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HomeMy WebLinkAbout0142 WILLOW RUN DRIVE - Health 142 WILLOW Y:, CENTERVILLE A=210.068 p ar UPC 12543 No,53LOR- HASTINGS, MN I TOWN.OF BARNSTABLE LOCATION/+�(,'t`Z WI LLOI.J 4" �L. SEWAGE# ZDZQ - 01'j VILLAGE C€4TS-P—UI LL C' ASSESSOR'S MAP&PARCEL ZIO 7(0$ INSTALLER'S NAME&PHONE NO. 4ci-Q_C4. 50-8-977- 8871 SEPTIC TANK CAPACITY I5 00 gcL� . w �(DDO 4a i. ewo P C4f40rMtb_M LEACHING FACILITY:(type) IZS qC_PrM13oe_ (size) QO X 9 NO.OF BEDROOMS 3 OWNER ;) M 4 84,r^re W N E PERMIT DATE'1 7-1 I ZQ COMPLIANCE DATE: 10 ZO Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Cp,s Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) �1 Feet FURNISHED BY 4D60 .( `f�✓. #r�+x w.�►�a�,✓� � �Flo 2 3 Z i3.3 39 3 lot- ice 9 i9.(� 98•S 5' z�•q ss 30 59 No. - Fee Me THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN QF BARNSTABLE, MASSACHUSETTS Yes 2pplitation for Disposal 6pstrm Construrtion Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. (4:a W&_L.ojj tR,,W b&I toe' Owner's Name,Address,and Tel.No. C " oar pit wr• �tC Assessor's Map/Parcel �.4®�(, i4lkliu.QW PDX) n r K Installer's Name,Address,and Tel.No. 50 9-t+-77-W"Z7 Designer's Name,Address,and Tel.No. `5_0S-d73-03"7°7 Type of Building: Dwelling No.of Bedrooms Lot Size 0,as t sq.ft. Garbage Grinder( ) Other Type of Building I?6-S(bF,�JS[E¢.(_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 336 gpd Design flow provided 3 3 2,9 gpd Plan Date !t" 3 ,10ao Number of sheets ` Revision Date Title NA 1 A I(U-4?k) 721 AJ IIZZ I V E_ Size of Septic Tank - 1 50� �.(Lt�(tJ� Type of S.A.S._(�) LC-(o da4ma Description of Soil 61�1 C�lc�.2.( e�it Z� nLA Nature of Repairs or Alterations(Answer when applicable) USG OVS-10-ta L Sue? 62kWO S&V7-14- TA&*-7b 1 t;ow 64"C*J 073L0 N �CW lb Aj 0-Bo1G i1M1�- ��,�4, r 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', f Health. Signed Date � V � 1d Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ®r Date Issued . -- - --- k y;h k No., v Fee /66) THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN-QF BARNSTABLE, MASSACHUSETTS 2ppliLAtion for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. IkR�dll: Owner's Name,Address,and Tel.No. -LA WAMAJIG Assessor's Map/Parcel a a A CGNTew 1,_L j 41, a' Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. � -03'7 7 I o�Sc T 49 Ouujaldo +'�►C Eiu4taJt rt�1CT �".tJC RAabj $ r Type of Building: Dwelling No.of Bedrooms "+� Lot Size 0 i ;1 9 +sq.ft. Garbage Grinder( ) Other Type of Building 12 ES I JEN t r-j,4mC_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ! 2,9 gpd Plan Date Number of sheets ( Revision Date Title J t l - � � j� � Size of Septic Tank 11;,5(] / tujl� Type of S.A.S. ( �, - Description of Soil T)1. �—!5;Av&,X3 CQ ;2 c[ 6is i2e, Nature of Repairs or Alterations(Answer when applicable) t� 9C lr- x Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by i Date Z / Application Disapproved by Date for the following reasons Permit No. Date Issued ------------------------.--------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS R Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by k©'pj�( at t Lj,c r F has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit Now-. - )/ 7 dated f� /)=)455 Installer ��� Designer ZrC 15: Xj)C_ #bedrooms Approved design flow Q gpd The issuance of this/permit shall not be construed as a guarantee that the system will fitnctio as de ign d. — --� Date v �(J Inspectors ---------------------=-------------=---------------------------------------------------------------------------------------------------- N / Fee — THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be com•'leted within three years of the date of this permit.—� Date � l v��(/ Approved by I Town of Barnstable Regulatory Services Richard V.Scali,Interim Director M"M Public Health Division ' Thomas McKean, Director fM, r... 200 Main Street,Hyannis,MA 02601 zr, k•• Office: 508-862-4644 Fax: 508-790-6304 Installer& Desi2ner.Certification Form Date: 10-3-20 Sewage Permit# ZDW —017 Assessor's Map\Parcel 210/68 Designer: =SC- Eo5tne_erf(1y,. `T,nc . Installer: Robert B. Our Co., Inc. (RBO) Address: 2hS l Cranberry Address: 363 Whites Path i=ns 4 6 t 53$ South Yannouth, MA On 00/zJ z,0 RBO was issued a permit to install a (date) (irista 1er� septic system at_142 Willow Run Drive based, on a design drawn by (address) 7T C Cv) gitieecco q } Tr1C dated 1-13-20 (designer) X I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactor y. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed i iance with the terms of the I\A approval letters (if applicable) j„� ASSgcyG XM L. 6 CHURCHILL& sta er's ure) CML .41 ADO (D ner's'Signature (Affix De t p Here) PL SE RETURN TO ARNSTABLE PUBLIC.HEALTH D SION. CERTIFICATE OF COMPLIANCE WILL NOT.BE ISSUED UNTIL BOTH THIS FORM AND AS= BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doe - 1 r v Town of Barnstable Inspectional Services Department BARNSTABLE. MA; Public Health Division tF0" s 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 1333 December 2, 2019 WANNIE, ADAM & PAMELA 142 WILLOW RUN DRIVE CENTERVILLE, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 142 Willow Run Drive, Centerville, MA was inspected on 11/15/2019 by James D. Sears, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1) year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. IPA,. �I�rna . 10 'J® PER ORDER OF THE BOARD OF HEALTH gp-0'1� <`F forrj c ean, Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\l42 Willow Run Drive Centerville.doc SNE Town of Barnstable P b 9 Inspectional Services Department rf0 AtiA'�A Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS O 1 YEAR DEADLINE CRITERIA *Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER w Repair deadline: 0:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc r Nov 19 2019, 829 HP' Fax , page 19 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name information is required for every Centerville MA 02632 11-15-19 page. City/Town State Zip Code Date of Inspection i 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. `\����mmuN1 0 F tMr�rr�����i Important:When A. Inspector Information 3' filling out forms / pZ�� _ ��� �- .�y on the computer, =g:. JAM ES ,r use only the tab James D.Sears ; key to move your Name of Inspector cursor-do not *? R use the rerun; Capewide Enterprises y' r% — fI..-�o �J key. Company Name . 1 153 Commercial Street h�F 5 INSPE��``�° yrnr nr1 Company Address Mashpee MA 02649 City/Town • State Zip Code > 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority _ 4, ® Fails r pactor'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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. Wnsp.doc•rev.7)MG19 111le 6 Ot<cial Inspection Form:Subsurface sewage oisposat system•page 1 o118 Nov 1,9 2019, 23:30 fV Fax , page 20 � Commonwealth of Massachusetts Title 5 Official Inspection Form `P Subsurface Sewage Disposal System Form-Not for Voluntary Assessments k� V 142 Willow Run Drive Property Address Adam Wannie Owner Owners Name equir ed fo atl fo is every r Centerville MA 02632 11-15-19 requir page, Cityf7own State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: Failed - Leaching.The system is a 1500 Gal Tank D Box and infiltrator's 2) 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 ❑ ND (Explain below): t5lnsp.doc rev.71M2018 Title 5 Official Inspection Four:Subsurface Sewage Disposal System•Page 2 of 1111 Nov 19 2019 23:30 HP Fax, page 21 Commonwealth of Massachusetts lF Title 5 official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Willow Run Drive L Property Address Adam Wannie Owner Owner's Name information is Centerville MA 02632 11-15-19 required for every _ page. City]Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms-not operational. System will pass with Board of Health approval if pumpstalarms are repaired. ❑ 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 ❑ NO (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ NO (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ NO (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 ❑ NO (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ NO (Explain below): 3) 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. a. 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: t5insp.doc•rev.w2e=18 Title 5Offdal Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 18 Nov 19 2019. 23:30 NP Fax • page 22 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments FOP 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name Information is required for every Centerville MA 02632 11-15-19 page, City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b• System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well", Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) 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 15insp.doc c•rev,7128r2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Nov 19 2019 23:31 HP Fax, page 23 Commonwealth of Massachusetts e Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name information is required for every Centerville MA 02832 11-15-19 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cunt.) Yes No ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in is less than 6"below invert or available volume is less than 1/2 day flow k EACH/ivy ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd_ ® 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. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no" to each of the following, in addition to the questions in Section CA. 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 151nsp.doc•rev.7126/2018 TiUe 5 0'5c!al Inspection Form:Sabsurface Sewage Disposal System•Page 5 of 18 Nov 19 2019 23:31 HP Fax page 24 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form •Not for Voluntary Assessments 142 Willow Run Drive Property Address Adam Wan nie Owner Owner's Name information isequired or every Centerville MA 02632 11-15-19 page. CityrTown State Zip Code Date of Inspection C. Inspection Summary (coot.) If you have answered"yes" to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C,5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling Inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® Was the facility owner(and occupants If different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information, For example,a plan at the Board of Health. ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] l5insp.doc•rev.712012018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page6 of 18 Nov 19 2019, 23:31 HP' Fax page 25 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form •Not for Voluntary Assessments 142 Willow Run Drive Property Address Adam Wannie Owner Owners Name information is Centerville required for every MA 02632 11-15-19 page. City/To%vn State ZI Code Date of In ection P sp D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 for example: 110 330 ( p gpd x#of bedrooms): Description: 1500 Gal. Tank D Box and Infiltrators. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: 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 2017-129,000Gal 9 ( y g (gpd))' 2018-112,000 Gal's Detail: Sum pump?P P P El Yes ® No Last date of occupancy: Present Dale t5insp.doc•rev.71M018 Title S C1Bcial Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Nov 19 2019 23:31 HP Fax page 26 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name Information is required for every Centerville MA 02632 11-15-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercialllndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/personslsq,ft.,etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No 1 If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No. Water meter readings, if available: Last date of occupancyluse: Date Other(describe below): 3. Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5lnsp.duc•rev.7126/2018 Title 5 WWI Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Nov 19 2019 23:31 4 Fax page 27 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 142 Willow Run Drive Property Address Adam Wannie Owner Owners Name information is required for every Centerville MA 02632 11-15-19 page. City/Town State Zip Code Date of Inspectlon D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known)and source of information: 1998 Permit # 98-783A. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5, 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. t5insp.doc•rev.7126R018 Title 5 Cf6cial Inspection Form Subsurface Sewage Disposal System•Page 9 of 18 Nov 19 2019 23:31 HP Fax , page 28 c Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name information Is required for every Centerville MA 02632 11-15-19 page. City/Town State Zip Code Date of Inspection D. System Information (cost.) 6. Septic Tank (locate on site plan): Depth below grade: 101,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: 4" Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle B' Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Asbuilt-Plan-Tape 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 working level. Tank and cover's 10" below grade. In and outlet tee's.Tank show's sign's of being over full. Note: Tank in need of pumping. t5insp.doc•rev.7126=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Nov 19 2019 23:32 4 Fax page 29 Commonwealth of Massachusetts - Title 5 official Inspection Form Subsurface is Sewage g Disposal System Form Not for Voluntary Assessments 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name information is squired for every Centerville MA 02632 11-15-19 page. CityfTown State Zip Code Dale of Inspection D. System Information (cont.) 7. 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 Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): B. 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 15insp.doc•rev.7/26/201 B Title 5 official Inspection Form:Subsurface Sewage Disposal system•Page tt of is Nov ,19 2019 23:32 .HP Fax, page 30 Commonwealth of Massachusetts Title 5 Official Inspection Form - `Ih Subsurface Sewage Disposal System Form - Not for Voluntary Assessments v 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name information is required for every Centerville MA 02632 11-15-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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.); i *Attach copy of current pumping contract(required), Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Full 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 Box is 16"-21"-25" below grade. Box is full to cover w/some solid carry over. t5lnsp.doc•rev.7f2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 r - Nov 19 2019 23:32 4 Fax• page 31 Commonwealth of Massachusetts 1. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form •Not for Voluntary Assessments r= j� 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name information is required for every Centerville MA 02632 11-15-19 page. City/Town State Zip Code Date of Inspection D. System Information (cost.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No" Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS)(locate on site plan,excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 4 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: 151nsp.doc•rev.T2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Nov .19 201.9 23:32. HP Fax page 32 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 0 W L= 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name information is required for every Centerville MA 02632 11-15-19 page. City/Town state Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont,) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is two set's of two each infiltratrators. D Box and line's full. Leaching not leaching - Failed. 12. 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 Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I t5insp.doc•rev.7MI2018 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 14 of 18 Nov.19 2M 23,32• HP Fax page 33 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �i 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name Information is required for every Centerville MA 02632 11-15-19 page. City/Town State Zip Code Date of Inspectlon D. System Information (cons) 13. Privy(locate on site plan): Materials of construction: Dimenslons Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t l5insp.doc•rev.7/2612018 Title 5 OtecW Inspection Form:Subsurface Sewage Disposal Syslem•Page IS of 18 Nov .19 2019 23:32 .HP Fax: page 34 Commonwealth of Massachusetts ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V_rw 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name Information is required for every Centerville _ MA 02632 11-15-19 page, City/Town 5tate Zip Code Date of Inspection D. System Information (cont,) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system,including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within.100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately 15inap.doc-rev,7126/2018 Title 5 0%al Inspection Form:Sibsurface Sewage Disposal System•paw i6 of 1a Nov .19 201-9 23:33.HP Fax page 35 Nov 0(719,02138p Capewide Enterprises 508-477-4977 p•3 ""4c, I"FACILM: (type) NO,OF (size) !. .!s R � •:) BEDROOMS .� ---• C / l ` ( 1)UUMM OR OWNER + PERMITDATE:12 COMPLIANCE DATE: Separation Distance Between the; Maximum Adjusted Groundwater Table to the Bosom oPLeaching Facility ILL FFeet PHvate Water Sayply Well and Leaching Facility (If aay wells exist on rate or with 200 feet of le"ag facility) Edge Of Weiland and Leaching Facility(If any Wetlands exist Feet within 300 feet of leaching fttcifiry Furnished by f k. ` S r a S+ 3 Nov 19 201,9 23:33 ,HP Fax page 36 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form •Not for Voluntary Assessments vly� 142 Willow Run Drive Property Address - Adam Wannie Owner Owner's Name information Is required for every Centerville MA 02632 11-15-19 page. CitylTown State Zip Code Date of Inspection D. System Information (cant.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to ground water: T-10" 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: Da1e-5-99 ❑ 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 12.5-98 G.W. at T-10". Bottom of Leaching at T-4" below grade. Bottom of Leaching at 4'-6" above G.W, Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Tine 5 Di6cial Inspection Form:Subsurface Sewage Disposal System-Page 17 or 18 III Nov .19 2019 23:33 HP Fax page 37 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Willow Run Drive Property Address Adam Wannie Owner Owner's Name information is required for every Centerville MA 02632 11-15-19 page. City/Town State Zlp Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B.Certification: Signed & Dated and 1, 2, 3,or 4 checked ® C. Inspection Summary: 1, 2, 3,or 5 completed as appropriate 4(Failure Criteria)and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t51nsp.doc•rev.TI25=18 Tide 5 official Inspection Form:Subsurface Sewage Disposal System•Page t8 of 1B 7 a Fee 1r59 E THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: X_"x Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for Migooal *pztem Congtructiou Permit Application for a Permit to Construct( )Repair(i/)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Yg &j 1 I ij .0 Owner's Name,Address and Tel.No. T U,�I)Ti— c. Assessor's Map/Parceln v, dv.� ._.. tc ,_►�- Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. c�Cc, VC Udbd 1 V-01t`f Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder 4f) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Ca Type of S.A.S. Ev d c x-0 Description of Soil Se A � Nature of Repairs or Alterations(Answer when applicable) Ci IDS y' 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 issued by this Board o Healt / / Signed r��� Date ! //�/ Application Approved by Date Application Disapproved for the follo ing reasons Permit No. Date Issued ate- "A No. �� — 7 3 , �•' ., Fee a s THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: a Yes 4 PUBLIC HEALTH DIVISION - TOWN11 OF BARNSTABLE, MASSACHUSETTS 2pprication for Digpooaf *potent Construction Permit Application for a Permit to Construct( )Repair(1/)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �a (� O W >2 Owner's Name,Address and Tel.No. Assessor's Map/Parcel 0/p .s.. Installer's Name,Address,and Tel.No. Des,* er's Name,Address and Tel.No. � (),I f d V-Pot"f apt e(01\ Qd 1:� 7 ly C .,,�5 M'C' ot..,. rat Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(/Vp Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of-Septic Tank U Type of S.A.S. Gam-J c..rc) Description of Soil SE k, Nature of Repai Z orAlterations(Answer when applicable) C� S�Z�c�GJ 7• Z— i 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 issued y this Board o Hea �//7/� \ Signed 1 Date 0 Application Approved by Date l a-f Application'Disapproved for the follo mg reasons t Permit No. 5 e - -7 3 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Comphattce THIS IS TO CERTIFY,that the On-site Sewage,Disposal System Constructed( )Repaired(Upgraded( ) Abandoned( )by 4 ��'���lT uC1JV\� C_ at L 7 k"A L`1)w (Z,/n a J c r-y has bee constructed in accordance with the pro�stons o`f`Title 5 and the for Dis osal System Construction Permitt - ated Installer ,o7(_c,,JCL M�r-C.�� Designer Lc) e The issu nce of thi permit shall not be construed as a guarantee that the syster�n wRD, nctio as designed. Date Inspector I_ . - - - — ��J ----------=---------------- __ No. Fee �.J y �0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS �Di5po5af *patent Construction Permit Permission is hereby granted to Construct( )Repair(VUpgrad ( )Abandon( ) System located at ZQ J I, 1 M G W f7 1.1 R. cJ ('.c_4tj-y �-- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. �7 Date: 7- 6 Approved by TOWN OF BARNSTABLE ✓� 'L- LOCATION & �I�-) QWel SEWAGE # VILLAG ASSESSOR'S MAP & LOT 10�� INSTALLER'S NAME&PHONE NO. ��� `� �� 7 7 V m ' SEPTIC TANK CAPACITY e- LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER 1�CA.L W6111^ /1 PERMTTDATE: ��� 17 PI COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility E2 0 Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching,facility) �f Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility JOY Feet Furnished by w i, v1 s I� Ll o 333 - AA pCox i - SST z LOCATION SCALE . Z." Zo'. . . DATE PLAN REFERENCE . . .... . •,Z199& X X J\ Min � Q� \ � r---•� V �� Pi r x XZO \9T� zr 41 Do 0Ile ly Wiry, .C�/riJy u; Iy s�7zea,�� cy 6), .�' fay 8� �o� � /Z•P�'�E- i9� o� EIVAR00 Kc-L Y_{ 26100 9fCIST ER�� c? _. is, LdN T. A 4 7 RAT �- EL... _ ins TkG�L��-Ivoex� 47/D Z a L T TOP OF FOUNDATION CONCRcTc COVERS -5iDG-3 7z-13G��Cr�v� .:i rr��rir„r /�L`�L/aG�rD Wi7�/ cGcN .. 4"CAS IRONT V'� OR SCHEDULE 40 4 SCHEDULE 40 P.V.C. (ONLY) g'MIN _ LEACHING TRENCH (2-)REQ. t „ P.V.C.PIPE MIN. PIPE-MIN. I/Sol I/2" WASHED STONE 3� MAX. iif PITCH 1/4"PER.FT PITCH 1/4"PER.l t, 2" i' INVERT GAS BAFFLE---a,. I I _ „ EL_.``.:7d.._ INVERT 1NV-R' 7if SEPTIC TANK EL..:...... sTo E — c o !_ -� -_ ;.. INVERT d -_ ��=�1=�����N CG.S, .... .. GAL.. INVERT EL. `:33 .. ... . S9/.- BOX INVERT 3/4 -11V?"-/ S7a. STA N DA R D WASHED STONE 6"CRUSHED STONE ������-_ I INFILTRATOR, ,, s®S / -� PROF]LE OF /9 �'• f�/-��.l D �vGLT� GROUND ZWATER TABLE SOIL LO G SEWAGE DISPOSAL SYSTEM DATE ....... TIME . 3'3o f M. NO SCALE TEST HOLE 1 TES HOLE 2 ci ELEv ..7 9.�... .. ELEv. .. . . .. . ... DESIGN DATA : `--8 r W 13.00' r,.:.,,.. NUMBER O DROOI.:S _ 1 TOTAL ESTIMATED FLOW .,3.30. . . GALLONS/DAY 20• Z4,4"y Zo'G''x 1o'io'_ ZZ-Z.oZ x a.7S-- ![G..57 G./?D,. r �c a", BOOM L CLI;�Gg s7 [C. SQ.ri./it=NCH C MGD. :'moo SIDE LEACHING AREA n/on/� SOX—I./TRENCH wi�h' cof3B(c''3 . . . . .... . � 3LN GARBAGE DISPOSAL .!`�O'`��:..(50% AREA INCREASE) C Z TOTAL LEACHING AREA . .'. =•� SO.ri. S.09 StiYi✓1� PERCOLATION RATE'. 44Ss.T3,;49 Mo PER.INCH AZ:Z.q� LEACHING AREA PER PERCOLATION RXI-Z :333pL SQ.r1/G.p C �sP. G.�•� o; o GROUND 'At:TER i-:BLE APPROVED .. . . . . . . . .. .. .. BOARD•OF HEALTH .......WATER ENCOUNTERED DATE ... . . .. . . ... _ � OF WITNESSED BY : AGENT OR• INSPECTOR WITNESSED WARQSS9 . . . .. BOARD OF HEALTH 14Z Wi6-6o w /Zv.� P12, ED _ o� E EY H ENGINEER . CL'�/ 72 f��LG E/ _!�'!/� : o . 26tO0 c 4 ALL all� � 0.527 � v !i .h Z,/o �r972CG-2 `B ssl9fC1$TERE °A. . . . . _. .. .v.• / l L Ds E AL1a3P=1TlONER �`�pQ04` 0a®s° 11/5/2019 ShowAsbuilt(1700X2800) TOWN OF BARNSTABLE {, LOCATION�4"" L 'IIQL-: r„ A Ca) SEWAGE# <7- .a VILLAGE Ce.,4-o- ! ALE ASSESSOR'S MAP&LOT 9101A INSTALLER'S NAME&PHONE NO. St y t -' C--,V,_- 7 7 SEPTIC TANK CAPACITY �S G t•c:I_ I i�I�G /� LEACHINO FACMXrY:(type) (e X in x C^/�Ll (rim)�T,.li✓f L IL':S U NO.OF BEDROOMS 3 BUBAEROROWNER PERMITDATE: Ia J l 7 J h ff' COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S.C_C) Feet Private Water Supply Well and Leaching Facility(If any wells exist /, on site or within 200 feet of leaching facility) r'1 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facihtyJ Jr, Feet i Furnishedby 40 s+ 3 3 H A-n a t sJ U Gam, https:HitsgIdb.town.barnstable.ma.us:8431/Home/ShowAsbuiIt?mp=210068&sq=1 1/1 r��� ��' PRO�DHDPE RISER v�REWOVABLE FINISH ^�1 {�' PROP VENT VNTHCHARCOAL FILTER TD ABOVE GRADE TOpOFFOUN��0N = =� � SECUnED W�E—|G�C���FGF [—' = —�'�� F(�|3HG��EOVERCH/�BERS = �1 .�' - ��.1' r����� � V �� � Y �� REMOVABLE WATERTIGHT RISER GLOpE6� 296KA\N0VERSYSTEN\ `o* /u1 //2 DOUBLE WASHED 1 UNLESS | ^~ b|VN� \V �Ki)VVNU� n�� | PROVIDE -- ` ' K8ETH{}DSSHALL 8E \N ACCORDANCE VV(THTITLE 5OF THE STATE ENV|RONKAENTAL ',`"' ' "'°`"� ur � c, \� r, u� u) - - DIA. OUTLET(S) 4/' SCHEDULE 40PVC INSPECTION PORT WITH ACCESS BOX CODE AND ANY APPLICABLE LOCAL RULES. 3/ 5'± FG OVER TANK EL 380 + 2" SCH. 40 MIN SLOPE 1% TO F G. (SEE GENERAL NOTE #21)FG OV�RPC �L ���jW u4 | U � �/um� umm�u��«�/�� �u/�« �*um�' 2� ANY (�HANGESTO THIS PLAN K4USTBE APPROVED 8Y THE BOARD OF HEALTH /\NDTHE DESIGN ENGINEER. PLACE RISERS ON ALL *25wwX 3 4^ SCHEDULE 4O PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED |NDISPOSAL ^" """` CHAMBERS WITH IN SYSTEM UNLESS OTHERVN8ENOTED � r"»/oncuo�/`u�— 4 TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOTBE LESS THAN � ( ELEVAT0N =4O40' FDRA0STANCE (}F15' AROUND THE PERIK4ETEROF THE SASUNLESS A | � ' � r»� `c | 4OK8|LGEOKAEN�BRANE LINER 0 PLACE AT LEAST RVEFEET FROK8SAS. AND THE TOP C)F 91. 1, TEE TO SAS / THE LINER |S NOT LESS THAN THE BREAKOUT ELEVATION