HomeMy WebLinkAbout0373 SKUNKNET ROAD - Health 373 Skunknet Road
Lot # 646 �F
170-116 Centerville
TOWN OF BAR_NSTABLE
LOCATION 516c �-,kAtev SEWAGE# �O f -O€37
VILLAGE ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. I v,,,��q!S
SEPTIC TANK CAPACITYfi
LEACHING FACILITY: (type) k,-c- 16 We (size) 2,63x 66
NO.OF BEDROOMS '3
OWNER —V-kC,c/ P
PERMIT DATE: y! 1 2 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility fee Iwo 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�,/S ff1!27vje-J
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vvI r7o,S MOT-3,y
t�P o�pr
No. 00 ,� —D�� _��" / Fee
10-0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
application for 11 08al 6pstent Construction Permit
Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 3,13 !Z Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel /70-116 r�a y el
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
�O�S�Ce S A ..c CO_7/S �,✓5 t^�e eY,%� Gad/�C$ 11;� -4/77`5- 1
Type of Building:
Dwelling No.of Bedrooms Lot Size 1 SP"p sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required)t -3'3 0 gpd Design flow provided 3 y 5-. gpd
Plan Date ' Number of sheets Z, Revision Date
Title
Size of Septic Tank Y_x 1 2rK'VC Type of S.A.S. rc `3 C, C _
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) J AX t-C,1� tg e.Lo S. c
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.
Signed Date N 6 /
Application Approved by .2 Date y`C7 -
Application Disapproved by Date
for the following reasons
Permit No. 0 I '" 6 � 7- Date Issued -1 - �'
No. do ,O(5 7- " f� Fee (� /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
p % PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
11ppllcatlon'f or -MIsposal �6pstrm Construction Permit
Application for a Permit to Construct( ) Repair(✓)/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
is a
Location Address or Lot No. '3 9 3 5 k<ry k at i-t /Z Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel / 7 6
Installer's Name,Address,and Tel.No. �. Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size F)(Xo sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided ''��(S . �( gpd
Plan Date Number of sheets 2 Revision Date
.Title
Size of Septic Tank x i ,f to,,,t Type of S.A.S. A t c c, N C
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Lti-JC,
r
Date last inspected: 1
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.
s
Signed Date
Application Approved by Date C('Gj ' L
Application Disapproved by Date
for the following reasons
Permit No. a O 6 X Date Issued
---- ---- ------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( )
Abandoned( )by .
at S 1r n -I - has been constructed in accordance tJ
with the provisions of Title 5 and the for Disposal System Construction Permit No. oq 01.1 b dated
Installer Q Designer
#bedrooms Approved design flow -z" 5, S gpd
The issuance of this permit sha. not be construed as a guarantee that the system wil function esi e
Date 9 Inspector
----- --------- - - --- -------------------------------- -------- --------
d
rr�� r ---- -------------------
No. o 1� � 6 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Bisposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair(Ll� Upgrade( ) ` Abandon( )
System located at 7 S I c v n►
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.. -�
Date - Approved by
04/10/2012 07:26 5084775313 ENGINEERING WORKS PAGE 01
Torn of Barnstable
Rectory Services
Thomas F.Geller,Director
Public Health Division
Thongs McKean,Director
200 Main Street, Hyannis,MA 02601
Officc: 50&862-,%0 Fax: 50 ?.W6304
Date: Sewage lf'ermit# Aa or's N*&arcel 1-1 0- 1 6
Installer& Desiner Certificatioa Form
Designer: t=r, ;; n W d V'U s, Inf. . Installer: k VL C .
Address: 1 z W. Cra r.s :r w "Izd• .Address:
on P, O ,&fU OUC was issued a permit to install a
(date) (installer)
septic system at S 7 I 5 kv A L,�naj- (W &k O1 I 1kased on a design drawn by
(address)
jod-e r Me-£-6--Ce eL dated "-a
(designer)
�. 1 certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Stnpout (if required) was inspected and the soils
were found satisfactory.
1 cez tify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any coil pgraent
of the septic system) but in accordance with State & Local Regulations, Plan.,revision or
certified as-built by designer to follow. Stripout(if required)wa . ed and.the soils
were found satisfactory. H OF
PETER T.
WENT£E
{ ler's Signature) CIVIL ti
19 It&35109 0
(Designer's Signature) (Affix Design )
PLEASE RETURN TO HARNSTARIA ALT19 IO T]T'I AT
F C MPLL&_N E WILL NOT BE ISS1 D 11L BO THIS FOR AND AS-
CAM RX JU BARN ABLE PjJ LIC HEALTH DIVI I
THANK YOU.
gAofice fb=\desiswrcertiffaetion form.&c
Town of Barnstable P#_ j 63 i5 27
Department of Regulatory Services
s tat$, i Public Health Division Date
»
200 Main Street,Hyannis MA 02601
Date Scheduled � O'er - .Time . Fee Pd. *l 4 @• tl d
Soil Suitability Assessment for S age Disposal _
Performed By: 11 � �" N ��r ��itnessed By:
LOCATION& GENERAL INFORMATION -
Location Address 373 SV vr1 i<VW_J-d2a Owner's Name_TYa e✓; M,01co-k A- e i S J
Cep-+-eem )(e 373 DVmv�tvkt-ICc�I , ce_, c. a ite c` X
Address
Assessor's Map/Parcel•l*7� ] & Engineer's Name T�j. C '��e ��
NEW CONSTRUCTION REPAIR ayTelephone# 0,?-737—q7 G F
Land Use Slopes(3'0) L4 Surface Stones lJ
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well_�2�ft
Drainage Way--,;, ft Property Line 2e��� ft Other ft
SKETCH:(Street name,dimensions of to exact locations of test holes&perc tests,locate wetlands fn proximity to holes)
T
�.
c)
5 v^u.re V
77
Parent material(geologic) y Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: /v�' Weeping from Pit Face !
Estimated Seasonal High Groundwater ' 2,0 I
DETERAUNATION'FOR SEASONAL-NIGH-WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in, Depth to soil mottles:
Depth to weeping f-aci side of obs.-hole: in. 'Groundwater Adjustment ft.
Index.Well# Reading Date: Index Well level,�,, Adj.factor- Adj.Groundwater t evpl,,,o
PERCOLATION TEST Date., Tvtne.�
Observation
Hole# Time at 9"
Depth of Perc M ^ Time at 6"
Start Pre-soak Time @ -Z L'` c3 w 1't11'- '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:\SEPTI0PERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture .Soil Color Soil I I Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
iteGravel)
yob!—,C Sb z�._57
3
DEEP OBSERVATION HOLE LOG Hole# z
Depth from Soil Horizon Soil Texture Soil Color Soil-` ' Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
onsistency.% ray
ia
-ram L �-C- �� Y
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Y Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%G ve
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
onsi t n
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No--lam- Yeses
Within 100 year flood boundary No-,!L— Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious 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-- - '1 •
I certify that on R9, (date)I have passed the soil evaluator examinatiomapproved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
-the required trai • ,expertise and experience described in 310 CMR 15.017. -
- Date 24
Signature
Q:1$BPTIGIPERCFORM.DOC
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF.ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFI CATI ON /f 0 11
Property Address: _7
Owner's Name:.
Owner's Address:
Date of Ins ection BCD
-� Nye of In pecto please pr'nt)
CIP
_ . 'Parry . ame: `
�� 11�ilinb.A dress• ��ty
u T�ephbne tuber: C� - ?27: gL �g
` RTIF A.TION STATE'MEN T
i iry that I have personally inspected the sewage disposal system at this address and that the information reported
C) l ow is tt-je, accurate and complete as of the time of the inspection.The inspection was performed based on my
ftning and experience in the proper function and maintenance of on:site sewage disposal systems. I am a DE.P
.-approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving'Authority
ails
Irispector'.s Sighatilrc: '�` Date: /0/((a
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 ,:b eater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving
authority.
Notes and Comments
****This report only describes.conditions at the time of inspection,and tinder 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 I
{
Page 2 of l 1
OFFICIAL INSPECTIONTORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE'DISPOSA.L SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 7:3 �2� '. Rbeeel
Owner: l
Date of Inspeetion:
Inspection Summary: Check A,B,C,D or E./ALWAYS complete,all of Section D
A. System Passes:
�I r I have not found any information which.indiicates that any of the failure criteria described in 310:ClvIR
15.303 or in 310 CNIR 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 2.0 years.older' 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 our 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 thanA times a year due to broken or obstructed pipe(s):Tlie system will
pass.inspection if(with,approval of the:Board of Health):
broken.pipe(s),are replaced
obstruction is removed
ND explain:
f
Page 4 of I I
OFFICIAL INS.PEC.TION:FORl`I NOT-FOR VOL.UNTARY:A.SSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION:FORM
PANT A.
CERTIFICATION(continued) -
Property.Address:,
'Owner:
Date of Inspection.
D. System Failure Criteria applicable to all systems:
You must indicate"yes" or"no"to each..of the-following for alt inspections:
Yes. No
Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
Discharge or pondin of effluentto the surface of the -round.: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 Iess than %day flow
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number
/ of times pumped V
_ V. Any portion of.the.SAS;cesspool or privy is.below high&•ound water elevation.
Any portion of cesspool or privy is within 100•feet of a surface water supply or tributary to a.surface
water.supply.
_ Any portion of a cesspool.or.privy is within a Zone 1 of a'.public well.
Any portion of a cesspool or privy is within 50 feet of a.private water supply well.
Any portion of:a cesspool or•privy.is.less than 1.00 feet but greater.than.50'fee-t.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 organiacompounds
indicates that the.well is free from oMition from that.facilit and the.' e
p r sense of ammonia
Y P
nitrogen and.nitr.ate nitrogen is equal.to or less than 5 ppm, provided that noI:other failure criteria
are triggered.A copy of the analysis.must be attached to this form.]
Yes/No The s -stem fails. I have( ) determined that one or more t Y m t of.he above failur.,criteria.exist as
described m.310.CNIR 15:303, therefore the system fails. The system.o.wn.er 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 1.5,000
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 an i tfo(yen sensitive area(Interim Wellhead Protection Area—IWPA) or am
apped
Zone I1 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 3,10 CMR
15.304.The system owner should contact the appropriate regional office of the Department.
Paee' 3 of l 1
i
OFFICIAL INSPECTION FORM -.NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE.DISP0SAL SYSTEM'INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 4 73 %,%1 A J JwA A?
Owner: A 4.A._
Date of In"pection: O
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 f et 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 PublicMater 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 l 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 aseptic 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
s.
*"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 most be attached to this form.
3. Other:
f
Page 6 of l l
OFFICIAL INSP4CTION'FORK 1'1OT.FOR VOLUiti T;ARY:ASSESSMENTS
.SUBSURFACE SEWAGE:DISPOSAL SYSTEM INSPEC7CIONFORIMI
PARRTT.,C
SYSTEM INF.OR.iMIATION1
Property Address- 7 Ohl 1( / J)�
Owner:
Inspection.
I ,
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms.(.design):, � Number of bedrooms(actual).:
DESIGN flow based on 310 CNIR 15.203 (for example: 11.0 gpd x rr of bedrooms):
Number of current residents:. , //
Does residence have a garbage grinder(yes or no):NU
Is laundry on.a separate sewage system(y9s or no):W Uf ves separate inspection required]
Laundry system inspected(y s.or no): O
Seasonal use: (yes or no): t,/�U
Water meter readings, if av ']able(last 2 years usage(gpd)):
Sump.pump (yes.or no): n
Last date of occupancy: 1 c�r
"
�
Afig/�'�-Ply
COrYIMERCIAL/INDUSTRIAL f
Type of establishment:.
Design, flow(based on 310 CMR 15.203): gpd
Basis of-design flow(seats/persons/s.gft,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
Source of information:
Was system pumped as part of the inspecti (yes or no): Jl/� ,
If yes, volume pumped: gallons--How was quantity pumped determined?
Reason for pumping:
TYP OF SYSTEM.
_VSeptic tank, distribution box, soil absorption system
_Single cesspool
_Overflow cesspool
_Privy
Shared system (yes or no)(if yes,attach previous inspection records, if ally)
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):
A r ximate aye of all components, date install d(if kiaown and source of information:.
Were sewage odors.-detected when arriving at the site (yes or7`0
Page 5 of 1.1 �
OFFICIAL INSPECTION,FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUE SURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART.P
CHECKLIST
Property Address: 3-
Owner: '. —
Date of Tn section:
Check if the following have been done.You must indicate"yes"or"no" as to.each of the followins:
Yes. �o
Pumping.information was.provided by the owner,occupant, or'Board of Health
Were any of the system components pumped out in the previous two
week-s ?
V""'Has the system received normal flows in the previous two week period ?
Have large volumes of water been introduced to the system recently or as part of this inspection ?
Were as built plans of the system obtained and examined? (If they were not available note as N/A)
Was the facility or dwelling inspected for signs of sewage back up? '
Was the site inspected for signs of break out ?
Were all system components, excluding the SAS, located on site
Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition
of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and.depth of scum
Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems
The size and location of the Soil Absorption System (SAS) on the site has been determined based on,
Yes no
Existing information. For example, a plan at the Board of Health.
Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable) [310 C1 411 1 5 3 02(3)(b)]
Paee 7 of 1 1
OFFICIAL INSPECTION FORM—NOT FOR''VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION'FORM
PART C
SYSTEM.INFORMATTON (continued)
Property Address: � ule
Owner:
Date of Inspection:
BUILDING SEWER (locate on site plan) !O
Depth below grade:
.Materials of construction:_cast iron _40 PVC_other(explain): _
Distance-from private water supply well or suction line:
Comments(on condition of joints, venting, evidence ofieakage, etc.):
SEPTIC TANK: _(locate'on site plan)
Depth below grade:
Material of construction: oncrete_metal_fiberglass polyethylene
—other(explain)
If tank is metal list age:_ Is agelconfirmed by a Certificate of Compliance(yes or no):_(attach a copy of
certificate)
Dimensions: . " )('
Sludge depth: on.�"/ /f
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness: /0 it
Distance from top of'scum to top of outlet tee or baffle: s ptIel '
Distance from bottom of scum to bottom of outlet�tee AA-or��baffle:
How were dimensions determinedC �� �
"Comments(on pumping recomme dations; inlet and outlet tee or ba fle condition, structural integrity, liquid levels
a related to outlet invert, evidence of leakage,etc.): ✓
F
/!
GREASE TRA (; ()ocate on site plan) 2�?
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,.):
' 7 '
Page 8 of 1.1
OFFICIAL INSPECTION I+ORM—NOT I+ORYOLUNTARY ASSESSMENTS`
SUBSURFACE SEWAGE DISPOSAL SYSTEM'INSPECTION FOR1M
PART C
SYSTEM INFORNfATION(continued)
Property Address: 2,7 3. . 611A eoao�'
Owner: Ad
Date of In ` ection: (��p
0
TIGHT or HOLDING TANK: Alu(tank must be pumped at time of inspection)(loc.ate.ou site plan)
Dept}:,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: (if present must be opened)(locate on site.plan)
Depth of liquid level above outlet invert:
Comments (note if box is level and.distribution to outlets ual,.any evidence of solids carryover; any evidence of
ak or out of_boxo
PUMP CHAMBER:, (locate on site plan):
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
Pate 9 of 1 1
OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORIM,
PART C
SYSTEM 1NFORIMA.TION'(continued)
Property Address: �L
: .Owner: ,t,!
Date o.1 spection: w
SOIL:ABSORPTION SYSTEM, (SAS): ✓ (locate on site plan, excavation not required)
If SAS not located explain why:
201�eaching
pits,number: `
-leaching chambers,number:
leaching.galleries, number:
7eac}iing trenches,number,leneth:.
leaching fields,number; dimensions:
overflow cesspool,number:
innovative/altemaci.ve system Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,
et
a, 1600
CAZ
CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:
Depth'—top of liquid to inlet invert:
Depth`of solids laver:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
lndicaiion of.groundwater inflow(yes or no): .
Comments (note conditionrof soil signs of hydraulic failure, level of ponding, condition of vegetation, etc'):
'PRIVY:A(locate on site plan)
Materials of constriction:
Dimensions:
Depth of solids:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):.
I
9
Page 10 of 11
OFFICIAL IiVSPECTIQi�i FOIZIYI =.I�10 O YO 1�'°tTAl t Aa. ESSMENT.S .
SUBSRFACE SEW U AGE.DISPOSAL SYSTEM INSPECTION FORM,
PART,C
SYSTEM INFORMATION(continued) ,
Property Address: 73 \
/—/A '
Owner:
Date of Inspection: (0
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.
t l Z
{ 1(0o
Page 11 of 1 l
OFFICIAL INSPECTION FORIM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
Owner: ,
•DateofI spection:
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water feet
Please indicate (check)all methods used to determine the high ground water elevation:
Obtained from.system design plans on record-If checked,date of design plan'reviewed:.
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:
42/
1]
Permit Number: Date:
Completed by:
HIGH GROUND-WATER LEVEL COMPUTATION
Site Location: ! , �Jea iewe/ lael- Lot No.
Owner:_ kn 1 ew 1 Address:
Contractor: )q ` Address:—.
otes ... ...._.
STEP 1 Measure depth to water table
to nearest 1/10 ft. .............................................................................. .Date
Ae—A/ev
month/day/year
STEP 2 Using Water Level Range Zone
and Index,Well Map locate
site and determine:
OA A ro riate.index well........................, �..
O- 40
B .Water-level range zone .....................................................
STEP 3 Using monthly report"Current
Water Resources Conditions"
determine current depth to Mq
water level for index well ..........................
month/year
STEP 4 Using Table of Water-level Adjustments
for index well (STEP 2A), current depth
'to water level for index well (STEP 3),
and water-level zone(STEP 2B)
determine water-level adjustment .......................................................................................... r
STEP 5 Estimate depth to high water
by subtracting the water-
level adjustment (STEP 4)
from measured depth to water
level at site (STEP 1) ......:...... ��
Figure 13.—Reproducible computation form.
15
�:.
a.,.,,.
.;j'
t
• + '
L 0 C A T ION SEWAGE PERMIT NO.
zc;), G �' ` �/t'�hn�ff�Z 5 s-- E,;k S
VILLAGE
74 t>>tlP
INSTALLER'S NAME i ADDRESS
-a UILDER OR OWNER
`vDATE PERMIT ISSUED195
DATE COMPLIANCE ISSUED
(,a.� 6 Y�
F
t
W
{
1
Kam` THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Two............OF........... . ' ?., .?'G� / ..................................
Avp trat,ion for Btipnaal Works Tnnstrnrttrrn Prrnttt
Application is hereby made for a Permit to Construct (✓j or Repair ( } an Individual Sewage Disposal
System at:
................. aR O +�
Location
-Address or Lot No.
a ....:1`m ------------------ .JL. t 5.......................................
� Installer Address
Type of Building Size Lot...... feet
Dwelling—No. of Bedrooms.........J..............................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons-_--__--____-_-.____.__-____ Showers ( ) — Cafeteria ( )
a' Other fixtures .................................. ... ...
W Design Flow............................................gallons per person per day. Total daily flow................... ............gallons.
1
WSeptic Tank—Liquid capacity./40OAgallons Length__ ''!v.__ Width---4.-la. Diameter-___-__-_•__-___ Depth...4=-b'
x Disposal Trench—No..................... Width.............._..... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---------%._____.... Diameter........0•_ Depth below inlet•.Z.,.7....... Total leaching area...4_.�l....sq. ft.
Z Other Distribution box ( ✓f Dosing tank ( )
`-' Percolation Test Results Performed by-----13r4 4.AV1W_.400A.W.44:�,1.4-40pGDate_......./PA1 ¢--_---__..
Test Pit No. L...-.4'_.?,...minutes per inch Depth of Test Pit......./z...... Depth to ground water....A✓ol��._.
(% Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-_. --_____-_-_-. -____
a •---•--------------- ------••--•-••--- ------.................-- ...........-----•---.-------------------------•-------..................-----•--••-
O Description of Soil-----------------------•----•---� --�-�---- �s�- ma 4-'----<7. /................................
4 '' • a .� ±--•--••••-•-•-•.................................................. y %Fv �1
W
VNature of Repairs or Alterations—Answer when applicable.--___-___________________________________________________________________________•----.-----__.
--------•---------------------------------------------------------------------------------------•••-•----•------•--•-•-------•-•--------•-------.._.....,..--••--•--••••••---.........................
Agreement:
The undersigned agrees to install the aforedescribed I.ndiv' ual Sewage Disposal System in accordance with
the provisions ITU 5 of the State Sanitary de— The u er igned further agrees not to place the system in
operation u rtificate of Compliance has b i ue t b r of health.
Signed`- - -- - -•-- ---- - -•-------------------------•---•-•--•--•-- fa
App ca pproved By--------•---------- --- v • •. ---------------•-........--------- --------••A pli Disapproved for the fo o ing reasons:_...-------•-------....-•-...-•-•----------•----------•-----••••---•-•-----•-----• -•...•-•-----
---•••••----••••---------------------•--•--•-•-•••••---•-•-----............•--•-----...------•-----......I.
------------------
Date
PermitNo......................................................... Issued.......................................................
Date
�7
No.........................
i THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF. 2 •fl��
Appliration for Dhipasa1 10orkii Towitrnrtiun Famit
Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at: /
Location Address or Lot No.
................. /,.� �••/' G...L C-/�� ._._.........__.._ Lj__7 A-11-2 4 5
........ ........ ......... ......... ......... ............_._ ....... ._z.._..._:....
1,Wa ............ .l fit .�. '1�`!.. 0 _$ _±�_�..L d�/ j. A e
Installer Address
Type of Building Size Lot.....� ?Z-_1=....Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
P4 Other fixtures ..-•--•--•-•...............•-------•----•-
W Design Flow............................................gallons per person per day. Total daily flow...................... . .............gallons.
WSeptic Tank—Liquid capacity.A�2?gallons Length._?9_`h.. Width...""._-1�. Diameter________________ Depth...-'_.:
x Disposal Trench—No. .................... Width.................... Total Length-................... Total leaching area....................Sq. ft.
Seepage Pit No........... Diameter--------l__ Depth below inlet.... ...... Total leaching area....--.A!.•..sq. ft.
Z Other Distribution box ( -) Dosing tank ( )
Percolation Test Results Performed by..... =.. �_/:�._�>�/11�! _�����Date__....../1?//1 1,54
Test Pit No. I.... ...minutes per inch Depth of Test Pit.......L.=........ Depth to ground water-.__�/�: _�_ -.._.
LEI Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a' --•-•---•----•-••--------------•--•••---....-•--••-••••-•-•-•-••••••-••--•-••-....----••.....................................................................
0 Description of Soil..................................0......... ................... - -��•l%�,.�_,:. -v'_ -`-�-- C=' '-a--✓
/2, , ems -- / <ti + -/,
U --•.........--••-•-•---....•-----•-••-•••••••-•-------••---•---•....................••••-••.......,.
W
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•••.
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
. •---••---•••------•----•----••-•---•••------------•---------•-•--•------....
Agreement:
The undersi ed agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions ITS 5 of the State Sanitary C_,gde— The u er igned further agrees not to place the system in
operation u a ertificate of Compliance has b ' itedl y t Z b of health.
Signed..
. .. v,�' A _., ' ' "-
/ .. ---� -------••- :.. ......
APP ca PProved BY j- -� ------------------------------•-- ------...... . e� .....
D to
Application Disapproved for the f o loaving reasons:--- •------------•-------------------------------------•----•--•-••--------•••.... .....•.................
.............•--•--•.........•-••-•••--•-•••-•-•••••-•---•••-••-•••........••••--••--•••-••-•---._...••--- ._.._..••-••-•-••-•-••-••-•••••••••-•-------•-•••-••---••---•......-•----•--••-•-•••--••---.
Date
PermitNo......................................................... Issued.......................................................
Date
_ 1
THE COMMONWEALTH OF MASSACHUSETTS
BOARP')OF HEALTH ,
C.... :`..................
f�rr�ifirtttr oaf f�nrnt�r�i�nrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed r Repaired ( )
by........ t' =�'�' ^1.. 1".. .>�` .-••...............•-•-••••••-•-••--.........•--•-•..........__...--••--....
�"..--
" InstllLc� �3
at ' .
has been installed in accordance with the provisions of T TLC 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.`c 5..-.� S................... dated--------- '"`t ................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TRUE® AS A GUARANTEE THAT THE
SYSTEM WILL � /T��O�N' SATISFACTORY.
DATE................. �F.t ........................................ Inspector..........---- --•- ........ ---......... •-•-----
THE COMMONWEALTH OF MASSACHUSETTS
E10ARD,,'OF HEALTH
...................................:......O F.. .. ?!°� ... FEE.. ----•.........
Elispoa Wor 15 Q-11onii4nrtion Prrmit
Permission is hpfeby granted----•---•-- '�=�"'�-- ------ - ---------�- -��= - . ..............................................................
to to Constrt �`or Re air/( ) an In 'victual Sewage isp sal Syst ,
...
treet
as shown on the application for Disposal,Works Construction Permit No"._- . ' ... Dated........
7"_..
DATE. j 1i 09 i o d of Health
...i. ......_�...... .......................................................
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
r -
r �
s.
T �
SITE PLAN SHEET I of 2
SCAL E: I = 20'
N
5IX4
57xG
BTO,f'�FC�?,4T Co�vC. �roGpL 5/x5
L/-AC.SN. /�9�/�c/ ,W�TN —
3'.SToc/E 92r�UvrJ \ l =6EevE
.Q � i
� N
N a sra.,oer�17 Co.�.
QQ `.L /GOO G/IG
N S.�.oT/C TANK
M I 14
u.o
3i3�2 ODYL.
: 51x3 SIx3 W
N N N
/4
14 m
m
I I �
�37ag I
TP
I
- I
0 I
¢s LOT c-o* 44;
�47
/s7,76 I I
I
. I I
S i
I I
I
I 51xS"
OF M,{�
c
WILUAM
g k
WAIiwICK
` No. 19"l
toI IEa��
t LAO
REG/STEREO LAND SURVEYOR FOR .� E/36L • .5o L�.D W5
Z 0T 62,46, 5k4m4e. 1%=r ,P_ogD
ZONE_ �C C.��VTE�VrLG E Mp�S . j
PLAN REF. DATE ��/+•/ 2B /965
BENCH MARK DATUM WM. M. WARWICK 6 ASSOC., INC.
DOMESTIC WATER SOURCE T wN Box 801 - NORTH FAL MOUTH
FLOOD ZONE.- 1V0A1-b97QgCD C�� MASS. 02556 - (6I7) 563 -2638
LEACHING BASIN SECTION NOT TO SCALE sh-c-c
24"C.I UH COVER
* EARTH F/LL BRICK AND MORTAR COURSES AS REO'0• TO BRING
COVER TO GRADE
4
INLET J8 FLOW LINE __,. �.y 2"_y"TO%" WASHED PEA STONE- FREE OF IRONS,
P/PE FINES AND DUST /N PLACE
43.. OPENING WITH 4%" Y4 TO l/2 WASHED CRUSHED STONE FREE OF
$3" OUTER DIAMETER IRONS, FINES AND DUST /N PLACE
AND 1314"INS/DE
D/AMETEK 1. CONCRETE TO BE 4000 PSI . 28 DAYS
' 2. REINFORCED WITH 6%6" NO. 6 GA. W.W.M.
3. 2'AND 4' SECTIONS ARE AVAILABLE FOR.
GREATER DEPTH REQUIREMENTS
40.. �--- 3 — 6'0" I 3"---� 4. NUMBER OF PITS REQUIRED a.ya
MIN. I NOTE: EXCAVATE TO ELEVATION -;,?.4- OR
EFFECTIVEE 0/AMETEK
(NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL
WATER TABLE - Np"(/E LOAM AND CLAY BENEATH PIT. REPLACE
EXCAVATED MATERIAL WITH CLEAN
TYPICAL PROF/LE GRAVEL TO DESIGNED GRADE.
FL./=1.53.0 /B"STO. LT. WGT. C.I.MH COVER
4"C./.PIPE 4"8/T.FIBER PIPE
TIGHT ✓0/Nr OUTLET LEVEL
DWELLING rFLOW L/NE TO FIRST JOINT ——
48.00 —T/4 00
1 1 U
/ c.I. TEE 47•S3 ;• ¢��3 I I 1 10�o 0
�5 1000 00 1 111
¢7 70 'STD• PRECAST CONC. 47.3n D/ST. BOX TO BE ¢�,pp 1 11000 00 1 1
• ;/LYb(AL.SEPTIC TANK. INSTALLED ON LEVEL, I I 1 100 00 0 111
I I
9:: ., :• j: STABLE BASE I 1 1 1 100 O 0 0.1 11
II 111
\SEPTIC TANK To SE 1 1 1 000 0 0 1 ( I
INSTALLED ON LEVEL I I 1 1001 O 0 1 ► ;
STABLE BASE. 1 1 1 10 0 0 0 1 1 1 1
1I
LEASHING BASIN : 11100 0011111 1 1 Q O 0 0 0 I 1 1
BASE TO BE L EVEL 1 i 1 1 0 0
SOIL AND PERC. DATA
PERC. RATE 2 MIN. /IN. 11 O TEST PIT NO. I 1 TEST PIT NO. 2
TmP 11u6,so:/ O
TEST BY r A5,-lJc- Alai / 3'
4, Gr-auc/
WITNESSED. BY: eaI? Q.,&,Z
TEST PIT GR. EL. / wee/• SQ"w
DATE; 2Z '
ND C/r�e! .e r 20
DESIGN DATA GENERAL NOTES
BEDROOMS 3 NO HEAVY EQUIPMENT TO RUN OVER SYSTEM.
DISPOSAL Nome SEPTIC TANK, DIST, BOX AN LEACHING BASINS TO BE STANDARD
EST. TOTAL DAILY EFFL. 33o GPD. PRECAST REINFORCED CONCRETE UNITS.
SEPTIC TANK /e4, GAL. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE
TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE,
SIDEWALL AREA?-S* GAL./SQ.FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF
BOTTOM AREA !.o_GAL./SQ FT. SANITARY SEWAGE EFFECTIVE ON JULY 11 1977.
LEACHING REQUIRED ZoO SQ.FT.. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD
ACTUAL LEACHING AREA OF HEALTH.
ZA�Q;FT. .AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE
BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION.
PITCH ALL SEWER LINES 1/41 / FT. UNLESS INDICATED OTHERWISE.
44
or`'' ''
MARR TIN SEWAGE DISPOSAL SYSTEM
• , ' �o`'�.
.a E. r FOR.'-
MORAN
1234171Q"4
G s7��r v� /fie rya ss
�ry�S`o"O/1AL E��
'�1+► i+i SCALE AS INDICATED DATE G ZB B5
• WM. M. WARWICK 8 ASSOC., INC.
80X 801 - NORTH FAL MOUTH
MASS. 02556 - (6M 56.E -2638
PROFESSIONAL EN61NEER
t.
� > J
1j x 100.98 EXISTING SPOT GRADE Stoney
--101 -- EXISTING CONTOUR N
—O.H:W.— OVERHEAD WIRES LOCUS
EXISTING GAS SERVICE Muska et Ln Po
_ _ _ _ N 35�29 06 E _ _ W EXISTING WATER SERVICE Prince o° Sao
fence line 101,55 - F TEST PIT Nnck/ey Rd NobSK° uc
105.00, x 01,95 $ BENCHMARK �° m Tucker
EXISTING LEACH P/T 1\` 0 LEGENDJU "
(LOCATION TAKEN FROM yc�� t, ! SPIKE aCc Nauset Ln Tomahawk 0<
RECORD AS-BUILT) + 1OL42 1 Ames iyay 7
TO BE PUMPED, FILLED _ 60' TP-2
WITH SAND & ABANDONED `� -_�- -_T--r--1-_T__ Powderhorn Way
PO EDT—.—
1 .87 \
1 x 101.07 VENT EXISTING SEPTIC TANK LOCUS MAP
TP-1 (TO REMAIN) NOT TO SCALE
TOP OF TANK, EL.= 100.86t y
N INV.(OUT) = 99.53t 38 �pG 9
u SHE 101.19 x O P 6
0
v A \ 101.32
PORCH x 101,3 BENCHMARK SET
100.56,' Outside Corner/Bulkhead GENERAL NOTES:
GfITE x 101.- _ EL.=102.04 (Assumed) 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
BOARD OF HEALTH AND THE DESIGN ENGINEER.
rJ GATE 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
0 I GARAGE EXISTING LOCAL RULES AND REGULATIONS.
HOUSE (#J7J) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
o 00 i T.O.F.=102.86f TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
} OO,I41 1 Z DESIGN ENGINEER.
I 1 ( I n F 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
`n '��� 102,2 , 101,59 c� } FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
102,39 c,i I ENGINEER BEFORE CONSTRUCTION CONTINUES.
Z 1 1 11 1 / O 1 O
1 1 i fV 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM.
99 �� I '
� 102,2.0 � 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
6z2,, .. THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
1 1
1 1 g 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
h '�
11 11 I o
8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
1 1 Q o ��'�� \ 1 1 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
I AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
o \1 ` DIRECTED BY THE APPROVING AUTHORITIES.
0 4) 1 OF Mqs 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
� �� �� S THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
/ \ 11 x 100,84 fly CONSTRUCTION.
L 1 � T.
. 1 o PETER �'/
1 1� I McENTEE �_ 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
(LOT 646) 0b IVIL
CD IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND
_ I C REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
11 1, APN 170-116 11 NR£G/ E� � 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
11 15,806±SF x 10045 M OFFS I A S EN INSPECTED BY A CERTIFIED SOIL EVALUATOR PRIOR TO BACKFILL..
1 1 , "-' 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
CBdh 1V. UP 1 ( - IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
99.65 Ix 100,11 ; .. CBdh
100.53 PROPOSED SEPTIC SYSTEM UPGRADE PLAN
R=310102'
edge '\\�r 373 SKUNKNET ROAD, CENTERVILLE, MA
99,53 PK SET\ Pavement
99.36 99,35 100.00 100,27 Prepared for: Michael Thayer, 373 Skunknet Rd Centerville, MA 02632
OWNER OF RECORD Engineering by: SCALE DRAWN roe. No.
SKUNKNET ROAD THAYER, MICHAEL L & ALEXIS J 1"=20' P.T.M. 128-12
373 SKUNKNET ROAD Engineering Works, Inc.
CENTERVILLE, MA 02632 '12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET No.
(508) 477-5313 3/20/12 P.T.M. 1 Of 2
s NOTE: TO PREVENT BREAKOUT, THE PROPOSED 4`
FINISH GRADE SHALL NOT BE < EL.98.3 60.0'
FOR A DISTANCE OF 15' AROUND THE r-------------- __
PERIMETER OF THE S.A.S. ___-__-PROPOSED _S_A.S__ - ---�
SEPTIC TANK PROPOSED S.A.S. I -�
INSTALL RISERS & COVERS OVER INLET & PROPOSED D-BOX
INSTALL RISER & WATERTIGHT INSTALL INSPECTION PORT OVER END UNIT CHARCOAL
T.O.F. OUTLET AND SET TO 6" OF FIkISH 'GF;ADE COVER SET TO 6" OF GRADE {{ VENT
1�
EXISTING � F.G. EL.=100.8t � F.G. EL.=101.0t F.G. EL.=101.3(MAX.) 9 '0
d'
MAINTAIN 27. GRADE (MIN.) OVER S.A.S. s�6•
+
S=1%3(MIN.) ® SL 1% (MIN.) INSPECTION PORT PORCH
4"SCH40 PVC 4"SCH40 PVC
6"
LLi
'D11I e' 10.75" TO
i
EXISTING 48" uaulD INVERT BACK OF HOUSE
LEVEL ADD INV.8.00 r-
GAS BAFFLE' INV.=98.17 PROPOSED INV.=98.00 1 TRENCH W/12 ADS Arc 36HC UNITS 05'/UNIT = 60'
INV.=99.53t D-BOX SOIL ABSORPTION SYSTEM (PROFILE)
EXISTING SEPTIC TANK EXISTING UNITS MUST BE STAMPED H-20 S.A.S. LAYOUT
ESTABLISH VEGETATIVE COVER
BACKFILL WITH CLEAN NATIVE OR
NOTES: PERC SAND TO TOP OF CHAMBERS --15.5" _ F 2"
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE ?"
INVERTS, PRIOR TO INSTALLATION. i
TOP ELEV.=98.33 '
2) D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.=97.90 �� 12"
GRADE ON A MECHANICALLY COMPACTED SIX Y" 15.5" :
INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.=97.00 6' 8.+
310 CMR 15.221(2). 2.83'
3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' MIN. ABOVE BOTTOM OF P
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE
T.P. EXCAVATION OR G.W. 3 OUTLETS - H-1 LOADING
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. EXISTING SUITABLE D—BOX
NO G.W., EL=91.3 MATERIAL
SEPTIC SYSTEM PROFILE ADS Arc 36HC UNITS TO BE INSTALLED IN
TRENCH CONFIGURATION WITH NO STONE -63.25"
N.T.S. TYPICAL SECTION
16"
DESIGN CRITERIA SOIL LOG 34.5"
DATE: MARCH 20, 2012 (REF#13,577)
�i - - - =
NUMBER OF BEDROOMS: 3 BEDROOMS SOIL EVALUATOR: PETER McENTEE PE (SE#1542)
SOIL TEXTURAL CLASS: CLASS WITNESS: DONALD DESMARAIS R.S. HEALTH AGENT
ELEV. TP- 1 DEPTH ELEy. TP—2 DEPTH TOP VIEW
DESIGN PERCOLATION RATE: <2 MIN/IN 60"
DAILY FLOW: 330 G.P.D. 101.2 A 0 101.3 A O END CAP END CAP
DESIGN FLOW: 330 G.P.D. SANDY LOAM SANDY LOAM FRONT VIEW SIDE VIEW
10YR 4/2 10YR 4/2 END CAP
100.7 loll '100.8 loll REAR/TOP VIEW
GARBAGE GRINDER: NO B B kmk
SANDY LOAM SANDY LOAM NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW
LEACHING AREA REQUIRED: (330) = 445.9 S.F. 10YR 5/8 10YR 5/8 TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
.74 98.2 36" 98.3 36"
EXISTING SEPTIC TANK: 1500 GALLON CAPACITY C C 4640 T BLVD
PERC LULJLLHILLIARD, OHIO OHIO 43026 Are 36HC DETAIL d
PROPOSED D—BOX:: 1 INLET, 3 OUTLETS, H-10 RATED 36"/48" ADVANCED DRAINAGE SYSTEMS. INC.e UNITS MUST BE STAMPED H-20
SOIL ABSORPTION SYSTEM M-C SAND M-C SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN
2.5Y 6/4 ; 2.5Y 6/4 373 SKUNKNET ROAD, CENTERVILLE, MA
USE ADS Arc 36HC UNITS IN STONELESS TRENCH CONFIGURATION
(GENERAL USE APPROVAL FOR 7.79 SF/LF IN TRENCH CONFIGURATION) Prepared for: Michael Thayer, 373 Skunknet Rd Centerville, MA 02632
12 UNITS = 60.0 FT 91.2 120" 91.3 1 120" Engineering by: SCALE DRAWN JOB. NO.
NTS P.T.M. 128-12
60' x 7,79 SF/LF = 467.4 SF PERC RATE <2 MIN/IN. ("C" HORIZON) Engineering Works, Inc. MA 02644 DATE CHECKED SHEET 2
DESIGN FLOW PROVIDED: 0.74(467.4 S.F.) = 345.9 G.P.D. NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdole, 3 20 12
(508) 477-5313 P.T.M. 2 Of 2