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0012 SOUTH PRECINCT ROAD - Health
12 South Precinct Rd 148-138 Centerville No. 4210 1/3 ORA Pendaflex' 100 • r i TOWN OF BARNSTABLE LOCATION SO '(-� KL'IN(d"�" SEWAGE# `J?g,.— J V,iLLAGE tF=PiM�J.,rASSESSOR'S MAP&PARCEL A 5� 6 �.. INSTALLER'S NAME&PHONE NO. VIWAM p1L\Ja C 17f7�.-5/1J SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 'y ( � (size) 3 X NO.OF BEDROOMS., OWNER n PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: ` f Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist, on site or within 200 feet of leaching facility) feet Edge of Wetland and L aching Facility(if any wetlands exist within 300 feet of leaching facility). feet. 11:2 FURNISHED BY 'FRo�JT- of �00 � jA-! . tq Y �- 123 t A-1 33 Y h_. y No. oo g Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Z1ppYicatiou for IDi.5pont *pztem Con0truction Permit Application for a Permit to Construct( ) Repair grade( ) Abandon( ) ❑.Complete System ❑Individual Components Location AdSiress or Lot N/Zy�� jq—FCI Owner's Name,Address;and Tel.No. Mv ,4c Assessor's Map/Parcel Lt $ P `38+ r�.�-1 P .��q'ilk ray/. Installer's Name,Address,and Tel.No. a ,gner's e, dd d Tel.No�'���� V �2( 7� s�- y� off/ / :2 W; 1�. �-/VOWJC 6�2-- - 2 Type of Building: Dwelling No.of Bedrooms Lot Size 1z sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)—< G ��� gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank � OD C7 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code an not to place the system in operation until a Certificate of Compliance has been issued by this B r of He lth. Signed Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. P—co d 6 Date Issued 6`117`d ———————————— No. Fee ( �• THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for 33iopoal 6potem Conoruction Permit Application for a Permit to Construct O Repair OK upgrade O Abandon O ❑.Complete System ❑Individual Components Location Address or Lot No. 1 ,�Z ' Owner's Name,Address,and Tel.No. , Assessor's Map/Parcel ,��r I Installer's Name,Address,and Tel.No. �,y.(4'�"'I l�1 � Designer's blame,Addr d Tel.No,/� �'V I��7`//`�' Q6 �lU174c, 57 �' h` !. a / /mod / 6l� ! / , `av��.�<vIC 413 f ; Type of Building: Dwelling No.of Bedrooms Lot Size '�./� -sq. ft. Garbage Grinder ( ) Other Type of Building ; No.of Persons ✓ t r Showers( () Cafeteria( ) Other Fixtures 7 Design Flow(min.required) ` !) gpd Design flow provided _ � ` ;/ gpd Plan Date Number of sheets Revision Date Title - Size of Septic Tank ;Z7 I/ GJG� Type of S.A.S. r ��, �w 77 Description of�Soil s ,v Nature`of Repairs or Alterations(Answer when applicable) Date,last inspected: r A n g eeme t.•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 /' i' a '/� Date a Application Approved by — Date ,-e Application Disapproved by: Date for the following reasons Permit No. aco a 65 Date Issued -------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (tom) ' Upgraded ( ) Abandoned( )by 6161 1. 1-141211 16962el at has been constructed in accordance with the provisions of Title 5 and the for-Disposal System Construction Permit No. - 2Do,e— 5 dated 6 19 �9 Installer / j/ �/ Designer #bedrooms Approved design flow 3'( i gpd _ � o The issuance of this permit hall of be nst ued as a guarantee that the system will c ion as desi ed. / a Date Inspector i // �, C./ Ir No. :2-w� Fee THE COMMONWEALTH OF MASSACHUSETTS 1PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS =igpoga[ *pg;tem Con5tructiou errrif t Permission is hereby granted to Construct ( ) R air (V/� Upgra ( Abandon ( ) System located at � � i 1 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of thiix: Date +O ' I� Approved by ,t V 1 Town of Barnstable Regulatory Services Thomas F. Geiler, Director &A"SrABLL Public Health Division \T�o► +°' Thomas McKean, Director 200 Main Street, Hyannis,NIA 02601 Office: 08-362-4644. Fax: 503-790-6304 Installer & Designer Certification Form Date: 14.09 Sewage Permits Q--- ssessor's flap\Parcel �`� Designer: Dftum 1'"t ° r'0ey Installer: Address: Po Kok 9p>I Address: it7T'/�G A Or. �� ��/•/ / 0,��, y issued a permit to install a (date) (installer) septic system at I SQ�f� �y�c ldJli� ��, based on a design drawn by (address) Wel zv-- dated z� o . designer 1 certify that the.septic system referenced above was installed substantially according to the design, which may include minor approved changes such as literal relocation o tlhe distribution box ands or septic tank. 1 certif-v that the septic system referenced above was installed with major changes (i.e. greater than 10* lateral relocation of the SAS or ari vertical relocation of any component of the septic system) but in accordance with State R Local Regulations. Plan revision or certified as-built by designer to follow. OF Mgss9 A�� 2 o D R N 1;�'kel R (Installer's Signature) No. 1140 SOI TAR�1' (Designer's Sig nanre) (Affix. Designer's Stamp Here) PLEASE RETURN TO BA STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CONIPL1ANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Sepric/Desi_ner Certification Form 3-26-4.doc 1 4 Torn of Barnstable. P# cq v °f De artment of Regulatory Services Q" l? I Date— Public Health Division was e$ 200 Main Street,Hyannis MA 02601. J ; �_ Fee Pd. �ed ' Date Scheduled Time i Foil' Suitability Assessment for,Sewage Disp�osal Performed By: ���rV </ `• / EVC Witnessed By: LOCATION& GENERAL INFORMATION Location Address .l t SO L,TN PR ECt N C r owner's Name �G O•�/, � (.X�a �1 �✓L� �✓rl, I Address 'u� �� I Engineer's Name Cv;V l e AM 62&� Assessor's Mapfl�rcel: l D 4��� p • i NEW CONS1RU�i70N REPAIRTelephone# 3E.2 � `2��AA�nn•�-• l•`� yy " ! Surface Stones - So ( ) Land Use � p , . ..,., Distances from: Open Water Body 7 1 b� ft Possible Wet Area�ft Drinking Water Well y2�Oft , ft.' Property Line 5/D ft ' Other ft Drainage Way SRE'I'CH:(Street name,dimensiods'of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) i PLAJ Co at d ! I d O I • O i a 1CCC�4�1 &aL✓� Depth t0 Bedrock dA{ Parent material(gedlogic) 1 • .�: �. �P Depth to GroundwaWr. Standing Water in Hole i Weeping from Plt Face fir• I `-�= Estimated Seasonal T /jigh Groundwater J ' D&ERMIN TION FOR SEASONAL HIGH WATER T"LEr Method Used: s L ` I In. Depth to s011 mottles; "S r` Depth dbserved standing;in obs.hole: ; in. ptoundwnter Ad)ustment D Depth toiweeping from side of obs.hole: , p� factor,,,,,.Adj.droundwaterlevel.,,,;e, Index Weli# Reading Date Index Well level j Date 6 s PERCOLATION TEST �-�/--� i Observation l Time tit 9" r A Hole# at 6" -- Depth of Perc Tune(99P.611) Start Pre-soak'Dme.0 (` -- E----- End Pre-soak ��' • ' I i ' Rate MinJlnch '. Site Failed; Additional Testing Needed(YIN) — Site Suitability AsscosmenC Site Passed _ . i . ' BeCompleted on Back Original:.Public H41th Division Observation Hole Data To p • ***If P ercolaOn test is to be conducted within 100' of wetland,.-You )wet k prior to begin must first notify the n_. ncrahir.('Aliservation Division at least one(1 g DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel PIA 3b"`-lgd4 C �Ugo• 2.Sy rol e/SD DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Du � ef 3 - (o Iaye S/? DEEP OBSERVATION HOLE LOG Hole# Depth from' Soil Horizon Soil Texture Soil Color Soil Other b Surface(in.) (USDA) (Munsell) Mottling (Structure;Stones,Boulders. C n iste c o ravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil exture Soil Color $oil ,. `. ;Other Surface(in.) (US (Munselq Mottlin `Structure,Stones,Boulders. F 5 Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes } Within 500 year boundary No K Yes 4�, f• 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? If not,what is the depth of naturally occurring pervious material? Certification I certify that on 16 Z9 7 _(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 requiredMinin�, xpertise and experience described in 3,10 CMR 15.017. Signature K Date. Q:WFrlLVERCFORM.DOC . o TITLE 5 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A RECEIVED CERTIFICATION Property Address:_12 S.Precinct rd.Centerville Ma.02632 JUL 2002 Owner's Name: Harold F.Buote,Jr. TOWN OF BARNSTABLE — HEALTH DEPT. 'Owner's Address: same Date of Inspection: 6/10/02 � Name of Inspector: (please print) Eric Stevens Company Name:_Mcshane Const. MAP Mailing Address: 20 Oriole In.Marston Mills Ma.02648 ceDC� — Telephone Number:_(508)776-9054 LOT ; CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CAM 15.000). The system: Passes Conditionally Passes Needs Further valuation by the Local Approving Authority Inspector's Signature: Date: 2O Zooz The system inspector shall submit a co of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector,and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments This system passes title V inspection.Recommend pumping now,then every even numb erd year.ie:04,06,08 ect. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. e OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A c CERTIFICATION(continued) Property Address:_12 S.Precinct rd centerville Owner: Harold F.Buote,Jr . Date of Inspection: 6/10/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _X_ I have not found any information which indicates that any of the failure criteria described in 310. CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: Everything is strucually sound and in good working order,should pump tank now than every other year. B. System Conditionally Passes: _n/a One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined". please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_12 S.Precinct rd.centerville Owner:_Harold F.Buote,Jr Date of Inspection:_6/10/02 C. Further Evaluation is Required by the Board of Health: n/a 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 CAM 15.303 (1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the j system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 12 S.Precinct rd.centerville Owner:_Harold F.Buote,Jr Date of Inspection:_6/10/02 D. System Failure Criteria applicable to all systems: You must indicate"yes or"no"to each of the following for all inspections: Yes No _ _X, Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than day —flow _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe (s).Number of times pumped _ X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X_ Any portion of a cesspool or privy is within a Zone I of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply _X_ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA) or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered`yes"in'Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:_12 S.Precinct rd.centerville Owner:_Harold F.Buote,Jr Date of Inspection: 6/10/02 z Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No' _x _ Pumping information was provided by the owner,occupant,or Board of Health _x_ Were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period?- x_ Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) _x _ Was the facility or dwelling inspected for signs of sewage back up? x _ Was the site inspected for signs of break out? 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 x _ Existing information.For example,a plan at the Board of Health. _x Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:_12 S.Precinct rd.centerville Owner:_Harold F.Buote,Jr. Date of Inspection:_6/10/02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_3_ Number of bedrooms(actual):_3_ DESIGN flow based on 310 CMR 15.263 (for example: 110 gpd x#of bedrooms):_330 Number of current residents:_2 Does residence have a garbage grinder(yes or no):_no Is laundry on a separate sewage system.(yes or no):_no [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no):_no_ Water meter readings,if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): no_ Last date of occupancy:present COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: homeowner Was system pumped as part of the inspection(yes or no):no_ If yes,-volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X_Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool —Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Approx age is 20 years old. Were sewage odors detected when arriving at the site(yes or no):_no_ OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_12 S.Precinct rd.centerville . Owner:_Harold F.Buote,Jr. Date of Inspection:_6/10/02 BUILDING SEWER(locate on site plan) Depth below grade:_13" Materials of construction:_cast iron _X_40 PVC other(explain): Distance from private water supply well or suction line:_town water Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: X (locate on site plan) Depth below grade:_18" Material of construction:, X concrete metal_fiberglass_polyethylene—other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions:_10'6"L x 5'8"W x 57 H Sludge depth:_5 Distance from top of sludge to bottom of outlet tee or baffle: 22" Scum thickness:_3" Distance from top of scum to top of outlet tee or baffle:_7" Distance from bottom of scum to bottom of outlet tee or baffle: 13" How were dimensions determined:_measured Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.):_Tank,D-box,and leach pit are all mi good shpe and seem to be working correctly. GREASE TRAP: n/a_(locate on site plan) Depth below grade: Material of construction: concrete metal_fiberglass polyethylene_other(explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_12 S.Precinct rd.centerville Owner: Harold F.Buote,Jr Date of Inspection:_6/10/02 TIGHT or HOLDING TANK:_n/a_(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow:. gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: X (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 equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.):_D-box was in good working order,no evidence of solids entering d-box. PUMP CHAMBER:_n/a_(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.): l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_12 S.Precinct rd.centerville Owner: Harold F.Buote,Jr. Date of Inspection:_6/10/02 SOIL ABSORPTION SYSTEM(SAS):_X (locate on site plan,excavation not required) If SAS not located explain why: Type _X_leaching pits,number. 1(1000 gal.)_ leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): leach pit was in good shape, 8"water in pit,no sign of staining any higher up. CESSPOOLS:_n/a—(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): PRIVY: n/a (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_12 S.Precinct rd.centerville Owner: Harold F.Buote,Jr. Date of Inspection:_6/10/02 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. Gzczqe— 1 - 1l ^ AL Y � OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_12 S.Precinct rd.centerville Owner:_Harold F.Buote,Jr. Date of Inspection:_6/10/02 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_18 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: _X_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) X Accessed USGS database-explain: j You must describe how you established the high ground water elevation: USGS maps and charts. F Commonwealth of Massachusetts �. S ' Executive Office of Environmental Affairs Department of4 Environmental Protection Wllllam F.Weld , Trud. :Cox Governor Arpao Paul CGiluccl VT9 uhs U.Governor mallorw SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A _ CERTIFICATION Property Address ' ���`�/!t(C �.Address of Owner. Date of Inspection: (If different) Name of Inspector. PGez! Compare Name,Address and Tele hone umber. l 4)6 7L44 /P /h� 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: asses _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: — 97 The System Inspector shall t a co sy py of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the stem is shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. ' The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C,or D: A) SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,passes inspection. Indicate yes, no,or not determined(Y, N, or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic tank is metal, cracked,structurally unsound, shows substantial infiltration or exiiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street a Boston,Massachusetts 02108 a FAX(617)356-1049 • TelaPhom(617)292.5= i~J Pnnted on Recydcd Paper p SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner. ' 1�t Date of.Inspection: n + B1 SYSTEM CONDITIONALL SES (continued) Sewage backup or b out or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, se ed or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(&)are replaced obstruction is removed ribution box is levelled or re ced' The system required pumping ore than four times a due t pan o broken or obstructed pipe(s). The system will pa inspection if(with approval of a Board of Health): brok n pipe(s)are ced chat ion is zp ved C1 FURTHER EVALUATION IS REQUIRED BY E OARD OF HEALTH: Conditions exist-which require further v tion by t e Board of Health in order to determine if the system is failing to protect the public health, safety and the environm t. 1) SYSTEM WILL PASS UNLESS OAR D OF HEALTH ETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PRO ECT THE PUBLIC H TH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy ' within 50 feet of a surface water Cesspool or pri is within 50 feet of a bordering vege wetland or a salt marsh. 2) SYSTEM WILL FAI LESS THE BOARD OF HEALTH ( PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THE SYSTEM IS FUNCTIONING IN A NER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND T ENVIRONMENT: The stem has a septic tank and soil absorption system and is 'thin 100 feet to a surface water supply or tributary to a ce water supply. e system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 9) OTHER (revised 11/03/95) 2 t 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner. Date of Inspection: •Z_(e� Q'7 Dl SYSTEM FAILS: #— i I have determined tha system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for thin determination is ident' below. The Board of Health should be contacted to determine what will be necessary to correct the failure. _ Backup of sewage into fa ' 'ty or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of etllu t to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distributio box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" low invert or available volume is less than 1/2 ow. Required pumping more than 4 times in t last year NOT due to clogged or ob cted pipe(s). Number of times pumped Any portion of the Soil Absorption System, cess 1 or privy is,be the high groundwater elevation. _ Any portion of a cesspool or privy is within 100 fee of ace water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a e I o a public well. Any portion of a cesspool or privy is 50 feet of a p 'vate water supply well. _ Any portion of a cesspool or vy is leas than 100 feet but ter than 50 feet from a private water supply.well with no acceptable water quality ysis. If the well has been anal ed to be acceptable, attach copy of well water analysis for coliform bacteria,vo a organic compounds, ammonia nitro and nitrate nitrogen.. El LARGE SYSTEM FAI The follo teria apply to large systems in addition to the criteria above: The m serves a facility with a design flow of 10,000 gpd or greater(Large S m)and the system is a significant threat to public and safety and the environment because one or more of the following conditi 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 compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.. (revised 11/03/95) 3 k SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner. Date of Inspection: Check if the following have been done: camping information was requested of the owner,occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. "'An built plans have been obtained and examined. Note if they are not available with N/A. 6—The facility or dwelling was inspected for signs of sewage back-up. 4Z.-fT—he system does not receive non-sanitary or industrial waste flow The site was inspected for signs of breakout. All system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or toes,material of construction, dimensions, depth of liquid,depth of sludge,depth of scum. � The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 I� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C n SYSTEM INFORMATION Property Address: a S 1" 0,&. Owner- Date of Inspec iot n2_ FLOW CONDITIONS RESIDENTIAL• Design flow: ons Number of bedrooms:_ Number of current residents:_ Garbage grinder(yes or no):-& Laundry connected to rystetn(yea or no): Seasonal use(_yes or no):J' Water meter readings, if available: 14 Last date of occupancy: — G - COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: /day Grease trap present: (yea or no_ Industrial Waste Holding Tank present: (yes or no_ Non-sanitary waste discharged to the Title 5 system: (yes or no) Water meter readings, if available: Last date of occupancy: OTHER ( ) of occupancy: GENERAL INFORMATION PUMPING RECORDS d source of information: System pumped as part of inspection: (yes or nqdO If yes,volume pumped: gallons Reason for pumping: TYP OF TEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components, date installed(if known)and source of information: / �' /G CCyyr /� ♦ Sewage odors detected when arriving at the site: (yes or no) (revised 11/03/95) b ti SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 Z. S PQ EG[a1<."l� /[� '�fvT✓. Owner. Date of Inspection: SEPTIC TANK (locate on site plan) N Depth below grade: Material of construction:L-e 9crete_metal_FRP—other(explain) Dimensions: Sludge depth: 11 J/-/- Distance from top of sludge to bottom of outlet tee or baffler Scum thickness: Distance from top of scum to top of outlet tee or baffle:_J �//,�- Distance from bottom of scum to bottom of outlet tee or baffle: IV1 Comments: (recommendation for pumping, conditio of inlet and outlet tees or n,depth of liquid level in relation to tlet invert, stqPtural iategri eviden of leakage, etc.) GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction: concrete_ etal_FRP_other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet e: Distance from bottom of scum to of outlet tee or baffle: Comments: (recommendat' or pumping, condition of inlet and outlet tees or baffles, depth of liquid leve relation to outlet invert,structural integrity, evidence etc.) (revised 11/03/95) 6 tV SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C �y SYSTEM INFORMATION(continued) Property Address: 11Z.4941 Owner. Date of Inspection: TIGHT OR HOLDING TANK:_ (locate on site plan) Depth below grade: Material of eonstruda n:_con metal_FRP_other(explain) Dimensions: Capacity: Azallons Design flow: aallona/day Alarm level: Comments: (condition of inlet tee,co ion of alarm and float switches,etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: f (note if level and distn ion is equal,evidence of solids carryover,evide ce of leakage into or out of box, .) 0 c'YX. PUMP CHAMBER_ (locate on site plan) Pumps is working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps appurte ces,etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C \ SYSTEM INFORMATION(continued) Property Address: to A Owner. Date of Inspection: Q 7 SOIL ABSORPTION SYSTEM (SAS):L� (locate on site plan, if possible;excavation not required, but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: .�.� leaching pits, number: /U 80 leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Co ents;,(note con 'tion of soil, signs 2f hydraulic failure, level of ponding, condition f egetat'on,etc. r y CESSPOOLS:_ (locate on site plan) Number and cc tion: Depth-top of liquid to ' et invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow(cesspool must be pumped as part of ins ion) Comments: (note condition of soil, signs of hydraulic failure, 1 of ponding, con ' ' n of vegetation,etc.) PRIVY:_ (locate on site plan) Materials of co on: Dimensions: Depth of soli . Comments: cote condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etcJ (revised 11/03/95) 8 i" SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C n/ SYSTEM INFORMATION (continued) Property Address: 1 SCw-.L , V. Owner: Date of Insp ction: a----L- R'I SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' f o c - 37 d • a c - 4- - 2? 3 -c - 9/ DEPTH TO GROUNDWATER Depth to groundwater 1:2= _feet 7,4 tJ S 6 S method of determination or approximation. 9 (revised 8/15/95) 11 ", TOWN OF BARNSTABLE 15c LOCATION /;, S O U T fY -eg e C. /A/C -r R SEWAGE # avvy - oS.- VILLAGE c:. ewT ele V1 u e ASSESSOR'S MAP & LOT — 3� INSTALLER'S NAME&PHONE NO. �� 44 ,4 C 0,14 /3 e/Z' Say SEPTIC TANK CAPACITY /- D 041 0i P, LEACHING FACILITY: (type) 3- /Al i7U T 8,4 o X (size) NO.OF BEDROOMS 3 3 v,s e BUILDER OR OWNER o�d(lec,✓ PERMITDATE: �� I ��y COMPLIANCE DATE: —4k/ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by f t 7 '., 4.. �b J d' G Jz,=- I�=p IN.sPeCT OA1 P O iz so ur# p/? ec IAI /' D No. � ° Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for Ztgpogar bpgtem Congtruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 12 S. P/zec.inct /2d. /�'�chaee Boucl2eau 12S. %aecinct /2cL. 148—Assessor'srcel Centeav i Qe, (7a, 026 32 Cente�zv i e ee, Na., 026 32 48- �38 Installer's Name,Address,and Tel.No. (5 0 8)7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. (5 0 8)4 7 7-5 3 13 a. / . Nacoin9e29.6on Inc.- Cng.inee,z ing Oo2k s 120. C zo,3.s/.ceid /2 Box 66 Centenvie e, Ma. 02632 1 fozehtdaee, /'a. 02644 Type of Building: Dwelling XXNo.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank l oo o (, Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) X.., A 4.r, 9 4 i gr 2 0 5 0 Z q 19 4,r i Q Z 4 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has be 'ss d oar _o Health. q wried Date I Application Approve Date 1_J U Application Disapproved for the following reasons Permit No. da 5 Date Issued c3 No. Fee S .- s \ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS 2ppfication for �Diopooal *potem Couotruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 12 S. 10aec inct Rd. Michae e Roudaeac' 12S. l aec inct Rd. Assessor'sMap/Parcel Cent e tv.ii ee, Na. 026 32 Cent eav i fie, Na. 026 32 38 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Bn (508)775-3338 (508)477-5313 ;- / . Macom&e2Lion Inc. Cng.ineea.ing Yoak s 1219. Eao.s s�.ce ed R il ox 66 Centeay.ieee, (Ia. 02632 Toae6tda2e, Na. 02644 Type of Building: Dwelling y yNo.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other 'Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /00 o (- Type of S.A.S. Description of Soil, Nature of Repairs or Alterations(Answer when applicable) _ r� t. n �, ;__3 n 5 n/ eor bCr/ ;Yf R'Z f n`P 11" A 4 on(jam LP 144 Cig g V J 6-i ag //need kia q a f 4 r 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 Certifi- cate of Compliance has been issued b -this Board of Health. `gned Date 1, !_o q Application Approved by ---'� Date lz - Application Disapproved for the following reasons Permit No. 51)0��S S Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( XA)Upgraded( ) Abandoned( )by 7. P. Nacomaea 9 Son Inc. at 12 S. Paec.inct /2d. Centeay.iXXe, /I&. has been constructed i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. '-d 0�l-�S�" dated '2 �/7/U v Installer Designer !� � t The issuanc'of this permit shall not be construed as a guarantee that the s ste will functio)as esigrie( . Date u o i Inspector LV� l471 ' �. No. ao )'7 — S� Fee . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS ioogaY *potent Cottgtruction Permit Permission is hereby granted to Construct( )Repair Upgrade( )Abandon( ) System located at 12 S. P/tec.inct /2 Cen.f>tinvi2�e. (7a. ," .f and as.4escribed in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comp, y with Title 5 and the following local provisions or special conditions. Provided:;q,ons ction must be completed within three years of the date o' f this permit. Date: 3 �d Approved by l TOWN OF BARNSTABLE LOCATION U RR e C IAI C-f R A9.SEWAGE # a00y OS.5— VILLAGE C. PN?e Vi LL a ASSESSOR'S MAP & LOT -/3J INSTALLER'S NAME&PHONE NO.. C 0 e R Say SEPTIC TANK CAPACITY. - 40 0 L In LEACHING FACILITY: ( pe) - + "/L d (size) .. NO.OF BEDROOMS BUILDER OR OWNER o��l�ea✓ PERMITDATE: COMPLIANCE DATE: o U Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i L G I. Ws,aeCrICIAI P OR7'• /� sov1"N PReel7r R0 Town of Barnstable Regulatory Services Thomas F. Geiler, Director lNAM F Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Fax: sob-790-6304 Office: 508-862-4644 Installer& Designer Certification Form Date: 7. 20 Q 4- �tv c> S Installer: ,i cr Designer: non-ee��r� .- Address: t2 W. C nisi :eV-c�.._ _ Address: - ��c G ( �3 b 4 _ t `4Co M 13C.�2 was issued a permit to install a (date) (installer) q septic system at 2 �a , �'��� ✓t L '�c;\ �: based on a design drawn by (address) S dated rL�Z� 0 (dent er) f%N1 I 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. I certify 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 component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Ss (Installer's Signature) o PETER T. G� MCENTEE CIVIL " �- No. 35109 es (Designer's Signature) (Affix D ` e LEAS RETURN TO BARINSTABLE PUBLIC HEAL T I TIFICATE F C® PLIANCE wMi.IVED BY THE >g E SNAB E PiJ H �J T TI1ANK YOU. Q:Health/Septic/Designer Certification Form LSD C AT ION SEWAGE PERMIT NO VELLAGE INSTALLER'S NAME i ADDRESS B UILDER OR/� OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED r 4 4.,_rd of Health No.... :o. 0®7 P.O. -Sox 6�;�k �s$�s n'�(� Flcs....S.�................._ H an�g4CC V8WVL7�#°'C 'MASSACHUSETTS,�' _ ABOARD �jOF HEALTH - e�.✓1..1./v..------.....OF..........&.1$e<!) 9.4% -------------------------------• App iratiun for M-4puual Mirkii Tono rurfivit umit Application is hereby made for a Permit to Construct �X) or Repair ( ) an Individual Sewage Disposal System at: ion e , Or t Own Add ss a -------------p-B ._. � Q - �!�l --------�------`a�W��. ►.......----- • M Installer Address UType of Building Size Lot_._ _ ....Sq. feet ` Dwelling—No. of Bedrooms..................................._._____..Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g -------------•-•--•-•-----•- P ( ) — Cafeteria ( ) Otherfixtures .-------•--•-••----•------------•---•-••••••••--------.....•-•------------••-•-•-•-••-•-----------------••----•-•�---•••......--•----•---•..•----- W Design Flow............................................gallons per person per day. Total daily flow---------- ...................gallons. WSeptic Tank—Liquid capacity&/Q.aagallons Length....452._.. Width.....4..A.. Diameter................ Depth.--_`..... x Disposal Trench—No. .................... Width......._......_..... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No......../........... Diameter-__ fit. __. Depth below inlet........6....... Total leaching areas Z Other Distribution box (� Dosingnk ( ®w�-L j�.� ��G.-of4(Z — {G-7 Percolation Test Results Performed b _ �.. JG=_........ -- • Y------------------ - ----- -•-•-----------` --� - ----_ Date. -3-------�-�'-��---- Test Pit No. 1-----<_� minutes per inch Depth of Test Pit._.1�?�..�... Depth to ground water_,Q..� !4_•'. G% Test Pit No. 2....'<.�minutes per inch Depth of Test Pit... Depth to ground watej4;qv,%)7d�'e w or w c r C. a i i/ ODescription of Soil................... ........._ ............................................................................. U --- ---..-•-------------- ----------- •----------- -.---•--------------------------------------------------- •------------------------------------------------------------------------------ ------ W V Nature of Repairs or Alterations—Answer when applicable................................................................................................ -----------------------------------------------------------•-----------...-•--•------.........----•----•-----••-----------------•----------••--------------------------•---•••••-•-------...-•--•------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL 1TL U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss by the bo d of health. Signed............................. -•-• ....... -:......................•-••••......• ................................ Da e Application Approved BY ......-•---•--•-- -------------•--- --•--- � � ........... Date Application Disapproved for the following reasons-------------------------------------------------------•---------------------•-----------------------....._..._._ ..............•-----------------------------------...-----------.........---------.....------...•..------••------------......•-•••--•-••-•-•----•••-•---------•••••-•--.....-••-----••-------•--.._..... Date PermitNo......................................................... Issued........................................................ Date No.__..._....q.-./ 4 -.f.... Fss.............................. TH:_�- COMMONWEALTH OF MASSACHUSETTS , 4 � BOARD OF HEALTH ..............OF......... f Application for Di"ns al Works Tonitrurtion rrutit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: • Location-Address or Lot No.®J .. styyFV'4e'-� ° ?� dr // } � � � 4lC .. �� jt d. . [ - -- --- e » 77;17 r ................................�...-../../....i• ,m n - /1 � as �' kr Type of Building. Size Lot....__ -,--��J..•..Sq. feet �-, Dwelling—No. of Bedrooms___..•......._-3-•-•-_-•-____•-__--_--__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures .------••---•----•----••------------------••--------•----...------....-•--- W Design Flow..............5.•...........•....•..••__gallons per person per day. Total daily flow.............. .©............•.......gallons. W Septic Tank—Liquid*capacity/.Q.�u.gallons Length.......... Width__-.�...._ Diameter................ Depth..;--r4___..... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------1----------- Diameter^__/.t>.__.-5.'. Depth below inlet.......!:?::......... Total leaching area T.6. _.—sq.»ft,, F'P Z Other Distribution box ( ) Dosing tank ( )=�O1-��� ¢� 7'/' c v e�' i , J'��2_ •7_ 4 - 77 1—' Percolation Test Results Performed by..t_v.4-a�..:`.1A)1�4« ,E!_)E_... 6 `•Date. = �� Test Pit No. 1....< minutes per inch Depth of Test Pit...Z5��t....... Depth to ground fs. Test Pit No. 2---:�._Zminutes per inch Depth of Test Depth to ground water-,> a- - D Description of Soil.................... .--:.....---...T'L,.,'l..)........----•------•-------------------------------------•-------------------------•----.................... W U ...............................................•--•-----••••-••-•-••--...----•••-••-••.................................................................................................................. x •••-•••----•------------•---------•--•••••-•----•-----------------------••-••--••-•-•--...---•-••-•-----••-----•••-•-•---••••---•••••••----•-••••••-••------•••••••-•--••......--••••-•................ U Nature of Repairs or Alterations—Answer when applicable................................................................................................ --------•---------------------------------••----------------------------•--•-----------.......----------------------------------------------•----------•------------------••-••------••-•-----------•--• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitar Code— The undersig d further agrees not to place the system in operation until a Certificate of Compliance s bpee issu l health. Signed............... rl _.... {u y Date ApplicationApproved By............................................................./.....---............----•--•------ Date Application Disapproved for the following reasons----------------------------•------------------------------------•---------------•-------------------:..----•---- -•-----•----•--•--••------•---•-•-------•••----••---••--•••--••••--••--•----.....-•----•...................................•-•--••-----•---••--•-••••-----••••-•-•••-••-••--•-•••-----••••••._.......... Date PermitNo......................................................... ls�sued....................................................... Date THE COMMONWEALTH OF"MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... %rrtifirzttle of TontpliFatta THIS �® CKRTIFY, That the Individual Sewage Disposal System-constructed ( ) or Repaired ( ) by .i1_... .. -- s �.. --- ------ -- ------ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... d-ated_............................................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..... ,!. .. ... ._.... Inspector...---- --- THE COMMONWEALTH OF MASSACHUSE TS' Sty 4 BOARD OF HEALTH Rw � ...........................................OF..................................................................................... No......................... FEE............_.....�.... >. iro %onitrttrtion rrutit xNePermission is hereby granted----•-`--- .:------•--•----------------------------------------•-•--•----------•---------.<.--------- ..:----....---•-••---...... to Construct oryRepa'x (at No.. pang Ind'vid 1 ew e s osra tem ' 1 sv ............................................................ r as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ------------------------------- Board of Health DATE................................................................................ FORM 1255 A. M. SULKIN, INC., BOSTON .A LEGEND Rd P�ec�r 562044'I 1"W 18.00' 99 PROPOSED CONTOUR 5 P�ec1� 99 PROPOSED SPOT GRADE LOCUS 40 EXISTING CONTOUR �,deh W APN 148— 1 38 30.23 EXISTING SPOT GRADE °Is csemocy LOT 20 TEST PIT z �o m "� %�� r0 W EXISTING UNDERGROUND ou{O`�� �� �� 19,487± 5F, � (�,�' ���1 UTILITIES (G. T/E) 4 �v IN/ = t v EDGE OF " BORDERING vEG�A1EDTLAND$ � td EXISTING TREE ` bNlf Totomoc _69 - - - - - -- 29.W —� 23.5' Route 28 "_ a0 PROPOSED S.A.S. — I a —9.5 LOCUS MAP N.T.S. 1_ N �i // N _1 S.A.S. DIMENSIONS GENERAL NOTES: N / / // —98— — — ro 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL �' BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 0 i // / OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE OF MgJs � OF M4SS9 LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR NO. 1 2 RICHARD G� o PETER T. TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE J. McENTEE _ DESIGN ENGINEER. / I STY. WD. PR. o HOOD CIVIL 4• ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING GARAGE �5031 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 3 BDRM. No. No. VIL ENGINEER BEFORE CONSTRUCTION CONTINUES. T.Q.F. = 103.74 F a �FGIS���E �� 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE'FAILURE OF / THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 1 l 7. WATER SUPPLY PROVIDED 8Y TOWN WATER SERVICE. 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 100' OF THE S.A.S. BRICK WA C EXISTING TANK 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED / ��✓N G7 TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. (f0 REMAIN) TOP OF TANK EL: 101.0± 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE I00'BUFFER — —� OUTLET INV. EL: 99.6± THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING I � CONSTRUCTION. TO B.V.W. �� ". .T.T " �/ 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS lX15TING S.A.S. IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. TO BE PUMPED REMOVED AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). BENCHMARK: -o (5EE ALSO, NOTE 1 1) PROP..05EO 5:A 5: CENTER BACK OF / < D CATCH BASIN RIM , �-� o PROPOSED SEPTIC SYSTEM UPGRADE EL: 100.00(ASSUMED) / �, �j Q 4nn� 117.93' Dc12 SOUTH PRECINCT ROAD, CENTERVILLE, MA _ _GO°48'48" WETLAND DELINEATION Prepared for: Michael Boudreau, 12 Precinct Road, Centerville, MA "— -- Surveying by: SCALE DRAWN JOB, NO. LEC Environmental Consultants Engineering by: LEACH Gi 3 Otis Park Drive EngineedngWorks HOOD SURVEY GROUP 1"=20' P.T.M. 109-03 CATCt18A31W Bourne, MA 02532 12 West Crossfield Road 18 Route 6A SOUTh PRECINCT ROAD (508) 759-0050 Forestdole, MA 02644 Sandwich, MA 02563 12 29 03 CHECKED SHEET N0. (508) 477-53.13 (508) 888-1090 P.T.M. 1 of 2 NOTE: TO PREVENT BREAKOUT, THE PROPOSED ELEV. TOP PROVIDE RISER OVER 'D-BOx ' FINISH GRADE SHALL NOT BE < EL.99.0 FOUNDATION TO VIXTHIN 6" OF FINISH GRADE ! FOR A DISTANCE OF 15 AROUND THE (Existing) F.G. EL: 101.6t FINISH GRADE: 101-102 PERIMETER OF THE S.A.S. =103.74 F.G. EL: 101.9t F.G. EL: 101.8t MAINTAIN 2% MIN SLOPE OVER LEACHING AREA e e'. INSTALL RISER OVER D-BOX TO WITHIN 6" OF FINISH GRADE e: u L = 24' L = 4' i -- 's'" 4" SCH 40 PVC 4" SCH 40 PVC 7 3" EXISTING : 10" 14" ® S= 1% (MIN.) 6' S= 1 % (MIN.) ° a' EXISTING ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° e: 1000 GALLON INV.EL: 99.6t ° ° ° SEPTIC TANK (EXISTING) D-B X INV, ELEV.=99.25 INV, ELEV.=98.50 INV. ELEV.=99.42 EXISTING INSTALL INLET & OUTLET TEES 3.5'* 3 INFILTRATOR 3050 UNITS= 22.4' 3.5'* GAS BAFFLE TO BE INSTALLED ON EFFECTIVE LENGTH = 29.4' OUTLET TEE AS MANUFACTURED BY SOIL ABSORPTION SYSTEM PROFILE TUF-TITE, ZABEL, OR EQUAL N.T.S. D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED BREAKOUT EL. = 99.0 s--- 2" LAYER OF 1/8"-1/2" STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2), DOUBLE WASHED STONE PIPE INV. EL. = 98.50 EFF. DEPTH = 2' 3/4"-1 1/2" (3) 5" DIA.OUTLETS SEPTIC SYSTEM PROFILE BOTTOM S.A.S. EL.= 96.50 DOUBLE WASHED STONE 15.5" �--16 �2" N.T.S. 5' MIN. ABOVE BO LEVEL ON A SAND BASE TTOM OF 3,5'• 4,2' 3.5�« CHAMBERS ARE LAID =1 SE T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 11.2' « PLACEMENT OF WASHED STONE SHALL O 12" BOTTOM OF TEST HOLE EL:91.0 _ BE NARROWED AT ENDS AS SHOWN. L L 15.5' 6 8„ SOIL ABSORPTION SYSTEM SECTION (SEE SHEET 1 FOR S.A.S. DIMENSIONS) N.T.S. 2' OF MAY SUBSTITUTE A TUF-TITE Mq 4HD2 HDPE D-Box (H-10), DESIGN CRITERIA OR EQUAL SOIL LOG o� PETER T. s D-BOX ,,,TA > NUMBER OF BEDROOMS: 3 BEDROOMS o McENTEE DATE: DECEMBER 23, 2003 SOIL TEXTURAL CLASS: CLASS I CIVIL N.T.s. No. 35109 SOIL EVALUATOR: PETER McENTEE P.E. DESIGN PERCOLATION RATE: 2 MIN./IN. NO. 12 DAILY & DESIGN FLOW: 330 G.P.D. ' �'ECIS�E��� Ss! STY. WD. FR. GRINDER: NO 0 Elev. TP Depth GARBAGE 3 BDRM. SEPTIC TANK REQUIRED: 1000 GAL. CAPACITY 101.5 A SANDY LOAM 0 10YR 3/3 T.O.F. = 103.74 LEACHING AREA REQUIRED: (330) = 445.9 S.F. 11,1 16k. 101.1 B SANDY LOAM 5 .74 98.5 10YR 5/8 36" USE 3 INFILTRATOR 3050 UNITS AS SHOWN C SIDEWALL AREA: 78.1'(SIDEWALL PERIMETER) X 2' = 156.2 S.F. 041� CCESS PORT FOR INSPECTION. BOTTOM AREA: 319.1 S.F. 95' 3/ 0 TOTAL AREA: 475.3 S.F. 89.5" (V 3y9 6y INSTALLED LENGTH DESIGN FLOW PROVIDED: 0.74(475.3) = 351.7 G.P.D. MED. SAND 2.5Y6/6 �/- - - - " N PROPOSED SEPTIC SYSTEM UPGRADE PROPOSED S.A.S. � 95%0' 30 INFILTRATOR.3050 INLET END - _ _ J 12 SOUTH PRECINCT ROAD, CENTERVILLE, MA (OPEN) �-- - - -- NOMINAL CHAMBER SPECIFICATIONS 91.0 126" I+-- 2'9A ---"{ Prepared for: Michael Boudreau, 12 Precinct Road, Centerville, MA SIZE (W x H x INSTALLED L) 50" x 30" x 89.5" Engineering by: Surveying by: SCALE DRAWN JOB. N0. WEIGHT 80.0 LBS- PERC RATE: 2 MIN/IN. ("C" HORIZON) Engle@@PIngWOrks HODD SURVEY GROUP NTS P.T.M. 109-03 CHAMBERS NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road 18 Route 6A S,A,S, LAYOUT Forestdole, MA 02644 Sandwich, MA 02563 DATE CHECKED SHEET NO. N.T.S. 12 29 03 (508) 477-5313 (508) 888-1090 P.T.M. 2 of 2 i , 1 ;> �# LEGEND �c �a�" °d C ASS 1Or 4q 'Q- N ,tjr�`0 br h'erj OF PROPOSED CONTOUR 2�� ® PROPOSED SPOT GRADE Y D M. EXISTING CONTOUR 1140 B E(`�( C( ( MARK + 96.52 EXISTING SPOT GRADE { .PFBIsl PAINT SPOT IN DRIVEWA`r W— EXISTING WATER SERVICE ' NIT00' ELEVATIOP,J 59.43 IS TEST PIT BARNS T ABLE CIS DATUM fl a c` Q ,vim•� ,Fad° 4 a � P 1-2, G v _ 163.26 ft ' - - �— s —\— 1- 1 - - - - - - - - t ! I \ \ \ I I \ \ 1 ,4lij �LOCUS MAP N.T.S. GENERAL NOTES:\ 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL Lj Q I 1 \ \ \ �� \ \ i BOARD OF HEALTH AND THE DESIGN ENGINEER. 1 \ \ \ \ I 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS \ j OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE 7- I 1 11 \\ \\ \\ \\ LOCAL RULES AND REGULATIONS. \ �C PAVED DRIVEI '� I j ( � � i 11 \I \\ � , I 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR \ TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. I I 1 I I 1 \ 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN I I I I ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. G! � I I I I I I � � ��er 11 ft ; r7 I I- 1 OI O I I I I 1 �C Q; ser rn I ( J 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF of j I I I I 1 20 ft .` r I z �� THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF j I I I I 1 I r i w HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. I 1 I I I 1 2 1 1`� W W 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 1 1 I I I 1 1 p I r10 I Q 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 11 I 1 \ I I 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE L O THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING n CONSTRUCTION. I I I 1 \ \ m m \ Tye I Y Li 10. EXISTING LEACHING IS IN SAME LOCATION AS PROPOSED LEACHING. Q I IT IS TO BE REMOVED AND REPLACED WITH CLEAN MEDIUM SAND. I I \ \ \\ 3: 1 w Existing Leaching 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION (Note 10) 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY I I \ \ \ \ I I I AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. W 14. NO WETLANDS WITHIN 150' OF PROPOSED LEACHING. ! Q I 1 \ \\ \\117.86' \\ \ \ / 1 Q O L 15. ALL PIPING TO BE 4" SCH 40 ® 1/8-/FT (UNLESS SPECIFIED) O f— w I \ \ L — — — — — — — — —I— — — — — — — — — 5 — — --\ ------------- 1------------ 1 — -----— — --- --- — — —� 167.22 f. PROPOSED SEPTIC SYSTEM UPGRADE PLAN 3 12 SOUTH PRECINCT ROAD, CENTERVILLE, MA y Prepared for: Mike Dedecko SURVEY REFERENCE: " 148 Engineering by: Surveying by: SCALE DRAWN JOB. NO. LOT. 138 DARRENM.MEYER,R.S. Boo-Teed Env/roame W 1"-20' DMM PLAN OF LAND BY BOSTON SURVEY CONSTULTANTS DEED BOOK. 15542 PO BOX961 (508) 364-0894 EAST SANDWICH,MA02537 DATE CHECKED SHEET NO. DATED: DECEMBER 3, 1972 DEED PAGE.•265 508-3622922 06/11/08 DMM 1 Of 2 ELEV. TOP FOUNDATION NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS (Existing) = 57.69 F.G .EL: 56.0 F.G.EL: 56.0 F.G. EL: 56.0 FINISH GRADE=56.0 A MAINTAIN 2% MIN SLOPE OVER LEACHING AREA MAX. COVER OVER LEACHING = 3.0 FT. COVERS TO WITHIN 6 OF GRADE _ 9iii Y RADE •. t s" • „• 4" SCH 40 .PVC s 4" SCH 40 PVC A ° ° ° ° a @S=2� 10"I ® S= 17 MIN. 6 (MIN.) TEE'S ARE TO BE 14 ( ) @ S= 1% (MIN.) ...A. 4" SCH 40 PVC INV.53,59 ° ° ° ° ° 53.89 INV.53.39 GAS PROPOSED DB-3 . U EXIST. OUTLET BAFFLE SED H-10 DISTRIBUTION BOX 35, INV. 54.14 EXISTING 1,000 GALLON SEPTIC TANK INV. ELEV.= 53.0 GAS BAFFLE TO BE INSTALLED ON ) CONTRACTOR SHALL VERIFY ALL EXISTING 9" MIN. NOTES: 1 aw r or apt-°°"� svm srowE PER Tl TLE 5 OUTLET TEE AS MANUFACTURED BY PIPE INVERTS PRIOR TO CONSTRUCTION TUF-TITE, ZABEL, OR EQUAL 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BREAKOUT EL. = 53.5 GRADE ON A MECHANICALL COMPACTED SIX INV. ELEV.= 53.0 INCH CRUSHED STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2) J/'"- '-ram 24" 3) REPLACE EXISTING 1,000 GALLON SEPTIC ooueU wASHM STMWW INI/ERT TANK WITH 1500 GALLOP! SEPTIC TANK IF FAILED, DAMAGED, ORi UNDERSIZED. BOTTOM EL= 51.0 -23" 50" 23" 4) INSTALL INLET & OUTLET,TEES AS REQUIRED SEPARATION 8.00 FT. I 916 I P#: 12234 SOIL LOGS SEPTIC SYSTEM PROFILE SOIL MOTTLING 0 EL. 43.0 SOIL ABSORPTION SYSTEM (SECTION) N.T.S. DESIGN CRITERIA DATE: JUNE 5, 2008 SOIL EVALUATOR: DARREN MEYER, R.S., CSE NUMBER OF BEDROOMS: 3 BR DESIGN WITNESS: DONNA MIORANDI SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) HEALTH AGENT DESIGN PERCOLATION RATE: <2 MIN/IN DAILY FLOW: 110 G.P.D. Elev. TH-1 Depth Elev. TH-2 Depth r DESIGN FLOW: 330 G.P.D. 55.5 q LOAMY SANG 0" 55.5 A 0" GARBAGE GRINDER: NO (not designed for garbage grinder) tOYR 3/2 L�OYR 3/2SAN0 55.0 6" SEPTIC TANK: 330 gpd x 2 = 660 gpd USE EXISTING 1,000 GALLON SEPTIC TANK LOAMY SANG LOAMY SAND B 55.0 B 6" LEACHING AREA REQUIRED: (330) = 445.94 S.F. 10YR 6/8 10YR 6/8 74 USE FOUR (4) INFILTRATOR 3050 UNITS WITH 1.9 FT. STONE 53.0 Cl 30" 53.0 C1 30" ON THE SIDES & 2.6 FT. STONE ON ENDS: 35' L x 8' W x 2'D u BOTTOM AREA: 35 x 8 = 280 SF PERC 0 51.87 SIDE AREA: (35 + 8) X 2 X 2 = 172 SF TOTAL SQUARE FEET PROVIDED = 452 vs. 445.94 REQ'D MEDIUM MEDIUM { DESIGN FLOW PROVIDED: 0.74(452 S.F.) = 334.48 G.P.D. vs. 330 G.P.D. req'd SAND SAND 2.5Y6/4 2.5Y6/4 �\ o �DARR N M.9cy PROPOSED SEPTIC SYSTEM UPGRADE PLAN L MEk. 12 SOUTH PRECINCT ROAD, CENTERVILLE, MA 39.5 192" 39.5 192" No 1140 "' Prepared for: Mike Dedecko PERC RATE <2 MIN/IN. ("C" HORIZON) PERC RATE <2 MIN/IN. ("C" HORIZON) �� p Engineering by: Surveying by: SCALE DRAWN JOB. NO. NO GROUNDWATER OBSERVED NO GROUNDWATER OBSERVED # S1E DARRENM.MEYER,R.S. COO-Teeb hnvlronmeatal N.T.S. DMM SOIL MOTTLING OBSERVED 0 12.5 FT (EL. 43.0) SgNITAR�p� POBOX961 (508) 364-0894 1: a EASTSANDW/CH,MA02537 DATE CHECKED SHEET NO. z 0 t 1 508-362-2922 06/1 1/08 DMM 2 of 2 BOX O 'oX ro LEfy CH F'r T _ D!U5 �'� 4� �srrr. Fes - T�h;A,. ;t 47.40 47.23 .40 �/NED /. p 4.7,7a - -- 42 34 -- 2 X Tom-A-'4D A L C_ E &: 9 pro 't{e. 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