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HomeMy WebLinkAbout0166 WEQUAQUET LANE - Health 166 Wequaquet Lane ,,Centerville P A = 250 159 I IN ad. `RECYCtpp�o UPC 12543 No.53LOR °oncoNs�� HASTINGS,MN �1 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Y�o ftplitation fordisposal6pstrm Cons"ttionpermit Application for a Permit to Construct( ) Repair( ) Upgrade(vj-'Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. �� C,L�{ Owner's Name,Address,and Tel.No. -3C0-cR('] Assessor's Map/Parcel - © Nz<�:��kK Installer's Name,Address,and Tel.No.S D`,? Designer's Name,Addre s,and Tel.No.5C -;3C©- 33 tj Ca l Type of Building: Dwelling No.of Bedrooms Lot Size 4)r44 'S sq R. Garbage Grinder( ) Other Type of Buildings No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Datea� � Title Size of Septic Tank ,d �v� �ype of S.A.S.C -a Lc. GZ,.�,,, �✓c Description of Soil SZc�I Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sign O Date Application Approved by Date Application Disapproved Date for the following reasons Permit No. Date Issued - -- - ----------------- f � No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes "application for Disposal *pstem Construction permit Application fora Permit to Construct( ) Repair( ) Upgrade(Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. kc C.(J--) e ��jj . Owner's Name,Address,and Tel.No. ems-3CO Assessor's Map/Parcel L® C.��-�J•lr. Installer's�vame, ddress,and Tel.No.so`? = �6O5" Designer's Name,Address,and Tel.No..SG'-3So-33t +Z _X7 Po 'moo o r� "c9 ale V08 o R�a3aac 9 Q C>>Sb Z�,`,��.� w. zQ947 Type of Building: Dwelling No.of Bedrooms Lot Size d, `1-4\r5 soft. Garbage Grinder( ) Other Type of Building f .��� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided J�� `'� ,j gpd Plan Date 1 s- ( gyp Number of sheets Revision Date Title Size of Septic Tank d t �fl �iype of S.A.S. t Description of Soil f , Nature of Repairs or Alterations(Answer when applicable) -,v1r�,1 l y\.-,tr c> Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in �. accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board �of—Health. n- -yam PS927�, l � Date Application Approved by l i if ✓%J,/� f l ; Date , Application Disapproved b / Date for the following reasons 1 Permit No. _ Date Issued y j THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO_CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(1/) Abandoned( )by �c -��,( \`op i� J-- ac L.,4 t�v�� I i at 6 ����c, w c� e L has been con"din rnce with the provisions of Title5 and the for Disposal System Construction Permit No (dated �� Installer '�``�a�SZ��v (Q��r� 44L29 .� Designer Y\A #bedrooms Approved design fl6 r gpd The issuance of((thi r e it shall not be construed as a guarantee that the syste Pill-funclttii n as d/eigned.(� Date t I Inspector ---- ------ - ------------ ///�.i - -- ---------------------------- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal 6pstem Construction Vermit Permission is hereby granted to Construct( ) Repair( ) Upgrade(( Abandon( ) System located at 6 G and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construucttio must st be lox within three years of the date of this permit. Date % Approved b PP Y ` . TOWN OF BARNSTABLE LOCATION 6 �C¢C> v�� .SEWAGE#Q���j— 01 kO VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. ��v1�R� ,I— kG'su,o SEPTIC TANK CAPACITY `CDC)O ck)"_ ✓ C LEACHING FACILITY: (ty e) c,�l s-C •e, � s ) 3a x q' KZ? NO.OF BEDROOMS OWNER c. PERMIT DATE:� COMPLIANCE DATE: Separation Distance Between the: C Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility J Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) r Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY l L d a 1� l C 3Y$ far 3a ° Q�" 16pY`' O O Town of Barnstable BIKE r, Regulatory Services Richard V. Scali, Interim Director • snaxsTnaLE, MASS Public Health Division rEc +A Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form g a©\F,-� ----Assessor's Map\Parcel D -- Date: ��0 �? � Sewa—'e Permit#- ��-. Designer: eie-4d 1✓1 G Installer: Address: �� �� ��1 Address: On Leas issued a permit to install a (date) �(installer) septic system at (0 W Q v_R V e f LN CA`�ased on a design drawn by (addre s) (, P�� SyV�S 1✓�c dated (designe l)arrt,�,,l�.��-/ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10"' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was construct e with the terms of the RA approval letters(if applicable) RA (ln aller's i atur ' 4 9 esigner's Signature) (Affix Designers amp Here) PLEASE RETURN TO BARN ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT.:CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc ToWn df Barnstable P# DepartinentofRegulatory'Services $ -Public Malih'Division Date MAM «gyp 200 Main Street, _Hyannis MA,02601 Date Scheduled 2 f! Tl'tne _ Fee Pd._ J oil Suitability Asses `ent for Sewage'Disposal Performed-BY: Witnessed By: LOCATION&:GENERAL'W'ORMATION Location Address (0 6 .C1,j�•��Z��N �i =0wnoes Name �n `^, I P A L A,O Y' R7 UIN'A Address 6 v 47�4Q f1�V �JO Assessor's Map/Parcel: G �e"'�, "`A i Engineer's Name NEW CONSTRUCTION REPAIR ` Teyle hone# 13 f Land Use Slopes'(-%)_ "t is Surface Stones � v Distances from: Open WaterBody� Possible Wet Area� • ft Drinking VYator'Well _ l�6 , Dcalhaga Way a. i ft '•Property-Une {t Other ft SICE'TCIie(Street name,dimensions of lot.exact locations of test holes&pare tests;lobate wetlands in proximity to holes) - , S�,�,�. j2�e-• � �- I" lam- �`u���� 6 1.� • Parent material(geologic) L _ d Depth to Sedm'k Depth to Groundwater, ding Water in Holo: Weeping from Plt Pnee Estimated Seasonal High Groundwater DETERA ATION FOR SEASONALMIGH WATERNABLE Method Used, Al . - Depth Observed s nding in obs.hole: la, Depth to sell mottles:, Deilth to weeping from side of obs,hole: ln, 'Groundwater Adjustment 1t. Index Weli# Reading Dato: index Well leveler Adl,fhetbr..,,,.., Adj..tlroundwatbrleval,.,_ PERCOLATION TEST- ~We x 'Thnr ObservationHole 0 - � Tliite at 9. ._ . Depth of Peen \ � Time at.6" Srt Pro-soak Time® 1 1 ta T lino(9'.6") 1 l End Pro-soak ���• Rate-Min./Inch l i+ Site Salability Assessment: Site Passed Site Palledi Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be.Cotnpleted on Back------- ' ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Consarvation Division at least one(1)week prior to beginning. Q:%SEPTICIPBRCPORM.DOC 0 �S DEEROBSERVATIONHOLE LOG Hole# Depth from Sall Horizon 5011 Texture Shcl Color Boll. 4thrr Surface(in.) (USDA) (Munsell), Mottling (Stnucture,StoneA;Boulders. Carrsis tencv.96'Ornvall L `'-Al '! 1,2r) ��. 2 �� 7/ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ^1 it t, y Z C :� 7I 'DEEP'OBSERVATION HOLE LOG HoljD# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(In.) (USDA) (Muosell) Mottling (Structure,Stones,Boulders.. DEEP OBSERVATION HOVE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Boll ther Surface(in.) (USDA) (Munsell) Mottling (Structure,Scones;Boulders. Consistency, QMyJll Flood Insurance Rate Map; Above 500 year flood boundary No Yes- Within'50or year boundary - No + Yes Within 100 year flood boundary No., , Yes Depth of Naturally Occurring-Pervious Material Does at least four feat of naturally occurring pe s aterlal exist in all areas observed thrpughout the area proposed-forthe•soll absorption system? If not,what is the depth of haturally.•,occurring rvious matarlall .. Cefti--�°;'• I certify that on (date)I have passed the soil evaluator.examination approved by the Department of-Environ ntal• -rotection and that•the above•analysis was performed by ma consistent with . the required ra n , ertls a d•exp rience described 10 CMR 15.01 Signature Date , Q-%Bpf rlCkPBRCPORM.DOC 1rt� Town of Barnstable P# � . Department of Regulatory Services ewuver U; P Public Health Division Hate M _ Pr'1 pP r'6 A 200 Main Street,Hyannis MA.02601 1 r 3 Date'Sclieduled ( Time` 11 /1V � -. ]Fee iDrl._ � �, c� ►Sruitability AssesSment,f'or Se e Dispo10 s x Performed By: —� Witnessed By: J LOCATION& GENERAL INFORMATION Location Address 1 U U3 � Owner's Name l 1 Q, -) � Address ( � eti Cry t� � � Assessor's Map/Parcel: Jv "C 5c I S�� Engineer's Name � n(1 t4al NEW CONSTRUCTION REPAIR Telephone# a9 4 -+y cf 8 Land Use �Sl(�P.(�`�-t5A Slopes(%) Surface Stones /j {� .. Distances from: Open Water Body f1 ft Possible Wet Area—`1 ft Drinking Water Well _t?IA_ft Drainage Way t� Pr ft Property Line O ./' ft Other I`r 1 s_ ft SKETCH.'(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands fn proximity to holes) •F'tofl�� Parent material(geologic) V l Depth to Bedrock Depth to Groundwater. Standing Water in Hole: � Weeping f-otn Pit Face kt f9C�0 Estimated Seasonal High Groundwater r' Ar ,.$QTr QA T DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: _ Depth Observed standing in obs.hole: In. Depth to Soil mrittles: la, Depth to weeping from side of obs,hole: in, Groundwater AdjuNtment (r. Index Well# Reading Date: Index Well lever ,_r Adj.Nelor. 9e Adj.C)roundwater Level PERCOLATION TEST Date 5,11we 11;oy Observation - Hole# Time at 9" . `r Depth of Perc _ �•}� Time at 6" Start Pre-soak Time @ (I C�C� Time(9"-6") -Min End Pre-soak Rate Min./luck _ L�MO� ••i. !5 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health ivisiom g' ,R -,� Observation Hole Date To Be Completed on Back---�--- ***If percolation test is to be conducted within 100'-of wetland,you must first notify, tlae. Barnstable Conservation Division at least one (1) week prior to beginning, Q:\.SBPTIC1PEaCPoRM.DOC �D ( iV J � �0 DEEP-OBSERVATION DOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. onsi tency %(3ravel) at'et5 DEEP OBSERVATION BOLE LOG Dole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsi ten 95Gravel) Q JL �3 IJ A Fy L3 ''C i 5C',� 15 34 tf bow DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%(joych DEEP OBSERVATION HOLE LOG ',v. Hole# Depth from Soil Horizon Soil Texture Sol!Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Flood Insurance Rate Man: Above 500 year flood boundary No— Yes . Within 500 year boundary No ,1.� Yes Within 100 year flood boundary No..V Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perA s material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is'the+depth of naturally occurring pervious material? Ceartification I certify that on Q^ �� i (date)I have passed the soil evaluator examination approved by the Department of EnviroamentalprQtection and that the above analysis was performed by me consistent with the required trAinin ,exp n x erience described in 10 CIvM 15.017. Signature Date i QASEPTiC�PERCPORM.DOC q, Z-0� � COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS Z DEPARTMENT OF ENVIRONMENTAL PROTECTION Y W S�e'� pPk 2 8 LO14 Q�N N V' � : �NuLE TIT L HEP& DEPT' OFFICIAL INSPECTION FORM—NO OR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION r� Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner's Name: O'SULLIVAN Owner's Address: 55 BROMFIELD ST.QUINCY MA 02170 Date of Inspection: 4/6/04 Name of Inspector: (please print) JOHN GRACI,INC. z ��®• + vIAP Company Name: SEPTIC INSPECTIONS PARCEL. + Mailing Address: P.O. BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 oYsses e 5(310 CMR 15.000). The system: X Passes _ Conditional _ Needs Furt errs valuation by the Local Approving Authority Fails ) Inspector's Signature: Date: 4/6/04 The system inspector shall submit i opy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspectij n. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner sh I submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ****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. Talmo c T.,o..n +;-Fnrm h/1 S/?000 1 Page y of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired.The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed ND explain: n/a Page 3,of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance n/a "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: n/a Page 4,of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than'/z day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped n1a. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] NO (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone It of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. A Page 5�of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 Check if the following have been done.You must indicate "yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site ? X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no X _ Existing information.For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] S Page 6-of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents: 2 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd))'=�e 0 2 . Z3300 Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sqft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X 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) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 18 YEARS PER OWNER Were sewage odors detected when arriving at the site(yes or no): NO Page 7-of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 BUILDING SEWER(locate on site plan) Depth below grade: 48" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 42" Material of construction:Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: L 8' 6" H 5' 7" W 4' 10"" Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle:33" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 24" Distance from bottom of scum to bottom of outlet tee or baffle:0" How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP: _(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a 7 Page$of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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 STRUCTURALLY SOUND. PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 4' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. SYSTEM SHOWS NO SIGNS OF FAILURE.PIT WAS EMPTY AT TIME OF INSPECTION.BOTTOM IS AT 10 FT. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a a 4 Page.10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet.Locate where public water supply enters the building. 2�3 �� 2U 0 Page„11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 166 WEQUAQUETTE LANE CENTERVILLE,MA 02632 Owner: O'SULLIVAN Date of Inspection: 4/6/04 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: HAND AUGER- 12+FT. y� FE:B.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ......... .0..............OF........�d-�r.G.l'P.). A.Z/c..------..............._.............. Appliratiun for Uhgpoii al Works Tontitrnrtiun Vamit Application is hereby made for a Permit to Construct --,/or Repair ( ) an Individual Sewage Disposal System at: L / l / Location Addres6/y( l or Lot No. _.;�?. /T/ C. .......���r2./�..... ..�. Owner _ Addre s -------------------- ._...--- ................ Address UType of Building Size Lot..94_r.17_-_..S eet Dwelling—No. of Bedrooms.................. .....................Expansion Attic ( ) Garbage Grin de k_* pa, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria Q' Other fixtures ..........................•••-----••-_....._ W Design Flow.................... __...............gallons per person per d�j y. Total daily flow................ ...............gallons. WSeptic Tank—Liquid'capacity_4040gallons Length..�r f':_ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... __..._.._._.__. Total Length..._...._......... Total leaching area....................sq. ft. Seepage Pit No........./--------- Diameter...../Q.-_...._. Depth below inlet_ __________ Total leaching area.Z$/_.$..�q. ft. Z Other Distribution box (r­f Dosing tank ( ) A Percolation Test Results Performed by___�l"�dGe_ ,f.��!t� 1(!1 � Date___..._�1118-3........... ,aa f/fil-6 Test Pit No. 1__� ---___minutes per inch Depth of Test Pit------- ?....... Depth to ground water.../_CA?/_2 rT Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --•-------- ---•----------------- --•--••------------•••--•--y --•-••••...•--....•-•- .. •••-• 0 .Description of Soil........................p' 5 ......,11'�p �� ! 5c �1 �n�'S i p � -........ _. ..........................................••--------..... .---• � 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 iITLL 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. Sig , .....-•----•--•----......--•........................:..............•---.._..----_• ............. Date Application Approved By --•--•- -- - ----------------------------•--_-•...._..........._...---•--•---•-- Date Application Disapprovedllowing reasons:-•-•--•--••--------•-------•---•----•----•-------•-----•-•----•-------------------•-••-•--......----...•-----._ ........••-••--•-•--•-•-•••-•----•••••-•------•••---------------------••......-•---•---•-•-•••------...••----•--------••-•------••---• ----•••------•••-••-----•--•••--••-----------•--••---•-•---•----- Date PermitNo......................................................... Issued....................................................... Date w k . No.. Fps.......... ....... ...... THE COMMONWEALTH OF MAS'SACHUSETTS t BOARD OF HEALTH , rl ration for Uiii' rr it Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal S stem Sat ,, -L _•a-��c'-7'-• 7C ..CCr� /'�i+�l�!L� / %?gf�a�/C ...... .................. ..'Location-Address 11// or Lot No. ' . ---------- - Owner Address ----• -----•-•••• ----••-•---•- ti Installer �. Address 2/ L�� U' Dwelling gNo. of Bedrooms _........................................___Expansion Attic ( ) Garbage Grinde ; T e of Buildin Size Lot_______. Other—Type of Building ............................ No. of;persons._;._ ..__.._.. ..-_.. Showers ( ) Cafeteria a Other fixtures ........................ Design Flow .___.. ,_:. a gallons per person per day Total daily flow............... 9 ...............gallons yW ' G4 Septic Tank Liquid capactty���gallons, ` Length ✓ c.P ��tdth Diameter Depth............... Disposal Trench—'�To Width TotalLength, Total leaching area _.. sq.-ft. i Seepage.Bit No...__.__j-_,_.___.. Diameter-- ld.-- ..___ Depth below inlet _;. ._____. Total eaching area �5Zsq. ft. Z Other Distribution box,(✓) Dosing tank ( ) f Percolation Test Results' Performed b /" ?' "_ � 'f !? -+ 'Date._.__- y./�"�_...____._-, y:-- 7 „ Test Pit No. 1-<. -...._.minutes per inch Depth of Test Pit._, Z........ Depth to ground water:.A1vnG4:---, Test Pit No. 2.........___....minutes per inch Depth`=of Test Pit.................... Depth to ground .water__ -..-............... O Description of Soil fir. /G"�- !t �� ri5 c? � -G , r _---- _-t_ ....................... ...... --- 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 iT: 5,of the Slate 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. i Si ........... ............................4-1 Application Approved BY .... : y Date Application Disapproved r t f ollow4n9 reasons:--- --- ..........._............. _ --•--- -- ------ ----- •---------- • ................. Date ` t Permit No..........................-•••-•-------••-----••-------- Issued.............•.......................................... f a Date ,a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f ' ........OF......... Trrtif iratr oaf f gwtialtrr a .` IS 0 CERTIFY, That the Individual Sewage Disposal System constructed (do or Repaired (` ) - bY-- --• -• •--- .... .- --•- --- ••-_.... Installer lias.been tnstalle(i in accord nce with the provisions .of .I.�, j_of The State Sanitary Cn ,c] scribed in the e application for Dig Posa�l \ r1�s-Construction,PermtN r C-�_�, ; dated: - ------ THl' ISSUANCE.OF T (S CERTIFICATE SHALL;NOT EE CONST.RUED�AS A GUARANTEE THAT THE NCTION SATISFACTORY. TEMV��[SYS DATE Inspector ector _4._ ---- ----- -------•- --------- -----•-•-------•-- ! -------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF.- HEALTH r - .........:......................OF............................. _. ... -.... _...... FEE:_� No ... ......... i n t1 u kkudivA Vamit x Permission is,hereby granted - -_ --� • --- ••-• - to Constr ) or Re ti, ( ) an Ind 43a1 Sew e Disposal System at No as shown on the application fo l Disposal Works street rks Construction Permtt No.__ :!_ Da- _j_i_' ._ ...... ......... Board of Health DATE: -•-•--, FORM 125 HOBBS & WARREN, INC PUBLISHERS �, ,?s.. ,.,.. .! _ ..� a' �� .,!-�i. ,-. a s -..::;. .,s: ,..;.�_w�3.xa?z+I•j.;...,. .. ..�.,...�a,.w:.�..u _n_,,��.,�.._...._:.. ..a tom.., �.d,�:.r. ...... ........ .. .d....,,i.... �#w , � f /6C LOCATION SEWAGE PERMIT NO. JA)P Qum a�/ ZA1 3" L VILLAGE INSTALLER'S NAME i ADDRESS f',�-�WsTota�L B U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED t �v� s f L4 �1 ss I LEGEND CEN'fERVILLE EXIST. LEACHING PROPOSED CONTOUR 64 See note 1.0 ® PROPOSED SPOT GRADE \� -- 98 -- EXISTING CONTOUR 62 WEQUAQUET 4, LAKE o + 96.52 EXISTING SPOT GRADE I en`,60 3 W— EXISTING WATER SERVICE ��, j TEST PIT a i p .32 pp, T"� � � o O SCALE: 1"=20' s� � I �' O y Ty,2 Q�� —r I O I I io f 3 LOCUS r i RTE 28 LOCUS MAP �U 4? 62 LOCUS INFORMATION J TITLE REF: 24416/77 o o J I j EXIST. 1 ,OOOG PARCEL ID: MAP 250 PAR. 159 IN STATE ZONE II Q x z II SEPTIC TANK W C) 0 J J Lu SEPTIC SYSTEM _W GAS REPAIR PLAN 64 LOCATED AT: WATER �' #166 WEQUAQUET LANE 0 GATE \� PAVED DRIVEWAY I CENTERVILLE, MA. PREPARED FOR PAULA MOURA/ J 66 ---- —J READY ROOTER EXC. � ------ JUNE 15, 2016 Jill REV: JUNE 20, 2016 $ OF �Ass9 ARR N ME R -a V O. 'PFGISIE� } MEYER & SONS, INC. P.O. BOX 981 PLAN BENCH MARK EAST SANDWICH MA. 02537 \` PAINT SPOT PH: (508)360-3311 SCALE: 1 in = 20 ft BLACKTOP CORNN ER 0 20 40 BARNS 9.E2c0is OAru FAX: (774)413-9468 meyerandsonstitle5®gmail.com 0 10 20 40 ,� SHEET 1 OF 2 J 1808 ELEV. TOP - FOUNDATION NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS (Existing) BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE FINISHED GRADE (61.50) max = 67.24 �F.G.EL: 62.0 F.G.EL: 62.0 F.G. EL: 60.0 � VENT a MAINTAIN 2% MIN SLOPE OVER LEACHING AREA SLAB EL. 59.74 X 2" OF 3/8" DOUBLE WASHED - F.G.EL: 59.31 3/4" 1-1/2" w DOUBLE WASHED STONE • • •.• • �� .: STONE OR FILTER FABRIC " 6" T 4" SCH 40 PVC 10"I MIN. ®®®®• O ®®®® 14 6 S= 1% ®®®®®®®®®®® TEE'S ARE TO BE INV.56.75 ®®®®®®®®®®®9M 4" SCH 40 PVC 2 EFF. DEPTH ..Y...a" INV.58.05 4r r INV.56.55 3.2 3 X 8.5' 3.25' GAS J PROPOSED DB-3 EXISTING OUTLET BAFFLE EFFECTIVE LENGTH = 32' :.• • ..,, .. ....- . ..•. DISTRIBUTION BOX INV. 58.3 (H20) INV. ELEV.= 54.50 EXISTING 1,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON �� OF ' ss9 BREAKOUT OUTLET TEE AS MANUFACTURED BY o ARREN M. s ELEV.= 55.50 TUF-TITE, ZABEL, OR EQUAL o M YER TOP CONC. ELEV.= 55.50 INV. ELEV.= 54.50 - ®� ®®® NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING \ ®®®®®®® PIPE INVERTS PRIOR TO CONSTRUCTION ST ®®®®®®® 2) TANK AND D-BOX SHALL BE SET LEVEL AND -4140a� BOTTOM EL.= 52.50 ®®®®®®E3 TRUE TO GRADE ON A MECHANICALLY COMPACTED 2' 5 FT. 2' SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2) SEPARATION 5.00 FT. TIME wi- - 9 3) INSTALL INLET & OUTLET TEES W/ SEPTIC SYSTEM PROFILE GAS BAFFLE AS REQUIRED BOTTOM OF TESTHOLE EL: 47 0, _ SOIL ABSORPTION SYSTEM ECTION (500 GALLON H2O LEACH CHAMBER) GENERAL NOTES: SOIL LOGS P#'1508g GN CRITERIA I. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL NUMBER OF BEDROOMS: 3 BEDRO BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: JUNE 20, 2016 SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) OF THE STATE ENVIRONMENTAL CODE. TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN IN LOCAL RULES AND REGULATIONS, EXCEPT AS NOTED BELOW. SOIL EVALUATOR: DARREN MEYER, RS, CSE 1614 / - 310 CMR 15.405 (1) (e): WITNESS: DAVID STANTON, BARNSTABLE HEALTH DAILY FLOW: 110 G.P.D. X 3 BR = DESIGN FLOW: 330 G.P.D. 1) A 3.00 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING GARBAGE GRINDER: NO (not designed for garbage grinder) TO BE 6.00 FT (MAX) BELOW GRADE VS REO'D 3 FT. (H20/VENT PROVIDED) I 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR ate. TP-1 Depth Bev. TP-2 SEPTIC TANK: TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE �' 330 gpd x 200� = 660 gpd, USE EXISTING 1,000 GAL SEPTIC TANK DESIGN ENGINEER. 59.50 0" 59.50 0 FILL FILL (330) = 445.94 S.F. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING LEACHING AREA REQUIRED: FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 58.00 A 18" 58.00 A 18" .74 ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. LOAMY S3A/2 LIOA 3/2 ° USE THREE (3) 500 GALLON PRECAST H2O LEACH CHAMBERS W/ 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 57.50 24" 57.50 24" 3.25' STONE ON ENDS & 2' STONE ON SIDES: 32' L x 9' W x 2'D THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF B SANDY LOAM B SANDY LOAM HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 10YR 5/6 10YR 5/6 BOTTOM AREA: 32 x 9 = 288 SF 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 55.50 C 48" I 55.50 C 48" SIDE AREA: (32 + 9) X 2 X 2 = 164 SF 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED PERC O FINE SAND I FINE SAND TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. EL. 53.67 2.5Y 7/3 1 2.5Y 7/3 TOTAL SQUARE FEET PROVIDED = 452 vs. 445.94 REQ'D 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE 51.83 92" 51.83 92" THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING C2 MEDIUM- C2 M _ DESIGN FLOW PROVIDED: 0.74(452 S.F.) = 334.48 G.P.D. vs. 330 G.P.D. req'd CONSTRUCTION. SAND I SAND 10. EXISTING LEACH PIT TO BE PUMPED. CRUSHED AND FILLED PER TITLE 5. 2.5Y 7/4. 2.5Y 7/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 47.50 1 144" 47.50 144" t2. TAND HIS IS NOT TO BE CONSIDERED SEPTIC SYSTEM NE SURVEY US ONLY 166 WEQUAQUET LANE, CENTERVILLE, MA <2MIIN/INCH IN "Cl" SOILS 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. NO GROUNDWATER OBSERVED Prepared for: Moura/Re dy Rooter Exc. 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. Engineering and Survey by: SCALE DRAWN DATE 15. ALL PIPING TO BE 4• SCH 40 0 1/8-/FT (UNLESS SPECIFIED) + I, Darren M. Mayor. R.S., CSE, hereby certify that I am Curren ey fy ty approved by MADEP pursuant to 310 CMR 15.017 MEYER&SONS,INC. N.T.S. DMM 06 15 16 to conduct soil evaluations and that the above analysis has been performed by me consistent with the PO Box981 SHEET N0. requirements of 310 CMR 15.017. 1 further certify that I hove passed the Soil Evol. Exam in October, 1999. EAST SANDW/CH,Ado 02537 REV. DATE CHECKED 508-362-2922 06/20/16 DMM 2 of 2 S/ TE PL A /V T YPICAL PROFIL E SCALE — l " _ �� �S c� NOT TO SCALE /B"SrO. L T. WGT C.I. MH COVER 4"C.1. PIPE — 4"Bt T FIBER PIPE TIGHT ,'/?/,V TS "-- FLOW L INE OUTL E.r LEVEL OrYEL L lNG 6 z /0" _-- - I4 -fi— -- o O O - i r----- — 1 TSTANDARD .I. rEE C.LTEE�z� - PRECAST `- 7,0 0 CONCRETE«'aO GALLON �U-I . G SEPTIC TANK 01STR/3UT.ION BOX J - B TO BE INSTALLED ON f LEVEL , STABLE BASE. SEPTIC TANK — rO BE INS TA L L EO ON / LEVEL , STABLE BASE 2"- //B" TO //2" WASHED PEASrCN.-- LEACHING P/T ALL AROUND FREE OF IRONS, FINES BASF_ TO L E t T ANO DUS T IN PL_ ACE _ BRICK 8 MORTAR COURES 3/4" TO I-I/2" WASHE D CRUSf/F. AS REOUIRED M BRING STONE ALL AROUND' FREE Cx- COVER rO GRADE. 24"C.I. MH COVER IRONS, FINES ANG OUST /N PL 4CF AND FRAME -- -------- - -- --- - La ----- ® 4 --- - ` LEACHING PIT SEC TION- INL£T- B' FLOW LINE - - - _1 - --------- _-_-._- PIPE I. CONCRETE TO BE 4000 PSI 28 DAYS ZZ dU w I 2. REINFORCED 'vV:TH 6'' x 6'' NO GA 'rV.W M. dj r 6 3. 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER 4".4v.0 Q ! �I DEPTH REQUIREMENTS. OPENING W/TH 4-//8 4, NUMBER OF PITS REQUIkEC -- I - OUTER DIAMETER 8 NOTE : EXCAVATE TO ELEVATION -__- -OR LOWER AS s 4 I I /-3/4 INSIDE DIAMETER 3" REQUIRED TO REMOVE ALL LOAM ^',ND CLAY BENEATH STD, ►� �� 4gT �7 �y r �(L. ( tP PIT REPLACE EXCAVATE(: PIATERIAL WITH CLEAN JAIG, GRAVEL TO DESIGNED GRADE rT ,y 'Ad,a 4 4� , L � 6,, _ - .r MIN. Cpfu,iG, I-PRA414 ti �� I EFFECTIVE DIAMETER m!$.4�i;�..i c1U d-/ 0 i (NOT TO EXCEED 3 TIMES EFFECTIVE DE,0TH) I - `v l \� C�� 2 i , Z 7 `�+ �--�� WATER TABL E -- - -� 4 SOIL AND f ERC. OQ TA GENERAL lV O TES I _ N 170 `741 a2" yi PERC. RATE L MIN. /IN . NO HEAVY EQUIPMENT TO RUN OVER SYSTEM TO 5' -P Til At ,lp I�t2UGe � C- L P WM, IyVA R�,C./tG14 ,AhS%.C, SEPTIC TANK, CISTRIBUTION BOX , LEACHING PITS TO BE STANDARL I�ACKr- s L WIT64 N ZV 4G5' Z� " E I5�'j, pp ' TEST BY: PRECAST REINFORCED CONCRETE UNITS isiT4p�L MAT.0IKlAj. l WITNESSED BY: Jy N &J J A Co b 1 ( p, t3, A. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TEST PIT GR. EL.� TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE , _ ��"'� f L ,u G _ DATE : S��l�� MINIMUM REQUIREMENTS FOR THE S )BSiJFACE DISPOSAL OF G- TEST PIT NO, I TEST PIT NO. 2 P 1'j67 '^L&4,,- SANITARY SEWAGE EFFECTIVE I juLy 1?77 O' 0' ANY CHANGES TO THIS PLAN MUST BE �"•FPROVEC BY THE TOf /�vr�hotc... Tatra/Svt�ott.. BOARD OF HEALTH. FIk.JEl� 4 GL >aY Al- r- ik-, r5 _ 5' 5' � "- ' � AT COMPLETION OF CONSTRUCTI(jN f'RI� R TJ BACKFILLING 'HE GaAR3E SJsIJD 7 Ivy F O f U M C BOARD OF HEALTH SHALL BE NOTIF;E FOR INSPECTION. ' NAP-Pt,.IhA 5A'ti1D PITCH ALL SEWER LINEq 1,'4" ,' FT UNL-ESS INDICATE^ IL SAn-I!7 � .02 --- L �? OTHERWISE. tll0 4G2oU1U0t,ciArf�(•L tic Cat?oL)KlPVJkT1cm DESIGN DATA - BEDROOMS 3 _ DISPOSAL pal F_ EST. TOTAL DAILY EFF. GALS. LEGEND - SEPTIC TANK lyoo GAL. 92 SIDEWALL AREA GAL./SO. FT. BOTTOM AREA I'V GAL./SQ. FT - SEWAGE GE DISPOSAL / T EXISTING GRADE LEACHING'REQUIRED 14"'"�� SQ.FT ,�r S I E/n V; ZONE ___ _ '" R =� FINISHED GRADE ACTUAL LEACHING AREA SQ.FT F�'K DOMEST!C WATER SOURCE: T19xj K.i '�' ��T r 9INVERT ELEVATION , PROPERTY LINE ^' �EU7gz�2 Z �J� PLAN REFERENCE - MEAN HIGH WATER SCALE' AS D,' T'E _ ' /_Z�1- 1'1- BENCH MARK DATUM 4�'5 742 �'o MARSH p -- — —_-- _ ►NM M AIA hWICK 5 A : nC/NTE �' ✓ r` i E It tU 0 h� - LA A 7-A. ia, C L FOX 80I - 11/0ri rH FA L .MOI J T H C?556 C HU,3E T T,-