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HomeMy WebLinkAbout0055 THREE PONDS DRIVE - Health 55 THREE PONDS DR., CENTERVILLE A= 173 053 No. 42101/3 ORA A ESSELTE 10% O O O O TOWN OF BARNSTABLE LOCATION,_ �J�__ hree. P6AJ5 A r i ue SEWAGE# a®V 3 -!00 VILLAGEG0_n-k_r1yi /It ASSESSOR'S MAP&PARCEL 1.73 + eof S3 INSTALLER'S NAME&PHONE NO.Cq0, uj,Jt, Eftjn.^jt3 LLr oa-*77-38 . SEPTIC TANK CAPACITY /®®® GF� LEACHING FACILITY:(type) S(F/;wh Q02,,iTY T F.Jifu�n s)(size) 3 5, b�X 6,-f3 i NO.OF BEDROOMS 3 N-d0 OWNER �'fav�tdl �C �GuGh�,it�� PERMIT DATE: Q - Q; ;t®f 3 COMPLIANCE DATE: Separation Distance Between the: A10 C5rn'J✓J14J- t— Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility E'y%feMc't r"i fsq Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) AFeet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY A-a=6;6` A —36 31F,d46 . 1 Pow ® t No. d 60 Fee bd THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Applitation for Misposal 6pstem ConstTULtion Vermit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No. $-5 -r444EC ?OtJ S DQKC- Owner's Name,Address,and Tel.No. WT�wlG - �'�SA�' 064Ua4A1fjC Assessor's Map/Parcel 7�y _ s flL'C. Installer's Name,Address,and Tel.Ao.S©S-4f,77 gg, Designer's Name,Address,and Tel.No. 50t-2,73-®.377 OW C; Type of Building: �+4 Dwelling No.of Bedrooms 3 Lot Size Za sq.ft. Garbage Grinder( ) Other Type of Building p E[DO�JT`/*(_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 10 gpd Design flow provided 3:3�t,2 gpd Plan Date 9-5- ,R0 i Number of sheets ! Revision Date Title 55 T1 'fitFLEG j?��D&IQ6 6aJZ&_41flL tj5_ Size of Septic Tank 1, O 0o Type of S.A.S. S C 14-1.8) R XM FA Description of Soil M CD ob <9 `7 ' t t I .5 EG pC_A l j Nature of Repairs or Alterations(Answer when applicable) (,_CEgS-rie a `©e ) 64[_6)0 Sty- riC- I .-rowk. -T"L9 MQa.,) H-a® Da30k, `moo 5 W 137ci 3- VW-IrT ® P;-- �� Q&711-5- O J 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 f Heal t kr( Sign Date � Application Approved by Date V— Application Disapproved by Date for the following reasons Permit No. P®13 — Date Issued r C --------------------------------� V tidy No. Fee THE,COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN-OF BARNSTABLE, MASSACHUSETTS Zipptication for -Wposal 6pstem Construction permit Application for a Permit to Construct( ) Repair(N Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 5 5 11"Re 'P00% OWL6 Owner's Name,Address,and Tel.No. �eNTo�v�cw VAP.�1 9 UCG-ti4t►�C" �.. Assessor's Map/Parcel 7 3 3 -,• _ b (�( Installer's Name,Address,and Tel.Ao.SOB-ti-n,,,gg 11 Designer's Name,Address,and Tel.No. 50g..,A73 '0377 .kM i 99- 40 wy E- Type of Building: Dwelling No.of Bedrooms .3 Lot Size t 9 3$ sq.ft. Garbage Grinder( ) Other Type of Building P IFS(D ).lTl Al_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures 4.Design Flow(min.required) --a (7 gpd Design flow provided 334,4,2 gpd Plan Date R-tw PO j'y Number of sheets Revision Date :. Title S 5 'Til p'Ec- Pout s)g1 uE . " = Size of Septic Tank 11000 Type of S.A.S. 5 (14-,;Lo) 14d '17M r Description of Soil k eb uaad,'S,e ob s Nature of Repairs or Alterations)(Answer when applicable) O<P &JUKT(aJ& /U y� C.�t..0 J S r«- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Sign e Date ^�� Application Approved by Date Application Disapproved by Date for the following reasons Permit No. oP O 13 — 0 Date Issued --,. --------------------------------------------------------------------------------------------------------------------------------------- TH S COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by A?r--ta) ,o �.� at S 5 'f iftpc 13M.S Gt'V IGLE has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.-070/3"3 dated Installer d A1P�p�1'D� 6��P,41�Z CLC. Designer y /J #bedrooms 3 w Approved design, ow , gpd The issuance of this permit shall of be c �is rue a guarantee that the system *Ivfu ,t/fo s designed! Date `/ Inspector � �J J/ iiy Ill d013 - 3W l&D No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ' S misposal *pstem (Construction permit Permission is hereby granted to Construct( ) Repair(X) Upgrade( ) Abandon( ) System located at 55 TH*_gaa porj-PS b oLt-;F7 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date �K�( ,J Approved by . . , Town of Darnstable Regulatory Services i Thomas F. Geller,Director BA MASS ' Public Health Division MABB. ,p te�p. �qr r ► ` Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508.862-4644 Fax: 508-790-6304 Date: 9-10'13 Sewage Permit# Ze i3 -3 o v Assessor's Map/Parcel ly3 Installer & Designer Certit' cation Form Designer: SG En`tc)ee.cco�� , T-�C.. Installer: Gc�pcw;'& etlFVPcise.S Address: l85`f C cc�,bec �{� �W Address: i 5 3 C o.�..•a�..,,�c s,— ras\ Wa�Clnurn HA 02538 M✓+s1-,,Ize r Gzt.-Yq ��"2 73 03 77 On " 8 13 d «.je cL� was issued a permit to install a (date) (installer) septic system at 55 -Onr ec- fo" DCiye— based on a design drawn by (address) 5 C E n gt�zzs cn5 ,Yv�c_ dated !a c�cs� 5, Z o i 3 (designer) V I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (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. Stripout (if required) ected and the soils were found satisfactory. S11 OF 1 JOHN L jCHURCHILL I (I ler's Si re) ��. ° 41W esigner s Signature (Af ix De gn ere P ASE RETURN TO ARKS EABLE PUIRLIC WRAY. DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UN BOTH THIS FORM AND AS BUILT CARD ARE RECEIVE STABLE PUBLIC ALTH DIVISION. THANK YOU. LIAOftice formsWesignenertification form-doe i tr s TRANS. NO.: CITY/TOWN: Centerville APPLICANT: Capewide Enterprises ADDRESS: 55 Three Ponds Drive, Centerville, MA 02632 DESIGN FLOW: 330 gpd REVIEWED BY: DATE: N/A OK NO f # GENERAL y � r.. ` . Legal boundaries denoted 310 CMR 15.220 4 a) X Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u) X Locus Provided 310 CMR 15.2204 t X Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] X Easements shown 310 CMR 15.220(4)(b) X System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required 310 CMR 15.412(4)] X Location of impervious surfaces (driveways, parking areas etc.) [310 CMR 15.220 .4 d) X Location all buildings existing and proposed 310 CMR 15.220(4)(c) X Location and dimensions of system components and reserve areas. 310 CMR 15.220(4)(e) X System Calculations [310 CMR 15.220(4)(f) X daily flow X septic tank capacity (required andprovided) X soil absorption system (required andprovided) X whether system designed for garbage grinder X North arrow 310 CMR 15.220(4)( X Existing and proposed contours 310 CMR 15.220(4)O X Location and log of deep observation holes (existing grade el. on each test) 310 CMR 15.220 4 h X Names of soil evaluator and BOH representative [310 CMR 15.220 4 (h) and i) X Location and date of percolation tests (performed at proper elevation?) 310 CMR 15.220(4)(i) X Percolation test results match loading rate? [310 CMR 15.242] X Certification statement by Soil Evaluator [310 CMR 15.220(4) ') X Observed and Adjusted groundwater (method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] X Address 55 Three Ponds Drive, Centerville, MA 02632 Sheet 1 of 7 r N/A OK NO Location of every water supply, public and private, [310 CMR 15.220(4) k X within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply X within 250 feet of the proposed system location in the case X within 150 feet of the proposed system location in the case of private water supply wells X Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. 310 CMR 15.220(4)(1) X Water lines and other subsurface utilities located [310 CMR 15.220(4) m (if water line cross see 310 CMR 15.211 1) 1 X Profile of system showing invert elevations of all system components and the bottom of the SAS 310 CMR 15.220 4 o X Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)] X Stamp of Registered Land Surveyor (required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] X Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405 1 (k) X Test hole adequate to demonstrate four feet of suitable material? 310 CMR 15.103(4)] X Test Holes adequate to confirm adequate groundwater separation? 310 CMR 15.103(3)] X Benchmark within 50-75' of system 310 CMR 15.220(4)( X Materials specifications noted? various sections of 310 CMR p [ 15.000 X System components not> 36" deep (unless Local Upgrade Approval or LUA requested) 310 CMR 15.405(1 b X Address 55 Three Ponds Drive, Centerville, MA 02632 Sheet 2 of 7 SEPTIC,Tt ., -r m r N/A OK NO ANK e o 4 Size OK? 310 CMR 15.223(l) X Inlet tee located ten inches below flow line 310 CMR 15.227 6 X Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] X Outlet tee with gas baffle or approved filter 310 CMR 15.227(4)] X Note regarding installation on stable compacted base [310 CMR 15.228(1)] X Separation between inlet and outlet tees (no less than liquid depth) 310 CMR 15.227(2)] X Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA 310 CMR 15.405 1 k) X Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(0] X Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" b 7/07 310 CMR 15.228(2)] X Access to within 6 " of grade - one port for systems<1000gpd, two fors stems>1000 gpd 310 CMR 15.228(2) X All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] X > 10 ft from building foundation 310 CMR 15.211 1 X Buoyancy calculation Required/Done 310 CMR 15.221(8)] X H-20 Where appropriate? 310 CMR 15.226(3)] X Setbacks from resources 310 CMR 15.211 X Required when other than single-family dwelling or flow>1000 d 310 CMR 15.223 1 (b)] X First compartment 200% daily flow-, Second compartment 100% daily flow 310 CMR 15.224(2) and 3) X "U" pipe through or over baffle, outlet of each compartment with as baffle or approved filter 310 CMR 15.224(4)] X Address 55 Three Ponds Drive, Centerville, MA 02632 Sheet 3 of 7 N/A OK NO Brt7ILDING,fSVRANDOTHER'PIPING:, Located at least ten feet from any water,line? [310 CMR 15.222(2)] X Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211(1)[1 X Cleanouts required/provided ? 310 CMR 15.222(8) X Thrust blocks specified in force mains? 310 CMR 15.221(6) c X Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable 310 CMR 15.222(6)] X Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252 2 (c) X Siphonproblem/ leachfield below pump chamber X Endca s or vent manifoldspecified? X Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252 2 (h) X Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) X DISTRIBUTIONBOX ,' T ;..... .� s � a� z. �. ? ��;c.ss.-.. � _.4i.'j Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] X Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323 3 (a)] X Riser if deeper than 9" 310 CMR 15.232(3)(0] X Inside minimum dimension 12" 310 CMR 15.232(2)(b)] X Minimum sum 6" 310 CMR15.232(3)(e X Watertight cover if<2000gpd); waterproof manhole if>2000gpd 310 CMR 15.232(3) d X P11MPCHANIBE2S . 7,7 .1.7 .. � � Capacity(emergency storage above working=design flow)? [310 CMR 231 2 ] X Proper setbacks 310 CMR 15.211 (same as septic tanks)] X Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE 310 CMR 15.231(5)] X Service components accessible (not too deep with piping, disconnects accessible) X Alarm floats - alarm on circuit separate from pumps specified? X Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and 8 X Stable Compacted Base 310 CMR. 15.221(2) X Buoyancy calculations needed ? Provided? 310 CMR 15.221(8)] X Address 55 Three Ponds Drive, Centerville MA 02632 Sheet 4 of 7 N/A OK NO SOIL ABSORPTIQN. SYSTEMS (SAS) GENERA �` Calculations correct? X 4 feet of naturally occurring material demonstrated? [310 CMR 15.240 1 X Required separation togroundwater? 310 CMR 15.212 X Aggregate specified as double washed 310 CMR 15.247(2)] X System Venting required/provided? (system under driveway or >36" deep) 310 CMR 15.241 X Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] X Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document X G`A[;L>CRIES I S C,,H lI�BERS=�31,OaCMR 15.253, Chambers and Gal. in trench configuration supplied with inlet every 20 ft. 310 CMR 15.253(6)] X Each structure with one inspection manhole (if>2000 gpd must be tograde) 310 CMR 15.253 2) X Aggregate 1' minimum- 4' maximum. 310 CMR 15.253 1 (b) X 2' sidewall credit maximum 310 CMR 15.253 1 a) X In bed configuration, inlet eve 40 s . ft. 310 CMR 15.253 6 X TRIi NCHES,'3k01C1Y 45 251 ,, = F 3 •� Width 2' minimum 3' maximum 310 CMR 15.251(1)(b)] X 100 feet- maximum length 310 CMR 15.251 1 a X Minimum separation 2x effective depth or width whichever reater(3x if reserve between trenches) [310 CMR 251 1 d X Situated along contours 310 CMR 15.251(2)] X Breakout OK? 310 CMR 15.211(1) 4 and Guidance Document X $ED S,ASh(Maaciijtiam size,,of, edpar field 5000 g d) x - t ,. minimum 2 distribution lines 310 CMR 15.252(2)(a)] X Maximum separation between lines 6' 310 CM RI5.252(2) d X Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2) e X Aggregate depth below discharge pipes 6" minimum, 12" maximum. 310 CMR 15.252 2 X Separation between beds IO' minimum. 310 CMR 15.252 2 X Bottom area used in calculations only 310 CMR 15.252(2) i X Address 55 Three Ponds Drive, Centerville, MA 02632 Sheet 5 of 7 D1D'THE P�,AN INVQLVF, .v N/A OK NO _ `an Pressure Dosed System ? Provided pump and piping calculations as required 310 CMR 15.220(4)(r X Pressure dosing required on all systems >2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] X If used in gravelless system - make sure jet is directed as not to scour soil interface Guidance Document X Inspections once per year(systems<2000 gpd) or quarterly >2000 dgood to note on plan 310 CMR 15.254 2 d X Construction in fill - Did the plan specify that the fill shall meet the specification of 310 CMR 15.255 3 ? X _ Impervious barrier and/or retaining wall ? Guidance Document X Impervious barrier installation must be supervised by designer 310 CMR 15.255 2 b X Retaining wall must be designed by Registered Professional Engineer r310 CMR 15.255(2)(a)] X Side slope not exceed 3:1 ? 310 CMR 15.25 5(2) X Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] X At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) 310 CMR 15.255 2 e X Gravelless S,stem$[I/A Ap roval.rLette�rsJ Check DEP Approval letters for credits and design conditions X If used with pressure dosing do not allow pressure discharge to scour soil interface X Alternative Se tics`stem[I/A:A roval Letters) " Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? X Is the technology being properly applied and does it meet all DEP Approval Conditions? X Is there a note on the plan regarding the requirement for perpetual maintenance agreement? X Any alarms involved on separate circuits X Did the applicant submit an operation and maintenance manual? X Hasa licant submitted a copy of a maintenance X 49 Are the variances listed on the plan ? [310 CMR 15.220 (4)(g) X RLS Stamp necessary on plan if a component is within five feet of property line 310 CMR 15.412(4)] X New construction or increased flow proposed - [Refer to 310 CMR 15.414] X Address 55 Three Ponds Drive, Centerville, MA 02632 Sheet 6 of 7 I N/A OK NO SeYtS �Ve4PellSRA p r Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] X Is the system proposed on the same lot as served by private well ? 310CMR15.2142 X Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] X Pumping to septic tank ? 310 CMR 15.229 X Shared System 310 CMR 15.290 X Address 55 Three Ponds Drive, Centerville, MA 02632 Sheet 7 of 7 TOWnnof' akrnEstabe - h`P# P �a De artment of lie Cory Servfces • Pubk Health Division Date sb3A a� - 200 Main-Street;Hyannis.MA 0260i " Date Scheduled Time Fee Pd, --.M ►5 ' Suitability Assessment for Se' e o Z 2 Performed By: Mi�,neC@�( Qcnnerti�el !r� I GSE' I Witnessed By: . .. I:OCATIONG& ENERAL INFORMATION " ~; Location Address ( :Owner's Name gyE��IcJ j�jp(�E/ rtJ . s •To -P0P-D S D& vl(.Ct Address 5S ilEt2� ."gpNDS i>P-. CZ j ,Ji j,c MA- Oxb3� � Assessor's.Map/Parcel• I l✓/0 S 3 Engineer's Name ` TG C aleeri�l CAP67wtbc c—i� its NEW CONSTRUCTION REPAIR X Telephone# 5 6�5-4!1 - 92�77 . 50.8-27 3-0 371 Land Use: Stnyle_'family dtuLiiinq slopes(96) "2- Surface Stones Distances from: -Open Water Body - ft Possible Wet Area ft Drinking Water Well L/A ft Drainage Way _ ft Property Line 7 /0 ft Offer ft SKETCH.,(Street name,.dimensions:of lot,exact locations of test holps_&perc tests,Jocate wetlarids i'ti_p x Adly`to holes _< . W �..a ^•c-t See-. akk Ted $iC,1 .. Go P M� o+ tuc�stn Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole:_ Weeping from Pit Face Estimated Seasonal High-Groundwater i 5 y k 3 DETERMINATION FOR SEASONAL HIGH WATER TAW x r Method Used: Di reek atase.rUa arc n Depth Observed standing in obs.hole: 7 f 5N In, Depth to soil tnoulatl:: In, Depth to weeping from side of obs.hole: in, Groundwater Adjustment._.,.,.: Index Well# -Reading Date: Index Well level..,.,..,, Adj.&ctor, ,er;,r AdJ .(linuedwcterLavgr,,_, PERCOLATION TEST Data 7-157-( ; Time - I I /Ij Observation Hole# Depth of Pere 7�-- 0 Time nt 6' I I0 Start Pre-soak Time @ 11:2U Ova — 'lime(9"-6") �'inirlS End Pre-soak Rate.Min./Iuch• 3 .. Site Sul lability Assessment: Site Passed �5 Site Failed: Additional Testing Needed(Y/N) N Original: Public Health Division Observation Hole Data To Be Completed on Back -- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. 0:1SEPTlMPERCFOR M.DOC DEEP.OBSERVATION_IOLE.LO.G `' Hole# Depth from r� Soil Horizon Soil Textpre .Sdil Color Soil Other Surface(in.) (USDA). (Munselly ° Mottling :(Slructtine,Stone:;;Boulders. 2y-2� Alc Ls L lob 0 S s Y b� / 1 b - s Y /e quo l d G ri S 2.5 DEEP OBSERVATION HOLE tOG Hole# 2 Depth from Soil Horizon Soil Texture . Soil Color Sail Other,: . Surface(In.) (USDA) (Munsell) Mottling (Structure;Stones,Boulders. 18- 22 LS. loir.3/i r 2.2-72 72 15'0 C, }1 S 9-5Y b/6 _ DEEP OBSERVATION HOLE LOG°' ` Holed#" Depth from Soil Horizon Soil Texture Sol]Color Soil Other' Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon. 'Soil Texture Soil Color Sail Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones:Boulders. Fl -ood Insurani Above 500 year flood boundary .No— .Yes Within 500'year boundary No—!L/ Yes._..: .. Within 100 year flood boundary No. !✓ Depth of NaturaDY Occurrent;Pervious Material Does at least four feet of naturally occurring pervious$aterlal exist in all areas observed thrpughout the area proposed for the soil.absorption system? If not,what is the depth of naturally occurring pervious material? Certification !U 27~9 9 I certify that on (date)I have passed the soil evaluatonexamination approved by the Department of.Environmental Protection and that the above analysis was,performed by me consistenl:With the required.training,expertise nd e e ience desfrtbed in 10 CMR 15.017. Datt; t3-5�13 Signature Q:1$EPT C\PERCFORM.DOC A S7 1v^Vro s s 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address of property S S T hr` Owner's name w tit -rc2 (3¢nne-tt Date of Inspection 9►, 3- q S 03 PART A CHECKLIST Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. __ZNone 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. VAs built plans have been obtained and examined. Note if they are not available with N/A. L/ The facility or dwelling was inspected for signs of sewage back-up. The site was inspected for signs of breakout. V All system components, excluding the SAS, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. The facility .owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. A_ A k 1 2 co � EP - ' 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential number of bedrooms _ number of current residents garbage grinder, yes or no laundry connected to system, yes or no seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if available: /9 q 3 1 99H 7- l3-S S' Last date of occupancy GENERAL INFORMATION Pumping records and source of information: ` N /L C : A �-- t��,! /ya A y /9 9 � Uj l?o o w 5��„oT'e Scr? System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Typed 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) Other (explain) Approximate age of all components. Date installed, if known. Source of information: �`'� Sewage odors detected when arriving at the site, yes or no 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued %EPTIC TANK: (locate on site plan) 1 ' depth below grade:1,_ material of construction: ✓concrete metal FRP other(explain) dimensions: ��'�r• +1 1 ��l �� 0 I sludge depth 41 -ldistance from top of sludge to bottom of outlet tee or baffle "'scum thickness �G`G"distance from top of scum to top of outlet tee or baffle _' distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) DISTRIBUTION BOX: ✓ (locate on site plan) Y5 depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for rAna irs, etc. ) k 7 A 3- `j a :v1 4: v✓2 a // t— el A G K S G' 0 R PUMP .CHAMBER: (locate on site plan) pumps in working/er, yes or no Comments: (note condition of ber, condition of pumps and appurtenances, recommendations fornce or repairs etc. ) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type r leaching pits and number Gc i S 16n_� leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) �v v CESSPOOLS (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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) PRIVY: (locate on site plan) materials of construction dimensions depth of solids Comments: (note condition of soil, .signs of/draulic failure, level of ponding, condition of vegetation, recommenfor maintenance or repairs,etc. ) 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' i 6�- w bG i v� 6 3a ., � 1 I DEPTH TO GROUNDWATER ) S depth to groundwater method of determination rm na�t`ion or approximation: S r 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) Backup of sewage into facility? Discharge or ponding of effluent to the surface of the ground or surface waters? �v Static liquid level in the distribution box above outlet invert? Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? Required pumping 4 times or more in the last year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: below the high groundwater elevation? within 50 feet of a surface water? within 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet of a bordering vegetated wetland. or salt marsh (cesspools and privies only, not the SAS) ? within 50 feet of a private water supply well? Al 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 analysi for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. k _ -- ----- - - -- -- TOWN OF / ri?.5 �11A— BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED [ // STREET ADDRESS ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME 41,'-tJ/e A i.64117 c 71 PART D - CERTIFICATION NAME OF INSPECTOR W.E. Robinson Sr COMPANY NAME W.E. Robisnon Septic Service COMPANY ADDRESS P.O. Box 1089 Centerville MA 02632 Street Town or City State LIP COMPANY TELEPHONE ( 508 ) 775-8776 FAX CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate, and complete as of the time of inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems. Check one: __L/_ System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15. 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have conducted has found that the system fails tc protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form. Inspector Signature r Date One copy of this certification must be provided to the OWNER, the BUYER (where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd.doc 13;. -� No. �._.. Fxs... ...... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .............. OF...�5 �lJ 4----------------------------------------- Appliration for DiopniFal Works Tongtratrtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: vR ................--................................................................................ ---••.._.....----...----•••-•-----•-----------•--------•--•-----...------•-•-•-........_._......-- Locatio -Add res or Lot No. ..............S a �,�° �1�f�1 sf.... ,�._l id�r s... P,rZZ...---------•-------•------------ Owner Address ---._...... " �rih.. ft�� �' ' ..... C', .�011 .. . r . 6 ................ Installe Address Type of Building Size Lot.... i5.!&X...._.Sq. feet Dwelling—No. of Bedrooms............ -------------Expansion Attic ( VC) Garbage Grinder (rvg pa, Other—Type of Building ____ 0 `j?__..___ No. of persons....... ................. Showers (a) — Cafeteria (/Yo Q' Other fixtures ------------------------------•• - W Design Flow......... L0...........................gallons per person per day. Total daily flow---- 3 ..........................._gallons. W Septic Tank—Liquid capacityYO-00._gallons Length_?./k...... Width---- 3�....... Diameter......57..•-.. Depth.. ....... x Disposal Trench—No..................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........1-.......... Diameter.........(o......... Depth below inlet.....4./......... Total leaching area./Cf.Cl_0/_......sq. ft. Z Other Distribution box (V) Dos' nk ( ) 0-4 Percolation Test Results Performed by * ...1�fal.1,7G1,gi'c._ ..._�..................... Date.....4.__nq-7a........... .. l Test Pit No. 1......____------minutes per inch Depth of Test Pit._/J'4_.._.__.. Depth to ground water... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O ........................••--••• - --..••••.- -----:----- ........ -.... ...... ----------------...._.....-•--•--------•----------- Description of Soil_______________...m_.1�-_�._.. 0 .. ... Q---------- v .......................................... G ..._�_._2�......: j,.A ¢.... ......J.pia't<@------------------------------------------------------------- 7 L,� -------------------------------------- �%c? L 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 TIT11,1, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sid . -----------------•- -- Date Application Approved BY F�� �/ 7 F��. GGa E -/ — ' Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------•--- •••--......._..-•-- -=-•-----------------------------•-•--------•------•-----•--•-•-•--------•--•---••--------.....--•-------I---•----•-•----•-----•-••-•--•-••••---•-•-•--••-------.... ._.... Date Permit No......................................................... Issued va a �- - •-••-----------•--. Date FNo.. .�__.. .`/ �$..a .._............... THE COMMONWEALTH OF MASSACHUSETTS :3 BOARD OF HEALTH Applira#ion for Uispooal Works Tonitrurtion Urrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -••............................................................................................... ...........•------------------------------------------•-----------------------------•------------- ,Location-Address/ �t. '7� / or Lot No. .SCIG�I� 4(.I�/ _. f_l11�. � 1. ... ._...... .............................. ....A.. .._...___.............. .................... ........................ Owner Address a 76-3.2 ��yr ... s ,t'r ......--= ............ ......C-'.e en�r'eO..4.4.:�1c 1? 0 Installer Address Type of Building -- Size Lot.... ......Sq. feet U Dwelling—No. of Bedrooms..................c.94- :..............Expansion Attic (K) Garbage Grinder (at) pa, Other—Type of Building ....&M-�t h....... No. of persons........-1................. Showers ( ) — Cafeteria (lye) f� Other fixtures ........•-•-••..........•••--- Gil Design Flow........1.Z.6...........................gallons per person per day. Total daily flow.......... _0.........................gallons. WSeptic Tank—Liquid capacity;lr:«..gallons Length.k '.� `.. Width..... .�_._..._ Diameter__._-_�__..... Depth...r�! `_.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........J........... Diameter........fn......__ Depth below inlet.....!kl......... Total leaching area_Z/+'?'.A.....sq. ft. Z Other Distribution box ()e`) Dosing tank (, ) Percolation Test Results Performed by............. ,�1� ,1.�'?r!fl''f._�._..._...•........._. Date..:..�r..���'�7 a Test Pit No. 1-------��-..._..minutes per inch Depth of Test Pit._✓S ._....... Depth to ground water-__•t!1 �� .... G4 Test Pit No. 2................minutes.per inch Depth of Test Pit.................... Depth to ground water........................ O Description Of Soil............. n `__.? ..' t�itt7., .� ` e� �L� ---------..------------............................... ------------------------.... _.. V ............................................. �� `�". .... .'it+.^.,€...... ----------------•-------------•-------------------•-------------- x W ---•••...................... _-. , . ........ ^ n --------oe t_d---------------------------------------------------------------------------------- UNature 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 TIT:.t;�. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ,/� / Date Application Approved By. ,�-G��� � Cx ��� '�J7 '" ff r" T" ! "_._• �' Date Application Disapproved for the following reasons:...........................................------------------------------------------------------------------- -----•---•-----------------------------------------------------•---•---•-------•-•----.....----------.....-•--------._...------------•--------•----•-••-•-•---•-•-------•-----••------••••-•••••------. Date PermitNo:....................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .� ....�= CI O F..... -5 3Mhk. s ,•' =9rdifiratr of Totnpliatta TH S IS TO .CERTIFY, That the Individual Sewage Disposal System constructed (,k) or Repaired ( ) y by rFr.j:� 7. ..........................••-----•-------••----. -----------------........... •----------•...--•-•-•---...............------.....------ Instalior at .........� ' ` ----- / ._!T7%Vf�__��.... f:--------�f.Y�t`s'C Lli J•............................................................ has been installed in accordance with the provisions of TILTn 5 of The State Sanitary Code as described in the application for;Disposal Works Construction Permit No..._ . _..___.S__%4°,t.._.__..___. dated_--..` .—Y..7" "°r__,._.____._. THE=ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS-A GUARANTEE THAT THE SYSTEke9 WILL FUNCTION SATISFACTORY. DATE--. '� , i._; _ _.. Inspector.... A . -•-- , } � .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............OF..... ✓ ✓C1� 11� ,1!� ........_....._........... _/�- / FEE.. .5....._ ... • �io�roo�tl orko �ono�rion rrani� _..���� Permission is hereby granted._.. :--•-•-----•---•----••--------•--•-------------------------- •-•-----------------------------.......-•-••••-•-•.:.._.. ........ to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No ........................................................... ... . Street as shown on the a lication for Disposal Works Construction Per o.___ _..__r._.__ Dated:.- PP P r' £ Board of Health / . r. DATE._.-.- 'r :? _.7Z............................................. ! FORM 1255 HOBBS & WARREN, INC., PUBLISHERS t 4 . LC<CA'T10N SEWAGE PERMIT N0. VILLAGE I N S T A LLER'S^ , NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED 8 _ 1.7 - 7K DAT E COMPLIANCE ISSUED 2Fj-7P. -� y 2 ' �� c. S � �b 2G' ' „ �� � -� �t TEs T . //O Z Es ' 89 7Z 98 G"aC. N. fo�No. jE/P ,Eit/c'O vNTl`7PE� TE S T 4 oyo . p --*IV Iva� Bq..Z .. �eES .�'L. TS LOT �y/vs� s/2o,7; ; P,.E,e 7'o.>^iN RECORDS :L O T. 38 I Lam I ~DA.TE . 6 ZO 78. TO LJN WA.T.E R " /-S Vie / L F7 B L E //VS P, /off,►vG M!//�14'.A Y'; OU/,. DUNG. 5ET3f9CK REQUIRE/111EA/T5 Z)R vr= W� Y A./ 0 7- To •L3E �L••C)CATED P,E OPOSED D ED2o•o/�IS 3 O vE/e S E WE ,;_=l r9C-1 E s-y,s -r,E/-1 UN.4-E55 DES.IG/�i FL-0 k 330 .G AZ-/DAy H-20 DES / G/V LOAD /NG• /S 'USED. SEPT-/e �''�o'��SED L E/90'/-/ 'FH,e'EF� 2dzv' CONFORM 7-0 O L r9.T/,O A/ TES T •• C O D E Q .D ,9 T ED .7-UZ-Y /;, 19 77 F9/t/D TOJ..//v of ,8�91'ivsT��LE' H E"A L -Tf••/ REG UL A 7-/ OA19- SILL ELEV. 7o roc >. �-- Fr. 19.80VE R.D. ,L PR O 'F. / -L. E, 2 % M %n//SHE7� TOP OF % .� G�2f9DE r9QOVE LEF9C'f4 -o U n/D ATi O A/=99•i0 o N O •SCALE • � MAA/HOLE eovE,e;To EXTEND 7•0 //`'/PE/eViouS CovE,e TD P,2EVENT FI/�/E$ J /O' W17-H/N I' OF F/N/SHED G,e�9DE F,,eOM /A/F/LT,e.9T/NG M/n/1MUM /0,/-1 MUM . 0 /y,t Z•¢"C'OV . WRS E�$ 8.t. D/ST. /�. _►I COVE,e /-/ED STONE 7 I BOX �2/"W/DE f�LL F��OU/VD 4„C,AST/ROA/ — ———mac` 3"M/A/• ^ �cY 2"H/A/. '¢ DJf3. WATF_,R t 0� 2 /`'I/N/MUM ,GHT '4 .. P/TeH FLOW L/,VE M/A/• P/T-C —" 14 '�FooT /o"M/,v /¢,. %4,. Foor z" r-//v. P/TcN /oDo _ y_ M/AA/ Z,S3 �¢ Fv o r ' Wf1 S H E D p p � .. C'Fl L 'nN •�/ c L���N STONE , ��• as GA.C.LOA/ /A�v� ,ET' , c.9' 6 , P/ T 4- /N VE,2T C A P,9 C' /T y (. /'9 R 0, . S E PT/C TF)N ( � (WfJTC,eT/G HT) /NV�,eT :/A/ VE,C-r Ic, (0�5 4 iz .M/N. . /A/VE,eT �p GA,E'Bi9GE GR/NDE� A,2EFA '�� �8 'MAX': 20' M/n//M UM ' /' " " > ~ � -•s" P/. / Q et" OF M G'/2O UnID k/F1 T�,e ELE V.O PL.. iqN L O C A T/ O A/. C'ENT.E,P AI'l E RONALD G p �j p g ARTHUR - $ C 19 .L E . / "- .30 DATE=�vLy Z6o // /,O" '�' GIFFORD ,2 E F'E,e E A1C E-: 8E /AjG L OT 4 Z AS 9/4oWA/• No.603 ;�" •. ON A )D HA/ /e E C O,e D F D /N THE BA,eA/- GISTER�� ST913LE Coc�NTy ,2EG / ST,ey O.� DEEDS SqN/TAR�P� LANO COURT sEGT/aN F 0,2 % -�6!19' EPT/ C 7-i9 /\//< To E E .A M//l/ D ,/ --� /MUM OF /O' FR0/"/ FO UNDF� + ' f'� �1 ��� T r / /�U� T T 1 O NA i�/D �C.E A C' N IP / T S . • g e o rg e C O cy C O. L E� e N / 7-S ro BE ,/�!l�ii- S //\-1 U M OF / o• R o P)e 0 PEPTY Z C E /2 T / FY TNA T T1-/ E. FavAjQA77X©n/ L / NE ,S i9 N D S F P7T/ C SPOWN oAJ TN /S PLf� n/ / S /Z ��'TE.-mO: 1HOF i9ND 2O' -F-'leO /`1 FOUND ,97T10AJ.. ON T 14 E G R O C./,A / D /9 S S l-!O W N N E,e .0/�/ yr•4P� Mqr D 7-N� 7 / 7 � aEs CpN �O,el-J <' GEORGE �sN DATE 7 -7 - 7J0 T P E B U /.k D l NG S E T 23, 9 C' K 'RE Q U/,eE- �� LOW,JR. — - - M E N T-5' O F T H E T G✓ ,Pr/I/ �f��3L� Z)/97 £3 Off ,CAD OF ,L-TH / � E G. L D 5 U V E Y 0 N 7-: \�V�'��y T�P,e o vE D FJ G E �''►►. fl PROP.VENT WITH CHARCOAL FILTER TO ABOVE GRADE 2"OF 1/8"TO 1/2" DOUBLE WASHED GENERAL NOTES T.O.F. EL.= 76.9'± FINISH GRADE OVER D-BOX= 69.5�± STONE OR GEOTEXTILE FILTER FABRIC PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER INSPECTION PORT WITH ACCESS F.G. OVER INFILTRATORS= 6$.7� - 70.0� 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& BOX TO WITHIN 3"OF F.G. 3/4"TO 1-1/2" DOUBLE WASHED STONE TO METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE RISER TO WITHIN 6"OF FINISHED GRADE i (SLOPE @ 2% MIN. OVER SYSTEM) OUTLET TO WITHIN 6"OF F.G. I 6"MIN.ABOVE CROWN OF INFILTRATOR CODE AND ANY APPLICABLE LOCAL RULES. A F.G. OVER TANK EL. = 72,Q�± 5" DIA. OUTLET(S) @ FND. EL.= 72.0'± - 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE N - f M DESIGN ENGINEER. Ii 4"SCH. 40 PVC @ PROPOSED 4" 48"MAX. MIN. SLOPE 10167 72 MAX. 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL EXISTING 4" _ 4"PVC TEE SEE NOTE 22 SEE NOTE 22 TOP OF SAS/B.O = 64.00 SYSTEM UNLESS OTHERWISE NOTED. -��-. ---- - SCH. 40 PVC SEWER PIPE � _ o 0 SEWER PIPE - 0_5, 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 6 3 3"DROP MAX 3„ 9„ L = 22'+ l 00 ELEVATION =64.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 2 DROP MIN MIN.SLOPE@ 1% - PROVIDE WATERTIGHT 00 - 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 10 4" PVC IN FROM JOINTS TYP. > � 1. 3' 00 16"TYP " ... I THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. „ 14" *69 2'± SEPTIC TANK 4" PVC OUT TO 0 92 (NP") r 11"TYP CONTRACTOR TO PROVIDE - • LEACHING FACILITY 00 i 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 00 ! 6, THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SPECIFIED DROP BETWEEN 12" 6" - 0 � 2•0 INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL T T 63.90' MIN. 63.73' 63.59' ? I k 62.67' (LAID FLAT) o 0 2.83 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE 4.0 4.0 00 6.25' j r 1 FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS AND CONDITION OF EXISTING TEES 0 0 GAS BAFFLE 6"CRUSHED STONE TYP. NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY 6.83' - I � AND DESIGN ENGINEER. TANK NECESSARY COMPACTED BASE 39.25' 8. ELEVATIONS BASED ON APPROXIMATE MEAN SEA LEVEL DATUM. BENCHMARK ELEVATION 5 OUTLET DISTRIBUTION BOX 4'MIN. INSPECTION PORT WITH ACCESS I --- - TO BE INSTALLED ON A LEVEL STABLE 61 .59 � BOX TO F.G. (SEE NOTE#21) ( OF 70.00' ESTABLISHED ON TOP OF A NAIL SET IN A 18"OAK TREE AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 55.87 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT HIGH CAPACITY INFILTRATORS (PROFILE) INFILTRATORS (END VIEW) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES CROSS SECTION VIEW TO THE DESIGN ENGINEER. 'CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR SEPTIC TANK PROFILE H-20 DISTRIBUTION BOX DETAIL H-20 HIGH CAPACITY INFILTRATOR DETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. TO ANY WORK & NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM © j i APPROPRIATE AUTHORITY. PERC NO. 14064 1 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS l INSPECTOR: Donna Miorandi, R.S. f LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE • 1 "�``ti �_ EVALUATOR: Michael Pimentel, EIT, CSE THEY SHALL WITHSTAND H-20 LOADING. C.S.E. APPROVAL DATE: Oct. 1999 ! 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. ',..,• DATE: July 15, 2013 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. 1 a REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, ELEV TOP= 68.70' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ELEV WATER= < 55.87' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN ZONE 2 SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. • _ a„ " �� � � , � PERC RATE _ THREE PONDS DRIVE 16. PROPOSED PROJECT IS LOCATED WITHIN: m (PUBLIC-40'WIDE) r s DEPTH OF PERC= ASSESSOR'S MAP 173 PARCEL 53 C) CBN EDGE OF PAVEMENT 6 1 ;. TEXTURAL CLASS: 1 OWNER OF RECORD: KAREN K. BEAUCHAINE 00 ® i ' - _ * • a • 1! _ ADDRESS: 55 THREE PONDS DRIVE CENTERVILLE, MA 02632 Z � - 72� L=138.45' / 4 0+ • �, " _ _ � • •� LOCUS 0 68.70' R=570.20 • a `�' •• • � � j Fill J -� ��4 N a -74 Ji6"OAK / 1 • � r c / w -" , �'� , • • • FEMA FLOOD ZONE C 6 0 a Q � / �t - • * , • ' 24" Loam Sand 66.70' COMMUNITY PANEL# 250001 0015 C • e Y �£ 12"OAK �u�' 10"OAK / 80 0 � +► ••• t # « • • + i • • +► • s ; A/E " 10Yr 3/1 a o I 12"OAK / , I o • • Q �r • s 28 66.3T 17. DEED REFERENCE: L.C.C.#138587 W MAP 173 -� o • i �. co80 o \ems I on£16 OAK LOT 53 �/ � � � \ lZ • • �' * ' � ` ` � � ( 18. PLAN REFERENCE: L.C. PLAN#38507-B(SHEET 5) M CO c, ' 15,938 S.F.± 0' • 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. �o o \ N / / Q ` • . • + B Loamy Sand MAP 193 ,+ • ' * *, + ` • ( 10Yr 5/8 20. PROPERTY LINE INFORMATION) IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY ' ZONE 2 ` • +� • • I FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY G / 10"PINE LOT 185 • • . !t \� �, • . •• ± • • I I FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. MAP 173 j 44 \ , 1, . • • • ( 100" 60.3T 21. A 4"PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A LOT 52 ` 6.,N v. ' PROPOSED H-20 ` ,'• : �� •' •f • • • • : DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A #55 DISTRIBUTION BOX __ �__ REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. j � EXISTING � DRIVEWAY ` \ \ I Medium Sand 22. IN ACCORDANCE WITH 310 CMR 15.401 -15.405, THE FOLLOWING LOCAL UPGRADE 3-BEDROOM ( GARAGE DWELLING ! 1 I Benchmark LOCUS PLAN C 2.5Y 6/6 APPROVALS A 3 0'WAIVER Q(3.0'S 6ED FROM 310 CMR 15.221(7): 0') OR THE MAXIMUM COVER OVER THE LEACHING FACILITY. lop TOF = 76.9'± \°PINE l Nail Set in Tree (2.) A 1.5'WAIVER(3.0'-45) FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. BFE = 69.6± ! J Elev. =70.00 SCALE: 1" = 1000' / ` Approx. M.S.L. 154 55.87 20"OAK J SCREEN �� 68x7 \ No Standing or Weeping Observed 1 - ---- ------ - � PATIO PORCH �r�� T/C- PROPOSED 5 H-20 HIGH CAPACITY DESIGN DATA TEST PIT DATA LEGEND � I • 18"OAK 6 INFILTRATORS w/AGGREGATE PERC NO. 14064 `J NUMBER OF BEDROOMS(DESIGN) 3 INSPECTOR: Donna Miorandi, R.S. 50xO EXISTING SPOT GRADE -' o \-C MATERIAL DOWN VEAL UNSUITABLE MATE O I \ �� ` % © EVALUATOR: Michael Pimentel, EIT CSE -- _. _ s� ��' �'t. TP 1 REMOVE L SU DESIGN FLOW 110 GAUDAY/BEDROOM - 50 - - EXISTING CONTOUR I \� a 68x7 \ TO"C"SOIL AND REPLACE WITH CLEAN TOTAL DESIGN FLOW 330 GAUDAY C.S.E.APPROVAL DATE: Oct. 1999 � \ \ I \ LAY OUND ' COARSE SAND PER 310 CMR 15.255(3) _ 660 DATE: July 15, 2013 50 PROPOSED CONTOUR i 18"OAK \ DESIGN FLOW X 200 % - GAUDAY ELEC EXISTING UNDERGROUND ELECTRIC LINE 68-- TEST PIT#: 2 TBEELINE \ 10"OAK N84021'06"W / \ PROPOSED INSPECTION PORT (TYP OF 2) USE EXISTING 1,000 GALLON SEPTIC TANK 137.55' ELEV TOP = 68.70' T/C EXISTING UNDERGROUND TELEPHONE &CABLE LINE L;=. u i . .,L-A) GAL. SEPTIC TANK ' W W- EXISTING WATER LINE ELEV WATER= <55.87' TO BE -71I_IZED IN THIS DESIGN EXISTING DISTRIBUTION SWING-TIES MEASUREMENTS PERC RATE = 3 min./inch GAS EXISTING GAS SERVICE LINE BOX TO BE REMOVED EXISTING LEACHING PIT TO BE PUMPED AND REMOVED ��o� MAP 193 INSTALL 5 H-20 HIGH-CAPACITY INFILTRATORS i DEPTH OF PERC= 72"-90" DESCRIPTION HC PC (ALONG WITH SPOILS) IN ACCORDANCE WITH TITLE 5 -- \ � $ TEST PIT LOCATION MAP 173 �� LOT 186 SIDEWALL CAPACITY TEXTURAL CLASS: 1 CORNER OF STONE(1) 21.5' 25.8'PROPOSED 4"VENT PIPE; LOT 54 (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY EXISTING 1,000 GALLON SEPTIC TANK ----- - - EXACT LOCATION PER OWNER CORNER OF STONE(2) 29.1' 65.0' (39.25'+6.83')(2 ) (2' ) (0.74 GPD/S.F.) = 136.4 GAUDAY 0" 68.70' PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE CORNER OF STONE(3) 33.2' 65.6' BOTTOM CAPACITY Fill CORNER OF STONE(4) 26.7' 27.3' (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY 18„ Loamy Sand 67.20' 0 PROPOSED H-20 DISTRIBUTION BOX (39.25'x 6.83') (0.74 GPD/S.F.) = 198.4 GAUDAY A/22" 10Yr 3/1 66 87' 0 PROPOSED H-20 HIGH CAPACITY INFILTRATOR TOTALS: B Loamy sand #55 10Yr 5/8 EXISTING TOTAL NUMBER OF INFILTRATORS 5 72" 62 70' REV. DATE BY APP'D. DESCRIPTION- 3-BEDROOM GARAGE TOTAL LEACHING AREA 452.4 SQ.FT. DWELLING ' TOTAL LEACHING CAPACITY 334.8 GAL./DAY Perc PROPOSED SEPTIC SYSTEM UPGRADE , PREPARED FOR: BFE = 69.6'± He CAPEWIDE ENTERPRISES SCREEN NOTE: C Medium Sand 2.5Y 6/6 PORCH DESIGN DATA FOR THE HIGH CAPACITY INFILTRATOR CHAMBER PER LOCATED AT PC (1 2) DEPARTMENT OF ENVIRONMENTAL PROTECTION GENERAL USE i 55 THREE PONDS DRIVE NOTES: APPROVAL ISSUED ON JUNE 6, 2013 (TRANSMITTAL NUMBER= X228042). (4 • coi CENTERVILLE, MA 02632 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF 39.25' 22.5' -- -- - - -- -- --EACH SEPTIC SYSTEM COMPONENT. 3) 154" 55.87' SCALE: 1 INCH = 20 FT. DATE: AUGUST 5, 2013 M �! 0 10 20 40 80 FEET No Standing or Weeping Observed .'A 0 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF ----- - PREPARED BY: THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST RESERVED FOR BOARD OF HEALTH USE CMUR HJOHN RJR JC ENGINEERING, INC. PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. +vo�V 2854 CRANBERRY HIGHWAY �'�' EAST WAREHAM, MA 02538 •�" �<�F srFIR R 3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS. SITE PLAN SWING-TIES PLAN. ° _ 508.273.0377 Checked MCP By:Designed SCALE: 1" =20' SCALE: 1° = 20' Drawn By: MCP '- By:JLC JOB No. 247