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HomeMy WebLinkAbout0034 ARROWHEAD DRIVE - Health 34 ARROWHEAD DR., MY.-ANNgS A= o s o TOWN OF BARNSTABLE LOCATION ,qq ArrowkemA. -or':or— SEWAGE# 2016 - 393 VILLAGE J4!Wa n rn i$ ASSESSOR'S MAP&PARCEL 1-11 /Z l INSTALLER'S NAME&PHONE NO. „Sa$• 971- OG 53 B'r'. 3 SXCAV SEPTIC TANK CAPACITY J5O0. 9o. LEACHING FACILITY:(type)Trc nchc S (size) Z x 3 x 33 NO.OF BEDROOMS OWNER PnScai PERMIT DATE: /- y-/L COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the.Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Al - Z`7 3y AZ 33 10 . R&AR A3 51 Aq" "-75 1 3 No. �.0 �P - C Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: C/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Replication for his -ar *pstrm Constr ion 3permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) omplete System El Individual Components Location Address or Lot No. A '(OW eaI �'d /O ne jt''s e,,,Adddress,and Tel.No. L Assessor's Map/Parcel A d71 PQr6e 5 ( �1� n U �7 tin 177y) qa& — 1,6 73 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 7 74 C��13 CXGG aheon Cs09 477-a&5,3 -rlq heel gnu iro17mecfa.( 9414 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ,33 ® gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title i ( Size of Septic Tank Type of S.A.S.-2 T fk 1 Description of Soil Nature of Repairs or Alterations(Answer when applicable) N 1p 15W naj S 1 T 12,o (� hrapa 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 H Sig d Date 0-3 -Q, Application Approved by 1A Date 11— Application Disapproved by Date for the following reasons Permit No. 16 - 3°l 3 Date Issued {�.. tea•-.-zY <..:. --..... -^.-.. ...-._ ._-... / _ -..- _. _.., .... . .. - .. 9.4 L p // 4 1 Akk No. • 10 �W �� / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: G/ ""PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0(pprication for his sa' 6pstem constr ion Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot A I No..3 ��(�W eQO rldO ner's e,Address,and Tel.No. I Assessor's Map/Parcel a7!�P_o (L e � j 1 j & &5 t011 �•/77y) L7 0& ` /5 73 Installer's Name,Address,and Tel.No. De signer's Name,Add ess,and Tel.No. 7 7 4 6+9 eXU7V0J1U() (509) L177-o653 4heel �nur"ranmecla( 9q14 - Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures t s Design Flow(min.required) 33 D gpd Design flow provided 369 9 gpd Plan Date Number of sheets Revision Date Title F Size of Septic Tank /SOO Type of S.A.S. 2 �ni—c�, 73 Y 3 k .) Description of Soil i Nature of Repairs or Alterations(Answer when applicable) Cf N 1 D I SlaU t ►V 2,o d UO 2 �rPn l e 5U to 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 Certificate of Compliance has been issued by this Board H / Sign d p Date Application Approved by Date Application Disapproved by Date I for the following reasons Permit No. )o /l - 3 Date Issued h " YA --------------------------------------------------------------------------------------------------------------------------------------- �' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the n-site Sewage Disposal system Constructed( ) Repaired(✓) Upgraded( ) Abandoned( )by rro vU head �hri\j t" �Tra nn is at has been constructed in accordance with the 2j?YjsionsAf Title5 and the for Disposal System Construction Permit No. 20/6 �� dated ��' L/ — Installer 1 �LQ\1 C.(_,1 (QI I Designer 1' a�\ ro e t #bedrooms Approved design flow .3 3 gpd The issuanceof this /permit shall not be construed as a guarantee that the system will cti n, designed.� Date��,�/1 (r! Inspector 4(,✓ No. -----------------------------------------, ---` � --- Fee ----- THE COMMONWEALTH OF MASSACHUSETTS T PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal 16pstem Construction permit Permission is hereby granted to%construct( ) Repair( ) Upgrade( ) Abandon( ) System located at 3 /'\r`� i U n �. } 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:Constru 'on/mu t/be completed within three years of the date of this permit. Date 117 L( ( Approved by VW �� Town of Barnstable THE r°o Regulatory Services Richard V. Scali,Interim Director BAMSfABLE, MASS. �0� Public Health Division 39. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: J/ 3.-JL Sewage Permit# Zo)G - 3 93 Assessor's Map\Parcel 271 Is I Designer: _Da_Qc. Installer: G iv a ExC.ayo�A i o,^ Address: P p, Gcm $) Address: 1g Tc.<aScrrw L.PJ Tac rrlo -l K!p or rOrcS�ola. G On £XCgxV0_J i o A was issued a permit to install a (date) (installer) septic system at 3 y A rro LJ1,cv.d -Dr-- based on a design drawn by (address) .03,Uc. lo,�n c rlu dated (designer) 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 satisfactory. 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 in compliance with the terms of the AA approval letters(if applicable) cti 9�S?�� DDDno D. (Installer's Sign e) FLAHERTY. JR. N No. 1211 �aTea (Designer's gignature (Affix WRmp Here) PLEASE.RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS ; t BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. a f THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc • s Town of Barnstable P# Department of Regulatory Services 1 .,M 1 Public Health Division Date 200 Main Street,Hyannis MA 02601 • AlEb � ;t „t. W -- Date Scheduled Time U 011 Fee Pd._ • a Soil Suitabiky Assessment for Sew ge Disposal N Performed•By: l'✓, ! Wltnessed By: " J� (nn n LOCATION&.GENERAL INFORMATION Location Address ?� / . Owner's Name l4_NN 3 Address y. N rv� Assessor's Map/Parcel:`z l j/s� Bnginocr's Na NEW CONSTRUCTION RBPAIIt Telephone fk —I r y /Zo Land Use- ;Slopes(96): O Surface Stones Distances from.; Open Water Body ( V y g possible Wet Area�ft Drinking Water Well _(�t Dralhago Way 4 ft Property Line �ft Other ft SIOTCH:(Street name,dimensions of lot,exact locations of test halos&pdro tests,locate wetlands I'n proximlty to holes) Parent material(geologic) ( Depth to 9edrook Depth to Oroundwater. Standing Water In Hohn VIA- Weeping*0111 Pit Pnoa Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL•HIGH WATER TABLE Method Used: ' Depth Observed standing in obs,hole: In. Dbpdi to soil mottles: In.- Dolith to weeping from aide of obs.hole: ln, Groundwater Adjustment tt. Index Walhf? RendingDato: Index Well level AcU,ihctor, r 'AcQ,Clrnundwater•Levol,,_ PERCOLATION TEST Mute U// "me la, Observation Hole# Time at oil 1 Depth of Pero 71 Time At 6" Start Pro soak Time @ lU.U� Time(9"4") .. End Pro-soak Rate Mln./Inch , L Site Suitability Assessment; Sito Passed Site Failed: Additional Testing Needed(YIN) _ Original; Public Health Dlvlsion' Observation Hole Data To Be Completed on Back--- - ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1)week prior to beginning. Q:\SEPrICU'BRCFORM.DOC t DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Shcl Color Soil• Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. e - �S Z N f r S- ; .C� DEEP OBSERVATION HOLE LOG Hole# �L Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(In.) (USDA) (Munsell) Mottling (Structureestones,Boulders. r3z J w t i DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.. DEEP OBSERVATION HOLE LOG Hole# Depth from Sol[Horizon Soil Texture Soil Color soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Scopes;Boulders, Flood Insurance hate Map: Above 500 year flood boundary No& Yes Within 500 year boundary No= Yes .;Within lo0 year flood boundary No,,X. Yes depth of Naturally'Occurring Pervious Material J: Does at least four feet of naturally occurring pervlous material exist in all'greas observed thrpughout the area proposed for the soil absorption syatem? If not,what is the depth of naturally occurring p rvious material? Certi^_fiication / + I certify that on !� �� UZ—(date)I havepassed the soil evaluator examination approved by the Department of Enviro me tal Protection and that the above analysis was perforined by me consistent with . the retjuired trainin ortise an erl a de lbed In 10 C1vIIt 15.017. Signature Date v" Z Q:WBPTIC\PBRCFORM.DOC (2 C0NL110\'�i ALTH OF MASSACHLSETTS F ug EXECL-ME OFFICE OF DYMON-1SEXTAL AFFAM, _ 'DEPARTMENT OF EN R0NMI NTAL PROTECTlOT 0XZ R2\TER STRE-7.BOSTO\MA 0210� 16I',242S�1a, i TRILMY COL Secretan- ARGEO PALL CELLUM DA11M B STP:'HS Gm-ergo- CosaMss:onr- SUBSURFACE SEWAGE DISPOSAL SYSTEIIII NSpECT10111 FORM PART'A CERTI1FICATION PropeilyAddress: 34 Arrowhead Dr. , HyannisNemaofOnrnar Anderson Address of Owrtar Date of lrsspwtion:n Name of Inspector:(Please Pri U WM. E. Robinson Sr. 1 am a DEP approred s inspaemr to Sacbon 16-W of Two 5 p10 CMR 15.000) comparwNante: & • E . Robinson Septic Service MaIngAddress: PO Box 0 9. Pntervi l l p M,A Telephi ne Number: 7 K—R 7:2 6 CERTIFICATION STATEMENT 1 certify that 1 have personally inspected the sewage disposal system at this address and that the information reported below is true. accurate and complete as of the time of inspection. The inspection was performed based on my trairing and-experience in the proper function and maintenance of on-site sew ge disposal systems. The system: asses Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: r Y Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority IBoard.of Health or DEP)within thirty (30)days of completing this inspection. If the system is a shared system or has a design flow of 10.000 gpd or greater.the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer. if applicable. and the approving authority. NOTES AND COMMENTS �^ <1 Pape 1 or 11 w SUBSURFACE SEWAGE Of5►OSAL SYSTVA■IISPEC HM FORM PART A CERTIFICATION fcondnueW Naparty Add►ess:34 Ari rowhead Dr. , Hyannis Jurner: Anderson Date of Yxspaction: /;1--,7-a-0-.w WSPEC'TION SUMMARY: Check B, C, or a A. PASSES: 77 1 have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. S STEM CONDITIONALLY PASSES: One or more system components as described in the"Conditional Pass"&action need to be replaced or repaired. The system.upon ompletion of the replacement or rapair,as approved by the Board of health,will pass. Indicate ye .no, or not determined(Y.N.or NO). Describe basis of determination in all atstanees. If'not determined'.explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance lactached)indicating that the tank was installed within twenty 120)years prior to the date of the inspection: or the septic tank, whether or not metal,is cracked,structurally unsound. shows substantial infiltration yr exfihration. or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipelsl or due to a broken,settled or uneven distribution box. The system will pass inspection if With approval of the Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is levelled or.replaced The system required pumping more than four times a year due to broken or obstructed pipels). The system will pass inspection if Iwith approval of the Board of hashh): - broken pipelsl are replaced obstruction is removed S;2/5C Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Icantirwed) PropertyAddress: 34 Arrowhead Dr. , Hyannis Owner: Anderson Data of Inspection: C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine it the system is failing to protect the public health, safety and the environment. 11 YSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CUR 15.303(1)(b)THAT THE SYSTEM NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a sell marsh. 2) S STEM WILL FAIL UNLESS THE BOARD OF HEALTH IAND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS NCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3 THER j - - �; PaRt•)or11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Icon6mm4 Prop"Add►en:34 Arrowhead Dr. , Hyannis Owner: Anderson Date of Inspection: D. SYSTEM FAILS: You mu t indicate either "Yes" or "No" to each of the following: 1 have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this etermination is identified below. The Board of health should be contacted to determine what will be necessary to correct the fauure Yes o Backup of sewage into facility or system component due,to an overloaded or--logged SAS or cesspool. Discharge or pondmg of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is less than 112 day flow. 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less-then 100 feet:but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E. L�1R E SYSTEM FAILS: You must ndicate either "Yes' or "No' to each of the following: e following criteria apply to large systems in addition to the criteria above: T e system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public he Ith and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking wate•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 11 of a public water supply well) The own e or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412). Please consult the local regional office of he Department for further information. PaRr 4 or 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:34 Arrowhead Dr. , Hyannis OwnwAnderson Dace of Inspection: Check if the following have been done: You must indicate either -Yes- or 'No as to each of the following: Yes No Pumping information was provided by the owner,occupant. or Board of Health. None of the system components have been pumped for at least two weeks andthe system has been-fee eiving rowmal flow rates during that period._Large volumes of.wate►have not been introduced into the system recently or as part of this / inspection. L _ As built plans have been obtained and examined. Note if they are not available with N;A. _-0 _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non sanitary or industrial waste flow. _ The site was inspected for signs of breakout. All system components. excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions,depth of liquid. depth of sludge. depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: Existing information. For example. Plan at B.O.N. Determined in the field(if any of the failure criteria related to Part C is at issue.approximation of distance is unacceptable) 115.302(3)(b)) _ The facility owner land occupants,if differe Subsurface Disposal Systems. nt from owner) were provided with information on the propermaintanaoea-cf ' I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION kop"Address: 34 Arrowhead Dr, , Hyannis Owner: Anderson Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow:3G 0 g.p.d.fbedroom. Number of bedrooms(design): 3 Number of bedrooms lectusp: Total DESIGN flow 3 G 0 Number of current residents:Q Garbage grinder Iyes or no):A-O Laundry Iseparate system) lyes or no)A,0; If yes,separate inspection required Laundry system inspected (yes or not Seasonal use (yes or no):A O Water meter readings. if available (last two year's usage(gpol: 1 C 29—?!11fln r gal - Sump Pump lyes or no;:,&--d 1 99$-1 999 19, 500 gal. Lest date of occupancy: Ri1it COtI MERCIALANDUSTRIA�L:� Type f establishment: Design flow: opd ( Based on 15.2031 Basis o design flov, Grease rep present: (yes or no)— Industri I Weste Holding Tank present: (yes or no)_ Non•sa tary waste discharged to the Title 5 system: Iyes or no) Water eter readings. if available. Last da a of occupancy: OTH : (Describe! Last d to of occupancy: GENERAL INFORMATION PUMPING RECORDS and so ree of information: System pumpird as part of inspection: Ives or no)- If yes. volume pumped: Aem6p gallons Reason for pumping G<, 1=e TYPE OF SYSTEM Septic tank%distribution box/soil absorption system verflgle cesspool Overflow cesspool Privy Shared system Ives or no) (if yes, attach previous inspection records.if any) VA Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components. date installed lif known) and source of information: 3,6 �,�• Sewage odors detected when arriving at the site: (yes or no) 04, C) SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTM FORM PART C SYSTEM NFORMATION 1confi ued) 'ropertyAddress:34 Arrowhead Dr. , Hyannis Owner: Anderson Date of hupeebon: aU ING SEWER: j Moc to on site plan) Depth elow grade:_ Materi I of construction:_cast iron_40 PVC other(explain) Distant from private water supply well or suction line Diamet Comme is: (condition of joints. venting, evidence of leakage.-etc.) SEPTIC ANK:_ (locate n site plan) i Depth elow grade:_ Mate 'al of construction:_concrete_metal_Fiberglass _Polyethylene_otherlexplain) If tank metal,list age_ Is age confirmed by Certificate of Compliance_(Yes/No) Dimensi ns: Sludge d pth: Distance rom top of sludge to bottom of outlet tee or baffle: Scum thi knees: Distance rom top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Mow di ensions were determined: i �omme is: Irecom endation for pumping, condition of inlet and outlet tees or baffles. depth of liquid level in relation to outlet invert.'structu►el integrity. eviden of leakage. etc.) GREASE P: floc on site plan) Depth beic w grade: Material o construction:_concrete_metal_Fiberglass _Polyethylene_otherlexplain) Dimension;: Scum INc ness. nce t om Dista top of scum to top of outlet tee or baffle: Distance f om bottom of scum to bottom of outlet tee or baffle: Date of le t pumping: Commen irecomme dation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert. structural integrity, evidence o leakage. etc.) cs SUBSURFACE SEWAGE DISPOSAL SYSTB4 INSPECTION FORM PART C SYSTEM INFORMATION Ieondrarad) 'rop"Address: 34 Arrowhead Dr. , Hyannis owner: Anderson Date of Inspection: /;L -7- TIG OR HOLDING TANK: (Tank must be pumped prior to. or at time of. inspection) , (locate n site plan) Depth b ow grade:_ Material f construction:_concrete_metal_Fiberglass_Polyethylene otherle:plain) Dimension : Capacity: gallons Design flow gallons day Alarm p►ese ; Alarm level: Alarm in working order: Yes_ No_ Date of pre Pus pumping: Comments: (condition o inlet tee, condition-of alarm and float switches, etc.) DISTRIBUTI N BOX:_ (locate on si a pran; Depth of liqui level above outlet invert: Comments: (note if level a d distribution is equal. evidence of solids carryover, evidence of leakage into or out of box. etc.) i PUMP CHAM ER:_ llocate on sit plan! Pumps in w ►king order: (Yes or No) Alarms in orking order (Yes or No) Commen Inote con itron of pump chamber. condition of pumps and appurtenances. etc.) 42 rev C I ` ' ` Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM NSPECTION FORM PART C SYSTEM WFORMATION leonmuid) loperty Address: 3 4 Arrowhead Dr. , Hyannis 01: Anderson Date of bupeebon:.)�L_7_Q_ E,� SOIL ABSORPTION SYSTEM(SAS):_ (locate on site plan, if possible:excavation not required.location may be approximated by non-intrusive methods( If not located, explain: Type, leaching pits, number:_ leaching chambers,number:_ leaching galleries, number:_ leaching trenches. number. length: leaching fields. number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil. signs of hydraulic failure. level of ponding, damp soil, condition of vegetation, etc.) CESSPOOLS:_ (locate on site plan) Number and configuration. — g Depth-top of liquid to inlet invert: Depth of-solids layer: 01--,? " depth of scum layer: - r' Dimensions of cesspool. LX Materials of construction. 6 )p C,)C 3 Indication of groundwater. Ja, r, inflov. (cesspool must be pumped as part of inspection; S�tr�3 Comments (note condition of soil, signs of hydra Iic failure, level of ponding, condition of vegetation, etc.) l3 do ,�' G . ,v 60 s r 01 Litee c dition of soil, sign70f hydraulic failure. level of ponding• condition of vegetation, etc.) Pap(9 of 11 SUB SURFACE SEWAGE DISPOSAL SYSTEM WSPECTWN FORM PART C SYSTEM WFORMATION leont9awd) '6ropatyAddress: 34 Arrowhead Dr. , Hyannis Jwnef: Anderson Date of Inspemon: 2_7—o—C_ti -- SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) V" �fcl� LL' I / C 7 PaQc 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM MSPECTION FORM PART C ; SYSTEM WFORMATION lees MOM ►opmtrAdd►m: 34 Arrowhead Dr. , Hyannis Omer: Anderson Date of Inspeedon: /,Z—rf—o L—*� NRCS Report name Soil Type.,- Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate OAP SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater �Zc)Feet Please indicate all the methods used to determine High Groundwater Elevation: -Obtained from Design Plans on record Observed Site(Abutting property.observation hole.basement sump etc.) Determined from local conditions :1//Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators. installers Used USGS Data Describe how you established the High Grounowater Elevation. (Must be completed) r 9;�2 /9E pare 11of11 COVERS TO BE WATERTIGHT AND SEPTIC SYSTEM'-PROFILE Flaherty Environmental Services TOP OF FOUNDATION BROUGHT TO WITHIN 6" OF FINAL GRADE EL. 100.0' EL. 98.0' (not(not t--�le1 INSP. PORT W I 3" OF GRADE � P.O. BOX 81 2" PEASTONE OR r EL.98.0'f CLEAN SAND Yarmouth Port, MA 02675 4" CAST IRON or EQUIVALENT GEOTEXTILE 774.994. 1166 MIN. PITCH 1 4" PER FOOT FILTER FABRIC VENT (IF REQUIRED) 4"SCHEDULE 40 PVC PIPE �� 4 SCHEDULE 40 PVC PIPE '• • ' ' ' '• •'• • '••• •' •• '• ' • ' FLOW LINE (rirst 2'to be level) ::f • ' ri 0' 6.8% EL. 95.1' -► . L.98.5' - 14^ —� 2' { EL.96.5' EL, 96.25' —DEL.94.03'. 9�= EL.92.0' 'f EL.94.2' GAS BAFFLE EL.94.0' SOIL,ABSORPTION SYSTEM CLEAN, DOUBLE- GAS 2.5%MIN. WASHED 3" 10-1-3" STONE ' 6"CRUSHED STONE OR, (2) TRENCHES 3r L W X 33 X 2 D USING 5.0' ° ' MECHANICALLY COMPACTED PERFORATED PIPE AND SURROUNDED Him BYDOUBLE-WASHED 3" TO 1 Z" STONE EL. 87.0, (DATUM: ASSUMED) 1500 GALLON SEPTIC TANK (PROPOSED) BOTTOM OF TEST HOLE EL. 87.0' / USGS ADJUSTMENT: N/A LOCATIONMAP GROUNDWATER ELEV: N/A • • �� l N TmH m 111,60, 10 R4 26LO CUS 3 J CUS 32.. 10' Nrs ® Y OWN OF7q' TH-1 TH-2 AVToro 10, o O ^ o: 21 EXISTING O FGISTER / 3 BR r ✓Y IV-TA DWELLING PROP, 1500 G.S.T. U DATE:111212016 REVISED: LOT 4 A _. 0,31 ACRES± © SITE AND SEWAGE PLAN FOR B & B EXCAVATION INC./ MAP 271 L❑T 51 11'9.47 ROBERT F. PRESTON 34 ARROWHEAD DRIVE SCALE : 1 —' 20 1 HYANNIS (BARNSTABLE), MA qg REF:PB 111 PG 29 PAGE 1 OF2 i k . .......................................................................................................................................................................................................................................................................................................................................................................... ............................................................................................................................................................................................................................................................................................................................................................................................................................ GENERAL NOTES DESIGN CAL CULA TIONS S YS TEM DETAIL Flaherty Environmental Services P. 0. Box 81 1. ALL PRECAST COMPONENTS TO BE H-1 0 Yarmouth Port, MA 02675 RATED. ALL COMPONENTS WITH ANY NUMBER OFACTUAL BEDROOMS 3 774.994.1166 ANTICIPATED VEHICULAR TRAFFIC TO BE 013S. PORT H-20 RATED. GARBAGE DISPOSAL UNIT NO 31 2. THE DESIGN OF THIS SYSTEM DOES NOT ------------- ALLOW FOR THE USE OFA GARBAGE TOTAL ESTIMATED FLOW GRINDER. (110GAUBRIDAYX3BR) 330 GAL./DAY 3. MUNICIPAL WATER IS AVAILABLE. REQUIRED SEPTIC TANK CAPACITY 660 GAL. 4. ALL CONSTRUCTION TO CONFORM WITH 310 CMR 15.000 AND ALL OTHER SIZE OF SEPTIC TANK 1500 GAL. (PROPOSED) APPLICABLE LOCAL, STATE AND FEDERAL CODES AND REGULATIONS. SOIL CLA SSIFICA TION 1 33' 5. INSTALLER/CONTRACTOR TO REVIEW& DESIGN PERCOLATION RATE <2 MIN./INCH VERIFY ALL ELEVATIONS AND DETAILS AND REPORT ANY DISCREPANCIES TO EFFLUENT LOADING RATE 0.74 GALADA YIFT2 DESIGNER PRIOR TO CONSTRUCTION OR ASSUME ALL RESPONSIBILITY, LEACHING AREA 6. INSTALLER/CONTRACTOR IS BOTTOM: (3'X33)X2= 198 FT2 9' MIN, OF SOIL RESPONSIBLE FOR MAINTAINING SAFE -- SIDES: 2' PEASTONE OR FILTER FABRIC) 288 FT2 WORK AREA, VERIFYING ALL UTILITIES [(2'X33)X2 (2'X3)X2]X2 TOTAL= 486 FT? AND NOTIFYING "DIG SAFE" (1-888-344-7233) 72 HOURS PRIOR TO X0.74= 359 GAUDA Y CONSTRUCTION. 7, ANY CHANGES TO OR DEVIATIONS FROM USE(2)TRENCHES OF PERFORATED PIPE SURROUNDED BY THIS PLAN MUST BE APPROVED IN TO I STONE,EACH TRENCH CONFIGURED AS 3/ - WRITING BY FLAHERTY ENVIRONMENTAL 3'WIDEX 33'LONG AND 2'DEEP SERVICES AND LOCAL BOARD OF HEALTH. RESERVE LEACHING CAPACITY NIA 8. FINISH COVER OVER COMPONENTS IS TRENCH END VIEW NOT TO EXCEED 3'PER 310 CMR 15.000 (NTS) UNLESS SHOWN PER PLAN. 9. ALL ABANDONED SEPTIC SYSTEM COMPONENTS TO BE PUMPED DRY AND FILLED WITH CLEAN SAND OR REMOVED SOIL EVAL UA TION AND REPLACED WITH CLEAN SAND. TESTHOLE#1 F*15189 TEST HOLE#2 P*15189 IAOFN 10.ALL COMPONENTS TO BE PROVIDED Evaluator.- David D.Ratio*Jr.,RS,REHS Evaluator- DavIdD.FlaheffyJr,RS,REHS DAVID WITH WATERTIGHT ACCESS PORTS SE#2755 SE#2755 BOH Witness: David Stanton,RS BOH Witness: David Stanton,RS D. Date: WITHIN 6"OF FINISH GRADE. Novemeber2,2016 Date: November2,2016 F E 11.ALL SEPTIC TANKS, DISTRIBUTION 0. BOXES AND PIPING TO BE INSTALLED TH-I ELEV.98.0' TH-1 ELEV.98.0' WA TER TIGHT. OISTE 12.NO KNOWN WETLANDS OR WELLS 0^ A LS 10 YR 312 0--6- A LS 10 YR 312 -9. WITHIN 100 FEET OF PROPOSED 9--25- B LS 10YR 516 6--24^ B LS I0YR516 Z, LEACHING. 13.THIS IS NOT A CERTIFIED PLOT PLAN AND UNDER NO CIRCUMSTANCES IS THIS PLAN TO BE USED FOR ZONING OR 25"-132" C MS 2.5Y614 24--120-1 C MS 2.5Y614 perc BUILDING PURPOSES. certify that on November 12,2002,I have passed SITE AND SEWAGE PLAN FOR 14.LOT IS SHOWN AS ASSESSOR'S MAP 271 the examination approved by the Department of B & B EXCA VA TION INC./ PARCEL 51 . Environmental Protection and that the above analysis ROBERT F. PRESTON 15. LOCUS PROPERTY'S PROPOSED SYSTEM has been performed by me consistent with the APPEARS TO BE WITHIN AN AQUIFER G.W.ELEV.NIA G.W.ELEV.NIA required training,expertise,and experience described 34 ARROWHEAD DRIVE PROTECTION DISTRICT(ZONE 11). in 3 10 CMR 15.018(2). HYANNZS (BARNSTABLE), MA BOTTOM TH-IELEV. 87.0'' 1 BOTTOM TH-2 ELEV. 88.0'' PAGE 20F2 .................................................................................................................................................................................................................................................... ............ ............................................................................................................................................................. ........................ ...................................................................................................................................................................... ..................................................................................... .................... ..........