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HomeMy WebLinkAbout0315 PINE STREET (HY - Health k315 Pine Street — f � Centerville F/R A = 228 k047 .. 0�iford. NO. 1521/3 ORA 10% i TOWN OF BARNSTABLE Gi LOCATION ' ��"�� SEWAGE # VILLAGE co--7- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY le. , �✓® LEACHING FACILITY: (type) '�"/G`C4 (size) NO. OF BEDROOMS BUILDER.OR OWNER PERMITDATE: COMPLIANCE DATE: J;e- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility � � Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 3.00 feet of leaching facility) Feet Furnished by ye�s� A, ,q 17E7 c . o GEC � 5" �� F 1 J A fa Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ��9 , 6 01pprfcatton for �topaar bpgtetn Conotruction Permit C,OJ Application for a Permit to Construct( bl'Repair( 4Jpgrade( )Abandon( ) O Complete System El Individual Components Location Address or Lot No.r `4'/.v�J�" /-e4A,/, Owner's Name,Address and Tel.No. r Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building �'C'`�' No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ®° gallons per day. Calculated daily flow ® gallons. Plan Date 0;5�1 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with,the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue�d,4 this Board of Health. Signed C Date , �d Application Approved by Date GO— Application Disapproved for the following reasons r Permit No. Date Issued TOWN OF BARNSTABLE LOCATION >''� SEWAGE# VILLAGE e:``'°' ASSESSOR'S MAP &LOT INSTALLER'S NAME-&HONE NO. �r�°"` `' I SEPTIC TANK CAPACITY ✓ �'9 �' ' '✓`� LEACHING FACII.IZ'Y: (type) (size) NO.OF BEDROOMS 't=�Ke< o <-� •� ' BUILDER OR OWNER PERMIT DATE: � �'a� COMPLIANCE DATE: " 7✓�� Separation Distance Between the:' P 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 Feet within 300 feet of leaching facility) Furnished by A c A '7 o AG gD a F .,e 0 jp y Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN 01�-BARNSTABLEs MASSACHUSETTS ` r� 0.ppfication for Mig;poaf *patent QCongtruction Permit ` Application for a Permit to Construct(lJr epair( L)*tpgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No.� -de/./✓E�lJ� a.►.j_ Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �y P 'pj? Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building �PF-r• No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow �' y gallons per day. Calculated daily flow 3 O gallons. Plan Date 4?n>4e-c. -M 9, oSe, Number of sheets _ Revision Date Title Size of Septic Tank /�t o� � Type of S.A.S. Description•of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned on-site agrees to ensure he construction and maintenance of the afore described on site sewage disposal system in accordance with.he provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b this Board of Health. Signed 0 Date Application Approved by _ ./ :� Date Application Disapproved for he following reasons r Permit No. Date Issued l ' - --- --.---------------------- —a— -----_ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( 1.4 Upgraded{ 3 I�Abandoned( )by at "'T-3 i��'.f? G �'J✓�' has been constru ted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. r a _ '1 dated L Installer !! Designer �''�� - _ The issuance of s permit shall not be construed as a guarantee that the7system will function as de i-ned. Lute inspector .1 NA-Z Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,, MASSACHUSETTS Migozaf *pztem Congtruction Permit Permission is hereby granted to Construct( )Repair(j�Upgrade( )Abandon( ) System located at .r' c!!!� and as described in he 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:Constructi /uss b6 completed within three years of the date of this frmi/1. � Date: !�/ A roved b ! _ � PP Y Apr 08 05 10: 12a p. l ft l v'1k. Town of Barnstable Rory Services ' L Thomas F Ceder.lhrcMr, was fabric HadthDivision Imorms McKee,Director 20 Mailm Street;Hyamis,MA 02601 Office: 508.862-4644 Fax. 508-790-6304 Installer&Des' CartWication Form Date: dD Resigner: 1.=G0 �� -'" 1 Imstaller -1 Address: ( 2 t ^Lyt A,ddrew: t On +' �D 4-5- was issued a permit to inslv�il a �/ �(4-,Cg� 1�) septic system at based on a desipp&t xm by teas) ✓d9e C 4Q1"datcd �...o ..,., `` I cttiify tho the septic systct:n mfermeed above was installed`snbstantially according to the d�whwb many melnd�e rs m"appt'oved dougm such aS Laiexatl relocation of the distaffion boat=&or se PM tank. I cetW that the septic systm referenced above was installed with t *jW chi (i.e. V+acr than 10'Deal tclocaotkm of tote SAS or any ver ical rdocation of any eoK."nent of the septic systo n)but ion a&ooardanm with State&Local RegniatiOm Plan revision or oecti5ed as-built by desiVm to foil". er's 7mt=) S S• ) ^— (A�1I DCSlgriet''S$lamp 1'Iere) PLEASE .A�BtJE usx.nC R�E�A�.'i'I!t>D _ CIER7l7[1HI � o CoN vtnaa� tvoT soma col A ws- D —CA"ARIL:RECh�BD UY BAlEt1VSTASLE pUXIIC HEALTH DIVISION. T9AMIK YO x Q.HealthtscptfeNesigner Canification Form COMMONWEALTH OF MASSACHUSETTS S S kiwi131 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS . DEPARTMENT OF ENVIRONMENTAL,PROTECTION FAILED INSPECTION �'r 1VED k;nv 1 7 2004 ,oe b-tRNSTABLE TITLE 5 1-iEALTH CREPT. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 315 Pine' Street Centerville PARCEL. Owner's Name: Anne Palmer Owner's Address: 20 Ftri arwnorl Lane- LOT Date of Inspection:(, Name of Inspector:(please print) Wi 11 i am _ Robinson Sr. Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville, MA Telephone Number: (508) 775-8776 CERTIFICATION STATEMENT I certify that l have personally inspected the sewage disposal system at this address and that the information reported below o is true accurate and as complete of i p 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 Co itionally Passes eds Further Evaluation by the Local Approving Authority Fails Inspector's Sigdature: Date: 6- .-6 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heatthvr DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the appro.ving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. A Title 5 Inspection Form 6/15/2000 page i Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART,A'a ►, . �. . ._.. a CERTIFICATION(continued) Property Address: 315 Pine Street Centerville Owner.• Anne Paimer Date of Inspection: 4-0 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. Syste Passes: 1 hav not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 3 0 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Co ditionally Passes: One or ore system components as described in the"Conditional Pass"section need to be replaced or repaired.The sy tem,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,do r not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The se p is tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,cxhi its substantial infiltration or exftltration or tank failure is imminent.System will pass inspection if the existing tank s replaced with a complying septic tank as approved by the Board of Health. •A metal se 'c tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating t the tank is less than 20 years old is available. ND expla' O servation of sewage backup or break out or high static water level in the distribution box due to-broken or _ obstruct pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approv I of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain. The s stem required pumping more than 4 tunes a year due to broken or obstrwed pipe(s).The system will pass inspectio if with approval of the Board( PP of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3ofII OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 315 Pine Street Centerville Owner: Anne Palmer Date of Inspection: . 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 fail' to protect public health,safety or the environment. 1. ystetn will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the s sten::is not functioning in a manner which will protect public health,safety.and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated.wetland or a salt marsh 2. Sy tem 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 su face water supply or tributary to a surface water supply. The system has a septic.tank and SAS and the SAS is within a Zone I 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 front a private water supply well** Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and - the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. (her: 3 Page 4 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 315 Pine Street Centerville Owner: Anne Palmer Date of Inspection: 0L D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No PI Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _Lb Static liquid level in the distribution box above.outlet invert due to an overloaded or clogged SAS or cesspool s _ Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow hb Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped ,o Any portion of the SAS,cesspool or privy is below high ground water elevation. _o Any portion of cesspool or privy is within I00.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. �o Any portion of a cesspool or privy is within 50 feet of a private water supply well. kO 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.lThis system passes if the well water analysis, performed at a DEP certified laboratory.,for colfform bacteria and volatile organic compounds indicates that the well is free.from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than S ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this forma J�t:J (YesfNo)The system fails.1 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 +;ill be necessary to correct the failure. E. Lar a Systems: To be co idered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gpd• You must' dicate either"yes"or"no"to each of the following: (The follow' g criteria apply to large systems in addition to die criteria above) yes no the sy rem is within 400 feet of a surface drinking water supply the sys cm is within 200 feet of a tributary to a surface drinking water supply — _ the syst m is located in a nitrogen sensitive area(Interim Wellhead Protection Area-1WPA)or a mapped Zone 11 of a public water supply well if you have answ ed"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section above the large system has failed.The owner or operator of any large system considered a significant threat rider Section E or failed under Section D shall upgrade the system in accordance with 310CMR 15.304.The sys m owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 31 5.-Pine Street Centerville Owner: Anne Palmer Date of Inspection:/L G Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Yes No _A::�?.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? _ JLd Has the system received normal flows in the previous two week period? Ii-0 Have large volumes of water been introduced to the system recently or as part of this inspection?.. /LU 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? (J3 _ Was the site inspected for signs of break out? S— Were all system components,excluding the SAS,located on site? UlaWere the septic tank:manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles ortees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _ 4� Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes-no Existing information.For example,a plan at the Board of Health. A 5 _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance / is unacceptable)(310 CMR 15.302(3)(b)) 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . SYSTEM INFORMATION Property Address.. 315 Pine Street en ervi e . . Owner: Anne Pa mer Date of inspection: " —0`- FLOW CONDITIONS RESIDENTIAIs' Number of bedrooms(design):. 3 Number of bedrooms(actual): '7 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x i1 of bedrooms): . Number of current residents: L p Does residence have a garbage grinder(yes or no): v Is laundry on a separate sewage system(yes or no) e) [if yes separate inspection required) Laundry system inspected(yes r no)- Seasonal use:(yes or no).L4i Water meter readings,if a ilable(last 2 years usage(gpd)): 2 0 0 3 — 8, 0 0 0 Sump pump(yes or no):Jj�,U 2002 — 12, 000 Last date of occupancy: COMMERCIAIVINDdSTRIAL Type of establis ent: Design flow(bas d on 310 CMR 15.203): gpd Basis of design w(seats/persons/sgft,etc.): Grease trap pres t(yes or no): Industrial waste olding tank present(yes or no):_ Non-sanitary wa to discharged to the Title 5 system(yes or no):_ Water meter rea ings,if available: Last date of occ ancy/use: OTHER(descri ): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part the inspection(yes or no):,!!LP n If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: y TYPE OF SYSTEM _ tic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): Approximate age of all c om ponent$,date installed(if kn wn)and source of information: Were sewage odors detected when arriving at the site(yes or no):/5-6/ 6 Paw 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION F0RA1 PAItT C SYSTEM INFORMATION(continued) Properly Address: 315 Pine Street Centervi le Owner: Anne Palmer Date of lnspeetlon: yr—i�� BUILDING S VER(locate on site plan) Depth below gr de: Materials of co struction:_cast iron _40 PVC_other(explain): Distance Gont rivate water supply well or suction lute: Comments(o condition of jui nts,venting,evidence of leakage,etc.): SEPTIC TANK:_ locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene _oUxr(explain) — If tank is metal list age: Is age confnnned•by a Certificate of Com pliance es or no): certificate) 1 O' —(attach a copy of Dimensions: Sludge depth: Distance Gorn top of sl dge to bottom of outlet tee or baffle: Stunt thickness: /�— Distance from top of s um to top of outlet ice or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: I low µ•ere dimension determined: Comments(on pum ing recommendations, inlet and outlet tee or Wile condition,structwal integrity,liquid levels as related to outlet ' vcrt,evidence of leakage,etc.): GREASE TRAP: (locate on site plan) - Depth below gra :_ Material of con ction:_concrete metal Fiberglass�iolyethylene__other (explain): _ — Dimensions: Scull)Chic css: Distance ont top of scum to top of outlet tee or baffle: Distant from bottom of scum to bottom of outlet ice or baffle: Date o last pumping: Con Items(on pumping recommendations,inlet and outlet ice or baffle cunditio:n,structural integrity, liquid levels as related to outlet invcrl,cvidcncc of leakage,etc.): 7 I - , Page 8 of OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO101 PART C SYSTEM ►NFORII-IAT►ON(continued) Property Address: 315 Pine Street en ervi e Owner: Anne Palmer Dole of Inspection:_ --o TIGIIT or IIOLDING T K: (tank must be pumped at time of ins pection)(locate on site plan) Depth below grade: Material of conswctio ___concrete_lnelal_fiberglass__polyethylene other(explaul): Dimensions: Capacity: gallons Design Flow: gallons/day Alann present(ye or no): Alarm level: Alann in working order(yes or no):— Date of last pu ing: Corrlments(co dition of alann and float switches,etc.): DISTRIBUTION BOX: if present must be opcncd)(locatc on site plan) Depth of liquid level abov outict invert:nti � 49 � Comments(note if box i evel and distribution to outict/equal,any evil ee oT s Irds carry-over,any evidence of - leakage into or out of b x,cic.): IWIP CHAMBER: cats on site plan) Pumps in working order yes or no):_ Alarms in working or r(ycs or no): _ Comments(note col itloll of l)ulilp cllatllbcr,condltioll of llui11l1S arld al)l)urlcnanccs,ctc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 315 Pine Street en ervi e Owner: Anne Palmer Date of Inspection: ' " " G L SOIL ABSORPTION SYSTEM(SAS):\ (locate on site plan,excavatiodnot required) If SAS not located explain why: Type d leaching pits,number:_ leaching chambers,number: leaching galleries,number: leaching trenches,number,length: � eaching fields,number,dimensions: r/ overflow cesspool,number: innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: i (d Depth—top of liquid to inlet invert: Depth of solids layer: j Depth of scum layer: t, Dimensions of cesspool: a Materials of construction: 13/e, Indication of groundwater inflow(yes or no): Conan is(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (loc eon site plan) _ Materials of con ction: Dimensions: Depth of soli Comments( to condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued). Property Address: 315 Pine Street Centerville Owner: Anne Palmer Date of Inspection:/ ^ —P'L SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. �) t �1 i 10 Page 1 I of I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) . Property Address: 315 Pine Street Centerville Owner. Anne Palmer Date;of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water I feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: S d S I1 PLAN REFERENCE CONTOURS o A � Z � =w LAND COURT PLAN 30469-A EXISTING - - - - - - - 50 ^ m oN w<3)oz ASSESSOR'S MAP. 228 TREE T MINIMAL GRADING PROPOSED c PINE STREET LOT: 47 I \ Z Fmr v-Zo pI�E OF PAVEMENT o - o<F DOD EpGE � � e0 e—LOCUS \Z o o s O o w e I_�_ � cc 2 H Q) N W Zw "' N ,? °0 Y CENTERVILLE. MA vo " 5 LOCUS MAP LLZ w o1 A ' NOT TO SCALE 54 Z o EXISTING J 3 S W W 541--= [)WELLING u U J > TOP orFNDN w = Q -J c�S EL - 5519 Q L1J ,<n w j o J V v SLAB 55 z FOUNDATION Lu •j•V� 1, d ~ < � '`>' `» 55 24ftx0.5ft x2ft LEACHING GALLERY O (� o W X M ` `� O 56 i e.7 f t 56 � �� CC V p p 1 � o O> LL w �, w 5 LEGEND U0 y \ N e �o� LU _ 600 GALLON zw o 0 0 C ip N m SEPTIC TANK CO 57 D-BOX O N�TEST PI7 ® .s1.Z + o VJ_ `r ! EXISTING n DAV D. CESSPOOL U' vi �J N F�11f.= ov'/R y BENCH MARK �; ll UTILITY POLE �a f� u, TOP OF FOUNDATION DRA9V ( ELEVATION - 551 A9 CLEANOUT PLUG--r I I I 1 USGS DATUM ASSUMED _ w w 0 O z LL 3 <u- co -� c O 20 6 4 0 LL 6 0 u I SEWAGE DISPOSAL SYSTEM PLAN ry I p F- I I -TO SERVE EXISTING DWELLING �- Q o ANNE C . PALMER o I LOT 47 g AREA - 22436 s f +- 315 PINE STREET CENTERVILLE. MA rn 0 LL � o ECO-TECH ENVIRONMENTAL 4� tn u) � N; 43 TRIANGLE CIRCLE SANDWICH MA 0256 V LLJ D C i Htn 88-5 f, 508 364-0894 ,Q ETE-1895> DEC 30. 2004 1/2 PLAN1 N THS PLAN IS TO BE CONSIDERED A DRAFT PLAN UNLESS IT BEARS TFIE STAMP AND SIGNATURE OF THE DESIGN ENGINEER4 SCALE. 1 in - 30 ft ORIGINAL PLANS INTENDED FOR SUBMITTAL TO TIE BOARD OF HEALTH WLL BE SIGNED N BLUE-AND STAMPED N RED. SOIL TEST LAG D5*,,SlGN CALCULATIONS DATE OF TEST: DECEMBER 29. 2004 SOIL EVALUATOR: DAVID D. COUGHANOWR, RS DESIGN FLOW: 3 BEDROOMS X 110 GPD - 330 GPD WITNESS REQUIREMENT WAIVED - NO VARIANCES SOUGHT SEPTIC TANK: 330 GPD X 2 DAYS - 660 GALLONS GROUNDWATER TEST PIT - I PAORENTT MATERIAL: E ROGLACIALDOUTWASH INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) PERC AT 74 in : 2 MIN/INCH IN C SOILS ELEVATION - 55.85 {- DISTRIBUTION BOX: USE 3 OUTLET D-BOX. DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER SOIL ABSORBTION SYSTEM: A 24 ft x 12.S ft x 2 ft LEACHING GALLERY CAN LEACH (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING Abot - ( 24 x 12.5 ) - 300 sf Asdw - ( 24 { 24 12.5 + 12.5 ) x 2 - 146 sf 0-10 Ap SANDY LOAM 10 YR 3/3 NONE FRIABLE A t o t - 446 sf 10-38 B LOAMY SAND 10 YR 4/6 NONE FRIABLE Vt 0.74 x 446 - 330.04 GPD 38-58 CI COARSE SAND 10 YR 4/6 NONE LOOSE USE A 24 ft x 12.5 ft x 2 ft GALLERY. Vt - 330.04 GPD > 330 GPD REQUIRED 58-144 C2 MEDIUM SAND 10 YR 6/4 1 NONE LOOSE GROUNDWATER ADJUSTMENT LEACHING GALLERY EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARBSTABLE CONSTRUCTION DETAIL GIS DEPARTMENT RECORDS. I r—DRYWELL UNIT STONE INDICATED GW 20.0 8'-6'x 4'-10'x 2'-9' INDEX WELL MIW-29 2 ft EFF. DEPTH ZONE D 24.0 f t READING DATE NOV. 2004 READNG 9.2 ADJUSTMENT 5.8 ADJUSTED GW 25.80 r� ul r&i"O T E-4,'S " 1) ARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN I 3.s 8.5• 8.5" 3.5' 2) ALL -LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 24 0 ft NOT TO t 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS SCALE OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) 4)- 1N'STALLER TO., VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. 5) EXISTING CESSPOOLS TO BE PUMPED. COLLAPSED. AND FILLED, OR REMOVED 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE 7) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-O- BEFORE PITCHING DOWN 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES SEWAGE DISPOSAL SYSTEM PLAN AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK -TO SERVE EXISTING DWELLING 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. ANNE C . PALMER 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. 315 PINE STREET CENTERVILLE, MA 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH ECO TECH. ENVIRONMENTAL SIX INCHES OF . CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING 43 TRIANGLE CIRCLE SANDWICH MA 02563 ETE-1895 IDEC 29, 2004 2/2