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Home My WebLink About0301 SKUNKNET ROAD - Health 301 SKUNKNET RD.) CENTERVIL'LE A = a TOWN OF BARNSTABLE LOCATION 301 SKyn Kn ci Rol • SEWAGE# c2Oo 7 - O 12 VILLAGE ASSESSOR'S MAP&PARCEL 17o /CPS3 INSTALLERS NAME&PHONE NO. _C3 i%B EXCAVA?tom Tog• 5177-0493 SEPTIC TANK CAPACITY loon on ) LEACHING FACILITY:(type) .3osD 2iv;=1, C3) (size) �a ,$ x a$ x Z. NO. OF BEDROOMS 3 OWNER "EA! 6v 6' Inv PERMIT DATE: /- /O —0'7 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 Ai y j' . 2,2' ' A?-' 39'6 A3- 65 REAR Hov5E- ,93-37' 6 q 8 A4- t6s' As y I J� No. _ 'D � - i Fee J0�/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:3 _ //--- PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Yes��J ZIppticatton for Migo!gal 6pztem Construction 30ermtt Application for a Permit to Construct( ) Repair(/) Upgrade( ) Abandon( ) ❑Complete System 1, ❑Individual Components Location Address or Lot No. 30 1 S C,V rtne_'r ZD Owner's Name,Address,and Tel.No. S D 9-431 — 24 o5 tc.nTeP_v1LLF_ G111tN UVTMMVT l Assessor's Map/Parcel i%A tf P 110 V A LE L a 5 3 3 01 5 tV M1Ct4ET-e0.tE Nj'EQv 1 Q:E Installer's Name,Address,and Tel.No. .5 0$— L01—0453 Designer's Name,Address and Tel.No. U01MT- 411.Poy—'B+B EX1_A\JkTUA DA-4E JNi1;50N- DBL EN.\1e01JMEK'7AL. 1 Type of Building: Dwelling No.of Bedrooms _3 Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33 0 gpd Design flow provided d gP Plan Date 1 -19 'two Number of sheets Revision Date Title 51'fEt SE�� ! tXDI SL!Qg lj;T' PQAa(:) Size of Septic Tank 1 � Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sig b Date 1 -$ Application Approved by Date Application Disapproved by: - Date for the following reasons Permit No. Date Issued ' c n. � 'Y v._r. r � .� ...�dcn�•-�--... .tom - .. -... .. -i No. Ci \ �:••'.°Y'`'$ Fee D .� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: __a Yes //, PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS A�60 t 0[ppYication for Wgpotal *pgtem Construction Permit Application for a Permit to Construct O Repair(✓) Upgrade( ) Abandon O Complete System ❑Individual Components r- �j Location Address or Lot No. 3 Q i IS�( u n\ 11e r ZD Owner's Name,Address,and Tel.No. 5 0 9 6 3 1 --�., CcnT> eviLLG CIIeI`A C-1t)Tf=,P-MUT•H Assessor's Map/Parcel L E A Q 5 b Installer's Name,Address,and Tel.No. 5 U 8- 1-i 1 7- U(o 53 Designer's Name,Address and Tel.No. 'RU6tK_I &IILF'Oy_ 13i13 E1(LAVATi(_A A\iC M}{5ow - 064- Is.0,1\J112b A4EW1AL I . r - }\i3 10 , _ rt 1= 5 �4A A'4- ,- Type of Building: Dwelling No.of Bedrooms' Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow(min.required) 3 3 0 gpd Design flow provided gpd Plan Date t( 2 9 -Ut Number of sheets Revision Date Title SITE i SE1..UAhT— _ 1FtKI J EJ SVUNIC0E-r ecao Size of.Septic Tank I L Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of 1 Compliance has been issued by this Board of Health. Sig 0_ e, Date Application Approved by './� _ Date Application Disapproved I 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 (f) Upgraded ( ) Abandoned( )by I' t-13 E_N.( ^V A'T"I O N at _3 n 1' 5 V 1>N K Q C T' l -0 C_F"-NA I:C&I J I L L E has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 1 ated Installer (�(�[_2 T Designer v a i` G u (A f N-1 A L #bedrooms Approved design flow /t gpd The issuance of this permit shall not qe construed as a guarantee that the system will fu e i• s e igned. / Date , 1 d",, � Inspect ----------s---------_-----------------=--_ '—=- 17- . 'No. I®/ .: Fee---¢T� ( THE`COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS 300i5po5al 6pgtem Construction 'Permit Permission is hereby granted to Construct ( ) Repair (,/) Upgrade ( ) Abandon ( ) System located at,3 D I 5 !)N 4XI C T" ?0 F"'ra ( r e k-1 I L L-F e and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction ust bg com feted within three years of the date of this permkj� Date Approved by Town Of Barnstable - - : ..r Regulatory Services y O Thomas F.Geiler,Director 9 � Public Hean]Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-8624644 Fax: 508-790-6304 Installer&Desiener Certification Form Date: .:114�I 23� ZDC--)q Designer: yr v t - U`�1��"y` Installer: Qokyqm Address: . �61_ Address: 1 4-'-e n he r r l r,r,e On_f J 10 -6 77(date) (installer) was issued a permit to install a • septic system at_30I 41-'CL'qT1& ased on a design drawn by (address) ("'J dated %� (designer) Or certify that-the septic system referenced above was installed substantial) . accordin 'to e design, which may include minor approved changes such as later ialocation of he tribution box and/or septic tank. I certif} that the septic system referenced above was install, d with major changes greater tl ag.4 0' lateral reloea#ion of the SAS or any vertical relocation-o€any comport of the-septi��gWm)but m accordance with State&Local'Regulations. Plan revisiono .� certified as�� by designer to follow. ' �H OF Q?) C1 ? DA D (Installer's Si B.Ims cl) sgNITAa�� er's Signature} (Affix er's Sump Heare} PLEASE RETURN TO BAMSTABLE PUBLI. -HEALTH D ` ION. CERTIFICATE OF COMPL ,NCR WII:I." Q BE ISSUED�UI\iL BOTH--TES FORM AND AS= BUILT CAS ARE REG'EFVED BY-THE.RAWSTARLE PUBL3[C HI AfL. - OTVISIOI�: THANK YOU. Q:Health/Septic/Designer Certification Fora __ - .:ram .;S_.•_ __ ____ram _ __ ,, :TOWfd OF BARNS'I'ABLE 'LOCA:`I`1011%_ SEWAGE -VILLAGE P�tom' (//c�L�- ASSESSOR'S MAP & LOT , INSTALLER'S NAME&PHONE NO. l l/ ��.�2 r ►�-D 3� 7�� SEPTIC TANK CAPACITY I S-2v it a, LEACHING FACILITY: (type) 3 (size) 3 3 a NO.OF BEDROOMS 3 BUELDER OR OWNER PEF-MrTDATE: 913 VCOMPLIANCE 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 �r n SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. SigMre item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received n�^^( nnted Name) C. D to of_D�I'very ■ Attach this card to the back of the mailpiece, �Nl�v �J or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No A,* or-s m iehac� Gr"ut hm uth cP/ �TkunKneV "Road C4mn-je»v1 Ak e M 14 daj,3..j, 3. Service Type ❑Certified Mail ❑Express Mail ❑Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (transfer from service label) m /= I PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE-,~ , n- - -First-Class-Ma r O`' Postage.&.F.ees Paid—, �. . F a LISPS Permit No G.10, • Sender: Please print your;name, address, and ZIP+4 in this box • I I I PUBLIC HEALTL-I OI` ITSION TOWN OF BAARNSTABI E 200 MAIN STREET HYANNIS, MASSACHUSETTS 02601 I 1 C��L 1111!N l'Little4��littli�illit��ttl�itl4i11t�11i1l��!lll�llil Postal a, CERTIFIED N (DomesticOnly; I � F F I C I A L U S E Postage $ CFjje Certified Fee ��JC3 J JC3Return Receipt Fee(Endorsement Required) a•IO Restricted Delivery FeeO (Endorsement Required) C3Total Postage&Fees $ � fL Sent To 0 C3 - 4 0- ht mac L ('matter ru h---------------------- N Street,Apt.No.;- (�L y-�.or PO Box No.J'/0 v_A t�r'1 k/t -5=y---�94`--�------------------------ City,State,ZIP0, c.:Z/1�`crvrt„L a h�R 4a 63� i PS Form :00 April 2002 Certified Mail Provides: o A mailing receipt e A unique identifier for your mailpiece , a A signature upon delivery o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail or Priority Mail... o Certified5NIail'Js not available for any class of international mail. o NO INSURANOBC OVERAGE IS PROVIDED with Certified Mail. For valuables,please c nsider Insured:or Registered Mail. o For an additionaL,ffeee,a Return Receipt may be requested to provide proof of delivery.To obt,to urn Receipt service,please complete and attach a Return. Receipt(PS Form 38�1)to the artidle and add applicable postage to cover the fee.Endorse mailpiece 'Return Receipt Requested".To receive a fee waiver for a duplicate return;receipt, a USPS postmark on your Certified Mail receipt is required. ° / - n For an additional' fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a'postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt andpresent it when making an inquiry. PS Form 3800,April 2002(Reverse) ?'. 102595-02-M-1133 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS ,) . 0 F P,)`€tPaS IA6LE DEPARTMENT OF ENVIRONMENTAL PROTECTION o- 1 6 JAN 10' Pij 1: 42 � See TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION `✓��' �53 Property Address: 301 Skunknet Road Centerville MA 02632 Owner's Name: Ellen & Michael Gutermuth Owner's Address: Same S5, 3�3 Date of Inspection: November 29,2005 Job#05-362 Name of Inspector: PATRICK M.O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02648 Telephone Number: 508-428-1779 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation b e Local Approving Authority X_ Fails Inspector's Signature. l/1/1 Date: 11/29/05 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments: Overflow pit has no effective leaching. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 301 Skunknet Road,Centerville Owner: Ellen& Michael Gutermuth Date of Inspection: November 29,2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with 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. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: TitIP C tnenartinn Pnrm 411 Vnnnn 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 301 Skunknet Road,Centerville Owner: Ellen&Michael Gutermuth Date of Inspection: November 29,2005 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Titla S incnartinn Fnrm 6/1 3 i Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 301 Skunknet Road,Centerville Owner: Ellen& Michael Gutermuth Date of Inspection: November 29,2005 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No —X_ _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X— Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool —X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than %day flow — _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. —X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _X_ Any portion of a cesspool or privy is within a Zone l of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal 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.) _Yes_(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Tltla 5 fncnarf;nn Rnrm All 1;i7nnn 4 Page 5 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 301 Skunknet Road,Centerville Owner: Ellen& Michael Gutermuth Date of Inspection: November 29,2005 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No _X_ _ Pumping information was provided by the owner, occupant,or Board of Health _X_ Were any of the system components pumped out in the previous two weeks? _X_ _ Has the system received normal flows in the previous two week period ? _X_ Have large volumes of water been introduced to the system recently or as part of this inspection _X_ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up? _X_ _ Was the site inspected for signs of break out? _X_ _ Were all system components,excluding the SAS, located on site? _X_ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _X_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems`? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _X_ _ Existing information. For example,a plan at the Board of Health. _X_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] Titlo r% Incnortinn Rnrm All ciInnn 5 i Page 6 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 301 Skunknet Road,Centerville Owner: Ellen&Michael Gutermuth Date of Inspection: November 29,2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents:3 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): No Water meter readings, if available(last 2 years usage(gpd)): 2003—113,000 gal.2004—91,000 gal.=279 gpd. Sump pump(yes or no): No Last date of occupancy: Currently Occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records: Tank pumped three years ago. Source of information: Owner Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X_Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: Overflow pit installed in 1990 Were sewage odors detected when arriving at the site(yes or no): No Title G Tmnantinn pr% m 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 301 Skunknet Road,Centerville Owner: Ellen&Michael Gutermuth Date of Inspection: November 29,2005 BUILDING SEWER: XX (locate on site plan) Depth below grade: V Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting,evidence of leakage,etc.): SEPTIC TANK: XX (locate on site plan) Depth below grade: 8" Material of construction:_X_concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions:8.5' long x 5.2' wide—1000 gal. Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: 26" Scum thickness: 3" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Liquid level at bottom of outlet invert tank is structurally sound Recommend replacing outlet baffle with PVC tee at time of repair. GREASE TRAP: No (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(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Ti11a G Tncnartinn Rnrm 411 S0000 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 301 Skunknet Road,Centerville Owner: Ellen& Michael Gutermuth Date of Inspection: November 29,2005 TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: XX (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: 0" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: No (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.): T41a S i"c—tin" Pn—411 cnnnn 8 Page 9 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 301 Skunknet Road,Centerville Owner: Ellen& Michael Gutermuth Date of Inspection: November 29,2005 SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required) If SAS not located explain why: Type _X_leaching pits,number: Two 6x6 pits in series. leaching chambers, number: leaching galleries,number: leaching trenches,number, length: leaching fields,number, dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): First pit previously failed and overflow pit has no effective leaching. CESSPOOLS: No (cesspool must be pumped as part of inspection) (locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: No (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.): T41. C Two—f;— P—4/1 V100n 9 f • Page 10 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM i PART C SYSTEM INFORMATION(continued) Property Address: 301 Skunknet Road,Centerville Owner: Ellen& Michael Gutermuth Date of Inspection: November 29,2005 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building. 23 42 17 Garage # 301 27 Water service Titla S Tncnartinn Anrm 4/14qi')nnn 10 . Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ? PART C SYSTEM INFORMATION(continued) Property Address: 301 Skunknet Road Centerville Owner: Ellen& Michael Gutermuth Date of Inspection: November 29,2005 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water 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: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: A perc test will be performed prior to repair to determine groundwater elevation. Titles C Incnartinn Pnrm All si11)01) 11 r Town of Barnstable P# Department of Regulatory Services • A8M • Public Health Division Date 1 Z7 0 t639 �� 200 Main Street..Hyannis MA 02601 A�0 M►tl , Date Scheduled _ �', ,i�p Time--�W _ Fee Pd. Soil Suitability Assessment for, wage Dis sal Performed —�-- Witnessed.By: - f� LOCATION& GENE��7 ORMATION t� Location Address er's Name �7f �`I9'-6'y!I[� Address Assessor's Map/Parcel: / �.3 ✓ Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Land Use ') y '.'_' Slopes('%) Surface Stones Distances from: Open Water Body �� ' ft ,Possible Wet Area �-- ft Drinking Water Well �- g Drainage Way ft Property Lineft Other---,--- . ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit RacerwO Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE >° 7-C-P Depth Observed standing in obs.hole: in. Depth to soil mottles: jn Depth to weeping from side - in, Groundwater Adjustment }), of obs.hole- Well# Reading Date: Index Well level Adj.factor— Atli.Orpundwater Level R PERCOLATION TEST Datr Thne Observation Hole# Time at 9" Depth of Perc / Time at 6" Start Pre-soak Time @ �JLf��G�J Time(9"-6") End Pre soak Rate Min./Inch Site Suitability Assessment: Site Passed Site•Failed: Additional Testing Needed(Y/N) . Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:�.SEPTIMERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sdil Color Soil Other Surface(im) (USDA) , (Munselq Mottling (Structure,Stones,'Boulders. Con isten ravel D-3 o e 2, Al0 2.a! DEEP OESERVATION,HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. onsistency.%Gravel) (3 --Zr3` Z1 141-71 �r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color. Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. consistency. o Gravel) 1 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munseli) Mottling (Structure,Stones',Boulders. Con ' ten 1 Flood Insurance Rate Male: Above 500 year flood boundary No— Yes V Within 500 year boundary No •K�Yes ., . Within 100 year flood boundary No + ves Death of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring perv' us material exist in all'areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? ' Certification date g 7 assed the soil evaluator examination approved by the I certify that on ( )I have P Department of Envir nmental Protection and that the above analysis was performed by me consistent with . the requ'r ing,exp s e erience described in 310 CMR 15.017. —7 Signatu Date b / Q NSHPTICIPERCFORM.DOC CO11\10\��£ALTH OF MASSACHliSETTS 1`%� -� EkECLTIVE OFFICE OF ENVIRONMENTAL DEPARTMENT OF ENVIRONMENTAL PRO ON 0 ONE WINTER STREET. BOS TON KA 02106 16171 292-55 n 0D �Cc CO 2 2 1999 � 6f TRH OXZ H4 1 • �D7 4 re:arc ARGEO PAUL CELLUCCI D STP.:.'HS Governor Commus:one- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM L PART A CERTIFICATION Property Address: 301 Skunknet Rd.. Name of Owner Ned. Burke C nt e i 11 e Address of Owner: Date of Inspection: ! G Name of Inspector:(Please Prirrt)Wm. E . Robinson Sr. I am a DEP approved system!inspector rsuamt to Section 15.340 of T-rde 5(310 CMR 15.000) mr copany Name: Wm. E . Robinson Fleptic Service Marling Address: PO Box 1089, Centerville .-YA Telephone Number: 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 sewa disposal systems. The system: zasses Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: Y(/• Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)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 and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS revised 9/2/98 Page Iof11 i� �c^ted on Recyclyd Panrr - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 'ropertyAddress: 301 Skunknet Rd.. , Centerville Jwner: Ned. Burke Date of Inspection: /a1-��9 INSPECTION`SUMMARY: Check/A.)B, C, or D: A. SYSTEM PASSES: J nAl have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 An failure exist. 7.7 Y criteria not evaluated are indicated below. COMMENTS: B. SYS M CONDITIONALLY PASSES: O e or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system. upon cc mpletion of the replacement or repair, as approved by the Board of Health, will pass. Indicate d care 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 complying septic tank as approved by the Board of Health. 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 approval of the Board of Health): broken pipe(s) are replaced obstruction is removed revised 9/2/98 Page 2ofII r - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Icontinued) Property Address: 301 Skunknet Rd . , Centerville Owner: Ned. Burke Date of Inspection: C. FUR EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Cond ions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public ealth, safety and the environment. 1) SYS WILL PASS UNLESS BOARD OF HEALTH DETERMINES W ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT NCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SY TEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUN TIONING 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 of 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) OT R revise^ Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 301 Skunknet Rd.. , Centerville Owner: Ned. Burke Date of Inspection:/0_„W`9 c, D. SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: 1 ave determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this d termination 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 orclogged SAS or cesspool. _ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. 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 YSTEM FAILS: You must in cate either "Yes' or "No" to each of the following: Th following criteria apply to large systems in addition to the criteria above: T e 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 alth 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 r operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of th Department for further information. revised 9/2/98 Page 4ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM, - PART 8 CHECKLIST Prop"Address: 301 Skunknet Rd.. , Centerville Owner: Ned. Burke Date of Inspection: s,2_�Q 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. l� _ As built plans have been obtained and examined. Note if they are not available with NIA. v _ 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 of the Soil Absorption System on the site has been determined based on: _ Existing information. For example, 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) f15.302(3)(b)] _ The facility owner(and occupants,if different from owner) were provided with information on the propermaintanaac"f Subsurface Disposal Systems. revised 9/2/98 Page 5of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM _ PART C SYSTEM INFORMATION rroperty Address: 301 S kunkne t Rd.. , Centerville owner: page d. Burke Date of Ins on: FLOW CONDITIONS RESIDENTIAL: Design flow3CO g.p.d./bedroom. Number of bedrooms(desi n1;- Number of bedrooms (actual): 9 _ Total DESIGN flow 36 6 Number of current residents:/f Garbage grinder(yes or no):.!E Laundry(separate system) (yes or no);�G; If yes, separate inspection required Laundry system inspected (yes or no) Seasonal use (yes or no)4i Water meter readings, if available (last two year's usage (gpd): 1 �9R 1 1 !llama 1 . Sump Pump (yes or no): Id 1997 164, oo0 gal. Last date of occupancy:j,�L—Z-9 COM CIAL/INDUSTRIAL• Type of tablishment: Design flo opd I Based on 15.203) Basis of esign flow Grease ap present: (yes or no)_ Industr' I Waste Holding Tank present: (yes or no)_ Non-s nitary waste discharged to the Title 5 system: (yes or no)_ Wat r meter readings, if available: Las date of occupancy: OTH R: (Describe) Last ate of occupancy: GENERAL INFORMATION PUMPING RECORDS and iuyef information: System pumped as part of inspection: (yes or no)�i d If yes, volume pumped: gallons Reason for pumping: TYPED YSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed(if known) and source of information: "I Sewage odors detected when arriving at the site: (yes or no) /b C) revised 0/2/9E Page 6(if II r ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'ropertyAddress: 301 Skunknet Rd.. , Centerville Owner: Ned. Burke Date of Inspection: BUILDING SEWER: (Locate a site plan) Depth bel w grade:_ Material f construction:_cast iron_40 PVC_other (explain) Distant from private water supply well or suction line Diamete Comme s: (condition of joints, venting, evidence of leakage,-etc.) SEPTIC TANK:_ (locate on site plan) Depth below grade: Material of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age J_ Is.age confirmed by Certificate of Compliance_(Yes/No) Dimensions: 4e, co Sludge depth: r a Z l Distance from top of sludge to bottom of outlet tee or baffle: r Scum thickness:�"�� I , Distance from top of scum to top of outlet tee or baffle:_ D > Distance from bottom of scum to bottom of outle,jee or baffler How dimensions were determined: 0 104: - 1 A comments: (recommendation for pumping, condition of inlet and outlet tee�or baffles, depth of liquid level ip relation to outlet invert, structural integrity, evidence of leakage, etc.) /G ' A i /V d ��g d Al &6s B�. N IL GREASE P: (locate on s e plan) Depth belton : Material oction:_concrete_metal_Fiberglass _Polyethylene_other(explain) Dimensio Scum thic Distance of scum to top of outlet tee or baffle: Distance om of scum to bottom of outlet tee or baffle: Date of lag: Comment (recommeor pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence e, etc.) revised 9/2/95 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'rop"Address:301 Skunknet Rd.. , Centerville Owner: Ned. Burke Date of Inspection: TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass_Polyethylene_other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm present 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:( (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidgnX solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER: (locate on site plan Pumps in working order: (Yes or No) Alarms in workin order(Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) revised 9/2/98 Page 8of11 L _ r , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(corttinued) 'rop"Address: 301 Skunknet Rd . , Centerville , Owner: Ned. Burke Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible; excavation not required,location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits; number:— leaching chambers, number:_ leaching galleries, number:_ leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure level of po ing, damp oil, condition of�ve t lion, etc.l 6-a--® �i y' �tr L A o 01. l l s ~� CESSPOOL '. (locate on site lan) Number and con figuration: Depth-top of liqu d to inlet invert: Depth of solids la er: )epth of scum la er: Dimensions of ce spool: Materials of const uction: Indication of grou dwater. inflow ( esspool 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 pl n) Materials of const uction: Dimensions: Depth of site Comments: (note condition of oil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) revise- 9/2/98 Pagr9ofII .y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPE17TION FORM PART C s. SYSTEM INFORMATION(coftnued) NopertyAddress: 301 Skanknet Rd.. , Centerville. Jwner: Ned. Burke Jate of Inspection: J _ .i�Cl SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) j3�cil � � r ) revised 9/2/98 Pap-10of11 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Icorttinued) ropertyAddress: 301 S�kunknet Rd.. , Centerville Owner: Ne d. Burke Date of Inspection: NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells oc. Estimated Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property, observation hole, basement sump etc.) Determined from local conditions/ Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers Used USGS Data Describe}how you established the High Groundwater Elevation. (Must be completed) 6 6 1 /�J� T'o b� i revises 9/2/98 Page 11of11 TOWN OF BARNSTABLE T OCATION a-X)i QKU NJ"ST SEWAGE # VILLAGE O- "\U-� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. t\kC�CJOT 00Q!W� CO TcbSC— SEPTIC TANK CAPACITY ` ®O Q LEACHING FACILITY:(type) (size) 'moo NO. OF BEDROOMS_PRIVATE WELL PUBLIC WATER BUILDER OR OWNE DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No y „D 1. V i ti N................. DfV V i. 1If$.. .......r....� THE COMMONWEALTH,OF MASSACHUSETTS �� BOARD OF HEALTH V ��yy1� TOWN OF BARNSTABLE ` ,� Iirtt#i>an for Disposal Works Tonstrnr#inn ramit Application is hereby made for a Permit to Construct ( ) or Repair( 41 Individual Sewage Disposal System at: ...� .......................• --••-•-•--••-•--•---•-------------......... --------------......_.................--•- ... Locatio ddressLot...................... t No. -----.?..k-- Lo ------------------------------------------- Owner ddress Q� c _ ejRZ►2v1� L� .--- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms--------- .Expansion Attic ( ) Garbage Grinder ( )�t 04 Other—Type of Building _______________------------- No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity............gallons ' Length................ Width................ Diameter_--_____-__-_- Depth................ x Disposal Trench—No..................... Width.................... Total Length_................. Total leaching area....................sq. ft. Seepage"Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date....................................... a a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water................... G=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water----_______-.___---____. ---- --------- ------- --------------------------------- ---------"....--•---......-----•-•--------- ...... 0 Description of Soil......... -•••-�z--.--•--S U-�------------------2 ---��----------•-!'C_ -�°�---•-------gi p ...._.- U •--•-•-•-•--••-•-••----••-•-•-•----•--••-•-••--•••••-•••••-----•-•-•-•-•--•-••-••-•--•••••-----•---•••••-----•••-------•-•••---••-•-•-•-------•-•...--••-•--•----•-----••-••--------...-•---•........... W U Nature of Repairs or Alterations—Answer whe pplicable.___PQ�____--__-tt 1.......Y��-...._.LC` ��^' ,,....... � - r..............me cca ...•••-•-...--•--......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE S of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli ce has been is ued by the board of health. ..zi�.6 Signed ---------------- ------ '- .... ........'6...D. ....... ate Application Approved B a to CEIr Application Disapproved for the following reasons: ----------- ........................................................................................................... ---------------------------------------------------------------------- --------------------- ------------------ ---- ------------------------------------------------------------------------------- ------ .................._- ------ ' Date PermitNo. .. p��. ........... Issued ----------------------.....................................-------- Date `► ' THE COMMONWEALTH OF MASSACHUSETTS — v� � BOARD OF -HEALTH TOWN-OF BARNSTABLE �iraftou for U phial- nxks Tonfitrurtinn 11amit Application is hereby made for a Permit to Construct ( ) or Repair ,an Individual Sewage Disposal System at: � Lot No. -•..................................•---- . ..........-------------.......-------•--• '."Locatio ddress `- -------.................................... ....... elt_1.��- .............-•-•--•---------------...........------ t� Owner �/ /��1 dress/� P Installer Address Type of Building Size Lot............................Sq. feet V Dwellin, No. of Bedrooms.........:... Expansion Attic�-+ Dwelling" -------------------------- p ( ) Garbage Grinder ( ) e of •p., Other'—Other fixtnresillg_______________�_--•_.--.---•-No:•-of persons------__--_•--•---_------ ---Showers--(----)--- Cafeteria (-•-)- a ' W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter..._----_______- Depth ............ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No......= ------------ Diameter....t.............. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (s, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------------------------------------- -----------------------•--•--------•••--.-•---•................................. 0 Description of Soil.....----0-2.......... .................. e-Y............ ....... ....... txj ---------------------------------------•--•--------------------------------------------------------------------------------•----•-------------------------------------------------------••--------- W try ---------------------------------------------•-------------------._.--------------------------------•---------------•----...---------^•_'---'-----------------•-------r--'------•-------------- U Nature of Repairs or Alterations—Answer when applicable_._TQP__...-___Q'N_�___.._..t o� ___.'.LClv1_\?�- -�------...... ----------` ----•---------5`-�.....L..............•------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ued by the board of health. Signed --c----"---- ..--r='" ............ .. 6.....--------�b te Application Approved By ..... -- .... 1,�� '`-fit' --- a Application Disapproved for the following reasons: .. -------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------- ..--------------.----------------------------------------------------------- ........................................ Date Permit No. . - -�---��.-Y-------- ------- Issued ------ -- -- -----....--------------- ------- Date THE COMMONWEALTH OF MASSACHUSETTS AL0, 6iBOARD OF HEALTH �u � � TOWN OF BARNSTABLE Te>r#ifi ate of W'amplianre THIS IS (T0 CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired a, )� by ............................................................-- -----------------....................................................--------------------------- Installer at . ... 1� ------- K`1rvK.1J�S, .----------��....... �-i-l�� has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. --_ --^ rl.�/............. dated ._GQ_d.-.___._._.--__ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..�1..8...��.• h-------- --------------------------------------------------------- -- Inspector,-------- .. . £4 ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No..vo..�z.x TOWN OF BARNSTABLE FEE.............. .. RaVo,ott1 Work.5 Tu.nnstr ion rrntit Permission is hereby granted.......... --------et, ------------------------•---...---------------•-•-------•--•-----................... to Construct ( ) or Repair ( an Individual Sewage Disposal System at No...........-7 9:A1-----------------=ro.J.�.J-�1.!!Va..----•---•-� \ -------------_---- Street // a as shown on the application for Disposal Works Construction Permit No---c7a:79, Date-d•.-_- �.................... ` Board of I��tli DATE.............. l FORM 36508 HOBBS 6 WARREN,INC.,PUBLISHERS I A SS(?R•'Y; MAP NO. e`Q PARCEL r�G LO C'A'T ION f SEWAGE PERMIT NO. VILLAGE l�2-7� � 9Ve. ZE7 �a I mot. I N S T A LLER'S NAMIE i ADDRESS � 8UILDER O/R� OWNER DATE PERMIT ISSUED � 2 DATE COMPLIANCE ISSUED /�� f P 6 ..r No°�-._ ..OD _A THE COMMONWEALTH OF MASSACHUSETTS Iv r BOARD OF HEALTH r-- ............ U W.t'�.......O F.......Q.J\W. S`�. ...... ....... Appliration for Dispasal Workg Tlan.itrudinn jJrrmit Application is hereby made for a Permit to Construct or Repair ( an Individual Sewage Disposal System at, _ �•- ._S-W.1 4�`"�! .. ... . ....... .............�hr:= F. ................ ocat........ ....... Y.11. ....... �j .G�_r Lot No........_._.....................»........ ....... er.�p Address ar................ • Installer Address 1(I e� Type of Building Size Lot....!:f' .l..c?....Sq. feet .4 Dwelling—No. of Bedrooms........... .........................Expansion Attic ( ) Garbage Grinder V/P `4 Other—Type e of'Building J of persons............................ Showers Gv YP g ••---•..................... p ( } — Cafeteria ( ) 04 Other fixtures .. ...... ................................................................................................... ..... firl►�1 Design Flow............`...�. .ro......._ �.1 gallons per p gr cry. Total da• w.........` ............ Ions Septic Tank—Liquid ca acit _ _ .. .. llons ,en h._ t `.1 Width:._. .. .. Diameter................ D P q P Y � l�ga gt x Disposal Trench—Nf..................... 3 Wi.dth : on A Tlcnnrgth Diameter_. ZDe t below rilet.._...�.... Total leaching area r ft. Other Dorm z Percolation Test Result Performed by.. ( -•• Date....L.!.. _..Test Pit No. 1..... inutes per inch Depth of Test Pit........ ....... Depth to ground water. 44 Test Pit No. 2................minutes per inch Deptthh(oof;Test Pit.......... ....... Depth to ground water....................... O Description of Soil..... a ... ,14 _ ............ 0 V ............................................................................. ..........•••-•-----•........._.....------------------------•-----•-- ................. ------------------------- ----- ------------------------•---------------------...-•----•-•..._..------------------------------......--•-------------------------•----------...----.. .............. U Nature of Repairs or Alterations—Answer when applicable...................................................•........._................................. ...................... .. --•--- •-- .........................................................................................................................................................'----------•-•---•----•--...-•--•-•--.............---..........--------•--•---•-•---...... Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:I':LZ 5 of the State Sanitary Co —The u ers• d further agrees not to place the system in operation unt't'a C i j f Co liance has be i b r f health. Signed....... . ...... �� "'»�� .--� //lv 7 5 ApplicationAppro d By......�.1� ..��...............................................•---...........--..-- •---..�.,1 .. .................. Date Application Disapproved for the following reasons:.............................................................................................................. ........-•-----••-•..................................................•-••--•----..................•.............-•----------......-•--••---•---•---......-•-•••-------•--................................ Date Permit No............ . �. z'/ �............ Issued........................................................ Date �... L ,r •.w; 4••t eN THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r .......OF . . ..:: :...-.... Appliratiun for Disposal Works Ton,o#rudiun Frrmit Application is hereby made for a Permit to Construc",( or Repair ( ) an Individual Sewage Disposal System at _ ��` ............. � .. -'. .`�� f<.... �_ J ': 4"0*`1 �,, �1 . /Location.Ad_ $` t � ��1� ' ... Lot No •••. ...yak/1 ../ t•_/: G' ,�.1 .... ......... j.. a T f _ r W ................. C/ Address ..................................._.._.. -•---- •--------- ---------------- pq ,Installer Address e�'--..- - d Type of Building Size Lot'Garbage Grinder feet aU p ( , ) ~� r;. ,( t) Dwelling—No. of Bedrooms._........�.........................Ex Expansion Attic . aOther—Type of Building ............................ No. of persons..........::.-.......... Showe s ( ) — Cafeteria ( ) ' Q Other fixtures .................................1^- w v' .......--•-----••-•----------------•------•-----•- WW Design Flow............ ...� ...... ..r.�i gallons pets person r day. Total daily f#ow........` `� .............gallons0 WSeptic Tank—Liquid capacity.y.s"�!� gallons Length.. P...:_Widtk.'' ` '1. Diameter:.._.y.._..._. Depth - x Disposal Trench—No. .................... Widdtth..... ........Total Length.......... A Total leaching area.r�� .....sq. ft. 4 f 3 Seepage Pit No.........)_...____... Diameter ,-..1.Z.fDepth below inlet.............. Total leaching area.--. ...Lsq. ft. z Other Distribution box ), ..i ,'AI)osing_tank r , Percolation Test Results 'Performed b .: � _::.... L / ' �...a � y... -� �..---- r .... Date.... .�...............•-•-- .._..... ,.a Test Pit No. 1......:.........minutes per inch Depth of'Test Pit....44F' ..... Depth to ground water ..0.. 44 Test Pit No. 2................minutes per�l;inch� Depth of Test Pit........ i -............ Depth to ground water..................,:.... _= VDescription of Soil....... . ... --••••.Z r ., �---. �...... ------,-----• ...1 ........-•---....•--•-••-•••-...-----•-••---....-•----......•.... .. Vv • ....... ........ W g i- `V Nature of Repairs or Alterations—Answer when applicable................................................. ........................................... •-••.........•... ••--•-•---••••...-•----•-•....•••-•...••-••---••--••-••.......••••-•._.....--•--••••...............•--•-••---•---•-----................................ Agreement: �\'', The undersigned agrees to install the aforedescribed Individual System Sewage Disposal S s 'g p y t m accordance with the provisions of:ITL: 5 of the State Sanitary Code— The unAersigned further agrees not to place the system in operation until a Ce%cateloA f Compliance has beeen/issssp d by the board of health. / �j -'' Signed. _ �//-/f.: / i/:.,� ! ��` - •.2"..�--_ Date ...... ..... .... D ,,�,;-� Date Application Approved By..--.-�:_.�. -.. .: ? G . ..................................... /�/2..r '.`' ;....... Date Application Disapproved for the following reasons:.............:...•--•-•-••-•-•--•-----------._....--•-•---...-•------.....-•-----•-•--•••...................... ..........--•----•.............•--------....----......-•-------.....--•---.........•......................---:-.......--•------------.......-•----.............._.................................:.... Permit No......�a�� #n!-1' ............. Issued_.......................................................Dau �j� THE COMMONWEALTH OF MASSACHUSETTS BOARD�OF HEALTH 2 �- Trr#if irtt#r of T>amplittnrr THISfIS-TO- rER-TIFY—That-the I_n.d,ividual Sewage Disposal System constructed 'f) o Rep aired ( ) by......a! f_! /'` 'Q y .:. - 11/1 (C --= " J--....... ...................................:... �� Install at has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the j'- application for Disposal Works Construction Permit No....:�Rj.-: `l ...... dated..... .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ----^� DATE....................... . 7................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 ,Z ..........................................OF.... -�7" .(/..�•?�� .L!rl4C No..............Q�L. , , Fes. ..... Disposal �19orka Tunstr�ur#iurt Virufit Permission is hereby granted.----.--- �L...C. .m1....................................... to Construct O or Repair ( ) an Individual Sewa a Dis oral System • atNo............ - ...----•-.. .................. l .. ...: . a ............................................................. Street as shown on the application for Disposal Works Construction Permit No��:_!��_Z-.- Dated..... /``,;, ............. ........ ... _. Z ...................................... Board Board of Health DATE..........�.�./__...�.�....5 - 11 AssEssoRs MAP: -170 TEST HOLE LOGS -0� PARCEL: - NOTES: SOIL EVALUATOR )AV I q t26 FLOOD ZONE: WITNESS- hl 1 1'1.. 1) The installation'shall comply with Title V and 'Town of Barnstable Board of REFERENCE: DEEiD G3aC e— 'W /3 3Z7 f 4, DATE: _ Health Regulations. PERCOLATION RATE• W41 , 1 t 2 The installer shall verify the location of utilities, sewer inverts and septic 1<j C�ILT77�'j�� ?�LD�►,l t��/ 4 �� f��+�'�1�� '— ) Y components prior to installation and setting base elevations. �(., �i � �/ L� �i i P P b b• ��1•J '-/ 8e TH- 1 TH-2 ( 3) All gravity septic pipingto be 4 inch Sch 40 PVC at 1/8" per foot. The first ! � two feet out of the dbox to the leaching shall be level. �'� �/� Mk/p /i' � •C� j 4) This plan is not to be utilized for property line determination nor any other purpose other than the proposed system installation. ' , '•�'j c t'`t t" tAw �'l i 5) All septic components must meet Title V specifications. ,. � Cv 0 6) Parking shall not be constructed over H10 components. septic P + OCAT I ON MAP 23 7) The property is bounded by property corners and property lines. eJO 8) The property owner shall review design considerations to approve of total ..j� design flow and number of bedrooms to be considered for design. Receipt of payment far the plan and installation based on the plan shall be deemed ' approval of the design flow by the owner. / 9) The existing leaching or cesspools shall be pumped and filled with material per Title V abandonment procedures. Those within the proposed SAS shall be �� 46A removed along with contaminated soil and replaced with clean washed sand 1D AD 4dWO. 04leL Ak� ` per Title V specs. 10)System components to be 10 feet from waterline. Sewer lines crossing the water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if E /jam, SEPTIC SYSTEM DESIGN applicable. 11) If a garbage grinder exists it is to be removed and is the responsibility of the 1 / FLOW EST I MATE owner to ensure such. 12)The installer is to take caution in excavation around the gas line if applicable „BEDROOMS AT 110 GAL/DAY/BEDROOM GAL/DAY SEPTIC TANK GAUDAY x 2 DAYS GAL USE IWO GALLON SEPT IBC( TANK SOIL ABSORPTION SYSTEM JI _ ( 15�b0, SIDE AREA: ZX ZS,�3 + /2126 X Z �,7 818 BOTTOM AREA: ,3 X, /2,Z + 7274. - it SEPT I C SYSTEM SECT I ON ` 4 l` a� Fill . 1 % `�� — Sy�� -�- o 0 0 0 / t n GAL ,5y/.S D-BO U� °; 9 �• SEPT C. K 531I r%A /Ar -� I � o 1 0 1 U IOU, /+9S �N OF DAVID WED B. MASON m F, VN 9No.,os6o y AGE PLAN � S i TE AND SEW r � . a`•¢ [[ FLOCATION . � 02 F 1 Z 29 p CafT ..Yi+LI.. .. PREPARED FOR : 5 F,...K CAWA+77t�.,/ P w o SCALE: DAV I D B . MASON 2�) DATE: �1 3 DBC ENVIRONMENTAL DESIGNS ^v EAST SANDWICH MA DATE HEALTH AGENT ( 508) 833- 2177 '_ lAJ0l WMAR SECTION - SEWAGE CALFSr 1�1 i 1 jZ -SEPTIC TANK- -"D"BOX- -LEACH 1 T ELEV 47,00 TO�P/OF FDN .lSf!t�d.(MS ,*, -"2"OFI/11TOIh" WASHED STONE TF 54,g _ - IN• OUT• IN• OUT �---G IN- o �2,Z2 51.�if3 EPTIC ELEV. TANK \S 5),_ 73 ` G 2 1 ELEV. ELEV. ELEV. AI 51��5 51, 3 3 ELEV. ELEV. —..r?. OF Vi"-1%" 1 WASHED STONE �2' S TEST HOLE LOG `�*� c��2 z � pp rf�_-ei,44I 6 -S, Go tj Lc>t-1 TEST BY L ' WITNESS 41 ��Q-r�JS e � TEST DATE I o�zg/�S DESIGN -� BEDROOM HOUSE ' tiSON ��. i T.H. ,r 1 T.H. 2 Al srt / ti` Q _ ELEV. i q' ELEV. NO L2 DISPOSER DISPOSER rr Lply/ PERC RATE MIN/IN. LO / �5 i ti 30 ,G1 FLOW RATE 3'3C7(GAL./DAY) �3 s J ' SEPTIC TANK 33o G P REO'D SEPTIC TANK SIZE d ` 0b., V 1 , 5 / LEACH FACILITY 'n 55 AV L• SIDE WALL JZrr4 7 (25') _ ,37�,8 .G/D. � �7 BOTTOM ;2 2 -2TT=f 1310 (l,n) _. 11 31 O G/D. i TOTAL 2 3 7 sr- USE: ��/� LEACHINGr `P/ L ►ac WATER ENCOUNTERED NOTES: (UNLESS OTHERWISE NOTED) giPE - lOi 1.DATUM(MSU TAKEN_ FROM S�}�S�Ll7 I C QUADRANGLE MAP 2.MUNICIPAL WATER -------AVAILABLE I 3.PIPE PITCH:µ"PER FOOT 4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO- 4-10 •44 `A OF S.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(1)FT. s*PIPE JOINTS SHALL BE MADE WATERTIGHT / ARNE H. 7:CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. STATE ENVIRONMENTAL CODE TITLES �, PLAN 8. Ty.-� -R-A--J I�o� �eA--� w�ogC�C ,�� a._,o -5•- ��-� vn LOCUS: LUT- 2Z SikUNeAFT 120A D I_Ior �bE UD �a� .�td?t=LAY t_�`tCz �T1aCn.�G> . __ or M _ CEn/T_F2Vr14 ^ASS REG.P OFESSip INFER ARNE yG rr, N l REF: J oo Y- y0 Z lit!G F 2 7 down cape en,fineering \, � ,•aA ^;'r PREPARED FOR: CIVIL ENGINEERS _ BOARD OF HEALTH , LAND SURVEYORS REG.LAND SU WOR - fin' /O CONTOURS (EXISTING)............. �,d,�^j�j"T"AQj " (PROPOSED)—O—O—O—O— APPROVED DATEA Y , Ili SCALE DATE ES S �� • 'v