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Home My WebLink About0029 CHECKERBERRY ROAD - Health Checkerrxer y Rose Hyannis I �I TOWN OF BARNSTABLE LOCATION C1 ChE'C_c®�' s- SEWAGE# / VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&fPHONE NO. ��,�4 SEPTIC TANK CAPACITY LEACHING FACILITY. (type) �"( yp�//„y e'�j�y,I fJ /f (size) oel, -ZA 2 NO.OF BEDROOMS OWNER 21A r ✓ PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: �F f,/f,S 01 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 4W1 1/V_4r jam,J"Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) . , I Feet Edge of Wetland and Leaching Facility(If any wetlands'ezist within,w 300 feet of leaching facility) R Feet FURNISHED BY f � I - ►S- 3^31 2-7. s r '2 3 S0 r _ i /- = s Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. Cityrrown State. Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer,use 1. Inspector: I � only the tab key to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. DOUGLAS A BROWN INC Company Name P.O. BOX 145 Company Address CENTERVILLE MA 02632 Citylrown State Zip Code 5084204534 S14297 Telephone Number License Number P. 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+'Sectiong1.5.340 o¢f Title 5(310 CMR 15.000). The system: _ {fi ..rw fit`,•, ® Passes ❑ Conditionally Passes ❑'Fa'ils r•J ❑ Needs Further Evaluation by the Local Approving Authority " 4/29/14 Inspector's nature 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 VOffi. ,.n :Subs Titleurface Sewage Disposal System•Page 1 of 17 I S Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every 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: AT TIME OF INSPECTION SYSTEM WAS ONLY 3.5 YRS OLD. OCCUPANT HAS BEEN DRIVING OVER TANK AND LEACHING SYSTEM. COMPONENTS ARE H-10 AND NOT DESIGNED FOR VEHICLE TRAFFIC B) System Conditionally Passes: ❑ One or mores stem components as described in the"Conditional Pass" section need to be Y P 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. Citylrown 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M s 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. Cityrrown 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 '/2 day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 29 CHECKERBERRY RD _ Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every 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. ,a 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 t ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® -Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and•examined? (if they were not available note as N/A) r ® ❑ 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? Z ❑ 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. El Z 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: r 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. City/Town State Zip Code Date of Inspection D. System Information Description: SYSTEM CONSISTS OF A 1500 GALLON TAND D-BOX AND 2 500 GALLON CHAMBERS WITH 4 FT OF STONE ALL COMPONENTS ARE H-10 Number of current residents: Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available (last 2 years usage(gpd)): Detail: 2012-----349 GPD 2013----290GPD Sump pump? ❑ Yes ❑ No Last date of occupancy: 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 . t f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: 4/2014 Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: SYSTEM INSTALLED IN JULY OF 2010 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 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.): Septic Tank(locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other-(explain) , t i If tank is metal, list age: years ` Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No I Dimensions: 1500 Sludge depth: MODERATE t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary.Assessments M , 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. Cityrrown 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 Scum thickness MODERATE Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? WOODEN POLE 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 COULD USE PUMPING. RECOMMEND PUMPING EVERY 2-3 YRS 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 , 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. Citylrown 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 29 CHECKERBERRY RD Property Address THOMPSON Owner Owners Name information is required for HYANNIS MA 02601 4/29/14 every page. Citylrown 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.): BOX LEVEL NO LEAKAGE 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): sry ' If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 _ J Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): CHAMBERS WERE VIEWED BY CAMERA AND FOUND TO BE IN WORKING ORDER AT TIME OF INSPECTION 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,M 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name inform ation is HYANNIS MA 02601 4/29/14 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at 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 r— Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is required for HYANNIS MA 02601 4/29/14 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to,high ground water: GREATER THAN 5 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: APR 2014 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) y ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: DESIGN PLAN Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Assessing As-Built Cards Page 2 of 2 http://www.townofbarnstable,.us/Assessing/HMdisplay.asp?mappar=269085&seq=2 5/1/2014 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °M 29 CHECKERBERRY RD Property Address THOMPSON Owner Owner's Name information is. required for HYANNIS MA 02601 4/29/14 every 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Assessing As-Built Cards Page 2 of 2 http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=269085&seq=2 5/1/2014 Assessing As-Built Cards Page 1 of 2 / TOWN OF�B fARNSTABLE LOCATION SEWAGE# VILLAGE f/yS ASSESSOR'S MAP&PARCEL dYt_ y�r�LZ f� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ix>Ual Chi Ca(size) /7.;2X .73_-7— NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: ' Separation Distance Between the: �/f.,q,S EL ?J,5V Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility/Yd_ S'Fed 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)�J �J Feet FURNISHED BY r/I/ �4?,!2a y✓ 5- 2� 4—2-7.S I � 2 " yl,S z 3 - 6-0 H `U http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=269085&seq=2 51112014 J , ego M — ,20 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0(ppIico.tion for Th5pont �&paem Cougtruction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 21 C k eC It a1641/y Q , Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ,SS A �jic9wav yN� ./ Type of Building: Dwelling No.of Bedrooms - 3 Lot Size 0-61`] sq.ft. Garbage Grinder ( ) Other Type of Building g ti No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) zj'3 p gpd Design flow provided 3 o $ gpd Plan Date 7� /�p Number of sheets 'L Revision Date Title Size of Septic Tank !S t0 N eU) Type of S.A.S. ,-60 &Ck]jp.,J ehc,,.Jay/fs Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 B f Health. Signed Date Q Application Approved by I Date — — () Application Disapproved by: Date for the following reasons r Permit No. C`0 t o— Qo Date Issued f r !Q s° Fee V� i - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes TippYication for �Digotor *r5tem Construction hermit M Y Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 2 / C h P/bp/jfr 12 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Qif —O .J Poets Instaallller's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 1/G�14�j A �jtC7wN �NC So -dlb0- /T �w •ter +mod ��✓ Gva✓ Type of Building: Dwelling No.of Bedrooms 3 Lot Size 12 61"7 sq. ft. Garbage Grinder ( ) Other Type of Building Cc,,,J 5 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) -_4,7'3 0 gpd Design flow provided_ !1 -3 1 , 4g gpd Plan Date � p��j p Number of sheets '� Revision Date Title Size of Septic Tank /S(Do N eo Type of S.A.S. Shp ('n Description of Soil P Nature of Repairs or Alterations(Answer when applicable) y ` Date last inspected: t: , i Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by ! _ Date d Application Disapproved by: Date for the following reasons Permit No. ' 1 o 6 Date Issued -7- ld ti 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 at 04 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 00/0 02 d dated -�d Installer'000-, A IA.w!)rJ NC Designer r ^✓r /ice• Z4.1104- #bedrooms 73 Approved design ow _ J gpd The issuance of thi pe it shall not be construed as a guarantee that the system will f9:1 i s designed. Date r? Inspector V\Fl —.=--No: —rf �(t —.—_—_--.—�.---Fee � ✓� —__a. (f THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS mitpoo 6p5tem Co �!g•tructton permit Permission is hereby granted to Construct ( ) Repair ( 1/) Upgrade (. ) Abandon ( ) System located at �i t� �/ IX41_1 / and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of th-is- ermit. t Date V Approved b pp Y C ! �� Y 07/29/2010 14:55 5084775313 ENGINEERING WORKS PAGE 01 Town of Barnstable Regulatory Services Thomas F.Geller,Director { ; Public Health Div" Thomas McKean,Director 200 Main Street, HyaaaK MA 02601 Office: 5OM62-4644 Fax: 506-790-6304 Date: ?Sl l 0 Sewage Permit# Assessor's Map/Parcel Zoo 9 — Installer&DesismerQrAficadgn Form Designer: +�.w:�►T �.i g w �rI C. - Installer: �, A • S�rc,••,�� I In . Address: 71W. Cre J 14, 1 y( 9-4� Address: R 0, i3ex 14 - Me.y rti� M14 4 yy C��+�N,1le 67-63 Z. on R A.3,v�, _ was issued a permit to install a to ins septic system at 29 01.4-ClAe fbe�r.� uyc, based on a design drawn by (address) FekV`3 - M C_.£.,r•c.,a T' f dated 71 FZ 16 (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. Stripout (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. greeter 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 catifiied as-built by designer to follow. Stripout(if required) was inspected and the soils were found satisfactory. OF MqS aA PETER ei's Signature) McENTEE CIVIL ,9 No.$5109 C � igner's ignature A a De PLFASURETURN To A&gjSjA= A B q: foeax=\d=jaw—ts=ianfb—d- TRANS..NO.. CITY/TOWN -4z'ram S APPLICANT: 17,A asa N� I ►1 c ADDRESS: 29 C]�.�cl-c t•- Y� r DESIGN FLOW: 3.30 gPd' REVIEWED BY:y �e-�� ^� ` DATE: l 0 N/A OK. NO :. MW Legal boundaries denoted 310 CMR 15.220(4)(a)] Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220 4 `u Locus Provided 310 CMR 15.2204 t Plan proper scale? (1"=40'for plot plans, 1 20' or fewer for ✓ components) 310 CMR 15.220(4)] Easements shown.1310 CMR 15.220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a)for ✓ upgrades]-if not, a variance is required 310 CMR 15.412(4)] Location of impervious surfaces (driveways, parking areas etc.) 310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR ✓ 15.220(4)(c)] Location and dimensions of system components and reserve areas. 310 CMR 15.220(4)(e)] System Calculations 310 CMR 15,220(4)(f)] daily flow septic tank capacity(required andprovided) soil absorption system(required andprovided) whether system designed for arba a grinder North arrow 310 CMR 15.220 4 Existin and ro osed contours 310 CMR 15.220 4 ✓ Location and log of deep observation holes(existing grade el. on each test) [310 CMR 15.220 4 h Names of soil evaluator and BOH representative [310 CMR 15.220 4 h and i Location and dale of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? [310 CMR 15.242] Certification statement by Soil Evaluator 310 CMR 15.220 4 Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220 4 n \. Address Sheet;I of 9 1 N/A OK NO Location of every water supply, public and private, [31C- CUR 15.220.4 k within 4.00 feet of the proposed system location in the case of surface water supplies and gravel packed public.water.supply within 250 feet of the proposed system location in the case ` within 150 feet of the proposed system location in the case of private water supply wells Location of all sprface waters and wetlands located up to 100 ft. beyond-setbacks-listed in 310 CMR 15.211 and any catch basins located within 50-%ft: `310 CNM 15.220.4 =1 Water lines and other subsurface utilities..located [310 CMR ✓' 15.220 4 m ] ` -water-line cross see 310 CMR 15.211 1 1 Profile of system showing invert elevations of all system ti/ components and the bottom of the SAS. 310.CMR1,5..22i .4 o Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220 2 Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line). 310-CMR.15.220 3 Test Holes adequate(two in each of the primary and reserve / unless.trenches as permitted in 310 CMR 15.102(2)or as approved for an upgrade under LUA at 310 CMR 15;405 l k Test hole adequate to demonstrate four feet of suitable material? 310 CMR 15.193 4 Test Holes adegµate..to confirm adequate groundwater separation? 310 CMR 15.103(3)] Benchmark within 50-75' of.s stem 310 CMR 15.220 4 Materials specifications noted?[various sections of 310 C-MR 15-:000 System compon4nts not> 36" deep (unless Local Upgrade Approval roval or.IUA requested) [3:10 CMR 15..405 1" Address Sheet 2 of 9 L N/A OK NO mom Size OK? 310 CMR 15.223 1 Inlet tee located-ten inches below flow line 310 CMR 15.227 6 Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] Outlet tee with gas baffle or--approved filter 310 CMR 15.227(4)] Note regarding installation.on stable compacted-base [310 CMR ✓ 15.228 1 Separation between inlet and outlet tees(no less than liquid depth) 310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater / (except as descrioed 310 CMR 15.227(5)) or permitted for upgrades under LUA 310 CMR 15.405 1 k Minimum cover " (Tanks buried more.than 9" must have risers on all openings and on the d-box) [310 CMR 15..2228(1) and 310 ✓ CMR 15.232 3 Three access coyers (inlet and outlet must be 20" or greater) - middle access at least 8" 7/07 310 CMR 15.228(2)] Access to within'6 of grade - one port for systems<I 000gpd, two fors sterns.>1000 d 310 CMR 15.228 2 All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10:fft from build ng foundation 310 CMR 15.211 1 / Buoyancy calculation Required/[)one 310 CMR 15.221 8 H-20 Where a ro riate? 310 CMR 15,226(3)] Setbacks from resources 1310 CMR 15.211 Required when other than single-family dwelling or flow>1000 d 310 CMR 15.223 1 First compartment 200% daily flow; Second compartment 100% daily flow 310 CMR 15..224 2 and .3 rjf/� "U" pipe through or over baffle, outlet of each compartment with as baffle or approved filter 310 CMR 15.224(4)] Address Sheet.3 of 9 N/A OK NO Located at least ten feet from any water line? [310 CMR J 15.222(2)] Disposal piping it least 18" below water line(when water and sewer cross, see 310 CMR 15.211 1 1 . Cleanoars required/provided ? 310 CMR 15.222 g Thrust blocks s ed in force mains? 310 CMR 15.221(6)(c)) Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable 3.10 CMR 15.222.E Proper pitch on all runs? (.005 within gravity-distributed trenches V/ and beds) [310 CMR 15.251 9 and 310 CMR 15.252(2)(c)] Siphon probleml eachfield below pump chamber Endca s or vent manifold specified? </ Size and orientation of discharge holes specified? (not smaler than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252 2 Materials specified (310 CMR 15.251(5) specifies various pipe types allowed Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or ba.ffie tee required on inlet/provided? (when ` pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if:deeper than 9".1310 CMR 15.232 3 Inside minimum dimension 12" 3.10 CMR 15.232 2 Minimum s " 310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd J 310 CMR 15.232(3)(d)] capacity(emergency storage above working--design flow)? [310 CMR 2,31(2)]l Proper setbacks 310 CMR 15.211 same as septic tanks Watertight 20-in minium access manhole at least 20"MUST BE TO GRADE L310 CMR 15.231 5 Service components accessible (not too deep with piping, disconnects accessible Alarm floats -alarm on circuit separate from pumpsspecified? Exceeds two unio must have two pumps operating in lead-lag mode. 310 CMR 15.231(6) and 8 Stable Com ed.Base 310 CMR.15.221 2 Address Sheet 4 of 9 Buoyanc calculations needed'?Provided? 310 C1VlTt 15.221 8 I a i Address Sheet S of 9 N/A OK NO Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240 1 Required separation to oundwater? 310 CMR 15.212) Aggregate specified as double washed 310 CMR 15.247 System Venting required/provided?-(system under driveway or >36" d 310 CMR 15.241 Inspection ports specified and within 3"final grade? [310 CMR 15.240 13 Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)r4] and +� Guidance Document] Chambers and Gal. in trench configuration supplied with inlet every 20 ft. 1310 CMR 15.253 6 Each structure v�ith one inspection manhole(if>2000 gpd must be tograde) 310 CMR 15.253 2 Aggregate 1'minimum-4' maximum: 310 CMR 15.253(1)(b)] c/ 2' sidewall credit maximum [310 CMR 15.253 1 a In bed confi ratio inlet ev=40 ft. 310 CMR 15.253 6 Width 2'minimum 3' maximum 310 CMR 15.251 1 j 100 feet-maximum length 310 CMR 15.251 1 a Minimum separation 2x effective depth or width whichever greater (� 3x if reserve between trenches) 310 CMR 251 1 d Iv Situated along contours 310 CMR 15.251(2)] Breakout OK? Ij 10 CMR 15.211 1 [41 and Guidance Document affiNEM i minimum 2 distribution lines 310 CMR 15.252(2)(a)] Maximum separation between lines 6' 310 CM R15.252(2 d Maximum separation between lines and outside of bed 4' [310 CMR 15.252 2 ,e Aggregate depth below discharge pipes 6" minimum, 12" maximum. 310 CMR 15.252 2 Separation-between beds 10' minimum. 310 CMR 15.252 2 Bottom area used in calculations only 310 CMR 15.252(2 i Address Sheet 6 of 9 i �J N/A. . , ,.;OK NO t' Pressure Dosed System ? Provided pump and piping calculations as required 310 CMR 15.220(4)(r)] Pressure dosing Tequired on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use ovals] / If used in gravelless system - make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd)or quarterly >2000 dgood to note on plan 310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet the specification pf 310G CMR 15.255 3 ? . Impervious barrier and/or retaining wall ? Guidance Document Impervious barrier installation must be supervised by designer 310 CMR 15.2552 b Retaining wall must be designed by Registered Professional Engineer 310 CW 15.255 2 a Side slope not exceed 3:1 ? 310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2)and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended 10 CMR 15.255 2 e gigm: Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a dote on the plan regarding the requirement for perpetual maintenanceagreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has a . .li*nt submitted a copy of a maintenance a eement? Elam Are the variances listed on the plan? [310 CMR 15.220 4 RLS Stamp;-necessary on plan if a component is within five feet of property[ine 310 CMR 15.412 4 Address Sheet;7 of 9 New constriction or increased flow proposed-[Refer to 310 v CMR 15.414' Address Shed 8:of 9 N/A OK_ NO. Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.21¢ - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? 310 CMR 15.21 2 Are the nitrogen loads proposed in compliance? [310 CMR 15.21 . 1 Pumping to septic tank ? 310 CUR 15.229 Shared System 51-CUR 15.290 ti h i Address Sheet 9.of 9 Town of Barnstable P Department of Regulatory f try Services Pubhc Heal#h Division Date S aye 200 Main Street,Hyannis MA102601 Date Scheduled a Ti Pdme �.V o - Fee I' Soil Suitability Assessment for Sewage isposal e � L Performed By Witnessed By: LOCATION& GENERAL INFORMATION Location Address 29 Cti e C�te✓�De�Y` Owner's-Name y rZe/ ' 7 AO H Y g n n s Address Assessors Map/Parcel: q —O Engineer's Name NEW CONSTRUCTION REPAIR - Telephone# V 5ta$ z,731 Land Use - :1 Slopes AJ ('fo) Surface Stones Distances from: Open Water Body _ft Possible Wet Area ft Drinking Water We117 .ft Drainage Way. ? 1:� ft Property Line ��ft Other ft SKETCH:(Street name,dimensions of lot-exaculocations of test holes&perc tests;locate wetlands in proximity.to holes)--- _ T 1 -- Parent material(geologic) N.�� Depth to Bedrock Depth to t3roundwater. Standing Water in Hole:: /v/ Weeping from Pit Nee '"1 Estimated Seasonal High Groundwater 77 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _—in, Depth to soil mottles. Depth to weeping from side of obs.hole: in, Groundwater Ad.usthimt ft. Index.Well# Reading Date: Index Well level,w- -_,., Adi,thctor`, _. :AdJ:drwandwaterLevel,,,,� PERCOLATION TEST Datr.��.�. Observation Hole# ' 71 me at 9" .......�. Depth of P :777777ero 7 Start Pre-soak lime® )// lime(9"•6")',,... ... z: End Pre-soak Rate MinJlneh Site Suitability Assessment Site Passed - Site Failed Additional Tesdng Needed(YIN)- D�- Original: Publio Flealth Division Observation Hole Data To Be Completed on Back - - 7- L, #**Ifpercolation test is to be conducted within 100' of wetland,you must first notify the, Barnstable Conservation Division at least one(l) week prior to beginning.. Q:�,SEPTICIPERGFORM.DOC, . . DEEP OBSERVATION HOLE.LOG' Hale# Depth from Soil Horizon q SoiLlolor Soil x Othet Surface(in:) (USDA)-. (Ivlunsell) - Mottling (Structure,Stones;Boulders:,. IOU d � A • DEEP O&SERVATIONiOLlyLO`G Hole# �z— Depth from, Soil Horizon Soil Texture Soil.Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders -C "l 41 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface :(ia:) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistefigy e.:. DEEP OBSERVATION BOLE LO'G Hole# Depth:from, Soil Horizon..r._ Soil Texture, Soil Color Soil Other Surface(in,) (USDA) (Mansell) Mottling (Structure,'Stones,Boulders. Com Flood Irigurance Rate Man:. .7— — . f Above}5,00`yearflood•boundary No _ Yes,! ,.. Within,S00year`boundary No!� Yes VY►thin:100 year'flood boundary No Yes' depth of Naturally OrawrrIng Pe,rvious Material Does at lastKfour:°fit of nattrlly occumng pervto u�aterial-exist:in all areas::observed throughoyt{�ckle , area proposed for the soil_absorpgon system? If not,what Is.the,depth of naturally occurring pervious material?,._. _. �ertiffcaUon I°cbrttfy that 6n (date)-I have:passed.the soil evaluator exatmnatton approved by tote Departtettt ofnvtronmental Protection and that the, above analysis was performed by me cdnstst�nt'wtth the required tr: ' 'ng,expertise.and experience descnbed.in10 CMR.15.017: Signature Date E. Q:\SEFnC:1FBRCFQRM:DOC } Y, i �' y N:,• —— IN 1 DO ——EXISTING CONTOUR Wellesley Cr Ix x 100.98 EXISTING SPOT GRADE 9 • E Rd in - 100 PROPOSED CONTOUR ; o Checker erry Rd s� LOCUS 4 Benchmark Set W EXISTING WATER SERVICE a P: HYDRANT TAG BOLT �' EL.=99. 78 (Assumed) , EXISTING GAS SERVICE Rd opine Rd OVERHEAD WIRES dale 0 � b o Rd N 71 9 e D Va YY• $ d in RSA 9L36 — — 94 ® TEST PIT 3 o D Y� -� RR vement -- ,96 $ BENCHMARK BE _ J ER edge °f P°_ �,'" . LEGEND WEST MAIN STREET N CK — — —� s �/ CH E - —�50" c 44 —_.76.17 (i 92,63 92.9894,3 N g6.271' �,'' LOCUS MAP J 94,4 95. 95.75 ,.,LOT 88 NOT TO SCALE 94,36 _� _------96--- —_--AP'N 269-085 x 94.6 J94,20 °0 12,817±S.F. 93,73 � GENERAL NOTES: 94.97 95,82 PAVED X. 96.10 x DRIVEWAY �y I 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL o� — �z �� BOARD OF HEALTH AND THE DESIGN ENGINEER. /� �•_ _,�---96�' 94, 96,03 �' 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 94,91 95 8 �I '0� 7 94.98 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. O vv GEC 95.22 o J 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR '� 97 45 97 it N TO IINSPE TION AND APPROVAL BY THE BOARD OF HEALTH AND THE i R. 1EXISTING 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING a 0 rn FROM THOSE SHOWN HEREON SHALL BE REPORTED. TO THE DESIGN HOUSE (#29) \ 0 98,05 T.O.F.=98.7f ENGINEER BEFORE CONSTRUCTION CONTINUES. 97,7 ��c° g 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 1� L, ZQ'_—/__'� --=�-- 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF a ; r�.. < �14 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF . ^ ' ':' r HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. (b 0 `.: 98 17 ' 98.14�`C EENED �4 I 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. O- CSC RCH s- h 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.98, + .y o `y ► 1 1 Ja'ove) 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS 97,87_vo3 S.:A x 99,08 ' P 98.50 � AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 99.52 00 98.9 ,x DIRECTED BY THE APPROVING AUTHORITIES. r• Z + 9.69 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY --- -- TP-2 ' - �; W ---~—---___ _—_ — ' ` THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING N —r— — ———— — ---_ BUSH CONSTRUCTION. Z ao 100 PROPOSED i \� —100 e — 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS a' TP-1 SEPTIC TANK v ck de �- . REPLACE WITHBCLEANHSAND ASORSPEC�FIEDL N SIDES CMR THE S. AND i fenIN THE AREA 100.e c a tock - - j10L6 x lOLl8 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL'BE INSPECTED BY THE DESIGN ENGINEER PRIOR TO BACKFILL. 1'3.ATHIS PLAN IS TO BE USED .FOR'SEPTIC SYSTEM PURPOSES ONLY AND �02 ��18� n E IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. , 100 0 -�'�- N -76.1� EOI BE TING SEPTIC FILLED WITH 1"4. THE ENGINEER IS NOT RESPONSIBLE FOR ANY STRUCTURAL PROBLEMS" 100.16 �.e- RELATED TO THE EXISTING CONDITION OF THE SCREENED PORCH LYING OVER • 1T c� 10 -rode fen FLOWABLE FILL. (SEE NOTE 14) THE EXISTING SEPTIC TANK. IT IS RECOMMENDED THAT THE OWNER CONSULT ., PK SET off! x�-�F stock OF M a WITH THE BUILDING DEPARTMENT REGARDING SUPPORT OF PORCH.•. s !�03.1 Assq�y EXISTING LEACH PIT (approx.)CONTRACTOR SHALL LOCATE, PUMP, PROPOSED SEPTIC SYSTEM UPGRADE PLAN G PETER T. FILL WITH SAND AND ABANDON McENTEE - 29 CHECKERBERRY ROAD, HYANNIS, MA o CIVIL `n r No.CIVIL ;' Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 OWNER OF RECORD SCALE DRAWN JOB. NO. Engineering by: , F THOMPSON, GEORGE & MARY TRS Engineering Works, Inc. 1"=20' P.T.M. 163-10 4 EN TH nOMPSON REALTY TRUST 9 9 , / 381 NORTH STREET 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. BRIDGEWATER, MA 02324 (508) 477-5313 7/8/10 P.T.M. 1 Of 2 - 4 41 " NOTE: TO'PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:96.1 FOO 'A DISTANCE of 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. (3) 5" DIA.OUTLETS INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL RISER &.COVER OVER ONE CHAMBER AND 15.5" _I 1 , 16' 2" T.O.F F.G. EL.=99.4(MAX.) . OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE '*. �, SET TO, 3' OF F.G. TO.. SERVE AS INSPECTION PORT �-■ � • EXISTING F.G.EL.=99.0t F.G. EL.=99.0t -� 12" 15.5" �— L - 19' L - 22' L = 4' 2-'fLAYER OF 1/B' TO 1/2' „ 6" ® S=1% (MIN.) S=1% (MIN.) ® S=1% (MIN.) DOUBLE WASHED STONE 4'SCH40 PVC 4'SCH40 PVC 4"SCH40 PVC (OR APPROVED FILTER FABRIC) p T 6° _ 1' 20'I ., as as „ t"" 7 s aea$aea H-10 LOADING 2 INV.=96.25 as" UQULEVEL �INV.=96.00 D_BOXLEVEL4' S.2' 4' /` GAS BAFFLE INV.=95.77 INV.=95.60 PROPOSED D-BOX EFFECTIVE WIDTH = 13.2' H-10 RATED PROPOSED SEPTIC TANK N.T.S.Mk dam INV.=95.50 2-500 GALLON LEACHING CHAMBERS TIE IN TO EXIST. SURROUNDED WITH STONE AS SHOWN _ SEWER, INV.=96.5t TOP CONC. ELEV.=96.4f NOTES: 1) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND BREAKOUT ELEV.=96.14 TRUE TO GRADE ON A MECHANICALLY COMPACTED INV. ELEV.=95.50 aaaa SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN a0a= aaaBa ®®E3® 0 310 CMR 15.221(2). BOTTOM ELEV.=93.50 eas7'!j'- aBaaa 2) INSTALL INLET & OUTLET TEES AS REQUIRED. 3' 2 X . 17.0' 3' ®®®®®® ® ®®® ® 33„ 3) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 4' MIN. OF NATURALLY W ®®®® EFFECTIVE LENGTH 23.0' AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. OCCURRING PERVIOUS MATERIAL `V z ®L-j® 4) MAXIMUM COVER OVER SEPTIC TANK, D-BOX & S.A.S. 5' ABOVE MAX. G.W. — SHALL BE 36". = LEACHING SYSTEM SECTION •NO G.W. ® BOTTOM OF'TP, EL.=88.5 1• SEPTIC SYSTEM PROFILE I W 102" N.T.S. I' 4" KNOCKOUT _ DESIGN CRITERIA . 20" DIA. COVER SOIL LOG NUMBER OF BEDROOMS: 3 BEDROOMS 4" KNOCKOUT 4 KNOCKOUT 62" DATE: JUNE 1, '2010 (REF. P#12959) SOIL TEXTURAL -CLASS: "' CLASS. I SOIL EVALUATOR:'PETER McENTEE PE, (SE#1542) , WITNESS: DAVID STANTON �' R.S. . DESIGN PERCOLATION RATE: 5 MIN/IN °• HEALTH AGENT f 4" KNOCKOUT DAILY FLOW: 330 G.P.D. Elev. TP- 1 Depth Elev. TP-2 Depth DESIGN FLOW: 330 G.P.D. 100.5 A o,. 99.5 A 0" ' GARBAGE GRINDER: NO SANDY LOAM SANDY LOAM 100.0 10YR 4/2 5 6" 99.0 1 OYR 4/2 6„ PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY B B 500 GALLON CAPACITY, H-10 LOADING SANDY LOAM SANDY LOAM ' LEACHING AREA REQUIRED: (330) = 445.9 S.F. �. 10YR 5/8 10YR 5/8 CHAMBERS' 98.0 96.8 74 ° ' >." ct c1 30. 32" 42 PERC . USE 2-500 GALLON LEACHING CHAMBERS IN SERIES 54 PROPOSED SEPTIC SYSTEM UPGRADE -PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES M-C SAND M-C SAND 29 CHECKERBERRY ROAD, HYANNIS, MA SIDEWALL AREA: 2(13.2' + 23.0') X 2 = 144.8 S.F. 2.5Y 6/4 2.5Y 6/4 BOTTOM AREA: 13.2' x 23.0' = 303.6 S.F. Prepared for: D. A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 TOTAL AREA:.......................... ...................................448.4 S.F. 89.5 2 88.5 132 NTS P.T.M. 3-10 Engineering by: SCALE ,3 " � Engineering Works, Inc 1 , NO GROUNDW TER, PERC RATE: <2• MIN./IN. 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74(448.4) = 331 .8 G.P.D. -.�, (508) 477-5313 7/8/10 P.T.M. 2 Of 2