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0619 MAIN STREET (CENT.) - Health
619 Main Street (Cent.) Centerville p INN-' A = 207 057 nCoe-g JA4EC1'C� UPC 10259 No. H_163OR HASTINOS, UN I r kv,FEE 1 QM ®1V VV HOf MASSAC LJ SETTS Board of Health, MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) UpgradeA Abandon( ) - 46 Complete System ❑Individual Components Location Q ^` Owner's Name ,�n ML �,,,� Map/Parcel# Address ?, UZ(e Lot# Telephone# Installer's Name vi 1 � S��(�'C'E r�` Designer's Name f � A'P—C-4 Address �Fj= ��j /"�� Address Z�e tl5 G Telephone# tg—o 3 _ V z-& Telephone# (_5WQ7 —S ( Z&Vy- TypeofBuilding GM 0U,- iQ/ I IL ` — Wif M,'I2 ay�!V � Lot Size ! sq.ft. Dwelling-No.of Bedrooms N. e Garbage grinder ( ) Other-Type of Building /Q 2� � 61�jCL a R i r S7q to,,, No.of persons Showers ( ),Cafete is ( ) Other Fixtures ` a t `n S e ,1 /-Y KGO �® X 5ZW =Sot1 a'0D fY Design Flow (min.required) gpd Calculated design flow_�Y�_ 6 Design flow provided �O�S pd Plan: Date 7,D/0% Number of sheets Revision Date Title (/�Gea-zed 5AA PNt UPS Y'� Description of Soil(s) !ZAZ flail Soil Evaluator Form No. Name of Soil Evaluator ekil' Date of Evaluation 2 CJ DESCRIPTION OF REPAIRS OR ALTERATIONS r ' e toZnstallthe above descri n r c the ro 'sions of TITLE and The unde signed afire s bed Individual Sewage Disposal System m accordance a with provisions 5 further agrees to not to pl ce the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date i Q _4TMp=MM TOy F BARNSTABLE LOCATION —>' SEWAGE # � '�t VILLAGE.� SESSOR'S A & LOT INSTALLER'S NAME&PHONE NOR -� �ag ,$3:3•�!fi�� r� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) rows I n i r (size) t" x4 < NO. OF BEDROOMS N./A R'w BUILDER OR OWNER f Lr- ` <®� a ,e --W PERMIT DATE:` 7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (1bany wetlands exist within 300 feet of leaching facility) Feet Furnished by yL���`, . Fa c pis .7 r ✓v No. 0v,Cv FEE r COMMONWEAL11 Of MASSACHUSETTS Board of Health, s MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to- Construct( ) Repair( ) Upgrade( ) Abandon( ) an indiNridual sewage disposal system at / I / C as described in the application.for rDisposal System Construction Permit No. 'dated r ded: .Construction shall be completed withi three years of the date of thipermit. All local conditions must be met. 5 Rev.5/96 A.M.Sulkin Co.Boston,MA Date ' 1oard of Health .'r. -.. �-. ,r ^-}-_ ry• >•, .,.. yrYr , r'•T'T .A �,�y5$''��,.+'3f„ry'{0..7'F«'Y .,AY�..T'w . '+'r - '!� . - .rt 'E. --Y^'` r.f�' ....:�'�wy.p"'. t 't. ."...•,..;.i, 1 .i'�' 'RR++�r '�-.'•- ,, _ A - FEE v $!V GM F,VMMQ,NW r,s -/Board of Health, Stv,�k-� , MA. APPLICATION FOR, ➢ISPOSAL SYSTEM[ CO%TRUCTION, PERMIT Application for a Permit to Construct( Repair( Opgrade,(X, Abandon( 4Complete System O Individual Components �rr � Location �� fit 1 r� E f-•- ` Tyl+Et ,< Owner's Name �'p ir;jil, IYjL t,�,,.G t 1 T 2 0 r�I V�o► x Map/Parcel# -4-7-- 5 5- -7 !} Address f, a , 767m K 30 O&-, �44 0 Z.("-- Y V," t . x _ n Telephone# Installers - Nm V G v / .v\ S �C - crDesigner's Name �� fT ti�✓p �[�ni n Address Address Telephone# 3 _ O Z:(e � Telephone# �� '7 2 _S 3/D Z( Type of Building ttiL.•rn M P2I'a e:�r`ce 1&e c,U/4i •Wr1. Lot Size 2X)t-sq.ft. L. - - Dwelling-No.of Bedrooms 1 Garbage grinder ( ) r Other Type of Building 19 Zb -SEE �1"ri'-^/�1' `C L7 C)1 A('r' 5q�t7v, No.of persons Showers ( ),Cafet/er a ( ) " ;• ." _t t X 1Gp9 �l.SGO`l Ci - Other Fixtures- HQ�/:lw,ry T,, .-" arir�t ll'1Cwi ✓ , n S�k� � � =.5� 00 r Design Flow (min.required) S gpd Calculated design flow 6 Design flow provided fd - gpd Plan `Date h/7 A I 0- Number of sheets I Revision Date :s�Qc tPlah";.�Descriptionof Soil(s)`° ' �� Soil Evaluator.Form No. Name of Soil Evaluator C f @,/I�f.�,r1 i Date of Evaluation �I��7 7 DESCRIPTION OF•REPAIRS OR ALTERATIONS The undersigned agrees to inlstall the above describedjnridividual Sewage Disposal System,in accordance with the provisions of TITLE 5 and A further agrees to'riot too place the system in operation until a Certificate of Compliance/has been issued by the Board of Health. ,3 Signed I' z' =-� Date No. - ` C®MMONWEAtTIj ®F MASSACIIU�SETTS Board of Health, sa r'ri S , MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The un signed/h&reby certify that the Sewage Disposal System; Constructed ( ),Repaired Upgraded ( ),Abandoned ( by: P/ I/� l s w a at has been installed in a ord'annce with the prov�sions of 0 CMR 15.00/(Title 5) and the approved design plans/as-built plans relating to application No. l,// dated 90 Approved Design Flow��(gpd) i o Installer in Designer: ff► G�i� /rD ('�/V 1 Inspector: Date: (7� The issuance of this permit shall not be construed as a guarantee that the system willYfunction as d signed. —.._ .—._.-- � �v' —�. wr �., : +e. _ ... " wP _—. ._. �.. •.�. +r -,,: � ti.. ._. -... ...r -•ems �..... �... �. I i 1 fa,;t �oY Town of Barnstable TM' Regulatory Services Thomas F. Geiler,Director ' Public Health Division Thomas McKean,Director , 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Designer: 1 V1 ff i rl ® Installer: C uCfiQ() 'P Address: ' P�^(_�a�� !P_�CId . Address: Po9A h d as ape tall a' On issued rmrt t juis . .. _ _. -(ins r) -. , p '& N(Ib ed on a des fgfn drawl by septic system at (address) dated A (designer) ' I certify that the septic system referenced above was installed sbstan ally according to u the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. i certuy that the septic system referenced above was installed -vviih major changes (i.e. greater than 10 lateral relocation of the SAS or any vertical relocation of any component of the s 'c system)but in accordance with State &Local Regulations. Plan revision or certifi -built by designer to follow. �� � _@��a��s o`er �yG PETER T. McENTEE (Installer's Signature) C.D CIVIL "' 9 No.351.09 O 0 PV AL P(Designer's Signature) - - - -- __.___.. (Affix Designer's Stamp Here) PLEASE RETURN TO BARNS TABLE-PUBLIC%HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DMSION. THANK YOU. Q:Health/Septic/Designer Certification Form 14 e PROPOSED S.A.S. 6 ROWS OF 4—HIGH CAP. H—2Q INFILTRATORS EXTENDED BY 2' OF STONE DESIGN CAPACITY = 548.8 GPD ti�� 168' � c CV i 1 ! REQUIRES NO ADDITIONAL VARIANCES BUT IS JUST OVER THE DESIGN CRITERIA ALTERNATE NO. 1 ALTERNATE DESIGNS ARE PROVIDED IN THE EVENT THAT UNDERGROUND TANKS ARE ENCOUNTERED DURING INSTALLATION. f PROPOSED S.A.S. 7 ROWS OF 4-HIGH CAP. H-20 INFILTRATORS REQUIRES BIGGER D-BOX DESIGN CAPACITY = 611 .2 GPD � 1 REQUIRES AN ADDITIONAL VARIANCE TO FRONT PROPERTY LINE AND MAY REQUIRE A HEARING AFTER THE FACT ALTERNATE N®..2 ALTERNATE DESIGNS ARE PROVIDED IN THE EVENT THAT UNDERGROUND TANKS ARE ENCOUNTERED DURING INSTALLATION. J DESIGN CAPACITY = 680.2 GPD WITH I/A PRETREATMENT ^�7 S.A.S_(IN)=97.00 i L=13' O DB(IN)=97.01 O DB(OUT)=96.84 �i BOTT. S.A_S_=95.00 O BOTT, TP=89.9 3-500 GALLON H-20 L=36' CHAMBERS STOUT)=97.37 .01b O SLUDEHAMMER ADDED FOR 50% AREA REDUCTION REQUIRES A HEARING FOR THE USE OF AN I/A TECHNOLOGY FOR A 50% AREA REDUCTION BUT WILL OCCUPY THE SMALLEST FOOTPRINT. IF THERE IS NO ROOM FOR THE OTHER OPTIONS THIS MAY BE THE ONLY OPTION AVAILABLE. ALTERNATE N Q o 3 ALTERNATE DESIGNS ARE PROVIDED IN THE EVENT THAT UNDERGROUND TANKS ARE ENCOUNTERED DURING INSTALLATION. WA TL R Cp METER Mfg O�r75 f_F/ A t � y VENT EXISTING 702 __ BUILDING #619 MAIN S T. 70 (SL'AB) t / O / /•' L L Q / WaskW"by _ O O V �r 11 700, 1. 05 10. 83 U 99,87 LAMP 100.00 BASIN ~ 99r93 Edge of pO�<ernent 99.89 ALTERNATE NO.3 (CONT.) r, Town of Barnstable P# } - Department of Regulatory Services Public Health Division Date tr, 200 Main Street;Hyannis MA 02601 I CFO DateScheduled .. 'Time h _. Soil Suitability Assessment for Sew ge_Iis oral23 a �, Performed By tl�('�� L�` eQ Witnessed By; �0 :LOCATION& GENERAL INFORMATION location Address �..l rf_W,,k j Ste- 6,& j r A 1�k Owner's Name Ca 3-h �r� 1�e. o• e Ada7,Q , tf 3 Assessor's:Map/Parcel:., 2 0 .-7 Engineer's Name NEW.CONSTRUCTION REPAIR Telephone# C�U � ?7?Alf � Land Use ir✓✓1 M-e/ L l 61�-5 Slopes M 2 Surface Stones / Distances from: Open Water Body? �0 ft Possible Wet Area ft Drinking Water VYetl I ft Drainage Way t S�f ft :PropertyaUne. o ft Other.... R, SMTCII;.(Street.name,dimensions of lot,exact locations of test holes&pert testsjocate wetlands�n proximity fo holes) -17 r: ,z : . Parent material(geologic) a_lc '( U sk Depth to Bedrock Depth to Groundwater. Standing Water in Hole: /v`n' Weeping from Pit Race ? Estimated Seasonal High Groundwater T DETERMINATION FOR SEASONAL HIGH.WATER TAH4 Method.Used: Depth.Observed standing in obs,hole: In, Depth,tosoil mottlae ltt. Doftto weeping from side of obs.hole: In, Groundwater Ad)uittil t . Index Well# Reading Date: tndex Well level , ,..„. Adj.thctor PERCOLATION TES: ' Observation f Hole# Depth of Pere Time at 6' Start Pre-soak Time 0 Time(9"-6") .. 9 ✓tit n v -►--c, End Pre-soak. Rate Min./Inch Site Suitability Assessment: Site Passed — Site Failed:!T_ Additional Testing Needed(Y(tJ):, Original: Public.Health:Division Observation Hole Data To Be Completed on Back -,---- ***If percolation test is to be conducted within 100' of wetland,you trust first.nola'fy tl�e Barnstable Conservation Division at least one(1)week prior to beginning. n.�-norrit/'1Dgbf`q/1pIN nrv, DEEP OBSERVATION HOLE LOG Hole# I Depth from Soil Horizon Soil Texture Soil Color Soil Other Surfact(rn)> (USDA) (Munsell): Moulin Struc' lure,Stones,Boulders. DEEP OBSERVATION HOLE.LOG Hole# 2 Depth from„ S94Horizon Soil Texture, Soil Color. . Soil Other Surface ) (USDA) (Munsell), Mottling (Structure,Stones,'.Boulders. / © -3 r ; tnV\ VuuR.�-- sc, 7�S'C�Jy DEEP OBSERVATION HOLE LOG Hole# �P9m Soillorizoa. Soil Texture, Soil Color . Soi't p�r SurPaCe (USDA) (Munsell) Mottling (Structure,Stones,Boulders. I DEE .08.SERVATION RULE LOG Hole# Depth from Sori otizon Soil Text u>e Soil Color Soil Other Surface(iq') (USDA) (Munsell) Mottling SEotres,Boulders. g (Structure, F: t Flood insuranceRate_Map• LL� � Above Sd0'yearfloodboundary N' _ Yes' Within 300year boundary Yes VYitlirn 100year flood boundary No_ '� Yes Death oiatull r...: Occttrrin_a�PervIousMaterlal �:; Does, least'four feet of naturall, oct:urri..y g pervi us material exist in-all_areas observed thrpughout the area prop AM,-'.for->the sotl;absorpdolrayslet 1 �s If not,what'Is the depth of naturally occurring pervious material? ,...... Cgrti�cation ,, 1l .`°lol.� I eemfy that on (date)I have passed the soil evaluator examination approved'by the Department`of Env.lronmental Protection and that the above analysis performed by me consistent with the requued framing,expertise and experience described in10`CI1TR 15.017. Signature Date Q:4SEP'flf;Ci'BItCAORM`DOE � � _,.;_ � I The Town of Barnstable ,y Health Department 367 Main Street, Hyannis, MA 02601 Op +679• `� �0 Nix Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health" DATE: 8-8-00 TO: A.M. WILSON ASSOC. P.O. BOX 486 BARNSTABLE, MA 02630 i RE: RESPONSE TO YOUR REQUEST FOR SITE INFORMATION IN COMPLIANCE WITH MGL 21E The Health Department files were searched for information regarding the property at 619 MAIN ST. , CENTERVILLE listed as Parcel number 57&58 on Assessor's map 207 and adjacent properties listed in the application form submitted by you on 7-28-00 The following items, if checked, apply to the property or adjacent properties: There are no records on file concerning underground fuel and chemical storage tanks found concerning this property or any of the adjacent properties. X The attached underground fuel and chemical storage information concerns the tank( s) located at: 208-124 401 MAIN ST. , CENTERVILLE (UNREGISTERED LEAKING TANK)-SEE REPORT 207-050, 207-012, 207-014, 207-015, 207-053, 207-054, 207-055 (ALL TANKS REMOVED - SEE COMPUTER PRINT-OUTS) No hazardous material releases were reported to the Health Department regarding the subject property or any of the adjacent properties. X The attached release information concerns the properties located at: 401 MAIN STREET, CENTERVILLE (PLEASE NOTIFY DEP FOR UPDATED STATUS) X There is no as-built card record on file regarding the existing onsite sewage disposal system. *FAST SYSTEM INSTALLED (SEE REPORT) The property is connected to Towh sewer. The attached onsite sewage disposal system information is . enclosed. X The Health Department has qo record of the private water supply well location onsite, if there is a well onsite at this property. ' It is- suggested you contact the appropriate Water Department to determine whether the building is connected to Town water. The Health Department records indicate there are private water supply wells at the following locations : WE HAVE NO RECORDS OF PRIVATE WATER SUPPLY WELLS ON ADJACENT PROPERTIES. Please forward me a copy of the 21E report after your completion of the report. My mailing address is : Barnstable Health Dept. P.O. Box 534 Hyannis, MA 02601 Sincerely Yours, Thomas A. McKean Director of Public Health COMMONWEALTH OF MASSACHUSETTS I ' EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON. MA 02108 617-292-5500 MAP LSD 5y,y PAR . •..Off" TRUBY CORE. WILLIAM F.`VELD LOT . L-f jT A Secretary Governor ' DAVID B-STRUHS ARGEO PAUL CELLUCCI Commissioner Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION ' Property Address: 619 Main Street, Centerville Address of Owner: Date of Inspection: 8/09/00 (If different) Name of Inspector: Arlene M. Wi l Snn I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (370 CMR 15.000) Company Name: A• M. Wilson Associates, Inc. Mailing Address: .Box Barnstable MA 02b30 ' Telephone Number: 508-375-0327 CERTIFICATION STATEMENT age disposal system at this address and that the information reported below Is true,accurate I certify that I have personally inspected the sew and complete as of the time of inspection. The Inspection was performed based on my training and experience in the proper function and ' maintenance of on-site sewage disposal systems. The system: ' y Passes Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fail — 8/10/00 Date: Inspector's Signature: ) days The System Inspector shall submit a c �this tion report to the Approving Authority inspector t i ynd 0the system complet ngsha thsubmit is inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, t the report to the appropriate regional office of the Department 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: A] SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria as defined in 31.0 CMR 15.303. ' Any failure criteria.not evaluated are indicated below. COMMENTS: B] SYSTEM CONDIT O V_ALLY 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. -Indicafe yes, no or-not-determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. ' The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of date of the inspection; or .Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the the-septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank 1 as approved by the Board of Health. ' Page 1 of 10 DEP on the Worid Wide Web: httpJ/www.magnetstate.ma.usldep Printed on Recycled Paper ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) ' Property Address: 619 Main St. , Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 61 SYSTEM CONDIIYONALLY PASSES (continued) 5ewa backup or breakout or high static water level observed in the distribution box is due to broken or obs cted pipe(s) r due to a broken, settled or uneven distribution box. The system will pass inspection if(with app val of the Board of ealth). Describe observations: broken pipe(s) are replaced ' obstruction is removed distribution box is levelled or replaced The system require pumping more than four times a year due to broken or obstructed p e(s). The system will pass ' inspection if(with a roval of the Board of Health): bro en pipe(s).are replaced obstr ion is removed C1 FURTHER EVALUATION IS REQUIRED BY T BOARD OF HEALTH: ' Conditions exist which require further evalu on by the Board of Healt in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALT DETERMI S THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER ' WHICH WILL PROTECT THE PUBLIC HEALTH A SAF AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a su water t _ Cesspool or privy is within 50 feet of a rderin vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD HEALTH (AN PUBLIC WATER SUPPLIER; IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A NER THAT PROT S THE PUBLIC HEALTH AND SAFETY AND THE ' ENVIRONMENT: The system has a septi ank and soil absorption system ( and the SAS is within 100 feet to a surface water supply or ' — tributary to a surfac ater supply. The system has eptic tank and soil absorption system and th SAS is within a Zone I of a public water supply well. The system h a septic tank and soil absorption system and the is within 50 feet of a private water supply well. _ The syste as a septic tank and soil absorption system and the S is less than 100 feet but 50 feet or more from a private ter supply well, unless a well water analysis for coliform cteria and volatile organic compounds indicates that the I is free from pollution from that facility and the presence of a monia nitrogen and nitrate nitrogen is equal to or le than 5 ppm. Method used to determine distance (ap oximation not valid). ' 3) OTH i ' (sevined 04/25/97) Page 2 of 10 t ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Address: n Street Centerville, MA SYSTEM A Property 619 Mai , Owner: 619 Main St. Nominee Realty Trust Date of Inspection: 8/9/00 D] SYSTEM FAILS: You must indicate ei;!,er "Yes" or "No" as to each of the following: ' following failure criteria as defined in 310 CMR 15.303. The basis I have determined that the system violates one or more of the for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. ' Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. _ X Discharge or ponding of effluent to the surface of the ground or surface waters clue 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 1/2 day flow. _ X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). ' Number of times pumped _ _ X Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. X Any portion of a 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 I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. . X well with no Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for ' coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. ' GE SYSTEM FAILS: You mu ' imte either "Yes" or"No" as to each of the following: The ing criteria apply to large systems in' addition to the criteria above: The system serves cility with a design flow of 10,000 gpd or greater (Large System) and the s is a significant threat to public health and safety the environment because one or more of the following cond' ' exist: Yes No the system is within 400 feet of a surfac 'n ' ater supply the system is within 200 feet t utary to a surfs inking water supply the system is I in a nitrogen sensitive area (Interim Wellhea otection Area-IWPA) or a mapped Zone II of a public r supply well) ' The ow operator of any such system shall bring the system and facility into full compliance with t roundwater treatment program rements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for furthe ' ormation. ' (ravised 04/25/97) Page 3 of 10 't SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 619 Main Street, Centerville, MA owner: 619 Main St. Nominee Realty Trust System B Date of Inspection: 8/9/00 D] SYSTEM FAILS: ' You must indicate e+t:.er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 Cc�1R 15.303. The basis ealth should be contacted to determine .what will be necessary to correct for this determination is identified below. The Board of H the failure. (Ps No Bac up of ;:wage into facility or system component due to an overloaded or clot ged '.AS or cesspool. x Discharge or ponding of erfluent to the surface of the ;round or surface waters +iue to an overloaded or ,_logged Sn5 or ' cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or cloggeo SAS or cesspool. x liquid depth in cesspool is less than 6" below invert or available volume is less than ',/''1 day ilow. _ x Required pumping more than + times in the last year NOT due to clogged or obstructed pipe(s). ' Number of times pumped _. _ X Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water suppiN_ X _ Any portion of a cesspool or privy is within a Zone I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria; volatile organic compounds, ammonia nitrogen and nitrate nitrogen. ' E] E SYSTEM FAILS: You must t 'cate either Yes" or"No" as to each of the following: The fo ing criteria apply to large systems in addition to the criteria above: ' The system serves ciliry with a design flow of 10,000 gpd or greater (Large System) and the em is a significant threat to public health and safety a the environment because one or more of the following co ns exist: ' Yes No the system is within 400 feet of a surfs nk' ater supply _ the system is within 200 feet of utary to a su drinking water supply the system is to in a nitrogen sensitive area(Interim Well he Protection Area-IWPA) or a mapped Zone II of a Public w upply well) The owner or rotor of any such system shall bring the system and facility into full compliance wit a groundwater treatment program requir nts of 314 CMR 5.00 and 1.00. Please consult the local regional office of the Department for fu information. ' (revised 04/25/97) page 3 of 10 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART A CERTIFICATION (continued) Property Address: 619 Main Street, Centerville, MA System C ' owner: 619 Main St. Nominee Realty Trust Date of Inspection: 8/9/00 ' D) SYSTEM FAILS: You must indicate et;!.er "Yes" f or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 Ct✓lR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine .vhat will be necessary to correct ' the failure. Yes `0 `3aci<uo of sewage into iacility or system component due to an overloaded or c ogoed 5A5 >r .:esspool. ' - x Discharge or ponding of ertluent to the surface or the ground or tiurface waters Iiue to an overloaded or -_logged `A5 or cesspool. X Static liquid level in the distribution box bove nutlet invert due to an overloaded or clogg o SAS or cesspool. 1 -_ _X Liquid depth in cesspool is less than 5" below invert or available volume is less tnan 1,/2 day ilow. _ X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _ X Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. _ X Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria; volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] E SYSTEM FAILS: You must 'ate either "Yes" or"No" as to each of the following: The fo ing criteria apply to large systems in addition to the criteria above: ' The system serves a 'lity with a design flow of 10,000 gpd or greater (Large System) and the syst s a significant tfireat to public health and safety a e environment because one or more of the following condit' exist: Yes No the system is within 400 feet of a surface i ater supply the system is within 200 feet o t utary to a surface i ing water supply the system is I in a nitrogen sensitive area(Interim Wellhead lion Area-IWPA) or a mapped Zone II of a i ' public supply well) The own operator of any such system shall bring the system and facility into full compliance with the ndwater treatment program r ements of 314 CMR 3.00 and 6.00. Please consult the local regional office of the Department for further in ation. ' (revised 04/25/97) page 3 of 10 f ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST ' Property Address: 619 Main St. , Centerville, MA `System A Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/09/00 Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Yes No .Barnstable WWTP, — urap� inping�con Factor by th owner, _ X_ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. System was Pumped 8/05/00 ' X As built plans have been obtained and examined. Note if they are not available with N/A. X — The facility or dwelling was inspected for signs of sewage back-up. X — The system does not receive non-sanitary or industrial waste flow. ' X — The site was inspected for signs of breakout. _ X_ All system components, excluding the Soil Absorption System, have been located on the site. _X _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of ' baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. X The size and location of the Soil Absorption System 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. ' X _ Existing information. Ex. Plan at B.O.H. _ _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)J 1 I' ' (ravined 04/25/97) Page 4 of 10 ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property y Address: 619 Main St. , Centerville, MA Owner: 619 Main Street Nominee Realty Trust System B ` ' Date of Inspection: 8/09/00 1 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pu pin information .v s orovided by th owne , .Barnstable WWTP, ' and pumping contractor _ X_ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or ' as part of this inspection. System was pumped 8/05/00 X As buiit plans have been obtained and examined. Note if they are not available with N/A. ' X _ The facility or dwelling was inspected for signs of sewage 'back-up. X The system does not receive non-sanitary or industrial waste flow. ' X _ The site was inspected for signs of breakout. X All system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: X The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. X _ Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (I5.302(3)(b)] ' (revised 04/25/97) Pegs 4 of 10 I ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST ' Property Address: 619 Main St. , Centerville, MA Owner: 619 Main Street Nominee Realty Trust System C ' Date of Inspection: 8/9/00 ' Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Y�s No Barnstable WWTP and owner, Pumping information was provided by th � ' `X pumping contractor _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. System was pumped 8/05/00 ' X As built plans have been obtained and examined. Note if they are not available with N/A. ' X — The facility or dwelling was inspected for signs of sewage back up. X The system does not receive non-sanitary or industrial waste flow. ' X _ The site was inspected for signs of breakout. _ X All system components, excluding the Soil Absorption System, have been located on the site. X _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of i baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: X _ The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. ' X _ Existing information. Ex. Plan at B.O.H. X _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)] (raviaad 04/29/97) Page 4 of 10 ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION ' Property Address: 619 Main Street, .Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/09/00 System A ' FLOW CONDITIONS RESIDENTIAL: Design flow: g.p.d./be om for S.A.S. ' Number of bedrooms: — Number of current res nts: Garbage grinder ( or no):_ ' Laundry conn el to system (yes or no):_ Seasonal (yes or no):_ Water eter readings, if available (last two (2) year usage (gpd): S p Pump (yes or no): ' Last date of occupancy: COMMERCIALIINDUSTRIAL: t Type of establ�s ge�L office Design flow+ gallons/day capacl y _+76U gp Grease trap present: (yes or no)-hp i ' Industrial Waste Holding Tank present: (yes or no) No Non-sanitary waste discharged to the Title S system: (yes or no)NO Water meter readings, if available: (combined With System B) 1997 +433 gp• 1998 - +143 gpd.. 199- +9,44 p rf - ' Last date occupancy: currently occupied OTHER: (Describe) ' Last date of occupancy: GENERAL INFORMATION ' PUMPING RECORDS and source of information: BSystem pumped as part of inspection: (yes or no)_O — rumpeci previous t0 inspection If yes, volume pumped: +600 Gallons ' Reason for pumping: annual maintenance TYPE OF SYSTEM ' Septic tank/-�s ►1 absorption system Single cesspool X Overflow cesspool Privy ' Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other ' — APPROXIMATE AGE of all components, date installed (if known) and source of information: over 20 years Site Plan ' Sewage odors detected when arriving at the site: (yes or no)No I , (revised 04/25/97) Page 5 of 10 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ' SYSTEM INFORMATION Property Address: 619 Main St. , Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 System B. FLOW CONDITIONS ' R NTIAL: Design ( g.p.d./bedroom for S.A.S. Number of be s; Number of current re nts:_ ' Garbage grinder (yes or no): Laundry connected to syste no):_ Seasonal use (yes or _ Vater meter r ngs, if available Ilast two ( ar usage (gpd): ' Sump p (yes or no): Last date of occupancy: ' COMMERCIALIINDUSTRIAI- •Ce and hairdresser Type of establishment: Design flow: +�57 gallons/day capacity +630 gpd Grease trap present: (yes or no) NO Industrial Waste Holding Tank present: (yes or no) separate from system Non-sanitary waste discharged to the Title mbined With or no 0 A yV�Sg�meter readings, if available: — +244 ' 1 y9 - +433 gpd; 1998 - + 999 gnd Last dare of occupancy: currently occupied OTHER: (Describe) Last date of occupancy! GENERAL INFORMATION PUMPING RECORDS and source of information: Barnstable WWTP Ace Cess ool Service ' System pumped as part of ins e ton: (yes or no o. pumpe previous o inspection If yes, volume pumped: Gallons Reason for pumping:annual maintenance ' TYPE OF SYSTEM _ 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) I/A Technology etc. Copy of up to date contracts' ' Other RR X,1bI�A .A£�d�(L �s @ �� a age - ±20 yes; inSLOalla.tloTnlEl�tSbc— oard 02 lrieal Ylf recoras source of information: ttSS Sewage odors detected when arriving at the site: (yes or no)_X (revised 04/25/97) Page 5 of 10 ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION ' Property Address: 619 Main St. , Centerville, MA System C Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 ' FLOW CONDITIONS RESIDENTIAL: Design flow: 110_g.p.d./bedroom for S.A.S. ' Number of bedrooms:_ Number of current residents: Garbage grinder (yes or no): Laundry connected to system (yes or no)l�—O— ' Seasonal use (yes or no): No Water meter readings, if available (last two (2) year usage (gpd): combined with off i ice Sump Pump (yes or no):_ya (see below) ' Last date of occupancy: currently occupied ' COMMERCIAUINDUSTRIAL: Type of establishment-. office Design flow:+220 gallons/day capacity +630 gpd Grease trap present: (yes or no) NO ' Industrial Waste Holding Tank present: (yes or no) 1�0 Non-sanitary waste discharged to the Title S sys em:.(yy@s or no) Water meter readings, if available: Combine wild apar-Um flows 1997 - +181 d• 1998 - +214 gpd; 1999 ' Last date of occupancy: currently occupied OTHER: (Describe) ' Last date of occupancy: GENERAL INFORMATION ' PUMPING RECORDS and source of information: Barnstable WWTP• Ace Cesspool Service, Inc; and owner System pumped as part of inspection: (yes or no) NO — pumpecl. previous to inspection . If yes, volume pumped: +600 gallons ' Reason for pumping: g4n31n7 maintpnant-p TYPE OF SYSTEM ' X_ Septic tan W . soil absorption system Single cesspool Overflow cesspool Privy ' Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contracts' Other ' of all components, date installed (if known) and source of information: age of system +15 yrs; APPROXIMATE AGE p , installed 1985; Board of Health records ' Sewage odors detected when arriving at the site: (yes or no)SjQ t ' (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) ' Property Address: 619 Main St. , Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 SystemD ' BUILDING SEWER: (Locate on site plan) ' Depth below grade: — — Material of construction: cast iron _40 PVC other (explain) Distance from private water supply well or suction line ' Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_ 1st cesspool serves as tank (locate on site plan) ' Depth below grade:' +1 Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) concrete block ' If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: +6' diameter Sludge depth: * Distance from top.,of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: ' How dimensions were determined:1980 plan by Edwar =e ley Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage, etc.) ; t hen um e s be tore inspection scum was e ow , maw rLi*�P' nn Qrnundwater inflow observecl,• no repairs require- ' GREA RAP: (locate on s Ian) ' Depth below grade: Material of construction: _ oncrete _metal _Fiberglass _Polyethylene _other(explain) ' Dimensions: Scum thickness: Distance from top of scum to top of outlet tee baffle: Distance from bottom of scum to bottom of outlet t or baffle: ' Date of last pumping: Comments: (recommendation for pumping, conditio inlet and outlet tees or ba depth of liquid level in relation to outlet invert, structural ' integrity, evidence of leakage, etc I ' - ' (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) ' Property Address: 619 Main St. , Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 System B ' BUILDING SEWER: (Locate on site plan) ' Depth below grade: Material of construction: _cast iron _40 PVC _other (explain) ' Distance from private water supply weil or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK. ' (locate on site piani Depth below grade:+V Material of construction: gconcrete _metal _Fiberglass _,Polyethylene _other(explain) ' If tank is metal, list age _WSge confirmed by Certificate of Compliance yeS(Yes/No) Dimensions: +5' x 1 n' ' Sludge depth: �c Distance from top of sludge to bottom of outlet tee or baffle:_y� Scum thickness: * Distance from top of scum to top of outlet tee or baffle: ' Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: 1 gIaQ P1 an htr Fr1Ward Kelley Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation.to outlet invert, structural integrity, evidence of leakage; etc.) Ai pr G i d t nl, was in gnnrl r•nnrli ti nn t SE TRAP: ' (locate ite plan) Depth below grade: Material of construction: _ ncrete _metal _Fiberglass _Polyethylene —other(explain) ' Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or ' Distance from bottom of scum to bottom of outlet tee or e: Date of last pumping: Comments: (recommendation for pumping, conditi inlet and outlet tees or baffles, dept iquid level in relation to outlet invert, structural integrity, evidence of leakage, et 1 ' (reviead 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) ' Property Address: 619 Main St. , Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 CSy3stemC ' BUILDING SEWER: (Locate on site plan) ' Depth below grade: material of construction: _cast iron _40 PVC —other (explain) ' Distance from private water supply Weil or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_ ' (locate on site plane Depth below grade: +1 t Material of construction: X concrete _metal _Fiberglass _Polyethylene _other(explain) ' if tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: +9x6' ' Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of Scum to top of outlet tee or baffle: �` y ' Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: 1984/85 Plan by Baxter & Nye Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural irl rsty, evidence,� leakage' etc.) umper said tan was no repairs required. SE TRAP: ' (locat site plan) Depth below g Material of constructs concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outle or baffle: ' Distance from bottom of scum to bottom of ou tee or baffle: Date of last pumping: ' Comments: (recommendation for pumping, conditi inlet and outlet tees or ffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, et ' (taviaad 04/25/97) Pago 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) ' Property Address: 619 Main Street, Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 ' ING TANK. (Tank must be pumped prior to, or at time, of inspection) TI OR HOLD (locate o to plan) ' Depth below grade: Material of construction: _ ncrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: Capacity: gallons ' Design flow: gallons/day — Alarm level: Alarm in working order es; No Date of previous pumping: ' Comments: (condition of inlet tee, conditio alarm and float switches, etc.) ------------------------- ' 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.) *Not dpterm.nah1P as system was ]M=ecl 5 days PUMP BER:_ (locate on site p ' Pumps in working order. (Yes or Alarms in working order (Yes or No) Comments: ' (note condition of pump chamber, condition of s an urtenances, etc.) 1 Page 7 of 10 (revised 04/2S/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C I ' SYSTEM INFORMATION (continued) Property Address: 619 Main Street, Centerville, MA Owner: 619 Main Street Nominee Realty Trust ' Date of Inspection: 8/9/00 System A SOIL ABSORPTION SYSTEM (SAS):_ ' (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: ' leaching pits, number:_ — leaching chambers, number: leaching galleries, number: leaching trenches, number,length: ' leaching fields, number, dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: ' Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) S3TctP_ m in Tsrk;na�nt- — no ntrarflnw nr harin,n jantind' Sao Dr-91 in13c y ' CE OOLS: _ (locate site plan) Number and c figuration: ' Depth-top of liqui inlet invert: Depth of solids layer: Depth of scum layer: Dimensions.of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pump e part of inspection) t ' Comments: (note condition of soil, signs of hydraulic failure, level of pon ' g, dition of vegetation, etc.) j PRIVY:_ (locate on site plan) ' Materials of construction: Dimensions: Depth of solids: Comments.- (note con ' ' n of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Page 5 of 10 ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) ' Property Address:619 Main Street, Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 (SysntemB ' SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible; excavation not required, but may be approximated by non-Intrusive methods) ' If not determined to be present, explain: ' Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number:_ ' leaching trenches,.number,length: leaching fields, number, dimensions: overflow cesspool, number: ' Alternative system: Name of Technoiogy: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) No sign of ponding, overflow or backup; see previous comments by pumper. %layer- DimensionsS: _site plan)d con ' uration:of liquid t let invert:olids layer.cum layer:s of cesspool: Materials of construction: ' Indication of groundwater: inflow (cesspool must be pumped as rt of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, tion of vegetation, etc) PRIVY:_ ' (locate on site plan) Materials of construction: Xetc.) Depth of solids: ' Comments: (note condition oil, signs of hydraulic failure, level of ponding, condition o ' (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 619 Main Street Centerville, MA ' Owner: 619 Main Street Nominee Realty Trust ' Date of Inspection: $/9/00 System C SOIL ABSORPTION SYSTEM (SAS):_ ' (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive metho s If not determined to be present, explain: Type: leaching pits, number: I leaching chambers, number:— leaching galleries, number: leaching trenches,.number,length: ' leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: ' Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) ' POOLS: _ (local n site plan) ' Number and nfiguration: Depth to of liqu to inlet invert: Depth of solids layer: Depth of scum layer: ' Dimensions.of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pum as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of p in , condition of vegetation, etc.) ' PRIVY:_ (locate on site plan) ' Materials of construction: Dimensions: Depth of solids: Comments: ' (note condi ' of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Page 8 of 10 l i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART C SYSTEM INFORMATION (continued) ' Property Address: 619 Main Street, Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) See attached installer's cards and composite plan. ' Also see Barnstable Board of Health DWIP #s 85-423 and 80-79 I ' (revised 04/25/97) Page 9 of 10 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART C SYSTEM INFORMATION (continued) Property Address: 619 Main Street, Centerville, MA Owner: 619 Main Street Nominee Realty Trust Date of Inspection: 8/9/00 Depth to Groundwater +14 Feet For Systems A & B; +8 feet for System C Please indicate all the methods used to determine High Groundwater Elevation: X Obtained from Design Plans on record ' X Observation of Site (Abutting property, observation hole, basement sump etc.) X Determine it from local conditions ' X Check with local Board of health _X Check FEMA Maps Check pumping records Check local excavators, installers ' X Use USGS Data ' Describe in your.own words how you established the High Groundwater Elevation. (Must be completed) USGS Topographic Quadrangle for Hyannis shows a bench in the intersection island just SW of the site with an elevation of 39' . The surface at the SAS for Systems A & B is within ' +2' of the intersection grade. The Town Watertable Contour Map shows a::water elevation of 10' MSL +150' downgradient (south) of the site. System B is noted as having a 1000 gal. pit (6x8' ) with 2' of stone for an effective bottom depth of +11' or +26' MSL. This would be +16' above average groundwater. Local USGS seasonal adjustments are +2' for ' 14' of clearance. For System C, the location is +8' below System B. This would be 8' between the system bottom and average groundwater and 6' between the system bottom and adjusted groundwater. (caviaed 04/25/97) Page 10 of 10 � 1 1 1 1 1 LIST OF EXHIBITS 1 1 1) USGS Locus Map 2) Town of Barnstable Assessors Map 3) USDA/SCS Soils Map ' 4) Town of Barnstable Groundwater Map 5) DWIP for System B 6) Installers Card for System B 1 7) DWIP for System C 8) Installers Card for System C 9) Certified Plot Plan 1 10) Composite System Location Plan 1 1 1 1 i 1 1 A.M. WILSON ASSOCIATES INC. From: USGS Topographic Quadrangle for 3261 Main Street P.O. Box 486 Hyannis, MA ' BARNSTABLE, MA 02630-0486 EXHIBIT 1 (508) 375-0327 FAX (508) 375-0329 r �I .. Little �. a `-�f I h/Great Pt Y y II; Pt.:`r l \ ('\� �� /I '�' Cray^1( ���`� 1•''�� rr/ 1 J� ° f"��� % �e 2R� .� \�A 9Zronberry '\10 Jej60� fir/ �• •\•:�I''I it .rJ��� , ','RS1aFr�"S�,•/. D`(I �( '\ 1�'i \I�IrI(� J�,�: nilrn 1 /,y �_i ,�,',,'LC,�L,yt^�i. 'r.n• \ I: ��P-- �� .l r ����•WT�1` J>� �t �4g �a Il' 1��•u -�- '��z !i f. �U-j� l� 1! / .;/ , 1�r l �rrjr->Y •, 7 �y\ + mi 5O1i1 !�„ j// W� �� /:'` rt o /.•.e'J �` %/it11. ®../ �. • I, uT 'rBM 'Il I/ I, .i� ✓�• jll F,sh r 'i Vic` \: •/n8M601 arnstable i (it Hatcr,erYr ;!1(f� :^ �� 26 �0n(f. I� ' ghSrhf, f I f I ill l�l\'' w ,` R�-�-'1 �) / '�� i�il iti� „•,— �/r if - +® \ L. r I u Beechwood -- � I - _IG,,, *J ter. I• •O�('.2(4..-_�,:I���j �---•a �Ir. , III--•�—.(�'✓il, �J M. ' � _ .- R"--�= I .� �-- n (: .� ./' , � I III,(_.� D , J��II,••-II`�I��'/� I.�A- �3U' 26 �,`� ) Q, >,.i 11 I� \' .(?.. � i �r��1. '.I � 1\\\� ''il I •'III ••LJ', j>.•�_h S3� -\6 9ti✓.-I 1 / �1Cranberry o•�ry••.�•:.�• Il l��r�• ��/u` ;�r �,r� 1 1'\\• "'PI•E• I'��• '�•n" [��`' � _ , •j. F^-� 3\\'- •��/.G)II- '� J •t q(C?anberry rr11 _ ,% (.,;.il1 aviel,,i �� ,.� 13.8. 7 �h g \�J I ,/ ��\ _/l 1 tJ, r. I t J' U_� _ 9• a \ '� �I,l\,\ , �%N, B° �{ � I � � I s� '� =mill •• _ 'o•' •i�` � :l\�. 1 I � ',• �3I �l-'^l,�,:/:Ue �e 'T�-�—�� 5 0`�,,.' L; �•�//� •„ 1 ,r. � I 0 VE .• x' / - ..f"�i �. 7 P.^`� r� � O '•� Sch . i1 fr�. ( �I •�i0r1'r�r /-.� 1 y .//�(r. , •r' `� \ �:1 I 3, ..'� 4 1 I I �. •//%.. (�•a •-+•,�\1 .1 'ui� { .�'r ��,lL� / \.1_�fw-. t'� \\t� (� ' ��\s7,��..^. 1 /��1 f ?� I _�.- � \,1.�\�• .��' Jam- - ! - / {)�✓.�Jr� /p) t" 1`,\ � .,�W) G�./, •�50 -��r ��P-� ('^� ��s,lo oF...� O -m '`%� GQ •• � 11 �"' .0 0 j"iScudder` -� �r J ` > A •�? gay - Lva - 'J� of U //1� - aJi '' ';) r• (I ®• •CQ L..�\���\\\ 0 `-`9•� `'.. : i1 ! i nr• IG•10.0 .l\ ' `•�" L • n; s. .y raagWlle B.eac _ ,�' ♦,I i �. '✓r Ciraa1g i •_ o" �. Pumtc: Beach cc 3 Landing: I aoc Spindle* - V� 1 ao !N7 0 :i Qj % CENTiER ILLE HARBOR'. 47 d %S4 Wa w ;11 D r6 Hya 04. :°,.J,� ^East B y. 1 se Beach 113 •li'o° ,yam�+� Gannet / .... RocksHle Pt .' :I I 20. l3 /a _- N A N T U� C K E - _.Gannet z O Led ge I_, PRODUCT 204-1(Sl4e Sholsl2054(Padbdl ' A.M. WILSON ASSOCIATES, INC. From: Town of Barnstable Assessors Map 207 3261 Main Street P.O. Box 486 ' BARNSTABLE, MA 02630-0486 (508) 375-0327 EXHIBIT 2 FAX (508) 375-0329 1 T'owN of 13 ay Ae , .z 11 AC. t�AC• I'bpMV .t 3s roar - :z,AC 44 r JD p esw• ae !C 4 CC NI LPYILLC ' J ' t j • 37. 3T / /� x 49 /Ac. tv AC. V .66 AC. / N '( .6]AC. q3 — t d z.rIAc j � 62P. 38 ' 6a q 2 .nl Ar- .50 AC. SI 1 ,. I 1 O idl , : .Al At ao 41 ^ HILL qI AC. rz Ac. ^ CHURCH ZL t 39 ynY c C .l O AC. 211 h ei z0! y7REET eo b 1,� b 53IT 20 .eone. J .ITAC. 19 A 19 .Dlw.n IOI OFr eMM4I�lA�e tpNAl CHURCH L .lOwL ' I 16 110A0 � 21-3 zt-4 s C 29AC .53P.C•5 v ° 54 14 190 ti RDAO _pL.ti R Lel Eee ZlAC' v ' � 1 , ee — RI w 9D Z2-1 p _.«Aa t M iaa t•: • �aM 11A AC. 41 PC. 12 .51 C.i1 AL T O ' 1u1.- � 41e� c 10 SIG. ' t1 03 1 2 G q t4' p re O q• `h �, T ar0 1 rnooucra,>t•t l�m�s�elsl zus't l�l ' A.M. WILS From: USDA/SCS Soils Survey of ON ASSOCIATES, INC. 3261 Main Street P.O. Box 486 Barnstable County, Sheet 28 BARNSTABLE, MA 02630-0486 ' (508) 379.0327 FAX (508) 375-0329 EXHIBIT 3 1 ------------------- -- .... CcA (Joins sheet 21) 1CdC pp CdA -07 .t .j n ,•i,_ .rip r'f'r bM ,�,��•f }, '��..,,i YO 9 9 '],t�'� .#; + �� E rk •. � Y s.r ,�' w , C�C'A�� &'� Y Cc yr ` 1 Na�� �,ti •'••�{ `.. �'�rt �I.;/�i ,a }fSY '. Ti �f`� 5 'S � �, y Y v rt r �""r,� f�✓, � : { dB,r !„ x �'"�.. �,++� ..,,Cd BF'e ( r�, .-.' 'lt °` zS"-?b:�� � hA1 . Psy F' �` w \ �)� 1 a M1„y, ro +-• \ ,-. a a� aG�' (�a '�d `\ .+7N- v; ,� .c '.. U� i � FP $Qy G CJ G +;a •}+� a.,Nq - .�k U - s` s .' 'S ''" Gr Y 0° '�R`-c CdG- :*1'�`L� _r �s 1 .•t"''�Y` k`.�' i d `nt iAv , � ,rl�'s �� ..�� r"{ _ga. r Cra1g I ,• � � C7�° { r ��' Vilt e (�w A' tsarn�t}1;ss- "lf' 1 fµ Grpy4�E g ,oy s r l }p � � � „�„sy,�`'}i�,�t n S✓p ��'{h ,�,�� n, n��a'���.. +u av,,r ��S a1 mwl � r �Dowsesz s � '� .'a- - Bh•cf tz.� +,Oster ,"pt h 2 1 t Po1rTt °m �' e Dh ? �t'+ r�� 4 3 Yr .. �� �� 4 .._S�'�i+�����R �-it��'��� t,94,'�$� f 4 Y:S , �•µ��✓j �'4 �� k ;M �t .. '. •.. '' YitsF�,x��c�'�����} �' St��7��. a�."'`�a r. s� � �, "f � t. _*- .t..r< ^r"Pffi -�^--,why i a _tl�F'M1 .,,i, 'E' 21�'t :4� r� ✓».5 G,T"z S2 `,yv4X 3��i�£ .,tR� . ` , b °aS 'r ?,eta ,... � �- �,+`•�s } i .a E�&r s ^�` 3 ':1 � G;�i ¢nt. �y� �T}kq�S�e '�lY i .�'��. r .: t ,,s, lwc na,sj 3�z a� ,a.. h' .•,.:.. .. �;+ .,- ..`�,:rt x_v, -•_�v:•�"�..::tiv�-,..s�C�'Y�:'.t _ c.:�,'f 910 000 FEET 1 1 PHOOUCT204.1(Sig1e SheVs)205-1(Padded) r ' A.M. WILSON ASSOCIATES, INC. From: Town of Barnstable Groundwater 3261 Main Street P.O. Box 486 Contour Map BARNSTABLE, MA 02630-0486 ' (508) 375-0327 FAX (508) 375-0329 EXHIBIT 4 ,FAQ;. co S � LAN R Ns T9C ^-_O PO7TCHIN o AJUMAD S Tp0 @ r ' � - I i i 7 .¢ vS 1•---I.. h w ! K I w b LAKEv �Fc r .I jO.N. so►.. �+ AVI. O Y t� r I j va O G3 i p0Or MIDWAYD: o Q RO s w. S � I EH GO T 2 SHA o P O E z O _ IN rs AY a o lTh fi a,. C cL J ,i ENNIE a Ny? RO h L IAT W M AME / V7 g OR1T,q,V0 g _ cO 9,yRDs ROq Q g= b k GIN Ao P1JaY O W a FALMO H ROUTE 28 ROUTE 20 �Yc R #-r SA BEM U'EST M.ejN t� j�JR ti \ i l�}BROOK RD. 44i W w�—I .. P s <i 9_�� d T\ _ =W ~ �m �m7� Ff•T I AY R ... In , m :.PINE STR PINE :t T W LEQR I AD 1 A 'A RIVER E ; ' O I C pt q i �--_ Off- a __ _ '' A - 4�• �^ Clf� TVµf' m COPPWES y� P pPgO�S gi LANE AOON ILL µ0 ATIRSIO IJr HICCSAD/O RO I M oQ E........... E, 9� DR II d V �oY' ' R. N z °a ISLSEE' 4 co 1� 09E /T&Y II RSESHO lur- LN I II WATWA ER �, Fr 0 AV K EACH.c OAD I spy C RDA �V1CCE IHD ROPD W ST r ` mo- I O W a kr Z P• m a' i PNDDUCT2114-1(Single Sheals(21g•I(Padded) (" ? FEN THE COMMONWEALTH OF MASSACHUSETTS EXHIBIT 5 7�G W1V BOARD OF HEALTH .l... ...................OF...ZRCtY5T.�q'Qklf.....................:...........- ppUration for Diiipuul Nark£ &witr tion Fermi Application is hereby made for a Permit to Construct (b ) or Repair ( ) an ,Individual Sewage Disposal System at: Mfilh)_ s�kri-__7�-sou'TH ./W)"f0v sr�CET ........_...... ......................-•••••-••••-•-•••-•-•-•-.................................................. ' Location-Address or Lot No. ..r�o.kD-----`j----. .......... ........................................•-----.........---............................---.._...... Owner -•-•...••------••.•••.•...••--••.Address _�'o Nov------�-r± . To o -------------------------- ........... Installer Address Type of Building Size Lot.SI-4.2.............Sq. feet ' Dwelling_No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building QFFX 5............ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------------------------------------------•-•------------..................-.....---- _--_-------------_---•-•-_-•- Design Flow-----...............................\.....gallons per person per day. Total daily flow............................................gallons. Septic Tank 4 Liquid capacity.z 4...gallons Length................ Width------.......... Diameter................Depth................ Disposal Trench—No.....................Width..._.. _.... ..Total Length..... Total leaching area...-_..._..._...___sq.ft. Seepage Pit No......_1.__.__... Diameter....._... ----- De th below inlet..... <......._.. ?..p Total leaching area...... 6_.�rsq. Et. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date--.................................. ... Test Pit �1o. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2----------------minutes per inch Depth of Te t Pit._.................. Depth t ound water........................ i Description of Soil _ i Z. r kl� --- 1 .-•............................................................................................................................................................................................... . ............................... , ..................... .. i Nature of Repairs or Alterations A sorer when applicable. ... L........ -7 ---------------------------••,� _�. --�------�� .. .............I----------------:_...._......-----........................................ ' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Igne �:_... ------•----" ---------------"---"•-------•-•-------------•--- -----.--..--D.-- y, Date Application Approved By..... -,�-q,4a ...../-°t•�t1 2-l... --_-----_------ -..1 ' Dace Application Disapproved for the following reasons:.......... ___.._....._....._..-_........._......._....._............._......___ Date Permit No...........__.....-..........._........._—__ Issued. :..1�s3:.. ........................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH ........... f' ..OF............... ........... 1!l...z..---......................... .. S 1 TO CE IF hat the Individual Sewage Disposal Systen i onstructed ( ) or Re aired by- _ xt"'�.. ._ _ _r/� !��j}, -------------- _ at. � T.. ..V-L ..... ....4:._ i_. _...�//i• ir.t_. f�..V. .._. fi�7 _. ......._....... ' has been instilled in accordance with the visions of T 5 of The State Sanitary Code as desc a in the application for Disposal Works Construction Permit No.. ......7��............ dated--...2._.-=13-........................ ? THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ "` ............. ....-.......- Inspector.....-"•- v.. ........................._........... THE COMMONWEALTH OF MASSACHUSETTS n BOARD OF/ EA,LTH No......7l•----••••• _` ... FEE...✓--_--_..�... ;_�a:n ton f�rmiPermission is hereby gr t . .................• _. ...........................__.. to C Instrgt R ( In jvdual Sew a Dis al Sysat No._ : -".I.GI�t►I_.� �d_+_. COrf9t. ..... ................................................. _.... • Street , as shown on the application for Disposal Wort Construction o.-,,,e _ .....................................� -�.3 . PP P i ya�ted_.11 / _i,) - . Board of Health DATE.............................•... .....................__........_.._.: ✓// ' FORM 1255 HOBBS &WARREN. INC.. PUBLISHERS L 0 C A T 10 N S. W A G E PERMIT NO. VILLAGI` l.o$h! ✓vr/�� ; ass ' INSTA LLER'S NAME i ADDRESS ' 9 U I,L D E R OR OWNER SJIv: 4 �l`v'iry DA T E PERMIT ISSUED f J3 - 2"a ' DATE COMPLIANCE ISSUED /s NJ III � S` FEJEZ)—O .�. EXHIBIT 7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Tow.0...................OF....3 — - ............ .................. Appfiraffun for Bi-qvunal War1w Tungtrurt- ' Vnmil Application is hereby made for a Permit to Construct or Repair ( 7.. Individual Sewage Disposal System at: 5r C ........ .... ..................... ------------- .. . ...... 5.TP .......... io5, %ddr"s No.. 4-� A .....................................................................r.V, .................... 0,,,r Wdress jafw...... ,0 . .... . ..................... 4 ..& .................... ...................................................... ................. ---------------------------------------- ...�n��T kdd�l 11_7 310 4� Type of Building Size Lot -------j..............Sq. feet Garbage Grinder oms . ......................Expansion Attic G, Dwelling—No. of Bedrooms........ . Other—Type of Buildill Fg No. of persons........I................ Showers Cafeteria �4 Other fixtures ---------------------------------------------------------------------------------------------------------------- Design Flow....................S.S.- gallons per person per day. Total daily flow__........ ...............gallons. zi 11 Septic Tank—Liquid capaci t, ..M-gallons Length-............... \Vidth................Diameter........_....... Depth................ Disposal Trench—No.....................Width...................Total Length..............I.....Total leaching-area..... .... ..........sq. ft. F. Seepage Pit No----------I.......... Diameter ........ Depth below inlet...... eo........Total leaching area.-14.-J......sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by......_.._...............••------------................................. Date ................ ............ Test Pit No. i................minutes per inch Depth of Test Pit....._._......_..... Depth to ground water..............._....._. Test Pit No. 2................minutes per inch .Depth of Test Pit.................... Depth to ground water...................._... ............................................................................................................................................................. 0 Description of Soil.................................................................................................................................................................... �4 ..............................................................................................I............ .................................I........................I----------- W .............I—.................. ..................................................... -------------- U Nature of epairs or Alterations—Answer v en a FU ................... ................ 'l--------p-p--I-ic'able.... aMf2VK 0--rD P ...........I............I.................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTLZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has cen issue y the and o health. issue ... . ...... &............ .. .... .......... -- ------ A6 pe. L..............?/ ate -- --------- Application Approved By............ ....... ................. ..... .............. Date Application Disapproved for the following reasons:..............................................................................................................- ------------------------------------------------ -----------------------------------------------------------------------------*------- -- ----------------------- -------------------- Date PermitNo............9S... .. .. ----------- Issued.......... ....-3 _2. _ ....................... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH — ......... ..........R,,\;, 4.I I .. . . ...............0 F .. ............................... (Intifiratp of Tmplianrr THIS IS TO CERTIFIr, That thl ;ndividual Sewage Disposal System constructed or Repaired , - !!-, . I - ................ by.............................................�Int .411�.!:_�l ..................................................................................... Instafler at........ --------------- ;L ................................................................................................. has been installed in accordance with the provisions of T1'-112 5 of The State Sanitary Code as describe�d in the application for Disposai Works Construction Permit No....S dated... . .. ........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............. ---------------------------- Inspector__.._..._... L - ---—--------------------�(................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH J ...................0 F .............................. j NO::"._....... ............... � ' Biapiloal Nor. q (ginuitnutian famit ............................................ Permission is hereby gted (-,;p. .... ....... . ran ................................ ............... to Construct or Repair an Individual Sewageisposal System A.1 —.j�. .7..................................................................................... at No.._._..L�j2j:�jl........... ajOt� Street 4� as shown on the application for Disposal Works Construction Permit No.. Dated.......... ............................ ..................................... --------- ...... L Board of Health DATE................./-./------------ ......................................... FORM 1255 HOBBS 8, WARREN. INC.. PUBLISHERS THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA .."'f3p ar:-'�,R"s•� t r }+a, q - ...� � �i: 4�S c f,�q'_i Fy d ?T y.•t.�, i '�� W{v 70 ,�y sn, .1 h fi f curt tl"`T�r. f ' ,q �s¢t� � rt� j '��•�...��i�A� i�-a' ,4� d, ri , h±U +-� =Y �� 'r #x` t ry s^4.+1' s .�..,, s, >, •°iI R.. ."i py�N".e-� d5�- � `x. '-� r '�C YL�2 f '�' +?e-•.i.3,..s grw:r F y al�_ ,:I � ,,,.o: S+w" 1 � re �''� - ,� .ti r•:;n ^r. � w,� � t �r r :"•'� �a",�.._..�K _.. _. .,3 �> �,s� m>'"_jT•N� r. �.Z �..,,.,. c. r.. lw.:�` a x x 'tee .,,,,..Rnz ... es es•7nasalrs .r. rs •.xt a ^s F^.,; , _ .yy gg,, �. -„F -rtmc}+.-. h ,t•.�„a c.. t�i„r, �'t'. i!t��°s�`M16a _.,uc �"��"? S =n •,- s - i� -�� �t �tf .�z���`��+„s 'yr�+:� �"'�g "''r�'>•�.`'3�'� "� r rw K��,• s � - . r f - � ��t aa�tKraF' 4cc'S?k• ,ts�-,spat-s 4�'t-.&�•3��''•K�Y'IK"` u'k��Y r�,� �'��k� +h- +.ter ' _ ';1A`• y �' 4 -... ... �'t 4. -5«"a. „nR.sr.�.F .✓:.':: ='�^�` R/r'+'�c.;^'�,�'t'•r'R7/-,+! _ L .y y111 �` fit j�q?. .� y � �!r'a �•y}`` "'' 9 ' 7 . ! :.. }� 4 H 1 _g.. .,. 1 tt {.: L 4�. :'7 1_ L1,-9� -' �• T.+Y+ 4L��; � "}��.. i�l'A� wl.�. ''r \'.�IT.0 {-•M1T`h 7"'�'z 'k S. t ) .�'�'mfSd nC4('9 f xT k k A i L`TdTxm � �-.. 1_ i [ r `q �;,,M.�,1, amps ?'� �•. x.' _ "'�''' .p ';.r '" * L.+�t.',1'r''s�a:�i'.aP'..eY,";x. �, ..�?','��nrz•`�w:fi 'go-_t z 1 aer..9;:�� K�t 9 ,�,. ."1 I ' A.M. WILSON ASSOCIATES, INC. 3261 Main Street P.O. Box 486 BARNSTABLE, MA 02630-0486 (508) 375-0327 FAX (508) 375-0329 EXHIBIT 9 7 / / H.. 1 S.F. q , SJ'foZ r vnea.tnln: ,h C. �• NYE a � 1:G�rVFY FttE'A(c�,uu;E:S.►,��tiU�' L: . � 13.U1t—pl4�C� :LS wcYi'I�ov.:�:. ? 8•�k"i�'�" NYC, (NC 1'�-I:iO.�.l'S:)JoT.:, �:i1J:C,L-,t��; �::t.;:' P•�.aD �t�1� t�J C�I'�Jl.f�'= I IUU `(.t�(Z'�i..cb D. :Pt,y'�•iU . . .._ i•i , GS'T-'EEC-�/l L.LC,Iv�A.• 1:.: :I;hereby c,rti. ,that this mortgage inspection was prepared for Heller, Borreliz & Katz and Wainwright Bank & Trust Company; 2. The location of the building does conform to the local zoning by—laws irn.effect at the time of construction with respect to horizontal dimensional setback requirements or is exempt from violation enforcement action under Mass. General Laws Chapter 40A, Section 7; and 1.. y ?y The building shown hereon does not fall in a F.E.M.A. flood hazard area as shown on flood panel no. 250001 xx`6 dated July 12,1992 and a Wffi 1pM. ` appears in flood zone C k'u`T 77 ' N Y E �L, r7. .���U �✓ •f tip.lsau o4f -• MMCTM4-1(ftbShMWjM5•1(?&W) 5 .S; "EXHIBIT 10. I. '' iusr►u. uw 1000�6Ac� t �u PrT wmF 2'oFS� ' 2YIST"i ; IQ4 '1-1.- grow Larr -se Sre 5 ' 1 , to ' SPA.'I (/J'Li'/ /� ��� �•'♦ r 5P�;3 0.� �`s�/'�� �t�'� SET ojA4 wTram-IV s 1 , a j & R SALES & SERVICE, INC. December 3, 1998 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Attention: Health Agent Reference: Single Home FAST® Treatment System Serial Number: BMR1030 Attached please find the Field Inspection& Service Reports and Testing Results(as required)for services performed on 11/13/98 at the home of Silva& Silva located at 619 Main Street. Please call if you have any questions or require additional information. Sincerely, Candy Gayares attachments 44 Commercial St. Raynham,MA 02767 Tel:508-823.9566 Fax:508-880-7232 02AN JII I f" '. I N C 0 R P 0 R A T E 0 8271 Melrose Drive -Lenexa, KS 66214 - Phone: 913-492-0707 . Fax: 913-492-0808 e-mail: onsite®biomicrobics.cam - www.biamicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System a`, - INSTALLATION A1=ORIZEI�SERUTCE PROVIDER Installation Address Name J& S 3l e s Service , Inc. Owner Name 3_ va 6e �i va Screet 44 ComnercialStreet - Mail Address 619 ",rain Street Mail Address Centerville, "'IA 02632 city State Zip cjryRa7nham State 1,I[Azip 027 7 508-775-1442 508-823-956A Phone Fax e-mail Phone ax e-mail Il TE I r. ZTOItI:'INEORNEK4 - Model No. Serial No. Date of Installation i Date of last pumpout SV 03n-';F _ FE°tIIF -� .__ '"' R., _�- htaTrhra�7ucr�@7HIED4ANDC©1VIIvfEit]TS.,�` Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating (if DreSent) Blower(s) Air Inlet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pam out Required: Prim Settling Zone Aerobic Treatment Zone fT`:b tioasl w .`3IlV '= WMSUL Estimated Daily Flow i H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor _ (not septic) OWNER SIGNATURE: TECHNICIAN SIGNATURE: : - ', SERVICE DATE J&R SALES & SERVICE, INC. August 20, 1998 Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Re: Single Home FAST Treatment Serial Number: BMR1030 Attention: Health Agent Attached'please find the Field Inspection& Service Report and Testing Results(as required) for services performed on 8/3/98 at the home of Silva& Silva located at 619 Main Street. Please call if you have any questions or require additional information. Sincerely, Candy Y G es attachments 44 Commercial St. Raynham,MA 02767 Tole.508 823 9566 Fax 508-880 7232 l I Y» '.. I M c 0 R P 0 R A T E 0 8271 Melrose Drive •Lenexa, KS 66214 • Phone: 913-492-0707 • Fax: 913-492-0808 e-mail: onsite®biamicrobics.com • www.biomicrobics.com • 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System - INSTALLATION 'AUTHORIZE.SE1WrCE PRG.VMER Installation Address Name J&P Sales & Service, Inc. Owner Name 1 Va i Va Street 44 COT=erc3_arStreet Mail Address 619 114 a in Street Mail Address Centerville, MA 02632 city State Zip Ci -a7nham State AZi 027 7 . 505-775-1442 08-823-9566 Phone Fax e-mail Phone rax e-mail T-A ��'r'rOWINEORMATtON Model No. Serial No. Date of Installation Date of last Pumpour SF C3. -S7 , Electrical Panel(s) Visual Alarm Operating Audio Alarm Operating if present) Blower(s) Air Inlet Filter Clean ✓ Blower Hood Vents Clear ci Excessive Noise Excessive Vibration -� Treatment units Unusual Odor Pum out Required: Primary Settling"Lone Aerobic Treatment Zone Estimated Daily Flow H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor not septic)- r OWNERSIGNATURE TEMSUCIAN SIGNATURE SERVICE DATE IN SALES & SERVICE, Inc. March 4, 1998 Town of Barnstable PO Box 534 Hyannis, MA 02601 Re: Single Home FAST Serial# BMR1030 &BMR1036 Attn: Health Agent Attached please find the Field Inspection& Service Report for services performed on 2/25/98 at the home of Silva& Silva located at 619 Main Street, Centerville. r. Sincerely, �a� f v% Candy Gayares cc: Silva& Silva 44 Commercial St. Raynham,MA 02767 Tale.508 823 9566 Fax 508-BB0 7232 r i ON w INCORPORATED 8271 Melrose Drive -Lenexa, KS 66214 - Phone: 913-492-0707 - Fax: 913-492-0808 e-mail: ons-ite®biamicrobics.cam - www.biomicrobics.com - 800-753-FAST(3278) FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System ... . INSTAET TION: r�M0.1 11SERuTCE PROVIDER: Installation Address Name J&'-R Sales & Service, Inc. Owner Name 11va ..llva Street 44 ComercialStreet Mail Address 619 "rain Street Mail Address Centerville, Y-4 02632 City State Zip Ci ?agnhars State"fAzip 0 2 7 6 7 508-775-1442 508-823-956 Phone Fax e-mail Phone Pax e-mail 5T1StLEt ZTO1�I WORiVft�'ED13I Model No. Serial No. Date of Installation Date of last pumpout 030 E� 141EI�`_-- =� _ -_.:� �-• ' __:� _�.,, _ >�rA��� �rm coNnr�rs<.>..�. Electrical Panels Visual Alarm Operating Audio Alarm Operating (if resent) Blower(s) Air Inlet Filter Clean v Blower Hood Vents Clear Excessive Noise v Excessive Vibration v Treatment unit(s) Unusual Odor v - Pun2 out Re cared: Primary Settling Zone v Aerobic Treatment Zone v Estimated Daily Flow H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor (not septic) OWNER SIGNATURE TECHNICIAN SIGNATURE SERVICE DATE � � a� �' J&R SALES & SERVICE, INC. November 10, 1997 Town of Barnstable Board of Health PO Box 534 Hyannis, MA 02601 Re: Single Home FAST Serial# BMR1030 &BMR1036 Attn: Health Agent Attached please find the Field Inspection& Service Report for services performed on 11/3/97 at the home of Silva& Silva located at 619 Main Street, Centerville, MA. Sincerely, C*aq Candy Gayares 44 Commercial St. Raynham,MA 02767 Tole.508.823.9566 Fax 50B•880 7232 MU=INCOMPORATeO 8271 Melrose Drive-Lenexa, KS 66214 • Phone:913-492-0707-Fax: 913-492-0808 a-mail: onsiteebiomicrobics.com -www.biamicrobics.com FIELD INSPECTION & SERVICE REPORT For Bio-Microbics Single Home FAST® System -:II�TST LLATIOIV ?rD'IHOR=SERVICE.-PROV-MM InsralIatioz Address I Name J& Owner Name Street 534 New State Hwv Mail Address Mail Address Ci z�i Stated}/Alu City Ra7nham Stat Zi SP�8J 823-95�6 880-7232�_ Phone Fax e-mail o e ax mail STAI L.k— ON-INFORNfATIOI - Model No. Seriai No. Date of Installation Date of last pumpout — ZvOR NI Y C.PM 1a_W EIectricnl Panel(s) Visual Alarm Operating Audio Alarm Operating if present) I Blowers) Air lniet Filter Clean Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment unit(s) Unusual Odor Pum out Required ::EIIEL p %MS9W.R.271 Estimated Daily Flow H Standard Units) 6-9 S.U. Color Clear Temperature Odor Slightly musty odor not septic) : _.:.O:WNEILSIGv - TJRI-; hEEIIGIE�N'SIGiVA'I:CIItE; I I f _ " TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS �3 i NAME ADDRESS 6121 A III t l T VILLAGE /�— LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL �7 r c (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: 1,91- TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS J SILVIA & SILVIA ASSOCIATES, INC. • BUILDERS AND DEVELOPERS RESIDENTIAL - COMMERCIAL 619 MAIN ST. CENTERVILLE, MA 02632 TELEPHONE: 775-1442 RONALD J. SILVIA FLOYD J. SILVIA PRESIDENT - TREASURER January 13, 1981 Town of Barnstable Board of Health 397 Main Street Hyannis, MA 02601 To whom it may concern, Enclosed, please find Underground Fuel and Chemical Storage Systems card you requested. Sincerely, Floyd J. Silvia FJS:nac Manager Sylvia & Sylvia Assoc. ,Inc. 56 Linda Lane Hyannis, Ma., Main Street, Centerville NAME ___ LOCATION Sylvia & Sylvia Assoc. , Inc. Main St. , Centerville 56 Linda Lane, Hyannis, MA 02601 (formerly Getty Ref. & Marketing Co.) BOOK & PAGE - DATE GRANTED Amount Stored Bk of Lie. , Pg. 290 5-3-20 37/293 6-22-51 77/155 10-26-65 5,000 gals. Date Paid MAR If;. .' z r N TBM-2 LEGEND PK Nail set, EL.=104, 12 104.37 _ _ __ z` Cimcr, Assumend Datum 99 `n 9 - �" ../ PROPOSED CONTOUR LOCUS bacon PROPOSED SPOT GRADE � .Lots A & B ' � �,�� 8,2o4f SF. !�• .N' _ ..70a--_.-- EXISTING CONTOUR 4 Ma 207 V x 103.87 EXISTING SPOT GRADE aP�� BURRIE'D ABANDONED GASOLINE _ P ' STORAGE TANK 5� FILLED W17H �� 7d —w EXISTING WATER SERVICE CONCRETE AND NEUTRALIZED Parcel �7 APPROXIMATE LOCAPON `"`_ �`�_ y , EXISTING SHRUBS Ca SEWER CONNECTION N0.2 - METE.„< INV.-99.1t (PROVIDE CLEANOUT) , h << PROPOSED S.A.S. ��,�s:r i "I , AP N.T.S. w �``� LOCUS .M G ROWS OF 5=RICH CAPACITY j Pi:; r,°f ;� � - , . 0�,7 H-20 INFILTRATORS . VENT GENERAL NOTES: T% r /// /// //� 1: ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL /. ws e 102i4 �' / '�� j ��T � j/ �/ j/ h BOARD OF HEALTH AND THE DESIGN ENGINEER. INSPECTION < - � : _ `x j �'/ j /i I �. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS PORT M / / / Q� OF i'HE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE DTP - EXISTING/ b /�'` ry' LOCAL RULE, AND REGULATIONS EXCEPT AS REQUESTED BELOW: 10 �E3UlLD/NG`i 310 CMR 15.405 1 b CONTENTS OF LOCAL UPGRADE APPROVAL: r� #619 MAIN ST. ' ( )( ) EXISTING CESSPOOLS _.__. _.. / ,;� � rt �� i � �C�F /, / 1) A �,' variAncp S.A.S, to 91i�t�, for c 5' setkYaak. 'To BE REMOVE�(� �. , f / TOr=103.30" (SEE NOTE 17) 1 , i�r<�v t� �G //,i 5`LAB)/ // E'XISMG 1 THE SEWAGE DISPOSAL: _SYSTEM SHALL_ NOT BE BACKFILLED PRIOR ' `EI �, / / ,% BUILDING TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 9 / / %/' DESIGN ENGINEER. 368 SO. MAIN ST. � '/,, ,//j'/ ,% # � 4• ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING PROP. "y y t; j/ ///// FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ( - ) �_..,m, a o �;. - , � � ENGINEER BEFORE CONSTRUCTION CONTINUE`. pt1rkI'P7 J, ALL ELEVATIONS BASED ON ASSUMED (DATUM: BGIr? IED ABANDONED ! ` , b. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE_ OF NEU ALl2Ei7 GASOL-lN '�' E THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF TANK APPfOX,) r'f�,. �' { �/ ! ! �/EIJT�! HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. _ 7. WATER SUPPLY PROVIDED By TOWN WATER. E S. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S:A:S. "T 5 . `�, WU ) �'N, !,/ j ' ' 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED (� 6_ TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR: I b�, � 10. IT SHALL BE THE RESPONSIBILITY Off' THE CONTRACTOR TO VERIFY �j #^ i THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 100,�1 � vI _ CONSTRUCTION, G,� , v _-_. NEW SEWER OUTLET 1 1. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS 0Po"li - -r - PROVIDE,ISOLATED SEWER FROM ONE SINK IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. IUD �• U— 10.83 TO HOLDING TANK INV.(BLOG,}=97.30(MiN,) AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). - .05, - - - SEWER CONNECTION N0:1 12. LOCATION OF ABANDONED GASOLINE STORAGE TANK IS APPROXIMATE. AS�IN -LA-M100,00 �avemerit `�'47 INV,i98.3 (PROVIDE CL-EANOUT) THE ENGINEER IS NOT RESPONSIBLE FOR ANY BURRIED OBJECTS. 99 Edge of PROPOSED SEPTIC TANK I�, EXISTING SEPTIC TANK 2000 GAL-2 COMPARTMENT (H 20) TO BE PUMPED, RUPTURED, r'ILLED EXISTING LEACH PIT WITHSAND AND AL3ANCJONED PETER T. q�d PROPOSED HOLDING TANK (SALON) PROPOSED SEPTIC SYSTEM UPGRADE d s TO BE PUMPED, FILLED Wl7"W � I McENTEE SAND AND ABANDONED 1000 GALLON CAPACITY (H-20) CIVIL 619 MAIN STREET, CENTERVILLE, MA INV.(IN)=96.84 No, 35109 �/� Prepared for: Sylvia & Sylvia, P.O. Box 430, Osterville, MA 02655 TBA — ' ' �f�l j���� `�Q Engineering by: Surveying by: SCALE DRAWN JOB. NO, PK Nail set, EL.=100.00 SOUTH MAIN 5 TREE'T ` Engineering Works WARNER SURVEYING 1"=20' P.T.M. 229-07 \ Assumend Datum 12 West Crossfield Road 22 Long Road \\ 1 �6`� Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. l 7 (508) 477-5313 (508) 432-8309 1 1/30/07 P.T.M. 1 Of 3 l � ii i NOTE: TO PREVENT BREAKOUT, THE PROPOSED _1 INSPECTION RISER'PIPE WITH FINISHED GRADE SHALL NOT BE < EL.97.2 PROTECTIVE COVER, SET TO FOR A DISTANCE OF 15' FROM THE S.A.S. T.O.F. PROVIDE RISERS, METAL FRAMES & COVERS ALL ACCESS PROVIDE RISER, FRAME & COVER OVER O--BOX GRADE IN BRICK WALKWAY (Existing) MANHOLES AND SET TO FINISH GRADE (ALL H-20 RATED) TO FINISH GRADE (ALL H-20 RATED) FINISH GRADE: 102.2(MAX.) VENT SLAB a EXISTING F.G. EL.100.6t F.G. EL.101.4t MAINTAIN 2% MIN SLOPE OVER LEACHING AREA BIAXIAL GEOGRID-BX TYPE ;6 EXTEND 1 FT. BEYOND S,A,S, L=34'(SEWEI L=42' SEWER-2 4" SCH40 PVC L = 27' W' --fl 4" SCH 40 PVC 12,. SLOPE=2%(MIN.) _. _ . _ . _. . 14" 14` ® S=1% (MIN.) &� a S= 1% (MIN.) 11' EFF. a 48" LIO. - -- -- DEPTH 4 LEVEL INV.=97.62 GAS' OAS PROPOSED _ ___ BAFFLE BAFFLE-_ Q-BOX INV.=96.82 6 ROWS OF 5 UNITS AT 6.25'/UNIT INV:-97.37 INV.=97.t 0- INV,=96.93 � SOL SORPTION SYSTEM (PROFILE) -- TIE IN TO EXISTING SEWERS PROPOSED 2000 GALLON SEPTIC_TANK 1H-201 RESTORED PAVED PARKING & BRICK WALKS EXITING THE BUILDING COMPARTMl NT NO: 1 = 1100 GALLON MIN MLIW1'STORAGE COMPACTED, CLEAN GRAVEL BACKFILL SEWER NO.1, INV et98.30± eOMPARTMENT NO. 2 - 55O OALLON 1MUM STORAGE NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISSTNG PIPE BACKFILL WITH CLEAN PERC SAND SEWER NO,2, INV:t299.16± INVERTS PRIOR 10 CONSTRUCTION. TO TOP OF CHAMBERS NOTE: CONTRACTOR SHALL VERIFY THAT 2.) SEPTIC TANK & D-BOX SHALL BE SETI LEVEL- AND BREAKOUT-TOP OF UNIT BIAXIAL GEbBGRID S8X TYPE ALL INTERIOR SEWAGE FLOW IS TRUE TO GRADE ON A MECHANICALLY COMPACTED TOP ELEV.=97,23 PR CEO GEORGIA AR CORP. ACCOUNTED FOR, AT CONNECTIONS. SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN INV. ELEV.=96,82 12 310 CMR 15:221(2). 3) INSTALL INLET & OUTLET TEES AS REQUIRED, BOTTOM ELEV.=95,90 ull m I uili�ll 4) GAS BAFFLE TO BE INSTALLED ON CUTLET TEES, 5' MIN. ABOVE BOTTOM OF - --- ---- - - 22" —� 5-4" POLY5EAL OUTLETS T.P, EXCAVATION OR G,W. EFFECTIVE WIDTH=16,8' 4� {.- 1 a" POLYSEAL INLETS 4" EXISTING SUITABLE SEPTIC SYSTEM PROFILE NO GROUNDWATER AT EL.=89,90 �_ MATERIAL USE 6 ROWS OF 5-HIGH CAPACITY INFILTRATOR CHAMBERS O O N N T.S WITH NO SEPARATION BETWEEN EACH ROW & NO STONE to 2 TYPICAL SECTION e' To View --� - Sactign DESIGN CRITERIA DB-5 H-20 BUSINESS USAGE: BEAUTY SALON WITH 4 CHAIRS �j , S01 LOG / _ _ s I P HAIR = 400 tsP ,/ I x 1 OO G D/C D T NO EMBER 2, 2 07 REF '1 1,985 OFFICE SPACE HAVING 1928 SF / / SOIL EVALUATOR: PETS Mc h NTE PE C`.SE DESIGN FLOW = 1928 SF x 75 GPR/1000 SFr 144.6 GPD f / EXI57"lNG ! r r - TOTAL DESIGN FLOW = 400 GPO + 144.6 GPO 544.6 GPO WITNL�S. DONNA Mif�FZANC)I�HEALTI� AGENT "/BUILDING/ 'e --.--- i SOIL TEXTURAL CLASS: CLA SS 1 #619 MAIN ST. EpV _P C)G th EIeV TP � DESIGN PERCOLATION RATE: <2 MIN. I N. a.,n nc oa na nn an an 101.9 IO2.0 C, GARBAGE GRINDER: NO nonn._ PAvMENT PA ENT LEACHING AREA REQUIRED: (544.6) = 7 35.9 S.F. .74 23 1 "f 101,E 3" 101.7 PROPOSED SEPTIC TANK: 2000 GALLON, 2 COMPARTMENT, SPLIT 1 150/550 ' e USE 6 ROWS OF 5 HIGH. CAPACITY INFILTRATOR H-20 UNITS WITH SANDY LOAM SANDY LOAM S IOYR 5/4 10YR 5/4 NO STONE FOR AN. S.A.S. HAVING THE DIMENSIONS. 1.18' x 31.3' °1, _--79t3,J - 3E " 100.0 --- -- -- - 24 C C SIDEWALL AREA: NOT APPLICABLE 44" BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.72 SF/LF OF INFILTRATOR) rv �C 30 UNITS x 6.25 LF x 4.72 SF/LF = 885.0 SF 19 "` ROPOSED i DESIGN FLOW PROVIDED: 0.74(885 S:F.) = 655 G.P:D. -- � ti" 34"' -� ,. S.A.S. -- , ,• E ---.--,, _ �:� M--.0 SAND M-C SAND PROPOSED SEPTIC SYSTEM UPGRADE S,de ;EW d_ V e 2.5Y 6/4 2,5Y 6/4 619 MAIN STREET, CENTERVILLE, MA HIGH CAPACITY INFILTRATORS, H-20 LOADING Prepared for: Sylvia & Sylvia, P.O. Box 430, Osterville, MA 02655 INFILTRATOR CHAMBERS IS 9a 144" 9aD ---- 144" Engineering by: Surveying by: SCALE DRAWN JOB. NO. 4. - Engineering Worky WARNER SURVEYING N.T.S. P.T.M. 229-07 NJ.& PERC RATE <2 MIN/IN. ("C" HORIZON) 12 West Crossfield Road 22 Long Road S.A.S. LAYOUT I NO GROUNDWATER OBSERVED Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. (508) 477-5313 (508) 432-8309 1 1/30/07 P.T.M. 2 of 3 VENT EXTERNAL T,O.F. TANK PROVIDE RISERS, METAL FRAMES & COVERS ALL ACCESS INDUSTRIAL HOLDING TANK SHALL BE (Existing) MANHOLES AND SET TO FINISH GRADE (ALL H-20 RATED) SUPPLIED WITH 2 -- INDOOR ALARMS, 1- FOR WATER LEVEL SET AT 75% EXISTING F.G. EL.100.6t LIQUID CAPACITY, 1-- FOR LIQUID SLAB ° CONTAINMENT SET AT BOTTOM OF a - TANK TO SIGNAL THAT CONTAINMENT o L=23' TANK HAS LIQUID IN IT. 4" 5CH40 PVC ` I SLOPE=2%(MIN.) A a,' FLOAT ACTIVATION TO BE SET - AT 75% OF LIQUID CAPACITY SET FLOAT AT 32" BOLTED AND GASKETED a K INV.=96.84 _ RING&COVER - _ Zft PROPOSED-1060_GALLON HOLDING _TANK SECTION — I EXTERNAL- PRECAST CONCRETE TANK i', I ✓ 4'-6TINLET PROVIDE NEWj SEWER OUTLET INTERNAL FRALO MODEL 1060 POLY TANK BOOSEWER INV.=9 7.30(MIN.) 7 HOLDING_ TANK PROFILE 8 B BOOT N.T,s. . 4"" S ED RING&COVER DESIGN CRITERIA - - -- ACCESS PORT FOR SECONDARY CONTAINMENT STRUCTURE FOR FLOAT, INSPECTION & PUMPING BUSINESS USAGE: BEAUTY SALON WITH 1 CHAIR DEDICATED TO HOLDING TANK DESIGN FLOW � 1 CHAIR x 100 GPD/CHAIR x 500% � 500 GPD (MIN. CAPACITY) HOLDING TANK PROVIDED: 1060 GALLON CAPACITY ----- --- - - - -- NOTES: 1) CONTRACTOR SHALL CONNECT TO NEW SEWER OUTLET WITH ISOLATED FLOW FROM ONE SINK 1> A INTERNAL TANK ACCESS SHALL BE BROUGHT AND PIPE INVERT PROVIDED BY PLUMBER SET AT, OR ABOVE, ELEV.m 07.30, TO WITHIN 6" OF CAST IRON COVER 2) INDUSTRIAL WASTEWATER TANK SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A PLAN MECHANICALLY COMPACTED STABLE BASE ONTO WHICH 12" OF MECHANICALLY COMPACTED CRUSHED STONE HAS BEEN PLACED. -- — - _ - - - 3) A 4" FLEXIBLE HOSE SHALL CONNECT THE EXTERNAL TO THE INTERNAL TANK. TO ALLOW FOR - MOVEMENT OF INTERNAL TANK, 4) INTERNAL TANK SHALL- HAVE 24" RISERS EXTENDING TO WITHIN 6" OF CAST IRON RING & COVER. " 5) EXTERIOR TANK JOINT SHALL BE SEALED WITH CS 440 FUEL & OIL RESISTANT JOINT SEALANT 8 AND SEAM SHALL BE BAND WRAPPED AFTER INSTALLATION AND BEFORE BACKFILLING: + 6) ALARM PANIIQU WITH AUDIBLE AND VISUAL ALARMS SHALL BE PROVIDED FOR BOTH EXTERNAL rl AND INTERNAL TANKS. THE EXTERNAL TANK ALARM SHALL BE SET TO THE LOWEST POSSIBLE 31-2" LEVEL, APPROX. 3", AND THE INTERNAL TANK ALARM SET AT 75% OF THE TANKS CAPACITY. 61-2" ALARMS SHALL BE ACTIVATED BY WEIGHTED FLOATS, OR EQUAL-, TANK ALARM SYSTEM SHALL 5' BE A "TANK ALERT AB" ALARM SYSTEM BY SJ RHOMBUS, OR EQUAL, 7) TANK SPECIFIED HAS AASHO-H--20 RATING AND ENTIRE UNIT, FULLY EQUIPPED, CAN BE " CAN BE PROVIDED AS A UNIT BY ACME PRECAST CO. INC., P.O. BOX 2034, TEATICKET, MA FltALO MODEL 1080 '4"1 POLY TANK 02536, (508) 548-9607. �� 1 ,I � PROPOSED SEPTIC SYSTEM UPGRADE 6" 619 MAIN STREET, CENTERVILLE, MA SECTION B—B SECTION A--A Prepared for: Sylvia & Sylvia, P.O. Box 430, Osterville, MA 02655 Engineering by: Surveying by: SCALE DRAWN JOB. NO. N 0 N HAZARDOUS INDUSTRIAL WASTE RWATE R HOLDING TANK EnglnmdngWorkr WARNER SURVEYING N.T.S. P.T.M. 229-07 12 West Crossfield Road 22 Long Road Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. N.T.S. I 11 30 07 a (508) 477-5313 (508) 432-8309 P.T.M. 3 of 3 I a t I i hi l I - P - ' i k - 3 q=10 t/z" m d 8� —rt1 31 I/2 GD ( 3 5zO _T4_(O � t Q ------ _ I 5000 2x4 WALL k O GD " ISz O a 54 9 ►� ! it _ i k0 GD -; zr--, " ! : \ : : x 6 2442 3Q'"�81 x53 %g 431 i a f Cr --- ___- - - - -- --- ❑ f �/ _. -- - Z44 2zczLLJ f I$'-1 ! . 27 _3 3/9 -10 /4 ... -a Ct r ! t I r I : r I J p — V i , e D n► I ►, _ 3 ( ' F-T ICE -� ,- Ld -= a co n I Htc�t}r j FURNACE 4A.L BOOM I { W W J -- _vOPPrR ROOF U LO f _ j ; III - _ J 0 ix �i i i i I 1 i 1