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HomeMy WebLinkAbout0091 WATERSIDE DRIVE - Health 91 WATERSIDE DRIVE, CENTERVILLE A= 227171 �14REcVCLftlCoym /if UPC 12534 No.2-53LOR '��src0j5`'��� HASTINGS, MN DATE:_-8/,1./95 PROPERTY ADDRESS: 91_ Waterside Drive RECEIVE) __-_Ce_nterville ,Mass . . AUG 7 1995 1 7 / 02632 HEALTH DEPT. TOM OFBARNSTABLE On the above date, I Inspected the septic system at the above address. This system consists of the following: j 1 . 1-1000 gallon tank . 2 . 1-distribution box . 3 . 1-1000 gallon leaching pit . Based on my Insorertion, I certify the following conditions: l . This is a title five septic system . ( 78 Code ) 2 . The septic system is in proper working order at the present time . Recommendations . 1 . Sprinkler lines should be reCted . around the septic tank covers . These can be broken during servicing of tank that has to be pumped at least once every three years . SIG NATUR!-: Name: J_. P_Macomber_Jr , Company:J_P.Macomber-& Son Inc . Address:-,., _x-- -6-------------- Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY s , JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools-Leachtleldt Pumped Installad Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6�12 I 7 _"E SE'riACE DISPOSAL SYSTEM Andress Of Proper.t.7y, 91 Waterside Drive Centerville ,Mass . Owner ' s name Estate Of Betsy Haywood Date of Inspection 8/1/95 PART A CHECKLIST Check if the following have been done: _FZ Pumping information was requested of the owner, occupant, and Board of Health. __L/None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period . Large volumes p g olume of water have not been introduced into the system recently or as part of this inspection. _,� As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. I he site was inspected for signs of breakout.. 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. We v71,06 iAvjpevC;6a,� 4Qp( 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.' i t 6UBS�.:;:.t" ACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM pRRT B SYSTEM INFORMATION J FLAW CONDITIONS. If residential 3 number of bedrooms _C2 number of current residents ? garbage grinder, yes or no 3• laundry connected to system, yes or no seasonal use, yes or no If nonresidential , calculated flow: Water meter readings, if available: Sprinkler system present 199 -15�, 00 gallon =GPD= 410. 96 1994=125 , 000 gallons =GPD=342 . 47 V Last date of occupancy GENERAL INFORMATION Pumping re ords and source of information: i �y Ld System pumped as part of inspection if yes, volume pumped yes or no Reason for pumping: . Type of system Septic tank/distribution box/soil -absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) _ other (explain) Approximate age of all components. Date installed, if known. Source of informatio Sewage odors detected when arriving at the site, es or Y no i i 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECIIoN FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: 7D0a i?Zo ,) (locate on site �lan) # Sjokl kl-e.Q depth below grade : Z Shol4u be ,�a.►Qoul material of construction: ,_zconcrete metal FRP other(explain) dimensions•: L t G `" bV— y' t L.� 6..' r sludge depth a6f distance from top of sludge to bottom of outlet tee or baffle 0 scum thickness distance frog. 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. ) Pump septic every two or three years . Tank is structura o evi ence of leakage No repairs needed at this times T rnrnmmo„rl sprinkler lines be moved ; They are running near the inlpi- and outlet end of the tank . ( DISTRIBUTION BOX•3CXXX (locate on site plan) NO 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 repairs, etc.) Distribution box level no solids carry over the distribution box, No repairs needed at this time PUMP CHAMBER: NONE (locate on site plan) NONE pumps in. working order, . yes or no Comments : (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) gNO rF SUBSURFACE SEWAGE DISPOSAL .SYBTZX INSPECTION ?ORX . PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : ; (locate on site plan, if possible; excavation not re approximated by non-intrusive- methods) gaited, but `maybe If not determined to be present, explain: Type leaching pits and number J7 leaching chambers and number ' ,vim leaching galleries and number leaching trenches, number, length leaching fields, »umber, dimensions overflow cesspool , .number Comments: (note condition of soil, signs of hydraulic failure, level of pondirig., c dit 'on f veg tation, r@commendat 'o s for mainte ance o rrea .atl� t-(�',QA�J,�� l p rs,etc. F,�-� 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 hydraulic failure, - level of .ponding, condition of vegetation, recomr:e;;dat..ions for maintenance or repairs,P• . , . . • 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION •FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L:SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' 7-6LtIN G!>A re \'h 'q t , JDEPTH TO GROUNDWATER depth to groundwater I met od of determi ati or approxi ation• 11 of � • i 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. Static liquid level in the distribution box above outlet invert? Liquid depth in rtces poe.l, <611 below invert or availab flow? le volume< 1/2 day Required pumping 4 times or pore in the last year? number of times pumped Al"Q Septic tank is metal? cracked7 structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? w'1 l Is any portion of the SAS, cesspool or privy; below the high groundwater elevation? Q within 50 feet of a "surface water? �Q within 100 feet of a,-surface water supply or tributary to a surface water supply? within a Zone I of a, public well? �Q within 50 feet of a bordering vegetated wetland or salt marsh- (cesspools and .privies only, not the SAS) ? i - within 50 feet of 'a private water supply well? less than 100 feet but greater than 50 feet from a private w supply well with no acceptable water alit analysis? water has been analyzed to be acceptable, attach co y If the well er anal, for coliform bacteria, volatile organic compounds, ammonia well tnitrogeri- and nitrate nitrogen. I .—I.J:TiL•T—.T1��T::t��.:y�.SSi�SS.T3S.��-A,.Z.-S.if��4C47?31L'C:.._ TOWN OF Barnstable BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION �iSTi:LSYTi�«Ts^.i fT mL'RTi'6Y'CTtCTf TR.'iT=.t�T.�IIGiL'iRfFI�T@{�'C'L7�S.Oti�S�3�TtL4Ct• I—_xsrrsTaz,TT.tr.=aenra•a-anrsaa mva�str.rvtsrxi•tr-s:-! —TYPE OR PRINT CLEARLY— PROPERTY INSPECTED STREET ADDJ2US ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME , 44,1 PART D - CERTIFICATION NAME OF INSPECTOR J P Macomber Jr COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville,Mass . 02632-0066 Street Town or City State COMPANY TELEPHONE (508 ) 775 - 3338 zta FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposa-I system at this address and that the information reported is true, accurate, and icomplete 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 : 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 to 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 . i Inspector Signature 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 within one year of the date of the inspection, unless allowed orthe requiredm otherwise as provided in 31,0 CMR 15 . 305 . Purr d -doo CC.,.mcnweacn cr Masscc�:aers ExecLzIve Office cr EnvirorimenTc Alf!a.s Department of Environmental Protection ' 40 Water Pollution Conrrol Tecnniccl Pssistence and Treining Sections WIIAam F.WOW Trudy Coxs Swwrr,EOEA Thomas&Powers 06/12/95 ATTN: Joseph P. Macomber, Jr. Joseph Macomber and San PO Box 66 Centerville, MA 02632- Dear Joseph P. Macomber, Jr. , I am pleased to inform you that you have attended training, met the experience qualifications, and have passed the Title 5 System Inspector exam, pursuant to 310 CMR. 15 . 340 . The passing grade for the exam was 39/52 or 75% . This is an official notification that you are a Certified Department of Environmental Protection System Inspector pursuant to 310 CMR 15.340. You will receive a System Inspector certificate at a later date. If you have any futher questions, please write to me at the following address : Kimball Simpson D. E. P. Training Center 50 Route 20 Millbury, MA 01527 Thank you very much for yoir time and consideration in this matter. Sincerely, Kimball T. Simpson, DEP Training _ . :,.ter Director (2405) Route ^n tilillbury, MA FAX 506-755.92S3 • Tei•wwns 508-756.7:41 I - Water .,.�. .. ....� Coris'ervati0 sauE Tips . . . ME. , . CHECK FOR LEAKS Water Loss in Gallons Due to Leaks Leak this Loss Per Day . Loss Per Month Size • 120 3,600 • 360 10,800 • 693 , 20,790 1,200 36,000 1,920 57,600 3,096• 92,880 0 4,296 128,980 . 0 6,640 199,200. 6,9.84 200,520 8,424 252.720 9,888 '' 296,640 ® 11,324 339,720 12,720 381,600 14,952 448,560 I TOWN OF BARNSTABLE LOCATION ��,���� SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO..OF BEDROOMS BUILDER OR OWNER PERMITDATE: 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 wetlands exist within 300 feet of 1 hin facility) / Feet Furnished'by, �` y �� , . � i�fi � _\ ;�� �� ��'� �q �� � 1;7/ �, 1V No-91-A-y Fps.... THE COMMONWEALTH OF MASSACHUSETTS t"q �Q BOARD'OE HEALTH - - 3- t .�.ocv�---.........OF...�I./..# s...`. . --- ................................... Appliration for liapnaFal Mirkii Tnnitrnrtinn Prrutit Application is hereby made for a Permit to Construct ( 4�­or Repair ( ) an Individual Sewage Disposal System at: .................. - ---------------••--•••••••••••••••••- Location-,Address or Lot No. Owner Address ..............•••••• •••...,t? T Installer Address UType of Building . Size Lot../ _�-�.....Sq. feet Dwelling—No. of Bedrooms..............-._.._.____.__.____.___Expansion Attic ( ) Garbage Grinder ( ) W'4 Other—Type, of Building No. of ersons____________________________ Showers g ---------------------------- P ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------•-••--------•••••••••••-••--._...------------•---:_._...--•••••-_... ••••-- 5.�_____________________gallons per person er day. Total dail flow...._...___ �P................. W Design Flow........... g p p y. y �___ gallons. WSeptic Tank—Liquid capacity vgallons Length__ ............ Width Width_._.... Diameter................ Depth_._�_!�_. x Disposal Trench—No_ ____________________ Width_._.__o_._.__._..__ Total Length.................... Total leaching area.............,......sq. ft. Seepage Pit No------,l........... Diameter..../ ....... Depth below inlet...6_C________ Total leaching area... _sq. ft. Z Other Distribution box ( Dosing tank ( ) '-' Percolation Test Results Performed by._, , _h�` ^�_ __._____ 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-- ........--•-'�-••••...•••---1 _`7•.s_......!K-- 'L'!.5.........;F--- W V Nature of Repairs or Alterations—Answer when applicable._____________________________________________________________.................................. -•------•---------------------------•------•------------------------•----•-•--••••••......•----._...._...._..--•-••-•-• ......•--•-•••••--••••------•-••----••••••-•-•-•••----••••-••---••----..._-••••- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h ed by the a �ea�lth. figne Ll% Date Application Approved By...... -•••-•• ••-••-•••••._..... Date Application Disapproved r e following reasons---------------••---••-•-•-------------------•-••--••••••-•••-•----------•••••--•----••--•--•-•-••------•••••-- ---------•----•---------------------------------------------•-------------------•---------------•--_____---------------•-----------------•-----•••--------------------------------------------__-•-••-- Date PermitNo......................................................... Issued-----------------------................................ Date • e No.... ' .Z. FEs.._......©............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF , HEALTH ------...."OF... cLf_ Appliration for Diipuiial Works Tonstrn.rtion "anti# Application is hereby made for a Permit to Construct ( 6-}or Repair ( ) an Individual Sewage Disposal System at: ........ls.:: % S •�� ice. .4-c?,✓---••-•--�.......................................•---•---•---- Location-Address r or Lot No. ' — �c�! c�o? j IC f /c'-) ,/"L..) C. ?1 111,.:r we,� -................................................../ . / 7 -....-•-••............................................................... •••---••---•-•-----------.........�- Owner Address Installer Address U d Type of Building �. Size Lot__Z�!? :2_._Sq. feet Dwelling—No. of Bedrooms............... _____________._.._____._Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures ---------------------------••-•- W Design Flow............ _____________________gallons per person per day. Total daily flow............._:;�.��____.__.._._____gallons. WSeptic Tank—Liquid capacityl�G'gallons Length__. `. _ Width..... '. { Diameter________________ Depth_.4✓5 . x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......./----------- Diameter....Zl�?....... Depth below"inlet.... -._f........ Total leaching area....' �.sq. ft. Z Other Distribution box ( �'' Dosing tank ( ) / �' '-' Percolation Test Results Performed by._=°�"? _% ��__..,_'...f<!_ `=� ._�.: r___._____ Date._:%//,/`�:" � -----------•_... Test Pit No. I________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ GT., Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water_-_____________________- Description of Soil_._;%' '`____ __ - ----------------•- - J `� -j --= yG - U /i1 -`?i .: ? f h'C. L'....................................................J�•`- — ................... W 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 TITL% 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. Application Approved By . s-• -•••••._._.....-•-•-•-•>•----•-•.................................. ........................................----------------- DateDate ApplicationDisapproved reasons--------------------------------•--•---------•---------------------------------------------------------•-•--..._ ---•-•-•--.....-----•.............•-••••-••-•••••---••------••••-•-••-••••••----•---•-•-...._..--••--•--•...-•--•-----•------------•-••--•--•••-••••---------•--••••••-•••-------.... -----•••--•--- Date s PermitNo......................................................... Issued._ .................................................... Date r i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (9rdifiratr laf Ton pliat rr TH_I�j IS T. ER T FY, That t Indi 'dual Sewage Disposal System constructed ( ) or Repaired ( ) by.......... .. ..YJ_....vv ...__.. .. ,---------------A, 4 - ----.........-----•------•------------•----•--•--....._..__...............------_.... at.. 1 -----------•------• -- --•-- • • - - ....... -----------••-•••••••-••-•-•------••-----••----•-••••-••....... ---•-•------------- has been installed in accordance with the provisions .of TT„ I ` The State Sanitary Co as cribed in the application for Disposal Works Construction Permit No._____-�___"`l`________________________ da.ted_r-- _. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST ED AS A GUA ANTEE THAT THE SYSTEM WI NCTION SATISFACTORY. DATE...... D. 3.................................................... Inspector__*------------------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF....................._...._._..._.................._.__...._........._.....__........ ,^ No. .... .. FEE......................... Mop lVnr in Cn �trlwl In, mil Permission is hereby granted-• M , to Con stru ) or Rep it ) atl ndiv?ikal Sewage D• posal System, at No.---� //- --°�'-k- ' - - -.-----•••••-••----•-••-..._•----...... Street r as shown on the application for Disposal Works Construction Permit No.. __ _ ___`_ Dated.......................................... ...................`-----•- ----- ------. ---------- -----------•----------••----.....-- Board of Health_ DATE•-{ ( ------------------------••- ----•-•••---•-•-•------•-• FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ,� LOCATION SEVAGI PERMIT NO. VILLAGE INSTA L.LER'S NAIVE i ADDRESS GUILDER OR OWNER DATE PERMIT ISSUED 2 �o DATE COMPLIANCE ISSUED �/� 3 r I2 i i r — �� of found LdG�s' Cons . covet-5 /aver of sch. 40 Pvc p/pe /Z ma7¢. Go"� washed min. Pitch % cover eastone. ;�i per ft. 4 4" Sch. ZO Pvc. P/Pe. P f/ow line sctr►d AF - �ECa � v� inv. e/. bo inv- c l- L O G A T/O.A/ Mf1 P septic fa.n K inv. SCALE : / washed inv. e • o al aJ PI-e G ea.S f • • 0 S f /eb aa G 17.1e iinn 9 t iodo�.,o. Q► '�oEW/9GE SSTC P)20F/L � O/" ho sce e�tu,✓a/e n o0 . ... _ ti bo-fJ-orr� G%. OR� S Z 2d 2 OE: S /GA/ OfgTf9 TE= 57- 1-40L• 4r.- 4- 04S AJUMB6 �e OF BEO�eOOMS 6>/9)2BAGE: O/SPo5�94- UiIJ/T . By TO T rq L� a S T!MR T E O E2GoLRT/OAJ �f9TE ^�- M/N. /J/AJGH - F L O!il/ Q ,LE,4e'<-4 7 7n4l - yE3,e. \ D/�i'�� w " ,� , ,� 3^ G L. DAY L D L A / \ )1I � _ z / _ HO 1 HOD 2 \ jo I RGTU�9L SEPTIC To=7n.f� SIZE : �G'.7`> GAL- ,tOAy f`��4^e .4 S✓ $ y✓ �e . 144G D T I G LRGH/Nfa Fa�2Ef� �EQU/,�EME/VTS : f,�4 }-` - TOTAL LEACHING CAPACITY �lr'vPC7�0 r ! •� '� � ? GAL. 3 Qn2M• l {?0 J LcL�/. ��5 /?� ESE-2VE L& RGH/A/G CAPHG /TY ---------------- + / 0 ` 5L NUTS S - 22 Co/VFOjE?M TO O. E. Q. & TOWN OF / �2UL & S fiNO �& GULF�TIONS F02 — /� 3 SUBSU,�2FRGE p/SpoSAL OF 2) C0MPL/,9A/G& WITH ZONING i2& GULr9TIONS �� D&T&i2/►'1//VEO BY BU/LU/NG �2 /NSPEC. 7-0 E' / GOMM /SS/ONEi2. 3) EXIST/ VG rgNU F/NRL G�eAp& S SHALL i2EMA /,A/ ESSENT/ALLY THE SAME. DAT� �iPPlE30 'V� o AGEAJF � P�eoPOs �- o GoivST� UCTIOI\.I L O C A T/O N r"c 12EFC- A=-> &NC& : -gel,-0c.," ,co?" i/ AS Ss�c. /,y..l r,..J G. ,veoej" vow 3�? gQ S / TE= PL �9 N P K P H i2 & D F O Ae S C 4q L LEGEND rtHcr fyp exisfin�p Spot e/e✓. = o. o /'` A / E�� •s e�GiStinc1 Gonfour _ — — — — — /Z WYMISD O 9SGO/V C-/VG //VE- ER1AJG I/VG . O C. Pf TAR A. fyp. prop. Ar7. ,n. spot /ev. o. o '� Cr Z P! v GAVI ,. prop. Goni'our = \C ►.. 2707 o�, 453 /E 0 UT� /34 Pest ho/e /oc a Lion roll 394 - 88 / Z �,�. voB #