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HomeMy WebLinkAbout0044 ZENO CROCKER ROAD - Health (2) 44'ZEN0 CROCKER ROAD CENTERVILLE A= 170 -100 N S M EAD KEEPING YOU ORGANIZED No. 12534 2-153LOR LE Fps MIN.RECYCLED Alm 111 INMTIVE CONTENT 10% CerflSed Fiber Sourcing POST-CONSUMER wmjrwogra—rg SUM MADE W USA GET ORGANIZED AT SMEAD.COM GI1 � stun No. Fee (00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitation for Disposal *pstem Construction permit Application for a Permit to Construct( ) Repair(()� ®Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 J 1,��, /n`lA h,I' Owner's Name,Address,and Tel.No. y�� ��,/ Assessor'sMap/Parcel — "��`, l/. I ,, �` j"'r�"`�' D qq vkb G�Vyl,tel staller's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. WW 6 4�xcm Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures p� Design Flow(min.required) 6� ® gpd Design flow providedy 8 gpd Plan Date ,T? Number of sheets CZ Revision Date �— Title, . Size of Septic Tank Type of S.A.S. 12A ,(_rh �,� . 6&C . h Description of Soil �`� t 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 oUe — U. �ned Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. a Date Issued ------------------------------------ �a No. Fee 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftPlication for 30isp9sar 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. V1, r/ ��. OHM Owner's Name,Address,and Tel.No. h0 ' -' 1 / �-h � $I'�,t,�''l q4 Cm� Assessor's Map/Parcel r . - vkD Y. � Installer's Name,Address,and Tel.No. Designer's Namea Address,and Tel.No. &11W f,)6 04; . ."04 MKS 4�69 0-913 Type of Building: .• , Dwelling No.of Bedrooms , Lot Size sq.fr. Garbage Grinder( ) Other Type of Building s� �^ (� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Desig43Flow(min.required)t tj gpd Design flow provided + y gpd Plan Date Number of sheets ca Revision Date Title (e b Craxr 1• Size of Septic Tank It Type of S.A.S. (�j)[ b✓�Clf. T ghit, i Description of Soil' 0 Y 1, 4.14 r r 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 a 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 eall� Signed 4Z� / Date ^ Application Approved by /� Date Applications spproved by Date for the following reasons U ,► /// r- ,.. r/o Permit No. Date Issued Q THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS - Certificate of Compliance THIS IS TO-CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) - Upgr'aded(,k Abandoned( )by at 7w lkb r has been constructed in accordance with the provisions of Title 5 and the or Disposal System Construction Permit No A ado` kr+ dated 5 Installer lrh� i � Designer t„h�ttl J #bedrooms • �j Approved desigJow �'�j� gpd The issuance of this permit hall no /e�coristrued as a guarantee that the system v 'll functio dessi'd. x Date �` Inspector - ----------------------------------------------��­-­­­-­­­­-------------------- ------------ o�U —Z'4 J Fee '--------------- No. /00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(A Abandon( ) System located at U ,�d�h C rb Lvi F-1110 ., 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:Constructio ust be om leted within three years of the date of this permit�� \ Date Approved by Town of Barnstable Regulatory Services Richard V.Scali,Interim Director MItIiST'ABLF„ public Real'th [7ivisiott Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-460, Fax; 508-790-0304 Installer-&Designer Certification Form Date: zZ3 Sewage Permit# Assessor's 117ap\Parcel � 7 V "E b. llesioner: b �V--er-,n,e t v�l C, Installer: Address: 1Z Wr r �_/c/ jZ Address: 3<1" ' '' 3 On aj,',)WS8,&MJca�4 was issued a.permit to install a (date) (installer) septic system at ' - -Ze-4 fir'n-CA C (Ice based on a design drawn by (address) tva"&-ro l k( d ated (designer) I certify that the septic system referenced above was-iiistalled 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. Ship out(if required)was inspected and the.soils were found satisfactory. f L certi that the system referenced above was constructed in >vith 'the terms fth I , proval letters(if applicable) w (Installer's Signature) CW NO 35109 a (.Designer's Siguature) (Affix l5esigne ere) PLEASE RETURN TO BARNSTAI3LE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WLL:L NOT .BE ISSUED UNTIL, BOTH THIS FORM ANb tiS- , ':BUILT CARD ARE RE,CEIVED BY'r-uE BARNSTABLE, PUBLLC`HEAUM DWISION. THANK YOU. Q:',Sepdc\VesignerCe-nification EomiRcv8-t4-1Idoe Engineers note:This certification is limited to an as-built inspection of system eornpononts a--inctaltod poor to backtitL Tbk engineer did not supervise construction of the system.Theinstalti�r assumes responsibility for all materials,wor",imanship;back6iPnq to spec Med grades with proper compaction and setting riserctcovers as cshr wn on the design plan. TOWN OPBARNSTABLE LOCATION 44 Zcnh CrJL"r 9Wd SEWAGE# 1010 ( J VILLAGE thNe 0e ASSESSOR'SIMAP&PARCEL I�0•ISO f INSTALLER'S NAME&PHONE NO. 17 C4V �OI1 a SEPTIC TANK CAPACITYVAPLuak QIlk Akn 1 LEACHING FACILITY.(type) } (size) J2.8`X 2S•b NO.OF BEDROOMS tDM c OWNER PERMIT DATE: S 2-d 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 fac'k} ` Feet. FURNISHED BY AZ- VV" A3-zq' 4f ze�� C,�� � W46 �zcar B3- 74` 3 z v O sir Town of Barnstable M' B� Inspectional Services Department M�" AS& � ' p p Public Health Division y r~tass. $ i639. �0 — 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 7893 July 9, 2020 BROWN, JAMES N 44 ZENO CROCKER RD CENTERVILLE, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 44 Zeno Crocker Road, Centerville, MA was inspected on 06/15/2020 by Mark Polselli, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box is above the outlet invert due to an overload or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH oma 301!an, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\44 Zeno Crocker Rd Centerville.doc Town of Barnstable HARNSTABLF. MA Inspectional Services Department S +aj.fC AAf�p Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS QbW 1 YEAR DEADLINE CRITERIA tatic liquid level in the distribution box is above the outlet invert due to an `overloaded or clogged SAS or cesspool ❑ A portion of the SAS, cesspool, or privy is below the high groundwater elevation ❑ A portion of the cesspool is located within a Zone 1 to a public well ❑ A portion of the cesspool is located within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: 0:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc I Commonwealth of Massachusetts /00 Title 5 Official Inspection Form Subsurface Sewage Disposai System Form -tic_fcr Vciuntal_�' Assessrnents ' operty Adores. V el s ro Owner 3,vner's Via-:-//'� !2� infortnZ�On C H ` __ /T ��j aP Q�O reQulr eQ ror every /� pace. Oitir!ovm . s ?z 0 cde late pf in ecGo Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. l'V655 Important: outforms A.Wrier! Inspector Info anon c� ou f Wrier! / on the com the the t er, use only t2b Ir ((( !!! rev to rove vcur Mane c-ins?ec6 ''''� cursor-do not L� use the return KEY. i.Omp2riV 4cro /�• � m I i Companv Address u �asT��`M oc wry;i owr , � ! �/ O State�" V� dip Code t�ae I i eie�hcn 'v . .ce _tense Nurnber B. Certification airy trzt: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000): i have persona[iy inspected the sewage disposal system at the property address iisted above: re information reported below is ace_ accurate and complete as of she time of my inspection: and the inspection was performed based or my training and experience in the proper func'aon and maintenance of on-site sewage cispcsai systems.A�ier conducting this inspection i have determined that the system: 1. Passer L. vvnQiUCnaiiV Passes 3. tie rurther Evaicaticn Cy'_re _oca!Approving W`..hert" f !nspecto's 'Gnat!:"e Jc=� Tine 3y5wn. :i peC Cr sha i s CT,i : p; i ns ::sperm Cn "epC^iC e Approving Authority(Board Oi i"'ieaitn Vr�t�i�,i Witn.^� �� day- v~CC^pleb^ iM i'.SpeC'i if the system has a design flow of CJ,I�CL uDd Or Cre2ter;'ine inSpeCCC7 anc the sysiem owners ail submit the report to the appropriate regional office of :e 'DEP.The ordinal fen-: shouid be sent tc t' e system owner and copies sent to the buyer: if applicable. and the approvirg authcrity. Please note:This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. -...a o ,rspez:r.`c. �..esc=zx 3e..zye Dsocsa Sysier..•PaSe of?e" Commonwealth of Massachusetts ? Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �7 Property Address Owner Owner's Name information is / _ �g ?? required for every - e N e11�6` V�.�O J� G J a.(7 page. City/Town Mate Zip Code Date of Insp ction C. Inspection Summary Inspection Summary: Complete 1, 2: 3, or 5 and all of and 6. 1) System Passes: El 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: 2) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass' section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined,' please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.00c•rev.7/28/201 8 71Ve 5(75aai;rspecacr Form:Su--scrace Sewage Dispose,system-Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Zero C� e Property Address L� r Owner Owner`s Name �w •� information is 4ylvi /- �� /ectionV� required for every �!4 page. City/Town State Zip Code Date of In C. Inspection Summary (cons.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health: safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/2612018 —isle 5 Offiaai,nspecvon For.:Suosur`ace sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts s Title 5 Official Inspection Form wj Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �i4o Property Address Owner Owner's Name //++information is �p l9Av-v, A/4 a G required for every page. City/Town State Zip Code Date of 14pectiorff C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well'. Method used to determine distance: **This system passes if the well water analysis; performed at a DCP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes ❑ Backup of sewage into facility or system component due to overloaded or gged SAS or cesspool Discharge or ponding of effluent to the sur ace of the ground or surface waters due to an overloaded or clogged SAS or cesspool :Sinsp.tloC-rev.72620 i8 -itle 5 3715 c.'_aai nsceon Fc.-r:SUOsunrace sewage oisposal System•page d of Is Commonwealth of Massachusetts 19�1 V Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address, Owner Owners Name information is Gg Nv` required for every y page. Cityonown State Zip Code Date of Insp ction C. Inspection Summary (cant.) 4) System Failure Criteria Applicable to All Systems: (coat.) Yes No L Stat" "quid level in the distribution box above outlet invert due to an overloaded clogged SAS or cesspool Li depth in cesspool is less than 5" below invert or available volume is less an 1/2 day flow ❑ 5pquired pumping more than 4 times in the last year NOT due to clogged or obstruc ed pipe(s). Number of times pumped: i- y portion of the SAS, cesspool or privy is below high ground water elevation. ❑ portion"of cesspool or privy is within 100 feet of a surface water supply or ributary to a surface water supply. An rtion of a cesspool or privy is within a Zone 1 of a public water supply `- ell. ❑ iy portion of a cesspool or privy is within 50 feet of a private water supply well. Li Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis chain of custody must be attached to this form.] r- The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. The system fails. i have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes' or"no-to each of the following, in addition to the questions in Section C.4. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surace drinking water supply El system is located in a nitrogen sensitive area (interim Wellhead Protection Area-IW PA)or a mapped Zone It of a public water supply well ;Sinsp.tlbc•-rev-72620'16 T;t,5 cf`ca:inspe.-cr=or:subsu.-;ace sewageasoosal system•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments `1`r` e o o Property Address Owner Owner's Name information is required for every C4004tv.-Vat— A41 page. City/Town State Zip Code Date of In ection C. Inspection Summary (cost.) If you have answered "yes"to any question in Section 0.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed.The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Ye s umping information was provided by the owner, occupant, or Board of Health ❑ Wer ny of the system components pumped out in the previous two weeks? ❑ Has the system received normal flows in the previous two week period? ❑ Have large volumes of water been introduced to the system recently or as part of is inspection? Were as built plans of the system obtained and examined? (If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components, excluding the SAS, located on site? ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? El information the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? T e size and location of the Soil Absorption System (SAS) on the site has tJ/ been determined based on: L Existing information. For example: a plan at the Board of Health. ❑ ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] 5insp.00c•rev.'/25/2018 `tle 5 cf`aei;nspeyaon=cr.:S;:.' ace Surge Disposal System•?age 5 of t8 �e, Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owner's Name /(,L�w •/ i required for every nformation is ems` �od30Z A page. City/Town State Zip Code Date of Inspe6on D. System Information .1. Residential Flow Conditions: Number of bedrooms (design): ✓C dumber of bedrooms (actual): JS DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Description: O / �7 � 1 f o�! /G a`► ti/ Number of current residents: 3 � Does residence have a garbage grinder? ❑ Yes �O Does residence have a water treatment unit? ❑ Yes No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes _ information in this report.) Laundry system inspected? ❑ Yes No Seasonal use? ❑ Yes ;,-No Water meter readings; if available (last 2 years usage (gpd)): Detail Sump pump? Yes No" 1A Ire - Last date of occupancy: H Date t5insp.doc•rev.7/26/2018 .ae 5.^`dal;nspecon rorm.suDsutace Sewage Disposai System•Page 7 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form '- r� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owner's Name �D information is required for every /p 5 page. City/Town State -Zip code Date of j specti n D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.).- Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as par of the inspection? ❑ Yes I o If yes, volume pumped: gallonn s How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7126120118 Slue-A 0�`aai nspecuor.=on:Subsedace Sewage Dispo;ai System•Page a of la Commonwealth of Massachusetts Title 5 Official Inspection Form i 1�. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments `� ZGtnd �j/V ei4,iw Property Address Owner Owners Name /' ) information is required for every page. City7own State Zip Code Date of In ection D. System Information (cont.) 4. Ty:77 Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): Approximate age of all components; date in ile known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes o 5. Building Sewer(locate on site plan): Depth below grade: feet Material of constructio;4-0- ❑ cast iron PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): '.rle 5;C`cai!^spectacn Fa.-.SuCsu ace Sewage]isposai system Page 9 of 18 t5insp.doc•rev.7/25/2018 Commonwealth of Massachusetts Title 5 official Inspection Form i� Subsurface Sewage Disposal System Form - Not for Voluntar y Assessments �lr-er- led Property Address Owner ro Owner's Name t "" '/ information is '✓`rvl�v � ad required for every """'"�GGGI��� page. City/Town State Zip Code Date of Ins p ction D. System Information (cunt.) 6. Septic Tank (locate on site plan): Depth below grade. feet Material o nstruction: concrete ❑ metal ❑ fiberglass ❑ po! eth iene Y Y ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy or certificate) ❑ Yes ❑ No Dimensions: v L/ < <l Sludge depth. 77 30 Distance from top of sludge to bottom of outlet tee or baffle 3o j 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 - How were dimensions determined? / le- � —c- Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert. evidence of leakage, etc.): uVIA#1 /'leCo ell M�v►%d t5insp.doc.rev.726120/8 -ate 9 otniaai Inspecacn onn.sucsu mace Sewage Disposal System•?age 10 of t8 Commonwealth of Massachusetts pl Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Property Address Owner Owner's Name information is C064-LIOOVI (��6 ?� is OZf� required for every ✓ page. City/Town State Zip Code Date of Ins ction D. System Information (cost.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage: etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: oalions Design `low: gallons per day t5insp.doc•rev.7/26;2018 'iJe 5 ctf aa(!nspacuon Fora:S:csuraoe Sewage asposai System•Page t t of 18 Commonwealth of Massachusetts -. Title 5 Official inspection Form 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owner's Name /^ 60L.41 information is / „N O'f 1/ C required for every l�� Vd t7✓ page. City/Town State Zip Code Date of insp tion D. System Information (cons.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Z—'ye Depth of liquid level above outlet invert 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.): I t5msp.tloc•rev.7282018- -:tle 5 cti:^speaaon For.Suos.nface Sewage D:sposar System•?age 12 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address arowo Owner Owner's Name information isAf-required for every — page. City[Town State Zip Code Date of Insp coon D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No' Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: ,or— Type: ` 5 leaching pits number. l ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number. length: ❑ leaching fields number, dimensions: ❑ overflow cesspool lumber: ❑ innovativeiaitemative system Type/name of technology: -- -"--- -iae 5 O`ioa:inspe.:�or.=cm:$uDs�fface Sewage uisposal Page 13 of 18 Sys[em• 5msp.doc•rev.712612018 Commonwealth of Massachusetts ip Title 5 Official Inspection Form Subsurface Sewage Disposal System For - Not for Voluntary Assessments GrO�ti-e,� �J Property Address . Owner Owner's Name Co information is h v required for every � � U�G,. -- page. City/Town mate Zip Code Date of In ectio D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 1�11014 c' ©vim 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t6inspAoc•rev.726/2018 iae 9 CTfcai nsoecvon Forri:Sucsu=ace sewage Disposai System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for VoluntaryAssessments !LL Property Address Owner �1J ln/�*•.. Owner's Name information is / J 14 ��TTl ) required for every Q V� (. Vd 6 LL 6 page. City/Town TSta e Zip Code Date of pection D. System Information (cons.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawing attached separately I I I i I � CW G w`Coh St�rft� f I I i XV RI;A/ t5insp.doc•rev.7/26/2018 -tle 5 otficai:rscenon Fcmn:subsLitace Sewage Disposal Sysen•Page 15 of 18 i Commonwealth of Massachusetts F Title 5 Official Inspection Form al Subsurface Sewage Disposal System Form - Not for VoluntaryAssessments e^0 C � Property Address Owner Owner's Name information is �� ` / � /� required for every _ (D page. City/Town State Zip Code Date of Ins ection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7126R2018 +tue 5 Om as,ns"ton=orr:.Scosur.'ace Sewage Disposes System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary tary Assessments Property Address Owner Owners Name information is �-;�� � / / required for every � �'�`'V 'e - Q�6,�.._ (� � p�.Q page. City/Town State Zip Code Date of in�Speotio D. System Information (cons.) 15. Site Exam: LI Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells V `T" Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record If checked; date of design plan reviewed: Date Ob ed site (abutting property/observation hole within 150 feet of SAS) (— Checked with iocai B d of Health - explain: Checked with local excavators. installers- (attach documentation) Accessed USGS database- explain.- You must describe how yo esta I' hed the high ground water elevation: c'c.de Before filing this Inspection Report, please see Report Completeness Checklist on next page. 5insp.doc•rev.726,2018 -,;;e 5 J'Scai Irspe�o❑=a Subsurface Sewage Disposes System•?age 1.7 of 18 `l Commonwealth of Massachusetts w: Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owner's Name i information is `� required for every /G��✓VVN--- ✓✓✓ �/ page. Cit Town State Zip Code Date of Ins ction E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: A. Inspector Information: Complete all fields in this section. Certification: Signed & Dated and 1, 2, 3, or 4.checked Inspection Summary: 11 2, 3, or 5 completed as appropriate 4 (F ilure Criteria) and 6 (Checklist)completed I D. System information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included Omsp.Aoc-rev.7126/2018 ":ue 5 piflaa::nspe jcn a-..S.:csunaoe Sewage Disposai System-?age iS of t8 LOCATION '+' SEWAGE PERMIT NO. ,f_dF /,� Y 75-A162 - OaCKS9 Pam VILLAGE I&I-M CZV I L L_ •T \ INSTALLER'S NAME A ADDRESS e U I L D E R OR OWNER: DATE PERMIT ISSUED DATE COIMPLIANCE ISSUED _ _ -- 'Sal t70 —f j No._ 5 THE COMMONWEALTH OF MASSACHUSETTS BOARD $MAR*", LTH , -----------------------------------------OF........................----•-..... ..------...0&.JW. fi.F. �E Applirathi t for ­­OF Works Tomitratrfivat Prrutit Application is hereby made for a Permit to Construct (.,/ or Repair ( ) an Individual Sewage Disposal System at: ................. Location- dress or Lot No w s..�- Addre s a j64t;;/.....-C'�_.1�`9�/...! ---- ----------�� �"-r-�", `� ........... Installer Address Q Type of Building - Size Lot_ .......Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................... .. W Design Flow........ .15.0.............. -----gallons per person per day. Total daily flow......... �J gallons. WSeptic Tank—Liquid capacity_v)(O.gailons Length................ Width....._.._._..... Diameter_______......... Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...-.�....J..�_._..._...sq. ft. Seepage Pit No----------)----- _ Diameter.......�.7�.._.. Depth below inlet... t�z�..... Total leaching area. ' �_sq. ft. ___ Z Other Distribution box ( �) Dosing tank Percolation Test Result Performed by AZi��C-.L .A-.S.S_Q .:.................. Test Pit No. l................minutes per inch Depth of Test Pit.___ ......... Depth to ground water_.___--•.............. /44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ w .................................. ... ................ y ._? Description o Soil.........•-- �---. j. ' ___._ ....._ __.._.......__._. W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -------- -------------------------------•-----------•---•---------------•--..........---•-•....------•----•• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Co — The u ersigned further agrees not to place the system in operation until a Certificate of Compliance has bee is d b t o of health. Signed....... -• .. . ... .. ........................................ / ..� at. 'Application Approved By........... ---- ........... .. Date Application Disapproved for the llowing reasons---------------------------------------------- -'-------------•----------------------------------.............._ --------------------------------------------•---•--•--------------•-----...-----------.......-------•----•----------•-----•--••-•----------•........................................................... Date PermitNo......................................................... Issued.----•---------•---•------------...._....--------_..... Date r•j + �{ 1 No................_....... Fins.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD► , LTH ........ ....... .....................oF...:. ...::, ": . ....... Appliration for Disposal Murks Tonstrnrtinn rnmit Application is hereby made for a Permit to Construct ( ��or Repair ( ) an Individual Sewage Disposal System at: t A 2 .... -�r��..r................................ ....... .1J [ V_It� . N�:�.........---..•. Location- dress n, or Lot No. - .. ...... a .::........ ......................... O n -• Addres... J' S Installer Address { Type of Building Size Lot..`. ......Sq. feet Dwelling—No. of Bedrooms----------------................._..........Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—Type of Building No. of persons............................ Showers g -------------------••------- .-- -....._. . ( ) — Cafeteria ( ) dOther fixtures -----•---------------------------------••--• ---------------------...----------------- W Design Flow......... . .........................•..gallons per person per day. Total daily flow........... °__ ...Q.._..........__.._gallons. WSeptic Tank—Liquid capacity...�9266gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.-•_-___.._.I----- Diameter........t.?...... Depth below inlet....-�16;.-?-.. Total leaching area.J�:.:.�2' sq. ft. Z Other Distribution box ( 4 Dosing tank ( ) aPercolation Test ResultsZ_ Performed by.CQ&Vl 4tl.-=-• SS a4-..:................ Date.._ Test Pit No. 1................minutes per inch Depth of Test Pit......I_z_.._.._. Depth to ground water------_.--............. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .................................... --........--- ..... I : - ----- - D Description of Soil.............. . �--• r`' ' �wi3 a1 J........... A`\1 -• - -- W •-•-•••-•-•-••-•••••-••••-••••••••---•---..._�'•- •-••--•-M-��...S.A.�-�-s `' I .._ 1..__ .t __ AQ x .................-...................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable.................................................................................._.._.......... ------••••---•-•--••-••------••------••----•-•-------••••-••--•••••--•---------•--•----......-••••••••---•---•-----••---•------•••-••••-•••--•...--•-•--•••-•-•-••--•••.•-•---.-••-•••....--•---•_--••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Co — The un rsigned further agrees not to plac/the stem-in operation until a Certificate of Compliance has been,"issjkfi b th o 'd f health. Signed t • ...... Date \�O7pplication Approved BY ... `" _Q_".. Date Application Disapproved for the Mowing reasons:--••--------------•--•-••---•------------••------...------•---•--•----•---------•-------•-•-••......--....-•---- Date PermitNo--------------------------------------------------------- Issued---=--.................................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH Trtifiratr of ToutpliFanrr THI I TO CF,RTIFY That the I!� al Sewage Disposal System constructed ( or Repaired ( ) by.. ........ =i ---•--•---------------------------------•---------------------------------•-•------------------•------_-__----- I allergy - .-- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.........-.��___5_"_s� ...... dated__..._."._ __3...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO TRUED AS)UARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............... `... ---....$-`�----............................. Inspector..........-•..US �- THE COMMONWEALTH OF MASSAC USETTS BQARD/bF -HEALTH ............. N.............................OF %.�•. -1,� .................. " No._ .. S OF FEE........................ r ` lltsposa nr s Tn trndiou rrmit Permission Vsh�e granted...._'_.__1'�: !Ste'._ / ' - " to Construct ( o Reps ) an Individuewage Disposal System f ';' ? Street. as shown on the application for Disposal- `:Works Construction Permit No.__-: '` ated_._.____.J�Z ......................... ................................. = 5 and Health DATE.. - -^>x ...........................................................0 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS SITE PL A N SHEET i OF? SCALE: I//= -4 o I s ':2 I 1 I t-,- r-r1 C. T-A t JV- (>fZvpv�i b yi' p>� V4 6s1 -^' l lv 4'/ I Apt o t10 <I- i i 1 r��a�: ,.n >✓N-z- z2 I i til K 4 ( 51K-2 � v ZN OF UJAM .o Mo. 9 r� G�SiEa� i LA I VTQ/LKJ�L—, FOR 1,� �� L - 5 G� l..-L C7�,<� � REG/STEREO LAND SURVEYOR FOR v T- G �'c�G le Er- ZONE G G rJ T V-- I L.L-E' ,- PLAN .REF: DATE -2/l '25'/`-- BENCH MARK DATUM A'L2 LLB V- WM. M. WARWICK 8 ASSOC., INC. DOMESTIC WATER SOURCE BOX 801 - NORTH FAL MOUTH FLOOD ZONE. flat-J 4 Aoki rz-D � MASS. 02556 7 (6I7) 563 -2638 ) LEACHING BASIN SECTION NOT TO SCALE shcc 5! e f Z 24"C.LMH COVER EARTH F/L L BRICK'AND MORTAR COURSES'AS REO D• TO BRING '. _.r• ,_ COVER TO GRADE INLET �B FLOW L/NE __;j •i 2' TO WASHED PEA 5TONE FREE OF IRONS, PIPE T FINES AND DUST IN PLACE G �� • ' i1 OPENING WITH �i%B 14 TO I Y? WASHED CRUSHED STONE FREE OF % •�� OUTER DIAMETER IRONS, FINES AND DUST /N PLACE ANO /3/4"INSIDE DIAMETER I. CONCRETE TO BE 4000 PSI 28 DAYS .•' 2. REINFORCED WITH 6%6" NO. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE'FOR GREATER DEPTH REQUIREMENTS 40" �1--}--so ��--� 4. NUMBER OF PITS REQUIRED Pt-At- NOTE: EXCAVATE TO ELEVATION O OR EFFECTIVE DIAMETER } (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL WATER TABLE LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. 3•a I8"STD. LT. WGT. C.I.MH COVER �.o -.. � 'y 5l•s s�.z 4"C/.pipe Plum.FIBER P/PE OUTLET LEVEL DWELLING FLOW LINE TIGHT JOINT TO FIRST JOINT -- ter, ,�— —• " O 00 14 110 00 t C.I. TEE �7 "Tg 1 1 0 1 00 11 it goo 00 11 It STD, PRECAST CONC. • (�.�f 5 D/ST. BOX TO BE 1 11000 0 0 1 1 I I , _'10GAL.SEPTIC TANK. INSTALLED ON LEVEL, G 1 1 1 1 00 00 11 1 1 I STABLE BASE III 100 0 0 1 1 ' I \SEPT/C TANK TO BE I it 600 0 0 1 1 + 1 ; INSTALLED ON LEVEL 1 1 1 1001 O O I I STABLE BASE. 11 1 0 0 O 0 0 1 1 1 1 � 11100 001111 ` LEACHING BASIN i if l Q 0 0 0 0 1 1 BASE TO BE.L EVEL SOIL AND PERC. DATA �3•0 PERC. RATE — MIN. /IN. 0+� TEST PIT NO. f 377z 0" TEST PIT NO..2 — �I�UL� TEST BYuP✓5all. �+ SAI.JD�-u/zAV�1- WITNESSED. BY _ n� U I 4,R-p_; MAD• ZAIvD TEST PIT GR. EL. DATE: 1 v/3o �1a4 f t >J a; sAN D tJv 4fZoL)j4pwaT'ir.,I< 30).a. DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL Q 4 SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFL*��GPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK GAL. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE SIDEWALL AREA Z,yGAL./SQ.FT. TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA ► GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY 11 1977. LEACHING REQUIRED z010 SQ.FT. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. �Q.FT. .AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE -- BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. .4,-' ••' +4�• PITCH ALL SEWER LINES 1/4" / FT. UNLESS INDICATED OTHERWISE. �3�it1.0A►��t'- o�.�"``" "s'� '� SEWAGE DISPOSAL SYSTEM MARTJNa L•_.� �U �dLLOu/• �� _E. • : r,� � FOR' S v MORA N H J23417 0 � L,0� st, A L&V►L.•Lam' ''^^ �7 S 01 SCALE AS INDICATED DATE 4:v -27 5 WM. M. WARWICK 8 ASSOC.1 INC. 8OX 801 - rNORTH FAL MOUTH PROFESSIONAL ENGINEER MASS. 02556 - (6/7) 563-2638 , i EXISTING SEPTIC TANK d -100- EXISTING CONTOUR TOP OF TANK, EL.=9799 x 100.98 EXISTING SPOT GRADE BENCHMARK INV.(OUT)=96.66t(VERIFY) COR./BULKHEAD W EXISTING WATER SERVICE ` ums EL.=99.68 G EXISTING GAS SERVICE77 EXISTING S.A.S. U UNDERGROUND WIRES ` S 7°44'04" W PUMP, FILL W/SAND & ABANDON TEST PIT c _1 fence fence 136.54' BENCHMARK 96.89 + edge of ,' LEGEND +. own I-=12.8'--{ , � T SHED J + 1-".' O PROPOSED S.A.S. �P� 2 LOCUS MAP \ 97.44 k 1 2-500 GALLON CHAMBERS k03 NOT TO SCALE i 1' '.•: N SURROUNDED W/4' STONE \ `\ + ),38 O x 9 7.1 1` / 0 TP-2 u 0 x 98,4�\ x 97.443 GENERAL NOTES: BM 0 \ O 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL \ BOARD OF HEALTH AND THE DESIGN ENGINEER. 99.68 Z 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 98.80 x 8.11 �� LQ OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE Ld 1-13: LOCAL RULES AND REGULATIONS. 98.7 X WOOD c t L 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 0O SHED t` Ln TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. �D x 98,64 /EXIST/NG <� ( 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING M0 AC HOUSE(#44) FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ccVO X 8.85 cNo = ENGINEER BEFORE CONSTRUCTION CONTINUES. N T.O.F.=f00.4f Z (n o 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. W 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF x 90 098.67 c V THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF d x 98,27 C� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. Z 0� x 99,39 Q 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. e5 ;99,35" 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. O DIRECTED F 9• ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS Q� MAsf9cy AGREED UPON BY THE APPROVING AUTHORITIES.UNBE OWNER AND AUTO OR OR AS OTHERWISE 0 J •DRIVEWA.YG o PETER T. s 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY McENTEE THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING x 99,00 ;:` '. • ' •`.r. 98,99 x 99,01 CIVIL CONSTRUCTION. x 99,61 q No. 35109 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND k LOT 634 -- R£6151 � REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). �O J :: ';. ':.:::.:':• �v� 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE Q 18,417 ±SF INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. x 99,15 CD <` j qq 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND DRA/NA E 99,14.,: EASEMENT NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC J SHOWN CD 99.16 SYSTEM COMPONENTS NOT S 0 N ON THE PLAN 136.54' 20.00' +99,99 N 27°43'14" E N 27°43'14" E PARCEL ID: 170- 100 x 99.74 _ PROPOSED SEPTIC SY STEM UPGRADE GRADE PLAN EDGE OF CATCeBASIN PAVEMENT 98.95 99 47 98.54 98 44 ZENO CROCKER ROAD, CENTERVILLE, MA 98.95 98,31 ,59 Prepared for: James Brown, 44 Zeno Crocker Rd, Centerville, MA 02632 ZENO CROCKER .ROAD OWNER OF RECORD EngiEngineeneering Works, Inc. SCALE DRAWN JOB. N0. 9 ry 1"=20 P.T.M. 215-20 I 44 ZENO CROCKER ROAD 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. CENTERVILLE, MA 02632 (508) 477-5313 7/22/20 P.T.M. 1 Of 2 f 4 NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:95.00 SEPTIC TANK FOR A DISTANCE OF 15' AROUND THE INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S.A.S. AND SET TO 6" OF FINISH GRADE. PROPOSED S.A.S. PROPOSED D-BOX PROVIDE ONE ACCESS MANHOLE TO WITHIN 3" EX/STING INSTALL WATERTIGHT RISER & OF FINISH GRADE FOR INSPECTION PURPOSES T.O.F.=100.4t COVER SET TO 6" OF GRADE HOUSE(#44) F.G. EL.=98.8t F.G. EL.=98.4t F.G. EL.=97.2f T.O.F.=100.4f' F.G. EL.=97.4f WOOD MAINTAIN 2% GRADE (MIN.) aa OVER S.A.S. SHED 3 • j • L = 50' L = 5' @ S=1% (MIN.) @ S=1% (MIN.) 6, - 4"SCH40 PVC 4'SCH40 PVC j pc 10"1 as O "4' 14" s 2' EFF. aaaaEXISTING 48" LIQUID DEPTH aaaaaaLEVELADD4' 4.8' P - ---GAS BAFFLE INV.=94.77 PROPOSED INV.=94.60INV.=96.66t D-BOX EFFECTIVE WIDTH 1 i tp� h� EXISTING INV.=94.50 1 EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN 1 1 H-10 RATED N� PROPOSED S.A.S. 1 1 TOP CONC. ELEV.=95.3f BREAKOUT ELEV.=95..50 ease 00 ease --- INV. ELEV.=94 1 1 SEPTIC LAYOUT eases 1--12.8'--I 8. NOTES: BOTTOM ELEV.=92.50 4' 2 x 5'=17.0' 4' 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE 4' MIN. OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' lm� 7— INVERTS, PRIOR TO INSTALLATION. PERVIOUS MATERIAL 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE ON 5' MIN. ABOVE GROUNDWATER LEACHING SYSTEM SECTION r ® 0 A MECHANICALLY COMPACTED STABLE BASE OR 6" CRUSHED BOTT. OF TP, EL.=86.2 — H- ®®® ® ®®®® 33" STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 3/4" TO 1-1/2" DOUBLE w ®®® ® ®®®® 3) INSTALL INLET & OUTLET TEES AS REQUIRED. WASHED STONE N Z ®®® ® ®®® 4) CONTRACTOR SHALL INSTALL A GAS BAFFLE ON — THE OUTLET TEE: 3" LAYER OF 1/8" TO 1/2" SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE (OR APPROVED FILTER FABRIC) 102" DESIGN CRITERIA SOIL LOG 4" KNOCKOUT DATE: JULY 10, 2020 (REF#TPT-20-138) 20" DIA. COVER NUMBER OF BEDROOMS: 3 SOIL EVALUATOR: PETER McENTEE PE(SE#1542) SOIL TEXTURAL CLASS: CLASS I WITNESS: DON DESMARAIS; R.S. HEALTH AGENT 4" KNOCKOUT 4" KNOCKOUT 58" DESIGN PERCOLATION RATE: <2 MIN/IN ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH 0 (0.74 GPD/SF LOADING RATE) 97.2 A 0" 97.4 A 0„ DAILY FLOW: 330 GPD SANDY LOAM SANDY LOAM lOYR 4/2 ' lOYR 4/2 4" KNOCKOUT DESIGN FLOW: 330 GPD 96.7 B 6" 9;7.1 4" B GARBAGE GRINDER: NO SANDY LOAM SANDY LOAM 500 GALLON CAPACITY, H-10 LOADING LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 1OYR 5/8 1OYR 5/8 .74 GPD/SF 94.9 28" 95.4 24 CHAMBERS EXISTING SEPTIC TANK: 1000 GALLON CAPACITY PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS PERC N.T.S. 26"/44" PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 2-500 GALLON LEACHING CHAMBERS IN SERIES � SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES M-C SAND I M-C SANDSIDEW 44 ZENO CROCKER ROAD, CENTERVILLE, MA 2.5Y 6/6 2.5Y 6/6 BOTTOM LL AREA: 2(12.8' + .8' x X 2 = 151.2 S.F. Prepared for: James Brown, 44 Zeno Crocker Rd, Centerville, MA 02632 BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. Engineering by: SCALE DRAWN JOB. No. TOTAL AREA:..............................................................471.2 S.F. 86.2 132" 86.4 132" Engineering Works, Inc. NTS P.T.M. 215-20 DESIGN FLOW PROVIDED: 0.74 GPD/SF(471 .2 SF) = 348.7 GPD NO GROUNDWATER, PERC RATE: <2 MINJIN. 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 7/22/20 P.T.M. 2 Of 2