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Home My WebLink About0145 BETH LANE - Health _ 145 Beth Lane Hyannis A = 272 = 166 h a TOWN OF BARNSTABLE LOCATION 145 eC-?l-( LAME SEWAGE# a®1 (p a 331 VILLAGE HYANNJ'�5 ASSESSOR'S MAP,&rrPARCEL A-Ia JIG( INSTALLER'S NAME&PHONE NO.CALPIFL CbE 1.��JTiMPAIS—C� LL C SEPTIC TANK CAPACITY r d Cif g L L6 iJ LEACHING FACILITY-(type Sc qt 4c, 0WICbGRS(size) 3(i��?� `0,% NO.OF BEDROOMS OWNER GAP- „ MA RROz J PERMIT DATE: R-..? - a2®((p COMPLIANCE DATE: Separation Distance Between the: ` Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility (V(i4 Feet Private Water Supply Well and Leaching Facility(If any wells exist on `�` site or within 200 feet of leaching facility) �4 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _ A J A Feet FURNISHEDBY 0APr-WIDC- E112 L wojs c� c7v c co r- v cm -G S S f� t3y i 77-1 No.' 01 KJ— T t Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓� - . PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplitation for MispoBaf 6pstem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System L24dividual Components Location Address or Lot No. 145 86!t'� 6V If YAIVN IS Owwn�e�r's amee,,Ad re and Tel No Assessor's Map/Parcel 7 A//61( 13 a FfI.�MM�6c�4�b L� /LUR7tf a4T7'es�c3 Installer's Name,Address,and Tel No. S d5� -Lf-)7-82'7'7 Designer's Name,Address,and Tel.No. 509-X7 3-0-377 Type of Building: Dwelling No.of Bedrooms Lot Size +sq.ft. Garbage Grinder( ) Other Type of Building of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided -3`7.7,7 gpd Plan Date 9 "'a() — a()t�? Number of sheets ( Revision Date Title ( 5 L56714 LA x-145 14Yo4t jAj/9 Size of Septic Tank (,O cn CAL y k, Type of S.A.S.(3M 5od Description of Soil 6ti1 FW 97 54&a 4"1? Nature of Repairs or Alterations(Answer when applicable) 056 6X l SST t V(:�Z-- /,C2 pQ Q—XI—Low <�A W bar. to cn4 3 rE"5r D - 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 He lth. Signed Date Cl-9-7-aolfa ApplicationApproved`by "" '"" -- Date Application Disapproved by Date for the following reasons Permit No. Date Issued —� MbtN::r? 36 � f �`*.., y. xwfW y...k ..� r 4 R:,,— e 4;.F. ,� Fee.,..: THE COMMONWEALTH OFTMASSACHUSETTS Entered in computer: a ✓'` j PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppflcation for Misposar 6pstem Construction Permit Application for a Permit to Construct( ) Repair`(, ` Upgrade(~) Abandon( ) ❑Complete System Q'Individual Components „ ,tt Location Address or Lot No.,,/ $ 1Y 6V ff A ` 1-S Owner's Name,Address and Tel.No. 94RL. MAA,W/ Assessor's Map/Parcel %All.e.<-, ('{08" &Aj0(P1'tP W,/vOR17 y+++-rr4j6A4bP-0 Installer's Name,Address,and Tel.No.154)% -417 SS 7-7 Designer's Name,Address,and Tel.No. . 012-«t 7 3—03"77 Type of.Building: Dwelling '`No.of Bedrooms Lot Size Ir.,600+ sq.ft. Garbage Grinder Other T e of BuildinShowers( 1 ' YP g �ZE�L "l�•C�• No.of Persons ) Cafeteria Other Fixtures Design Flow(min.required) gpd Design flow provided -3 7'7,7 gpd Plan Date'' 9 -A0 (0 Number of sheets 't. .Revision Date Title E.q 5 13 1 LA05 t VANA! S Size of Septic Tank (,b 00 GA"e NJ Type of S.A.S.('M '©Q Gov-(-p&)l..&Cr 4(jL) ( ' • Description of Soil CIA 41/EL Nature of Repairs or Alterations(Answer when applicable) L)5 4 6x is "t"!;r l j oe-n G:4GLoxj -.5 t- "l c. t / c�cS cures Q .�-G-t �+C+C- et-z Sett 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 pa.oI�,/� m Application Approved by - - -- Date Application Disapproved by Date for the following reasons Permit No. Date Issued � 7 THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by CAPE(Q11)6 Ism C.1L1� at °^d° &C-mo 64Wi5" h-(Yn4 AAV f� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No7jOb M dated 12 371-e.0/6 Installer CAP6(V(D6 Glt 7Z:*.PAi, 5-,- 44(Z Designer C #bedrooms Approved deZgfurt1lioln ' flow 3 gpd The issuance of this ermit shall not be construed as a guarantee that the system w as desig td Date !f d� Inspector In ul ,> !� V --- <. -- -- -- - 7 7 7---------- _._-.----------------------------- No. Feet,(0001 . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Bisposal 6pstem Construction Vermit Permission is hereby granted to Construct( ) Repair(X) Upgrade( ) Abandon( ) System located at 1�4 j _AC- / Ajr- yJ 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. - -. `rr I Provided:Coristructioninust be completed within three years of the date of this permit/ Date ' 4,� Approved by ' - Town of Barnstable i Regulatory Services Richard V. Scali,Interim Director e t arasr�M.e MAS& ' Public Health Division019. - o Thomas McKean,Director 200 Main Street,Hyannis,MA,02601 Officc: 508-862-4644 Fax: 508-790-6304 i Installer& Designer Certification Form_ / Date: 10-1 - 1 6 Sewage Permit# a20lCp 33 Assessor's Map Parcel Designer: �G Ert�t�eeri� �✓IL_ Installer: Ca G-erEu «e Address: 2.813y Gronbe-r(_y lliglnu)Qy Address: 155 CoMMe-rClal ski+ ea.sA LucirJpa." , Hft e2-5ag K0- OZ(. y7 On �'1 - al- of 0 ( Coe e 4L E0�erect3 L was issued a permit to install a { (date) (installer) i septic system at y e.Akh /,an e- based on a do;ign drawn by (address) 7S C Cn.ginee-CLO ,'Tne. dated S 2,O, Zol to / (designer) - V/ 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 wit major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocat on 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 i ispected and the soils were found satisfactory. I certify that the system referenced above was constructed i iance with the terms of the IAA approval letters (if applicable) F s yG s d014N s� CHURCHI JR N j nstaller's a re) CML :tt A 0 (D ner's Signature (Affix De t p mere) E FL S ARN TABLE PUBLIC HEALTH D SI IC `€ OF COMPLIANCE W LL NO 1§$M 0T1b_LiQJX_-_fHI L FARM AND AS- BUILT CARD ARE RECEIVED BY IHE BARNSTABLE PUBLIC ALTH DIVISION. JHANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc 100/100 'd 68094 L960ELZ809 69: L1 9LOZ/1WOl®a is Town of Barnstable P 15 15 3 Department of Regulatory Services 1M.w61-AW4 Public Health Division Date MA93 �p ieJ9• 200 Main Street,Hyannis MA 02601 Date Scheduled [ p, �'a"' ` Time I Fee Pd. `� (�• 3 0� Soil Suital5zli Assessment for Sew e Dzsposal Performed•Bv: FTT CSEWitnessed ✓I-y 44-�, 2 �l LOCATION&.GENERAL Mi ORMATION Location Address 1 Owner's Name t q 5' 0lr7N �E. 14YAAJ S ARL t I Ailao w {{ c Address 13 A 4ot`j w,4%-L V.N.ATT. o BcA? Assessor's Map/Parcel` �� •l I�O CAPGWtD6 Engineer's Name 4't,€&)&(Nc�lXX—, NEW CONSTRUCTION REPAIR !` Telephone# jpg 77-R91- SO8-�73-03�) Land Use• /'�- � Slopes(�) v Surface Stones ' ALIA Distanceafrom: OpenWatcrBody � >)OOft possible WetAtea t0O ft DrinkingViatcrWell ft Drulhage Way 1,0 ft .Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of teat holes&pare tests,locate wetlands in proximity holes P tY to ) see �1 i • -. -. n--.4_.--�._. � _ -._..�..c �_ _m=- -Vie.. - -.-. -.+.�1y. _ _. .e- -. v - .� ..-.. .• - .._ _ _ I l C Parent material(geologic)��GOfAI ®�T WA � Depth to Bedrock >d JJ�_a, Vr v J ' Depth to Groundwater. Standing Water in Hot' >t 8%2! G Weeping from Pit Fncc Estimated Seasonal High Groundwater DETERAGNATION FOR SEASONAL-HIGH WATER TABLE Method Used: D i f e ct M�Q t'yex Can Depth Observed standing in obs,hole: > i°?' In. Depth to sell mottles. > j ! In.' DelIth to weeping from side of obs.hole: �': � �e�; in, Groundwater Adjustttlent 7A fk, Index Well-# Reading Date: Index Well lovoi- Adj4hotor, —. Adj.droundwater••Level.:_ PERCOLATION TEST Dille ; Time' Observation Hole# Timn at h" _ Depth of Pere + Time at 6" r f° Stitt Pro-soak Time @- Time(9"-6") Pp -c Test Co►,JL e C. D. SPOR End Pro-soak I Rate Min./Inch Site Sul lability Assessment Sito Passed > Sitc Failed: Additional Testing Needed(YIN) Original: Public Health Division. Observation Hole Data To Be Completed on Back--------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Consefvation Division at least one(I:) week prior to beginning. Q:1SEPTlC ERCFORM.DOC r DEEP.OBSERVATION HOLE LOG Hole# I +2 Depth from Soil Horizon Soil Texture „Shcl Color Sall• Other Surface(in.) (USDA) (iblunsell) Mottling (Stnucture,Staneg;Boulders. 181stency.V01ivoll d MC 6 (�Pn son DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. h DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(in.) (USDA) (Mundell) Mottling (Structure,Stones,Boulders, Consistency. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sall Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, t , Flood Insurance Rate Map: Above 500 year f lood boundary No_ Yes—Z Within 500 year boundary No Yes Within 100 year flood boundary No.z Depth of Naturally Occurring Pervious Materlal Does at least four feet of naturally occurring perv�o s material exist in ail areas observed thrpughout the area proposed for the soil absorption system? --- If not,what is the depth of naturally occurring pervious material? .�..�.. Certification I certify that on 10~2-7-9` (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 ex lence descrlbec.in;1 10 CMIZ 15.017. Signature 4 Date Q:1a"11PTiCVBACPORM.DOC 1 27 2016 22:39 Jim The Inspector Man 5085349919 page 1 'm Commonwealth of Massachusetts Title 5 Official Inspection Form `1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments IC C! 145 Beth Lane t-+ Property Address V Earl Marrow. Owner Owner's Name Information is -� required for every Hyannis _ MA 02601 7-25-15 wt page, City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any i way. Please see completeness checklist at the end of the form. Important:When A. General Information _ filling out forms �I�s� `\\��►ttutntpNf�ii�, on the computer, J/ OFMgS4� use only the tab �.� k� key to move your 1. In ��.��;• ,may% cursor,do not �c ,LAMES mom' use the return James D.SearS _ ^^ o key. Name of Inspector ^u; CT�fTS Capewide Enterprises, LLC -Company Name 153 Commercial Street �i,F s I N SP `�°N`\ ipq nno1�N Company Address Mashpee MA 02649 Cityrrown Slate Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: i ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 4�Le� 7-26-16 nSpector'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 should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. 9 t5ins.doc•rev.6116 -• Title 5 officiai inspection Form:Subsurface Sewage Disposal system•Page 1 of 17 hotp iKs Jul 27 2016 22:39 Jim The Inspector Man 5085349919 page 2 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form-Not for Voluntary Assessments `f 145 Beth Lane Property Address Earl Marrow Owner Owner's Name information Is required for every Hyannis MA 02601 7-25-16 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont:) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CM 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Failed system -pit. The system is'a 1000 Gal Tank D Box and pit , B) 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): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Jul 27 2016 22:39 Jim The Inspector Man 5085349919 page 3 Commonwealth of Massachusetts Title 5 Official Insp ection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow Owner Owner's Name information is H annis MA 02601 7-25.-16 required for every y State Zip Code Date of Inspection page. CitylTown B. Certification cost. ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND.(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ .The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND'(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in.order to determine if the system is'failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning In a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water o ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins doc-rev.6116 Title 5 Official hnspeclion Form:SLbsurface Sewage Disposal System•Page 3 of 17 Jul 27 2016 22:39 Jim The Inspector Man 5085349919 page 4 Commonwealth of Massachusetts G Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow _ Owner Owner's Name information is Hyannis MA 02601 7-25-16 required for every - Y page. CityTTown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system SAS and the SAS is within Y P P Y (SAS) 100 feet of a surface water supply or tributaryto 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. 3. Other: i D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or ® clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® 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 Y2 day flow /0/r t5ins.doc.rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Jul 27 2016 22:39 Jim The Inspector Man 5085349919 page 5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow Owner Owners Name Information is required for every Hyannis MA 02601 7-25-16 page. Cityrrown State Zip Code Date of Inspection B. Certification.(cont.) Yes No f , ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: El ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® . Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.. k ❑ ® 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.] 0 ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.30 , therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: 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 mt4st indicate either"yes",or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ Lithe system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc•rev.6116 Title 5 Offidal Iispectlon Form:Subsurfooe Sewage Disposal System-Page 5 of 17 r Jul 27 2016 22:40 Jim The Inspector Man 5085349919 page 6 Commonwealth of Massachusetts 10 Nam- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments P Y 145 Beth bane Property Address Earl Marrow Owner Owner's Name information is H annis MA 02601 7-25-16 required for every Y _ page. , Cityffown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No Z ❑ 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? M ❑ 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) Z ❑ 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. 0 . ® 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)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3- DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 l5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 r Jul 27 2016 22:40 Jim The Inspector Man 5085349919 page 7 S Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow Owner Owner's Name required fo is Hyannis MA 02601 7-25-16 required for every .; page. City/Town State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal. Tank D. Box and it. y p Number of current residents: . 2 Does residence have a garbage grinder? ❑ Yes No I.i Is laundry on a separate sewage system? (In'clude laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes 0 No 2014-10,900Gals Water meter readings, if available (last 2 years usage(gpd)): 2015-15,700Ga1's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq:ft., etc.): Grease trap present? ❑ Yes ❑ .No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter:readings, if available: t5ins.doc•rev.6116 Titles Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Jul 27 2016 22:40 Jim The Inspector Man 5085349919 page 8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 145 Beth Lane Property Address. Earl Marrow Owner Owner's Name information is required for every Hyannis MA 02601 7-25-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): . 2 General Information Pumping Records: Source of information: 2011 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no).(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the,DEP approval. ❑ Other(describe): t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i Jul 27 2016 22:40 Jim The Inspector Man 5085349919 page 9 Commonwealth of Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 145 Beth Lane Property Address Earl Marrow Owner Owner's Name information is required for every Hyannis MA 02601 7-25-16 page.. City[Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1980 80-162. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 14 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 & SCH -20. Septic Tank(locate on site plan): Depth below grade: 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: 1000 Gal. Precast H-10 Sludge depth: t5lns.doc•rev-5116 - Title 5 Official Inspection Form:Subsw face Sewage visposal'System-Page 9 of 17 Jul 27 2016 22:40 Jim The Inspector Man 5085349919 page 10 Commonwealth of Massachusetts _ r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow Owner Owner's Name information is required for every Hyannis MA 02601 7-25-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 2611 Scum thickness 2 Distance from top of scum to top of outlet tee or baffle 12" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Asbuilt-Tape- PlanSludge 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 covers at 3"below grade. Inlet tee, outlet Baffle. No sign of leakage. Tank should be pumped. °q �t Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from,top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Jul 27 2016 22:40 Jim The Inspector Man 5085349919 page 11 Commonwealth of Massachusetts t Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow Owner Owners Name information is required for every Hyannis MA 02601 7-25-16 page. City/Town State Zip Code Date of Inspection D. System Information cont. Y (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 1 i< Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions.- Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No `Alarm level.' Alarm in working order: ❑ Yes ❑ No 0 Date of last pumping: .. Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins_doc-rev.8116 - - Title 5 Official Inapectlon Form:Subsurface Sewage Disposal System-Page 11 of 17 Jul 27 2016 22:40 Jim The Inspector Man 508534§919 page 12 .g Commonwealth of Massachusetts W Title 5 Official Inspection Form 9 _ Subsurface Sewage Disposal System Form Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow owner Owner's Name information is required for every Hyannis MA 02601 7-25-16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is 16"x16"-10" below grade wlone line out. Wall's are bad. Need to replace D Box. Pump Chamber.(locate on site plan): Pumps in working order: ❑ Yes ❑ .No Alarms in working order ❑ Yes ❑ No' 4 Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): If,pumps or alarms are not in working order,•system is a conditional pass. • Soil Absorption System (SAS) (locate on site plan, excavation not required): R , If SAS not located, explain why: f t51ns.doc•rev.ell - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pogo 12 of 17 '2 Jul 27 2016 22:41 Jim The Inspector Man 5085349919 page 13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow Owner Owner's Name a information is required for eVM Hyannis MA 02601 7-25-16 page. City/Town State Zip Code Date of rnspeetion e D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: 4 ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: °g - t Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): t Leaching is a 1000 Gal. Precast pit w/2'stone. Pit and cover at 16" below grade. Pit is full. Level at 2" below inlet . Pit has been full over inlet and up to cover. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): a 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 4 t5ins.doc•rev.6116 - Title 5 OfrGal Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Jul 27 2016 22:41 Jim The Inspector Man 5085349919 page 14 Commonwealth of Massachusetts _ Title '5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1 19§ 145 Beth Lane Property Address k Earl Marrow - Owner Owner's Name information is required for every Hyannis MA 02601 7-25-16 page. City/Town State Zip Code Date of Inspection D. System Information (coat.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): :R Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): e s 9. l5ins.doc•rev.6l16 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Jul 27 2016 22:41 Jim The Inspector Man 5085349919 page 15 Commonwealth of Massachusetts w - W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow owner. Owner's Name information is required for every H annis MA 02601 7-25-16 y page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) . Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at 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 Gp/PA� FAR B � o t5ins.doc•rev.6116 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Jul 27 2016 22:41 Jim The Inspector Man 5085349919 page 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 145 Beth Lane Property Address Earl Marrow Owner Owner's Name information is required for every Y H annis MA 02601 7-25-16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) k Site Exam: ❑ Check Slope ❑ Surface water 6 ' ❑ Check cellar ❑ Shallow wells O Al - -r Estimated depth togigh ground water: 12 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; 10-18-79 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board.of Health -explain: ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: T.H.on Design plan 10-18-79 no G.W.at 12'. Bottom of pit at T-4" below grade. Bottom of pit at 4'-8"above T.H. Depth. n . Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.tloc•rev.6116 Title 5 Official Inspedion Form Subsurface Sewage Disposal sys:em•Page 16 of 17 Jul 27 2016 22:41 Jim The Inspector Man 5085349919 page 17 - Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments F: 145 Beth Lane Property Address Earl Marrow Owner Owner's Name information is a required for every Hyannis MA 02601 7-25-16 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System'Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file { • ; :1 • i t5ins:doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 IKEr Town of Barnstable i-,, Barnstable AW . �° Regulatory Services Department 'cap j lARNSrABM MASS.9 Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO r CERTIFIED MAIL# 7015 1730 0001 4989 0328 July 20, 2016 -Earl R. Marrow III 132 Homeward Lane North Attleboro, MA 02760 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 145 Beth Lane, Hyannis,MA was inspected on 07/08/2016. by David B. Mason, certified Title V Septic Inspectoi 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: • Leaching pit or cesspool with high liquid level,<12" below inlet (per Town Code 360-9.1). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification., Failure to repair/replace the septic system within the deadline period will result in future i enforcement action. a F THE BOA OF HEALTH n, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\145 Beth Lane Hyannis.doc Town- of Barnstable anxrrsr"L& Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA'02601 Office: 508-862-4644 Richard Scali,Director, FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 i 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 ONE (i)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 pit or cesspool with high liquid level, <12" below inlet(per Town Code N360-9.1) 4 o Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc �Ap(a Commonwealth of Massachusetts' W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 145 Beth Lane rC.. Property Address Earl Morrow III Owner Owner's Name information is required for every Hyannis V MA 02664 July 8, 2106 �. page. City/Town State Zip Code Date of Inspection t\7 N►: Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not David B. Mason use the return Name of Inspector key. David B. Mason „y Company Name 4 Glacier Path Company Address East Sandwich MA 02537 City/Town State Zip Code 508-367-1617 S1287 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority zXz;;;0t, July 14, 2016 � (Xu� Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 -� Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is required for every Hyannis MA 02664 J"l 8, 2106 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i - Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° 145 Beth Lane M Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 Jul 8, 2106 required for every y — y page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 Jul required for every _Y y 8, 2106 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic 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. 3. Other. D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 %day flow 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GSM 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Jul Hyannis MA 02664 required for every H_y _y 8, 2106 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: 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 D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 Jul required for every y y 8, 2106 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 — Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Beth Lane M Property Address Earl Morrow III Owner Owner's Name information is Jul Hyannis MA 02664 8, 2106 required for every y � page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 4+ Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d Yes 9 ( y 9 (gP ))� Detail: 2014; 80250 gallons and 2015;125,250 gallons Sump pump? ❑ Yes ® No Last date of occupancy: Unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ® No Industrial waste holding tank present? ❑ Yes ® No Non-sanitary waste discharged to the,Title 5 system? ❑ Yes ® No Water meter readings, if available: l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 _ Jul required for every Y y 8, 2106 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Board of Health Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Beth Lane _'M Property Address Earl Morrow III Owner Owner's Name information is Jul Hyannis MA 02664 required for every y �/ 8, 2106 page. Cityrrown State Zip Code Date of Inspection D. System Information (coat.) Approximate age of all components, date installed (if known) and source of information: 1987 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): -- Distance from private water supply well or suction line: 10+feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 3 inches 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: 1000 Typical Sludge depth: 8" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is H annis MA 02664 Jul 8, 2106 required for every Y _ y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 36" Scum thickness 5 Distance from top of scum to top of outlet tee or baffle 3" Distance from bottom of scum to bottom of outlet tee or baffle 16 How were dimensions determined? Scour Stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Effluent level with outlet invert. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle — Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: _ Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 Jul required for every _ Y y 8, 2106 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 Jul required for every H y y 8, 2106 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Not Applicable. 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.).- Distribution box does exist but did not inpsect based on condition of the leaching pit 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. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 Jul required for every Y y 8, 2106 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.).- 6 foot pit with 2' stone. effluent up to inlet pipe with staining above. leach pit is 16" below grade. An excessive amount of food grease was observed in the leaching pit. There is evidence that the effluent has been above the leaching pit cover. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 Jul required for every Y y 8, 2106 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of MassachlUseft W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is J Hyannis MA 02664 July required for every y _ y 8, 2106 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is Hyannis MA 02664 Jul required for every Y y 8, 2106 page. Cityrrown State Zip Code Date of Inspection D. System Information (coot.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 18 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: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Groundwater Contour Map ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater Contour Map Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of(Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Beth Lane Property Address Earl Morrow III Owner Owner's Name information is J Hyannis MA 02664 July required for every y _ y 8, 2106 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B; C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Assessing As-Built Cards Page 1 of 2 LOCATION SEWAGE PERMIT NO. !Y-,- 3-YA VILLAGE INSTALLER'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ,�c k /000 OA i '6epifc. SAL �sr i 1000 am http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=272166&seq=1 7/7/2016 N 6k 4,9 Ar 41 a Afe 15-Jce, Na Z I �o--— — - — ---- — eel 1p Tell a : - r _ - I w h v . c YOU WISH TO OPEN A► BUSINESS i For Your Information: Business certificates4[cost_ �IQ00 for 4 years). A business certificate OD\ILY REGISTERS _dU jNAME in�tovii lwhicK, you must do by M.G.L.-it does not give you permission-to operate.) Business Certificates arelavailable a�the Town CI rlc's Office; 'Y".FL., 367 Main Street, Hyannis, MA 02601 (Town,HaIQ,!' i 't '$' ar*"':r y x '. .+n•'W *P t ay-r 7'�ga�as ""Y v #�j '"t I f Y k f DATE'S/ 0%� s w Fill in'please5 �� 7 t;T, r. 'r•:v' a rn < '3 r+ .: ',; YOUR.NAME 4. n APPLICANTS ,A ; S:/ a i* X„s Izr �. ,�,,,�, Lr� �7ht BUSINESS ~f a - YOUR�HOMEADORESS: 1 sr.,cd F'Fri: dL e 3 x da .W Y a i y Lle' '- Iri��'TIYn S� �ljii d, TELEPHONE # - Home Telephone Number •' ar,k Mat ' t- ". ' ' NAME OF CORPORATION: ; - " = d SS o� /n! - - 3s Y NAME OF NEW BUSINESS d ) TYPE;OE,BLISINEST` - "011c)SGanii IS THIS A HOME OCCUPATIONS Y S / .NO ADDRESS OF BUSINESS S 2 L MAP/PARCEL NUMBER R, / (Assessing) When starting anew business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist,.you in obtaining he information you-may need You MUST ;GO TO 200,'Main St. -'Qcorner of Yarmouth Rd. & Main Street) to make sure you have the appropriate,permits and licenses required to legally operate your business in,this town. 1. BUILDING CO J� nZf6rrr, E UST COMPLY WITH HOME OCCUPATION This individ al any p it requirements that pertain to this type of busines$„'Signature* r MI MAY ► I.►1- III 'I AN. cam MENT - 1 2. BOARD OF ALTH This individual has b informed of ermit r uir ments that pertain to this type of business. Authorized Signature MUST COMY WITH ALL COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: Da►te:5- I N l/.f TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: M BUSINESS LOCATION: /y��La +Lfc,Qn n)s- INVENTORY MAILING ADDRESS: S ,4-6b-fie _ TOTAL AMOUNT- TELEPHONE NUMBER: y. 4 ka - o-s ti 6t CONTACT PERSON: C1 v 6A'R>r<3 0sa- EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: INFORMATION / RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section'31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink ` Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt&-roofing tar PCB's Paints, varnishes, stains, dyes _ - Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetracfilo`ride)- = ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes s- on Qa fir` h POVef Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids - (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signatu . Staff's Initials LpCATIOa SEWAGE PE MIT G0. HIf LAG E IgSTA IIER'S NAME ADDRESS 0 U I L D E R OR OVC3 ER wZMA-f- t 1 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Z1,3 O 4X ,0 No... . .............. Fims.�. .. ................ f THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH - � 0..............oF..........3.m�1... Appliration for Uiipniia1 Works Totelrnrtign Vamit Application is hereby made for a Permit to Construct (�) or Repair ( ) an Individual Sewage Disposal System at: • .�_ 119 Locat' n-Ad s or Lot NoC lot a .........::......:. ...... i .�...................�_. Installer V Address dType of Building 3 Size Lot__ -�._�Q..........Sq. feet Dwelling—No. of Bedrooms........................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons__---_______-__•.___-__-____ Showers ( ) — Cafeteria ( ) Q" Other fixtures ...................................................... W Design Flow................. ....� ..gallons per person per day. Total daily flow-------------- W Septic Tank—Liquid capacityJAP.0gallons Length-------f3_.... Width....'--------- Diameter---------------- Depth...4....... .. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.--_____-_.. -___-_-- Diameter....®_b__..._. Depth below inlet..... ............ Total leaching area_-S._..sq. ft. Z Other Distribution box (Y.) Dosing tank ( ) Percolation Test Results Performed by..._�a__!. .,.. ---------------------------- Date____�. >.. ...7 __-. Test Pit No. I... .....minutes per inch Depth of Test Pit......2---------- Depth to ground water.-_ Test Pit No. 2------'`___._._minutes per inch Depth of Test Pit......A.!.......... Depth to ground water.........: _---_-___- --••----------- ------------ - . , O Descri tion of Soil o 2 � � - ..� — Y----.. . ---•-•-•---•-----•- -. . J---------------- ........................ ••----------•--•-••-------- ------------------------------------------------------------------------------- ------•---•--------•----------------------------....-•---------•-----•-----------------•---•--•---•-----•-------......•. 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'?' LL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bet* uy the board o th.Si ..-- ...7/fiDaApplication Approved By----- . . ----- - � --- --•-----------------•---....--•-- ......... ��--Af-�----------- �� ate Application Disapproved for the following reasons--------------------------------------------------------------------------------------------•---•......---....... Permit No......................................................... Issued_.._ ."1a` ...... 9 � Date No........... ..A,2.: FEs................. .......... THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD OF HEALTH --..........OF..........,.�.�.'� ,'' 5 � .... Appliratian for Bi4p.aq al Works Tnnitrnr#iun JIrrmit Application is hereby made for a Permit to Construct x/) or Repair ( ) an Individual Sewage Disposal System at .. 49 •-------•-----.....fr.`- .-•---.� ��' ✓ Z ram`" -_.�_ _ ----- . Location-Ad s ---- Own Ad ess w . ..e ,/-----'�- ... ._..._... a Installer - Address Type of Building Size ------Sq. feet .� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—T e of Buildiii a yp g ____________________________ No. of persons.................. .. Showers ( ) — Cafeteria ( ) Otherfixtures d xurs -------------•----------------.•• ------•-•-•----•--------------------------.........-------------•-------•-•----•-----•---•--•----••------•-•-•-.�} w Design Flow..................4-4. ........- ».-•__.gallons per person per day. Total daily flow._..._....___:__=a. '._.__._______._._gallons. WSeptic Tank—Liquid capacity._.?,"22j?gallons Length------_..-".. _._ Width.._'+........ Diameter................ Depth.._°- ......... x Disposal Trench—No. .................... Width.................... Total Length........... Total leaching area....................sq. ft. Seepage Pit No.................... Diameter____ .` .._... Depth below inlet.....L_......... Total leaching area... _____sq. ft. z Other Distribution box (K) Dosing tank ( ) 0-4 Percolation Test Results Performed b __ _:�` �`.. .............................. Date.... ................................... ` Y '= Test Pit No. ....... ......minutes per inch Depth of Test Pit .............. Depth to ground water.?. ' Test Pit No. 2..._............minutes per inch Depth of Test Pit.........'_._....... Depth to ground water W r ..?....._.._._ ..................... 4 ODescri tion of Soil....... 4�1 f y, .}- --._ _ --------...................-.-� >----•_-•---•---- ........................ � .. » v�.............. t .1 ..-----_•---__---------------------------------------------- ------------------------------------------------------------------------------- . W UNature 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 i T'T[E, p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been<,issued by the bar of h. ff QQ �f Si r ..--•-•-.••---- ------•-••••. •-------•-••-•-•••----•-•-• -_-�---.................. / Da Application Approved B f ' ' PP PP Y •_, . °: ` -----------••--------- ..... Application Disapproved for the following reasons:...............---------------- .....•-•--•-•--•-•••.........................•----•----------••-•---------------••-----•--•--•---...-•-----------------------------._..._..------------------------------------------------------------ Date PermitNo......................................................... Issued-...........................•--........................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....O F.. ................ - ........ �. _. C.5rdifirFa#r of TaTlrliFanrr 4 f'") T S I TO CERTIF , Th e Inu viduaal Sewage Disposal,System constructed ( or Repaired ( ) by------ -- -- ---------- .: •t1__' • / ' Jl Astaftx ----------------------- has been installed in accordance wit i tl provisions of T ` o TWe State Sanitary Code as-desc bed in the application for Disposal Works Construction Permit No. - __.. ! ______________ da.ted._..._. "` "" ___.._.__.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE, SYSTEM WILL FUNCTION SATISFACTORY. DATE....... ...................... ^ � Inspector THE COMMONWEALTH OF MASSACHUSETTS • BOARD OF EALTH .._........ °� ._.... No ...... .................. FEE......d?.............. i �ra 1 nrk . Can #r ' nrraYtit Permission is hereby granted_.._ - --- __V — it'L'••- to Construct ) or e a ( n Ind v' ual Sewage DI pos S stemma atNo. .� . " -- f-- ---•--------------------------------------- S reet as shown on the application for Disposal VG orks Construction P it Nd _. %:__._r._ Dated..____ .............................. 'm Board of Health DATE............:.......................................................--•----.....--- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS s3-00 ; TYPICAL SYSTEM PROFILE - ^ AREA PLAN ------ FDN TOP FINISH GRADE=S .00 i NOT TO SCALE / SCALE : I11= 3 `�' �`• ' ��"' FINISH GRADE OVER TANK= .�_�G' FINISH, GRADE OVER PIT= L T 39 BETH' E:�. LANE h 15 -P V C OR . r4�.� ✓' O OTv --- e 1 : . J • II • . v � I `,�C. I. TEES `_ 48, j � • . `/ • 0 1 v e BSMT ��- — �'. •o o .::`e �.: a.;.��'S'o' v • o o � • • e + o v FLR 95.00 /000 GAL. 4a1 rj o • v , • " REINFORCED /1 DIST. BOX S'82� � � • • + 1 C.e. D CONCRETE N_ • 1 1 1 e • • . • v o 1 8 TO BE INSTALLED ON , �j A LEVEL STABLE BASE v 1 a • • o o v , v Lo 0 0 • 1 / e • • • • 0 • • 0 SEPTIC TANK TO BE INSTALLED ON A 1 e • I • • 1 1 ' L STABLE BASE LEVEL STA .. .mac se•a �C �'�+�..� .:�-^m+r xaaw.'� � �� • 1 0 • • • • • • • 1 1 y. >, 211-1/811 1/2 "WASHED PEASTONE ALL • • w • • • • o �' BRICK a MORTAR COURSES AS AROUND FREE OF IRONS, FINES REQUIRED TO BRING COVER TO GRADE ` k AND DUST IN PLACE - 2411C.I. MANHOLE COVER a 3/4 " TO 1-112 "WASH ED CRUSHED LEACHING PIT rPp�rya 14 QQ \ FRAME - SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL S ± IRONS, FINES AND DUST IN /� J Bk.�a _ PLACE r ' I \ FOR FIN. GRADE SEE SYSTEM PROFILE �. �• - =�� r , �_�� a P , . ,,, I_,• SOIL AND PERCOLATION 16 { 4 T 1 '� r__. 4 DATA It r PERC. RATE MI f IN. L 4I °• o FOR INV. ELEV SEE N I T • C D. SPOHR © I NLE ° , SYSTEM PROFILE 611 TAKEN BY . tty)(# ��-/r .may j9j LINE ' - , Z-aT p OPENINGS W%4-I;'8 110 WITNESSED BY: F o . - OUTER I -3/4 _ ° � � '� - DATE : 46 aC'T /� 79 7 INSIDE DIA . , f. - � 1 6 I U D TEST PIT -GND ELEV, %' " TOTAL D o D D AREA _�-- _3 y a -. n.�1 �Ct> 'oc F o - i ° , o _ 0 0 0 D ,zP, S• F. 0 0 0 _ U F� a LO 1 1_ P LC G E" 0 0 0 p D D 0 _ - °` ° ` .—:.>'�" Old. WA / I QI� `4 i _— o — 0 0 0 0 0 ] U 0 0 II i 6 6 DIA . 2 � I & c- /0 6 '' EFFECTIVE DIA. �'` 4.SI .+lt+ ` BOT. PERC. HOLE L E AC H I N G PIT SECTION ---� ANC V DOWN -48 i Cjc G.�, .��,��_ ,�.:�.��t�� N No SCALE DESIGN DATA : rc 7f-1 Tory/te cr e, sr-ra,r- �F;>iE'Ar°.�'"`�%�t".f- .�'�`�/s7.� ;' :�� NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM Zone i u% �Ecr�p�-.�r�o�S." ,�,E`��;a,f pl r-/ot1 ,�,�:. 2!! �',: �r,� N 0. 0 F BEDROOMS � I LEACHING PIT NOTES: Al C DISPOSALEST. TOTAL DAILY EFFLUENT e` GALS . I . CONC. TO BE 4000 P.S.1 a 28 DAYS . SEPTIC TANK C L42 1 GAL 2 . REINF W 6 t1 x 6 11 06 GA. W. W. M. 3. 21AND 4 ' SECTIONS ARE AVAILABLE FOR CENERAL NOTES GREATER DEPTH REQUIREMENTS I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN NOTE . EXCAVATE TO ELEV. - OR LOWER AS ACCORDANCE WITH TITLE 5OF THE STATE SANITARY CODE DATED JULY 1, 1977 & ANY LOCAL RULES APPLICABLE. REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPRID. IN �W f I LEkS c, B U I L D E R . MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL WR i T I NG BY MR. CHARLES D. SPOHR. WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY r - COMPACTED IN PLACE. 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, /c 6 7 P/ TC-1-4Ef,2.i SIDE AREA = /` -i=l S. F. , 4 S. F./GAL 4 `✓% GALS NOTIFY THE ENGINEER AND EtCNRt-) OF- HE 4ALTH FOR 'NSPECT!ON BOTTOM AREA= ' / S. F. d S. F/GAL GALS 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED, TOTAL AREA = 2�`.. TOTAL ��`��- GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN S. F. APPROVAL BY CHARLES D. SPOHR. LEGEND 6 FOUNDATION INSPECTION RF- D WHEN EXCAVATED, Bo M. NCTE. + 50.01 EXIST. GROUND ELEV. � 50.01 FINISH GROUND ELEV.i'UNDERLINEC" r-�- f 4750 PIPE INVERT. ELEV. REv DATE DESCRIPTION O TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM AREA FLAN: 0 o SEPTIC TANK FOR t f% /��C��t7 U ' y��r' 1 L - Al � DISTRIBUTION BOX --- ��f f� I� �r �i i IV�V 1� V � �� } f'J 0 T E ` L o r Is ,low i �c� 3. �. : /�. c , sc.�a�E- - . o LOT #39 H ; ' 4. . . . I - 2 5 / -''', ". �' Y' } fir /.5�r ,�' > .SL�'k'y `r' G C? , 4 C. I . PIPE a A f�J E 11 4"BIT. FIBER PIPE (P I T'C�-� ER 5 WAY) H Y A(`J f J I_S ti tt�- - TIGHT JOINTS - -- - PROPERTY LINE DESIGNED. C.D.SPOHR DATE DRAWING No. MAP SEC PCL LOT HOUSE Tr-) 'jr'y`r f r`f-r' , MIN. CODE DISTANCE DRAWN: = SCaLE:4SSHOWN CHECKED: C. D" S . 7 0' T.O.F. EL.= 6071 FINISH GRADE OVER D-BOX= 58.5'f FINISH GRADE OVER CHAMBERS= 58.7' - 58.9' _ GENERAL NOTE S ° 3/4"TO 1-1/2" DOUBLE WASHED PROVIDE EXTENSION RISER SLOPE @ 2/° MIN. OVER SYSTEM STONE TO CROWN OF PIPE WITH COVER OVER INLET& REMOVABLE WATER-TIGHT H-20 COVER 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OUTLET TO WITHIN 6" OF F.G. OVER RISER TO WITHIN 6"OF FINISHED 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL ' F.G. OVER TANK EL.= 58.4'f GRADE 5" DIA. OUTLETS) MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) N OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. @ FND. EL.= 58.5 t STONE OR GEOTEXTILE FILTER FABRIC f 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 4 + PLACE H21D RISERS ON DESIGN ENGINEER. PROPOSED 4" 9"MIIN. TOP OF SAS =56.70' ALL CHAMBERS WITH � � SCH. 40 PVC 36 MAX, 9'MIN. 3. 4' SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE 55.70' 36"MAX. BREAKOUT EL= 56.20' INLET PIPES TO 6"OF SYSTEM UNLESS OTHERWISE NOTED. FINISHED GRADE 3" DROP MAX 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 6" 3" 2" DROP MIN 3 9 L = 3O± PROVIDE WATERTIGHT ELEVATION = 56.20' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A t MIN.SLOPE Q 1°1 13" 14 4" PVC IN FROM0 JOINTS TYP. o O 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF SEPTIC TANK 4 PVC OUT TO O °o o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE LEACHING FACILITY o SPECIFIED DROP BETWEEN � ao � � � � � � � � � � 00 � � � � � 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL `� 56.10' MIN, 6 55.93' 2' oo °° o0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF \ OUTLET TEE 0 0 0 °° ao C� 0 ao 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION EXISTING SEPTIC F EXISTING TEES AND REPLACE AS GAS BAFFLE � OVER MECHANICALLY p � � � Q � � � � � a a p � � � o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS TANK NECESSARY COMPACTED BASE10 - NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 3 OUTLET DISTRIBUTION BOX 3.0 �- 8.5' (TYP) -I 3.0 3.0' 3.0' AND DESIGN ENGINEER. I 4.83 8, ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 60.00, TO BE INSTALLED ON A LEVEL STABILE 31.5' (TYP.) ESTABLISHED ON THE CORNER OF BULK HEAD, AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.- < 47.70' PIPES TO BE LAID LEVEL. 5j3.70 10.83' 9, CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION 5' MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK CROSS SECTION VIEW 3 - 500 GALLON H-20 CHAMBEt� t.r-It;lvlcl`�� +t_Evu v iv v 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES ELEVATION SEPTA" `�ANIK PROFILE H-20 DISTRIP' ITtI'")NI BOX DETAIL TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. ON PRIOR TO ANY WORK& H-20 CHAI��'��' ETAI LS NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. f 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING "' r�.jfti TP�T PIT n A T REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM f rar eater APPROPRIATE AUTHORITY. PERC NO. 15153 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED :-- INSPECTOR: David W. Stanton, RS UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR + TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. (4) � \ '~�''�. MAP 272 ! �• � "� ^ �( EVALUATOR: Michael Pimentel, EIT, CSE lao, ~ .m. LOT 167 " 4 It �• C.S.E. APPROVAL DATE: Oct. 1999 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. 108, S7g'34,02aE d+ J� • I.,l DATE: September 7, 2016 °` 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE GRAVEL AREA �2p.00• . TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. TP 1 3} }� Jl • ' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, ' - • ELEV TOP= 58.70' •` ,l Q �` FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 58 7 ELEV WATER= <47.70' TP 2 9 ' 4 ,�*' "• . 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN C., PROPOSED 3-500 GALLON / ' •• • • • J SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. PERC RATE_ <2 min.Jinch 00 H-20 LEACHING CHAMBERS 58x7 \ `'- , ` • , ;` " '� 1 / t ' £' 16. PROPOSED PROJECT IS LOCATED WITHIN. a WITH AGGREGATE va Benchmark �, .. • . , M Corner of BH V1 • I: DEPTH OF PERC= 36"-54' ASSESSOR'S MAP 272 LOT 166 r O Elev. =60,00' •..• • LOCUS 1 �, I J� N TEXTURAL CLASS: 1 m ROPOSED H-20 Approx. M.S.L. Ct�iw l/ .b OWNER OF RECORD: EARL R. MARROW III d ,�. i a PROPOSED INSPECTION P RT DISTRIBUTION BOX i �-- ntt w� r Q JI • {f �. � ` \ 0 ADDRESS: 132 HOMEWARD LANE _ C \�`A 0„ 58.70' NORTH ATTLEBORO, MA 02760 0C-1 ,_,�.. 1l � _ � t Fill FEMA FLOOD ZONE X 4 58.37 f _ , • � yVa * A Loamy Sand COMMUNITY PANEL# 25001CO566J 19.3 BH � w� /5 t Sew ' 12" 57.70' 17. DEED REFERENCE: BOOK 20308, PAGE 133 o (1) I'' '' rj 1/, '•!/ • ' I Sal «'l 18. PLAN REFERENCE: PLAN BOOK 271, PAGE 83 O \ k, Usy� • • • • ( w c.,;,w.- t • �. t Loamy Sand M \ r \` 29 : `. 10Yr 5/6 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. MAP 272 / w�`� � •` �` `• °/ a �1�, 36" 55.70' 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY rr 1 FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY LOT 56-2 .�r.. ' �_ / _�-- . �� . . ' z FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. EXISTING �`, ,-� ,' �,' , • _ ' Med.-Fine Sand SHED I �` . . ;' • : 4. C-1 2.5Y 6/6 21. A 4" PERFORATED SCH. 40 PVC (PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A ` • �• 10-20% Gravel DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A ,�. • . . ' ! REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS, 22. IN ACCORDANCE WITH 310 CMR 15.401 - 15.406,THE FOLLOWING LOCAL UPGRADE L.R EXISTING 96' 50.70' APPROVAL IS REQUESTED FROM 310 CMR 15.211: 3-BEDROOM �n DWELLING BIT. DRIVEVWAY LOCUS PLAN Medium Sand (1.) A 0.70'WAIVER (20.00'- 19.30') FOR THE MINIMUM SETBACK DISTANCE FROM A S.A.S. EXISTING LEACHING PIT TO BE / \ TOF=60.T± (APPROX LOCATION _W C-2 2.5Y 6/6 TO A FOUNDATION. I PUMPED& FILLED WITH CLFA.I•� _.-�' .- \ ` io SCALE: 1"= 1000' Loose 23. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL COARSE SAND AND ABANDONED ` 9 REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. (APPROX, LOCATION) .. '` �., �� `"`Y- _ / ry 132" 47.70' LEGEND EXISTING D-BOX �- 2 - No Mottling, Standing or Weeping Observed (APPROX. LOCATION) -- � 57 \ DESIGN DATA *Perc test conducted by C. D. 50xO EXISTING SPOT GRADE DECK / SPOHR on 10-18-79 tht5 i ii+iv 1,000 vt,i�v+ �' 50 - � / EXISTING CONTOUR TANK TO BE UTILIZEL \ TEST PIT DATA DESIGN _ , � NUMBER OF BEDROOMS (DESIGN) 3 50 PROPOSED SPOT GRADE / %-HC-2 ' DESIGN FLOW 110 GAUDAY/BEDROOM PERC NO. 15153 PROPOSED CONTOUR O ' ' BASE TOTAL DESIGN FLOW ON 330 GAL/DAY INSPECTOR: David W. Stanton, RS - EXISTING OVERHEAD WIRES 1(! r= DESIGN FLOW x 200 % 660 GAUDAY EVALUATOR Michael Pimentel, EIT, CSE ) C.S.E. APPROVAL DATE: Oct. 1999 EXISTING GAS LINE Ia <C >- USE EXISTING 1,000 GALLON SEPTIC TANK S9� W J DATE: September 7, 2016 p X Q TEST PIT#: 2 EXISTING WATER LINE LU MAP 272 \ ~ L / 3 ELEV TOP = 58.70' LOT 56-1 S GARAGE m v % TEST PIT LOCATION INSTALL 3 - 500 GAL. HI-20 CHAMBERS W/ STONE ELEV WATER= <47.70' f PERC RATE = EXISTING DISTRIBUTION BOX SIDEWALL CAPACITY . MAP 272 LOT 166 �J (LENGTH + WIDTH) (2 SIDES) I(2' HIGH) (0.74 GPD/S.F.) = GAUDAY DEPTH OF PERC = EXISTING 1,000 GALLON SEPTIC TANK 15,000 S.F.± (31.5'+ 10.83')(2 ) (2' ) ( 0.74 GPD/S.F.) = 125.3 GAUDAY TEXTURAL CLASS: 1 PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE 68 BOTTOM CAPACITY (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY ❑ PROPOSED H-20 DISTRIBUTION BOX 1' (31.5'x 10.83') (0.74 GPD/S.F.) = 252.4 GAUDAY 0 11 58.70' � a I 4' Fill 58 37' � PROPOSED 500 GALLON H-20 LEACHING CHAMBER A Loamy Sand 10Yr 311 Soso _ TOTALS: 12" 57.70' REV. DATE BY APP'D. DESCRIPTION 1 02"F 1 TOTAL NUMBER OF CHAMBERS 3 12o.00. PROPOSED SEPTIC SYSTEM UPGRADE TOTAL LEACHING AREA 510.4 SQ.FT. B Loamy Sand Y( TOTAL LEACHING CAPACITY 377.7 GAL./DAY 10Yr 516 PREPARED FOR: 36" 55.70' CAPEWIDE ENTERPRISES C-1 Med.-Fine Sand 2.5Y 6/6 LOCATED AT 10-20% Gravel MAP 272 145 BETH LANE LOT 165 HYANNIS, MA 02601 96" 50.70' SCALE: 1 INCH = 10 FT. DATE: SEPTEMBER 20, 2016 NOTES: SWING-TIES C_2 Medium Sand rR�$ � 0 5 10 20 40 FEET I 2.5Y 6/6 1.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE DESCRIPTION HC-1 HC-2 Loose' PREPARED BY: PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF RESERVED FOR BOARD OF HEALTH USE a SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. CORNER OF STONE (1) 40.0' S3.0' 132" 47.70' CH J CH L JR� JC ENGINEERING, INC. CORNER OF STONE(2) 30.5' 46.4' No Mottling, Standing or Weeping Observed ass 2854 CRANBERRY HIGHWAY 2). ENTIRE PROPERTY IS LOCATED WITHIN A DEP APPROVED ZONE 2 AND THE � ' - EAST WAREHAM MA 02538 GROUNDWATER PROTECTION OVERLAY DISTRICT. SITE PLAN CORNER OF STONE(3) 29.2' 74.9' �''� � � 508.273.0377 SCALE: 1" = 10' CORNER OF STONE (4) 39.0' 79.2' ` + Drawn By: SJI Designed By: SJI Checked By MCP JOB No. 3596 i I