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1017 SHOOTFLYING HILL RD - Health
1017 Shootflying Hill Road Centerville A= 191 -030 UPC 12543 �a No...O R `�rco '� HASTINGS, MN i Commonwealth of Massachusetts 0 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 1017 Shootflying Hill Road 1 Property Address u ty jl Lorraine Dunnett Owner Owner's Name / I 1 information is ✓ :�, required for every cerrtervirre MA 02632 5-3-15 M. page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, ������ use only the tab 1. Inspector: Awl key to move your cursor-do not ,lames D.Sears _ DAMES R, e the return Name of Inspector key. CapewideEnterprises,LLC =*Company Name °€ ° � - 153 Commercial Street Company Address Mashpee MA 02649 CitylTown State Zip Code 508477-8877 S1623 Telephone Number license Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority c 8-3-15 spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. '4o��d- vs t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every Centenfil'e MA 02632 8-3-15 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The Tank system is a 1500 Gal.y a a k- D Box and two 500 Gal. Chambers. 13) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ NO(Explain below): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "< 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every Centervitte MA 02632 8-3-15 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or pmry is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 i Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °yc 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information a CentervrNe MA 02632 8-3-45 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tarn and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ 0 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Z Liquid depth in esupeol is less than 6" below invert or available volume is less than Y day flow .- €/,�i?IIIA14' t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every Centerville MA 02632 8-3-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CItr1R 15.303, therefore the system far(s. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For Large systems, you must indicate either"yes"or"no"to each of the t0owing, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every CerrteMlle MA 02632 8-3-15 page. City/Town state Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ 0 Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)1310 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Dis posal sposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �< 1017 Shootflying Hill Road Property Address Lorraine Dunneft Owner Owner's Name information required for every ft-Centery MA 02632 8-3-15 page. Cityfrown State Zip Code Date of Inspection D. System Information Description: The system is a 1500 Gal. Tank D Box and two 500 Gal. Chambers. Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage 2013-35,000Gais g ( y g (gpd)) 2014-63,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: PresentDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M '< 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every Centerville MA 02632 8-3-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 2014 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: 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) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form;Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every CenteMile MA 02632 8-3-15 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 2007 Permit # 2007-338 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 20"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH -40. Septic Tank(locate on site plan): Depth below grade: 18"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal. Precast H-10 Sludge depth: 2" t5ins-3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every CenteryrNe MA M32 8-3-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 28" I' Scum thickness 0" Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 18" Tape How were dimensions determined? Asbuift-Pharr-T Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tank at workinglevel. Tank at 18 below grade w/both covers at 2 . I 9 nand outlet tees. No sign of leak age or over loading. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every Cerrtervrtte MA 02632 8-3-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form-Not for Voluntary Assessments � 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every Centerville MA 02632 8-3-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Sox is ITx1T-W below grade w/cove at 20". Sox is clean and solid wltwo lines out. No sign of over loading or solid carry over. Pump Chamber(locate on site plan): Pumps in working order: * P 9 ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '< 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every Centemi're MA 02632 8-3-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is two 500 dry well chambers 24'xUB. Chambers at 42" below grade wlcover at 1'. 2"water in chamber. Wall's clean like new. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owners Name information required for every Centerville MA 02632 8-3-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner owner's Name information required for every Centerville MA 02632 8-3-75 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at feast two permanent reference landmarks or benchmaft. Locate all wells within 100 fleet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below 13-- 9 R EAR H8 #AYE 1 `' Y IY , i i I t5ins-3113 Title 5 official kispection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every CenteMffe MA 02632 8-3-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 40' feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 7-31-07 Date Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: T.H.on Design plan 7-31-07. 1 T-6" no G.W.. U.S.G.S. Well SDW 252 Zone A D J G.W. at 40'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1017 Shootflying Hill Road Property Address Lorraine Dunnett Owner Owner's Name information required for every Centervri'le MA 02632 8-3-15 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 c ' I i; - 'cIN t+NQ jp & m _ cl� T1 -I ALL A9 v 01 TO iY OMMODAR H LAYOVr � eXISTING MNW WPOOWS EXISTING WPm W OWs LOUVERED GLASS I IN IAMED TO BE REMOVED PAHeL WALL& S TO BE ///_ REMOVED �b di._ IIEW�2RXEY WALLS J019TS AHD O PLYWOOD TO �p RAZE PLOOR EXISTING DOOR lW TO MAIM AND STEPS TO OR tD HOUSE LEVEL? REMOVED / ;o NEW HIGH TRANSOMS <V 16' _ r-23 RO a'-3Z' EXIS71NG SCREE 12,451. I FORCH 6- BA7 I 'RIVATE RESIDENCE iOOTFLYING HILL ROAD-CENTERVILLE, MA SUED FOR REVIEW-26 OCTOBER 2015 EXISTING AND FLOGPLANA1.f RENOVATED R .` TOWN OF BARNSTABLE LO 'XtION ®/ d6 Al/ rem� SEWAGE# oZU07 ti 3 3 VILLAGE ASSESSOR'S MAP&PARCEL jq J a 3® INSTALLERS NAME&PHONE NO. (?64ialfoCoaJ Jijgh L SEPTIC TANK CAPACITY l S®® LEACHING FACILITY:(type) 2 kw r cir4l/e&j- (size) A a S x NO.OF BEDROOMS / rr OWNER MR(-A A PERMIT DATE: COMPLIANCE DATE: 7 A! 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 Y'within 300 feet of leaching facility) Feet FURNISHED BY c o ffoosc- � R r � 3 sTi 1 0 a^l 37"?" 2, Of a a'' 3 qqr gee ti J � Fee 100.00 3 No. ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RPPrication for Oi.005ar 6p.9tem Con5truct-ion Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1017 Shoot Flying H 1 Twner's Name,Address,and Tel.No. Centerville Lorainne Dunnett Assessor's Map/Parcel , Installer's Name,Address,and Tel.No. W.E, Robinson Designer's Name,Address and Tel.No. P.O. Box 1089 C'vill Eco-Tech 508-775-8776 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (nd Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date 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) I n s to 11 a T}t S septic system to plans of Eco Tech Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of.H alth. r Signe Date ✓ Application Approved by Date e� Application Disapproved by: Date for the following reasons Permit No. Date Issued } 104 Fee 1 00.00 + . THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIPPYtcatton for Mtg'pogal 6paem Cougtruction Permit Application for a Permit to Construct( ) Repair(X)t Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 1017 Shoot Flying Hi I 1),'ner's Name,Address,and Tel.No. i Centerville Lorainne Dunnett Assessor's'Map/Parcel Installer's Name,Address,and Tel.No. W.E, Robinson Designer's Name,Address and Tel.No. P.O. Box 1089 C'vill -Eco—Tech 508-775-8776 43 Tri ancll A Cir Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder (nd Other. Type of Building No.of Persons Showers( Y ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date - Title Size of Septic Tank Type of S.A.S. r Description of Soil � E Nature of Repairs or Alterations(Answer when applicable) T n s ta,11 a Till c 5 septic system to plans of Eco Tech Date last inspected: - Agreement: - The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Ijealth. % Signed Date Application Approved by Date -r, Application Disapproved by: _ Date for the following reasons _ Permit No. Date Issued =———————————————— f v Dunnett THE COMMONWEALTH O> MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance �- THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired x g P Y ( ) p ( ) Upgraded Abandoned( )by W.E. Robinson Septic Seraice at 1017 Shoot Flying Hill Rd C'vi 1 1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. � dated Installer Designer _ #bedrooms �'-j Approved design flow ✓ gpd The issuanc of th's permit shall not be on ued a guarantee that the system wi Ilion as/desig�n¢ed.. � Date Inspector ------------------------- ------ - = -- -- No.c2av Fee 10 0.0 0 . Dunntitt THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS a lwfgpogar 6pgtem Con5tructton Permit Permission is hereby granted to Construct`( ) Repair (x ) Upgrade ( ) Abandon ( ) System located at 1017 Shoot Flying Hill Rd Centerville and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided:jConjtruction must be completed within three years of the date of t s e Date (0 Approved by COMMONWEALTH OF MASSACHUSE17S EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1017 Shoot Flying Hill Road Centerville Owner's Name: Mar art/Chambers Owner's Address: Date of Inspection: Name of Inspector:(please print) Sean Jones Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville MA Telephone Number: f 5081 775-8776 I CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewag e disposal systems. approved system inspector pursuant to Section15.340 of Title 5(310 CMR 15.000). The systemam a DEP +/ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority r + Fails - Inspector's Signature: Date: l co The system inspector shall submit a copy of this inspection report to the Approving Authority(Boa , f Health��or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design ti of 10, , gpd or greater,the inspector and the system owner shall submit the report to the appropriate regionao ice of t -{ DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and1! approv rag authority. j 1 Notes and Comments Pe�C4s o�L—�I.w. Pia`• Srs}rw� �s �ic�„�. .}-0A,5 5 k �Zli bye CS re+r-pn Mw r)arn AnJ ****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 Title 5 Inspection Form 6/15/2000 page l Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1017 Shoot Flying Hill Road Centervi e Owner. Marcia Stobart Chambers Date of inspections a Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. Seen Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B- System Conditionally Passes- Al f ,101 One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.if"not determined"please explain. The septic tank is metal and over 20 years old*o turallyr the septic tank(whether metal or not)is struc unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. •A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to-b obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with ken or approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required Pumping more than 4 times a year due to broken or obsul-ocxed Pipc(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is rtmoved ND explain: Page�of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address- 1017 Shoot Flying Hill Road Centerville Owner: Marcia .Stobar- C am erS Date of Inspection: S-1 V1 v , 10 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: „ Cesspool or privy is within 50 feet of a surface water — Cesspool or privy is within So feet of a bordering vegetated wetland or a salt marsh 2. System will fail ri unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 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 welt is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 pprn,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: 3 Pagc 4 of t I OFFICIAL,INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1017 Shoot Flying Hill Road Centerville Owner: Marcia Stobart Chambers Date of inspection: D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all.inspections: Yes No 11 ,/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 overload clogged SAS or cesspool overloaded or Static liquid level in the distribution box above outlet invert due to an /cesspool ov erloaded or clogged SAS or Liquid depth in cesspool is less than b"below invert or.available v V volume is less t Required pumping more than 4 times true e day flow g es ut the last year,NOT due to clogged or obstructed pipe js).Number /of times pumped , ✓_ Any portion of the SAS,cesspool or privy is below high groundwater elevation. Any portion of cesspool or privy is within 100-feet of a surface water su water supply. pply or tributary to a surface / Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private xatrr supply well with no acceptable water quality analysis.(This system passes if the well water analysis, performed at a D£P certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free.from pollution from that facility and the presence at ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that en other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: /V To be considered a large system the system must serve a fact!ity with a design flog•of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a sm-face drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Prolection Area_IWPA)or a mapped Zone If of a public water supply well If you have answered"yes"to any question is Section E Lice System is considered a significant threat,ar answered "yes"in Section D above the large system has faikd.'ilie ovular or operator of arry large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with ed CMR i5.304.The s}stem owner should contact the appropriate regional office of the Department. 4 Page 5 of l i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBS URFACE SEWAGE DI SPOSAL OSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1017 .Shoot Flying Hill Road Centerville Owner: Marcia Stobarj, �hambers Date or Inspection: 5 0 2 Check if the following have been done.You trust indicate` es"or"no"as to each of the followin Yes No ✓ = .Pumping information was provided by the owner,occupant,or Board of Health r✓ Were any of the system components pumped out in the previous tw P o weeks? Pas the system received normal flows in'the previous two week period? Z Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined . (If they were not available note as NIA) / Was the facility or dwelling inspected for signs of sewage back up? ✓ _ Was the site inspected for signs of break out? Were all system components,exclud ing dutg the SAS,located on site? 6eSSinsJ Were the septie-ten#manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum 4 _ Was the facility owner(and occupants if different from owner)provided with info a maintenance of subsurface sewage disposal systems? rm Eton on the proper 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. `✓_ Determined in the field(if any of the failure criteria related to Part C is at issue a roximatio is unacceptable)[3I0 CMR 15.302(3)(b)] PP n of distance 5 Page6ofll OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1017 Shoot Flying Hill Road Centerville Owner: Marcia Stobart Chambers - Dale of Inspection: o 7 RESIDENTIAL FLOW CONDITIONS Number of bedrooms(design):.3 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x it of—bedrooms): �� n Number4 of current residents: i ). Does residence have a garbage grinder(yes or no): N0 Is laundry on a separate sewage system(yes or no): .vz) [if yes separate inspection required] Laundry system inspected(yes or no):�4 Seasonal use:(yes or no). ND Water meter s readin if available g , atlable(fast 2 years usage(gpd)): 2006 — 27,000 Sump pump(yes or no):wo — 0 Last date of occupancy: rrloyf COMMERCIAL/INDUSTRIAL Type of establishment._ /� 14 end Design flow(based on 3 IO CMR 15.203): Basis of design flow(seats/persons/sgft,etc.): r Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: -- Last date of occupancy/use: OTHER(describe): Pumping Records GENERAL INFORMATION Source of information: Was system pumped as part of the inspection(yes or no): If yes,volume pumped:Coco gallons--Haw was uantit Reason for um in g pumped determined? ,2,P P ,8:- CtSsPa.�il y-a taa R,mP<<� . e vi�}ea., C.�CeGZ S�Y'ai�vra.l Inft ri TYPE OF SYSTEM f � _Septic tank,distribution box,soil absorption system _Single cesspool ✓Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank .—Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): ,v C) 6 Pagc 7 of I 1 OFFICIAL INSPECTION FOI(A1—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORA-1 PAR'r C SYSTEM INFORIliATION(continued) Properly Address: 1017 Shoot Flying Hill Road Centervi e Owacr: Marcia Stobart C am ers Dale of Inspection: /:,l / IJUILD1NG SEWER(locatc on site plan) Dcpth below grade: Materials of construction:_cast iron —✓40 PVC_voter(explaut): Distance from private water supply well or suction line: Comments(on condition of juutts,venting,evidence of leakage,etc.): SEPTIC TANK: (locate on site plan) Dcpth below grade: Material of construction: curtcretc metal fiberglass_ltoiyethylcne _othcr(explain) _ — — If tank is metal list age:_ Is age confinucd•by a Cc»ificate of Compliance(yes or nv : cc»ificatc) ) —(attach a copy of Dimensions: Sludge depth: Distance from Scant thickness:top of sludge to m botto of outlet tee or ba(lle: _ Distance from to of scull, to top o(outict ice or baMc: Distance from bottom of scum to bottom of outict tcc or bafljc:I low were dimensions determined: Comments(On pumping recommendations, inlet and.ou(ict tee or baflie cOtrditien, as related to outic( invert,Evidence of leakage,ctc.): Slructwa) inte6rit}, liquid levels GREASE TRAI': N_(Iococa(c on site plan) DcpUt below grade:_ Material of construction:_corrcrctc metal fiberglass polycalylCtc olltcr (explain): -- - Dimensions: Scum thickness: Distance from top otscull,to top of our{et tee or baf>7c: Distance from bottom of scum to bottom of outict tcc or baM _ Date of last pumping: Conumnls(on pumping recontmcrtdatiurts,utlet and outlet ice or banle cunditiu:t, structural integrity,as related to oullct invert,evidence of leakage, etc.): rity liquid Ict cis 7 'age &of 1 l OFFICIAL INSI'ECTION I' SUI3SUIZ.FAC,C SEWAGEIU SI'OOAL'OISZ O LUNTA� INSI' ItY ASSL•'SShgLNTS PART C CC.TION FQIt)�1 SYSTEM IN"ORItiIATION(continued) Property Address: 1017 Shoot Flying Hill Road Centervi e Owner: cia Sto art Chambers Dane of Inspection: �y a TIGHT or HOLDING TANK, A/ 1 r" (tank must be pumped at tune of inspection)(locate on site plan) Depth below grade: Material of construction: concrete__theta!_____fiberglass___ p lycthylene Dinrcnsiorts: othcr(cxplairt): Capacity: Design Flow: allvns Alann present(Yes or no): gallons/day Alarm level: Alarin irl working order(ycs or no): Date of last pumping: Cotrtrncnts(condition Of to ann and float switchcs,etc.): D1STIUFIUr10N IlOX:N IA(if Present must be opertcd)(Iocate on site plan) Depth of liquid Itvel above outlet invert: Continents(note if box is level an bw d Jistriion to outlets equal,arty evidence Of solids ca leakage into or out of box, etc_): rr}•orcr,any evidence or I'UiltP C1tAfa1D>:il; � � ._ _(locate on site plan) Pu"'Ps in-orking order(yes or no): Alarms in tis•orking order(yes or no):_ Comments(Holt condition of pump cltatnber, cuttditivn of puntl)s and appurtenances,etc. Page 9 of I l OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1017 Shoot Flying Hill Road Centervi e Owner:_Marcia Stobart C am ers Date of Inspection: �1- Wo? SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: T�leaching pits,number: 1 '" %voc, leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number. innovative/alternative system Type/name oftechnology: f p Comments(note condition of sail,signs of hydraulic e,failur level oondin�,damp soil,condition of vegetation, etc.): mL � S ' .,.., L,A d-F �.,��,1 a b!e e°�C.d...� . ,fc, ,.vJ •�/J Y-rc��.,c� CESSPOOLS: i/ (cesspool must be pumped as part of inspect to P ion)(locate on site plan) Number and configuration: l t!on ct�a-c Depth—top of liquid to inlet invert: Depth of solids layer. ------- — Depth of scum layer: �----� i7u+.Pr�� ri �„Y �� ,,,4 pec)4,+ti Dimensions of cesspool: Materials of construction: r CIA c'tc.4-iacY Indication of groundwater inflow(yes or no):AjV Comments(note condition of soil,siens of hydraulic failure, level of ponding,condition of vegetation,etc.): nip S; h �^ 17 �I, •�,, ,,.� , e • �t PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.)- 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: 1017 Shoot Flying Hill Road en ervi e Owner: Marcia o ar C am ers Date of Inspection: S v 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. _ S \,ADO 3 c r �u2f'��ow his` -9 t (.7 i 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1017 Shoot Flying Hill Road Centerville Owner, MarriA Stobart/Chambers Date of Inspection: �y SITE EXAM Slope ---- V Surface water Check cellar Shallow wells Estimated depth to ground water 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: r::Pew 's it Town of Barnstable P# —// Department of Regulatory Services WA,R Public Health Division Date ��s6A�b 200 Main Street,Hyannis MA 02601 y� v Date Scheduled cJ Ul y 31, 200 Time P Fee Pd. l D0. Soil Suitability Assessment for Sewage Disposal ' aii-vt d Performed By:-��l�1 �( ���D 1!�h�h��►'1' Witnessed ByD : DcoS 1NLGf Yq/'S - LOCATION& GENERAL INFORMATION Location Address 1013 S hoof FlYf r q Ri�a 1 Owner's Name RDat( (WhM9 C64+,b erS C eHi-.er vi'l I e Address tDl7 S �oof F(Yt'ns ` 11 ��1 C�n>i-e�ry i jl e Assessor's Map/Parcel: 0113 O Engineer's Name NEW CONSTRUCTION REPAIR �— Telephone# Sog t j 64 005 Land Use P-e5 1 CLP 14 t;C11 Slopes(%) ( 0 Surface Stones V1 45 Distances from: Open Water Body t 0 0 ft Possible Wet Area /t^oo-4 ft Drinking Water Well i (� ft Drainage Way SD ft Property Line I`y + ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands In proximity to holes) GROUNDWATER ADJUSTMENT 293.03 EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE �— GIS DEPARTMENT RECORDS. INDICATED GW 36.00 i�1 t INDEX WELL SDW-252 ZONE D N �_-�1 READING DATE DEC, 2007 --- READING 47.0 ADJUSTMENT 2.8 ly ADJUSTED GW 40.80 TP-1 — r®z N 301.60 f t Parent ma terial.(geologic) r U IBC l� 6 U� SUS Depth to Bedrock IA 014 e Depth to Groundwater. Standing Water in Hole: V1 r)C Weeping from Pit Face n©K e Estimated Seasonal High Groundwater See o bO V e DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: ! Ct 0V-e Depth Observed standing in obs.hole: ____in. Depth to soil mottles: In. Depth to weeping from side of obs.hole: in. Groundwater Adjustment Index Well# Reading Date: Index Well level,�-,,,,.m�, Adj.factor- Adj.Groundwater Level PERCOLATION TEST Date 713 Thne 5 Pm Observation Hole# l 'lime at 9" A ct Depth of Perc (O L in Tlme at Start Pre-soak Time® "00 Time(9"-6") End Pre-soak 06 Rate MinAnch 2 Hip Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICIPERCFORM.DOC aSOIL TEST LOG --�— I DATE OF TEST: JULY 31. 2007 t I SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. PERC NUMBER:. TEST PIT 1 NO GROUNDWATER ENCOUNTERED I PARENT MATERIAL: PROGLACIAL OUTWASH PERC AT 60 to - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 65.15 0-2 0 LOAM 10 YR 2/2 NONE FRIABLE 2-3 E LOAMY SAND 10 YR 6/1 NONE FRIABLE 3-8 A LOAMY SAND 10 YR 4/4 NONE FRIABLE 8-38 B SANDY LOAM 10 YR 5/6 NONE FRIABLE 61.98 38-128 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 54.46 NO GROUNDWATER ENCOUNTERED TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH PERC AT 60 in - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING i 65.00 ' 0-2 0 LOAM 10 YR 2/2 NONE FRIABLE ( 2-3 E LOAMY SAND 10 YR 5/1 NONE FRIABLE l 3-8 A LOAMY SAND 10 YR 4/4 NONE FRIABLE 9-39 B SANDY LOAM 10 YR 5/6 NONE FRIABLE 61.75 f 39-136 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 53.50 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stopes;Boulders. Consi ten t Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes—J/— - Within 500 year boundary No Yes : Within 100 year flood boundary No Yes Depth of Naturally Occurrim Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that out QOV 19 5 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me co �H OF,�s the required training,expertise and,,experience described in 310 CMR 15.017. s90 7k, DAVID� y�N S — w�»'t�y"�' Date 7�3, /0 7 D. Signature N COUGHANOWR `r0 "/CENSER Q EVALU QASEPTIGIPE RCFORM.DOC - .Town=®f Barnstable a Re - _ A .Semces - -. Thomas F�Geller Director... i'i bHc Health Division Thomas McKean,-Director 200 tt+iain Street-Hyanni%MA.02601 Office: 508-8624644 Fax: .508-790-6304. Installer&Designer Certificattfln Foram Date: 8-6 0 9_ Sewage-Permit#- Assessor's MapWarcel _ Eco-Tech .. - . .. .. Designer: rustan W.E.r• Robinson Septic 43 Triangle Circle Address: Address: -P.O. Bbx_ 1-089 Sabdwich On w:E_ Rob i.n oil Sep t i c�'as issued a permit#o:install (date). (installer) septicsystemat--1017 ..Shoo.t Flyinf, .Hill Rd based on a design drawn by I (address) Centerville - - do . t _ Eco-Tech I certify that the septic system referenced above was.installed substantially according to . --:.the-design, which may:include_i=c _approved.changes:such.as lateral-relocation.of the distribution-box and/or septic tank: .. I.certify that-the septic system referenced above.was-installed with-major changes (i.e. greater than:l:0' lateral relocation of the SAS or any vertical relocation of any component. of the septic systeirij but in 4rcarilahce-wi`h State-&Local Relations. -Plan revision or certified_as built.by designer to follow. NOFMAS��'y .. .. . . f � c� ViD D. (In er's'Signature) o COUGHMAN No. 1093 GIST SqN!TAR%PN (Designer's Signature) (Affix Designer's Stamp Here) :. PLEASE: RETURN: TO :BARNSTABLE. PUBLIC :HEALTH 0IViSIOAI, CERTIFICATE OF COMPLIANCE WELL.RIOT.-BE--.ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARcNSTABLE PUBLIC HEALTH DIVISION..THANK YOU. Q:Health/Septic/Designei Certification Form 3-25-04.doc #81- . 233 "LOCATION SEWAGE PERMIT NO. 1017 Shoot Flying Hill Rd. Lo Vj(+j-2,#' Ass j gt - D 30 }VILLAGE Centerville, MA 02632 INSTALLER'S NAME i ADDRESS A & B. Cesspool Service 128 Bishops Terrace Hyannis 02601 BUILDER OR OWNER William Chambers 1017 Shoot Flying Hill Rd. , Centerville, MA 02652 DATE PERMIT ISSUED 6/16/81 DATE COMPLIANCE ISSUED ��ao / �/TvC�1 iyin NO[ i low 1 �! N081.:..3 33...... _ _ Fps. .$... 94....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .....................T own....--.--..0 F....Bs,mst able..........----------........----------...-•----•-----------. Appliration for Disposal Works Tonstrartiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: .101.._,Shoot Flying Hi11•,Rd,,,, Ce tery �,�e-0 (32•...................... -Location-Address or Lot No. William Chambers ............................................... 1Qa.7_.. Y�QQt..f! ,yi�ag.Hi11..8d...,.:.0en e rill r. 02632 Owner Address A & B--- ... Cess.. pool Ser Installer Address_s.„],2$ Biskl9ps..Txd�e+--Iiynm�.s.,...MA._...Q?.6iQl.-- .. .. Type of Building Size Lot--___----------------------Sq. feet Dwelling—No. of Bedrooms..........3...............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons....2..................... Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------•------------------------.....•-----------•---•------•------......... W Design Flow............................................gallons per person per day. Total daily flow.................................._.........gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ------•----------•-•---------•----•...--------•----•---------------••---------......•.....-•----••--••-••-----••••••-•-•.....-----•.......------------------ ODescription of Soil.........................aand------...z•-•--•-••--•--.....--•-•------...-------------------------------•---------•. x w UNature of Repairs or Alterations—Answer when applicable._ nsta �,at =...9f._;a...l,000._gall an,...pra-cast, stone packed_-(12 Ton__of-_stone__leach-,Pit„_(•ove,rX.1jw�----------------- -- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITA U 5 of the State Sanitary Code— The undersigned further agrees n to place the system in operation until a Certificate of Compliance has be i sued by the bo d f health. i d ri I E f / Application Approved By....... • • - - j / - Date Application Disapproved for the following reasons- - ---------------- ..-•---------•-•---•---....-----•---•-----------•-••------------------------------------ Date Permit No.... 81--••-•-•••--••-••---•------•-•---• Issued...............61---/81....................... Date No8..................... Flza.....$...5.:.00....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........T-own..........OF....Ba=stable.......... Appliration for Disposal Works Tonstrurtinn Errant Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at ...1017...Shoot.Fly-ing.Hil�.-� � -G�At,9X!111A.02.43Z --......----•---------------------- -Location-Address or Lot No. ...William Chambers ............................................... .1017.3 Cen_texvil1e.,..02632 Owner Address a ......&.... .Cesspool._Service...................•••-.............----- �,28_.B k�og,� Tex'x c � �iyanzus...l1A._..D26D1.... Installer Address UType of Building Size Lot............................Sq. feet .-� Dwelling—No. of Bedrooms..........3...............................Expansion Attic ( ) Garbage Grinder ( ) �`4 Other—Type T e of Building 2 yp g ............................ No. of persons___.___.......___...._____._ Showers ( ) — Cafeteria ( ) d Other fixtures w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity.........._.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribuiion box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 14 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water....................... fX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 .---•-•------------------------•----•--------------•--....------•--•--------•........-----•--•....--........................................................ ODescription of Soil-•------•--------------eand....................................................................................................................................... x U ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•••--•----------------- w V Nature of Repairs or Alterations—Answer when a..pplicabl e._ista llation_of_a._l,.000__ga t . _ ,_- x stone packed of stone) leach -pit (overflow) , Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT?,;. 5 of the State Sanitary Code— The undersi ned further agrees n to place the system in operation until a Certificate of Compliance has be ' hued by the bo d f health. G W!! Si ned ' y 61�`181 tfG Application Approved By...... --•-•-.....:. ..! ---....../ r ................................ --...--•------------ -/81 ----....... Date Application Disapproved for the following reasons:......�................................................................................................... ................................................................................................................................................................................................ Date PermitNo. .......... 81 •-------•--••--------•----•---... Issued................ /81....................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................T own.........OF..........Barnstable ........................................................... Tertifiratr of Toutph anre , THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) b A & B Cesspool Service, 128 Bishops Terrace, Hyannis, MA__ 02601 - -6264 y •...----- -••...............•---. •--- .......-•--.. .-•-- ----------•----._.7_ 5..-- ------•--•-••------ Install at__1017 Shoot Flying Hill Rd., Centerville, �2632 - William Chambers • -----------------------•---•-------••------•-------......._..---- ----•------------------•-••-----••------•----------------•--•----------•-•-----•----•--••--•-----•-•_... has been installed in accordance with the provisions of TIT LE 5 of The State Sanitary Code a de•cribed in the application for Disposal Works Construction Permit No dated_.-..-_--_..6 _.. 81.._......._........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.........7/-.../8....................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 81-3'3`' ...........................Town....OF....Barnstable.................----........._...------------........ No....81...........j.. FEE..$..5-.00 .... Disposal Works TDnn,s#rnduaat pamit Permission is hereby granted.....A,& B Cesspool Service, 128 Plshops•TerrBCe,___Hxannis, 02 to Con t ct (( or Repair ( ?� an Individual Sewa a Disposal System b7 Shot Flying Hill Rd., Centerville, t� 026�2 William Chambers at No...........................................................................................--.....-_--- Street as shown on the application for Disposal Works Construction Permit Al-................... Dated.''........61 181 7/ /81 Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS i . txc 1 10 X �J Goa, ,r s tos r } 58 56 CENTERVILLE. MA CONTOURS 60 GARBAGE GRINDER 66 64 62---�-- mo MOONPENNY p� OBF<� IS NOT ALLOWED �- , rn LANE, p fNT R EXISTING - - - - - - - 50 WITH THIS DESIGN. Z O90 MINIMAL GRADING PROPOSED J J 293=�_ I I _ _--- , I 68 �- < LOCUS 3 Q 'z 1 ti � z I 1 o z o N 1 11 0 LOTS I1 & 12-A I - +_ / 1 LOCUS MAP I AREA 4895� sF � 1 1 1 � 54 NOT TO 1 / BENCH I`1ARK NEo I I 1 NOT TO SCALE DISTANCES SCALE / � � TO LEACHING GALLERY PK NAIL IN ASPHALT ALL DISTANCES ARE IN DECIMAL I ELEVATION = 64.17 FEET NOT IN FEET AND INCHES. 1 / / BARNSTABLE GIS DATUM A I B C 1 21.7 32.1 35.9 6dr I 1 2 22.1 41.2 44.9 1 / I L 3 36.6 56.2 53.0 WI GARAGE 4 58.2 69.2 53.5 5 63.7 79.0 65.7 A o -�--�� B �I b Is-o _ PAVED DRIVEWA 2 1 1 _ QO4 WATER LINE 1 � Z s O�Os� EXISTING OI \ \ 1 D 1 8 O 2 BEDROOM I L- 5 q 24 FE x 12.5 Ft X 2 a O I5-A 233 Ft DWELLING \ I 1 1 LEACHING GALLERY �On N I TR TOP OF FNDN I I / EL = 64.79 0 I NOTES i TP- O LEGEND EXISTING CESSPOOLS ARE TO BE PUMPED. 66 / I 1 1500 GALLON , , COLLAPSED AND FILLED. EXCAVATE ALL ASSOCIATED CONTAMINATED SOILS ❑ SEPTIC TANK ®° IN THE VICINITY OF THE PROPOSED LEACHING 301.60 f'E --���_ I / / EXISTING LEACH GALLERY AND REPLACE WITH CLEAN MEDIUMPIT/CESSPOOL O SAND PER TITLE 5. 64 -- � 1 O s2 �� UTILITY POLE $ TEST PIT® D-BOX❑ ALL PIPE ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS �J F L-O W PROFILE PLAN DECIDUOUS CONIFEROUS EXPRESSED IN DECIMAL FEET NOT FEET AND INCHES. TREE qQp TREE SCALE. 1 to = 30 f t "�b I-M Iz P RAISE COVERS TO WITHIN SIX INCHES OF FINAL GRADE -NUMBER REFERS TO DIAMETER IN TOP OF FOUNDATION ONE INSPECTION RISER FOR LEACHING GALLERY TO 30 0 30 60 O OAKNC-ES A APPLLE TEREO PNPINE C-CEOAR EL = 64.�9+- WITHIN 3 INCHES OF FINAL GRADE AS INSPECTION PORT, 65.10 0 10 20 30 SEWAGE DISPOSAL SYSTEM PLAN 3 f t ALL PIPE TO BE ��® � ���� -TO SERVE EXISTING DWELLING D-BBX MAX SCHEDULE 40 F.VC 3" DROP AND TO PITCH AT EST. MARTHA E. CHAMBERS FLOW LINE 62.10 1/8 in/Ft MIN. _ - OWNER OF RECORD 10' 14• � PRECAST �"�"'`I 101� SHOOT FLYING HILL ROAD 48• GAS ?Si 1995 "Ir F CENTERVILLE. MA NO M BAFFLE DRYWELL _ Z qs ZHOFMq 6 in Q BOTTOM OF yam `s9C Sr9 ® PROPERTY ADDRESS 62.�9 61.90 STONE61.53 LEACHING y` GALLERY Boa DAVID you, �o�� DAVID cyGJ, �ON�� BASE D. a ASSESSORS MAP 191 PARCEL 3 0 EXISTING 1 CIRCLE � D. 43 TRIANGLE C CLE 0 0 62.15 6 in STONE BASE 61.70 GALLERY � COUGHANOWR �' " COUGHANOWR `� SANDWICH MA 02563 LAND COURT PLANS 24645 A & B 1500 GALLON 61.40 (END VIEW) 59.40 5.00 FL + No. 1093 506 364-0694 q o DATE: AUGUST 2, 2007 SEPTIC TANK SEE DETAIL ON REVERSE SGIgTrr, `S01 CENSEP�p� JOB #ETE-2699 PAGE 1 OF 2 VERSION: Py 29 Ft 18 Ft of 5 Ft 12.5 Ft q Ir �P FVALU THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED 6l 12 Ft y Chi> �CL SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM ADJUSTED SEASONAL_ = 40.60 1 DEPICTED HEREON. FOR ANY OTHER CHANGES TO PROPERTY INCLUDING HIGH GROUNDWATER PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS. OWNER fA'vrdt6+ '2i 2 00 7 SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. a R t SOIL TEST LOG DESIGN 'CALCULATIONS DATE OF TEST: JULY 31. 2007 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. PERC NUMBER: INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) DISTRIBUTION BOX: USE 3 OUTLET D-BOX. TEST PIT 1 NO GROUNDWATER ENCOUNTERED SOIL ABSORBTION SYSTEM: A 24 fE x 12.5 fE x 2 FL LEACHING GALLERY CAN LEACH PARENT MATERIAL: PROGLACIAL OUTWASH PERC AT 60 to - 2 MIN/INCH IN C SOILS A = ( 24 x 12.5 ) = 300 sf Asdw = ( 24 + 24 + 12.5 + 12.5 ) x 2 = 146 sf ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER Atot. = 446 sf (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING VE 0.74 x 446 = 330.04 GPD 65.15 0-2 O LOAM 10 YR 2/2 NONE FRIABLE USE A 24 Ft. x 12.5 ft. x 2 fE GALLERY. VE = 330.04 GPD > 330 GPD REOUIRED 2-3 E LOAMY SAND 10 YR 6/1 NONE FRIABLE 3-8 A LOAMY SAND 10 YR 4/4 NONE FRIABLE 61.98 8-38 B SANDY LOAM 10 YR 5/6 NONE FRIABLE LEA CHING GA L L ER Y 38-128 C MEDUIM SAND 10 YR 6/4 NONE LOOSE USE SHOREY PRECAST 500 GALLON NOT TO 54.48 LEACHING DRYWELL (H-10 LOADING) SCALE 1500 GALLON SEPTIC TANK TEST PIT 2 NO GROUNDWATER ENCOUNTERED CONSTRUCTION DETAIL DIMENSIONS AND DETAIL NOT TO PARENT MATERIAL: PROGLACIAL OUTWASH USE SHOREY ST-1500-H-10 SCALE PERC AT 80 to - 2 MIN/INCH IN C SOILS DRYWELL UNIT STON 7 ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 24.0 ft (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING m�' 1 In 65.00 m Ll 4J Ttlo 0-2 O LOAM 10 YR 2/2 NONE FRIABLE 4-2-3 E LOAMY SAND 10 YR 5/1 NONE FRIABLE N mo3-9 A LOAMY SAND 10 YR 4/4 NONE FRIABLE m N 5 Ft- m� n 9-39 B SANDY LOAM 10 YR 5/6 NONE FRIABLE W c, in61.'�539-13B C MEDUIM SAND 10 YR 6/4 NONE LOOSE 3.5 ft 6.5 f t B.5 �E11 .5 F53.5024.0 ft.GROUNDWATER ADJUSTMENT k� EXISTING GROUNDWATER LEVEL 500 GALLON ORYWELL BASED ON TOWN OF BARNSTABLE DIMENSIONS AND DETAIL GIS DEPARTMENT RECORDS. INLET CENTER OUTLET USE H-10 UNIT END COVER END INSTALL ONE INSPECTION INDICATED GW 38.00 RISER TO WITHIN THREE INDEX WELL SDW-252 INCHES OF FINAL GRADE 3 IN DROP ZONE D AND INDICATE LOCATION W FLOW LINE AS-BUILT PLAN FROM READING DATE DEC. 2007 ON A BUILDING 101, g 14 TO READING 47.0 ,n `.:D-BOX ADJUSTMENT 2.6 ADJUSTED GW 40.60 48,n 0 33 LIQUID GAS o ��oo moo O�Op° in LEVEL BAFFLE o �0000000000 0�0 NOTES 10z !r, CROSS SECTION VIEW 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. 2) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT CROSS SECTION VIEW PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREM-ENTS 2 In PEASTONE t- i TONE SEWAGE DISPOSAL SYSTEM PLAN OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). ' -TO SERVE EXISTING DWELLING 4l INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES �; �e`; 2g sia,,, ro EFFECTI26 BEFORE EXCAVATING FOR SYSTEM. "`)' � -'. tn -iiz,.,cRAVELDEPTHIn MARTHA E. CHAMBERS 5) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON.' FINES AND DUST IN PLACE. 6) ECO-TECH ENVIRONMENTAL RECOMMENDS THE- INSTALLATION 0F'.,L.OW)'= 46 in FLOW FIXTURES 58 In 46 to 1017 SHOOT FLYING HILL ROAD CENTERVILLE. MA AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK=-`==" 150 to EEO-TECH ENVIRONMENTAL Z) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ONJ A LEVEL INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND 'ON TO WHICH FABRIC IN PLACE OF THE 2 ,n. PEASTONE LAYER SPECIFIED. 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. ETE-2699 AUGUST 2. 200? 2/2