /4�o G�.vT,� Owner: o+K.* .i 4S. #04PZ4 Date of Inspection: //�/A/V 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): 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 approyal 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 PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feel to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and 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. D] SYSTEM FAILS: 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. Backup of sewage into facility or system component due to an overloaded or dogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or dogged SAS or cesspool. (revised 8/15/95) 2 .SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: a 6 AoIC/T el?47 C 0-A-rA%Z v/GG.e Owner: Zia. d '*X6, /1.CT, 4 v�ffl v/ Date of Inspection: D] SYSTEM FAILS(continued): 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. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of system is 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: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone 11 of a public water supply well) 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. (revised 8115195) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: .26 X v c e,r7',eC W-14e-IC 'y 1q Owner: Afl.-V Ae-w& /? Date of Inspection: /`/"AJs Check if the following have been done: Pumping information was requested of the owner, occupant, and 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 a5 part of this inspection. 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 t/The site was inspected for signs of breakout. L/AII system components, excluding the Soil Absorption System, have been located on the site. /f 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 existing information or approximated by non-intrusive methods. 1,::�fhe facility o�%ner (and occupants, if different f om owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:.&-16 Skvv4liE)7 A0 G4eA-7 At vr�� � ,a7.001 Owner: )�'Al' /d.W/—'&L '00 Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: gallons Number of bedrooms:_ Number of current-residents:.77 Garbage grinder(yes or no):Y/b Laundry connected to system (yes or no): YZU Seasonal use (yes or no):,A/O Water meter readings, if available: �!y - k aUa 6'ec . 12- 5 — !?3,"'!--- Last date of occupancy: PRA?4Gr/rd y COMMERCIAUINDUSTRIAL: Type of establishment: Design flow: tallons/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: y L"Jir G/.- - Z045.15y System pumped as part of inspection: (yes or no),�o If yes, volume pumped Qallons 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) Other(explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: - A06-5,d Sewage odors detected when arriving at the site: (yes or no) (revised 8/15/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION (continued) Property Address: a6 c zA1e_,e klew, 1015%i42 Owner: ^�,�y 0X r4,( Date of Inspection: SEPTIC TANK:_ Ty,PS LriA 5 7-AI /.-�o �.�a o+ T/rt F/.CST G,CSS�ar,L (locate on site plan) Depth below grade:�_� Material of construction: _concrete _metal _FRP_other(explain) Dimensions: 77N 08,CP '61;4dari411C O.u°T.s') eo r t Sludge depth:_ Distance from top of sludge to bottom of outlet tee or baffle: y,3 Scum thickness: ;7k ., Distance from top of scum to top of outlet tee or baffle: 3 ,� Distance from bottom of scum to bottom of outlet tee or baffler 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.) or/Tl_Xr 11AC IIA&2 A 7WZ R,eo 77y-.0 jr Qy .7 a Tlt'e_ IZ fu Z'.V 1-1'�4 a v Tssr GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP —other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of crurrn to bottorn of ou!fet tee or Dante: 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 6/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: I�/irj 'a&.m e Ia Date of Inspection: TIGHT OR HOLDING TANK-- (locate on site plan) Depth below grade: Material of construction: _concrete_metal _FRP—other(explain) Dimensions: Capacity: zallons Design flow: aallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution i; eq:::!, evidence of so!id! carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER: (locate on site plan) - Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ,ZG Owner: '410 "O'er" 10 L 614WIA-1, Date of Inspection: SOIL ABSORPTION SYSTEM (SAS):_-4e� (locate on site pian,'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: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) 5v .o.s ZviIc�,Eo vP ocik r /.v�T ��, 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 8/15/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: aG e'C'e"'r 4 4-14.G4 .q•A Owner: *V�AV Aerd,( 10 Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' Q� I I I poRc� °o ;;. I �� I DEPTH TO GROUNDWATER Depth to groundwater: /0.5 feet method of determination or approximation: 6Ai?,vs1'Ai3LF &/S 44f 5S� T/7,£ TH2 '5��45.f.��/�D 4i/fT.L/.� T�L—� ✓"Z.ri� /�33.t O,C.9c�i,vG Si/�ws Ti'�.! c�l9rn�.t i/�,�r�.� �,i— �t..��i�>'.�•.+✓ .3�' TNR pis cs G y/1/I.�cTov �S 3.v' (revised 8/15/95) 9 •r4 I I � ` �1 f`�/ j�' No. � f Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE., MASSACHUSETTS Zipphration for Pioogai *Potem Construction Permit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 2 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow �3 gallons. Plan Date Number of sheets Revision Date Title Description of Soil 6 e_j e,,. \Ah' Nature of Repairs or Alterations(Answer when applicable) 1 U1� S i f T✓�W k- 0 I `� 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 an not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board e Signed�— Date Application Approved by ' Application Disapproved for the following reasons Permit No. ^�1� Date Issued CO HF MA ACHUSETTS PUBLIC HEALT� DI �6L ION - BARNSTABLE, MASSACHUSETTS " Certificate of Compliance THIS IS TO CER ;,tt t the-In- tLe Sewa e-Disposal System installed(� )or repaired/replaced( )on for �v- L u c K-t N i as (LQ— tM\A-. as been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No ated Use of this system is conditioned on compliance with the provisions set forth_be1ow:1 ��T �' /�� / Fee �� F� No. / / .THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1w5pont *pwm CBngtruction permit Permission is hereby granted to to construct( )repair(-'I an On-site Sewage System located at (o S u I-rT- 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. All construction mu be completed within tw ears of the date below. rf� Date: / `.. �"�-- �� Approvem-v �� .lil�� � ✓��L TOWN OF BARNSTABLE LOCATION � � � NKXV e;- LQ SEWAGE# "�.i:LAGB �,�-ziv"ke ASSESSOR'S MAP&LOTS -0 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY P-4 o—1 LEACHING FAciLrrY: (type)—V,1 (size 3,0 Li NO.OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: � ^' '+� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 as Vr6✓�5 5K'\, No. '�-• U Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01ppric tion for lkgpo l *p$tem COtt$truction Permit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. 2 Installer's Name,Address,and Tel.No. - Designer's Name,Address and Tel..No. i Type of Building: Dwelling No.of Bedrooms Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 33 gallons. Plan Date Number of sheets Revision Date Title Description of Soil Gl ek. Naattu-ree of Repairs or Alterations(Answer when applicable) l (TI S e iO l I r�T k- Q`► S F 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 an not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board ealt _ Signed _ Date `r�— —7 , Application Approved by Application Disapproved for the following reasons Permit No. r�f/ Date Issued / ..V"' '— No. Fee i 6l THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS, 01pplication for 3Digpo.5a1 *pgtem Construction Permit Application Whereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. yCvK.k-��T Cetti (YkV_ Lv ����t HZ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. d �3tA�GTG J t i 'I f Type of Building: Dwelling No.of Bedrooms J Garbage Grinder( ) Other ' Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixt res Design Flow l` -gallons per day. Calculated daily flow 33 gallons. Plan Date J Number of sheets Revision Date Title g Description of Soil G C� Nature of Repairs or Alterations(Answer when applicable) L(-a " + Date last inspected: { Agreement: The undersigned agrees to ensure the construction and maintenance-of t`Sie f k desccribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code a not to place the system in operat'ion,until a Certifi- cate of Compliance has been issued by this Boarrv_,� e Signed �, Date - 7-y.s Application Approved by Application Disapproved for the following reasons i 'Permit No. ^ Date Issued _,_THh C�"N1A�t��L 'OF MMAASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance - THIS IS TO CERTIFY,t t the ' a Sewa a Disposal System installed(Z )or repaired/re$laced( )on_41 by -c,.� I u�c� S for V"\N v- L y e- as T Cev,-"T- tM\A, bas been constructed in accordance r with the provisions of Title 5 and the for Disposal System Construction Permit No. �ated Use of this system is conditioned on compliance with the provisions set forth be,owl No. ��"' Fee :THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH`DIVISION - BARNSTABLE, MASSACHUSETTS x1igpo!5ar *p�tem Coonn5truction permit Permission is hereby granted to to construct,( )repair(`,I an On-site Sewage System located at Ca S�c.v`-� K-rT and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to I comply with Title 5 and the following local provisions or special conditions. All construction mug�be cot leted within two ears of the date below. Date: ��"�"~ � -ApprovecLI). � CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL "WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works ' construction permit signed by me.dated �-- - concerning the .�, property located at_ �5 4s-,'Kk-r'j t:!6 k Ce w` ` meets all of the following criteria: 4 There are no wetlands within 300 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed There are no variances requested or needed. SIGNED: DATE: LICENSED SEPTIC S-k TEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. l S v F7 000 15vo l 1 T.O.F. EL.= 61 .4'± ' ��- INISH GRADE OVER D-BOX= 58.9 '� 4"SCHEDULE 40 PVC ' GENERAL NOTES PROVIDE EXTENSION RISER @MIN. SLOPE 1% FINISHED GRADE OVER BIODIFFUSERS = 58.9 - 58.5 WITH COVER OVER INLET& REMOVABLE WATER-TIGHT COVER OVER INSPECTION PORT WITH ACCESS SLOPE @ 2/o MIN. 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OUTLET TO WITHIN 6"OF F.G. RISER TO WITHIN 6"OF FINISHED GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL.= 60.2'± F.G. OVER TANK EL. = 59,6'± 5" DIA. OUTLET(S) BOX TO WITHIN 3"OF F.G. (ONE PER TRENCH) CODE AND ANY APPLICABLE LOCAL RULES. i -� -_ 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. PROPOSED 4" 9"MIN. -EXISTING 4 36"MAX. 9"MIN ! 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE PVC SEWER PIPE 1 36"MAX. TOP OF SAS/B.O. = 56.13' SYSTEM UNLESS OTHERWISE NOTED. -� 3"DROP MAX " -.-L PROVIDE WATERTIGHT 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 6" 3" 3 9 L = 31 ± --- - 2" DROP MIN MIN.SLOPE t� JOINTS (TYP.) ELEVATION =56.13' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 10" 4" PVC IN FROM CLEAN SAND 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 14" \�* 7.j'± SEPTIC TANK 4"PVC OUT TO 1.33' THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 5 0__ 16 TYP LEACHING FACILITY 0.90, (TYP.) 10.75"TYP 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 12" 6" + 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. CONTRACTOR CONTRACTOR SHALL � ; SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE 57.00 MIN. 5G.83' 55.70' �- 54.80' (LAID FLAT) 2.875'(34.5")--I-----5.75' --I 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE 5 0� (TYP.) FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY (TYP.) 11.50' NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 5'MIN. AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX 30.0' (TYP FOR BOTH TRENCHES) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 61.52' ESTABLISHED TO BE INSTALLED ON A LEVEL STABLE ON A NAIL SET IN CORNER OF BULK-HEAD AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 48.37' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1,500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW BIODIFFUSER (PROFILE) BIODIFFUSER (END VIEW) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES "CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL 12 - ARC 36HC (#3616 B D) BIODIFFUSERS TO THE DESIGN ENGINEER.TO ANY WORK & NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING SWING-TIES , a +`- • , TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM • • ! APPROPRIATE AUTHORITY. PERC NO. To be Determined DESCRIPTION HG1 HC-2 b • jt '�+ INSPECTOR: David W. Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS • LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE BIODIFFUSER CORNER(1) 23.3' 28.5' • • +► . , ,' w • EVALUATOR: Michael Pimentel, E.I.T. THEY SHALL WITHSTAND H-20 LOADING. ` BIODIFFUSER CORNER(2) 34.8' 38.5' • • �� • 0 C.S.E. APPROVAL DATE: Oct. 1999 •+ • • #« . •/ ° • DATE: May 6, 2010 113. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.BIODIFFUSER CORNER(3) 45.8' 37.3' - ,�- --. " Q ' ` « 0 y7� • ` • : ` " • • TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE BIODIFFUSER CORNER(4) 37.8' 26.9' 'a • �` $ a # MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. «'•«+ + e " # • * • Ito • ELEV TOP= 58.70' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, . + •` „ • • « . '40• ELEV WATER= <48.3T MAP 192 FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). N vO/ k LOT 48 ' • �` : • « _ <2 min./inch15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PERC RATE - w k • • • SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. k / / S 1ST 'E _ Benchmark ++ ,! R` • DEPTH OF PERC = 30"-48" 16. PROPOSED PROJECT IS LOCATED WITHIN: N O %� 4g _ _ Nail Set in B.H. Comer « �•� * • • " • •' TEXTURAL CLASS. 1 ASSESSOR'S MAP 192 PARCEL 49 Y °0 00�/ \� W x - Elev. =61.52' , �` •! ; • +► : • OWNER OF RECORD: PAUL R. ANDERSON z �/ _ Approx. M.S.L. /--EXISTING 1,500 GALLON SEPTIC TANK TO y ,� y • LOCUS ' ' g \ BE UTILIZED AS PART OF THIS DESIGN ZONE 2 ; ' L U 0" 58.70' ADDRESS: 42 SKUNKNET ROAD �v ` . '"4 • • CENTERVILLE, MA 02632 k ! ��� \\ t / r « " •" • i Fill W EXISTING 30' x 4' x 2' LEACHING TRENCH TO BE �i • • * «« , 12" 57.70' 60/ �� \60 ABANDONED (TYP OF 2) (APPROX. LOCATION f • • • • I • • •«•« • « « . Loamy Sand FEMA FLOOD ZONE C PER AS-BUILT CARD ON FILE WITH BOH) « ` f B COMMUNITY PANEL# 250001 0015 C / If • • « • • 30" 56.20' 17. DEED REFERENCE: DEED BOOK 13801, PAGE 24 k I ` ti ` ' . • Perc e r . . ,► • � ! 18. PLAN REFERENCE: PLAN BOOK 224, PAGE 127 ' • • • .• 48" r 54.70' x MAP 192 B N. # j Medium Sand 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. / a \ LOT 49 : : + + « • • + �, ( C-1 2.5Y 6/6 15,312 S.F. ± O / _ • * . _ ( (loose) 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY k O #42 - „ • ♦' • . FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY U / ) , • a • 72" 52.70' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. EXISTING i ' • a • •, * +r8 _, • 4 oN k \ 3-BEDROOM I MAP 192 lit Ifl"V e *" -�•• ` • . �• . _ r ti $ DWELLING PAT/O / LOT 122 Coarse Sand C-2 2.5Y 6/6 LOCUS PLAN (5-10%gravel) Z W APPRox;T GAS O e Gq I O _ SCALE: 1" = 1000' k E VERIF/ED GAS / O 124" 48.37' / \ No Mottling, Standing or Weeping Observed IRE x \160 % DESIGN DATA TEST PIT DATA LEGEND � PERC NO. To be Determined� DECK �°� PROPOSED ELECTRIC LINE INSPECTOR: David W.Stanton, R.S. 50xO EXISTING SPOT GRADE PROPOSED DISTRIBUTION BOX NUMBER OF BEDROOMS (DESIGN) 3 \ EVALUATOR: Michael Pimentel, E.I.T. - - - 50 - - - EXISTING CONTOUR� ICI O BASEM DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 1999 50 PROPOSED CONTOUR SLAB ENT TOTAL DESIGN FLOW 330 GAUDAY DATE: May 6, 2010 BIT. DRIVE / ��" TP 1 DESIGN FLOW X 200 % = 660 GAUDAY - ❑/H/� EXISTING OVERHEAD UTILITIES HC-1 23.3' � F 7' TEST PIT#: 2 \ pl 4FC USE EXISTING 1,500 GALLON SEPTIC TANK ELEV TOP = 58.70' ELEC EXISTING UNDERGROUND ELECTRIC / GARAGE ESE 2 ELEV WATER= GAS EXISTING GAS LINE 'TP 2 EXISTING ELECTRIC LINE PERC RATE _ r TO BE RELOCATED AWAY INSTALL 12 - ARC 36HC (#3616BD) BIODIFFUSERS W W EXISTING WATER LINE 58 T n T FROM SAS AS SHOWN o DEPTH OF PERC = �I \ HC-2 C 58x7 o CIV SYSTEM CAPACITY TEXTURAL CLASS: 1 TEST PIT LOCATION MAP 192 (TOTAL L.F. OF BIODIFFUSERS)(7.8 SF/LF)(0.74 GPD/SQ.FT.)= GPD 0 Q EXISTING 1,500 GALLON SEPTIC TANK o SHED LOT 121 (60.0')(7.8 SF/LF)(0.74 GAUSQ.FT.)= 346.3 GAL. LEACHING/DAY 0" 58.70' a TREEL/NE�� M 58x5 Fill PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE 12" 57.70' B Loamy Sand TOTALS: O PROPOSED DISTRIBUTION BOX .\ � PROPOSED ARC 36HC(#36168D)BIODIFFUSER TOTAL NUMBER OF BIODIFFUSERS: 12 10Yr 5/8 58x4 PROPOSED TOTAL 12 ARC 36HC BIODIFFUSERS TOTAL NUMBER OF COUPLINGS: 0 30" 56.20' (4 ''� 58x4 (6 BIODIFFUSERS EACH TRENCH) TOTAL LEACHING AREA: 468.0 SQ.FT. '- ko 75, TOTAL LEACHING CAPACITY: 346.3 GAL./DAY REV DATE BY APP D. DESCRIPTION C 1 5 '--PROPOSED INSPECTION PORT WITH ACCESS Medium Sand PROPOSED SEPTIC SYSTEM UPGRADE C_1 73-3T4p� o �'' '�� 3) BOX TO GRADE (TYP OF 2) 2.5Y 6/E ` \ 154.93, 58x7 (loose) PREPARED FOR: 0 NOTE: 72 52.70 CAPEWIDE ENTERPRISES MAP 192 EFFECTIVE LEACHING AREA OF 7.80 SF/LF OBTAINED FROM THE 0 1 O \ DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER LOCATED AT LOT 61 "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO Coarse Sand 58x8 ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003(LAST C-2 2.5Y 6/6 42 SKUNKNET ROAD MODIFIED FEBRUARY 18, 2010). TRANSMITTAL NUMBER=W000052. (5-10%gravel) NOTES: CENTERVILLE, MA 02632 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF 124" 48.37' A0AA4 SCALE: 1 INCH = 10 FT. DATE: MAY 7, 2010 EACH SEPTIC SYSTEM COMPONENT. 58x8 o e ,o Zo 40 FEET i No Mottling, Standing or Weeping Observed `F.:"«'��,: PREPARED BY. 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF RESERVED FOR BOARD OF HEALTH USE JC ENGINEERING, INC. THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST 2854 CRANBERRY HIGHWAY PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. s `. EAST WAREHAM, MA 02538 SITE PLAN 5_08.273.03_77 3. PROPERTY IS LOCATED WITHIN THE ESTUARINE ZONE WATERSHED. SCALE: 1" = 10' ' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No. 1818