Loading...
HomeMy WebLinkAbout0043 VALLEY BROOK ROAD - Health 43 VALLEY BROOK RD., CENTERVILLE A= 188158 7/1 • I//l7rie[llG® � y� NoP2-12534 RS HASTINGS.MN I Commonwealth of Massachusetts �g8-- _ : Title 5 Official Inspection Form �Io Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - 43 Valley Brook Road r ' Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. City/Town State Zip Code Date of Inspection'- I 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. so A OF Mdr 11'i Important:When ``���� . .. q�,%i�� filling out forms A. Inspector Information 5l ,oa:• y. on the computer, -''�:' JAMES ':m use only the tab James D.Sears key to move your Name of Inspector c�: :cn� cursor-do not Robert B.Our Co. INC. use the return Company Name '�� CF • T y 363 Whites Path ����grr5�+�lgsi �G`\0� r� Company Address South Yarmouth MA 02664 City/Town State Zip Code 508-477-8877 S-1623 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 5-21-20 pector'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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 r Commonwealth of Massachusetts 1p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: The system is a 1000 Gal. Tank D Box and two 500 Gal. dry well. chamber's. 2) 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): i Lt5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 i c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. Citygown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �1� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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 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 must be attached to this form. c. Other: 4) 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in anazzut is less than 6" below invert or available volume is less than '/z 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 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 water supply 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 2000 d- ❑ ® Y p 9 Y 9 9p 10,000 gpd. ❑ ® 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. 5) 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 C.4. 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 t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 43 Valley Brook Road - `�� Property Address Sharon Naviaux Owner Owner's Name information is Centerville MA 02632 5-19-20 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: 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? El ® 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 El ® 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)] t5insp.cloc rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u- 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. Cityfrown State Zip Code Date of Inspection D. System Information 1. 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 Description: 1000 Gal. Tank D Box and two chamber's. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): NA Detail: Sump pump? ❑ Yes ® No Last date of occupancy: NADate t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 c Commonwealth of Massachusetts i �9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments V!% 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: 5-2018 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 I , cam, Commonwealth of Massachusetts �n Ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known) and source of information: 2008 Permit # 2008 -256. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 22 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH -40. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c , Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments !% 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is Centerville MA 02632 5-19-20 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): 1' Depth below grade: 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 1000 Gal. Precast H-10 Dimensions: 2" Sludge depth: 28" Distance from top of sludge to bottom of outlet tee or baffle 1" Scum thickness Distance from top of scum to top of outlet tee or baffle 8° Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt- Plan -Tape Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank at 1' below grade and covers at 4". Inlet baffle and outlet tee. No sign of leakage or over loading t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts �n ,lp Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is Centerville MA - required for every 02632 5 19-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts ip Title 5 Official Inspection Form I, Subsurface Sewage Disposal System Form Not for Voluntary Assessments Y 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. 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.): D Box is 16"x16"-31" below grade w/cover at 10". Box is clean and solid w/two line's out. No sign of over loading or solid carry over. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 i c Commonwealth of Massachusetts Title 5 Official Inspection Form '= I� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ............. ,.a,r 43 Valley Brook Road V� Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type. ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form -Not f 9 p Y or Voluntary Assessments 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name required for is every Centerville required for eve MA 02632 5-19-20 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is two 500 Gal. dry well chamber's w/3.5' stone. Chambers at 32" below grade. Chamber's are clean and dry, No sign of over loading or soid carry over. 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System-Page 14 of 18 i jc Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,,.,• 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form lo Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V!% 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 - fc-k l o � o 3 P3 = 56 6, �4=60 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 <e�-o Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form Not for Voluntary Assessments 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells /VO 11' Estimated depth to high ground water: 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: 6-11-2008 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: T.H. on Design plan 6-11-08 11' no G.K. Bottom of chamber's at 5' below grade. Bottom of chambers at T above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u— 43 Valley Brook Road Property Address Sharon Naviaux Owner Owner's Name information is required for every Centerville MA 02632 5-19-20 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist . Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included f{)a om C#Am8iRf �, I No t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 r No. 2-00$ '25�.� r Fee /00• THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for �Diopooal *p.5tem Cott.5tructiou Perron Application for a Permit to Construct( ) Repair K) Upgrade( ) Abandon( ) ❑ Complete System g❑Individual Components Location dress o of No. �1�,�.I U Owner's Name,Address and Tel No.50 O—qai ,- 3 a 43 Assessor'sMap/Parcel ' ls� 43 VUJl ?�-wy—zn'�, Ckp4ax--OA� Installer's Na Address,and Tel o. Designer's Name,Address and Tel.No. I,i)Mb'a'�Sc1r Type of Building: Dwelling No.of Bedrooms 3 Lot Size /h, G Z 5 sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 o gpd Design flow provided 3 3 0 ,0 C/ gpd Plan Date 6— /2" LOOS Number of sheets Revision Date Title S1FwQ4L 91 i 100 >Ac- S�/S'GGw1 JAA Size of Septic Tank 1600 Type of S.A.S. Z- S-Go aA-e- 6r4c4-fi._p4 Description of Soil 5 0C IL- /9 L 4 Nature of Repairs or Alterations(Answer when applicable)'1rn , no,� 1 t 1�'� t!:> 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 He .. Signed Date Application Approved by a Date Application Disapproved by: Date for the following reasons Permit No. 2 o G Date Issued G ^/6. 2 6 O r _ {�.•. �i .,�� "!''' r -....a'.., ...+ t>,.+ram,-.•+v-...r+'�+,` p-v,�•'-'r.i:c *.c: - �"',,-�,��, •-r w.w*� c..-„v'.`* _, No. GsFJ C3�►.' Z.5�� .r: <«� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEATH DIVISION - TOWN OF BARNSTABLE MASSACHUSETTS Yes Zipplication for �hgp dal 6p!5tem Con0truction Permit Application for a Permit to Construct O Repair K) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location.Address or-Lot No. � �� Owner's Name,Address,and Tel.No.50�-1" ,90- Y 4 a 3L H3 vZ� 1. rco\Qrc.06,cl, Assessor's Map/Parcel ,� t S )k V ( �Q,�!- _1 -.-�`\(p Installer's Nane,Address,and Tel..No ;' v; 1 L. Designer's Name,Address and Tel.No. -,740q Type of Building: Dwelling No.of Bedrooms Lot Size /b, (; Z-5 sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 U gpd Design flow provided gpd Plan Date Z 0O5 Number of sheets Revision Date Title SZf ^G 91 �,Tcu. t 11'w Size of Septic Tank 1600 tN4. TypeofS.A.S. Z - sGo CA -. Cif�tui ., Description of Soil S (- la L-A ti m• - l E. Nature of Repairs or Alterations(Answer when a© ble)�,,�4- 1.0 nek.t_-�7-1 S vtS Q 1 puns c o t e G-� al Y`7 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 H ayh Signed Date Application Approved byk Date Application Disapproved by: Date for the following reasons Permit No. G 8 Date Issued " �(p— 2 G 4 --------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS NAV I AUX BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ) Upgraded ( ) Abandoned( /)byM ',,►,C- at 14_�) v �(/� —6foc �.. C)C�r `IC1,1/I has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. OG(5 dated c/-, ' lG ' Z.G 66 Installer Designer 4E G CG — 7£C-H #bedrooms Approved design flow lt' d The issuance of this permit all noube construed as a guarantee that the syste ill f l etion as designed/ c G' Date Inspector , ��, No. Fee THE COMMONWEALTH OF MASSACHUSETTS ;M PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS Migozal 6p!gtem Construction Permit Permission is hereby granted`t`o Construct ( ) Repair ) Upgrade ( )1 Abandon ( ) System located at � V o J�1�t,1 r and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this pe it. Date _ 2 o D cu; Approved by Y r�— V �j ToWn of Barnstable Regulatory Services } Thomas F. der,Director * BABNSTABM + 9�A 1639. Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,W4 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Resigner Certification Form Date: $" Sewage Perms Assessor's Maplparcel I 5 0 1 _ ll �'� Designer: (' Installer: l;�'�'l )tiJl n �S Address: i (`IC-UnG�l i'�CJ Address: F0 yso-K On ,was issued a permit to install a (date) (installer) septic system at 1 � �lL e 1 based on a design drawn by (address �V io 1 e_L� , dated (designer) certify that the septic system referenced above was installed substantially according to the_design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 1 0' lateral relocation of.the SAS or any vertical relocation of any component of the Septic system)but m accordance with State &Local Regulations. :.Plan revision or certified as built by designer to follow. (H OF 414sS DAYWD. (Installer's Signature) COUGHANOWR No. 1 3 i G/ TER 4 (Designer's Signature) (Affix➢esiper s Stamp Mere) PLEASE RETURN TO B.4RNSTABLE PUBLIC HEALTH DIVISION. CERTMCATE OF CO1MTLIANCE WILL NOT..BE ISSUED UTNM BOTH THIS FORM AND AS-B€UT CARD ARE RECEIVED BY THE BAMNSTABLE PU'B11C HEALTH DIVISION. THANX YOU. Q:.Health/Septic[Designer Certification Form 3-26-04.doc Zoo g,- tsz; Town of Barnstable P# i 22 3 01 Department of Regulatory Services _ : .eBNBrnBM ; Public Health Division Date fur l 5 1 ' NUM �' 639. z�� 00 Main Street,Hyannis MA 02601 MIS / /OsDate Scheduled l l I bb o D Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: �� ����H►f N��✓�2 Witnessed By: m0- LOCATION& GENERAL INFORMATION, Location Address z,3 l� Owner's Name a C � �-i.eK�����:�eeR cur_ Ro. i� Sh r� e.�o►v,a uX CE`�,jit%I'�VJUL,— Address ¢, Valley bradk d Assessor's Map/Parcel: �h -e f' I I le �� 1 1 Engineer's Name NEW CONSTRUCTION REPAIR Telephone# 5 0 97 3 C& OINK—,11 J11 _ Land Use P—ewl eh. Slopes(%) U Surface Stones Distances from: Open Water Body Do -4 ft Possible Wet Area AL—ft, Drinking Water Well L& +- ft Drainage Way D ft Property Line( + ft Other g - SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes / Q- / z W W J 5 m /L0_ w W `C V � U� J Z O Aif W<0 "�� `�S2j�e i; �O �mO m3 >- to In 3W� N�O�Iwt�� / ZZZ W 03. J Z OOz ❑w O WO -. / 3 zz O Zan- UWz<<-)� '63 9� ZA z Ow ZzNOWWO❑ mot\` ,54q• I O �coIn O (Y<< C W M CD 1 r I [ ,/� Parent material(geologic) r `GG A ` 7 Depth to Bedrock Y`D M Depth to Groundwater. Standing Water in Hole: D V)e. Weeping from Pit Face A(9 4 Estimated Seasonal High Groundwater See G b DETERNIINATION FOR SEASONAL HIGH WATER TABLE Method Used: —C&E Oky0f Depth Observed standing in obs.hole: in, Depth to soil mottles: in. Depth to weeping from side of obs.hole:. in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor— Adj.Groundwater Level PERCOLATION TEST Ditte 611119 Time Observation �- Hole# Time at 4" Depth of Perc 7 u �i 11 Time at 6" V1 lei Start Pre-soak Time @ ^ 'lime(9"-6") End Pre-soak* SD Rate MinJlnch Ya 1 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/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. Q:\SEPTICWERCFORM.DOC SOIL TEST L00 DATE OF TEST: JUNE 11. 2008 APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR. #461 WITNESSED BY: DONNA MIORANDI. HEALTH DEPT. j PERC NUMBER: 12239 NO TEST PIT I PAARENDTUNDWATE MAATERIA ENCOUNTE PROGLACA LED OUTWASH PERC AT 5B 1n - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 44,05 + 0-2 O LOAM 10 YR 2/2 NONE FRIABLE 2-4 E LOAMY SAND 10 YR 5/2 NONE FRIABLE : s i 4-9 A LOAMY SAND 10 YR 3/4 NONE FRIABLE 9-32 B LOAMY SAND 10 YR 4/6 NONE LOOSE 41.38 32-132 C MEDUIM SAND 10 YR 5/4 NONE LOOSE 33.05 NO TEST PIT 2 PAARENOTU MATERIAL: PRBGLA IALD OUTWASH PERC AT 60 in - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING i 44.15 0-3 O LOAM 10 YR 2/2 NONE FRIABLE 3-5 E LOAMY SAND 10 YR 5/1 NONE FRIABLE 5-10 A LOAMY SAND 10 YR 4/4 NONE FRIABLE 10-34 B LOAMY SAND 10 YR 4/6 NONE LOOSE 41.32 34-13B C MEDUIM SAND 10 YR 6/4 NONE LOOSE 32.65 DEEP OBSERVATION HOLE LOG , Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi't n Flood Insurance Rate Man: Above 500 year flood boundary No— Yes z Within 500 year boundary No '�' Yes Within 100 year flood boundary No _ Yes Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area for the soil absorption system? q Q S -- proposed If not,what is the depth of naturally occurring pervious material? Certification I certify that on D J (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent wit the required training,expertisp9d experience described in 310 CMR 15.017. � l �C: 41 Date'l"C ��, � ��°�� DAVID Signature o D. COUGHANBWR �O �'CENSE� Q:\SEPTICIPERCFORM.DOC /� EVALUA�O f , Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection William F.Weld ` C' Trudy Coxe Governs ' D b 5-t"Y Aryeo Paul Celluccl e�t� David B.Struha LL Giov+mor E C«mJwlor»r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION PropertyAddresa 43 Valley rook Road Centerville,MA Address of owner..814 Daniel Shay;Highway Date of Inspection: 4 3 0/9 6 (If different) Athol,Mas s. 01331 Name of Inspector. Joseph P. Macomber Jr. Company Name,Address and Telephone Number. J.P.Macomber Jr. Box 66 Centerville,Mass . 02632 508-775-3338 CERTIFICATION ST,+_TFhfENT I certify that I have per-_,on .11y inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the tune of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site eewage disposal systems. The system: YPasses _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails sy l Iaspectoa's 3tgnature• �k" (/ a Date: 7 (O The System Inspector : .'1 submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the sy ,. :z 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 appron; ::. :::gional office of the Department of Environmental Protection. The original should W -ent to the system owner And copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMM..1:;1*Y: Check A,B,C,or P: Y A) -SYYS�TEM PASS±:-.: I have not ' any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failur-a not evaluated are indicated below. BJ SYSTEM CONDIT;C:TALLY PASSES: One or more c<,;,crn components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes, o,or r.o!. ')termined(Y,N,or ND). Describe basis of determination in all instances. If"no determined",explain why not) ptic tank is metal,cracked,structurally unsound,shows substantial infiltration or exMtmtion,or tank failure is The system will pass'inspection if the existing septic tank is replaced with a Conforming septic tank as approved of Health. (revised 11/03/95) 1 One Winter Sv ,nt • Boston,Masuchusetts 02108 • FAX(617)SW1049 • Telephone(617)292-5500 i Printed on Recycled Paper I - r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) i Property Address: 43 Valleybrook Road Centerville,Mass. Owner. Ralph Catane s e Date of Inspection: 4/30/96 B)SYSTEM CONDITIONALLY PASSES(continued) Ab Sewage backup or breakout or ho 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 AJ 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 C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: _A Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES 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 a surface water d Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. Z) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. 40 The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 6 ppm. 3) OTHER s (revised 11/03/95) 2 ' t • i j SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontinucd) PropertyAddms- 43 Valleybrook Road _Centerville,Mass . Owner. Ralph Catane s e Date of Inspootlont 4/30/96 D) SYSTEM FAILSt e I have determined that the system violates one or more of the following failure criteria as daII:ud in 310 Cbat 16.803. The besii for this detu=1nation is idautified below. The Board of Hoalth should be contacted to determine what will be naoassary to cornct.ths failure." 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 tround or surface waters due to an overloaded or clogged SAS or cwpool. d/D Static liquid level in the distribution box above outlet invert due to an overloaded or cloggod SAS or cmpool. Liquid depth in wacpooi it less than 6"below invert or available volume is less than W day flow. Required pumping more tl=4 times• in the tut year NOT due to clogged or obstructed pipo(s). Number of times pumped Any portion of the Sor�tt Absorption System,cesspool or privy is below the high groundwater elevation. j,6AV h Wes" &,IV Any portion of a cos is within 100 foot of a surface water supply or tributary to a surface water supply. it/fI Any portion of a is=w:thin a Zone I of a public well. Any portion of a� is within 60 foot of a private water supply well. cT Any portion of a is less than 100 feet but greater than 60 feet from a private water supply well with no acceptable crater quality aasly:is. I1'the well has boon analyzed to be acceptable,attach copy of well water analyst for eolVorm bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: -VO The system servos a facility with a dejign flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and ths•environmmt bocause one or more of the following conditions exist: the system is within 400 foot of a surface drinking water supply ilG'f the system is within 200 feet of a tributary to a surface drinking water supply the rystom is located in a nitrogen sensitive area(Interim Wellhead Protection Aron MA)or a mappod Zone II of a public water supply well) The owner or operator of any such system sha.l bring the system and facility into lull compllana with the groundwater troatmsnt program requirements of 314 CMR 6.00 and 6.00. Plow:a eonsult,the local regional office of the Department for farther information.. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM j PART B f CHECKLIST PropertyAddreaa: 43 Valleybrook Road Centerville,Mass . Owner. Ralph Catanese e Date of Inspection: 4/3 p/9 6 Check if the following have been done: Pumping information was requested of the owner,occupant,and Board of Health. 2xons 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 v.%ter have not been introduced into the system recently or as part of this inspection. 2A,built plans have been obtained and examined. Note if they are not available with N/A. ZThe facility or dwelling was inspectedfor signs of sewage back-up. Ze system does not receive non-sanitary or industrial waste flow The site was inspected for signs of breakout. V/All system components,Aicluding the Soil Absorption System,have been located on the site. /The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of bai'iles 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 or approximated by non-intrusive methods. ZThe facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 43 Valleybrook Road Centerville,Mass . 02632 Owner. Ralph Catanese Date of Inspection: 4/30/96 FLOW CONDITIONS RESIDENTIAL. Design flow: FP ns Number of bedrooms: Number of current residents• 0 Garbage grinder(yes or no):7ZD - Laundry connected to system(yes or no):z�j Seasonal use(yes or no):Ob Water meter readings,if available: Or Last date of oocupancy:Z/—N'4: COMMERCIAL/INDUSTRIAL- Type of establishment: AM Design flow:-&d-galloas/day Grease trap present: (yes or no)A& Industrial Waste Holding Tank present: (yes or no)&6- Non-sanitary waste discharged to the Title 5 system: (yes or no)dg 1l Water meter if available:— i�� !U Last date of occupancy:A)A OTHER(Describe) 1U Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and of' ormation: / System pumped as part of i9tppoctiioon:: (yes or no If yes,volume pumped: G�' - grallons Reason for pumping TYPE 97 SYSTEM Septic tank/distribution boa/soil absorption system Single cesspool - - Overflow cesspool , D Privy Shared system(yes or no) (if yes, attach previous inspection records, if any) Other(explain) PROXIMATE AG components,date installed(if known)and source of information: WA Sewage odors detected when arriving at the cite: (yes or no)42_ (revised 11/03/95) 5 5tW61L- FAMILY - --5 BG-'DgaOOM WO' GAcZ5AGc 621h1D52 VAr..LEyg�a.,I�: �•p DA►L%( PLOW .: ►lox 3 = 3306.PR „ SEPTIC. TANK = 330915o% =-t956.P R U5r-- I 000 6AL, i +, lo1•-1fi 'Dl5Po5AL. Prr -u5C- t000 GAL.. 150 5.F X 2.5 = 375 G•Pq ' BOTTOM AIZF.A: S0 ,iF• I w. b' I 50 S.F x t, o 5o G.Pa -ToTAt- DE51GN V .4-ZS C7•P 12 ( oN- , N, •Te>TAL. pAI►-Y FLOW = 33o(5•Po• PCI ZcoL.ATID4 RATE; i"w vftj o2Lr=55 1711 r � / o M (I T i �I)%orit,q 'tIµ Of (p� f/ A. F110HAnou Trb { u RAX1T�i +i, ! j 1 � tI rw.t gmA8 N I. o- F SO r . Tlr`!5;T (�1218. .. d6 To 01-ND 4-7 ►I h LE- ��3�82 FG=J ram+- 1"• �.oawt ,o ov lN�• B X INS. GAL. Z IUGv fN�l,;' f TANK,. � toar✓,a GAt.. g ; I yaN� L.6AGtt I ; G.�Av PIT INV. INV.a I��S/4•I%z WASNLD ��. 97 ` EL- - — L o G r i o N f�EJ�TE(zVf L 99' 12 NO SGAt_E SCALE. (oQ,. ' :.VA.Ttc G-'l3•BZ ; . I cSRT►r- -THAT THE FooQbXTl0W1 : HWoWN NG-P-SOW GOMPU 6 WITNTHa Slt>SL.lW C-z A►..ID 66'TC .G �L,,6QutR.i✓MF_I�t'TS �F "TNE- , 4-�T �� i `jo WN OI= SAD 11 ,e77ASL6 AND. 1$ � / LO<-AT=D WITNI TN t%000 P AIM 1 LA►.� -OuIZT BAxTBIZe MYS INC. REG I S•t EQ.F:b'L.AL!D 5 u i�.Y E�(atZS -F%Al5 PL&M t 5 Norr bkl' AN dSTEi�VILLE • MA55. lW5-rRUMl::IJT ;v1�VE.`( _-TNE O�FSE"r5 Suout,D ", ►rc>T 5E- VSC�D'S'b pI T�=L'.MItitC L..o'�' 1rINE�� APPL IGA►JT JOSS , b SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 43 Valleybrook Road Centerville ,Mass. Owner. Ralph Catanese Date of Inspection: 4/3 0/9 6 SEPTIC TANK:l-/®OO V, 2ol v 7,954 e (locate on site plan) Depth below grade:/1� Material of construction: ooncrets_metal_FRP—other(explain) Dimensions: 40c e Sludge depth: •t Distance from top o sludge to bottom of outlet tee or baffle: scum thiclMess::_ Distance from tap of scum to top of outlet tee or baffle:_ Distance from bottom of scum to bottom of outlet tee or baMe:—Q _ Comments: (recommendation for pumpn$ing,conditi es on of inlet and outlet tau or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage, etc.) rump septic tank every 2-3 years •Inlet & outlet tees are in place •Li uid level is aT-3TW—Septic tank is structurally sound: There is no evidence of leakage from the tank No repairs are needed at the present tiMe . GREASE TRAPc,&j7.V, (locate on site plan) Depth below grade: Material of construction:&!Awncrete_metal_FRP—other(explain) to A Dimensions: Scum thiclmess: A)fj Distance from top of scum to top of outlet tea or bafile:_&& Distance from bottom of scum to bottom of outlet tee or baffler Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidencefjf leakage,etc) �A � �Bll� � (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) property Address: 43 Valleybrook Road Centerville ,Mass . Owner. Ralph Catanese Date of Inspection:4/3 0/9 6 TIGHT OR HOLDING TANK 111011"e, ° (locate on site plan) s Depth below grade: Material of constrwtion:&0oncreta_metal_FRP_other(explain) AW Dimensions:. Capacity: ona Design flow: ons/day Alarm level:_ Comments: (condition of inlet too, ndition of alarm and float switches, etc.) r, .� DISTRIBUTION BOX.-L-_____ (locate on site plan) ,t Depth of liquid level above outlet invert: /V Comments: leveljand ton is equal, evidence of solids carryover,evidence of leakage into or out of box,etc.) leaks ge (�° ox is leve�l;No evidence of solid e OX. PUMP CHAMBM&&0 C, (locate on site plan) Pumps in working order:(yes or no) Comments: ( oondi ' n of pump chamber, condition of pumps and appurtenances,etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (oontlnuod) PropertyAddresc 43 Valleybrook Road Centerville ,Mass . Owner. Ralph Catanese Date of Inapootlon: 4/3 0/0 6 SOIL ABSORPTION SYSTEM (SAS):z (locate on sits plan, if possible;excavation not required,but may be approximated by non-intrusiv methods) . • If not determined to be present,explain: Type: leaching pits,number: leaching chambers,uumber:- lea^:hing galleries,number:_( leaching trenches, number,length: leaching fields, number,dimensions:_ overflow ceaspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) Soils . loamy sand to sand & gravel;No signs of hydra ai ure or level of pondina; All vegetation is normal, No repairs are needed at the present time CESSPOOLS:d64A-1 (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids lVer. A] Depth of scum layer. A)A Dimensions of cesspool:_ Materials of construction: Indication of groundwater: inflow(osspool must be pumped as part of inspection) �Q Commen� (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:�/04-t- (locate on site plan) Materials of oonrtrugtion• /�� Dimensions: Depth of so":, )ff Commeats: ( condition of wil, signs of hydraulic failure,level of pending,condition of vegetation,etc.) tid ur1 T5 (revised 11/03/95)' 8 � SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (oontinued) Property Addreaa: 43 Valleybrook Road Centerville ,Mass . Owner. Ralph Catane s e Date of Inspeotion:4/3 p/9 6 SKETCH OF SEWAGE DISPOSAL SYSTEM: • include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' Centerville Osterville Marstons Mills Water company 428-6691 r i DEPTH TO GROUNDWATER Depth to groundwater. 16 + feet See page 5 A method of determination or approximation: (revised 11/03/95) 9 ��. .-•t��» S fC w Y THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. u Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 anj Section 13 Ch2 General Laws. Issued by The uc. l iLIA r A. \Jlliii�llLail '�:;;..., 1:�1,. June 8, 1995 Acting Director of the ion of Water Pollution Control >•TRT'lrrtt•rT.-n— �r:S.r.•rrs-rr—�rsr.T.T..r.::sr.:rssrr:Tras-r:r"I s•C�'f�r.-�TtT.ISi: .. .. —. — .. —TrrtZ:r-.r.�r�:..--.r—••h � TOWN OF Barnstable BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION YM `/ F-••r.:•s-r••.-::+--.sr..^.--nrn�+-r.:rr:—z-s.r.—•r.ram-*—"s+-,.—rc:-s*-r-s-r+rnecr rasf-nr:-s:rrsra rsm n•mrrnrrr+Trrrr.+r..•.•nrrr•r.•-sr•—r.+s -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 43 Valleybrook Road Centerville .Mass . ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME Ralph Cata'nese • -- • . •��=fl�- PART D - CERTIFICATION I NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J,P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or City State LIP COMPANY TELEPHONE ( ) - FAX ( ) ,�08 775 3338 508 790 - 1578 lS SCTtfTiT � f i �.�. 'CR 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 : XXXXXXXXSystem 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 to protect the •public health and the environment in accordance with Title 5 , 3.10 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signatur - 14-1444 o. Date 5/3/96 '` One copy of this cert.ification 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 ayetem within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR !15 . 305 . partd.doc t ; , TOWN OF BARNSTABLE LOCATION S Vfi�LV kt-01 k rPcS� �/.D SEWAGE # " 1 VILLAGE, Oe , 1 G _ ,gASSESSOR'S MAP & LOTT'�'' INSTALLER'S NAME&PHONE NO. �� e �� i�i ' C e- AIl� SEPTIC TANK CAPACITY �' 1 74 �C �� k�" /;Ox LEACHING FACILITY: (type) --ItIGG 1247 01,11-7 (size) �U NO.OF BEDROOMS ,^ BUILDER OR OWNER r PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wet ands exist within 3�00.feelaecacility) Feet Furnished b� 142 Valte.y rc� ,� � CM � ► LOCATION sEWIVE PERMIT NO. /-OT'0 Jj VA L y dloa0, r e VILLAGE c Ftiit/�t�/� INSTA LLER'S NAME i ADDRESS 05 T^ �- BUILDER OR OWNER �� SM irk DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED /�/� � e sA 3a a TOWN��OF BARNSTABLE LOCATION ,a' An . A4 SEWAGE�� 4-2-6 VILLAGE G Gam` , ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 016 1A,,s d- SEPTIC TANK CAPACITY LEACHING FACILITY.(type) (size) t NO. OF BEDROOMS .3 OWNER a /A v 24 o PERMIT DATE: `� 'C7 COMPLIANCE DATE: 4, 4` 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 Llaching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY r 17 �e 9 i 7. No. Fms..:...:s.................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH VD.U30.......----......OF........lj..OXn .. .V ... Appliration for Dispasal Works Tomitrurtilara runfit Application is hereby made for a Permit to Construct or'Repair ( ) an Individual Sewage Disposal System at: ................ ...... ....... 2.(;X ................ .......... ...... . Location Addre or Lo No. .................................................... Owner Address W Installer .............................................Address..................................................... 04 Type of Building Size Lot.« -- :3....._.Sq. feet Dwelling—No. of Bedrooms............:...........................Expansion Attic (010 Garbage Grinder V,:) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) � Other fixtures ........................ ------------------------------------•-•------------------•-......•---------•--------•---------•...--------•-•--•--•--------- W Design Flow.............U-.0..................... per person per day. Total daily flow.__.......-.-2._.3®..._._........_....._gallons. 94 W Septic Tank—Liquid capacityX9 gallons Length................ Width................ Diameter._._____.___.... Depth.............. Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing t nk ( ) Percolation Test Results Performed by-------2> .....ir.......N Y......._____ Date.......t..".�.`._�.�``___. a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water----_-_________-----.-_. fr4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------`` --------------....------•--....------•--•--------------•----.... O Description of Soil------..... ?...._.... •------•-- �-s�- 1 x P 6 o O G ..N..........."t...----S`� .- 1.. o ............s�!A-y------------�c�.• ...... x ---------------------------------------`A -� ---------- -ran�...--------- - 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 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. Signed ' .� ................................ ate Application Approved By.... �.._ ' g. Date Application Disapproved for the following reasons:............................................................................................................... --------------------••-••••-••------------•-••---...---•--•--•••••-••----....•••--•-••-----•----•......--._......••--•-•-----------•--•--•-------•-------•-----------•----•--------------•-----•••----... Date PermitNo......................................................... Issued-....................................................... Date r .0. No-el.-3 2.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .n................OF....... . ........................... ApplirFa#ion for Disposal Works Tomitrnrtiun ramit Application is hereby made for a Permit to Construct ( v�' or Repair ( ) an Individual Sewage Disposal System at: ............... ..........." __V Location Address_ or Lo No. W Owner Address Installer Address Type of Building Size Lot..� ...."....__•..___Sq. feet �-, Dwelling—No. of Bedrooms..........._ 3...........................Expansion Attic ({�l�p Garbage Grinder QJ 14 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow..............,V.0._......._...._.....gallons per person per day. Total daily flow..........3_3'•......._............gallons. WSeptic Tank—Liquid capacityIQP;�gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing t ( ) a Percolation Test Results Performed by......... ..... . __._._... Date......... ...... a"`_ ?"___ ...... . Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----- --------••-•----••------•...-•--•=.... --•-•---•--......-------••-•........................................................ O Description of Soil------... ....---�Cam cr1----•-••-•-�---- �,~a�j.5 � �► �--- V ----------------------------------------e __. .......... ' " ..--•----• S r� "-}.------------ r��t............................................... ------_4....._i. ------------- 4............�5--4_:�'-n ----------------------------------------------------------------------------- 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 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. Signed.........•== � -.^�----•-- +------•.""��^-''--- -------- ------•-----------••- -- Application Approved By __ i ,� f• ........................... ........................---------------- Date Application Disapproved for the following reasons------------------------•---•-•-------------------------------------------------------------••--•-----......._.._ Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............:l .Jk,#�.n..........OF............. 3�' `''!.n. . r..`' .............. C9rdifiratr of Tuntphatirr THIS TQ CERTIFY, That thndividual Sewage Disposal System constructed ( 'or Repaired ( ) by Installer has been installed in accordance with the provi 'ons of TI1' j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... .......__.•___ dated_.... ......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATI�FACTORY. DATE............................•--••----•-•••--.-3 P'.............. Inspector.......... ' ............---•................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD" OF HEALTH 1.1�.t`............OF............... ��M' .L .._ i ............... No.... FEE... .................. Tq�rks Uawnntr n rfutit Permission is hereby granted___________ _____-'�'�'._e_.�_ _.________.___.._ to Constru t ( or Repair ( ) an Individual Sewage Disposal System at No......... ............ .............\1_("V .& \\r* Street as shown on the application for Disposal Works Construction Permit No..............:!t�... Dated.......................................... / 11 Board of Health .................................................. DATE.......................................... L---... .�1------••-•---- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS KI SI►�Gt� FA BG OQOoM ' ►.JD GARC'SA6E (�21NDl-2' YAK--L.�/p �� FLOW .: 11 o x 3 = 35 0 G.P jP /C>IGC�CJ `EPT1G TANK = 330x15cl-% = .495G.PQ ot5Po5�t_ F't�' V5� tvo0 6AL• 'S DE YJAt.L AP-St, _ 23 f i 150 s.t x 2 5 375 G.Po Fug. BOTTOM AZE.A= �O S O P 5 a G. � �2 I. p�o�° ' a A4 ! -ToTAI-- U>EStGN %: ArZ5 G•PD. I r*Pik- F -Tz>-rAl._ DA t L-{ PGZCOLATIO►.l SLATE : 1" N ZPAIN OR-Lr=55 ( el �! i N OF A4ar A. I� i •.. / klAX'I f:R P'd.n.',;048 r J V p 4 'Q }9T�P .� 1pAW1 ►oov INq- 1 Suers-saw. vls�c'. INS. aC,°r.��� � BUX Z IUdU INS '��'G 'TANK ; LEAG44 INV.WITW r WASNGD ' ' ��. 37 ' i C_E-%z.TtF•tGo PLOT Pt_A.Q �� ----- L o C A-T t o tJ NO SCALE SCALD �c WAT6e— N RE E P-E Ca 1 CE �TtFY THAT TNT �7vuaDATIOIJ SNoww I! N6,RE.o1-1 GOMPLYS YJITN�1aE. S1o�LtiN� �T �f AI..1D SET�.GK 2,EC'ut2�MEtil'TS oF -tµ� �vWN //� t.-OGp.T-U> W1'1"t{iN TN GLOOD P AlN LAI.� (.OUZT - S' 245. B A'AlM 8 I.J Y E INC. ; RSG 15-T f-_2C-,r>'►..Aw o 5 u 7-V R* 6Z6 -VW5 PL&ti 15 KJO-r Oki E2VILLE- - MA55. y tir,4�T 6E- VyE D •CCU DE�Tt-�' Mt�C l_c>T t_I�IE_T� APPt_IGA►�T J�ti{E..S �1 �j,(/(I'1"{.! CONTOURS FA MO ROAD C �, ROUTETE 2� EXISTING - - - - - - - 50 ° C)K cl R O MINIMAL GRADING _PROPOSED o - - - - -� MENT�� - - �� - �4po ROAD N F P LL V A�i ,,��\L, OF / NOT TOww� E% } DISTANCES SCALE ROOK Rpgp TO LEACHING GALLERY LOCUS ^I U J ' �� O ` ALL DISTANCES ARE IN DECIMAL 'V o J -0 Lq FEET NOT IN FEET AND INCHES. m J(33 mm =i0� ; (J � f-- O \ CENTERVILLE. MA �- I � ` LOCUS MAP >�_ �i, y w>< _j \ NOT TO SCALE a \ \ZW LOT 11 ` < m=z u, 1 m w . w \ LEGEND O ?o :::;::: � m o AREA = 18623 sF +- za � � w z RI ` c:::::D o �zw �J w OD \ �\ 1 z J U Z m Z 3 x w 0 EXISTING r o <cn<- J W 1000 GALLON Jw W} U 7= \ Zm \ 1 SEPTIC TANK Z _jIL , �af < � o J N �i \ A B EXISTING LEACH 1 52.3 24.? O z Lnn ``X n'� Z � \ \ T I N G \ PIT/CESSPOOL �- m� W � W w 2 48.6 48.5 W2 o c,u v ww EXI ROOM \ 3 61.1 51.2 2 UTILITY POLE $ z r J U Q T :''a ii w g L ,:,:,. >: : I N 3 :,:.;:::,.: E �o J w¢ � :., ,y : TEST PIT® D-BOX � w z :y : \ �F FNDN e Z J O >:::::7:::. \ Z,W w o C X ul ,, TOP- 43 84 + ` DECIDUOUS CONIFEROUS W W LL < E� - BENCH MARK TREE �qo� TREE *12-poof z m m m L_n_N \ 43TOP OF FOUNDATIONabb I2-M W z w Lnw 0 m o \ ELEVATION = 43.84 -NUMBEINCHES. LETTER ETTER DENOTESREFERS TO ETER TYPErN W I = O dl O-OAK M-MAPLE P-PINE C-CEDAR U W z � w � V BARNSTABLE GIS DATUM W W ~ Z w CL� X ow LL J U) F-U \ �jN OF MASS ZH dF MgSS Z q q e U 0 p U Z �~ CO m _o \ GARBAGE GRINDER �o� DAVID �, �o� DAVID yG� IS NOT ALLOWED D• s z 3 ?z \ COUGHANOWR D Lu O = ` WITH THIS DESIGN. COUGHANOWR No. 1093 W� U) 03 + c� \ B TP 2 \ �FGI3TE��0 `9 410ENS��O� �W mN 43 \ O /�1�� T® \ 24 f t x 12,5 Ft X 2 Ft SAN �N E�A�°� J x o 5<- -is o I LEACHING GALLERY �W 17, W09 W � \ \ 8-O z7p I `N T� � SE DISPOSAL SYSTEM PLAN w -TO EEXISTNDI w 7�j J ch� z —� \ 44 qoD ' \v 2 EST. SHARON A. NAVIAUX L 0 0 m m —J \ I , Qom I P OWNER OF RECORD O f J U \ F b � 43 VALLEY BROOK ROAD \ la-P I \ 1995 �' i �- \ E MA X � 1 � � CENTERVILL , � e L1J CD LLLI \ I� 12 P/ + / ONRA PROPERTY ADDRESS n O \ / co FLAN \ tom- / 43 TRIANGLE CIRCLE ASSESSORS MAP 188 PARCEL 158 3 { SANDWICH MA 02563 LAND COURT PLAN 35548-D O z SCALE: 1 in = 20 f t ` ` 508 364-0894 o „ Z Z F / / \ DATE: Jl1NE 12. 2l�JtaB a N N z 20 0 JOB E T E-2 J 4 PAGE 1 OF 2 VERSION: O x w w THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED ~ w SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM 0 10 20 -�-ter -- � 10�24 {-E __7•---- -- __ DEPICTED HEREON. FOR ANY OTHER CHANGES TO PROPERTY INCLUDING {! PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS. OWNER 42 1 SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. _ A � 7 SOIL TEST LOG OESIGN CALCULATIONS DATE OF TEST: JUNE 11. 2006 APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR. #461 DESIGN FLOW: 3 BEDROOMS X HO GPD = 330 GPD WITNESSED BY: DONNA MIORANDI. HEALTH DEPT. SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS PERC NUMBER: 12239 USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL TEST PIT 1 NO GROUNDWATER ENCOUNTERED CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) PARENT MATERIAL: PROGLACIAL OUTWASH DISTRIBUTION BOX: USE 3 OUTLET D-BOX. PERC AT 5B 1n - 2 MIN/INCH IN C SOILS SOIL ABSORBTION SYSTEM: A 24 Ft x 12.5 Ft x 2 FL LEACHING GALLERY CAN LEACH ELEVATION Abut. = ( 24 x 12.5 ) = 300 sF DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELLI MOTTLING A s d w = ( 24 24 12.5 12.5 ) x 2 = 146 a 44.05 Atot = 446 sF 0-2 O LOAM 10 YR 2/2 NONE FRIABLE Vt 0.74 x 446 = 330.04 GPD 2-4 E LOAMY SAND 10 YR 5/2 NONE FRIABLE USE A 24 Ft x 12.5 Ft x 2 Ft GALLERY. Vt = 330.04 GPD > 330 GPO REOUIRED 4-9 A LOAMY SAND 10 YR 3/4 NONE FRIABLE 9-32 B LOAMY SAND 10 YR 4/6 NONE LOOSE L EA CHING GA L L ER Y 1000 GALLON SEPTIC TAW 41.38 DIMENSIONS AND DETAIL NO T TO 32-132 C MEDUIM SAND 10 YR 5/4 NONE LOOSE USE SHOREY PRECAST 500 GALLON NOT TO USE EXISTING H-10 WIT SCALE 33.05 LEACHING DRYWELL (H-10 LOADING) SCALE NO GROUNDWATER ENCOUNTERED SEPTIC TANK IS TO BE PUMPED DRY TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH CONSTRUCTION DETAIL AT TIME OF INSTALLATION AND IS TO BE PERC AT 80 1n - 2 MIN/INCH IN C SOILS DRYWELL UNIT INTEGRITY. INSTALL STA L T NEW PRVC AL OUTLET S T O N7 TEE EOUIPPED WITH A GAS BAFFLE. ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 24.0 Ft (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING m 1 Irn 44.15 TAPER 0-3 O LOAM 10 YR 2/2 NONE FRIABLE �, m +� 3-5 E LOAMY SAND 10 YR 5/1 NONE FRIABLE ro LnLn 5-10 A LOAMY SAND 10 YR 4/4 NONE FRIABLE N n p 41.32 � 10-34 B LOAMY SAND 10 YR 4/6 NONE LOOSE m 34-136 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 3.5 F t 6.5 f t 1B.5 FL .5 F t Lo 32.65 24.0 Ft N�l ,1 6 P�-6 GROUNDWATER ADJUSTMENT In A 4� 500 GALLON DRYWELL EXISTING GROUNDWATER LEVEL DIMENSIONS AND DETAIL COVER OUTLET T COVER BASED ON. TOWN OF BARNSTABLE GIS DEPARTMENT RECORDS. IISE H-10 WIT i"u"Aa... .. gk'a4"."�Wmf�O:A i"" A^ INSTALL ONE INSPECTION 3 IN DROP r RISER TO WITHIN THREE —> FLOW LINE INDICATED GW 12.00 INDEX WELL M1W-29 INCHES OF FINAL GRADE FROM IB In = 14 TO ZONE D ON AS-BUILTEPLANATION BUILDING AND In TO READING DATE MAY. 2008 48 in GAS READING 7.8 LIQUILEVEL BAFFLE ' ADJUSTMENT 3.5 ADJUSTED GW 15.5 DO 33 0 �oao�oo��oo 00000 1n CROSS SECTION VIEW NOTES �000000 00 ��` 0 50 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. lo,- 2) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. CROSS SECTION VIEW 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 2 In PEASTONE 21n PEASTONE SEWAGE DISPOSAL SYSTEM PLAN 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. o C3 -TO SERVE EXISTING DWELLING 28 3/4 u,TO EFF13 24 ECTIVE 4 In TO 26 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. In -1/2u,c�AVn DEPTH I-v2"'GRAVEL 1n SHARON A. NAVI/�UX 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE. S 43 VALLEY BROOK ROAD CENTERVILLE. MA Z) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES 46 1n 581n 46 1n AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. 1501n ECO-TECH ENVIRONMENTAL 8) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH FABRIC IN PLACE OF THE 2 i,,. PEASTONE LAYER SPECIFIED. 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. ETE-29471 JUNE 12, 2008 1 12/2