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Home My WebLink About0431 STRAWBERRY HILL ROAD - Health �.— 431 STRAWBERRY HILL RD. ,CENTERVILLE_ 248-165 No. 42101/3 ORA ESSELTE � 10% 0 0 o a r - C0 1_l10\-WEALTH OF MASSACHUSETTS _ EXECUTIVE OFFICE OF EN`VIRO'MENTAL AFFAIRS DEPARTMENT OF ENviRoNMENTAL PROTECTION ONE WINTER STREET, BOSTON ALL9 02106 (617) 292-5500 TRUDYCOXE Secretarc ARGEO PAUL CELLUCCI DAVID B. STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 441 Strawberry Hill Rd., NameofownerMichael Fasanella Centerville , MA Address of Owner: Date of Inspection: Z �3 e g Name of Inspector:(Please Print) ITI. E . Robinson Sr 1 am a DFP appr ved sys�erp inspector rsuanI to Section 1¢-340 of T-rtle 5(310 CMR 15.000) Company Name:lNm. R0jnson luept1C Service Mailing Address: P.O . Box 10bg, Centerville , MA Telephone Number: 7 7 5—8 7 7 0 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-siVsewge disposal systems. The system: es Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails inspector's Signature: I Date: t 9 The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty (30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS 9 . d �A AY 1 2 1999 �, ►�+uf+oa►r. ,�, E revised 9/2/98 Page Iof11 t) Pneted on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A 4 CERTIFICATION (continued) •rop"Address:441 Strawberry Hill Rd.. , Centerville , MA Owner: Michael Fasanella Date of Inspection: ``—3 - F INSPECTION SUMMARY: Check 0B. C, or D: A. 7YWM PASSES: I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. _SYSTEM CONDITIONALLY PASSES: e 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. Indicate y s, no, or not determined (Y, N, or NO). Describe basis of determination in all instances. If "not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty(20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed t �t revised 9/2/98 Page 2of11 P SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(corttinued) Property Address: 441 Strawberry Hill Rd.. ,Centerville , MA Owner- Michael Fasanella Date of Inspection: Al_3e4 C. RTHER 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 the ublic health, safety and the environment. 1) S STEM 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 THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SY M WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FU CTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) THER revised 9/2/98 Page 3of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A y CERTIFICATION (continued) Property Address: 441 Strawberry Hill Rd.. , Centerville , MA Owner: Michael Fasanella Date of Inspection: /__3 9 D. SYSTEM FAILS: You st indicate either "Yes" or "No to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes o Backup of sewage into facility-or system component due to an 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 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50.feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for <coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: 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: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA) or a mapped Zone II of a public water supply well) The own r or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of he Department for further information. revised 9/2/98 Page 4ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Prop"Address:441 Strawberry Hill Rd.. , Centerville , MA Owner: Michael Fasanella Date of Inspection: 3-g Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and-the system has been receiving Normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. V _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. J/ _ The system does.not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. _v _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: _ Existing information. For example, Plan at B.O.H. _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 115.302(3)(b)I _ The facility owner(and occupants,if different from owner) were provided with information on the propermaintenanrie-0f Subsurface Disposal Systems. revised 9/2/98 Page 5ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION rroperty Address:441 Strawberry Hill Rd.. , Centerville , MA Owner: Michael Fasanella Date of Inspection: FLOW CONDITIONS RESIDENTIAL- Design g.p.d./bedroom. Number of bedroom design): Number of bedrooms(actual):3 Total DESIGN flo ] Number of current residents: Garbage grinder(yes or no): /L 0 Laundry(separate system) (yes or no):AeL? If yes, separate.inspection required Laundry system inspected (yes or no) Seasonal use(yes or no): t O Water meter readings, if available (last two year's usage(gpd): 1998 65, 000 gal. Sump Pump(yes or no):/?i O 1997 49, 000 gal. Last date of occupancy: —g CO MERCIAUINDUSTRIAL: Type f establishment: Desig flow: gpd 1 Based on 15.203) Basis design flow Grease rap present: (yes or no)_ Industri I Waste Holding Tank present: (yes or no)_ Non-sa itary waste discharged to the Title 5 system: (yes or no)_ Water eter readings, if available: Last da a of occupancy: OTHE dale Last f occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: I AA System pu ped as part of inspection: (yes or no))Ap If yes, volume pumped: gallons Reason for pumping: TYPE O�YSTEM 1✓ Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records,if any) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed(if known) and source of information 129 �T Sewage odors detected when arriving at the site: (yes or no)A-61 revised 9/2/96 Page 6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'rop"Address: 4.41 Strawberry Hill Rd . , Centerville , MA Owner: Michael Fasanella Date of Inspection: L` II T OR HOLDING TANK: (Tank must.be pumped prior to, or at time of, inspection) Iloc to on site plan) Dept below grade:_ Mate ial of construction:_concrete_metal_Fiberglass_Polyethylene_other(explain) Dime sions: Capa ity: gallons Desi flow: gallons/day Alar present Alar level: Alarm in working order: Yes_ No_ Dat of previous pumping:. Co ments: (c dition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:z (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, eviddeenFe/of solids carryover, evidence of leakage into or out of box, etc.) - PUMle MBER:_ (locaite plan) Pumorking order:(Yes or No) Alarorking order(Yes or No)Com(nottion of pump chamber,condition of pumps and appurtenances,etc.) revised 9/2/98 Page 8of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'ropertyAddress: 441 Strawberry Hill Rd.. , Centerville , MA Owner: Michael Fasanella Date of Inspection: BUI ING SEWER: (Coca eon site plan) Depth elow grade:_ Materi I of construction:_cast iron_40 PVC_other(explain) Dista a from private water supply well or suction line Diam ter Com ants: (condition of joints, venting, evidence of leakage,-etc.) SEPTIC TANK:_ llocate on site plan) 1 Depth below grade: — — — Material of construction: concrete metal Fiberglass Polyethylene_other(explain) If tank is metal, list age_ Wage confirmed by Certificate of Compliance_ (Yes/No) Dimensions: l V Sludge depth: l_G „ e Distance from top of sludge to bottom of outlet tee or.baffle:y6 Scum thickness: % , ' Distance from top of scum to top of outlet tee or baffle: e Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: _; 4 1� comments: (recommendation for pumping, c ndition of inlet and putlet to s or baffles, de h ofJ i�level in relation to outl t invert',structural integrity, evidence of leakage, etc.) ®�� /�` �� ' J� Q /G S !�-' d ` L" GR SE TRAP: (Iota a on site plan) Dept below grade:_ Mater al of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) Dime ions: Scum hickness: Dista a from top of scum to top of outlet tee or baffle: Dista ce from bottom of scum to bottom of outlet tee or baffle: Date f last pumping: Corn ants: (reco mendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evid nce of leakage,etc.) revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'rop"Address: 441 Strawberry Hill Rd.. , Centerville , MA Owner: Michael Fasanella Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): I/ (locate on site plan, if possible;excavation not required, location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits, number:1 leaching chambers, number:_ leaching galleries, number:_ leaching trenches, number, length: leaching fields, number, dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of pond' g, damp oil .) , condition of ve etation, etc c a-a A / .S 7-6h = 4 G 4-e� L � a s G o �•-� / I ® rGf1A�L CES OOLS:_ (locate n site plan) Number nd configuration: Depth-top of liquid to inlet invert: Depth of s lids layer: )epth of s um layer: Dimensions of cesspool: Materials o construction: Indication o groundwater: inf ow (cesspool must be pumped as part of inspection) Comments: (note condit on of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate o site plan) Materi of construction: Dimensions: Depth of olids: Comment (note con ition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) revised 9/2198 Page 9ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C F SYSTEM INFORMATION Icorrtinued) 'rop"Address: 441 Strawberry Hill Rd.. ., Centerville , MA )caner: Michael Fasanella Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 1 J✓ (' L 4 y � A v 4 l J revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM „ PART C SYSTEM INFORMATION(continued) rop"Address: 441 Strawberry Hill Rd . , Centerville , MA Owner: Michael Fasanella Date of Inspection: ��✓``j�/ NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers Used USGS Data r Describe how you established the High Groundwater Elevation. (Must be completed) revised 9/2/98 Page 11of11 TOWN OF BARNSTABLE � LOCATION YJ/ S7Q,¢,.yh4W$�AdI h�_ SEWAGE 9Y- Z3/ VILLAGE LItA-Z7ZW&C ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. I3 C � '7 17 y y'/ SEPTIC TANK CAPACITY f®D® C ST LEACHING FACILITY: (type) E C Z (size) Coo 6LD NO.OF BEDROOMS .-3 BUILDER OR OWNER Pill` PERMTTDATE: OMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i 4-ra z , y ZZ . •. -1-6 3 INSPECTION DATE/TIME: -_:w M/P # 1 -•! zf o.. ......... . , N .,! �..._.... Fps. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... OW N o F. -.......... -........ i2. sTs Appliration for Disposal Works Tonstrur#iun Vrrmit Application is hereby made for a Permit to Construct or Repair ( } an Individual Sewage Disposal System at• -••-- - -- - "•-• - • Lo tion- .. roe or Lot No. .G¢ ¢• ........ AL.. ................ .........•-----------•-----•...._............_.............................._...__................ W nO00000 ,^..Wx , t �rr` --.. .............Address •-•-... �C-Y ---....---•-••................. ............_.__-......_....-•----.....��----... Installer Address < Type of Building Size Lot...//-��0.....S feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (� P4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures tn*,p ---------------------------------------------------------- --------------------- W Design Flow l.fA gallons perr edW. Total fly flew ..................................Olorip, WSeptic Tank—Liquid capacity.l........gallons Length................ Width............. Diameter................ Depth.��Y.-.. x Disposal Trench—No..................... Width......?............. Total Length......i....._ Total leaching area.__.............._..sq. ft. Seepage Pit No----------I---_____ iameter.......12....... Depth below inlet---T-:.6.T.... Total leaching area..2.'F2,Asq. ft. Z Other Distribution box ( Dosing to Percolation Test Results Performed by..... �. ....... Date.... ._�/--------------------i Test Pit No. 1..............minutes per inch Depth of Test Pit....154Y.77,... Depth to ground water..___? ...<3-'y. Gr4 Test Pit No. 2... ..........minutes per inch Depth of Test Pit.../J��....... Depth to ground water..?_.. a' - - --az......... ._._ ... Description of Soil----. ... .*.S?Z/ z-....... O -- Z. ,7`-0� � �v�Sa iL /-------------------•-------------------- x >n6Di a.11.1 /C o.j�S r��T> ........ /zOa� t � v ... ..... f......• ---- --•-•---.a ....-------•----••.• --_..._..---•--•-----....................... UW ----•---•---------••......--•--•--••-•-----••-------•--••--•--•.......•-•••--•--•-•-••----•••••-••-•-------••••------•-----•-------••---•-----•----•••••••••----•-----•••••.............•--•.._......._. 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the oard of health. Signed �- .. s...-- .... -P``�-- .. -! ' ......... Application Approved By .. - ...... ... .... . ..... .. t................. ....... .... ...............'-........ . e . ...............Uate................-- Application Disapproved for the following reaso ...................... .............................................................................................. ..... ......... ...... � Date ................. Permit No..... -- ....•.......... Igsued ........ Date - INSPECTION DATE/TI �- M/P # 1 qZ1 No.. /.. ......01 f Fnic THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH TOWN........ ........OF............-5,! �t�S Appliratiun for Disposal Works Tonutrurtiun rruti# Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at 7`F.4 Vic= iz:� �� L G `tom•- - / P/► '1i'� r........ ................•-- /r f r Lo ation-/A dress ........ .l."_.�d A• t 1 le_ !�v! or Lot No. .... ......./ .........J I ....... f ,�(O�rL !f�l ...... .....Address........................ -........_. Installer Address G' Type of Building ��U.....Sq. feet � Size Lot...�t......... Dwelling—No. of Bedrooms.............................. .....Expansion Attic ( ) Garbage Grinder ("') aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other fixtures -------•--------------------------- W Design Flow_______________!�.,9....-..._...._.....gallons per.2person�per,day. Total daiI flow... ��..._.._.ggaj�s. WSeptic Tank—Liquid capacity.��.��-gallons Length..-`.�-------.... Width.. ....�e.. Diameter............... Depth_.._...._.._. .. x Disposal Trench—No..................... Width.................... Total Length.................... Total leachingarea........•...G.... . ft. Seepage Pit No. ...... Depth belo ___...__�.____.__.. Diameter.._._._�2. w inlet... .:.6.�.... Total leaching area.. 'J.Zsqq. ft. Z Other Distribution box (1- Dosing tank '—' ` j e.J e-Tr TS,s Z a Percolation Test ResultsC' Performed by . •--------------•-----------•------------ -•----.. Date---... ........... Test Pit No. I..�_._.....minutes per inch Depth of Test Pit----f .y._.... Depth to ground water•-_ Test Pit No. 2.."r..u....minutes per inch Depth of Test Pit... _ U_____. Depth to ground water._7.../. . ---. x — �� C - - iescrpton o Soil._... .... - � cu 4; Z ?j -r/- VA ..---------•................. .............................••-_--.... �U ----- � -----•--'----------------•---•--•-•----------•--- u .................................................�_......_...__............__............................_....-----........._......................................_.................................. 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ,/ Signed .......... 4t ,4v, C.7J. if.. ..-- >`� s Y�� Dare Application Approved By ,. Z. T///�,.. .._....-: ..�----- 1 i =�. -'� - ...... Date Application Disapproved for the following reasons" ------------------------------------------------------...-....------------------.........------.......--------------------_-------- Permit No. ,.. ..,!..... ........ Issued Dare...-. Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --------------TOWN............... OF -------------------DEIV-N1V .. i9 ! sT.9�3�e 01Erti irate of Crumplin 'Ve i U THIS IS TO CERTIFY, That the I dividual Sewage Disposal System constructed ( ) or Repaired ( ) by -_----------- ��..-.(..h N----� 1 :��.1�L�._� ........................................ ..........------ ...........------------..... .... .---------------C_............................ � Installer tt ,�-� / � ,-•_ at ------- --------..1. 31- ._S� ,ti.I 1.; -r. A l�-<S 4F(/.,1,x...._. ��- t-F-: ....-... .. has been installed in accordance with the provisions of TITLEOf he St e vironmental Code as described in the application for Disposal Works Construction Permit No. ' . T�-�.�--....�. ... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY n DATE.............r`1......... ...; .....--� ..''-------d THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN DENN S �A�2rJsis �C ................ O F.....................•..................--•-----..................................... FEE........................ Disposal or �(��ua�u V litPermission hereby grantedJ1 __Y 1_ . .,l ' to Construe or Re h an vi ual Sew a isposal Street as shown on the appl cation for Disposal Works Construction P mit,No.... .............. D ed..__V__r, ..... DATE....... --- Board o H Ith •----�. Revised 1 /1 /90 �I 20 FT. MINIMUM SOIL TEST TOP OF FOUNDATION — ----- --- --- --------- __ H l 10 FT. MINIMUM DATE OF SOIL TEST ELEV. _ _ CLEAN SAND WITNESSED BY CONCRETE PERCOLATION RATE —MIN./INCH. COVERS =" 4" SCHEDULE 40 PVC PIPE 2" LAYER OF OBSERVATION HOLE 1 OBSERVATION HOLE 2 MIN. PITCH 1/8" PER FT. " _ CONCRET I 1/8" TO 1/2 ELEV.=------ ELEV.= CO�ERS T� WASHED STONE 0" TOP AND 74 , '�� SUPSOIL fvf3 +� 12" MAX_ Ly {� 4" CAST IRON PIPE — - (OR EQUAL) MINIMUM PITCH 1/4" PER FT. Z r 91..1 r/ca'l rat' �y �+v.•r/rdr �� FLOW LINE +r!t ELEV. _ ��.5 10" MIN. ° ° ELEV. ��G �-� 19 ELEV. = 2'0" ° o ELEV. = cL r� &I � % LEVEL 00 9y �.% ° 00 a ELEV. — ° o 0 0 ° WATER AT EL.- WATER AT EL.= `> 0 i o ° 0 -- DISTRIBUTION ELEv. _ _ F o °3/4 TO 1 1/ DESIGN CALCULATIONS � BOX WASHED STONE 00 0 0 0 ° NUMBER OF BEDROOMS 1000 GALLON TO BE WATER TESTED ° ° w ° ELEV. _ �� GARBAGE DISPOSAL UNIT IF MORE THAN ONE OUTLET 0 ° ° TOTAL ESTIMATED FLOW SEPTIC TANK GAL./BR./DAY X BR.) 3 GAL./DAY PRECAST LEACHIriG 6' DIA. � ,clr/ REQUIRED SEPTIC TANK CAPACITY GAL. BASIN OR EQU!� Z ZONE ACTUAL SIZE OF SEPTIC TANK GAL. (Z ,��A INDEX LEACHING AREA REQUIREMENTS SIDEWALL AREA GAL./S.F. + ADJUST SEWAGE DISPOSAL SYSTEM PROFILE LEACHING CAPACITY (BOTTOM /+ SIDEWALL) r � GAL./DAY NOT TO SCALE - I BOTTOM OF TEST � OLE OR USGS PROBABLE WATER TABLE ELEV. _ RESERVE LEACHING CAPACITY GAL./DAY OBSERVED WATER TABLE ( / / ) ELFV. = NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN OF �,g�.' RULES AND LEGEND:/ EXISTING SPOT ELEVATION 00x0 REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. Q�l 6 'v -t \.. v EXISTING CONTOUR ----00---- 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO FiNAI SPOT ELEVATION pQ, WITHIN 12 OF FINISHED GRADE. 15 la IhA� �UNTOUR - { - 3- EXISTING AND FINAL. GRADES SHALL REMAIN ESSENTIALLY THE SAME. 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF SOIL TEST LOCATION WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN UTILITY POLE -c>_ 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE /p' + D TOWN WATER —W —W USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. L\Q '' r✓F CATCH BASIN 5. ANY ®\ R 4ASONARY UNITS USED TO BRING COVERS TO GRADE SHALL �, =1 lV/ r _ BE MORTARED IN PLACE. 6. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDEQ OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 7. J 1 j Of WIL SHU CRAIG yG RT r, � iO 4 0 � j t 3d i . No�27L c , , 9 APPROVED: BOARD OF HEALTH SUR a� i0 DATE AGENT PROPOSED PLOT PLAN FOR �.` 0.. / r 01 � r �Q/ PROJECT LOCATION YML�.r STANLEY9 R WEESTREETSER, INC. . EL�-U /t�•� ,�,. �'1r� � �` DENNISPORT, MASS. 398-3922 02639 s SCALE _ l DATE I REVISED REVISED — LOCATION MAP Coa No. � SHEET OFJ�