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HomeMy WebLinkAbout0051 ZENO CROCKER ROAD - Health 51 ZENO CROCKER ROAD 170-105 Centerville No. 4210 1/3 ORA Pendaf lexo 100 • r � 4 7 i 3 fo 5 can k f r c4 No. D E COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH �OWtn OF Bacns���1e 4 PPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade (Abandon ( ) - NComplete System ❑Individual Components 51 Zeno Ccodwv- QA Ak\oe,rt Vo Edhca "1', Scakmf t Location Owner's Name 11® \ 2 evno C('®cICQ( �d _ C e n\e(,J11k e- r R A Map/Parcel# Address kos Lot# Telephone# Installer's Name Designer's Name lb5'� (`_cort�oecry W- . C- w©ceV►crn + Hfl; 02536 Address Address 5�8- 273-0377 Telephone# Telephone# Type of Building: SinS(e- �aml Lot Size I5,5`/8 Sq.feet Dwelling—No.of Bedrooms -inCee_(3 Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min. required) 330 gpd Calculated design flow 331- S gpd Design flow provided 3'U• 5S gpd Plan: Date 8- 16-0 7 Number of sheets o�rle(I) Revision Date Title Noe osed See kC 5yskeynn Ue!1to JQ Description of Soil(s) See- alppve- eka,n Soil Evaluator Form No. — Name of Soil Evaluator K Qt ve_0 V--1 Date of Evaluation 7-19-0 7 DESCRIPTION OF REPAIRS OR ALTERATIONS C-Xt5-ttD5 JA0 II�� atn a Qkc { k �0 At-j-ku10J ,0A box kD 2-500 p1loo (eaClnivis G'A �70Cr< The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed A R ate FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 NO.6W� TE OMM NWEALTH 0[F MASSACHUSETTS FEE, w VtS?A/1, f CBOARD OF HEALTH j CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System�I The undersigned hereby certify that the Se age Dis osa`l System;�onstructed(„),Re ,aided?(,#).,Upgraded( ),Abandoned( ) Dr by: A U) I L-IZIV- , onlA at _ f\ _ ! 11�--1E' has been installed in accordaiF"ted ions of 310 CMR 15.00•(Title 5) and the approved de 1 snss//as-built plans relatingrto application No. Approved Design Flow e (gpd) Installer ,,/��-n /�f /lIn. ff l Desi ner:. I �(d(-�iC-1 9' Ins ector 111 U! t, 4( at g P _ . The issuance of this certificate shall not lie construed as a guarantee tha h system will function as designed. ` FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 No. H OF MASSACHUSETTS FEE �OARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair` ) U rade ( Ab don ( ) an individual sewage disposal system at l � u--X- ( - as described in the application for Disposal System Construction Permit No. ©y--�- 3 � ,dated ' ` 07 Provided: Construction shall be completed within three years of the date of this pe;T*L 1411�local co 62ps must be met. Date -t — f " y Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBS&WARREN'" PUBLISHERS- BOSTON 't J/ n a o {r� No. E COMMO NVVEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH - OF PPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade (Abandon ( ) - Complete System ❑Individual Components 5 ti Zeno Ccoc WC( Q fA 00EA V. a C-d"A (,I"'i Location Owner's Name " Map/Parcel# Address ►05 r Lot# Telephone# i En lrlt?e<< tiC Sh c Installer's Name s esigner's Name },. Zb 5� f c o+n4pe( Nwv wo(e",;Wl ; NA 02 53 8 + Address Address 548 273-0377 Telephone# t Telephone# j Type.of Building: )inSke- jo,m�iY Lot Size 15)5'y 8 Sq.feet Dwelling=No.of Bedrooms Awec(3 Garbage Grinder ( ) Other..—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures ..x. Design Flow(min.required) 330 gpd Calculated design flow 3 31.-5 gpd Design flow provided TU. 5 gpd Plan: Date 0 7 Number of sheets one. (1) Revision Date �— Title Qru,po5rd seek`C 5yske- l UP55t06e r i Description of Soil(s) see_ 0bmve- +�,a :{ i Soil Evaluator Form No. Name of Soil Evaluator K P+anevn k Date of Evaluation 7- t 9^Q r DESCRIPTION OF REPAIRS OR ALTERATIONS E kan k � ax ( c 1 i�t5 t"ttDtl� Of1 DUX ko 2.- 300 q*0U(1 leQc.AIi v)S C_.`I►uyv)oaP l S a The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. y �ew�� Signed' . ate FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 „ ;r, SEP-24-2007 08 :57 AM JCENGINEERING 508 273 0367 P. 01 Q2,"2'5/19a4 02:26 508-7S0-�ti/B J.P.MAWNIBER E SOIL PAGF- 03 Towne of Barntable Re latory Services i 1 Thomas F.Galler,QirMar Pub&Besrlth Division Thomas McKmm$Dinjetor �00 Male Straw Hyaq�,N[A 8Z60' Office: 509462.4644 ! Pax: S08-790•6304 Doter 9 .3 7 Dw4per: .��C t r'�f�,.Ylke ��� .tv1C. itAutTN C[, Eme' Qi Addra>!u 2 r_11. C © 3o� l0 3 ( E' u.Ic ttlr Gvr ?t A. A� ....`..._...� .. _. (..�IrT e+ , r.. _was i5=4 a permit to ftwW]a septic sysctem atf based an a dersip dawn by dated 75t 4b � 2UO� ' i'oft" *0 the septio system reforamced abovc was installed substantiallyy acco to the desip, which. may include minor approved champs such as lateral reloaatia�tbte disti�lbutton box wd/gr septic tank. _— I certify Ut the`eeptio seyystem ref+arm eed above 1 installed with m oz cheuges (i.e. Sm 1p' lateral re ocat:16 of the S.A$ or an`y verdcal xelora� �' In0 any c mt Of ft HITUC syete A but in accoidsm with State&y;aral Regulations. Plan revisionvi or cort{tisd as-built by designer to Wow, JOHN L. S e CHURCHILL Ctrs JR. CIVIL 1 ai�7 Eaf�Or 9Ddawr SUMPWE&WAUREQ. BY CTG o L i Q He9%4"a0edptr Cet10011106n:Iso_m TOWN OF BARNSTABLE LOCATION `-/ ZQ✓%o Cm dtAA SEWAGE# 38(o 'U .VILLAGE ASSESSOR'S MAP&PARCEL 170 - J OS INSTALLERS NAME&PHONE NO. `cue 'w Cv��- k ads y�a•$ SEPTIC TANK CAPACITY WUO VJ V LEACHING FACILITY:(type)' o?) 14 2Cu Soo 1-4. (size) 12 K a�" .,NO. OF BEDROOMS 3 , OWNER A 6AAAsca, ( �4-0 1 PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A1610ft Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY C t 4�oua.e p b � ' 34.0 +c 3 Vo•u eb 8 d Cy 4�. � C5 50. 0 C �o S� - ?SqTown of Barnstable P# Department of Health,Safety,and Environmental Services THE ' Public Health Division Date /ok �,. . 367 Main Street,Hyannis MA 02601 BARNHCAH nrAss. 'DIEo tnA+" Date Scheduled Time Fee Pd. Soil Suitability Assessment for Sewage Disp# sal Performed By: (�1cHr�Ey�j irvtE,vTiE>I, 1 T. C. ,r, Witnessed By: p Syr t 1 LIJ AT ON &` ENERAL'INFOIMAT. Location Address J Owner's NameTP Ll�y - OE-J 14PZOLL 16; /►)A. AddressS/ 24/D Cogj,*69 _ :9 u'• Assessor's Map/Parcel: /70 1(4)S Engineer's Name ' rrt_ NEW CONSTRUCTION REPAIR Telephone fv Land Use ZEStplrj�171gt,;'I,AWW Slopes(%) 1D-1°/ Surface Stones MntG Distances from: Open Water Body 1d6 ft Possible Wet Area >IOC -ft Drinking Water Well >100 ft 1 Drainage Way > IG19 ft Property Line :t 10 ft Other R SKETCH: (Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) ry -see E+U,05ce --i►TE '?,Aw ^' m Parent material(geologic) 00TV 6V* RAIN Depth to Bedrock > 12 - �S Depth to Groundwater: Standing Water in Hole: VG., 6LS Weeping from Pit Face 1Z(_* BfcS Estimated Seasonal High Groundwater 12(v t3lOS D T N CJN fJ1 ;S AS0 'VS�AT I T�l�l t•; Method Used , { ®�g � y ". Depth Observed standing inobs.hole: >Il(7 �� in. Depth to soil mottles: ITS6S m. ( �- Depth to weeping from side of obs.hole: '>��(c~ 5 in. Groundwater Adjustmen /ly n Index Well#_ Reading Date:_ — lndex Well level Arl .-j.factor Adj.Groundwater Leve 7:2 777 PER+COLATI(�I�i Tl✓S'I' Atc' Timd tf!# iJ Observation Hole# Time at 9" Depth of Perc rjj-gyp' Time at 6" Start Pre-soak Time @ 16!05 404 Time(9"-6") F End Pre-soak io=13 AM .Rate Min./Inch Z M.P.1. Site SuitabilityAssessment: r n[. Site Passed Site Failed. Additional Testing Needed(YM) lJ Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant DEEP OUSE: t�ATtO1V Depth from Soil Horizon Soil Texture Soil Color L�* Of, ; Surface(in.) (USDA) (Munsell) ture,Stones,Boulderes. isigricy.° Gavel 0-52 1 a- IMP ' DEEP OBSERVATION HOLE LOG ::Hole# -� . Depth from Soil Horizon Soil Texture Soil Color. Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° ra e `5t- 102. G-t CaaRgL �AiWO Z.�a eo f ao-ua�,� G _ r �oz-tz� G•Z mn�ntu 1AM0 -5Y DEEP OBSEI2`UATION H�I.E LqG Ho[e# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency N. r I DEEP OBaERVATION H(J�T.E LOG H�Xe Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. c ra - Elrod n ur nceR8k MIS.;, 1 Above 500 year flood boundary No_ Yes `Within 500 year boundary No Yes Within 100 year,flood boundary No `� Yes Depth of Naturally Occurring 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 on 10 IZ4 W (date)I have passed the soil evaluator examination approved by the *'Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and exV4rience described in 310 CMR 15.017. Signature4' Date 6_1S'-07 Town of Barnstable �FIME Tp� o Regulatory Services sexivsrnatE Thomas F. Geiler, Director 9� 1639. ��� Public Health Division QED MA'S A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 18 2007 Mr Alan Scalingi 51 Zeno Crocker Road Centerville,MA 02632 ORDER TO COMPLY,WITH STATE ENVIROMENTAL CODE, TITLE 5 The septic system located at 51 Zeno Crocker road, Centerville,MA was last inspected on May 91h , 20079 by Mark Polselli, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: System is in hydraulic failure You have 60 days from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HE H DEPARTMENT Thomas A. McKean,R.S., C.H.O. Agent of the Board of Health COMMONT"TA1` _� �T Tu OF IV��SS r L1-1CS i TS EXECUITTVE OFFICE ZR , I j?: 7� sc= % LEPARTMENI OF Fii��II�QIVIVIE'V �, PR.('1'TECTI0 \? TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESS-AfEN TS SUBSURFACE SEWAGE DISPOSAL SYSTEIT FORz-T PART A CERTIFICATION 110197 Property Address: �.z Owner's Name: f Owner's Address: CZ /f/o rf[, Date of Inspection: S 9 '9 r;. Name of Inspector: lease print)1G/y� Company-\Tame: 1Tailing Address: o Telephone Number: �s�4q s_ r- ca? i O � CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the -ifn-r;;,t;on, e-por�ec below is true; accurate and complete as of the time of the inspection.The inspection-was�`'�o—tic based en training and experience in the proper function and maintenance of on site sewage disposals:sterns. I an, aDEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) ire Passes Conditionally Passes Beds Further Evaluation by the Local Appro-�rntr:A U7,,o �> Fails Inspector's Signature: �. Date: 9 p The system inspector shall submit a copy of this inspection report to the An prOvmg AuthO-t.%('Boar`of�%ealt�O: DEP)within 30 days of completing this inspection. If the system is a shared system or has a desi t_or• gpd or greater, the inspector and the system owner shall submit the report io the appropriate rez"- al o=-ce o_ he DEP. The original should be sent to the system owner and copies sent to the buyer,if anpl1cable. and the a,,_o,_ authorLn. Notes and Comments ""Y"This report oniy describes conditions at the time of inspection and under the condi time. This inspection does not address how the system will perform in the future unde ttons of use at that conditions of use. r the same or different Title SInspection Form 6/25/2000 patre_t Pane 2 of 11 OFFICIAL INSPECTION FORD—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL, SYSTEyI INSPECTION FORA CERTIFICATION(continued) Property Address: S� !/!p C✓oc 4y Q� e Owner: C'a /i&I Date of Inspection: S 9 Inspection Summary: Check A,B,C,D or E!ALNYAYS complete all of Section D A. System Basses: N I have not found any information which indicates that any of the failure criteria described u_=10 C•,'R 15303 or in 310 C VM 15.304 exist.Any failure criteria not evaluated are indicated below-. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"seciion reed t. be rculaced or repaired. The system; upon completion of the replacement or repair,as approved by the Board of Health,. w M pass. Answer yes; no or not determined(Y,\';\ )in the for the following states ents. If"not deter-maned"please explain. The septic tank is metal and over 20 vears old*or the sep is tank(whether metal or not) s s_ uct<ural_':v unsound, exhibits substantial infiltration or exfiltration or tank failure is i-imdnent. St-ster~ ..1 Hass i=pectior.if e existing tank is replaced with a complying septic tank as approved b, the Board of Health. *A metal septic tank will pass inspection if it is structurally sound;not leaking and if a Cer-=care of Co--n'_ia ce indicating that the tank is less than 20 years old is available. ND explain: Observation of sewa,e backup or break out or high static water level in the dis tTbution boy;due to b-ol:e- Or obstructed pipe(s) or due to a broken,settled or uneven distribution box. System w"ill pass nspe-=-1 (T-r approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced \rD explain: The system required pumping more than 4 times a year due to broken or obst3 acted pi e s'__ The pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed \?D explain: Tit)a �Tr=cnor+:nr. T=nrm �/1 G/'l!1!1!1 � Pale 3 of 11 OFFICIAL INSPECTION FORvI- NOT FOR VOLL-N-T-ARY ASSESSMENTS SUBSURFACE SEWACF DTSPOSAL SYSTE-Al INSPECTION FOR-VT PART A CERTIFICATION(continued) Propert-N Address: e ./ /� " Owner: �/A t Date of Inspection: C Fur her Evaluation is Required b` the Board of Health: Fur exist which require further evaluation by t Health -1,n r -.-- --,q h..Board of in order:o d_se,__�e�_.�<. s_��:e,,. is failing to protect public health. safety or the environment. 1. System will pass unless Board of Health determines in accordance Toth 310 CATR 15.303(1)(b)that the system is not functioning in a manner which will protect public health...safety.and the environment: Cesspool or pricy is«ithin 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a Sall~mrSh 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 soii absorption system(SAS)and the SAS is vv ithin 1v0 ;et a surface water supply or tributary to a surface water supply. The systern has a septic tank and SAS and the SAS is-within a Zone 1 of a public v zte_ .v. The system has a septic tank and SAS and the SAS is within 50 feet of a private rater The system has aseptic tank and SAS and the SAS is less than 100 feet but 50 feet or more fr ~o- a private water supply well**.Method used to determine distance **This system passes if the we'll water analysis,,performed at a DEP cert:=ed laboratolt. for coli-o- bacteria and volatile organic compounds indicates that the well is free from pollution l-cr~fz_at facili :and the presence of arru-norna nitrogen and nitrate nitrogen is eeual to or less than 5 n_nr�T-ems ded that no o failure criteria are triggered.A copy of the analysis must be attached to`ibis forte 3. Other: Title Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR tiOLUI TA.RY ASSESS�vIEtiTS. SUBSURFACE SEWAGE DISPOSAL SYSTENI INSPECTION FORM P_a:RT A CERTIFICATION(continued) Property Address: S� z2�p Clot 4-er 0 rer• CA i n Date of Inspection: 9 01-11 D. Svstem Failure Criteria applicable to all systems: You must indicate "yes"or"no"to each of the following for all inspections: Yes .o ac'klup 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 % aters due-to an overloaded or dogged SAS or cesspool (/ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged S-AS or /cesspool ✓ ,i"6uid depth in cesspool is less than 6"below invert or available volume is less than'' day, _ Required Dump ing more than 4 times in the last year\OT due to clogged or obs n�cted p_ e(s).lumber �6__Iimes pumped _ ' portion of the SAS,cesspool or privy is below high ground water elevation. —✓ Any portion of cesspool or pritry is;dthin 100 feet of a surface water suppl;-o-u buta_ to a surface e`er supply. _ ✓ -w portion of a cesspool or privy within:a Zone 1 of a public well. v portion of a cesspool or privy is within 50 feet of a private water sup-l.3 c.el':. Any portion of a cesspool or privy is less than 100 feet but -eater than.50 met fl o n a vi ate-=rater supply well with no acceptable water quality analysis. [This system passes if the-well water analysis. performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility-and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/l�c) The s�'stem fails.t have determined that one or more of the above failure criter a e> st as described in 310 CND 1 5.303,therefore the system fails. the system owner should contact the Boars o- 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 vdth a design flow of 10.000 gpd to 15.000 gpd• You must indicate either";yes"or"no"to each of the follo'MR-2: The f llowring criteria apply to large systems in addition to the clittetia above) s no the system is within 400 feet of a surface drinkirg water supply the system is within 200 feet of a tributary to a surface drink ng rater suppl.> — — ' e system is located in a nitrogen sensitive area(Interim Wellhead Protec :cn A_ea. -1.:?_ ' o-:a Tnan .:_ Zone II of a public water supply well if you have answered"yes"to any question in Section E the system is considered a si_an=fican, -ea- o-=-_- "yes"in Section D above the large system has failed.The owner or operator of any large_: _ c0115 a significant threat under Section E or failed under Section_D sha11 u grade the syste_u; 2CCC''G-o J 15.304. The system ow-ner should contact the appropriate regional office of the Depart=rre_ra. Page 5 of',1 OFFICIAI, INSPECTION FORM-\�OT FOR VOI,UNT-kRY ASSESSMENTS SUBSURFACE SENVAGE DISPOSAL SYSTEII ENSPECTIO_N FORM PART B CLIECTaIST Property Address: �� � !/10 C/oc l+•�r �2�/ G'2✓+fP�v�� t � Oa G 3� ON%mer• C ' Date of Inspection: D Check if the follo,dng have been done.You must indicate"yes"or"no"as to each of the follovi-ns: Yes N;1/ ✓Pumping information was provided by the ovkrer; occupant, or Board of Healrh `- Were any of the system components pumped out in the previous two Reeks 4, 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-h;s insnec-L-10n'? yWere as built plans of the system obtained and examined?(If they were rot 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 respected f o-t ILIon of the baffles or tees.material of construction,dimensions, depth of liquid;depth of sludge and der--- of scu_l:? f Was the facility owner(and occupants if different from owner)prof iced ?t'n_inf o�-ratio:, c ri_.e p-o-_ e= maintenance of subsurface sewa6e disposal systems? The size and location of the Soil Absorption Svstem(SAS)on the site has been de`e-n_�ned based on: Yes o _ xisting information. For example,a plan at the Board of Healt1L Determined in the field(if any of the failure criteria related to Part C is at issue aL roxir a=on cf di_- is unacceptable) f310 CMR 15.302(3)(b)j " i+lo Tncr ar+inn Ln „, 411:!7hnn C Page 6 of 11 OFFICI_AL INSPECTION FORM—NOT FOR VOLUNT_�RY-�SSLS'N. -TS SUBSURFACE SEII%AGE DISPOSAL SYSTEI•T INSPECTION FORAIT PART C SYSTEM INFORMATION Property Address: �1-V1,q C-Oc 4-e, RIJ Owner: Date of Inspection: p p F]�OW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN tlo-,v based on bedrooms,': CMR 15.203 (for example: 110 gpd x_obedrooms,': Number of current residents: O Does residence have a garbage grinder(yes or no) Is laundry on a separate sewage system(yes or no): if yes separate inspection reaui-ed! Laundry system inspected(yes or no): Seasonal use: (yes or no):A'V Water meter readir_as, if available(last 2 years usage(gpd)): Sump pump(yes or no): Last date of occupancy: /v COINZERCL 4L/INDUSTRTAL Type of establishment: Design,flow(based on 310 CMR 15.203): g d Basis of design.flew(seats/persons/sgft,etc.): 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 occupancvluse: OTHER(describe): GENERAL I`FORINIATIO?ti Pumping Records Source of information: ov Was system pumped as part of the inspection(yes or no): If yes, volume pumped: gallons--How was quantity-pumped determined? Reason for pumping: LI-'P SYSTEM eptic tank. distribution box. soil absomtion system _SingIe cesspool_ _Overflow cesspool _Priory Shared system(yes or no) (if yes,attach prey ous inspection records.if any) _Innovative/Alternative technolo(-y y.Attach a copy of the current operation and mainTena-c c o= _ obtained from system owner) _Tiaht tank _Attach a copy of the DEP approval Other(describe): Approximate.age of all components; date/�ed f if own)and source of infor_nafion: Were sewage odors detected when arriving at the Site(yes or 120):/f V Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLL-NI_ARC'ASSESS-A-E'-',-TS SUBSURFACE SE"A'AGE DISPOSAL S`s'STE-I n-SPF CTION FORM PART C SYSTEiVI INFORMATION(continued) P. Property Address: �/ ZP00C-O c l-e,_ pQc/ ' Owner: S;c a 1/h H Date of Inspection: S O BUILD NG SE«'ER(locate o}3 site plan) Depth below grade: 2ateriais of construction:_cast iron 4� 0 PVC_other(explain,):_ Distance from private water supply well or suction tine: Comments (on condition of joints..venting,evidence of leakage,etc.): SEPTIC TANK: _<locate`� on site plan) pp r/ Depth below grade: O Material of constnrction:_cv oncrete_petal_fiberglass_po?veThyl'ene other(ezplain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): _(a-ach a cod: of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: �a Scum thiclmess: Z—PS-?-/ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottoW gf outlet tehcr baffle: How-,were dimensions determined: a .e— a Corriments(on pumping recornrnerdations.inlet and ,let tee or baffle condition. structural i�te ?cuiC le els as re .ed to outlet inve—It. evidence of leakage. e`c.): QC's i vi ri�o ov, ,Aa I, J GREASE TRAP:4/(locate on site plan) Depth below, grade: _ Material of cons ractien:_concrete_metal_fiberglass_�olve+hvle e_other (explain): Dimensions: Scum thickness: Distance from tort 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: Comments (on pumping recommendations; inlet and outlet tee or bafrle condition. s ruic-n_?1_-e_ lr= _!er as related to outlet invert; evidence of leakage, etc.): Page 8 of 11 ®FICIAI INSPECTION FORM NOTFOR VOLU\"T_-A—RY ASSESS1IENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM p,�kgzT C SYSTEM IN FORMATION(continued) Property-Address: 2Ppla C/Oc�rPr 2� Owner- Date of Inspection: 9 0 TIGHT or HOLDING TA2%-K: tank must be pumoed at ti ne'of insDection)(locaie on-Site plan) Depth below grade: Material of construction: concrete metal_fiberglass polvethylene e,her(ex-1 ain't : Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no-): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBU TION BOX: L(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids ca r­n ti of -:, an•,-evlcI e o= leakage into or out of box, etc.): PUMP CHAAMER: /lam (locate on site plan) Pumps in working order(yes or no): Alarms in workir_g order(yes or no): Comments (note condition of pump chamber,condition of pumps and a, urtenances. etc.!: Paoe 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLLTINTA'IRY ASSESSNIENTS SUBSURFACE SEW4,GE DISPOSAL SYSTEIT INSPECTION FOR:V P-,kRT c SYSTEM INFORMATION(continued) Property Address: �/ zeN O C/OC key PC—/ Owrer: C o. Date of."inspection: _ S.OM ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain whv: Ll�' Type leachin_6 pits;number: leaching chambers;number: 7�0 leaching galleries;number: leaching trenches; number. length: leaching fields; number, dimensions: overflow cesspool,number: innovative/alternative system Type/name of techb-iology: Comments (note condition of soil, suns of hydraulic failure.level of ponding, damp soil, coed' on of 4vege'at=on. etc-): CESSPOOLS: cesspool must be pumped as part of inspection)(locate on site-plar_) J \umber and configuration: Depth—top of liquid to inlet invert: Depth of solids laver: Depth of scum.laver: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil, suns of hydraulic failure, level of ponding. condition of-.-egetaton. PRIVY: /V (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments (note condition of soil, signs ofhydraulic faillyre.level ofpondin?, coLdi=o-of re<_.=-_-o- T;+lo : T+,c .,+;_ �!i v�nnn q I Page 10 of 11 OFFICIAL INSPECTION FORA-NOT FOR YOLLI .,i-RY"ASSESS-AIENTS SUBSURFACE SEWAGE DISPOSAL SY_STETVI INSPECTION FORM P_3RT C SYSTEM INFORANIATION(con mued) Property Address: �/ ZPdlO /Ot ✓ 2�rn e✓vi G ©d-6 7, Owner: SC e. /i e y i Date of Inspection: 9 D� SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the se-,vaffe disposal system including ties to at least two permanent reference Iandr-a-ks o- benchmarks. Locate all xvells within 100 feet. Locate-�chere public water supply enters ,e bui d m c. 14 T;rla i Page 11 of 11 OFFIC'IAL INSPECTION FORM—NOT FOR,OLI,N RY ASSESSzT-EN—rS SUBSURFACE SEWAGE DISPOSAL SYSTEIN NSPFLTION FORxj PART C SYSTETIM INFORMATION(continued) Property. Address: Owner: CU l ✓l Bate of Inspection: 9 O� SITE EXAM Slope Surface water Check cellar Snallo«,wells Esrmated depth to ground water feet 7V Please indicate(check) all methods used to determine the high ground eater elevation: Obtaine om system design plans on record-if checked.date of design plan rep owed: O' - rved site (abutting property/observation hole« l'n 150 feet of SAS) 1 , - I Checked w_th local Board of Health e � g 0 s xp�ain. 5 —f— , , Checked with local excavators, - documentation)ators; irstal�ers (attach Accessed uSGS database-exriain: You must des ri ho-v you establis the high ground rater elevation- i T41. Tn rno..tinn Fn,-m G/,c!�nnn I COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,.and 3.Also complete A. Sign atu item 4 if Restricted Delivery is desired. X ❑ gent ■ Print your name and address on the reverse r ddressee so that we can return the card to you. B. Fieceived by( rinted Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, %Gt-L4.'j 1 (,—?I-a7 or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: . If YES,enter delivery address below: ❑No Mr Alan Scalingi 51 Zeno Crocker Road Centerville, MA 02632 3. Service Type Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise =s ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number f i l ; 1 �7005 :1.160 0000 i 0191 3363 —' (Transfer from service label) PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 j� G UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 Sender. Please print your name, address,-and ZIP+4 in this box• F BLIC HEALTH DEPARTMENT OWN OF BARNSTABLE 200 MAIN STREET HYANNIS, MA 02601 f � !i(z�s��l�l,�f;�il�f►�„'!iEl�t�ii�,�ii�s;s,l�iil„s11�;,31�I�i � J THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ------------ --OF... - - Appliration for Uiivluiittl Warkii Tatuarurfian Prrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ..... ........... t_ l '................................... Location-Address or Lot No. .. . •- ✓ ..-.�.- c--------------------------------- a --�O 1� ........................... , ........-----------....----......-----...L ? � Installer Address U Type of Building Size Lot-----1 7,.!AAI--Sq. feet �_4 Dwelling—No. of Bedrooms................................•__..._.....Expansion Attic ( ) Garbage Grinder ( ) W`4 Other—T e of Building ..._..... No. of persons............................ Showers —Type g --------•---------- P (----)--- Cafeteria ( ) Otherf xres .........................................-•--•--•-•---•-•---•-•------•--•---•--•----------------•--••--•--•. -----••--- w Design Flow......_....°`;?ld.........................gallons per person per day. Total daily flow...........`77.Z). ...............gallons. WSeptic Tank—Liquid capacitA_a.M..gallons Length__ ;.. ... Width................ Diameter-_______.______ Depth................. x Disposal Trench—No..................... Width..---__-_-_--__-_--- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... Diameter--- _ Depth below inlet...�� area.. ..... Total leaching _ _ Z Other Distribution bo (�) Dosing tank ( ) . �----sq. ft. aPercolation Test Results Performed ................ Date..... ,.a Test Pit No. 1_.4........_.minutes per Inch Depth of Test Pit....... "I....... Depth to ground water...... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q'+ ••--•••--- t.........l.................................. ................................. O Description of Soil-•••-•-•C2..-•�......•} �i j .;� '.= --- '- a_ \ ..... ------------------_-------------------------------------------------- --------------------------- U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ------------------------------------------------•----------•---•--------------------....•-•------•----••---••-•-•••--•---•----------•-••--------•-----•-•-••...•--•--••. •--•-•--•-••......---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLi: 5 of the State Sanitary C de— The er igned further agrees not to place the system in operatioljl a Certificate of Compliance has be ued of health. y�{{ 2/_ Signed---• __ . -----•---------------•••--......---. lication Approved By............ ..... .......... Date Application Disapproved for the llowing reasons-.........................................-...................................................................... --•------------------------------------------------------•-------------••---•-••........... Date PermitNo......................................................... Issued...................................r"`.---•-•--- BOARD F HEALTH .........................................OF...... `: /re ................... THIJI,� TO Tatifiratr of Tomptiaurr ,�RTIFY h� the 14�4;yidual Sewage Disposal System constructed (Repaired Repaired Y. �-_/.................... ........................................... h. .........f......J.r...........>........... -------"-------------*, x at-----. -------- �nFnl------------------------------------C has been installed in accordance with the provisions of TITTE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated_._.-__.__._._________.____._.................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C011,'I, TRUED AS GU*KANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. .. .................. ....... ...... ....... DATE................................................................................ Inspector........... I.........................(;.# THE COMMONWEALTH OF MASSACHUSETTS BOARD ,9F HEALTH. ........... ................ ...I....OF....... ........... Billposal, orkii (11Lanotn ion Vanfit ................ Permission is hereby granted.---------?.1 e .... . . ... ..... .. ......................................................... to Construct or Re tge Repair an Individual Sewage isposgj;vatm ............... No.... --------- evn;�4tj-. ......... ..................................... at Street as shown on the application for Disposal Works Construction Permit No..................... Dated., ................ ......................................................................................................... Board of Health DATE---------------------------------------------------............................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No ....:`-y 3 Fps ' '�..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH _................ ........................OF... %1 .. .��" � :.......................... Appliratiou for DhipmFal Works Totw4rurfiort rantit Application is hereby made for a Permit to Construct ( f) or Repair ( ) an Individual Sewage Disposal System at: .....----•-...._...---•- ................ _-�..._..._.. ----......• . ! _._.................----- Location-Address of Lot No. ......................�-_ 7 1 1.:��t J`? I c,...4`'�- ....r�'� 'z�✓..__ ' .! c ..�-5..........�:t_ .�................................. _ _ ¢rr R d ss b� / Installer Address 1 d Type of Building ,, Size Lot....... ....`�_l_�..LSq. feet Dwelling—No. of Bedrooms....._...•...................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures •---••......-•--••-------------- W Design Flow...........`;?.12........................gallons per person per day. Total daily flow...........-:��.7.-e...............gallons. R; Septic Tank—Liquid capacit,�E c.tc=c.)..gallons Length._` a... Width................ Diameter................ Depth................ W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No----------- --------- Diameter....... U-_ Depth below inlet.._ '?? ..... Total leaching area..F f.?...sq. ft. Z Other Distribution box (,/) Dosing tank ( ) G r Percolation Test Results Performed by!, SU---� (---ri_-----1------ ._..��?��_______________ Date------ �_�_��?_..�%._� Test Pit No. 1__`-......._..minutes per inch Depth of Test Pit........FS._... Depth to ground water..__.. ..........__. Gi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O Description of Soil.......... ----- U -••...........-•-••-.. ---- - -- 1 {.. --_-•--- ---- ..... _ .i.L?----------------------- W --------------------------------------------------------------------------- -------------------------------------------------------------------------.................................-----•----•--- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------•--------------------------------------------------•------------------------........-•----•-----------------•-------------------.....--•-----------------------------------------------.....•••- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary C de—The ersigned further agrees not to place the system in operati a Certificate of Compliance has been uedy Aa of health. Signed ... = �--` -----•-- -------•-----------•- f' to lication Approved By••••-•--•-• •.... ..-- --• ................. ........................................ Date APPlieation Disapproved for the llowing reasons: --------------- -------------------•-------------------------•-••---••• ....-- n` Date PermitNo......................................................... Issued............................................................. Date S C. U S S 70 - !oo LOCATION w E� s 1 S E W I�_cnc-_ E_R_M I T N Q. (P ` PILLAGE - L44,-s INSTALLER'S NAME j ADDRESS R U:1 L D E R OR 'OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUEDf- I fo`' .� V . c SITE PLAN SHEET I OF 2 SCALE: I = Zd t'��U�;yT Gor�•aG C�oo�aL G J • fl l hT t3ox. ' - loco. GD•L• h�I"1"I G � \� '� 5'iYs 0 _o N 4A- lb 3L r � I — hZ0 Co �-O - I I �.ov 11�h'• 50� I 51s<4 SIIL.e ' OF go WILLIAM yG� ®� 1 L7 tT M. WARWICK -No: 19771 ,o F AEGisn"�� s3�oaAL LG+�il FOR REGISTERED LAND SURVEYOR L o ;r _ ZONE. c,r-, -re, V I L L. M A S g I PLAN REF. DATE BENCH MARK DATUM D 5 y 8- WM. M. WARW/CK .B ASSOC., INC. i DOMESTIC WATER SOURCE TvlAd t-J w/aT I: I, h r4 BOX 80/ - , NORTH FA L MOUTH FLOOD ZONE. N oaJ - t4 A EA-m D MASS. 02556 - (6/7) 563 -2638 LEACHING QASIN SECT/ON NOT TO SCALE She•c?l 2 z 24 C.1.MH COVER EARTH FILL BRICK AND MORTAR COURSES AS REO D• TO BRING 4 COVER TO GRADE IN 8 FLOW LINE 2'�- TO%" WASHED PEA STONE FREE. OF IRONS, PIPE T; FINES AND DUST IN PLACE q ,• / 414" TO I%2"WASHED CRUSHED STONE, FREE OF [ d OPENING W/TH 4/B rj�J �� • '• OUTER DIAMETER IRONS, FINES AND DUST IN PLACE AND 13/4"INS/DE DIAMETER I. CONCRETE TO BE 4000 PSI 28 DAYS c. �`• 2..REINFORCED WITH 6%6° NO. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS 4'0" � �-6 0" --I--- �I —� 4. NUMBER OF PITS REQUIRED o N fL MIN. i EFFECTIVE DIAMETER -i NOTE: EXCAVATE TO ELEVATION �+OR (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO REMOVE ALL WArER rABLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN . TYPICAL PROF/LE GRAVEL TO DESIGNED GRADE. L•FL•53.5 IB"STO. LT. WGT. C.I.MH COVER 52 5 52.0 5l.lo Sl _ 4C.1 PIPE 4"8/T.FIBER PIPE OUTLET LEVEL FLOW LINE TIGHT JOINT 0• DWELLING TO FIRST JOINT /4" e OO 110 00 to .00 C.I. TEE �I$.23, 1 1 0 I 00 1 TD. PRECAST CONC. D/ST. BOX TO BE 1 11000 00 1 1 1 1 GAL.sEPr1c TAN INSTALLED ON LEVEL, 1 11000 00 0 1 1 I STABLE BASE 1 1 1 0 0 0 00 4,1 1 1 NSEPT/C TANK To BE 1 If 0 0 0 0 0 1 1 + 1 INSTALL 0 0 LEVEL 1 11 100I O 0 1 11 STABLE BASE. it 0 I 1 0 0 0 0 1 11 D 1 1 LEACHING BASIN I 0 0 1 lff30 , BASE TO BE LEVEL + if O 00 1 1 LL• 50/4 AND PERC DATA ; PERC. RATE �Z MIN. /IN. TEST PIT NO. F 37&7 TEST PIT NO. 2 0. 0 7� TEST BY: $ IzuG4 L 1aIr- pS4a�lL WITNESSED BY' t� 'TEST PIT GR. EL. 5I' G L•i;tl.fJ M�D. DATE' l 3v SA►.� D Ea. 12. o N G.yzavrJ pvxjA.Z9t 39,7 . DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL SEPTIC TANK., DIST. BOX AN LEACHING BASINS TO BE STANDARD EST.' TOTAL DAILY EFFL. GPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC: TANK GAL, ALL .SYSTEM COMPONENTS' SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, SIOEWALL AREAGAL./SQ.FT. . MINIMUM REQUIREMENTS FOR THE .SUBSURFACE DISPOSAL OF .,BOTTOM AREA GAL./SQ.FT. SANITARY. SEWAGE :EFFECTIVE ON JULY 1 , 1977. LEACHING REQUIRED LOO SQ.FT. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. Q,FT. AT -COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES 1/4 / FT. UNLESS INDICATED OTHERWISE. rp MAU �Alh SEWAGE DISPOSAL SYSTEM per' MAR 'OR•' �-CiO L y cilwW w MORAN H Lv l�Zo t-a0 .� .p 123417� � �l� i ST SS/oUAI�N `ice SCALE AS.INDICATED DATE-- y ► `b 5 • WM. M. WARWICK 8.ASSOC. INC. BOX 801 - NORTH FAL MOUTH we ` MASS. 02556 - (617) 563-26.38 PROFESSIONAL ENGINEER PROVIDE PRECAST CONCRETE FINISH GRADE OVER D-BOX= 56.8 ± ' PROPOSED VENT WITH CHARCOAL EXTENSION RISER WITH CONCRETE FINISH GRADE OVER CHAMBERS= 57.2 - 56.6 TOP OF FOUNDATION COVER TO WITHIN 6"OF FINISH GRADE REMOVABLE CONCRETE COVER FILTER TO ABOVE GRADE ELEV- 58,5'± 3/4"TO 1-1/2" DOUBLE WASHED OVER INLET AND OUTLET COVERS. TO WITHIN 6"OF FINISHED GRADE 4"SCHEDULE 40 PVC MIN SLOPE 1% 4" PERFORATED PVC PIPE WITH SCREW STONE TO CROWN OF PIPE FINISH GRADE GENERAL NOTES @ FND. EL.= 57.5' ± FINISHED GRADE OVER TANK EL. = 57,0'± 5"DIA. OUTLET(S) TYPE CAP TO WITHIN 3"OF F.G. 2"OF 1/8"TO 1/2" DOUBLE SLOPE @ 2% MIN. OVER SYSTEM (SEE NOTE#21) WASHED STONE 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION 20"MIN.ACCESS COVER � } PLACE RISERS ON ALL (TYPICAL FOR 3) PROPOSED 4" I TOP OF SAS = 53.40' CHAMBERS TO 6"OF METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE EXISTING 4" PVC SEWER PIPE 36"MAX. , 9"MIN. FINISHED GRADE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. SEWER PIPE f �, EXISTING 4°' 9"MIN. 52.40 36"MAX. BREAKOUT EL = 52.90� 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD � " 3" DROP MAX SEWER PIPE OF HEALTH AND THE DESIGN ENGINEER. 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL 6 3 2" DROP MIN 3 9 BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. - PROVIDE WATERTIGHT o 0 0 0 *55.2'± " e 4" PVC IN FROM JOINTS (TYP.) O O 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 14 i "JAI•. � SEPTIC TANK 4" PVC OUT TO p °° c� o ELEVATION = 52.90' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS (MEASURED) (APPROXIMATED) O LEACHING FACILITY po o o o A 40 MIL GEOMEMBRANE LINER IS PLACED AT LEAST FIVE FEET FROM S.A.S.AND THE TOP 0 0 o OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR CONTRACTOR SHALL 12" 2' o ° SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE 54•00, MIN. 5j3•83' °° o o� 5. SLOPE ALL SOLID PIPE AT 1.0 /o MINIMUM. AND CONDITION OF EXISTING TEES 00 EL FILTER 0 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. EXISTING SEPTIC AND REPLACE AS MODEL#A1801-4x22 6" CRUSHED STONE oo °° _ oo 0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO TANK NECESSARY OVER MECHANICALLY 4 0• I 4 0' BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR COMPACTED BASE 8.5' (TYP. FOR 1) {- 3.55' 3.55' INSPECTION. SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING 5 I 4'9r APPROVAL FROM BOARD OF HEALTH AND DESIGN ENGINEER. OUTLET DISTRIBUTION BOX 25.0' (-�P ) TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.- 33.0� * 12.0' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L DATUM OF 57.9' EXISTING 1000 GALLON CONCRETE SEPTIC TANK BASE. FIRST TWO FEET OF OUTLET zrj0.40 ESTABLISHED ON A NAIL SET IN A TREE AS SHOWN ON PLAN. PIPES TO BE LAID LEVEL. 2 - 500 GAL. CHAMBERS 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION CROSS SECTION VIEW 5' MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE "CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR SEPTIC TANK PROFILE TYPICAL CHAMBER PROFILE CHAMBER END VIEW AT1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISTRIBUTION BOX DETAIL H-20 CHAMBER DETAILS DISCREPANCIES TO THE DESIGN ENGINEER. TO ANY WORK& NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE AS SHOWN ON GROUNDWATER CONTOUR MAP PROVIDED ON TOWN OF BARNSTABLE WEBSITE 10• ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE --` ----`-- - --��------ STRUCTURES SHALL BE MADE WATERTIGHT. NOTE: . • TEST PIT DATA 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR 1.) MAGNETIC MARKING TAPE SHALL BE „' . ` • + " �� PERC. NO.: 11859 ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH PLACED ALONG THE TOP EDGE OF EACH 11Z. DETERMINATION FROM APPROPRIATE AUTHORITY. SEPTIC SYSTEM COMPONENT. ` • i ,! INSPECTOR: David Stanton rep • � • • ���' 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS \ k6 * i ♦ • , SOIL EVALUATOR: Michael Pimentel, E.I.T. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE 1� .� +#• ;• '+ • w•�� � ' DATE: July 19, 2007 THEY SHALL WITHSTAND H-20 LOADING. TEST PIT#: 1 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND i1 �r +*• s .�` •* ELEV TOP= 56.77' FINES. t 14 �� « •»• +�; * w 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND t • ELEV WATER= <46.27' UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF f !• *"' • LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN PERC RATE _ <2 MIN/IN COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN ' ,� + ACCORDANCE WITH 310 CMR 15.255(3). MAP 170 r S ,• DEPTH OF PERC = 52"-70" 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PARCEL 103 j r r 1 • " r�� . TEXTURAL CLASS: 1 SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. an �1\ + 16. PROPOSED PROJECT IS LOCATED WITHIN: PROPOSED 2-500 GALLON j� , i 46 0" 56.77' ASSESSORS MAP 170 PARCEL 105 o H-20 LEACHING CHAMBERS \\, w OWNER OF RECORD: ALBERT V. & EDNA T. SCALINGI PROPOSED VENT, EXACT LOCATION :- = -�-- Fill ADDRESS: 51 ZENO CROCKER ROAD � TO BE DETERMINED BY OWNER � 4 CENTERVILLE, MA 02632 r` l • • FEMA FLOOD ZONE C �CO' 62"�6' �'"• r 1 4 5 + w AS SHOWN ON COMMUNITY PANEL# 250001 0005 C PROPOSED DISTRIBUTION BOX MAP 170 3' • 52" 52.44' EXISTIN._: :_._:;GHING PIT TO "_ -: - 23" •• • Perc - 17. PLAN REFERENCE: BE PUMPED FILLED WITH - PARCEL 101 �j� i _ 1. PLAN BOOK 386, PAGE 92 = o - I 70" 50.94' CLEAN, COARSE SAND 23 • ,� * 18. DEED REFERENCE: Tq 2 MAP 170T + ' • Coarse Sand 1. BOOK 4783, PAGE 275 59.80 C-1 2.5Y 6/6 Benchmark PARCEL 105 ; �` ` w ' 19_ ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. �j . f! (10-20% Gravel) Nail set in Tree TP/� 15,548 S.F. ± L '' "' ; y Elev. =57.9' q \��✓ ! _ • • s (( 20. PROPERTY LINE INFORMATION IS APPROXIMATE, ONLY. THIS PLAN IS TO BE USED ONLY 56.77 ``' o s. '. * : : N tSI1 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY Approx. M.S.L. a • • w 102" 48.27' GARAGE / / x 'a ' HatC Medium Sand FOR USES OF THIS PLAN OTHER THAN I ITS INTENDED PURPOSE. _ J / C-2 25Y 6/6 (Loose) 21. A 4" PERFORATED SCH. 40, PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION, TO A 1 r / 126" 46.27' DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A EXISTING 1000 GALLON SEN l+ DECK / DRIVE / LOCUS PLAN REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. TANK TO BE UTILIZED AS PART = ( #51 OF THIS DESIGN \ EXISTING / _ No Standing, Weeping,or 22. IN ACCORDANCE WITH 310 CMR 15.401 - 15.405, THE FOLLOWING LOCAL UPGRADE 3-BEDROOM / / // / SCALE: 1„- 1000 Mottling Observed APPROVAL IS REQUESTED FROM 310 CMR 15.221(7): DWELLING TOF = 58.5'± / / TEST PIT DATA (1 > A 0.8'VARIANCE (3.0-3.8') FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY. SWING TIES MAP 170 N ` AoR 1� O PARCEL 104 oorn f/� \� \ \ Cy / // / � OQ- DESIGN DATA INSPECTOR: David Stanton LEGEND DESCRIPTION DC GC �N / �/ / / ! �,` � E SOIL EVALUATOR. Michael Pimentel, E.I.T. SEPTIC COVER IN (1) 9.7' 33.7' h� // o� �?� � J�� DATE: July 19, 2007 _ _ _ _ ^b /� 1�, 100 EXISTING CONTOURS � �O I TEST PIT#: 2 SEPTIC COVER OUT(2) 7.1' 30.1' _ _ - '�� h`O /� Q� V NUMBER OF BEDROOMS 3 I 102 PROPOSED CONTOURS y y �/� 0 Q<v DESIGN FLOW 110 GAUDAY/BEDROOM ELEV TOP= 56.80' LEACHING CORNER(3) 35.5' 34.7' { �tr �� ��w\ wv h� /C- V� TOTAL DESIGN FLOW 330 GAUDAY ! ELEV WATER= <46.27' 102 PROPOSED SPOT GRADE LEACHING CORNER(4) 25.8' 10.1' \ � // w /�� 20 DESIGN FLOW X 200 % = 660 GAUDAY PERC RATE_ -X-X-X-X-X- / / EXISTING FENCE LINE LEACHING CORNER(5) 37.8' 18.3' `�� `" 'C/ S, /� USE EXISTING 1000-GALLON SEPTIC TANK DEPTH OF PERC= LEACHING CORNER(6) 45.0' 37.9' 7 10 \ G9S� \� /) E/T/C EXISTING UNDERGROUND UTILITIES 7�6 28"F / TEXTURAL CLASS: 1 GAS EXISTING GAS LINE DISTRIBUTION BOX(7) 25.9' 17.9' \ c INSTALL 2 - 500 GALLON CHAMBERS o" 56.80' W W--- EXISTING WATER LINE MAP 170 \ l %�.k �� PARCEL 152 i ( \ i SIDEWALL CAPACITY TEST PIT LOCATION (6) CABLE BOX \, �`� Fill O O EXISTING 1000 GALLON SEPTIC TANK ELECTRIC HANDHOLD r TELEPHONE BOX (LENGTH +WIDTH)(2)(2'HIGH) (0.74 GPD/S.F.) = GAUDAY (25.0'+12.0') (2)(2') (0.74 GPD/S.F.)= 109.5 GAUDAY PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE O - - (5) / O~' 52" 52.47' 0 PROPOSED DISTRIBUTION BOX (3) =_- _ / BOTTOM CAPACITY = i 0 PROPOSED 500 GALLON H-20 LEACHING CHAMBER (7) (4) / ( LENGTH x WIDTH ) (.74 GPD/S.F.) = GAUDAY GC (25.0'x 12.0' 74 GPD/S.F. = 222.0 GAUDAY ) (• ) Coarse Sand D REV. DATE BY APP . DESCRIPTION C-1 2.5Y ' PROPOSED SEPTIC SYSTEM UPGRADE (2) GARAGE TOTALS: (10-20% Gravel) PREPARED FOR: �.� 102" 48.30' ALBERT V. SCALINGI D �a TOTAL NUMBER OF CHAMBERS: 2 C-2 Medium Sand 2.5Y 6/6 LOCATED AT (1) #51 TOTAL LEACHING AREA: 448.0 SQ.FT. 126" (Loose) 46.30' EXISTING TOTAL LEACHING CAPACITY: 331.5 GAL./DAY 51 ZENO CROCKER ROAD 3-BEDROOM DWELLING No Standing, Weeping, or CENTERVILLE, MA 02632 TOF = 58.5'± I Mottling Observed RESERVED FOR BOARD OF HEALTH USE SCALE: 1 INCH = 20 FT. DATE: AUGUST 16, 2007 0 10 20 40 80 FEET VA Jor!N L. G a PREPARED BY: "uF Cr"`� JR. JC ENGINEERING, INC. G`W 2854 CRANBERRY HIGHWAY No 4 .+:;` EAST WAREHAM, MA 02538 SITE PLAN- 508.273.0377 SCALE: 1" =20' Drawn By: BSM Designed By:BSM Checked By: JLC JOB No.1245