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0052 WESTMINSTER ROAD - Health
52 Westminster Road Centerville P A► = 168 067 No. 4210 1/3 O A Ips n d& 10% ug O o O a Fee THECOMM Entered in computer: COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MA&3ACHUSETTS Yes ZIPPrtcation for W5pagal *pgtem com9truction Pvermit Application for a Permit to Construct( ) Repair(ao<Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. `L WeSi?y,t6,DS t Cf ;]1 Owner's Name,Address,and Tel.No. �ICJ Assessor's Map/Parcel Installer's Name Address,and Tel.No. Designer's Name,Address and Tel.No. k5 A Name, TNa svf3-yod-71 gy t ,,,���,cP tV"tis CA)C7 t ks Type of Building: Dwelling No.of Bedrooms '; Lot Size ®S'�g�— sq. ft. Garbage Grinder ( ) Other Type of Building jgo vs 1e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided �n� 3 gpd Plan Date f 1105 Number of sheets £2_. Revision Date Title Size of Septic Tank 1000 5t-in1�. Type of S.A.S. A re, 3G OG Description of Soil Nature of Repairs or Alterations(Answer when applicable) r mc,{- -ti A)eW S A ,�) 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 r of ealth. Signed Date it Application Approved by Date . Application Disapproved by: U Date for the following reasons Permit Date Issued �. yt No. J Fee i V l THE COMMONWEALTH OFAASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Y a tI � Y r 'Application for Dizpogal 6p5tem Cowaructioi Verm.it Application for a Permit to Construct( ) Repair(✓j Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 5 /-wes+m tn)S t r( ' Owner's Name,Address,and Tel.No. � t, C C^�t—&v 1 11 p II+ Assessor's Map/Parcel In taper's Name�Address,and Tel.No. Designer's Name,Address and Tel.No. ItrS ga,SlC��^� NC 5-DE5 400-7/5_`! CwStnzrPft+�S WnikS Type of Building: Dwelling No.of Bedrooms Lot Size � e � sq. ft. Garbage Grinder ( ) Other Type of Building I(2 us!e No.of Persons Showers( ) Cafeteria( ) Other Fixtures } Design Flow(min.required) 3 gpd Design flow provided 3�(,, gpd Plan Date A 31 I Number of sheets 'L_ Revision Date Title r l Size of Septic Tank 1000 EX IS y c Type of S.A.S. A Description of Soil Nature of Repairs or Alterations(Answer when applicable) I Ns 1 C.I I O e(A) S A •S \ M } Date last inspected: Agreement: JThe 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 r of ealth. Signed Date 1111716-)5 Application Appr`ovFd by Date Application Disapproved by: Date for the following reasons Y a� o Permit No._a, n- ?>77 f' Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( �raded ( ) Abandoned( )by<� �fti 5 at ,0- (,mile cr An 1n3c F r/ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ),( - 3 K dated ,) Installer'D V)j-s A 79(oww TNc y Designer C ti�,y t.t. i�,a Id71�1 #bedrooms _� +' Approved desigrrflQw A t4r.. gpd The issuance of this pe it shall not be construed as'a guarantee that the system will functto a�deesigne . Date ��$ �� Inspector �_ �- N. `_J' U �j� ) Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS mi,gponl *p6tem Construction Permit Permission is hereby granted to Construct ( ) Repair ( Upgrade ( ) Abandon ( ) System located at S 2 w,,s+,���E,,/, ,✓lA ef'. .t, and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty 101'to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date `� b Approved by VK\ L ;1 1 TOWN OF BARNSTABLE ' OCATION X W ca%t 1 wS1 r( SEWAGE# VILLAGE `e ASSESSOR'S MAP&PARCEL 168 06`y INSTALLER'S NAME&PHONE NO. t. A SEPTIC TANK CAPACITY rnex � SCI.S� faiA) d&C'e LEACHING FACILITY:(type) ACC (size) 81,K60 `NO.OF BEDROOMS _*) OWNER W&JC. PERMIT DATE: COMPLIANCE DATE: 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 Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BYC_ G® c wr 2c.5 2,8 91 11,A fc,3Cft-it aO 004S IN `51, Fcps K0,,ATT g 0,4 7-2.0 0� �pxis�;eqq���S Py"r �Qt I e, s r N, � A..... W , TM .,,, m�i',..Gd ,� .w.s,,,,r #✓.Z+`, ..' .' ...'„'`�!„'v �, :.�.ao- - ,« �,w ti'.n .'�,,.., :�' cea. INSTALLATION GUIDE IG 8.01 Arc'" 36 &Arc 36 HC Chamber July 2008 The Arc 36 and Arc 36 HC chambers are an economical, easy-to-install alternative to the conventional on-site leachfield system. In a conventional on-site leachfield system, 4-inch pipe and gravel are used to fill the excavation. The Arc chamber units eliminate the need for gravel, thereby reducing many of the problems inherent in gravel systems, including compaction, loss of storage, and fines. The open bottom design of the Arc chamber maximizes infiltrative surface area, while its structural design ensures long-term trench integrity. As allowed by state or local codes, chamber system designs commonly result in sizing credits that reduce the leach field area required within the field footprint. This affords a decrease in machine time, trucking costs, and labor to the installer and increased usable land to the homeowner, and developers. Trench Installation Guidelines 1. Excavate trench to proper width and depth as described in the design and required by state and local codes. Excavation and proper elevation should be set according to a permit formulated from a soil evaluation by the local health department, soil scientist, or engineer. For any traffic condition up to an AASHTO H-10 (16,000 Ibs/axle) maximum load limit, the minimum cover over the crown of the chamber shall be 12 inches. The total minimum trench depth,when measured to the bottom of the chamber, shall be 18 inches for the Arc 36 and 22 inches for the Arc 36 HC, both in non-traffic applications. For trench installations, a minimum 3-foot wide trench is required for both the Arc 36 and Arc 36 HC. Reference system design and state or local codes for minimum separation specifications between trench s lines. r' 2. Smooth irregularities in the excavation and trench bottom and clear any large rocks or debris from the bottom of the trench. Scarify the soil if smearing is present. ADS/Hancor Inc. recommends all drainfield trench bottoms or 3 absorption beds should be prepared level. Any allowed slope or fall should be � n determined and based on your state or local codes. 3. Chamber Assembly ! , a. Install the first chamber with the"dome end" (A) of the "lock&drop"joint at the header end of the trench. m Please reference the installation directional arrows which are located on the top of the chamber % inspection port. (A) b. Assemble the Arc 36 or Arc 36 HC chambers in the trench excavation by first placing the"dome end"of (B) the incoming chamber over the"post end" (B)of the chamber already in place. Raise the post end of the incoming chamber and slightly pull the chamber back until the dome stops and is locked into the post end joint. c. The trench area in front of the base should be free of rocks, ` soil clumps or other obstructions to ensure proper base fit and "lock&drop"joint chamber engagement. A positive connection to the"lock&drop"joint will occur when the incoming chamber is laid flat on the trench bottom. www.arc-chamber.com 1 AIG801 ©ADS 2008 Bed Installation Guidelines 1. Excavate bed to proper width and depth as described in the design and as required by state and local code. For any traffic condition up to an AASHTO H-10 (16.000 Ibs/axle) maximum load limit, the minimum cover over the crown (top of chamber) of y �' the chamber shall be 12 inches. f. 2. Smooth irregularities in the excavation and clear any large rocks or debris from the bottom of the bed. Slope of the bed shall be determined based on state or local code. 3. For chamber assembly, see steps 3 through 10 in the Trench Installation Guidelines above. 'Cover height and live loading limits are impacted by both soil type and compaction requirements.ADS/Hancor,Inc.should be contacted when poor soils are encountered or,if unknown,when fill heights exceed 4-feet. ' S nY�N;eawH .aa� y Arc 36 Arc 36 HC Length(A) 63 in 63 in Repeat Length(E) 60 in 60 in Invert Height(B) 7.25 in 10.74 in Overall Height(C) 13 in 16 in Overall Width(D) 34 in 34 in Capacity 8 cu ft 10.7 cu ft 60.14 al 80 al 4 www.arc-chamber.com AIG801 ©ADS 2008 Aor"?h f ire vlt d. A"push-out'tab is located on the"post end"of each chamber. This tab should be utilized at the end of each trench line run to prevent soil migration from entering the septic system. Press the "push-out"tab over the"post end" lip until it snaps into place. "I tMA P , e. Arc 36 and Arc 36 HC chambers are designed with an articulating joint that allows for a free-range horizontal rotation of 20 degrees,with z a maximum of 10 degrees in either direction. Do not over-rotate the " , joint beyond 10 degrees. Each Arc chamber is equipped with the"lock &drop"joint which will allow up to 10 degrees of rotation per five foot chamber section. Installation of the Arc Side Port Coupler(SPC)will increase trench radius of up to 10 additional degrees of articulation in either direction or increase plumbing inlet options. a, This unit can be installed between any two chambers within the trench line or at the end of a run with the universal <• end cap. I 4. Prior to installing the end caps, remove the appropriate knockouts for pipe connections by placing the end cap face down on a hard surface and cutting with either a hole saw or utility knife. Where a hole saw is used to create a pipe opening, centering pilot dimples are placed in the middle of each knockout for the hole saw bit. The knockout will accept 4° SDR 35,4" Schedule 40 pipe, 4"ADS-3000 TripleWall®pipe, or 4"ADS Leach Bed pipe. 3"options are denoted by the inner ring knockout. Inlet pipe must not exceed 2 inches in length beyond the end cap. Inlet pipe extending beyond 2 inches will interfere with the chamber and hinder end cap assembly. Upper knockouts shall be used for inlet piping. Lower knockouts are provided for return lines or continuous circuit piping.in bed or mound systems. 5. Place lip of end cap over the end of the chamber unit and snap into place. Secure in place with backfill. The universal end cap is designed to fit both ends of the Arc 36 and Arc 36 HC chamber. The end cap shall be placed so that the Arc logo faces outward. Receiving pockets for 6"x 8" splash plates are incorporated into every end cap. 6. Where required by local codes, a splash plate shall be placed under the inlet end of the chambers. Each end cap is equipped with splash plate " receiving pockets. Place the splash plate into the positioning fins prior to end cap assembly. Connect serial or manifold lines of the chambers in the same manner as described in steps 4 and 5 above. 2 www.arc-chamber.com AIG801 ©ADS 2008 i Ar�c _ M / '�i/ ✓/ iG' s 7. The"post end" has slots to accommodate zip straps in order to hang pressure-dosing pipe. Where pressure- dosing pipe is used, end caps should be prepared with a hole saw to adequately accommodate the outside diameter of the dosing pipe. 8. An easy-knockout inspection port is provided in each Arc 36 or Arc 36 HC chamber. Once the knockout is removed,the resulting opening will accept 4"SDR 35 (4.5" O.D.)or 4" Schedule 40 (4.215" O.D.) pipe. The Schedule 40 pipe may require - moderate coaxing with a rubber mallet. Arc chamber inspection ports are " labeled with both size knockout rings. x" Inside view 9. Fill sidewall area to to of chambers with native soil or select fill where required). Fill shall be compacted to P ( P the minimum requirements necessary for the soil type used. "Walking in"the soil is an acceptable means for achieving the compaction level along the sides of the chamber. 10. Complete the backfill of the system with native soil or select fill to the x depth specified in the system design and as required by state and local codes. Avoid large rocks and debris in backfill material, as they may ' eventually impinge on the chamber.As common practice, avoid driving any equipment over the chambers prior to final backfill. Where vehicular loading will be anticipated, all Arc 36 and Arc 36 HC x, chambers are approved for AASHTO H-10 (16,000 Ibs/axle) loading when installed with a minimum of 12 inches to a maximum of 8 feet of cover after consolidation*. 11. When preparing the final grade, grading shall be such that stormwater is diverted away from the drainfield. System final grade should be crested or sloped, never left flat or concave. Channel storm and downspout water away from the drainfield. Final grading " should be slightly to moderately limited soil to help maintain an aerobic state in the drainfield. Venting is not required, but is recommended to promote oxygen access to the drainfield. Venting ° practices may be required by state or local code. ,.., www.arc-chamber.com 3 AIG801 ©ADS 2008 11/18/2009 21:25 5084775313 ENGINEERING WORKS PAGE 01 Town of Barnstable Regulatory Services Thomas F.ceder,Director 1 %L1 g Public Health Division +ass+ Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6304 Office: 3OS-862-4644 �� 3 17 AAss—r's map/Parcel 1 —Q�o7 Date: � Sewage Permit# � seller& er Cert fi lion Form Designer: ti n C- Installer: Address• JZ w. Cce t s :{1 cA 6ZA Address: ��Q• 13 rdul4 I MC was issued a permit to install a On (date) (installer) tics stem at Z � 1`n S>�/ � �'based on a design drawn by � y (address) � dated 3 L ( esigner) 1 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 this distribution box and/or septic tank. Stripout (if required) was inspected and the 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 arty component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required)was inspected and the soils were found satisfactory. OF M4e.L? PETER T. st8 ler's Signature) MCENTEE � CIVIL 9 No.35109 tgner's ignature ( jx Die i$ ) P E iav ARN ABLE P C WI N. CERTMCAU CE l=CAM ARE HE pyM AX—THE T TRAM YOU q:bR9ee fortrmdealgoeteariTimdvn fortn.dnc Town of Barnstable- P# .75 �- Department of Regulatory Services ? 011 Public Health Division Date z.�Q 0 MAK, 2 5W A�� 200 Main Street,Hyannis MA 02601 ' Date Scheduled 0 �q t1.1) Time _ Fee Pd. \ d Soil Suitability Assessment for Sewtage spos l S Performed By. 1 Witnessed By: rQ LOCATION& GENERAL M- ORMATION Location Address n -' Owner s Name ��,, y c� 2. W e5 �w� S/ �/ �`�, � 4Wt n� t90 $ �.✓1 �'�/ Address/ �c�aCoC f 0 Assessor's.Map/Parcel: F_6(01 ? Engineer's Name NEW CONSTRUCTION REPAIR Telephone# —CZT-7 374d'LA-1(D.V land Use )t-`OA l Slopes(%) 2 G u Surface Stones 11)1A Distances from: Open Water Body 7ft Possible Wet Area/ _ ft Drinking Water Well Drainage Way d ft Property Line 36 ft .Other ft .SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) --— C") to t m i n r /� � Parent material(geologic) � £�1 4 V °�� Depth to Bedrock / / Depth to Groundwater. Standing Water in Hole: I-J14 Weeping from Pit Face Estimated seasonal High Groundwater 12 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: 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, ;q Adj.Groundwater Level,,;,� PERCOLATION TEST Date Time Observation Hole# r� Time at 9" Depth of Pere: `.v2 `� Time at 6" - Start Pre-soak Time® " 'Time(9"-6") End Pre-soak Rate MinJlnch. Site Suitability Assessment: Site Passed 11>111-11, 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:XSEPTICIPERCFORM.DOC DEEROBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.. Consistenc� Gravel) o � � 2, 5- DEEP`OBSERVATION HOLE LOG Hole# ` Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%: LS (® (Z'- ,� ZC� b! DEEP OBSERVATION HOLE LOG Hole# Depth from. Soil Horizon Soil Texture Soil Color. Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Can i toncy.%'Graveh DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. Flood Insurance Rate Man: . Ah2ve 500;year flood boundary No_ Yes Within'500-year-boundary No Yes. , within 100 year flood boundary No—J�; Yes Death of Naturally Occurring_Pervious Material Does at least four feet of naturally occurring pervious inaterial exist in all areas observed throughout.the area proposed for the soil absorption system? e� If not,what is the depth of naturally occurring pervious material? Certification I certify that on ` (date)I have passed the soil evaluator examination approved by the Department of Fnvir nmental Protection and that the above analysis was performed by me consistent with . the required.training,expertise and experience described in 110 CMR 15.017. Signature Date Qi\SFpn0PBRCFORM.DOC COMMONWEALTH OF MASSACHUSETTS z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS t d DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED e� �a APR 2 9 2003 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 52 West Minster Road Centerville Owner's Name:Marie Souza Owner's Address: fib. . Date of Inspection: 3/12/03 MAP PARCH Name of Inspector: Timothy Lovell Company Name: Accurate Inspections LOT Mailing Address: 550 Willow Street W.Yarmouth,MA. Telephone Number: 508-771-3700 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 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature. -> Date: 3/12/03 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 is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the 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 At time of inspection ****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. Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection: 3/12/03 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: B. System Conditionally Passes: _N/A 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 infiltration 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 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 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: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection: 3/12/03 C. Further Evaluation is Required by the Board of Health: _N/A 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(l)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _N/A_Cesspool or privy is within 50 feet of surface water N/A 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: _n/a_ 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. n/a_ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. n/a The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _n/a_ 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 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 The are triggered. A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 t OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection: 3/12/03 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'h 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 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: N/A 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 _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 H 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 anoronriate regional office of the Denartment. i ' Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection:3/12/03 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)] Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection:3/12/03 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: 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): _n/a_ Seasonal use: (yes or no): no_ Water meter readings, if available(last 2 years usage(gpd): 2001(49000 gallons)2002(73000 gallons) Sump pump(yes or no): _no_ Last date of occupancy:_current COMMERCIALANDUSTRIAL n/a Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft, etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):— Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: never pumped Was system pumped as part of the inspection(yes or no):_no_ If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: 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): Approximate age of all components,date installed(if known)and source of information: 3/20/95 AV—nu,,. -A—A.+.,t.A—1— o.-r..,..,,.of tt,o—+-A———V AT., ' Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection:3/12/03 BUILDING SEWER(locate on site plan) Depth below grade: 42" Materials of construction:_cast iron _x_sch 40_other(explain): Distance from private water supply well or suction line: 30+' Comments(on condition of joints,venting,evidence of leakage,etc.): Joints look tight no evidence of leakage,venting is working at time of inspection SEPTIC TANK:_x (locate on site plan) Depth below grade:_cover 8"tank 32" Material of construction:_x_concrete_metal_fiberglass_polyethylene_other (explain) If tank is metal list age:_Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 1000 gallons Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: 28" Scum thickness:_5" Distance from top of scum to top of outlet tee or battle:_5" Distance from bottom of scum to bottom of outlet tee or battle:_13" How were dimensions determined: in the field tape measurements_ 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 is structurally sound,tees are in place, liquid level is at invert out,no evidence of leakage tank should be pumped every 2 years for proper maintenance, • GREASE TRAP:_n/a (locate on site plan) Depth below grade:_ 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage, etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection:3/12/03 TIGHT or HOLDING TANK:_n/a_(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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX: z (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.): Distribution box in good condition,liquid levels at invert out,no evidence of solid can over or leakage PUMP CHAMBER:_n/a (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): i ` Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection:3/12/03 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type _x_Leaching pits,number:_1_ Leaching chambers,number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): 1006 gallon leaching pit with approx 2' stone cover 16" deep to risers liquid level 4'below invert no evidence of hydraulic failure at time of inspection,vegetation normal CESSPOOLS:_n/a (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 or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): PRIVY:_n/a_(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.): • Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 52 West Minster Road Centerville Owner's Name: Marie Souza Owner's Address: Date of Inspection:3/12/03 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. %16 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 52 West Minster Road_ Centerville Owner:Marie Souza Date of Inspection:3/12/03 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 20'_feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: 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) x Accessed USGS database-explain: Plate 2 You must describe how you established the high ground water elevation: Information provide by Cape Cod Commission well data Well#SDW-253 G.W.is 52.F below ground surface in zone C Adjusted 8.1 =43.7'below ground surface that put G.W.around elevation 12.0 Information provided by Topo Zone indicate that Topo in that area is approximately elevation 40.0 which would leave a 19.5 separation from bottom of SAS to ground water TopoZone-The Web's Topographic Map Page 1 of 2 + i Target is UTM 19 385901E 4611781N - HYANNIS quad [Quad Infol CU. Co right 12000 M a s a la carte Inc , °``a • '' + ♦s , '% ` + .-.. JD +• 1� T i '�:;� � C�,'°'' �;ii'. jam` °,�tl ,...��, 1: +ipfi �- e qr a "an4er J0 -+� r4Pln, Ope l 'V yd _ ft ♦' fi1.j1Y�'�. y�� 'Y�� � 4 �..,r� „� � r -may r� ������ t� .-'}�, �Q�� ' � �}. •, •. • �•y �\1(`iW*If•I � , 0 500 1000 1500 20DO meters I . I - I 1 I miles 0 0.5 `I.0 http://www.topozone.com/print.asp?z=19&n=4611781&e=385901&s=25 3/31/03 TOWN OF BARNSTABLE LJCATION 0t-,5 ROAal SEWAGE # NMI AGE CeA�ew,#C, ASSESSOR'S MAP & LOT 0kSQ0&6ER'S NAME&PHONE NO. /MZL-A s!e.,/fJC-'r>nSPeJ1Vn 7 7/-3?a0 SEPTIC TANK CAPACITY 14Dw 6a//o,s LEACHING FACILITY: (type) I-CAG-414y (size) Aft 644Aa .J NO.OF BEDROOMS 3 BUILDER OR OWNER ////grP'e Soy?A PERMITDATE: COMPLIANCE DATE: I�SDeEh 6�1 3IIZI�3 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 70 ~ Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r � y 1 .�. � I �2 ae' 6` 3�� D 1 No.--q � _ .. Fa$ ............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABL.E Apphratuan for Di_npwial Wnrkg Tomitrnrttnn Permit Application is hereby made for a Permit to Construct ( ) or Repair (V an Individual Sewage Disposal System at: L cation-:\ddress or Lot No. �c., .� •`S C�r�r ----------•---------------•..._ ------•----------------•-----.....--•----•---------- Owner Address, w Installer Address UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms-- -------------------------------------Expansion Attic ( ) Garbage Grinder (�k)u Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ................................ W Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. R; Septic Tank—Liquid capacity./'COO-gallons Length---------------- Width---------------- Diameter................ Depth................ W Disposal Trench—No. .................... Width ................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No--------------------- Diameter...............----- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water..-__-.-_--.-------..._. Lz, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a --...-----••-------------------••-•-••--•---------------••-••--•------••---••......•---•-----------......................................................... 0 Description of Soil.................................. ----------------------------------------•----------------------------•--------------------------------------•-••-----....--------••-- x U ...--•••••••••-•......------•-•-----•-•---•-•-•-••--••--•-......-••-•-•--••-.....••---•••--....--•-------••-------•-----------------•-••-----------•----•--•------------•--------.....•---••-•---...---- w ---- ----------------------- t --------------------------------------------------------- U Nature of Repairs or AA4rations—Answer when applicable.-.A.J- .___.__ dd-l_.. -,l�.Cn.�------ (�r�_._.. fior�_1� �n c� ........�-U�.&f L.---..l. r� 1�..�t ...... ._. _ -- .S- ------�`r��' ------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE S of the State Environmental Code —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of health. ff Signed ............. . ..... .----------------- ........ .. .1- Date Application.Approved By ----- ...... .... ... ..... .. ............ .... ... . ------- -------- ........................................ ............... Date Application Disapproved for the following reasonf .........................................:................................... ....... . .... ..................................... .............. .... ...... ---------------------- Date Permit No. �` --- Issued �ail � No. .......... Ftms....... .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Di- rn3ttl Workii C owitrnrtion runtit Application is hereby made for a Permit to Construct ( ) or Repair (L/an Individual Sewage Disposal Syst ......qJ......C.V' i ILE- em a.!�a....t: ............ .... ........... . --•-----------------------•--•--------........--------------------•----------••---••----••---..... _ cation-Address or Lot No. ------------------------------ Owner Address, a S( M Cf.S•✓Z .................. A-s-s----C... ........ ......� � �C"... j.... Installer V Address / UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms._�3_-------------------------------------Expansion Attic ( ) Garbage Grinder (�u aOther—Type of Building ---------------------------- No. of persons..;.Y.._.............._. Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------- ----------------------------------- ---......----- w Design Flow............................................gallons per person per day%Total daily flow.._--.-------_-_---•__.---.------_--_--•----gallons. WSeptic Tank—Liquid capacity-/00-gallons Length--.___-_--._k_ Width---------------- Diameter.-.--.-_--__.-- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.................... ft. Seepage Pit No.............. ...... Diameter----.-_.-_-....-.--- Depth below inlet.................... Total leaching area...._..__._.......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~" Percolation Test Results Performed by-------------------------------•----_------------------------------------- Date........................................ Test Pit No. 1._.--_----_---minutes per inch Depth of Test Pit-----t.............. Depth to ground water_.-__-.----__-__-----.-. (� Test Pit No. 2................minutes per inch Depth of Test Pit.-.................. Depth to ground water.....-.................. 9 ...........................................................................................•.....••......................................................... DDescription of Soil........................................................................................................................................................................ x c., w U Nature of Repairs or A�rations—Answer when applicable_.A-J-4-------I NJ-()-I �_l�Cn.�------�..,Q E�;(�__.._(a,(`' ... .........vQC-&C L-----..U-(^.C-tA IFiA ---12- F{ 2 ��►n j Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of health. Signed .......... .......a---------------------- �.----------- --�. 1 - Dace A lication Approved B Q PP PP y -- _..........__......._.. ----------------- - --- ------- .. ..... . -------- ------...._................. � Date Application Disapproved for the following reasons- ------------------ _----------------------- ------------------...._..._------- . ....... ................ ----------------------------------- - - - - ,. --------------------------- --------------------- atPermit No. _...._ Issued Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Terttttrate of C ompltttnre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( �) by ---------.Sk.akA..r^..X7---_t'/",\A---------------....._......------------ r Insr,Jler -a . has been installed in accordance with the provisions of TITI_E of e t E WCONSTkUE ironmental Code as described in the application for Disposal Works Construction Permit No. ..._. .... dated ._.__... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT E AS A GUARANTEE THAT THE SYSTEM WI FUNCTION SATISFACTORY. DATE......_. `-'._ .. - -.... ..- �.�.. .. . . Inspe �.�--------- ---------------- --- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -'� TOWN OF BARNSTABLE NO. .................. FEE..(. 4R .spopal nrk.5 Tomitrudirin "rrmit Permission is hereby granted----- ' ._4" ._ M.�........................................................................................ to Construct ( ) or Repair V) an Individual Sewage Disposal System I cJ - Strcet �� as shown on the applicat' n f r Disposal '"forks Construction Permi o. __ _._-. at ........ o C Board of H alt DATE--------------•-••• ..�).'/----- --------------- FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS ''. TOWN OF BARNSTABLE SEWAGE # VILLAGE. C��Cervi \VQ ASSESSOR'S MAP & LOT/0/?- 0 467 INSTALLER'S NAME & PHONE NO. �XO� 1�'7r--5� SEPTIC TANK CAPACITY�� Ge,- ., � E 6 LEACHING FACILITY:(type)y/`Esc (size) 11J� NO. OF BEDROOMS PRIVATE WELL O PUBLI:C>WATER _ BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No l� 1 b a� : 3 Sleyf��- t 12 SrAr u P I r ,. JI I { _ o � 5*f�J7 �. 13 4c�f=.FM �;� �' '� ' � ✓.J�( { WALLS, Iz�i;�'Rya$ O�tfi B�t Db T T�� t- J vV F S `^0 1j j2 tfj ch V h v J , a r � - d a ® t J�2 W vJ STD= h 1 G% /'`9 ` (�`� I t-( � II , 77S` `�f 5Z -M LA..))W SrA RS O ` - - { �v s o 2--^ �� d v ovq r i r:. ! t j t S " Q a e 1 - - F � � � 4 v p ' a � c fl; t�6�f1' �ot�9�•1'�C'�F T�Yj{.�,� Ij tr 1 Q8 77S"-- `�f 5Z LEGEND N 79°55'58" E -- 98 -- EXISTING CONTOUR Ralf 100.07' 99.35 x 100.98 EXISTING SPOT GRADE Tor°"°` Re 99,81 H.� OVERHEAD WIRES � p O 99.69 I U � UNDERGROUND WIRES Route 2s W EXISTING WATER SERVICEWestminsterLOCUS G EXISTING GAS SERVICE 100,77 TEST PIT E ��e Lot 6 \ 99.83 J 01 + BENCHMARK LOCUS MAP 0' h 15,391f S.F. NOT TO SCALE Map 168 \� 99,20 a Parcel 067 X 100.56 Lawn /rrigotion� GENERAL NOTES: 27' TP-1 TP-100. 9 I 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL w 100.48® BOARD OF HEALTH AND THE DESIGN ENGINEER. O 2.83'� _ _ _ 60' __ _ t _ '- 13' 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE N _I_I_J FR�P�sECI s =S]__[_I� _ 10 LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: TBM No.2 LO LO -310 CMR 15.405(1)(b): p 101.05 100.50 99,4 (n 1) A 2' variance to the 3' maximum cover requirement, for 5' of Top Of concrete footing X X 1 max. cover. S.A.S. shall be H-20 and vented. EL.=101.09 (Assumed) N b o 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR v TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE LA DESIGN ENGINEER. X 101.36 DECK 100.42 1L0,0 v' � LOCATION OF VENT 101.77 G X co 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING MAY BE CHANGED V W/ X O FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 0 99,5E = ENGINEER BEFORE CONSTRUCTION CONTINUES. 17+1 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF EXISTING THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF GARAGE HOUSE (#52� 1\06�.0 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 100 57 ' 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 101,96 X 101.81 2 TBM No. 1 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS 101.89 - Top of concrete landing AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE EXISTING SEPTIC TANK -P1 1.22 1N)0.82 • 99.85 EL.=102.45 (Assumed) DIRECTED BY THE APPROVING AUTHORITIES. TOP OF TANK, EL.=98.55E 10' 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY INV.(OUT), EL.=97.20t 10149 CONSTRUCTION. 101.99 �P� O I�10' p 5 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING tom, 4r 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS 'n N '� SLEEVE SEWER 10 EACH� `'^ � (III�IJ� PAVED 1, 101, IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND DRIVEWAY SIDE OF WATER CROSSING REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). � D,q. A� , EXISTING LEACH PIT 100. 5 I x 99.77 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE TO BE PUMPED, FILLED 24 INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. W/ SAND AND ABANDONED GRAVEL - 100,96 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 100,72 100 PARKING 99.99 IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. N 82• '10" E 9PgE9,66 PROPOSED SEPTIC SYSTEM UPGRADE PLAN o PETER T. ✓ 52 WESTMINSTER ROAD, , PETER �1 101,08 100,55 CENTERVILLE MA CIVIL `� 100,80 Edge of Pavement 100,27 I0 99,96 9982 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 No. 35109 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. N0. REr.11cl ��� �`� NOWAK, STANLEY & F WESTMINSTER ROAD En ineerin Works, Inc. 1"=20' P.T.M. 218-09 ES AL HIGHAM, THOMAS B Engineering P.O. BOX 550 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. BARNSTABLE, MA 02630 (508) 477-5313 10/31/09 P.T.M. 1 of 2 mow..-+w�` Cr/•"' NOTE: TO PREVENT BREAKOUT, THE PROPOSED 2.83' FINISH GRADE SHALL NOT BE < EL.96.3 7 r 60'FOR A PEERIMETDEIRTOFCTHE S.A.S.AROUND THE T _I_I_� Pt�OPcESE[I S.j_.S SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. CHARCOAL OR �� 63 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & WATERTIGHT INSTALL INSPECTION PORT OVER END UNIT CONVENTIONAL VENT Nco T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE COVER SET TO 6" OF GRADE N 0 EXISTING o 5g �, N F.G. EL.=101.2t F.G. EL: 99.6f F.G. EL: 101.3(MAX.) DECK ff MAINTAIN 2% GRADE (MIN.) OVER S.A.S. , i non ,gym , . 5. INSPECTION L = 86' L = 2'(MAX) PORT ® S=1%• (MIN.) � S=1% (MIN.) 4"SCH40 PVC 4'SCH40 PVC 6" EXISTING t0 I HOUSE (#52) EXISTING 48" LIQUID 14 s e" 1 IIN ERTO GAR GE LEVEL INV.=95.87 i-- - I ADD INV.=96.077:�pirPOSED INV.=95.90 (1 ROW OF 12 UNITS .AT 5.0'/UNIT) = 60.0 GAS BAFFLE INV.=97.20f D-BOX EXISTING f SOIL ABSORPTION SYSTEM (PROFILE) EXISTING SEPTIC TANK S.A.S.LAYOUT ESTABLISH VEGETATIVE COVER BACKFILL WITH CLEAN NATIVE OR PERC SAND TO TOP OF CHAMBERS 15 5' (3) 5" DIA.OUTLETS 16- 2, TOP ELEV.=96.33 NOTES: INV. ELEV.=95.87 W �- 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE w•• 1s.s 8. 12" INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=95.00 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND 2.83' Section 2" TRUE TO GRADE ON A MECHANICALLY COMPACTED 5' MIN. ABOVE BOTTOM OF Top Vlew H-10 LOADING SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN T.P. EXCAVATION OR G.W. �/ 310 CMR 15.221(2). EXISTING SUITABLE D—BOX 3) INSTALL INLET & OUTLET TEES AS REQUIRED. NO G.W., EL=89.3 = MATERIAL 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE SEPTIC SYSTEM PROFILE IN HW ONFIGURATONrWITHHNOUSTONE NITS 63.25" AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. OF 12-ADS N.T.S. TYPICAL SECTION � 16" DESIGN CRITERIA SOIL LOG 34.5" NUMBER OF BEDROOMS: 3 BEDROOMS DATE: OCTOBER 29, 2009 (REF#12,752 SOIL TEXTURAL CLASS: CLASS I SOIL EVALUATOR: PETER McENTEE PE(SE�1542) WITNESS: DONALD DESMARAIS R.S. DESIGN PERCOLATION RATE: <2 MIN/IN HEALTH AGENT TOP VIEW DAILY FLOW: 330 G.P.D. ELEV. T P—1 DEPTH ELEV. TP-2 DEPTH 60" DESIGN FLOW: 330 G.P.D. 100.5 q 0 100.3 q 0" END CAP END CAP LOAMY SAND LOAMY SAND FRONT VIEW SIDE VIEW GARBAGE GRINDER: NO 10YR 4/2 10YR 4/2 END CAP 99.7 10" 99•5 loll REAR/TOP VIEW LEACHING AREA REQUIRED: (330) = 445.9 S.F. B B LOAMY SAND LOAMY SAND NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW 74 10YR 5 8 1 OYR 5 8 TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY / / DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. PROPOSEEXISTING TANK: 1000 GALLON CAPACITY 97.8 32" 1111111114mPROPOSED D-BOX:: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED - 0 97.3 36" HLLARD, OHIO 4302s ( ) Are 36HC DETAIL C PERC • 42" ADVANCED DRAINAGE SYSTEMS.INC. USE 1 ROW OF 12—ADS Arc 36HC UNITS F-M SAND PROPOSED SEPTIC SYSTEM UPGRADE PLAN IN TRENCH CONFIGURATION WITH NO STONE 2.5Y 6/4 F-M SAND 52 WESTMINSTER ROAD, CENTERVILLE, MA (GENERAL USE APPROVAL FOR 7.80 SF/LF IN TRENCH CONFIGUATION) 2.5Y 6/4 Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 12 UNITS = 60.0 FT 60.0' x 7.80 SF/LF = 468.0 SF 89.5 138" 89.3 138" Engineering by: SCALE DRAWN JOB. NO. PERC RATE <2 MIN/IN. ("B/C" HORIZONS) Engineering Works, Inc. NTS P.T.M. 288-09 DESIGN FLOW PROVIDED: 0.74(468.0 S.F.) = 346.3 G.P.D. NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (508) 47775313 10/31/09 P.T.M. 2 Of 2 ,