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HomeMy WebLinkAbout0102 ZENO CROCKER ROAD - Health (2) 102 ZENO CROCKER RD, CENTERVILLE A= 170 134 R �r No. 42101/3 ORA ESSELTE 10% (a ® O O O Oh h, sw ti . r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION M 1- + i r `y r; TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION jj Q Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner's Name: BRIAN COMB Owner's Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Date of Inspection: 11/10/00 Name of Inspector: (please print). JOHN GRACI Company Name: . SEPTIC INSPECTIONS Mailing Address: '.,A,P.O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-68b'FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system p g inspector pursuant to Section 15.3404 Title 5(310 CMR 15.000). The system: X Passes ,t _ Conditionally;Passes _ Needs F h Evaluation by the Local Approving Authority Fails Inspector's Signature: 1 Date: 11/10/00 The system inspector shall submi 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 A THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEMS USPFULL LIFE. ****This report only describes cgn''�litions 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. Title 5 IncnPrtinn Fnrm h/150MV) �. 1?• 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 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: THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. B. System Conditionally Passes: " _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. n/a The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled'or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distrib`ufion box is leveled or replaced ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): _broken pipes)are replaced _obstructions is removed ND explain: n/a til Page 3 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 It C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and 'soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank-and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance n/a "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: n/a CIA Page 4 of 11 : OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than 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 IM. 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.] (Ye&The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet iof a tributary to a surface drinking water supply i, X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D'shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. d i Page 5 of I 1 of OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 # 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? 4. 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? tNx 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 sysiems? 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)] r. ar] F :4 it Fj a' Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):3 Number;of bedrooms(actual): DESIGN flow based on 310 CMR 15.20(for example: 110 gpd x#of bedrooms):330 Number of current residents:3 Does residence have a garbage grinder(yes or no):NO Is laundry on a separate sewage system(yes or no):NO [if yes separate inspection required] Laundry system inspected(yes or no):NO Seasonal use:(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a d COMMERCIAL/INDUSTRIAL* s, Type of establishment: n/a Design flow(based on 310 CMR 15:203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no):NO Industrial waste holding tank present(yes or no):NO Non-sanitary waste discharged to the Title 5 system(yes or no):NO Water meter readings,if available: n/a Last date of occupancy/use: n/a i OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: 1998 " Was system pumped as part of the inspection(yes or no):NO If yes,volume pumped:n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.,Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Y. _Tight tank Attach a copy of the,bEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 15 YEARS Were sewage odors detected when arriving at the site(yes or no):NO is N 6 Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 BUILDING SEWER(locate on site plan) Depth below grade: 12" Materials of construction:_cast iron _40 PVC Xother(explain):20 PVC Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): THERE IS TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade:6" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6" H 5' 7" W 4' 10"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle:32" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle:6" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: MEASURED Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. GREASE TRAP:_(locate on site plan) Depth below grade:n/a II Material of construction:_concrete_meial_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.)':"" n/a :� 7 Page 8of11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal—fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no):NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): THE DISTRIBUTION BOX IS STRUCTURALLY SOUND. PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a 4 R Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a ;innovative/alternative system ,Type/name of technology: nla Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.):. THE LEACH PIT APPEARS TO BE FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no):NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a U Page 10 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 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. A Ag c: sir � AA ig H AR k -3 � 3a ��q go 3q qq in Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 102 ZENO CROCKER RD.CENTERVILLE,MA 02632 Owner: BRIAN COMB Date of Inspection: 11/10/00 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators,installers-(attach documentation) YES Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS- 12+FEET § 7 z, , 3 11 l us L-X-Q 0 TOWN OF BARNST AD LE LOC �4�2--enaj SEWAGE # �tVILLAGE Ps(V1lL.Q—_ ASSESSOR'S MAP & LR 63� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER l� PERMITDATE: 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 by e ' 013� . �C 31 1° �D 3a � acy �� N,f (',OMMONwisii .urti OF MASSACHUSETTS Exi-,cu, IVF, OF ENVIRONMEN`I'A.L AFFAIRS DEI'AIt.'I RENT OF ENVI.ROIJM.ENTAL, PROTECTION ONE WIN'1'I?R STRFE,r. BOS'I'ON MI 02108 (617)i292-5500 WILLIAM F. WELD �('� TKUDY COXE Governor 1 cc� Secretary ARGEO PAUL CELLUCCI DAVID B. STRUMS Lt. Governor Conimussioner SUBSURFACE SEWAGE DISPOSAL SYSTEM I PECTION FORM PART A CLRI'IFICATION Property Address:too Ze.10 ' C Gc C&r Qd _ Ceneelvc�� Address of Owner: Date of Inspection: Sv��j Sy Ae18 (If different) 04 � /) 49 Name of Inspector: r I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.)O0) I014 C 1 ' Company Name: _ Mailing Address: 1u ViLxml, S I.,W► Ey ._._O�S�\7 a 4�ory FnTT�e(F �� Telephone Number: 50a-q4l 7.7 Sr._ _ _ 4r, / CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal sV,gern at This address and that (lie Information rehortec is true, accurate jy and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper iunction and maintenance of on-site sewage disposal systems. Tlie syurn,: FF _Passes fveerl% Purifier YyiIIIIJ11(111 0 t.Moo. ine Authority a s- I Inspector's Signatur Dale: 7 -114" P The System Inspector shall submit a copy of th. inspection repon to the Approving Authority within thirty(30) days of completing this #? inspection. If the system is a shared system or has , 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 Depariment of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: Al' SYSTEM PASSES: �F s I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. J Any failure criteria not evaluated are indicated below. COMMENTS: _ 5,jc-tF m is i� a�crr � +ter 1�►n4 arc\V!' . B) SYSTEM CONDITIONALLY PASSES: ;Y �Q One or more system components as des ibed in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, < approved by the Board of Health, will pass. (S` Indicate yes, no, or not determined (Y, N, or NO). .D(scribe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal, unless the wner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating it it the lank was installed within twenty 120) years prior to the date of the inspection: or ,e septic tank, whether or not met I(lie , is cracked, structurally unsound, shows substantial infiltration or exfiltrauon, or tank failure is imminent. The sysiem wi I pass inspection if the existing septic lank is reDlaced with a conforming septic tank as approved by the Board of Healil . "t (revised 04/25/97) Pave 1 of 10 j1 . .e �• 1'nn1�.I.n,Hrcvrlyd 1'uwr - ,. I i ri S. I�. j.,i SUBSURFACE SLWAGk, DISPOSAL SYSTEM INSPECI"ION FORM Ai p PART Ar CERTIFICATION (continued) Properly Address: Zeno Crecte` Qd Cenkervi %%E. Owner: RI qfl ben'tic Flncor% Dale of Inspection: 61 SYSTEM CONDITIONALLY PASSES unli nredl i - _ Sewage backup or brea oul or high static water level observed in the distribution box is clue to broken or obstructed pipe(s) or due Io a broker aeltled or unevrn djstribulion box. The system will pass inspection if (Willi approval of the Board of Health).' Describ observations: broken p wts) are replaced obstruclio is removed distribution uix is levelled nr replaced The system required pumping rnr re than four limes a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the nard n1 Flva(lh): broken pipes) a e replar-ed ,.y obstru(tion'is rer oved C1 FURTHER EVALUATION IS REQUIRED BY THE BOA 7 OF H[ALI H: s3 �« )' N0 Conditions exist which require frrrlher evaluation I v the Board of hteallh in order to determine if the system is failing to protect the i public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALIH )[TERMINUS THAT 114F cYSIEM IS NOT FUNCTIONING IN A MANNER i>,:;:r , I PROi;rt T14; . ,'R:s, ti .. MFtiT: Cesspool or privv is within 50 feet of a surf,ce water Cesspool or privy is within 50 feet of a bor( ,ring vegetated Welland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEAL (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER 1HA PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE )` ENVIRONMENT:, The system has a septic tank and soil absorp on system (SAS)and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. _ The system has a septic lank and soil absorp ion system and the SAS is within a Zone I of a public water supply well The system has a septic tank and soil absorp ion system and the SAS is within 50 feet of a private water supply well.. The system has a septic tank and soil absorp ion system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well wat r analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that faci (y and the presence of ammonia nitrogen and nitrate nitrogen is equal io or , less than 5 ppm. Method used to determin distance (approximation not valid). r 3) OTHER (revised 04/25/97) Page 2 of 10 t l ., f , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM {i PART A CERTIFICATION Icontinued) ?, Property Address: Mer►0 C.re,0LE(' Qd Ccn4er0%% k . Owner. 'A1gn r�er%ic� Aqt-otn , Date of Inspection: ;f a DI SYSTEM FAILS: You must indicate either "Yes"or ' o" as to each of the following: 1 have determined that the . stem vjolales ('me or more of the following failure criteria as defined in 3I0 CMR 15.303. The basis for this determination is iden fled below. The Board of Health should'oe contacted to determine what will be necessary to correct }.: the failure. x:r Yes No Backup of sewage into fa Ility or syslem curntronow due to an overloaded or clogged SAS or cesspool. Discharge or ponding of Cif rent w ine surface of the ground or surface waters due. Io an overloaded or clogged SAS or cesspool. Static liquid level In the distnhl Ilan Iw\ ahove outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspuol is less I in 6" helow invert or available volume: Is less than 1/2 day ilow. rr Required wm ring more than 4 tin s in Ilse last Car NO F doe to clogged or obstructed pipets). Number of limes pumped Any portion of the Soil Absorption Sy tem, cesspool or privy is below the high groundwater elevation. <I. Anv portion of a cesspool or Irriry is w hin 100 I^et of a surface \eater supply or Iribulary to a surface water supply. pu'"On Of a CSvj: ) ,. j: �... _ I ..71 a.G c.11 7, Any portion of a cesspool or privv is with r 50 feet of a private water supply well. Any portion of a cesspool or privy is less 0In 100 feet but greaser than 50 feel from a private water supply ca ill with no acceptable water qualiIV analysis. If[lie wr. I has been analvzed to be acceptable, attach copy of well water analysis for t'{fr coliform bacteria, volatile organic conrpoun s, ammonia nitrogen and nitrate nitrogen. k'iSltr El LARGE SYSTEM FAILS: You must indicate either"Yes" or "No" as to each of the followi g: P The following criteria apply to large systerns in addition to the criteria above: e a The system serves a facility with a design flow of 10,00 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because o e or more of the following conditions exist: Yes No t the system is within 400 leer of a surface drink rig water supply r the system is within 200 feet of a tributary to a surface drinking water Supply y the system is located in a nitrogen sensitive are i (Interim Wellhead Protection Area - IWPA) or a mapped Zone 11 of a public water supply well) The owner or operator of any such system shall'bring the system nd facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the loc I regional office of the Department for further information. - t}, d=. (revised 04/25/97) Page 3 of. 10 f . f` 1.: Y.a { i'•'.it r t' SUBSURFACE SEWAGE DfSPOSAC SYSTEM INSPECTION FORM PART B CHECKLIST Yti Property Address: 10 a Ze n/0 C t GcM:-E r c e n to r v l It - Owner. E�tr1n r�tIR%iLE. t tAton Date of Inspection: Check if the following have been done: 1 ou i nist nidicaie either "Yes" or "No" as to each of the following: Yes No _ Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been punlped for at least twig weeks and the system has been receiving normal flow riles during That period. Large volumes of water have not been introduced into the system recently or, / as part of this inspection. $,' ✓ _ As built plans have been ohtainei,l and examined. Note if thev are not wailal)le with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakoiri. _ All system components, excluding the Soil Absonition System, have been located on the site. Ft baffles or lees, n'iaiei'iai of ivi%triiii ril, ii;:il it+iiiiii, depth Ct I;:.iuid, depth of sludgc; depth of scum. The size and location of the Soil Absorption Svslem on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.U.H. t•', ✓ _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is r unacceptable) (15.3020)(b)l (revised 04/25/97) Page 4 of 10 C� x. - " }.. 'apki SUBSURFACE SEWAGE DISPOSAL SYS'IEM,INSPECTION FORM PART C SYSTEM INFORMATION Property Address: IOa Zeno ceec.k.Er V_ck Cente�villE Owner: MAO r Jt<liC� Achr0n Date of Inspection:, FLOW CONDITIONS RESIDENTIAL: Design flow: g.p.d./bedroorn for S.A.S. !"0 Number of bedrooms:X Number of current residents: i Garbage grinder(yes or no): t�0 Laundry connected to system (yes or no):%Af Seasonal use(yes or no):_b ,.. Water meter readings, if available (last two Q) year usage (Rpd): 7 Sump Pump (yes or no):_%lp `• r Last date of occupancy: #x?. COMMERCIAUIND TRIAL• K Type of establishment: Design flow: gall Is/clay 'r Grease trap present: (yes no)_ #eE, Industrial Waste Holding nk present: Lyes or no)_ Non-sanitary waste discharg.d to the Title 5 system: iycs or no)_ E r Water meter readings, if ava able: i scr r:n,n nr nr.:,,,., ,,, " x'. OTHER: (Describe) is Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information:ste p rape r y Syd as part of i pection: (yes or no)_tW If yes, volume pumped; _ gallons Reasonpumping:R for TYPE OF YSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool } '^ Privy t•.' Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? f na Other Y. APPROXIMATE AGE of all components, date installed (if known) and source of information: i"1 ka 18 5 Sewage odors detected when arriving at the site: )yes or not -tip, (revised 04/25/97) Page 5 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM I; PART C SYSTEM INFORMATION icontinued) ).. Properly Address: 16a Zeno Croch_er Ccnker'J"tq t' Owner. P.%AtS i nn , f-nicF— t"IAroYI Date of Inspection: BUILDING "WE (Locate on site ("a Depth below grade: Material of construdi cast iron _ 40 l"VC _rather (explain) (.t Distance from private water supply well or suction line ,I Diameter Comments: (conditioi of joints, venting, evidence of leakage, etc.( r SEPTIC TANK: (locate on site plan) Depth below grade:_ Material of construction: _Zconcrele _nw.tal �Fiherplass _Polyethylene._othe..r(explainl If lank is metal, list age _ Is age continued by l.e0111cale of Compliance _(Yes/No) Dimensions: Ira K 5 Y.+"1 Sludge dewh:_ A"— t'' ;.i Scum thickness: ...Q , —'sPO't'ilL .;; Distance from top of scum to top of outlet lee or hattle:A__ , ,r Distance from bottom of scum to bottom of outlet tee or battle: ! ` How dimensions were determined: Comments: ' (recommendation for pumping, condition of inlet and outlet tees or haffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) _ TAnk i}�`.eeA CA net,inn A►► Cav►A lruet`5 ar V- car rEc T Wn sinn' e, Ie A ;42C GREASE TRAP: (locate on site plan) Depth below grade: Material of construction: oncrete _metal `Fiberglass _Polyethylene._other(explain) Dimensions: Scum thickness: Distance from top of scum to to of outlet tee or baffle: Distance from bottom of scum to ottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping, condi ion of inlet and outlet tees or battles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) ° -(revised 04/25/97) Psga 6 of 10� ! i • t 1' i u, E)f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ill PART C r SYSTEM INFORMATION (continued) rt Property Address: lOaZeno CcockEr e-d CenleC 3 XkJL Owner: A\An �cniC£ 0A('on Date of Inspection: ? : TIGHT OR HOLDING TAN (Tank must be pumped prior to, or at time, of inspection) (locate on site plan) '. Depth below grade: ti G Material of construction: _concrel _metal _Fiberglass _Polyethylene _other(explain) tii .9 'i Dimensions: Capacity: gallons 4= Design flow: gallons/day j . •,c•sf Alarm level: Alarm in workir , order ties No IN, -- — t Date of previous pumping: Comments: (condition of inlet tee, condition of alarm nd float sww,hes, etc.) �e 'ors DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert:_ Comments: [ (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) �zr 1-)QTEr- /—e j ►e el in L- —f-Irs _Sa28S Orr QCA ", Ahi, 1e t'\ I; etAC �'..,Sh ��,l�h N e V"'o AA 611" (ZIC Ah$ ba-k \e Ir PUMP CHAMBER: (locate on site plan► Pumps in working order: ( .s or No) r Alarms in working order(Y or No) €t: ` Comments: (note condition of pump cha ber, conditi( imrops and appurtenances, etc.) h. s ni ,y ' I f' ,i ' (rwimed 01/75/97) Page 7 of 10' .% d: 44, SUBSURFACE SELVAGE DISPOSAL SYSTEM INSPECTION FORM PART C r SYSTEM INFORMATION tcontinued) Property Address: %0a Z eno f`coekf f e& CtAEer J" Owner: A1gr., beAM_ AAcor1 Date of Inspection: t SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible; excavation not W(jUiWd, but may by approxim:;led by non-intrusive methods! 1. If not determined to be present, explain: Type: leaching pits, number: j leaching chambers, number:, leaching galleries. number: leaching trenches, number,length: leaching fields, number, dimensions: i overflow cesspool, number: t Alternative system: Name of Technology: :Fz Comments: (note condition of soil, signs of hydraulic failure, level of ponrfing, condition of vegetation, etc.! i "s CESSPOOLS: (locate on site plan) ,1,' Number and configu\,nve fir; Depth-top of liquid t Depth of solids layerj+I Depth ofacum layer:,+•,;, Dimensions.of cesspMaterials of construcIndication of groundinflow (cess pumped as part of inspection) Comments: (note condition of soil, signs of hydr ulic failure, level of ponrfing, condition of vegetation, etc.) k 4. ;;• PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydrauli( failure, level of ponrfing, condition of vegetation, etc.) t+ (revised 04/25/97) Page B Of 10 I j!t SUBSURFACE SWAGE DISPOSAL S1'SIIao1 INSPECTION FORM PART C ' i ' SYSTEM INFORMAIION (conlinued) Pro pertv Address: IOa Zen0 C.,rccv-ir CenteroillE, Owner: Al/jY� , 1tAiCt plAcpr\ Date of Inspection: 98 Y9< {) ;# SKETCH OF SEWAGE DISPOSAL SYSTEM: if ties to at least two permanent reir•mnrcc landmarks or benchmarks ( locate all wells within 100' (Locate whew w1hilc water supply comes nHo housr•1 'f 5{� „*y l - szD£ A 4"" fl, AC EF _ 33° A- 44 ,•b 3 , (revised 04/25/97) Pegs 9 of 10 i`,' SUBSURFACE SEWAGE DISPOSAL SYSTEMJNSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: loa Zeno Crec-tF-(- ?A— Center vi%%IL Owner: Almon, btn--cL PIPCOT% Date of Inspection: 1_(y .9a Depth to Groundwater _ Feet wAj�C 0.T 1 i Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record a observation of Site (Abutting property, observation hole, basement sump etc.) ternine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words Itow you established :he Mg! L ,,, ndWs: . E!erauun.. K.Iusf be Compived) . ��dnCt �hE S'-4ree� -here Clf� GA�ch IpASinS �or �hE. waT'Er` MAer- deEecrniniA e1evA-Zion\ . C-AmV— }o the cos1c1v5ior� h►rJh y001 WATFr is no Fqc nor . r (re.tsw 04IM" Nge 10 0(10 LOCATION _ SEWAGE PERMIT NO. VILLAGE ; t �7 m!c��� 2nr 2 f INSTA LLER'S NAMIE & ADDRESS - 1 ��+ `� C x ��R��UIIILL D E R OR OWN ER DATE PERMIT : ISSUED ; -� j D A T E COMPLIANCE ISSUED Z Aw i P �✓ Po -- ,3 Q- 10 CAT IO SE-WAGE PERMIT NO. ..VILLAGE - s I N S T A LLER'S NAME i ADDRESS B U I L D E R OR" OWNER N j—'i 97 L - SQL CC kIS DATE PERMIT ISSUED a DATE COMPLIANCE ISSUER Z �� ;�� ,,.,....�...,,,.�, 1 ` �V ��, �� 1 � � " /�/ lib 4� �.. .` i _ ,�t� t � � � � ,� i ��, s ,! No _..:zZ?! THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -'' ....c.../1..................._0F....... ..................................... , pplirFatinn for Disposal Works Tonstrurtinn thrutit Application is hereby made for a Permit to Construct (cam) or Repair ( ) an Individual Sewage Disposal System at: ---------- --•-•--- - Location-Address /� or Lot No. -----.... .r^. ...._ ?a L-5................................... �. ress ............ ..........11 /ter of ......r 1,..................... Installer Add, U Type of Building .� Size Lot_A77,t�'�'-f�___Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder a`4 Other—T e of Building No. of persons............................ Showers ) YP g ------•-•------•------------ P ( ) — Cafeteria P4Other ,fixtures ..........................................................•••-•-•--•----•.........------------•-••-••-•-••......-•- W Design Flow.......... .......................gallons per person per day. Total daily flow...... ......................gallons. WSeptic Tank—Liquid capacityjO 4?gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--•_____---.I........ Diameter--------- Depth below inlet......1�._____. Total leaching area.Z .�___sq. ft. Z Other Distribution box ( ./5' Dosing tank W ) , '-' Percolation Test Results Performed b L __. W0�.................... Date.....4A�Vl Test Pit No. 1----�Z_minutes per inch Depth of Test Pi .......12-i...... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O .---•••--•-•••••-•-•-•-•----••-•••--•-•••••-•-••---•-•••-•-••-••--•--••••---•••--•-•-......•-----•--._.. ..-- ......................................... •..........................__ �s Description of Soil--------------�----�---�Q��S �-4�=t•--�---�-----------��--�•`-�-`-�-P---- -... !.��:�1.,. W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------------------•-----------------------------------------•_.._..... ••-•--••-••---••-----=•••--•••--••----•--••----••••-•-•---•--•-•-••-•---••-----••..._----•....... Agreement: The undersi ed agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisi of 1 I.L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in o io nti rtificate of Compliance has b n sue y e board of health.Of —, Applic tion Approved BY _ .....------..... ...�............................. ..........l �.... Date Application Disapproved for the following reasons----------------------------------------------------------------------•---------•-- •---•---•-----...._.._.-. ----------------•---•------...-----•--------•-----•----------.......---------------------...---------------••-••---••••--•--•••-••--------•----••••----•---•••-. •-----••...-•-----••••---•••••-....••- Date PermitNo....:::2............................................... Issued_..................... --- ............. D e a-' •'cyti`+�a�i No :�-�---�-�•P Fps. �.1.=?'.�...... THE COMMONWEALTHOF MASSACHUSETTS BOARD OF HEALTH H �. ..........0 F....... . c (�h'-��- -`-Ot �5 1._..� (- _..._.... ..................................................... Appliratinn for Disprrial Workg Tomitrurtinn ami# Application is hereby made for a Permit to Construct (Vl�or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. ......... .a.r .t� �__ 1.. ... ......... OP JCL- dress ...._......_ ........� ?! .............•... Installer AddrT 4 C� UType of Building Size ot______________• _:�__`':�__Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( } Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -------------------------------•-------------------------------------------------------_..---------------•----------------------••••---•......_.._... W Design F ....r,�.......................gallons per person per day. Total daily flow-_-___: �� ..__.._...._....____..gallons. WSeptic Tank—Liquid'capacity.t!�'f�.'�gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width..........._........ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.............t------- Diameter----------(a-`- Depth below inlet....._'........ Total leaching area..7.:r;.-.:.17..sq. it. Z Other Distribution box ( ✓ ' Dosing tank ( ) Percolation Test Results Performed by.----n .:.-f/ - --------------- Date....- --------- Test Pit No. 1___.2�:Z::: .minutes per inch Depth of Test Pit___....12_....... Depth to ground water---------n........... rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Pa ---------------------------------------------------------------------------•••.._..-----•--....•........r................................................... D Description of Soil-------------- 1� ' " ' .1 . W UNature of Repairs or Alterations—Answer when applicable.................................................................................•.._._.....__. ------------------••---------------------------------------------------------------------------....--------•------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bet n i sue b'y e board of health.�� -----Signed `, . ----••-- •. . ; Date Application Approved BY .... _= • .... .. .........•�. :`_::..:...._.--•-....•-••-•-•--•--•- r� >_ : Date Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------•..... .. ..... •---•-.....•---•----•----••.............••-••.....I. Date Permit No.•-•R.S- �-� -----------••--•••.. Issued-.---...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD/,-,OF HEALTH . .. ��....................:OF..... �,. / 1 �nrtifirFa#r of TI-I ptiFanrr THIS S TO RTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by-------------- r f= ' ................................................... ................................. ......................................................... �--- Install Vf at.............. 1 has been installed in accordance with the provisions of TITi 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-----__K 1_... dated---- -4 ��. ... .............. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.... ..._f_2 . ... Inspector_... �•• THE COMMONWEALTH OF MASSACHUSETTS ,�� �f BOARD QF HEALTH C.r•-'�» � e' r�f> ✓r ........................... v�� N ............ ........... FEE. ' :.�2.......... R.011110Fa1 nr�� �nrn rnnr uan Trani Permission is hereby granted.......7 _._ ... ......_ to-Construct or Repair ) an Individual Sewage Disposal S3 t n .. Street as shown on the application for Disposal Works Construction Permit .N _.:.__..___ Dated...��?`r?_�r` ............................... ........... -.. : r ........ Board of Health DATE......... ------------...._.._.......--------------------•--- ----- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - - 5.,,';1 .tri....yi'.i' •Y Y", K ^= >' .� .,swf�'P.tct;c,:f s„" .fir:.:;'+'v4 r�.# Ft:.. ,:.,;:., ... `f-ry #ymn Z'7ra.K� j`fir ?" �"., 3?n..i.'�, t .;;1 . nz­ SITE PL A N SHEET / OF 2 SCALE: / . 2,-' 13aj o� S2 w%r►-1 z'�Tor�E ,�R�v�''D � a � Is j A.�� 1 lovO G.A1..�5.�-PT1L ' 1 TD.NK j 11 d 17 -+4,2 . / �? III � L — t O �j, 4-a)' � • S p% f c WILLIA6+A Gs M. WARWICK N No. 197T1 AFCISTE���• � FOR REV STEREO LAND SURVEYOR L©^,' 2 t3© �J v ZONE L 4- -P.6 PLAN REF, DATE JZ3 �5 BENCHMARK DATUM GI�t,�J �ay�zv WM. M. WARWICK 8 ASSOC., INC. DOMESTIC WATER SOURCE �`�'`�''-' ``J A-2-1 80X 801 - NOR TN FAL MOUTH FLOOD ZONE. �"J' �' � �- MASS. 02556 - (6/7) 563 -2638 I C i. .� i LEACHING /3ASIN SECTION NOT TO SCALE z 24"C,/.MH COVER EARTH FILL BRICK AND MORTAR COURSES AS RE00• TO BRING _ _•r.�_ _ COVER TO GRADE 4 8"FLOW LINE `- l INLET �— _ ._ _—'.':__ :. 2�-�"TO/2 WASHED PEA STONE FREE Of IRONS, PIPE FINES AND DUST /N PLACE OPENING WITH 4%B" �•• •,' 314 RONSo sHeD FINES RAND DUST cRu�N PLACEE FREE OF 7 : OUTER DIAMETER AND /314" INSIDE DIAMETER " 1. CONCRETE TO BE 4000 PSI 28 DAYS 2. REINFORCED WITH 6"x6" NO. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS 4,0„ sb" I 2� —� 4. NUMBER OF PITS REQUIRED MIN Io NOTE: EXCAVATE TO ELEVATION *0-3 OR EFFECT/VE DIAMETER , r--- (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL w &_F - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROF/LE GRAVEL TO DESIGNED GRADE. 1811STD LT. WO C.I.MH COVER 4"C.I P/PE 4"8/T.FIBER PIPE TIGHT JOINT OUTLET LEVEL DWELLING FLOW LINE TO FIRST JOINT -•- ti ,-. �, r� O 00 7 !SLL 14" 11 00 to C./. TEE SoSa SoS� I11000100 11 I I oj7 .'STD. PRECAST CONC. 5a,71 0/ST BOX TO Be 50,�j ' '1000 00 of '. II dooGAL.SEPTIC TAN INSTALLED ON LEVEL, 1 1 1 0 00 0 0 0 1 1 I STABLE BASE ' '1 0 0 0 0 0 0 1 1 : . if f 0 0 0 0 so \SEPTIC TANK TO BE '1 600 O 0 1 It I INSTALL D ON LEVEL, l if 100I O 0 11 STABLE BASE. i ' 1 0 0 0 O O 1 1 000 G 0 1.1 „ LEACHING BASIN lot O O D D BASE TO BE LEVEL 1 1 8 0 O 1 50/1 AND PERC. DATA PERC. RATE Z MIN., /IN. 0 TEST PIT NO. P 37v 0� TEST PIT NO. 2 z TvP/5�S5o�1-- TEST BY WITNESSED. BY: TEST PIT GR. EL. ��' GL��.tJ MAD• 5aN1> DATE I /Z S �a�l- li ab No aR.our-'owA Lcs��,y DESIGN DATA GENERAL NOTES BEDROOMS 2 NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL 1''��� SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFO GPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK Laoy GAL. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, SIDEWALL AREA�'S GAL./SQ.FT. MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA LO' GAL./SQ,FT. SANITARY SEWAGE EFFECTIVE ON JULY 11 1977. LEACHING REQUIRED t79'ISQ.FT. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. ZEESQ.FT. AT -COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES I/4" / FT. UNLESS INDICATED OTHERWISE. SEWAGE DISPOSAL SYSTEM o` MARTIN E. a.� MORAN H �� �3aj Z.L�I�IO GrLoG�s��fZ �oA7 .p f23417�Q c� `�!• 9nFcclS"tE.� ��,� w . G E rs-r��...�11�-l.� , N�-�`��i dk_ FSp.,. � SCALE AS /NO/CATED DATE .l L 3 Z3 2ZS • blur. M. WARWICK 8 ASSOC., iNC. BOX 801 — NORTH FAL MOUTH MASS. 02556 — (617136.E-2658 PROFESS/ONAL ENGINEER