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HomeMy WebLinkAbout0634 SKUNKNET ROAD - Health 634 SKUNKNET ROAD, CENTERVILLE A= 169 015.019 ���� �gECYC(EpC UPC 12543 No. Hasr�r�os,a�N No. �d� 06 Z Fee THE COMMONWEALTH OF MASSACHUSETTS En tered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes fltlfltat[on for -MispoBal 6pstem Construction i3ermit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.&3k1 SYcin Kvte;f-(4a,AdY Owner's Name,Address,and Tel.No. LcTit% &Il � `�,Assessor's Map/Parcel ((p •-p%* 019 r, G. Sj p Installer's Name,Address,and Tel.No. 4gwl Designer's Name,Address,and Tel.No.1✓njy,ee,,n CJo�=ups 'iPo3�,�'zt�� ez�� c�tussG�t�l Yk,%-j Type of Building: " Dwelling No.of Bedrooms // Lot Size Z10,Ct 14"L t--Sq.ft. Garbage Grinder Other Type of Building _, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 'L gpd Design flow provided 5 s. gpd Plan Date 3-Z,-(- Number of sheets Revision Date Title ZoZi{ sKL.2exy. Size of Septic Tank 1000 Ai 44- "+6 V Type of S.A.S.��l S�Zf�1 t,SS 7 j"t.�,.a1 '- 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 alth. Signed Date ZoM� Application Approved by ` S Date `�- 2 q-Z-00 rl Application Disapproved by Date for the following reasons Permit No. 2-06 q L 6 L Date Issued ,? y Zc�G No. 200,1 -''CJG Z_ E. .- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for M1sposal *pstrm Construction permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.(v344 vZo A'd�Q. Owner's Name,Address,and Tel.No. Coo` Y;,�„� n�`� Lot Assessor's 6R11 1 n tlf� Ci'' 1 5 Assessor's Map/Parcel ,(o -O%j -O 19 ' Installer's Name,Address,and Tel.No '�,A Qom;(k(sr Designer's Name,Address,and Tel.No.C-0� ,,e,(,n j �oCz.us 1�03o,-7ca3 i tzt_3 •c<��5c 6(d Type of Building: " Dwelling No.of Bedrooms Z Lot Size 10, G,4 Zt- sq.ft. Garbage Grinder( ) Other Type of Building �. ,,� , No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 2 Z.D gpd Design flow provided �?, g S. gpd Plan Date 3- Zy- Number of sheets Revision Date Title 6?Ll SVOAv. Size of Septic Tank IQp70 ,n t_ Q-06s\ } Type'of S.A.S. Mn,,EA-C 3 1 J c c_L Description of Soil Niture of Repairs or Alterations(Answer when applicable) Date last inspected: 1j005 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 Boardrof Health. Signed 8 j Date ---- Application Approved by S. Date T Application Disapproved by Date for the following reasons , Permit No. ZV C) — D 6 2 Date Issued T 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 im J,Li UULr,nv at (r,3 J S 11 r Ao AJl has been constructed in ac oG�rdance with the provisions of Title,55 and the for Disposal System Construction Permit No.�lJ -dated Installer .►t7i'(3ij-c- Designer 1 Q #bedrooms Approved design flow ,f :�® ,gpd The issuance of this permit hall n t''bbee cc nstrued as a guarantee that the system i "function as desi ed CY / L Date (J/ Inspector j ' g�+ Y// ?'f�/ -- --- --- ---------------------- No. 2 C�6 c- n�,2 Fee ".---- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-'BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction i9ermit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at f�,'3 •� L un �, �-- (l D ,,,,Y tit if�,sL 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 M A('-�\A 2 �t 2oo� Approved by Lv� S d TOWN OF BARNSTABLE �OCATION -10314 Sk ul^)C O e2ii - SEWAGE# .Z o� 0 C®z VILLAGE Q-Q.r\Ae_M ASSESSOR'S MAP&PARCEL /(e 0 15—_ 0101 INSTALLER'S NAME&PHONE NO. 1/0'm SEPTIC TANK CAPACITY i ,,, LEACHING FACILITY:(type) oQT��� NO. OF BEDROOMS, OWNER t .d PERMIT DATE: COMPLIANCE DATE: — Zt. ' Zeal) Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility (..r feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and L,aching Facility(if any wetlands exist within 300 feet of leaching:facility). (� - feet FURNISHED BY p�,,0 i �1'� By a�,v 63 ffy tok,oLi BS coa.3 y 03/30/2009 15: 01 5084775313 ENGINEERING WORKS PAGE 02 ,B Town ®f testable • � �y des .x TbQM*s F,QUer,Dir-rotor Pavia H"�k:ui u Thomas McNean,.Direator M A+ qb. trot,Syaau*MA1.02"l 0lttce: Fax: M-79 43.04 Ago. 2©��-Ofo a �e�wA a Peraaft# Assses egr s M MA 2.. _ _..� � as iaswed.a.permit w iasz>all a ( i1or) . .e�gkics�:`�,C°�� s�wtkr+c�- �2tf, GGBt� based on a daa��r dre'tvu.bY (address) B B�-tt 10 F • dated 2 9 -aseptic s�+stern reformood above was in$t�11ad.sub to ',. te vs l ti y i altz+ a mkw approved cbnses such as 1 teas ..ca .: a e .,tbet a►e, septic symm referenced above was iAstalied with m40r cbau�ea .l 0 leitazai relocation of the SAS or any vertical relo.�atiou ota�4y opm wt ;s�► �but in saccordaaace with State &.l oc4l l4gWation8. Plin re;►Siwor .., �>wi3�i•by dEassi�sr to follow. • ���qF►OF PETER T. McENTEE . CIVIC, Cl) 0 9 No.36109 Q 9oF�ss isr e�G�gs�`` 8 ) (01 D. ISSV90 MQTR INS FORM AND DIVISION TRAM Y(M Q:H=.WA *4D=i=Ca iScation Form 3-26-04,doo TRANS. NO.: CITY/TOWN: Lc APPLICANT: P -�� ADDRESS: VZ4 DESIGN FLOW: 330 god REVIEWED BY: fck. Me-£-'-ce f L DATE: 3 J24I°5 N/A OK NO s ,.,., -. Legal boundaries denoted 310 CMR 15.220(4)(a)) ✓ Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220 4 'u Locus Provided 310 CMR 15.2204(t)] ✓ Plan proper scale? (1"=40'for plot plans, 1"=20' or fewer for components) [310 CMR 15,220(4)] Easements shown 3.1.0 CMR.15.220(4)(b)] ✓ System located totally on lot served [310 CMR 15.405(1)(a)for upgrades]-if not, a variance is required [310 CMR 15.412(4)] Location of impervious surfaces (driveways, parking areas etc.) [310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR 15.22.0 4 c Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] ,System Calculations 310 CMR 15.220(4)(01 ✓ daily flow ✓ septic tank capacity(required and rovided ✓ soil absorpiion system(required and rovided ✓ whether system designed for garbage rider ✓ North arrow 310 CMR 15.220(4)(g)] ✓ �',nooxd Existing and ro osed contours [310 CMR 15.220(4)(g)] ✓ G�+�d ^5 Location and log of deep observation holes(existing grade el. on to Jae`'e" each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220 4 h and i Location and date of percolation tests (performed at proper ✓ elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? 310 CMR 15.242] ✓ Certification statement by Soil Evaluator [310 CMR 15.220(4)(j)] ✓ Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] Address � 3�' � (,(,.M l�tre)-- � �fi' Sheet 1 of 9 I P N/A OK NO Location of every water supply, public and private, [310 CMR 15.220(4)(k)] within 400 feet of the proposed system location in the case " of surface water supplies and gravel packed public water supply, within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water Imly wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins ,/ located within 50 ft. 310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR 15.220(4)(m)] (if-water-line cross see 310 CMR 15.211 1 1 Profile of system showing invert elevations of all system components and the bottom of the SAS .310 CMR1.5.220(4)(o)] Stamp of designer 310 CMR 1 5.220 1 and 310 CMR 15.220 2 Stamp of Registered Land Surveyor(required if construction ✓ activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate(two in each of the primary and reserve � unless trenches as permitted in 310 CMR 15.102(2) or as / approved for an upgrade under LUA at 310 CMR 15.405 1 k Test hole adequate to demonstrate four feet of suitable material? [310 CMR 15.1 q3 4 Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75' of system 310 CMR 15.220(4)(g)] ✓ Materials specifications noted?jvarious sections of 310 CMR v 15.000] System compongnts not> 36" deep (unless Local Upgrade Approval or LUA requested) 310 CMR 15.405 1 b Address �0 3 S VLJ Sheet 2 of 9 N/A OK NO Size OK? 310 CMR 15.223 1 Inlet tee located ten inches below flow line [310 CMR 15.227 6 Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] Outlet tee with gas baffle or approved filter 310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 5r2 off 15.228(l)] Separation between inlet and outlet tees(no less than liquid depth) 310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as descri�ed 310 CMR 15.227(5)) or permitted for upgrades under LUA 310 CMR 15.405 1 k Minimum cover 9".(Tanks.buried more.than 9" must.have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232 3 Three access covers (inlet and outlet must be 20" or greater) - ✓ s t middle access at least 8" 7/07 310 CMR 15.228 2 Tar�^ Access to within 6 of grade - one port for systems<1000gpd, two fors stems>1000 gpd 310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from buil4ing foundation 310 CMR 15.211 1 Buoyancy calculation Required/Done [310 CMR 15.221 8 H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources 310 CMR 15.2111 Required when gther than single-family dwelling or flow>1000 d 310 CMR 15.223 1 b First compartment 200% daily flow; Second compartment 100% N 14 dailyflow 310 CMR.15..22 .2 .and 3 l "U" pipe through or over baffle, outlet of each compartment with as baffle or approved filter [310 CMR 15.224(4)] Address 3 �- Sheet 3 of 9 J t N/A OK NO Located at least ten feet from any water line? [310 CMR 15.222 2 Disposal piping�t least 18" below water line(when water and sewer cross, see 310 CMR 15.211 1 1 Cleanouts required/provided ? 310 CMR 15.222 8 Thrust blocks s et/in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222.6 Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] Siphonproblem/ eachfield below pump chamber ✓ Endca s or vent manifold specified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] Materials specified (310 CUR 15.251(5) specifies various pipe types allowed Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or-steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if deeper than 9" f310 CMR 15.232 3 Inside minimum dimension 12" 310 CMR 15.23 2 2 b Minimum sum ¢" 310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd v 310 CMR 15.232(3)(d)] Capacity(emergency storage above working--design flow)? [310 CMR 231 2 Pro er setbacks 310 CMR 15.211 same as se tic tanks)] % Watertight.20-in minium access manhole at least 20"MUST BE TO GRADE 310 CMR 15.231(5)] Service components accessible(not too deep with piping, disconnects accessible Alarm floats - alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. 310 CMR 15.231 6 and 8 Stable Compacted Base [310 CMR.15.221(2)] . Address Sheet 4 of 9 1 , lBuoyancy calculations needed?Provided? 310 CMR 15.221(8)] Address Sheet 5 of 9 N/A OK NO T . rc Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240 1 Required separation togroundwater? 310 CMR 15.212 Aggregate specified as double washed 310 CMR 15.247 2 System Venting required/provided?-(system under driveway or >36" deep) [310 CMR 15.241 Inspection ports specified and within 3"final grade? [310 CMR 15.240 13 Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CNIR 15.211(1)[4] and Guidance Document] fi F Chambers and Gal. in trench configuration supplied with inlet every 20 ft. 310 CMR 15.253(6)] Each structure with one inspection manhole(if>2000 gpd must be tograde) [310 CMR 15.253(2)] Aggregate P minimum- 4' maximum: 310 CMR 15.253 l b 2' sidewall credit maximum 310 CMR 15.253 1 a In bed confi ration, inlet evM 40 s . ft. 310 CMR 15.253 6 Width 2'minimuXn 3'maximum 310 CMR 15.251 1 100 feet -maximum length [310 CMR 15.251 1 a] Minimum separation 2x effective depth or width whichever greater 3x if reserve between trenches 310 CMR 251 1 d Situated along cpntours 310 CMR 15.251 2 Breakout OK? [�10 CMR 15.211 1)[41 dance Document minimum 2 distribution lines 310 CMR 15.252(2)(a)] Maximum separation between lines 6' 310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6" minimum, 12" maximum. [316 CMR 15.252 2 Separation between beds 10'minimum. 310 CMR 15.252 2 ] Bottom area used in calculations only310 CMR 15.252(2)(i) Address Sheet 6.of 9 N/A OK NO _ P Pressure Dosed System ? Provided pump and piping calculations as required 310 CMR 15.220(4)(r)] Pressure dosing Tequired on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A / Remedial Use Approvals] If used in gravelless system-make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd) or quarterly >2000 dgood to note on plan 310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255 3 ? Impervious barrier and/or retaining wall ? [Guidance Document Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer 310 CMR 15.255 2 a Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2)and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [ 10 CMR 15.255 2 e ] Check DEP'Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge / to scour soil interface Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a rote on the plan regarding the requirement for perpetual maintenanceagreement? Any alarms involved on separate circuits , Did the applicant submit an operation and maintenance manual? Has a lic4nt submitted a c2z of a maintenance a eement? Are the variances listed on the plan? [310 CMR 15.220 4 RLS Stamp"-necessary on plan if a component is within five feet of property line 310 CMR 15.412(4)] Address 6 ��� � o �' �" Sheet 7 of 9 I r New construction or increased flow proposed - [Refer to 310 CMR 15.4.14 Address Sheet 8 of 9 r N/A OK NO Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? [310 CNM-15:214 2 Are the nitrogen loads proposed in compliance? [310 CMR 15.216 1 ], Pumping to septic tank ? 310 CMR 15.229 Shared System [�i-O CMR 15.290] Address �� �"�` - 1��9n�" Sheet 9`of 9 Town of Barnstable P# �Ci� �5 Department of Regulatory Services oFlume, Public Health Division Date ir 200 Main Street,Hyannis MA 02601 auwsreetE, � �!. 'OTED B& Date Scheduled Time Fee Pd.' Soil Suitability Assessment for Sewage Disposal Performed By: ��r �✓ 2� -1-- . / Witnessed By: 6&A . :.......... ...............::...:..........I.....I::..I.....r..r.rlr.,ri....1.1.r........I.....a....1..:....,..:..:r.......r..r.r.........:.rl..........:..:I:..r.....I1..rr.....,:.i.l....._:..r....l............- ..... : .. , ..... u ...�r..i... .i.........r. .._ ..... :. ..r .. .. ..... ...............I ..:..,...I, ::.i. ::.....:::. .y.,...... .:..... .:.......,,:u, 1,..11..1 .....� ..:.:::.,,.� .,,:,,...:._,...u.::....rr...........,.rll!.r....,:...,......:..u:,.....:..,....,,::.:..,:,a,,,.::: ..�-::,:.:.._.,,r,r,:,..:,.,.,. Location Address `s v `� j =r`� , Owner's Name gqi-p L 4/ �/t�1 t L Ce^^ Address (a3q S Ku nA4 e-1" Assessor's Map/Parcel; 5-A1q Engineer's Name &/a(l, NEW CONSTRUCTION REPAIR Telephone# S 8 Z 4 O Land Use e S ri Slopes(%) l Z Surface Stones N/-A Distances from: Open Water Body-;>Z00ft Possible Wet Areann_Z I UCJ ft Drinking Water WeII­ZLS6 ft Drainage Way -J !4 ft Property Line '�—ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) l i S d^ 1 a ' ii <` e fi, 7.. ' ° 1< 11IT 1 P4O4_0 Parent material(geologic)�14G a t/d Depth to Bedrock ;> Z Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater 77 41 ....,.,;:.....:....:.:..r,,:--...;...-.:._.:......,..•;•,rr„-:_,,:,:.:.-_.-�.::,;.,_:,..,:,,:::,•-<,_:.<,r<-_,..:.;::,.-.:-.,:: .__...,:::,:_::..:::,.::r:::::-::.-:,.,:,::,:-:,:::,:::::r::r.r„<sir!-,!!�.:!::I:!rl:^::t::,!I:':�:�r:4�!<_!!r.!r:,ar!1�-etr,!!!r!Ii::ff!:!!:,�!r;:a�:,:s�:!�ii!-r:,�:!:�:;':!;r !!! t i:,;:;,:...ri..,..v.....I.,a.:.a.r...._:n,..,.:inf:r:<,r.r,v...........�r.........,r..0...............:_............:_,.._............,.T:::!ei�i'v::iv:_...:..,....i................_..:..:,-....I...R._:.:..-....... !'! :...vi. '::.Btu Method Used: - TI°-Z_ Depth Observed standing in obs.hole: in. Depth to soil mottles: -75" -77`' in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ .:_,:........,i..........L.,:r,..:...r.... .. r...............Ir..a... ......r............. ....,.,.!.�.. .. ..........:..u..,.....,.,L..... .!...:..i.r._,......,.,r......,....!:.......... � ........:.......L.,I! t.,_,.....:_..!...,..i ...,..,.( :..., ..,..,...,......::.:,.� !._��.n(!!!!!!!!:!::::.:::::.F.:.u!: r!rr.:,:,::,: ��::,,r:.,�::r,:!:r.,::!:::..:r:.!.r..r,<rr.....r._............:._ Observation Hole# 2 Time at 9" ?� Depth of Perc 6 (I 4. Time at 6" 45 Start Pre-soak Time @ © A c'. . End Pre-soak T Rate,Min./Inch I Site Suitability Assessment: Site Passed J Site Failed: Additional Testing Needed(Y/i) Original: Public Health Division Observation Hole Data To Be Completed on Back-----.— Q:HEALTH/W P/PERCFORM .......................... ........................................................ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. ronsistencya0 G -8 A. - 5 t,., to Y n I j z. g-3s 3 5 1 is Y l2 s7 7 8 C, :�,16yfzrlj --7511(7-5-lftz�&) P.:. . Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. 0 a 36-78 CI r S L -ja y'��s%3. _«. Y2 �16 78 a 2� C,z- f Depth from Soil Horizon Soil,Texture Soil Color Soil Other Surface(in.) (USDA) ,y (Munsell) Mottling (Structure,Stones,Boulderes. ° Y^' i , : ...:......::::: r:o� ...A..:..:.. :........:: ,o.c................... . ....... ..................................... ... 1 Texture Soil Color;; S:;:l,:,>:::.. Other Depth from • Soil lioriion��� "So o Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones,Boulderes. IConsositificy.° Gravel) Flood Insurance Rate Man: Above 500 year flood boundary No_ Yes Within MO year boundary No 0� Yes Within 100 year flood boundary No=\ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist'in all areas observed throughout the area proposed for the soil absorption system? Ye S _ If not,what is the depth of naturally occurring pervious material? Certification 1 certify that on ���� (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,ex c and experience described in 310 CMR 15.017. ate 3 Signature D �l ' 1 i Commonwealth of Massachusetts Executive of Environmental Affairs e DEP ; Department of Environmental Protection P � SUBSURFACE SEWAGE DfSPOSAL SYSTEM INSPECTION FORM `-- PART A - -- CERTIFICATION - - Property Address: G3 y Sk V . Address of 0 wner: IsL; Cam\C... \\G (if different) ip, cr Date of Inspection: ir�3ol�i� Name of Inspector: Michael DeDecko Company Name, Address and Telephone number: Atlantic Environmental P.o Box 2384 - Mashpee Ma 02649. Tel : (508) 4771420 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection . The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. The system Passes --- Conditionally Passes ---- Needs further evaluation by the local Approving Authority ---- Fails Inspector 's Signal "im Date: , 6 The system Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office or the Department of Environmental Protection. The original should be sent to the system owner and copy sent to the buyer, if applicable and the approving authority. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: t-A . Owners : Date of Inspection : 4 INSPECTION SUMMARY: Check A, B, C, or D A SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CM 15.303. Any failure criteria not evaluated are indicated below B) SYSTEM CONDITIONALLY PASSES: ---- One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determinate (Y,N, or ND). Describe basis of determination in all instances. If "not determinated",explain why not. ---- The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration ,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. ---- 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 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A z CERTIFICATION (continued) Property Address : ro3� S1C�.i►.,�� Owner : Date of Inspection : i Y C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ---• Conditions exist which require further evaluation by the Board of Health in order to de- termine if the system _is_faling to protect the public_health, safety and the environ- ment. 11 SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETYAND THE ENVIRONMENT: •-•• Cesspool or privy is within 50 feet of a surface of water ••-- Cesspool or privy is within 50 feet of a bordering vegetated wetland or a small marsh. . 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNC- TIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND. THE ENVIRONMENT. •••. The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. ---- The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. ---• The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. ---• The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply wen,unless a well water analy- sis for coliform bacteria and volatile organic compounds indicates that the well is free from polhation from that facility and the presence of ammonia nitrogen and nitrate notrogen is equal to or less than 5 ppm. D)SYSTEM FAILS: •• I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identVied below. The Board of Health should be contacted to determine what will be necessary to cor- rect the failure. --- Backup of sewage into facility or system component due to an overloaded or or clogged SAS or cesspool. 3 s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 6S2— Owner: Date of Inspection : D) SYSTEM FAILS (continued) •- 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 over- loaded 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 cesspool or privy is within 100 feet of a surface water supply ortributary 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 ana- lysis. 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. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: L-�iZ CV_Qj.a V Owner: Co\a_jp,\\L, Date of Inspection : i 1301cj." E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above : The design flow of system is 10,000 gpd or greater Large System and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist : -- the system is within 400 feet of a surface drinking water supply --- the system is within 200 feet of a tributary to a surface drinking water supply -- the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area - IWPA)or a mapped Zone II of a public water supply well. The owner or operator of any such system shall bring the system and facility into full compli- ance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please, consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST I j i 1 i Property Address: Owner: Date of Inspection: Check if the following have been done : -x Pumping information was requested of the owner , occupant and Board of Health. --x None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during the period. Large volumes of water have not been introduced into the system recently or as part of this inspection. --x As built plans have been obtained and examined. Note if they are not available with N/A. -•x The facility or dwelling was inspected for signs of sewage back-up. --x The system does not receive non-sanitary or industrial waste flow. --x The site was inspected for signs of breakout. --x All system components,excluding the Soil Absorption System, have been located on the site. -•-x The septic tank manholes were uncovered, opened and the interior of the Sep- tic tank was inspected for conditions of baffles or tees,material of construc- tion, dimensions,depth of liquid, depth of sludge, depth of scum. --x The size and location of the Sal Absorption System on the site has been deter- mined based on existing information or approximated by non-intrusive methods --x The facility owners and occupants if different from owner were provided with information on the proper maintenance of Subsurface Disposal System. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: e4 Owner: Date of Inspection: RESIDENTIAL: Design flow: `C�� gallons Number of bedrooms : O Z Number of current residents: C> Garbage grinder (yes or no) : Laundry connected to system (yes or no): yc S Seasonal use (yes or no) : two Water meter readings, if available: Last date of occupancy : S. COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow : gallons/day Grease trap present: (yes or no) Industrial waste holding tank present (yes or no) : Non-sanitary waste discharged to the Title 5 system (yes or no) : Water meter readings, 0 available : Last date of occupancy : Other: (Describe) ............................................................................................................ Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection (yes or no) :...1..cD........ W yes, volume pomped: .................... gallons Reasonfor pumping :............................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) .Property Address: �3y Qcl Owner: D ate of inspection: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system --- Single cesspool --• Overflow cesspool --- Privy •-- Shared system (yes or no) (if yes, attach previous inspection records, if any) (explain) .................. .................................. - - - ---- -- - - -- APPROXIMATE AGE of all components,date installed (if known) and source of information ........................ Sewage odors detected when arriving at the site : (yes or no).....k SEPTIC TANK : "'�' ''" (locate on site plan) Depth below grade: _ � ��,aR—Material of construction: .:�.. concrete ......... metal ........ FRP ..•..... other (explain) Dimensions: .�....... -� ►r Sludge depth :..s.: ....•. Distance from top of sludge to bottom of outlet tee or baffle:........-�. •.••••• Scum thickness :...4"L....'......•••••• �� Distance from top of scum to top of outlet tee or baffle: .........�.b....••••••••••••••••••••• bottom of outlet tee or baffle : �'• Distance from bottom of scum to Comments (recommendation for pumping ,condition of inlet and outlet tees or baffles, depth of liquid level in rel tion to outlet invert,stryctural integrity,evidence of leakage.etc. ...................... • G i . . .... . .>.s.a. . . . ....... ...................��`` GE DISPOSAL SYSTEM INSPECTION FORM I� SUBSURFACE SEWAGE PART C • SYSTEM INFORMATION (continued) f. Pro erty Address: 63`� p Owner-. Date of inspection: �`���.6 GREASE TRAP : •.••..fib (locate on site plan) Depth below grade: ............... - - -- - -- --- -- -- -- - Material of construction: ....:.::concrete:...:. ..metal........FRP........other(exp am .... Dimensions:............................... Scum thickness:............... utlet tee or baffle: Distance from top of scum to top of o Distance from bottom scum to bottom of outlet tee or baffle:............................... Comments: condition of inlet and outlet tees or baffles, depth of liquid (Recommendation for pumping evidence of leakage, etc.)........................ level in relation to outlet invert,structural integrity, ... ............................... .... ......................... .................................................................................... TIGHT OR HOLDING TANKS:.. (locate on site plan) Depth below grade: other (explain).......... Material of construction*.........concrete........metal.........FRP....................................................... Dimensions:............................ Capacity:....................gallons Design flow:...............gallons/day Alarm level:............................. Comments: (condition of inlet tee, condition of alarm and float switches:etc. i GE DISPOSAL SYSTEM INSPECTION FORM SUBSURFACE SEWAGE PART C SYSTEM INFORMATION (continued) VA property Address. Owner: Date of inspection: DISTRIBUTION BOX'.L.A�:� (locate on site plan) Tts� .. •u Depth of liquid level above outle t inveil: �-�t -- s Carr over,evidence of leakage into q4r Comment: ale idence of s (note if level and distribution e Q,�o. �S1.C.�'�.• t -.fix. .a .Yam?<�. .. or out of box,etc.) . �.� Q.�.�.�.�• ............ Q ...................................................................................................... ........... PUMP CHAMBER, ..I (locate on the site) Pumps in working order: (yes or no)........... Comments: condition of pumps and appurtenances, etc.)..•• (note condition of pump chamber, .................. ........... ........................... .................................................................... .... ............................. , SOILABS (bcate on site planORPTION SYSTEM (SAS):.. S•.••• approximated by non- if possible; excavatr not requ�ed,but may be pp . ethods) : ` intrusive m to be present, explain if not determined ....................... T ype-. leaching pits,number: ...• •(�?iC. leaching chambers,numb r:........ leaching galleries,number:........... number ,length:Leaching trenches,num ' leaching fields,number,dimensions:.................... overflow cesspool,number:........... con iti n vegetati Comments: drautic fail re,level of ponding. , edition of soil ,signs y '' (note � 1�1 4 et 3. �d SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address : �3 �►�'Owner: CA\c`�\\p Date of inspection: ,`bo`cl b SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate at wells within 100' - G J D l � J z� DEPTH TO GROUNDWATER: Depth to groundwater: .l`j..!.feet Method of determination or approxi ative: ! ....`.V.v... ,1 .CZ ........ ..................................................................... ......................................................................................... . a � N LOCATION SEWAGE PERMIT . 0 _ ,f Z QT VILLAGE ' { I N S T A LLER'S NAME & ADDRESS e U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED j ,q�' - - _ �� �� z �� 4 �� d �'�G � , • �yi� � ,�15� it �" G 2��� • AS6 SSOR-S MAP NO. i PARCEL IS - 161 "Ln CATION SEWAGE PE tAIT NO. 01r V 1 L L A C E -r ref I N S T A ILER'S NAME i ADDRESS 8 U 1 L D E R OR OWN ER LAB d DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �C f tc�od G� w -TAW K P W r TOWN OF BAR�NS�TnABLE � c �LUt A �� + SEWAGE # LOCAA TION� � J VfLLAGES�VVRL � l � ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by A-t 3i sz LA 30 tIA s3 No.. _./. ?: .. * <� .�� �Y Fxs... .../...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEAL H . ............OF.... (/�y\C...... Appliratinn for UWpnna1 Works Tomitrnrtion ranfit Application is hereby made for a Permit to Construct (�or Repair ( ) an Individual Sewage Disposal 3�Sys em at: .......- it d� ......••�•� ---•.................. ........ham�•-•-•-. ..\ .....----•------•--..........------•---.....--- Loca&n-Addre + or t o. • -, .v............ .. •--------------.............. _... - owner ddr s Installer Addressu UType of Building Size Lot____-------}'_--.•-..-.-.-Sq. feet �. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (�1C➢ a'4 Other—T e of Building No. of persons............................ Showers YP g ---------•-----------------• P ( ) —.Cafeteria ( ) dOther fixtures ------------------------------------•--------------------•••-••-----•---•••-••----•-•--.....••-•-•---•--•----••••-------------:•--••----------•--... W Design Flow..............V»-....................gallons per person per day. Total daily flow............3 ...................gallons. WSeptic Tank—Liquid capacity-MOgallons 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 ( ) -Dosing4ank ~' Percolation Test Results Performed by._. .4,Jk.eA......�`... ..' '................. Date._ � '` ." `?� Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ LXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ------ ------------------------------------- -----------••--------:--•------------------- ------ ----------------------------------------------- O Description of Soil----••.O ---------------- -� M-......�i 5`�h ....................................... U ....................................... ....................-'- &....-----•...xLn_�---------•- --- -----•--------------•--------------------•----------- W ---••-•-••-•-•----------•----•.......V"o—AA---------------------ph:P_.6............ U Nature of Repairs ovAlterations—Answer when a plicabl Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTTI 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the boardof health., q Signed ... C1.�1( �' \A, C 1_-. ......... A...... Dge Application Approved By........ . .. -------------------_----- z�/ � � =- •• ---------- -•----- - Date Application Disapproved for the following reasons:----------------------------•---------...--------------•---------...------------.------•--•••-••--•-•••-------- .....-•-------------••-•--•-•---------------•------•---------------------------------.....•-----••-••••--I••••--•----•--••-•-----••-••••••----•••----•-•-••-••----••----••---•••-----•--•-•--•--••-•----- Date PermitNo......................................................... Issued....................................................... Date Q/r N ................ V. Fx$.............................. THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH .............OF...... C%h�f1 �-�060 ........... Applir�atiuu for Disposal arks Cnuaa,�truriiuu Vrrmit Application is hereby made for a Permit to Construct (L4 or Repair ( ) an Individual Sewage Disposal System at: ........: � n �:=::, ....G . �a....................... ...... Location•Address .: ........ ._ � - ._.. . Address-4or Lo .No....-----^-------------------------•^-- ........... ----------- Owner�� � ._.� .................................. ddress � Installer Ad$ress —. UType of Building Size Lot.-0 4---..`•----- .Sq. feet Dwelling—No. of Bedrooms.............`...........................Expansion Attic ( ) Garbage Grinder aOther Other—Type of Building ............................ No. of persons....................._...... Showers ( ) — Cafeteria fixtures .......... ...... W Design Flow.............\.\-Q.................._.._gallons per person per day. Total daily flow........... ...................gallons. WSeptic Tank—Liquid capacityk,"V U1-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 ( ) 1c ` a Percolation Test Results Performed by.... sty. . .. ...... .....U." '--•-••..._.__..___ Date_�)_. �----- Test Pit No. 1................minutes per inch Depth of Test Pit....._._..........•. Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ ..........................:......................................................................... Description of Soil......z"' = -:;L ...........:. ( .:r U ...............•••• ................ " �.4...........m.......isM a: _.........•..... ...................................... ................................. ...•• . n`.l ..C� `. �1`�� ------------------------------------•---------------------••------------•---------- V Nature of Repair or lt>��4'- nswer wha'�ip . ................................--••---.._..-••.....---•••••--•-•..............---......---•••............._.-•-•••-----••--••••-•-...-••-••-••-.......•••--............................-----------••-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTf F T �,:p. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. � k I ne ..�_cif±. k-rY`�.�. .................... ,lz..i....... , ApplicationApproved By.................................................................................................. ------•---------------ate --•--...----• Application Disapproved for the following reasons------------------------------- Date --•----------------------------- _.----.._..__._ ...•.....................•-•----••----•------••••----•-•------•--.........-••--••••---•-•••-•-••-.................................................................................. Date Permit No--------------------------------------------------------- Issued......... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............. ........OF.......... ..�!� \. ..:1..: �. .... .... .............................. Trdif irtt#e of T'uutpliFaurr THI J IS�TO CERTIFY, That the Individual Sewage Disposal System constructed ( l/S or Repaired by---------•---•--•---' ) c 1 staler ( j at. sz`..u.. -•-,- .- � �1- t�e � �'... . ` n '>l v _1 e!•------•-•- has been installed in accordance with the provisions of T ?��" j of he State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated_...__..._._._._.__......___._...___._.......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �f DATEInspector.......... ......................................................................... THE COMMONWEALTH OF MASSACHUSETTS ! r2 f BOARD OF HEALTH ................ 1{u.n..........OF...............T .C- :^..R.5 ...C`::.._.._..... ................. No......................... FE�.................... . Disposal Works Tuuu#rudiuu Prrutit Permission is hereby granted........... .....................N�.-rlJ = _.......... to Constru t (I, or Repair ( ) an Individual Sewage Disposal Sy tem at No.......... ? 's L�-� .�iS`�. (1_c. ••-•� -- --....... Stre as shown on the ao> for Disposal Works CoeY4r> t'No ated. ...................... DATE Board of Health --------------------•---•-------•--•-----------••-------.....------•---•-•---.... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS • SIwCat_� r.v,�nl�.� - 3 �SEvenoM • tip 4 3 Sao G.pv. `.G-PfIG Tn+.l4C = 330� (�iC % • 4��7 E•.P.D. . �\ U S'E- t o ob 6 Q.L.. Zo,942� . , 15PC PST - uSE. Gov: Gam. l.3'L SG' )c Z.S • 33v G.P.Q. 0 prop. )7.5 ` �L P17 M ,a,e�� t.•I 3 �'• ( 13 sue. 1 .o = l l3 s.Po. ➢rya +� TOTAL rA*J c i .; . 33D�t?•n. 97.8 4 GEf2GDt.�.Tto�.1 �'l�TE : ("IL.1 2ht.1I\t' OIZ L�S�S. F �G''�`^ lC i { r ;l o o•aJr .p £.! / 4 l � .,?y t• g l D �y}f'/ F98i.iJl\ 7 ( ION A.AX - 'qu•� f4c 2li�@ STFFi c f, 21,4_L.--- T�sT aa¢7 , �_9 Tor Vwtn loo.c' FG=9p o; /^ ^\�// �/ 4••p/Ab -y ' S�tS 4`pp� Iw- e.4L. %73 Z' 'box 97/ SePnc I c tuv, T"orAtK + FIT STOWE-- !G•� - } Sam � � • " C6eTtF1ED PL(!:>T oCATIo" CLWTE�Vl't.._u 1.10 S.a1.0 i 1 _ GGRT.iF�( TE•IAT Tt4r-- T1o1J Staowll 4-tF•QInDI 1 GorV1Pl.�5 pt- W ITIA Auv Ise- �AGK �r4u10E��uTS o1= 't'�IC- LOT 'To W w 61= �'A R.fJ�7T�a)►� VF_tiU{Z= 1-I15 /i�t..Aat t5 �.IOT ZASC.p 06.4 AN O;TEC�/�l_t_L UJ t' cJMCwT �,uc:•�t3�{ T�{L oFc,�T�, ,Idawl>•u APIt_IGAti.1T %�:' _ � K..ArZ- �/: ��'AA i-i-1 LEGEND N Z L EXISTING CONTOUR Q seons PG 49 x 100,98 EXISTING SPOT GRADE �e`c Cir��e v10 8K 339 —flE••W— OVERHEAD WIRES Ames �,yoy PLAN N G EXISTING GAS SERVICE. s 1N EXISTING WATER SERVICE �o o et posh � I` TEST PIT BENCHMARK Q Tofo�OC Rd �`C`c LOCUS .S Q 1 � ASS Route 28 a PROPOSED ".S. ENCHESI westminster Rd G� e i s 2 ROWS OF 6-16",BIODIFFUSERS LOCUS MAP INVERT(IN)EL.=95.34- NOT TO SCALE BOTTOM EL.=94.4 _ GOOD SOILS (CI), EL.=93.7±--- 96--_-- ADJUSTED G.W. EL.=90.4 2 5 96 INSPECTION PORTS x .W7 � ., 38p 5 x 9 9 STRIPOIJj BOUNDARY S s?S (SEE NOTE 11) 19 Gk x 96.7 TP c3`. -.x 96.74 oti 7}' 1} EXISTING LEACH PIT TO BE PUMPED, FILLED W/ SAND & ABANDONED n� � .' �EXIS77NG SEPTIC TANK x 97.04 (TO REMAIN) x 96.54 } ^,P TOP OF TANK=97.04 99.44 INV(0UT)=95.71f(VERIFY) Benchmark Set x ORANGE PAINT/SON07UBE EL.=9Z59 (Assumed) x 97.14 DECK 97,66 i ; .' LOT 16 ' I - oo'. "V EXISTING HOUSE (#634)B o TOF=99.08f i ! : CS a, 7 J J i , I I ; i GRA VEL tl ilyjoo-, DRIVE WA Y NOD x 97,59 � �+ % Z LOT 20 x 97.33 _ C� .55 • LOT 19 •'��--•' A��J�\� APN 169-015-019 20,942 S.F.f c� CJ \ 0 y c J J 100.00' x 97.47 �; � \ c I' N 11'11 58" E � LOT 17 LOT 18 W N � Qin j 96.37 97A 5 WA R METER i 1.46' :--edge 11.11'58 E 96-10 SKUNKNET 95.8,q ROAD •Es Agss9�hG PROPOSED SEPTIC SYSTEM UPGRADE PLAN PETER T. o E 634 SKUNKNET ROAD, CENTERVILLE, MA McENTE CIVIL No. 35109 P P P •ewide for:Prepared Pre Ca Enter rises, P.O. Box 763, Centerville, MA 02632 OWNER OF RECORD �'f6/STEREO Engineering by: SCALE DRAWN JOB. NO. CAROL YANNUCCI £ N Engineering Works, Inc. 1"=20' P.T.M. 120-09 634 SKUNKNET ROAD CENTERVILLE, MA 02601 12 West Crossfield Road, Forestdale, MA 02644 DAZE CHECKED SHEET NO. A 0 S (508) 477-5313 03/24/09 P.T.M. 1 of 2 6s, r NOTE: TO PREVENT BREAKOUT, THE PROPOSED t FINISH GRADE SHALL NOT BE < EL:95.73 y FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & WATERTIGHT INSTALL INSPECTION PORT OVER END UNIT T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE COVER SET TO 6" OF GRADE EXISTING F.G. EL.=97.7t F.G. EL: 97.3± F.G. EL: 96.8t 9" OF COVER(MIN.) 36" MAX. COVER MAINTAIN 2% GRADE MIN. OVER S.A.S. � . Now , INSPECTION L = 10' L = 5'(MAX) PORTS-BOTH @ S=1% (MIN.) (�➢ S=1% (MIN.) TRENCHES 4'SCH40 PVC 4'SCH40 PVC 6` ° s 11.3" TO -11 14' INVERT EXISTING 48" LIQUID LEVEL GAs�9FLE INV.=95.57 p�ZOPOSEO INV.=95.40 r TRENCHES W/6 UNITS AT 6.25'/UNIT = 37.5' INV.=95.71 t Q-BOX INV.=95.34 ' EXISTING 1000 GALLON SEPTIC TANK (EXISTING) 2 OUTLETS (MIN.) SOIL ABSORP11ON SYSTEM (PROFILE) ESTABLISH VEGETATIVE COVER BACKFILL WITH CLEAN SAND ;NATIVE OR PERC SAND) UNDISTURBED GROUND NOTES: TOP EL.=BREAKOUT EL.=95.73 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV.EL.=95.34 INVERTS, PRIOR TO INSTALLATION. BACKFILL WITH PERC SAND V TO EL.=95.5 (MIN.) 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE BOTTOM EL.=94.40 ON A MECHANICALLY COMPACTED SIX INCH CRUSHED 5 7' STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 4' MIN. ABOVE GROUNDWATER TRENCH (TWICE THE EFFECTIVE WIDTH) TRENCH 3) INSTALL INLET & OUTLET TEES AS REQUIRED, 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE HIGH G.W. EL=90.4 I EXISTING SUITABLE AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. (MOTTLING) = SOILS, EL.=93.7t 2 TRENCHES WITH 6-16" (H-20) ADS BIODIFFUSER UNITS MIN. REQUIRED SEPARATION = 2 x EFFECTIVE WIDTH (5.7') TYPICAL SECTION SEPTIC. SYSTEM PROFILE "`& i - N.T.S. SOIL LOG 7.0' DATE: MARCH 3, 2009 (REF#12,495) o� SOIL EVALUATOR: PETER McENTEE (SE#1542) WITNESS. DONALD DESMARAIS R.S. HEALTH AGENT r , ELEV. - TP- 1 DEPTH ELEV. TP-2 DEPTH 96.6 A 0„ 96.8 A SANDY ,LOAM SANDY LOAM � 41. 95.9 10YR-4/2 „ 96.3 10YR 4/2 8 „ B B 6 S.A.S. LAYOUT }, SANDY LOAM SANDY LOAM 10YR .5/8 10YR 5/8 r 93.7 35" 93.8 36 GENERAL NOTES: 'r C1 C1 FINE FINE a SANDY LOAM • SANDY LOAM 10YR 5/3 PERC 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL b 10YR 5/3 BOARD OF HEALTH AND THE DESIGN ENGINEER. 54"/66" 9C,4 MOTTLES 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 75" 90,4 MOTTLES SZ 77" OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 90.1 78" 90.3 78" 7.5YR 5/6 = 7.5YR 5/6 - LOCAL RULES AND REGULATIONS. '. ' C2 C2 3, THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR MED. SAND MED. SAND TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 2.5Y 6/4 2.5Y 6/4 DESIGN ENGINEER. ` 86.8 STG. G.W. _ 1181, 86.8 STG. G.W. = 120" 4. ANY CONDITIONS ENCOUNTERED DUPING CONSTRUCTION DIFFERING 85.9 - 128" 86.3 128" FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. PERC RATE 6.3 MIN/IN. ("Cl_ HORIZON) 5. ALL ELEVATIONS BASED ON ASSUMED DATUM, STANDING GROUNDWATER, EL.=86.8 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF f SOIL MOTTLING (EL.=90.4) THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. THERE ARE NO PRIVATE WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DESIGN CRITERIA DIRECTED BY THE APPROVING AUTHORITIES. NUMBER OF BEDROOMS: 2 BEDROOMS 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE SOIL TEXTURAL CLASS: CLASS It THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. DESIGN PERCOLATION RATE: 7 MIN/IN 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS DAILY FLOW: 220 G.P.D. (APPROVED FOR 3 BEDROOMS-RECORD) IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND (S.A.S. IS NOT WITHIN A ZONE II) REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). DESIGN FLOW: 330 G.P.D. GARBAGE GRINDER: NO 12. ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC SYSTEM COMPONENTS NOT SHOWN ON THE PLAN. LEACHING AREA REQUIRED: (330) = 550.0 S.F. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND "r 60 IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. EXISTING SEPTIC TANK: 1000 GALLON CAPACITY PROPOSED D-BOX:: 1 INLET, 2 OUTLET (MINIMUM), H-,d RATED PROPOSED SEPTIC SYSTEM UPGRADE PLAN I USE 2 TRENCHES WITH, 6-16" (H-20) ADS BIODIFFUSER 634 SKUNKNET ROAD, CENTERVILLE, MA UNITS IN EACH TRENCH FOR A TRENCH LENGTH OF 37.5' Prepared for: Capewide Enterprises, P.O. Box 763, Centerville, MA 02632 BOTTOM AND SIDEWALL AREA: Engineering by: SCALE DRAWN JOB. NO. (GENERAL USE APPROVAL FOR 7.9 SF/LF OF BIODIFFUSER) Engineering perks, Inc. NTS P.T.M. 120-09 12 UNITS x 6.25 LF x 7.9 SF/LF = 592.5 SF 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.60 x 592.5 = 355.5 GPD (508) 477-5313 03/24/09 P.T.M. 2 Of 2 ti ,