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Home My WebLink About0024 ZENO CROCKER ROAD - Health (2) 24 Zeno Crocker Centerville A= 171-283 S M EAE? No.2-153LOR UPC 12534 smead.com • Made In USA r �� 5�, / O h Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd \ Property Address Paul Whelan - Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. Cityrrown State Zip Code Date of Inspection 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. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification • I certify that I have personally inspected:the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system:' ® Passes ❑ Conditionally Passes ❑ Fails ,❑ Needs Further Evaluation by the Local Approving Authority AD , µ; 2-12-13 a _T1 nspector's Signature Date UZI The system inspector shall submit a copy of this inspection report to the Appr ving AutWty (board of Health or DEP)within 30 days of completing this inspection. If the system i a sharedysysteit"tjor has a design flow of 10,000 gpd or greater,the inspector and the system ow r shall submit OR report to the appropriate regional office of the DEP. The original should be sent to the *err`Owner and copies sent to the buyer, if applicable, and the approving authority. ****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. t5ins•11/10 Title 5 Official Inspect on F rm: ubsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form -. o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D' A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. - Comments: System is in good working order with no sign of failure. 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. 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. E1.1( ❑ N ❑ ND (Explain below): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts , Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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): 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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: **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 must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface ofthe ground or surface waters due to an overloaded or clogged SAS or'cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts s Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a,public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone 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. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts ' Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Mg0 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any 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 this 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? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 I Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump?. ❑ Yes ® No Last date of occupancy: 2-12-13 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) - Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No i Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner--not since new in 2010 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: New system Type of System: ® Septic tank,distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool a ❑ 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): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form m Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) ' Approximate age of all components, date installed (if known) and source of information: 2010 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): 18" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form :Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of inspection D. System Information (cont.) cont.Tank Septic p (cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" i Scum thickness 1" 6" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 1511 How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. . 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 t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °7M 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town, State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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: gallons Design Flow: gallons per day 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G'A 24 Zeno Crocker Rd - - - Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) :Y Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Good condition with water at working level and no sign of back-up from field. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 10-Infiltrators ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): Infiltrator leach field in good condition with no sign of back-up into d-box or surrounding stone. 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts - s W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G M , 24 Zeno Crocker Rd - Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts = M Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 A c � _ t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 1 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12' 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 ® Observed site (abutting property/observation hole within 150,feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts m Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Zeno Crocker Rd Property Address Paul Whelan Owner Owner's Name information is required for every Centerville MA 02632 2-12-13 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF EARNSTABI. Ze LOCAVON SEWAGE VILLACa& e /er (/ `1� ASSESSOTS M"&.3.07 .�..7— INSTA��LE12'S NAME�&'�€f?NE Y�TO. SE 'I'YC TMK CA&';�.CITX .- - ,. LEACI�TNO' ?ActLI TY (typAM e) � D ova O� zz Sepserat�oci FJS€aebceetv� [a tie 11Vlax�t�urn lju '�Gt alniciwitec'�' kle to elacc�nntri ut l,e�c;hEn Nacliey �- .»� 91�Iv 4 WaBssr aupNty 1Jcil s�ci L eaahiag aC lity sany e�etis cxis2 an site acr�thsn x0A feet;of leaetirl';facility) . •_— •r Edlct9ans9 d Uac6t�► it+aci i¢y( any w�;tlznds gist (per' viitlatsa'jd0 fc.eevf! al�in$ purj'�:►hed by s�.- ' i -c-�d � -0- 3�6• � -o-3a •ASSESSOR'S MAP N0. PARCELS'" I �r L6'CATION a�{' SEWAGE PERMIT NO. VILLAGE INST-A LLER'S NAME i ADDRESS e i4 B U I L D E R OR OWNER es DATE PERMIT IS.-SUED , i DATE COMPLIANCE ISSUED i° IS rr -16CA �.. Town of Barnstable + oFt"E'° ,> Regulatory Services o� Thomas F. Geiler,Director Z .LA"STAaze. Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form :*L21 D 4z7 Date: y Designer: C—A S Sy rZ I E Installer: K1G TA,- V- A, 5- �i Address: PO O0_1� 1_1 f- Address: FO J0o-! 4-v CAM tc-(��Pr of -9WdisepvrM - 6Z&59 On l 0- Z2 O 1 VZ_i Kea G was issued a permit to install a (date) (installer) septic system at 1* o C. oc.4✓ Coyi ✓vi Ne based on a design drawn by 1 (address) = dated 10- 18 -ly (designer -�--- A_ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. 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. oVzH of�SS9 ti (Installer's Signature) og DADVID oGN� FLAHERT' , JR. y \, No. 1211 N Y STE?- (Designer's Si ature)Z��/ (AffixP p Here) PLEASE RETURN TO BARNSTABLE PUBLIC Iil✓ALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Desiper Certification Form 00 No. Zo to Feet/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIppgicatiou for Ti5po5al �§pgtem Coug;tructiou Permit Application for a Permit to Construct( ) Repair(A Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No.Zy �2no �r®� � Owner's Name,Address,and Tel.No. Shun ke^ Jy 6 221' 2` l-,e� Res Assessor's Map/Parcel I �� Installer's Name,Address,and Tel.No. T';L 'T:,LA Designer's Name,Address and Tel.No. E.A.S, Suwa,7 P.O. Sox 4L7- Du a.,s�� MA O-LG39 IN I 'GA . P.o, Cox 11LI Sa.1.4 MA S®8- SOS_ 6!`t Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 310 gpd Design flow provided 36 Q gpd Plan Date 10v1$-10 AA Number of sheets '�. Revision Date N/A Title serc Slt�, F-� m-y, NAM e�++ I Size of Septic Tank Ipw aau�.. Type of S.A.S._litkilra M ►" srnr( Description of Soil eo Q 40-si w'- 104 S Nature of Repairs or Alterations(Answer when applicable) IRs�alll olts ,iUteOg lax And . SAS Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed y^-�"o'""'' Date _��t-1® Application Approved by Date /O 2Z- /t] Application Disapproved by: Date for the following reasons Permit No2b P' 42"7 Date Issued (a --Z2- - /C7 J' No. � ?< Fee v Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS ; p Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS l: Application for Mil gal 4p!5tem Cougtructiou Permit -. Application for a Permit to Construct O Repair(X Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components t Location Address or Lot No. Zy �¢^� -�� pu' Owner's Name,Address,.and Tel.No. S�avn ken^e %.ZZ1 '2�� 2`f2ea�oo „12 . Assessor's,M.ap/Parcel " S.� � V i I Q 1 + Installer's Name,Address,and Tel.No. M,`uL 7;,L-h Designer's Name,Address and Tel.No. E•A.S_ Sury ty LZ Dt-^^ sp.J Mr. 0Z639' (M 1 RQJq. GA P.U. D., 170 SC„J% •cL MA 508-'77�- z Soft• 8Q -36r 9 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 310 gpd Design flow provided 34&U rI gpd Plan Date 10-18—I U Number of sheets Z Revision Date N/A Title SO-C. SLf�Q , Pia^ I Size of Septic Tank j0og Ida. Type of S.A.S. In t.-1 C r,4,.r z im V sc.J Description of Soil '$ �es� kulo_ 10q S Nature of Repairs or Alterations(Answer when applicable) 1Aslj o(,sf,-,Lj'bh ta^d SA S Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. C Signed -a-' '*'"""" Date la ',I-10 Application Approved by Date /O 2 Z.- /(� Application Disapproved by: Date s for the following reasons Permit No.021 0 42 7 Date Issued /0 -Z 2- t 0 �+?�*A57�!�2'!��,, THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) \. Abandoned( )by f�, at 2`� L�`ENy "�" (£j)>64-VI LI.C, AAA has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �l tJ TZ� dated(0-27—^f o Installer Designer #bedrooms Approved design flo gpd The issuance of this permit shall not be construed as a g Y guarantee that the system will ct'on as designed Pt I Date �� (� Inspector .k.-4►.s....«..�.��.,N...u�.is_�srf.—e+0l-:eae_sr.,ia— 0 � --.a .5f�r.�k:�P'Ptw®�v'3'i .�r . No. G�� Fee �� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS &.gpo.5al �.&p!gtem (Con.5truction Permit Permission is hereby granted to Construct ( ) Repair (x) Upgrade ( ) Abandon ( ) System located at 2-4 2,fil D Ck c:C� G2 Kcl C: rTtG1�✓I j m and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. ' Provided: Construction must be completed within three years of the date of this permit. / � A Date /U 2� / Approved by , U 1 TOWN OF BARNSTABLE %LOCATION O—OrC er . rA SEWAGE# �()'r��JJ`? 1 VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. A K.c T K G►Gh SEPTIC TANK CAPACITY J X40 LEACHING FACILITY: (type) 0 ro,+orS s (size) � o a5 NO.OF BEDROOMS OWNER PY-ennecl PERMIT DATE: /G c2-1-I IG .� c OMPLIANCE DATE: /D 1 v Separation Distance Between the:1011-- , 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 3 to9l o 3 � Ct Li 0 3 Town of Barnstable P# Department of Regulatory Services Public Health Division � �s Date 9-/)'- /o 'OrEo�erN►`�$ 200 Main Street,Hyannis MA 02601 i Date Scheduled_- 1 Time ( Fee Pd. 4�919 Soil Suitability Assessment for Sewage is osal p Performed By: Witnessed By: - LOCA�.'ION&GENERAL INFORMATION FLmocationddress �� V IL�3-e--ItD ' /VILOwner's Name �,� 1i�vL ` � Address . 3 'j` `�ssessors Map/Parcel: Engineer's Name C�jJ v C� NEW CONSTRUCTION REPAIR Telephone# 572 Land Use (� �_. (' Slopes(9'0) �U� Surface Stones wld�_ Distances from: Open Water Body ft possible Wet Area � Drinking Water Well Drainage Way ft Property Line —�ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands In proximity to holes) -\ 1 � rpD SEP 1 5 RECT i . i By Parent material(geologic) l GEC GJ1 S Depth t0 Bedrock Depth to Groundwater. Standing Water in Hole: A14 \ Weeping from Pit Face Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE Depth Observed stan in obs.hole: Depth to weeping from si f obs.hole: In. Depth t0 Soil mottles: ln. Index Well# n. Groundwater Adjustment ft, Reading Date: Index Well level.--- Adl.factor AdJ.droun liter Level PERCOLATION TEST brats lv x�lmp Observation Hole# / J� Time et 9" Depth of Perc -- �'j--- Time at 6" Start Pre-soak Time @ Time(911•611) End Pre-soakZ3 Rate Min./Inch 24 7x� Site Suitability Assessment: Site Passed v Site Failed: ' Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) week prior to beginning. Q:\SEPTICVERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other . Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistencv.%Gravel) 75 K s -7 G DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C nsi ten %Gravel 6"_/6y � . Z 7,5 /v �'��32, G2 C��se Z•b771 /a/� a cp d DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i to c Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones:Boulders. Consi ten I I F' .,od Insurance Rate Map: / Above 500 year flood boundary No— Yes Within 500 year boundary No_ Yes Witi;in 100 year flood boundary No._ Yes Depth of Naturally Occurrina Pervious Material Does at least four feet of naturally occurring pervio s material exist in all areas observed throughout the area proposed for toe soil absorption system? 'R If not,what is the depth of naturally occurring p vious material? Certification I certify that on 9d (date)I have passed the soil evaluator examination approved by the Department of Environmental Protectio and at the above analysis was performed by me consistent with the required training, erti a exp describe 0 CUR 15.017. Signature_ Date Q:\.S.EP nCU'ERCFORM.DOC No..L?:.�..�1 Ole FzS.......r..�. '.-.�. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH L7 M.W.Usk..........OF... !-•-J••1c�4c�T- � •-- ............. Appluttttun fur Utuouual Workii Cnunutrudivit thrmtt Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ......1. .. �.... .. ..�.. .._.... `TI J.�.V. l:. D�G ..................... ....._.�e� .....!_eation.na ress.................................. ......... •-� Lot No. ................................__..... w !�, — Owner Ate dress ........•• �. ..: ................•-._.._._..... . , ._._...--------------.---...... Installer Address n f . Type of Building Size Lot__t.�_)'.l�.S..Sq. feet �-, Dwelling—No. of Bedrooms............... ......................Expansion Attic ( ) Garbage Grinder `4 Other—Type T e of Building No.- of persons............................ Showers f� YP g -•------•=---•-•--...------- P ( ) — Cafeteria ( ) a Q Other fixtures ................................... ---•............................. ...._........-•---•----•-•-••-•----------••-•----....-----••-•------.....--=-•-•-•-•--............. Design Flow....... _._\__[ ......................gallons per per- er`day. Total dai� Aow......... .� .................. lont, Septic Tank—Liquid capacity_Mn.gallons Length_...(a...... Width:..5..�._ Diameter________________ Depth x -Y. Disposal Trench—No. ................... Width:....1 ------- Total Length..............t.._.. Total leaching area_._........_.._ .-Sq. ft. 3 ,: Seepage Pit No.._..__._:�._._.__. Diameter...... ._..__. Depth below inlet......�....... Total leaching areatio.t....sq. ft. Z Other Distribution box Dosinnk ( ) `'" Percolation Test Result Performed by'.. ._.��-2��1 ... .. Date....UQ. ..�r S..it,........... . 1.4 ,-. Test Pit No. 1.. '._.._minutes per inch Depth of Test Pit... ..... Depth to ground water.........o_5-4.E� ~"f _minutes pe inch Depth of Test Pit.................... Depth tQ;ground water__..._..........._...._.Test Pit No. 2..._._.__�.._. .._ .. Description of Soil_.. .... f .._ . � V.... � V ............ •---------- ...............•----------••...._•••-•-•-----•••••••--....__............................_....._.... ...- --____••--••----•---------- ...._____ . .................______.. W ---•••...-•------•--•-=-•--•--•-•-•.......................•-•----•-•----------•-•-•--•-•-•--•--•----•--•-•-•---•-•-••-- -•-•--.-•---•-•----•.._......-•---•-....._...-•---...._:_........------•--_..... U Nature of Repairs or Alterations—Answer when applicable.................................................................................4............. ........................................................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 'AITLZ 5 of the State Sanitary C e— The de i ed further agrees not to place the system in operation until a Certificate of Compliance has b ss d e of health. Signed................... ...............•••_....__.._..........-- / D.�( . Vv_ _ Application pproved By..... ::................... 14-Date Application Disapproved for the following reasons:............................................................................................................ ......:......:.::..........•--•-=--...............--••--•-•------...-----............---........_._..............----....-----•---•--.........._....__..._._..--•-•--.....----........................... Date Permit No.......L ram.....-�p - ..._ Issued....................................................... Date No..:�.�.. I Q Fr�s..... � THE COMMONWEALTH OF MASSACHUSETTS - p ly'BOARD OF pHEALTH ..........OF... : .I\..! 'uaj. :. .� tlutttiun fur 9i pu�ttl orko Tonstrudion Vermit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at ......1�,��:(.(�,...(6-.:: c., O �..�o�IC�-i� .rcOAQ �::�ow—A.Q 6 zo E...................... .......t�C tl✓ 4._.^.� Location J� -Address e'� Lot•..... ........... ..... Owner )e �A�dress M Installer Address Q7i Type of Building ! Size Lot.._..-.....►..., q. feet Dwelling—No. of Bedrooms--------- .........................Expansion Attic ( ) Garbage Grinder (►e Other—Type of Building No. of persons............................ Showers — W YP g •----•--...---•-----•-•----- P ( ) Cafeteria ( ) 04 Other fixtures -------------------••---•---•--•- _..:.A:-..:................................................................................................... W Design Flow............... .....................gallons per persorroper day. Total dairy ow_._......................._................. gallons. WSeptic Tank—Liquid capacity_M�.gallons Length 9�?_.n1k... Width;.."" Diameter................ DepthA,'.1.Q_. x Disposal Trench—No_____________________ Width.................... Total Length..............t----- Total leaching area.....................Sq. ft. 3 Seepage Pit No........... Diameter....... ...... Depth below inlet___.._....... Total leaching area.... sq, ft. Z Other Distribution box�( ) Dosing-tank Percolation Test Results Performed by.... .:. �'' :- ..r�................. � - Date.... .............. ............ Test Pit No. 1_. minutes per inch Depth of Test Pit...�' � �?...__ Depth to ground water.._T`..... (�C 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth tq•ground water........................ O :t.. �t � F x Description of Soil_._��_____ _.. .. ?. r ;�� V -----•----•-"-"•----------••-•-•--•-•• -------------- --------------------------------------------------------------- •••-•- . .. -•-••._............ VW •--•-"-•--------------------"-----.._....--•--------•---------._...-------"-------•----"-"-•-"----------•--------------------- -------•---------"---........"-"......•-•--".._.....-"-...._..--•_____... 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 TITLZ 5 of the State Sanitary Coyle— The urridersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.•........... •-�� }.' . Date Application"Approved By... :..._ :..._.. �.....i: ...............Date Application Disapproved for the following reasons:_.______•___________________________•______________•__...._.._...________________........_...................... -•••-••--•.............•---...--•-•---._...--•--•••--•------••--•----•----•••-...._...............................----•---......_....__._..._..._..----------..__.......----"-........................_. Date Permit No..........rK .......... Issued.. .................... Date j� THE COMMONWEALTH OF MASSACHUSETTS _ ""'""-^_ Y".•_._ BOARD-"OF HEALTHf (Irr#if ratr of Toutpliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed !_,,)-or Repaired ( ) by........ r� 1 . ...... ---.._..... ......... -� ......�` ........_.......... ...... ..........................................................._..... 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...... ........._E.L_43_. dated......�?''.___.(0.___../_`.�'�:......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIONi SATISFACTORY. y� DATE...........t.... �. -�--�......-•••-•'-.......... 'Inspector--•••-"rr `--------•--"•--•--•-•-------•-'...---- •....._......••..... .... ,�,..__ _...... •...__ M �_ .----_____ _..... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD _ F HEALTH J' OF.................. .................................................................. Disposal Voorks Tono#rudion Orrutit Y.gr"nted..------ �_......_.__..... ..................................................... Permission is hereb f at No............... repair O an .Individual Sewa a Disposal System �� to Construct ( ) or R '��l> 1 / Street Ts— as shown on the application for Disposal Works Construction Permit No....'':_.'..n.`_.'__ Dated.... _._ ......... '] ... ..-. . ...... ...4.-,-C-5—.1.�_................................................ Board of Health DATE.......�_Z ? - ---------••---•-••-•"-•---•-•--••-•-••- : ti t i TOP OF FOUNDATION EL=56.9' 2 OBSERWATION 4" SCHEDULE 40 P.V.C. PORTS W/SCREWCAPS 16'f MIN. PITCH 1/8" PER FOOT TO GRADE EL=55.8' EL= 55.5' . 6" MAX.' .�. ,... EL= 55.0 ° iER ::::::::: :::::::::::::: 9" MIN. ADD ................... ...•,,:::::::..,;�:;;:::.,:::::::......,. RISER COVER ISER & CONC. ..............., ..�.. .............,.:;� COVER COVER CLEAN SAND FILL EL= 54.21 RISER & LEVEL INVERT EXISTING PIPE 10' g_ 1 COVER FORS. EL= 51.68 PER 310 CMR 15.255 2.9'f FDrai; 10' ' s=.o1 EL= - - 11 I INVERT INVERT 0 �6„EL=53.16' MIN. EL= 51.95' 6" SUMP EL=51.78' EL= 50.77 EXIST. ` "INVERT 6" BASE OF MECHANICALLY COMPACTED SAND 4 PROP. DB3 I! 31 .25' DISTRIBUTION (2 ROWS OF 5)-HIGH CAPACITY H-20 INFILTRATOR CHAMBERS EXISTING BOX 1 ,000 GALLON TANK (34"W X 75"L X 16"H) EACH z (TO REMAIN) PROFILE OF i SOIL ABSORBTION (TRENCH FORMATION) SEWAGE DISPOSAL SYSTEMI, SYSTEM (S.A.S.) 11 .33' X 31 .25' ''ui (NOT TO SCALE) BOTTOM OF TH #1 ELEV.= 43.4' 11 GENERAL NOTES I CERTIFY THAT I AM CURRENTLY APPROVED BY THE'DEPARTMENT OF (NO GROUND WATER) ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMRI 15.017 TO CONDUCT 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS ,HAS BEEN PERFORMED TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE FOR SUBSURFACE DISPOSAL OF SEWERAGE. DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY THAT THE RESULTS OF MY DESIGN DATA 2. AT LEAST ONE ACCESS PORT OVER TANK TEES SHALL BE SOIL EVALUATION, AS INDICATED ON THE ATTACHED $OIL EVALUATION FORM, ACCESSIBLE WITHIN 6" OF FINISH GRADE, WITH ANY REMAINING ACCESS PORTS BROUGHT TO WITHIN 6" OF FINISH GRADE. A D WITH 310 CMR�15.100 THROUGH 15.107. 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE / NUMBER OF BEDROOMS.........--3_-- CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE GARBAGE DISPOSAL................. UNDER OR WITHIN 10' of DRIVES OR PARKING AREAS THEN THEY EDWARD A. STONE, CERTIFIED IL EVALUATOR TOTAL ESTIMATED FLOW MUST WITHSTAND H-20 LOADING. _ 330 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION (110 GAL./BR./DAY X 3 ------ OF ALL UTILITIES PRIOR To ANY EXCAVATION. TEST PIT RESULTS P 13 0 91 330GPD X 200% = 660 GAL 5. ANY MASONRY UNITS USED TO BRING COVERS To GRADE USE EXISTING 1000 GAL. TANK OR WITHIN 6' OF GRADE SHALL BE MORTARED IN PLACE. SOIL TEST DATE: OCTOBER 8, ,'2010 INSTALL: 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE OVER THE S.A.S. AND DISTRIBUTION BOX. B.O.H. AGENT: DAVID W. STANTON, R.S. 10-HIGH CAPACITY H-20 CHAMBERS (34"W X 75"L X 16"H) 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF SOIL EVALUATOR: EDWARD A. STONE AND BACKFILL WITH CLEAN SAND FILL PER 310 CMR 15.255 SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM of 6' ABOVE THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND SOIL CLASSIFICATION................ LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN DESIGN PERCOLATION RATE..... <2-MjUI,/_IN. 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT TH#1 EL.=54.5 PERC RATE<21VlIN./IN. BOT.=52" EFFLUENT LOADING ELEV. DEPTH IN. RATE.........-_74___ ELEVATION OF THE OUTLET PIPE. HORIZON TEXTURE COLOR MOTTLING OTHER 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. ) REQUIRED LEACHING CAPACITY.....-- G---335 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS 54.2 0-4" A LOAMY SAND 10YR4/3 LEACHING CAPACITY PROVIDED..... _EALDAY�- BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. 2 ROWS OF 5 INFILTRATORS X 7.. 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND 53.33 4-14 B LOAMY SAND 7.5YR5 6 ( ) ( ) j., 791 S.F./L.F. FIRST TWO FEET OUT OF THE DISTRIBUTION BOX SHALL 51.67 14-34" C1 SANDY LOAM 10Y6 6 R 62.5 L.F. X 7.79 S.F./L.F.= 486 S.F. BE LEVEL. p�C 486 S.F. X .74 GPD./S.F.= 360 GPD 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION 43.5 34-132 C2 COARSE SAND 2,.5Y7 6 1AGERAVEL To EAS SURVEY, INC. FOR B.O.H. AND DESIGN f NO MOTTLING & NO GROUNDWATER ENCOUNTERED ENGINEERS REVIEW AND APPROVAL. 360 GPD PROVIDED - 330 GPD REQUIRED = 30 GPD RESERVE TH#2 EL.=55.1 N OF CONSTRUCTION NOTES: Z ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER ��'�� s9c SEPTIC SYSTEM DETAIL PAGE 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND o DAVl� s 24 ZENO CROCKER ROAD ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING 54.6 0-6 A LOAMY SANDf7.5YR5 0YR4 3 `��. # WORK ON THE SITE. 53.77 6-16" B LOAMY SAND 6 F H CENTERVILLE, MA. 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE »WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 51.93 16-38 C1 SANDY LOAM OYR6 6 1 0 IS TOTOBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 44.1 38-132" 1 C2 ICOARSE SAND 2.5Y7 6 1o%GRAVEL �GlsTEQ`�c OCTOBER 18, 2010 3. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING NO MOTTLING & NO GROUNDWATER ENCOUNTERED IV-AN TAR P� SHEET 2 OF 2 J# 1283 TAPE OR A COMPARABLE MEANS. ` CENTERVILLE PARCEL ID: o 171/215 O PARCEL ID: N �' -°o 171/278 Locus: 90 O 24 ZENO CROCKER RD. TBM: 1 562, CORNER OF BULKHEAD o AMES 76 A6,, ELEV.=56.00 (GIS±) WAY PARCEL ID: Lp rn F o0 171/224 ��' LT, 7 0S62, i `r 10' LOCUS MAP Is4 S6, / ' 5 PARCEL ID: LOCUS INFORMATION 10' 171/279 TPLAN REF:ITLE REF: 9121/101 NOV 25.9, REBAR 3/27\ C ..... GA : o•1 � PARCEL ID: MAP 171 PAR. 283 IN STATE ZONE II S62 7`34 s I— cV p� �"� FLOOD ZONE: ""GROUNDWATER PROTECTION ZONE" (GP) 5.5 ` ` ,�8•. COMMUNITY PANEL: 250001-001 5—C DATED:08/19/85 55.8 W #24 SEPTIC SYSTEM 3—BED. 9 \ 7 / :'DWELLING \A 3 ,pECK 5� PUMP, CRUSH & REPAIR PLAN 9 _ W , TCF=56.9 p FILL EXIST. LEACHPIT LOCATED AT: PER TITLE V #24 ZENO CROCKER ROAD 55 S — �M 0 � -I) CENTERVILLE, MA. 6 ? PREPARED FOR ' SS :+ PARCEL ID: SHAUN P. KENNEDY 23 PARCEL ID _ 171/282 71 11 171/283 cyM OCTOBER 18, 2010 AREA=17,705f S.F. �o 77 q `H OF Atj 6, 2 � �� EDWARD ctiG PARCEL ID: A a t. 170/248 STO E No.P§ 80 T I r PARCEL ID: E. A. S. 170/255 SURVEY, INC. GRAPHIC SCALE 141 ROUTE 6A ' SALT POND BUILDING 30 0 15 30 BO 120 P.O. BOX 1729 60 SANDWICH, MA. 02563 ( IN FEET ) 1 inch = 30 ft. BUS:(508)888-3619 CELL:(508)527-3600 } SHEET 1 OF 2 J 1283 M SECTION --SEWAGE , p , rZ 1 —SEPTIC TANK— <f _"D"BOX — �' LEACH. TOP FDN441 • a -U _ "2"OF VeTO WASHED STONE 740 , E a N OUT• -.' IN- OUT • ,.; : � OUT • •: ... „� ,- .".. *; .,SEPTIC Lie 2 . TANK ELEV.k- ELEV. ELEV.'. ELEV. . . r I / V 1 � ELEV. ELEV. .,. _. W HE T N AS D,S O Eril �..., i ec.E� 43;4 L /2 TEST HOSE LOG P�SoGq- _ _ �e � oT# CV TEST BY .� �AI'1;t3 � !J. lorlL.of� 4 s" CJ/23/8� WITNESS cc _ BEDROOM HOUSE. x / TEST DATE T—f DESIGN a .' :`. _ .. T T.N. • 1 T.H. +� 2 - I�y 5 ELEV. e!f ELEV. r II �� >C�FA.: PERC BATE .G2 MIN/IN. FLOW RATE DIS NO .. DISPOSER 330 (GAL./DAY) 33e7 .tom S •4 . �.,.- _ _ M p, -- - SEPTIC TANK Q REQ DSEPTIC TANK SIZE �OOO LU 1 J 5 c ; II LEACH 'FACILITY g .' N -7-4t SIDE WALL /SCE,Fj (Z.5) 3 771e:'.G/D. BOTTOM 2 _ r-5 !:0) _ _. G D. _. �ut� IUN TOTAL .01.11 Sr USE: V' !�E LEACHING a _L—WATER ENCOUNTERED I �� P,'�rY' A eFF Z) , x G I F_pl NOTES: IONLESS OTHERWISE NOTED) L U 1 I.DATUM(MSL)t TAKEN FROM,hi�tit�G�J�e-* QUADRANGLE'MAP 4s�*.. �C � 'v l�" 2.MUNICIPALWATER �1. AVAILABLE ��`''- L-r-� �r ' FRONT - 201 3.PIPE R PITCH: "PER FOOT 1 4.DESIGN LOADING FOR ALL PRE CAST UNITS:AASHO- _I .44 �Q` t — ANE `i s E S.MIN.•GROUNOCOVER OVER ALL SEWAGE FACILITIES:(Ij FT. 6.PIPE JOINTS SHALL BE MADE WATERTIGHT I u Q A 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. N - - - SITE M.A STATE ENVIRONMENTAL CODE TITLE S 6 f Fo G 7tr�� a ►..u�G�C p..�`�C ago 5+�o��.-� �f t¢:r. 3` /�`1!1 Of �qf LOCUS: 2 T-/�A ?�hl O C.�0!Y�� 1ZO ft :Jo-r-idE t1�D Pam '.�SZta."c:.'a:.-`� L.`tG- �i-d.�•+�c" - _ _I1 Q'liL L.h1stJ/TLE, TR/I �. JETGl1EFl.(...- . _. REG.PRO AL ENGINEER - _ _ H. r"2 _.a-i-avI 5.4.S� a F(��V� a L. 8S .$� -' - " - - - . - ...- __ -- - -- - - - -- `�' _p.IALA - `n - -REF: - - l,�O D K ZIO PA(2 a'7 W w �e I� In o -- - ,` PREPARED FOR: L� 1 .1e-SQ2LO�e�JS � Mom, �.a,�o o a ca end eer �. � /O � CIVIL ENGINEERS � � 5 • --- � £ LAND SURVEYORS _.. .BOARD OF.HEALTH IIS�IA S4. . REG. R VEYO CONTOURS (PROPOSED)-0-O•-0-0- :. APPROVED DATE- - e�`� MA 1 ►�� SC ALE— DAr ,p