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Home My WebLink About0228 STONEY CLIFF ROAD - Health 228 Stoney Cliff Road Centerville F/R 190 158 UPC 12534 No. 2153LOR HASTINGS.UN i TOWN OF BARNSTABLE LOCATION t — C—(V SEWAGE # VILLAGE �' �- `�' AS ESSOR'S MAP & LOT INSTALLER'S NAME&PHONE N0. SEPTIC TANK CAPACITY + r LEACHING FACILITY: (type) �!�C�S`a''�"� (size) ��r� '�l r C NO.OF BEDROOMS 3 BUILDER OR OWNER Q C-5>F NT^ PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i fCvu� Falz�t �� 31 TOWN OF B.AdtNSTABLE '-LOCA"PION 4 SEWAGE #i YILLAGE' S ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY e s LEACHING FACILITY: (type) � � � (size) i5�o NO. OF BEDROOMS 13 BUILDER OR OWNER �, - PERMITDATE: COMPLIANCE DATE: Z� 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 f lc thin ifility) Feet Furnished b r 1 1 I No Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RlOration for Misposal 6pstem Construction 3permit Application for a Permit to Construct( ) Repair V1 Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. G� jSk ` ' C`NC� wner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. c� Designer's Name,Address,and Tel.No . wA PA �rUn� 1� Z Ok Yc„or�o� � S. cic-0k-Cck,\ 1 SS' fyty Ryas �. S, 3r14 OU ®Y q Type o Building: Dwelling No.of Bedrooms 3 Lot Size q.ft. Garbage Grinder(NO Other Type of Building No.of Persons Showers( ) Cafeteria( ) " Other Fixtures Design Flow(min.req r red) 3 6 gpd Design flowprovided�� gpd Plan Date 1 � ' a Number of sheets Revision Date Title !� Size of Septic Tank A��sr L�Au ?`'�ype of S.A.S. Description of Soil e A� Nature of Repairs or Alterations(Answer when applicable) ` ' LQ 5 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 Boar Health. / J Signe Date �h /�ri Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued e No. L^`*.f' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABL'E, I MSSACHUSETTS Yes application for 33isposal 6pste-m Construction Permit Application for a Permit to Construct( ) Repair 1 Upgrade( ) Abandon( ) ❑Complete System ►s Individual Components Location Address or Lot No.'' G r �j / p �Owner's Name,Address,and Tel.No. 11C�1� (� j� .. Assessor's Map/Parcel 0't ��w, C,gA4y Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. S w!\ rn F�wyC..�t 3 d 1 d «,.wt%% �J %. 4 c o}G cc., Is r G c o f Z c� Type dBuilding: Dwelling No.of Bedrooms 3 Lot Size 1,76 �{sq.R. Garbage Grinder'(NO G Other Type of Building a No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided i V gpd Plan Date Number of sheets ,Revision Date Title r� 4 s Size of Septic Tank` . L t hype US.A.S. C,,C,M�^}Qf'�j Description of Soil Nature of Repairs or Alterations(Answer when applicable) LC C-k "Date last inspected Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe «�� DateQ�•/ c PP PP Y Date (� �kla Application Approved A b Application Disapproved by Date for the following reasons x Permit No. o Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(� Upgraded( ) Abandoned( )by at ( , k-6Nes/ C��r� ( 4 ry i`N e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No;li 1-, dated Installer <_ 1;CTA,w Designer Coy i a n p u-) r #bedrooms 3 Approved design flo ) gpd The issuance of this ,erm'it sh ll not be construed as a guarantee that the system tfun:c)c6las designed.Date d Inspector >, � 1 .._.-.----No• ��_..�R J d-�--•----•--_.__,_.__.__.__._._�_.__._,__. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction 3permit Permission is hereby granted to Construct( ) Repair(l/ Upgrade( ) Abandon( ) System located at �� 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 b'compl"ted within three years of the.date of this permit. Date Approved by Town of Barnstable Regulatory Services Richard V. Scali, Interim Director aA ,MAS& Public Health Division y ABB. xbyq. 1 '0��or9p Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 tax: 508-790-6304. Installer& Designer Certification Form Date: 9/25/20 Sewage.Permit# 2a a a),3 Assessor's Map\Parcel 177/44 Designer: David D. Coughanowr RS Installer: S- (—(-C1-1V1- Address: 155 George Ryder Rd South Address: O-Al-\ P-j Chatham, MA 02633 S Ci rJ d 6 I Oil kA t"A TC-CvYC, was issued a permit to install a (date) (installer) septic system at 286 Stoney Cliff Road based on a design drawn by (address) David D. Coughanowr dated May 9, 2020 (designer) X I certify that the septic system reverenced 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. Strip out (if'required) was inspected and the soils were found satisfactory. 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. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the I\A approval letters (if applicable) ! � ��Ita , tavic D. D . nsta er's Signature) "' .,., Tz. 0 g ) C OUCaNA.N010"t, 1 COUG AJ." AN � ,)j No 1093 4 i r "' .w d . (Designer's Signature) '• ner's PLEASE RETURN TO BARNSi"ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL, BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEAT.TH DIVISION. THANK YOU. Q:\Scptic\Designer Certification Fonn Rev 8-14-11doe EXISTING CESSPOOLS INCLUDING ANY NW SHOWN ON THIS PLAN - - SEPTIC COMPONENTS ARE TO BE LOCATED AND SHALL BE PUMPED. COLLAPSED & FILLED. ��5u5 oa0 kssuyF�,�, 1500 GAL ® ELEVATION SEPTIC TANK WATER LINE T-� 55.25 0 e, EXISTING WATER GATE O Op OF CONCRETE OC�� • LEACH PIT/ — GAS LINE �G CESSPOOL GAS GATE O o. DISTRIBUTION BOX 0 OVERHEAD WIRE off S4 THIS IS A TEST PIT 38 q3 ft COLOR t PLAN 7 f 55 69' 3 � USE COLOR PLAN ONLY FOR INSTALLATION LOT O T Gl-�j �j I FULL DETAIL IS BEST / G VIEWED IN AREA = 15018 $ f - FULL COLOR PROPOSED SOIL � � � 55 ABSORPTION PLAN BOOK 224 PA E 87 SYSTEM A SSR MAP 177 PCL 44 -SEE DETAIL ON BACK i HEDGEROW � HEDGEROW ® 0�13 • E57 ------ I o —_— G G O 2 - 10 ft � ft - - - - -- - - - - - -; U) - E #S§NG 1 3 BEDROOM j 1 O WEL L W O 54-— G GARAGE 1 \ j 1�®Gp ®(� G nMDln�l SLAB FNDN EL o 55a25 �0 53 I, I. IN oNTO C (TYP) MINIMAL / Z� GRADING m GIMP,0 PROPOSED is.16 / Z IAIN AV (A 89.44 ft ___� _ 7 h ? bmxw , VEME IQA ,� �� F 1j, x �9- 311 Rmo t� D go PLAN CIOTE . SCALE: 1 in = 20 ft INSTALLER MAY SUBSTITUTE AN GARB APPROVED POLYETHYLENE SEPTIC G R 0 20 40 TANK IN PLACE OF THE CONCRETE OWED TANK SPECIFIED. 0 10 20 THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF'THE SEPTIC SYSTEM PRINT ON 8—1 12 X 14 in DEPICTED ON IT. FOR ANY OTHER CHANGES TO THE PROPERTY INCLUDING PAPER FOR PROPER SCALE PLACEMENT OF ADDITIONS. SHEDS.FENCES OR SWIMMING POOLS. OWNER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. CENTERVILLE MAF � r 1 WAGE DISPOSA�� 1 r � •I aryo, �. ��'Oo c� y SYSTEM PLAN 0! tt � �a �t�" [ r Y i ,r9% B by i N fS9 Pk•YN Of 1114SS -TD SERVE EXISTING DWELLING DAVID CyG� o� DAVID 9�yGv _4 _ 1 1 rguJ ;mom— D THOMAS AND D. k� f m� ,, • a COUGHANOWR s COUGHANOWR N ° DEBORAH GEILER t ue a C s,'F RhS h s ,, a 'ChegYJoaaY No. 1093 No. 461 OO OWNER(S) OF RECORD Y J J oad • c . Y o e' P O 2 V x�. - N = s apaWsRoatl N`0,�,^ J' y�o' �Fc ° q o R E S ONEY CLIFF ROAD r ne 1 s pPROVE CENTERVILLE, MA �1 N A(2 O Aw 155 Geo Ryder Rd S PROPERTY ADDRESS Chatham, MA 02633 David<ou@HotmoiLcom =� `DATE: MAY 9. 2020. 1 _ _ �� 0 C V S M A P 1508 364-0894 PG.1I2 ..JDBa ETE-4457 ABcoEl !TESrTPIT TOR: DAVID D. COUGHANOWR, ASE *461 DESIGN FLOW: 3 BEDROOMS X 110 GPD - 330 GPD D BY: DONALD DESMARAIS, HEALTH DEPT. SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS 1 NO GROUNDWATER ENCOUNTERED PERC AT 56 in - 2 MIN/INCH IN C SOILS INSTALL NEW 1500 GALLON SEPTIC TANK. ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER DISTRIBUTION BOX: INSTALL UNIT DEPICTED BELOW. 54.50 INCHES HORIZON TEXTURE (MUNSELL) MOTTLES 0-10 Ap SANDY LOAM 10 YR 2/2 NONE FRIABLE SOIL ABSORBTION SYSTEM: 51.83 10-32 Bw LOAMY SAND 10 YR 5/6 NONE LOOSE THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE 32-132 C MEDIUM SAND 10 YR 5/4 NONE LOOSE SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES 43.50 PER INCH = 0.74 GALLONS PER DAY PER SQUARE FOOT. TEST PIT 2 NO GROUNDWATER ENCOUNTERED THE 'L' SHAPED LEACHING GALLERY DEPICTED CAN LEACH: 2 MIN/INCH IN C SOILS BOTTOM AREA =294.4 sq. ft. ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SIDEWALL AREA = 2x PERIMETER = 157.56 s ft. 54.40 INCHES HORIZON TEXTURE (MUNSELL) MOTTLES q' A TOTAL AREA = 4 1.96 0-10 SANDY LOAM 5 s ft. O 10 YR 3/2 NONE FRIABLE p q 51.90 10-30 Bw LOAMY SAND 10 YR 5/6 NONE LOOSE FLOW CAPACITY =0.74 x 451.96 = 334.45 gal/day 30-138 C MEDIUM SAND 10 YR 6l4 NONE LOOSE 42.90 INSTALL THE 'L' SHAPED LEACHING GALLERY AS CONFIGURED BELOW. FLOW CAPACITY = 334.96 gal/dog WHICH EXCEEDS THE 330 gol/dog REQUIRED FOR A THREE BEDROOM DESIGN. 500. GALLON, -SEPITIC TANK DIMENSIONS.>& DETAIL :.. . TING TANK IF eFt7RAr1_Y OUND. �S OMQL� E �n�� G I� ��I � PUMP SPECT TANK REPLACE WITH W S U "S"�E111�u CONSTRUCTION' DETAIL 4 AT TIME OF REPAIR 1500 GALLON TANK USE .SHOREY PRECAST'500'GALLON-LEACHING DRYWELL I in IF CRACKED, ROTTED OR OTHERWISE 12.83' PERIMETER = TAPER COMPROMISED. 12.83 o A 14.50 � �� `r' 8.50' 4. 5.67 8.50 = ,� A - 4.12 S f t- v 4' � ,� a 7.83 � 8 ill 1� � 4 4' � +25.33 =78.78 NOT � DRYWELL 25.33' q UNIT TO BOTTOM AREA = (12.83x14.5)+(8.83x12.50)-1/2(4xl) = 294.4 IO ft-6 /n SCALE 500 GALLON DR YWEL L INLET OUTLET DIMENSIONS INSTALL ONE INSPECTION RISER COVER COVER ,V TO WITHIN THREE INCHES OF „ ri & DETAIL FINAL GRADE & INDICATE -► �3 IN DROP FLOW LINE r LOCATION ON AS-BUILT FROM = Ti in _ 14 USE BUILDING 0� '^ D-BOX 33 - H 10 -==•48�/n -•=� � �s >� f �p��l�r in UNIT LIQUID GAS LEVEL BAFFLE IN Q \� ,m - 102 0 58 b in STONE BASE SEPARATION BETWEEN INLET & OUTLET CROSS SECTION VIEW (SECTION A-A) TEES NO LESS, THAN LIQUID DEPTH INSTALL AN APPROVED GEOTEXTILE CROSS SECTION VIEW FABRIC OVER STONE SE D§S TU Q§BU §ON BOX'UDB 3H�20Y 28 l-1/2�nt GR�EL '� EFFECTIVEe 24 in 3/4 In TO 1 1/2 in GRAVEL 9, In +i DEPTH � c -.Ix a£t: DIMENSIONS, PIPES EXITING D-BOX TO RUN LEVEL ' AND DETAIL ' FOR 2 FEET BEFORE PITCHING DOWN 24 in 58 in 24 in 106 in ►2 /n C MIN -INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE N STARTING WORK. FROM -S S -ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM " N TANK TO REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC SAS CODE (310 CMR 15). L� ll T -ECO-TECH RAPID RESPONSE RECOMMENDS THE INSTALLATION b In nc oCP OF LOW FLOW FIXTURES & APPLIANCES. AND PERIODIC \� STONE BASE E PUMPING OF THE SEPTIC TANK. 21 in 2� CROSS SECTION VIEW -SYSTEM NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. S DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. Oo p Oo TOP OF FOUNDATION RAISE COVERS TO WITHIN ALL PIPE TO BE 4 In SCH. 40 PVC EL = 55.25 +- 6 in OF FINAL GRADE AND TO PITCH AT 1/8 in/ft MIN 54.4 m USE H-20 MAX INSTALL 51.4 AFM 7ET/+NG 1500 GAL LOCI a0000aoaoo ��P�� 00000�gs PRECAST o0000000 �A�� 51.500�00�08o DRYWELL oao°S�oa 6 in so.s3 or REFER TO DETAIL BOX 51.00 STONE MLA ABSORPT fry BASE 50.65 SYSTEM DETAIL TO w IB ft COMPACT-b !n STONE BASE O 36 ft 5-I6 ft DETAIL BOX 48.65 NO GROUNDWATER LO BELOW MOTTLING OBSERVED _ 42.90 SEWAGE DISPOSAL SYSTEM PLAN ` 286 STONEY CLIFF ROAD CENTERVILLE. MA IMAY 9, 2020 ETE-4457 PG;2P2 1 ' Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Ricky L. Wright use the return key. Name of Inspector B & B Excavation, Inc. Company Name 14 Teaberry Lane Company Address Forestdale MA 02644 ' CitylTown State Zip Code n;, 508-477-0653 S14595 c--) Telephone Number License Number .I B. Certification = r I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 7/22/10 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal Syste •Pa e 1�f� 1 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)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. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent 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: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 '<L Commonwealth of Massachusetts W Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is Centerville MA 02632 7/22/10 required for every _. page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 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 fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered"yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Rim Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® 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? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. CitylTown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: July 2009 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): — Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 2004 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2' feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 70 feet Comments (on condition of joints, venting, evidence of leakage, etc.): At time of inspection building sewer appears to be in good condition -no signs of leakage Septic Tank(locate on site plan): Depth below grade: 16"feet Material of construction: ❑ concrete ❑ metal ® fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ® No Dimensions: 170" L X 66"W X 50" Sludge depth: no sludge t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 228 Stony Cliff Drive M Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle no sludge Scum thickness no scum Distance from top of scum to top of outlet tee or baffle no scum Distance from bottom of scum to bottom of outlet tee or baffle no scum How were dimensions determined? scour stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): At time of inspection septic tank appeared to be in good condition Grease Trap(locate on site plan): Depth below grade: feet 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: Date l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(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 per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): At time of inspection d-box appears to be in good condition - no signs of carryover Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5 infiltrators ❑ 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.): At time of inspection leaching appears to be in good shape- no signs of hydraulic failure Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately --p-leo,- "D2cK OI.O A I - 27'.6 B I - 25 ' A2= '43 ' Bz= z.9 ' 1�3 = Ai4'5 '' '63 ^ 32,3 " t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: > 12'feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: hand augered hole down to 12' -no groundwater encountered Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 228 Stony Cliff Drive Property Address Bank of America Owner Owner's Name information is required for every Centerville MA 02632 7/22/10 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 FAILED INSPECTION COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL fFFR IEIVED DEPARTMENT OF ENVIRONMENTAL PRC��Q 12004 t d TOWN OF BARNSTABLE Ago 0WW OAP HEALTH DEPT. PARCEL LOT TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 `9c) 151' Owner's Name: JANET NUGENT Owner's Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Date of Inspection: 6/3/04 Name of Inspector: (please print) JOHN GRACI,INC. Company Name: SEPTIC,INSPECTIONS Mailing Address: P.O. BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes — n , _ Conditionally ; s j s _ Needs Further : uation by the Local Approving Authority X Fails Inspector's Signature: Date: 6/3/04 The system inspector shall submit a copy this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If t'Il 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 SYSTEM FAILED TITLE V INSPECTION.LIQUID LEVEL IS OVER ALL PIPES. SYSTEM IS IN HYDRAULIC FAILURE. ****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. Titla 5 Imnerttinn Fnrm 6/1 5/?000 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: SYSTEM FAILED TITLE V INSPECTION. LIQUID LEVEL IS OVER ALL PIPES. SYSTEM IS IN HYDRAULIC FAILURE. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a 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: n/a n/a 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: n/a n/a 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: n/a Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance n/a "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: n/a Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 D. System Failure Criteria applicable to all systems: You muss 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 ''/z 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 SYSTEM HAS NOT BEEN PUMPED IN TWO YEARS PER OWNER. 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 1 of a public well. _ X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] YES (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no 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 11 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. a Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X I _ Was the site inspected for signs of break out'? X _ Were all system components,excluding the SAS, located on site ? X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction, dimensions,depth of liquid,depth of sludge and depth of scum? F X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no X _ Existing information. For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] ; Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 RESIDENTIAL FLOW CONDITIONS Number of bedrooms(design):3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents: 1 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): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): R4 0 3 9 gL100D Sump pump(yes or no): NO r Last date of occupancy: n/a 0 rJ COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: SYSTEM HAS NOT BEEN PUMPED IN TWO YEARS PER OWNER Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM _Septic tank,distribution box,soil absorption system X Single cesspool X 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): n/a Approximate age of all components,date installed(if known)and source of information: 1969 PER OWNER Were sewage odors detected when arriving at the site(yes or no): NO . Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 BUILDING SEWER(locate on site plan) Depth below grade: n/a Materials of construction:_cast iron _40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: (locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: n/a Sludge depth: n/a Distance from top of sludge to bottom of outlet tee or baffle: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle.condition,structural integrity, liquid levels as related. to outlet invert,evidence of leakage, etc.): n/a GREASE TRAP:_(locate on site plan) J Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a 7 Page 8 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level:N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:_(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: n/a Conunents(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.): n/a PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a. Type 1000 GAL 6' X 6' leaching pits, number: n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): LIQUID LEVEL IS OVER ALL PIPES IN SEPTIC SYSTEM. SYSTEM IS IN HYDRAULIC FAILURE.BOTTOM OF LEACH FIELD IS AT 9 FT. CESSPOOLS: X(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: 1 Depth—top of liquid to inlet invert: 0" Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: 6' X 6"' Materials of construction:Q{eiC4Sir Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): LIQUID LEVEL IS OVER ALL PIPES IN SYSTEM.SYSTEM IS IN HYDRAULIC FAILURE.CESSPOOLS ARE PAST THE EFFECTIVE DEPTH OF LEACHING PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a A Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 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. 0 " sZ ' in • Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 228 STONEY CLIFF ROAD CENTERVILLE,MA 02632 Owner: JANET NUGENT Date of Inspection: 6/3/04 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 10+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: GROUNDWATER DETERMINED BY HAND AUGER- 10+FEET tt r No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYicatiou for Migpogal *pgtem Con5tructiou Permit Application for a Permit to Construct( )Repair(X Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No. g L g :S- ooic%( 0,%CF VA Owner's Name,Address and Tel.No. Cv,,aev,-)iril%M0 ZA,,c-r ,ju T Assessor's Map/Parcel 1 Q O 5('f1A G Installer's Name,Address,and Tel.No. G Ll S—53\® Designer's Name,Address and Tel.No. �o�OoC s SQ�?.Jke $ex'J"'G2 st}A'z E,.1Ur¢ea�a� SAC �r�crn r� cr 2S� Type of Building: Dwelling No.of Bedrooms Lot Size 1SiJ6® sq.ft. Garbage Grinder(� 4, t Other Type of Building b�t� No.of Persons a Showers( KCafetefia( U) Other Fixtures 1c:Ne�t ��1: 1�\ Design Flow 33 gallons per day. Calculated daily flow 0 °Bo gallons. Plan Date S 1 IA_Number of sheets Revision Date Title v T seC\ Nn <,4 V-M Size of Septic Tank 1,500 G',Q oLl Type of S.A.S. O° X i,..1 vt L-1-V2 A TTDzS Description of Soil Nature of Repairs or Alterations(Answer when applicable) b��t.S Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the nmental Code and not to place the system in operation until a Certifi- cate of Compliance has been'ssued b this oard f al Signed i X Date Application Approved by Date Application Disapproved for the following reason "" Permit No. Date Issued Fee No. + E COMMONWEALTH OF MASSACHUSETTS Entered in computer: FH� tYes PUBLIC HEALTH DIVISION -TOWN OF,BARNSTABLE., MASSACHUSETTS _',p tcation for bigozar *raem Cow6truction Permit Application for a Permit two,Construct( . )Repair(><Upgrade( )Abandon( ) Xc omplete System ❑Individual Components Location Address or Lot No. oZ),$ STbor Y Cu47F RA Owner's Name,Address and Tel.No. C'e�>Qcv�11e MA �An1CT n1UGF,j-r Assessor's Map/Parcel } SA NA C M�jQ ISM Installer's Name,Address,and Tel.No. G Lk 13'S3\O Designer's Name,Address and Tel.No. �o\a�xk s Sup}is SQ",\ e SQC.S O r_3ox 1�-;�'l t Cc 1v-no.At k M o 25- �ccc�, ,,Type of Building: Dwelling No.of Bedrooms a Lot Size 1 S t i E5 0 sq.ft. Garbage Grinder(�J/i4 Other Type of Building N dam. No.of Persons -Showers( `rCafeteria( L/ Other Fixtures Design Flow, gallons per day. Calculated daily flo gallons. Plan Date Z _4 1 1 !O�A Number of sheets k Revision Date Title `' b Owe\ l n C Size of Septic Tank 5 O Ct�\o(\ Type of S.A.S. 1 d X S :)V "Tfe.n Ch Tj I n.! `FI L..Ttr2 F�TbQ'S Description of Soil i Nature of Repairs or Alterations(Answer when applicable) Date last inspected;f 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 Envignmental Code and not to place the system in operation until a Certifi- cate of Compliance has been ssued by this oard A J;lealth,. A Signed, .; (A Date Application Approved"by �l' 'PI ! ) Date Application Disapproved for the following reason Permit No., Date Issued _: THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY thiat.the On-site Sewage Disposal System Constructed( ) Repaired ( ) Upgraded(✓5 Abandoned( )by . Pb�E TS5- at aaE STbN C- '% r CrtiT has been const led/in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �)Y-3 33 dated 7M Y Installer � �u��% Designer fj R The issuance_ s_ , t shall not be construed as a guarantee that the system u:rtilo as designed. Date Inspector � � � � ��.yC.,�-----------------------Fee -^ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ;Mi!6poga1 *pgtem _Cong4ructiou Permit Permission is hereby granted to Construct( )Repair( L ' grla ( )Abandon,( ) System located at 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. a Provided: Cgn c do M,4tpe completed within three years of the date of Date:_._ '_ `/ Approved by '-- A Town of Barnstable �tME tp� Regulatory Services Thomas F. Geiler, Director • EAMSUBM M� �� Public Health Division pTED3,ts Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 7/7/04 Designer: Shay Environmental Services Installer: Roberts Se ti' Service Address: 34 Thatchers Lane Address: 5 Trenton St eet ' East Falmouth, MA 02536 Yarmouth A On 7/2/04 Roberts Septic Service was issued a permit to install a (date) (installer) septic system at 228 Stoney Cliff Road, Centerville based on a design dr wn by (address) Shay Environmental Services dated 7/l/04 (designer) X X I certify that the septic system referenced above was installed substant ally 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 m jor 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. (Installer's Signature) CRAA1` w 6HAY N. a_jr�, ' Na. 41M q P�, (Designer's Signature) (Affix De Iftere) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. ERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEA TH DIVISION., THANK YOU. Q:Health/Septic/Designer Certification Form TOWN OF BARNSTABLE LOCATION J C►1 SEWAGE # VILLAGE C�ti`s��- � S ESSOR'S MAP & LOT 7 INSTALLER'S NAME&PHONE N0. SEPTIC TANK CAPACITY ` r LEACHING FACILITY: (size) NO.OF BEDROOMS BUILDER OR OWNER U�CNT PERMUDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Learching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by e �71 n0 _ `7 9r SECTION A -A *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. '� OUTLET PFES Frwrr nE ~��+ 10' min. from VENT PIPE (O Least 24 Inches tall) PROFILE VIEW OF ADDITION TO LEACHING SYSTEM OtslRf Y10N Box SMALL BE w Existing Foundation house to septic tank Schedule 40 PVC w/Charcoal Odor Filter SET lFrE1 FOR AT LEAST 2 FT. 12' -' oovElt TOP OF FOUNDATION ELEV. 100.00 (Assumed) �I+ tank covers must be 3' of 1/8" - 1/2" Washed Peastone within 6 in. of rk,Mhed grode 3/4' to 1 1/2 Washed Crushed Stone I J - S'OUTLET arods over Septic Tonle - 59.00 Qada ow D Box - 99.00 w+r SAS - 95.00 <\ KNOCKOUTS + A 5• OU TtET I 1r IeLET ,_ •o S - 0.02 3 HOLE BOX o s' uoxan,rrr Cover Load - Elev. -96.25 lee, � tte te..q aw fY NEW s-o•o1 a Greater i NEW r8E 14 1,500 GAMM L. s- 0.01" per root . 1ss a' - SCH. 40 T FROe EXIST. FQ1/10ATHT1 lJ °1 SEPTIC TANK 8 �' o" Effet:ely.Depth '-._. Jw POLYETHYLENE �, Go 5 Units a 6.25' 30' PLAN SECTION CROSS-SECTIQN r r rp;` � � jam- `� CONCRETE FULL FOUNosTgN-•-� N H-10 eiL3' s"Oi R ,v a� 0.83' (10 inches) 3l„- , P�,. • / • �0 0 0 a, 1n 31.25 I �•.\ a 3 HOLE H-10 DISTRIBUTION BOX SYSTEM PROFILE 6 in.of 3/4'-1 1/2' t 37.2s' � c compacted store 5 a o er Effective length NOT TO SCALENot to Scale - c o o O OM Orr MOIW 6 Dme+e+m>ta �+�.r+se. r^ 4' 4' ° S❑IL ABS❑RPTI❑N SYSTEM (SAS) -- 6 in.of 3/e'-1c1/2' $ o5y INFILTATR❑R HIGH CAPACITY (H-20 L❑ADING)/ GE❑RGE ❑'BRIEN GENERAL NOTES compacted stone EVFecttve 1A° ' OR EQUIVALENT Not to Scale NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE o ( ) 1. Contractor is responsible for Digsafe notification u Bottom of Tat Hds 1 l7ev.=BB.00 m NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18' /EFFECTIVE HEIGHT IS 10' and protection of all underground utilities and pipes. No Groundw ater observed • 132" -- - -- --------- 2. The septic tank anj distn ution box shall be set level on 6" of 3/4 -1 1/2" stone. 3. Bockfill should be clean sand or gravel with no _ stones over 3" in size. 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc. LOT #29 5. The contractor shall install this system in accordance P E R C 0 LAT I O N TEST with Title V the Massachusetts state code, the approved plan and Local Regulations. 6. If, during installation the contractor encounters any Date of Percolation Test: JUNE 19, 2004 soil conditions or site conditions that are different Test Performed By. CARMEN E. SHAY, R.S., C.S.E. 140.96' from those shown on the soil log or in our design 1. Results Witnessed By. WAIVER ( per Barnstable B.O.H.) installation must halt & immediate notification be SHAY ENVIRONMENTAL SERVICES, INC. made to Carmen E. Shay - Environmental Services, Inc. Percolation Rate: Less Than 2 MPI 0 36" ��.r, C6SSQ� 7. No vehicle or heavy machinery shall drive over the septic system unless noted as H-20 septic components. 37.25' 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. ; ';± �•; •ti. •i 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. e e 10. All solid piping, tees & fittings shall be 4" diameter Test Hole I ., No. 1 c`' s" °V. i=+r+: �'��:'}` 4" PVC Schedule 40 NSF PVC pipes with water tight joints. DEPTH SOILS ELEV. VENT 11. Municipal Water is Connected to ALL OF The Residence and Abutting -0 99 00 D-Box Properties Within 150 Feet. �dy TEST HOLE #1 Loam ELEV.= 99.00___ THE PROPERTY LINES ARE APPROXIMATE AND 10 Y 3/2 I - 28' COMPILED FROM THE SURVEY PLAN GENERATED BY 98.00 LOT #26 O O O CHARLES SAVARY OF HYANNIS, MA 0"-12" A ENTITLED " SUBDIVISION PLAN OF LAND OF ALAN SMALL IN BARNSTABLE, Sandy <t MA', DATED JULY 22, 68, & PLAN BOOK 224, PAGE 87 and The Loan, NEW 1500 gal. to' DEED DESCRIPTION ( BOOK 2987 PG 020) 10 YR 5/6 C t Septic Tank 12"- 36' Be 96 00 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN THE SEPTIC SYSTEM INSTALLATION. Med. Sand i5 Y 7/4 EXISTING LEACH PIT TO BE PUMPED OUT AND 36"-132• C, 88.001 EXISTING Q LOT #28 REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION 2 BEDROOM NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE HOUSE FROM THE EXISTING LEACH PIT TO BE DISPOSED PROJECT BENCH MARK #228 OF AS PER BOARD OF HEALTH SPECIFICATIONS. TOP OF FOUNDATION - -- - = , I NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY ELEV. 100.00 (Assumed) 1 I ASSESSORS MAP 190, PARCEL 158 1 I LEGEND Perc #1 LOT #27 DENOTES PROPOSED Depth to Pere: 38" to 56" 1 i 15,780 Square Feet +/- 98 104X 1 SPOT GRADE Perc Rate= Less Thar 2 MPI - 1 Groundwater Not Observed No Observed ESHWT - ,\\ u x 104 DENOTES EXISTING ADJUSTED H2O Elev. = None i �\\ .46 SPOT GRADE 9$' , PL PROPERTY LINE ---- ---- - ' ' L I I 100 00, >uo� - PROPOSED CONTOUR - - - - - -97 EXISTING CONTOUR --------------------'�� MAY SUBSTITUTE FOR 1500 GALLON POLYETHYLENE TANK �1__ 35>.46' GEORGE OBRIEN, INC. OR EQUIVALENT --- - - DEEP TEST HOLE & PERCOLATION TEST LOCATION J 2a' aA�. ACCESS MANHOLES - _ �, 6 FOOT STOCKADE FENCE PLOT PLAN MET � / �` / l�/• T � 0 F 00l RIGHT OF CC � R �,� I� MET THE ACCESS COVERS FOR THE SEPTIC TANK, Are OF PROPOSED SEPTIC SYSTEM UPGRADE DISTRIBUTION BOX AND LEACHING COMPONENT SHALL BE RAISED TO WITHIN 6" OF PREPARED FOR STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE. PLAN vlEw INSTALL TUF-T1TE GAS BAFFLES OR EQUALS M S . JAN ET L. N U G E N T � 3_24 REYOHAe1.E �� ON ALL OU TIE T TEE ENDS # 228 STONEAT Y CLIFF ROAD s• min olsorand I 1r eeEr fN�T tr T_Lr mr,. Inlet to outlet OUTi.ET er, C E N T E R V I L L E, MA - --� - !� _ s -r ter is '� !_ I 5 -r Design Calculations _ ZNOFAI� PREPARED BY: 0 �� ua Number of Bedrooms: 2 Equivalent to 220 Gal./Day (330 Gal./Day Min. per Title V) r ' l Garbage Grinder: No O E \1 CARNET E. SHA Y Leaching Capacity Proposed: 330 Gol./Day Minimum (Min. Per Title V) Septic Tank - 2 x 330 Gal./Day - 660 USE NEW 1,500 GAL. Septic Tank. 0 20 40 50 v, ENVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch 1 CROSS SECTION END-SECTION Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallons I I q o P.O. BOX 627 Sidewoll Area: 0.74 gal./sq. ft. x 78 sq. ft. = 58 gallons - sT EAST FALMOUTH, MA 02536 Providing: = 331.80 gallons 1TARIK� TEL/FAX : 508-548-0796 TYPICAL 1500 GALLON SEPTIC TANK SCALE: 1 "=20' Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, SCALE: 1 "=20' DRAWN BY: CES DATE: JULY 1 , 2004 NOT TO SCALE TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE (H- 1 0 LOADING) ON THE ENDS. NO STONE UNDER. PROJECT#SD596 FILENAME: SD596PP.DWG SHEET 1 OF 1