HomeMy WebLinkAbout0070 DUNN'S POND ROAD - Health F
UNNS POND RD., HYANNIS270 018
I
J
TOWN OF BARNSTABLE
LOCATION 0 D� � (�l SEWAGE#
'7 ��S �ac�� 7
VILLAGE HyAMN t s ASSESSOR'S MAP&PARCEL x7d
INSTALLER'S NAME&PHONE NO CA PEW(t)G GN'Tt-k-A(5( S 4
SEPTIC TANK CAPACITY 15 6 O C2ALL aAJS
0 0
LEACHING FACILITY:(type) � �L CNa1Al& size) 1;X 18 X e Ls
NO.OF BEDROOMS
OWNER G G 0 k1,C M/CI+E 4_C— COLc C
4
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility jay/t4 Feet
Private Water Supply Well and Leaching Facility(If any wells exist on AA
site or within 200 feet of leaching facility) N A Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
A-I 23 a
6.3- aa•3
C-Z 23.2.° p
C_3e
c-y- 3fl' c
0
33•S 6
® 0 : ®
D-S - L1l
TO F BARNS
E
LOCATION L SEWAGE #
-VILLAGE LAW c t c-, ASSESSOR'S MAP & LOT u
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
�.
Jr
NO.OF BEDROOMS
BUILDER OR OWNER �� ( ��
PERMrrDATE: DATE: GQ
1,
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetl4gds exist
within 300 feet of leaching facility) Feet
Furnished by
n
rN
of
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01ppliLation for -Misposar *pstrm ConstCULtion Vrrmit
Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.'7 O 12(>tV IV S Po 1z> Rh. Owner's Name,Address,and Tel.No.
bN pRew-+ M 1 G{ELLL GOLD.
Assessor's Map/Parcel 2 [y 10 I 2 70 bU 15' 2002 Eb t4 V M 1
Installer's Name,Address,and Tel.No.508-rf,77�-TV 7 Designer's Name,Address,and Tel.No.
.153 Ce t
Type of Building:
Dwelling No.of Bedrooms Lot Size � -- sq.ft. Garbage Grinder( )
Other Type of Building P_E 1 Q El)-rt A C� No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided 3 49,4 gpd
Plan Date 4-a to-i-r Number of sheets l Revision Date
Title ''I) C)U tV A)9 IJ)DpJ6 R ble 14 Y OAJ I S
Size of Septic Tank 1500 C®AJ Type of S.A.S. 1 Soo eg l &) f�3�
Description of Soil COAR-SC
Nature of Repairs or Alterations(Answer when applicable) S6JS7* _ l SO® C,,-AL®w St"pT Ic -Mx)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
,qccordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Cpmpliance has been issued by this Board of Health. ?
Signed Date Za�. .T
Application Approved by Date Y^
Application Disapproved by Date
for the following reasons
Permit No. pZ®c Date Issued ^l
;ol
No. ,,`G.,� Fee /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
'
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
application for Disposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.-70 VL^4$ POND Rh Owner's Name,Address and Tel.No. �►
pag
Assessor's Map/Parcel a o /o 8 7U tuS Aorvt� �� R(4)JM15
Installer's Name,Address,and Tel.No.509-4(77,-S$77 Designer's Name,Add ess,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size / G— sq.ft. Garbage Grinder( )
Other Type of Building �j /.>EVT1 /��.. No.of Persons Showers( ) Cafeteria( )
Other Fixtures t
Design Flow(min.required) t 0 gpd Design flow provided gpd
r ,
Plan Date 4_at;--f'T Number of sheets j Revision Date
j
Title '70 pV:tVA)S 1OtUb P22110 t4yAtXIS
Size of Septic Tank j 500 6,4<L0►V Type of S.A.S.(a) 5QO cn; O t AVNC -s
Description of Soil CUl4 SLc c (�, �4/St�
r i
Nature of Repairs or Alterations(Answer when applicable) T Al v�Z16E.t.: t j SOU G�G&wN/ 56T r IC, -tAA)K
'Its OC?AJ D-hQ& W �_2) 500 6bkt Ox) C.44 al"C—. C.649-[404� W(TT4-
'
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in ;
,�ordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate Hof
}'. G,ompliance has been issued by this Board of Health.
h( Signed Date
Application Approved by Date Y " —
Application Disapproved by Date
for the following reasons
Permit No. 9 0( IdL V Date Issued 111-
THE COMMONWEALTH OF MASSACHUSETTS
z BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( )
Abandoned( )byEA� 1V l (�
at 7o"'(�V�1V-5 AoP b k HVAiVA)-/S has been constructed in accordance
r with�t e provisions of Title 5 and the for Disposal System Construction Permit No. oZOI �� I dated
Installer �AE 1C&6et.5� Designer C�PEcy �7"G F=FtJ&<tjau&
#bedrooms,. Approved design flow 2e�� gpd
The issuance of this permit shaJI not 14 construed as a guarantee that the system 111 functi a
N.
Date / Inspector "
'- No. -----------
Fee
---- ----------------------------- - =
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Veposaf *pstem (Construction Vermit
Permission is hereby granted to Construct( ) Repair( x) Upgrade( ) Abandon( )
System located at ']o b UMU S P of i b koO "HY-A m RJ is
f
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
�; Date L' ( Approved by / ///
#5461 P. 001/001
Town of Barnstable
°�`"� ►.$ Regulatory Services
.�. Richard V. Scali,Interim Director
S awara�rssre,
"'"M Public Health Division
Thomas McKean, Director
ZOO Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 5-8,17 Sewage Permit# aGi-1 1;LLJ Assessor's Map\Parcel
Designer: TC- Eoc�inee-c�o-i S,nc,. Installer: _Gape.wik 6r .r_rPc(seS
Address: 2S51 Cra4ercj iglnWa,/ Address: 155 Com,r+erci'o1 &V(ee,�
East wceonaw , !1A 02.558 MoS��ee.� A 2lay
On Capewide. Lrl�4rp(6es was issued a permit to install a
(date) (installer)
septic system at 70 Doo 5 fond g6ad based on a design drawn by
(address)
G Lo5l ►e.erirl h I ,nC , dated AQrI� zb, Z01
/ (designer)
b I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State&'Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed a with the terms
of the I\A approval letters(if applicable) P� MaS
J JOHN L, U,
/ CHURCHILL AR.
(Ins Iler'. Siggatur c1
.O i►ro 18p?
(A tg e s is re) (Affix Des' er mp Here)
PLEASE RET N TO BARNSTABLE PUBLIC MALT I DI SION CERTIFICATE
OF COMPLIANCE WILL NUT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTAftE PUBLIC HEALTH DIVISION
THANK YOU.
Q:\septic\Designcr CcrtMcation form Rev 8-14-13.doe
Town of Barnstable
Department of Regulatory Services
n�rwarent�o k Public Health•Division Date Et b
MAas. +
s�3P 200 Main Street,Hyannis MA 02601 X1
[�/ � l Time Y
Date Scheduled_ '�• /•�. � •� ""'
. e Fee Pd._ •�
• Soil Suitability Assessment for se,�7�eispoi*wl
.
Performed•By: e'1G2� Pt7Y•¢yt`¢i i �1 I CSC ' �
• Witnessed Hy:
LOCATION&.GENERAL INFORMATION
Loentlon Address Owner's Name
Address 1v ovlv!uS Vb&j! POO "Y
Assessor's Map/Parcel: 0 f 8 Engineer's Name aG — �lAtylrsG
NEWCONSTRUC77ON REPAIR X, Telephbne 500-273-0377
Land Use [1't41Q kidYV11�V (�Ll2�TIG Slopes(96) 0 Surface Stones
Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage Way i ft Property Line ft Other _ ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pero tests,locato wetlands-in proximity to holes)
See PIC'M
Parent material(geologic) C)lA t'was. Depth to Bedrock 7 13pZ'�
Depth to Groundwater. Standing Water in Hole: 30l . bsrS Weeping from Pit Foos > 13 a blS
' u
Estimated Seasonal High Groundwater -7 13 Lag
DETERMINATION FOR SEASONALMIGH WATER TABLE
Method Used: t7itrcl &ow_ryyAj0A
Depth Observed standing in obs,hole: 713•L in, Depth to still mottles: k3'X In,'
Depth to weeping fiom side of obs.hole: 7 t 3— -- 111, .Groundwater Adjustment fk.
Index Well-# Reading Date: Index Well level Arj,-ftrctor, :�Adj.Groundwater-Level,,
PERCOLATION TEST Dole,9t1_51 rime 10tao AM
Observation
Hole# Time at 4" —
N
Depth of Pero 16 Time at 6"
Start Pro-soak Time® &Q?_AM Time(V-6")
End Pro-soak 0'15, m
Rate Min./Inch G
Site Sul tabillty Assessment: Sito Passed y/ Site Failed: Additional Testing Needed(YIN) Aj
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 Conservation Division at least one (I)week prior to beginning.
Q:ISEPTICIPBRCFORM.DOC
DEEP•OBSERVATION HOLE LOG Hole# / 4Z '
Depth from Sall Horizon Soil Texture Sdil Color Sall. Other
Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders.
Pi stency.%'aravel)
0-6 -
6- 36 3 LS 10''y'r
36-13 C G S 2.5 Y-6/4 - Sane ejMVel•$cobbles
DEEP OBSERVATION HOLE LOG Hole#
Depth from Sol]Horizon Soll Texture Sall Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Sall Texture Sall Color Sall 'Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders..
Consistency.
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil horizon. Soil Texture Sall Color gall Other
Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders,
Flood Insurance Rate Map:
Above 500 year f load boundary No— Yes �_ f
Wlthln 500 year boundary No Yes
Within 100 year flood boundary No.V Yes .
Death of Naturally Occurring Pervious Materlal
Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the
area proposed for the soil absorptibn system? 5
If not,what is the depth of naturally occurring pery ous material?
Certification
I certify that n 1 • 2�. (dated I havepassed the soil evaluator examination approved by the
Department of Environmental Protectioqqd that the above analysis was performed by me consistent with .
the required trainin ertis• and ex ri cc described in 10 CMR-15.017.
Signature Datb N 26 1
Q.Mjrrl0PBRCP0RM.D0C
FES 8 1998
j-� COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS John Graci
DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector
ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119
TeaTicket,Ma.
(508)564-6813
TRUDY COPE
Secretary
ARGEG PAUL CELLUCCI DAVID B.STRUHS
Governor Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: 70 DUNNS POND RD. HYANNIS MAP 270 PAR018
Name of Owner n/a
Address of Owner: LOU GUERRIEO;2 ARROW ST.BILLERICA MA.01821
Date of Inspection: 1/20/99
Name of Inspector:(Please Print)JOHN GRACI
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000)
Company Name: John Graci Title V Septic Inspection
Mailing Address: P.O.Box 2119 TeaTicket,Ma.02636
Telephone Number: (608)664-6813
CERTIFICATION STATEMENT
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 inspection.The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems.The system:
X Passes
_ Conditionally P s s
_ Needs Further luation By the Local Approving Authority
Fails
Inspector's Signature: �y Date:212199
The System Inspector sh I submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of
completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner
shall submit the report to the appropriate regional office of the Department of Environmental Protection.The original should be sent to the
system owner and copies sent to the buyer,if applicable,and the approving authority.
NOTES AND COMMENTS
THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING SYSTEM EVERY YEAR TO PROLONG THE SYSTEM'S USEFULL LIFE.
revised 9/2/98 Page 1 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20/99
INSPECTION SUMMARY: Check A, B, C, or D:
A. SYSTEM PASSES:
_ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated
are indicated below.
COMMENTS:
System passes Title V inspection
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.
Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not.
ND The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or
the septic tank,whether or not metal,Is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank
failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as
approved by the Board of Health.
NI2 Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)
or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).
broken pipe(s)are replaced
obstruction is removed
_ distribution box is levelled or replaced
NI2 The system required pumping more than four 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
obstruction is removed
revised 9/2198 Page 2 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20/99
C. FURHTER 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 the public health,safety
and 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 ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within 50 feet of surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh.
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 AND SAFETY AND THE ENVIRONMENT:
The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a
surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well.
The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well,
The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the
well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less
than 5 ppm,Method used to determine distance nLLa_(approximation not valid).
3) OTHER
nta
revised 9/2/98 Page 3 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20/99
D. SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is
identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure.
Yes No
X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool.
X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped nLa.
X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
X Any portion of a cesspool or privy is within a Zone I of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well,
X 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds,
ammonia nitrogen and nitrate nitrogen.
E. LARGE SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and
safety and the environment because one or more of the following conditions exist:
Yes No
X the system is within 400 feet of a surface drinking water supply
X the system is within 200 feet of a tributary to a surface drinking water supply
X 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)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the
Department for further information.
revised 9/2/98 Page 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20/99
Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following:
Yes No
X Pumping information was provided by the owner,occupant,or Board of Health.
X None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates
during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection.
X As built plans have been obtained and examined.Note if they are not available with N/A,
X The facility or dwelling was inspected for signs of sewage back-up.
X The system does not receive non-sanitary or industrial waste flow.
X The site was inspected for signs of breakout,
X All system components,excluding the Soil Absorption System,have been located on the site.
X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles
or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption
System on the site has been determined based on:
X Existing information,For example,Plan at B4O,H,
X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)
[1 5.302(3)(b))
X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of
SubSurface Disposal Systems.
revised 9/2/98 Page 5 of 11
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner! n/a
Date of Inspection:1/20/99
FLOW CONDITIONS
RESIDENTIAL:
Design flow.,o g.p.d./bedroom
Number of bedrooms(design): 2 Number of bedrooms(actual):nta
Total DESIGN flow: nta
Number of current residents:nLa
Garbage grinder(yes or no):NO
Laundry(separate system)(yes or no): DLO If yes,separate inspection required
Laundry system inspected(yes or no):JLO
Seasonal use(yes or no): YES
Water meter readings,if available(last two year's usage(gpd): Wit
Sump Pump(yes or no): DLO
Last date of occupancy: nLa
COMMERCIAL/INDUSTRIAL
Type of establishment: nta
Design flow: Wit gpd(Based on 15.203)
Basis of design flow: nLa
Grease trap present:(yes or no):DLO
Industrial Waste Holding Tank present:(yes or no): Na
Non-sanitary waste discharged to the Title 5 system:(yes or no):NO
Water meter readings.if available:nLa
Last date of occupancy: nta
OTHER: (Describe)
n&
Last date of occupancy: Wa
GENERAL INFORMATION
PUMPING RECORDS and source of information:
SYSTEM HAS NOT BEEN PUMPED IN 10 YEARS
System pumped as part of inspection:(yes or no):NO
If yes,volume pumped Wit- gallons
Reason for pumping: n&
TYPE OF SYSTEM
X 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)
1/A Technology etc.Attach copy of up to date operation and maintenance contract
Tight Tank Copy of DEP Approval
Other: Wa
APPROXIMATE AGE of all components,date installed(if known)and source of information:
SYSTEM IS 50 YEARS OLD
Sewage odors detected when arriving at the site:(yes or no) DLO
revised 9/2/98 Page 6 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20199
BUILDING SEWER:
(Locate on site plan)
Depth below grade: ]'
Material of construction:_ cast iron _ 40 PVC X other(explain)
Distance from private water supply well or suction line: TOWN
Diameter: nLa
Comments: (condition of joints,venting,evidence of leakage,etc.)
n&
SEPTIC TANK: X
(locate on site plan)
Depth below grade: LEVEL
Material of construction:X concrete_ metal_ Fiberglass Polyethylene _ other(explain)
nLa
If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): N
Wa
Dimensions: 6'X6'BLOCK CESSPOOL
Sludge depth: 3"
Distance from top of sludge to bottom of outlet tee or baffle: I
Scum thickness:
Distance from top of scum to top of outlet tee or baffle: 6"
Distance from bottom of scum to bottom of outlet tee or baffle: 17"
How dimensions were determined: MEASURED
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,
etc.)
IN cEsSPOOL AND ALL COMPONENTS ARE STRUCTURALLY SOUND RECOMMEND PUMPING SYSTEM EVERY YEAR
GREASE TRAP:
(locate on site plan)
Depth below grade:
Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain)
Wa
Dimensions: Wa
Scum thickness: nla
Distance from top of scum to top of outlet tee or baffle:_uLa
Distance from bottom of scum to bottom of outlet tee or baffle Wa
Date of last pumping: n/a
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,
etc.)
nLa
revised 9/2/98 Page 7 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20/99
TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection)
(locate on site plan)
Depth below grade: nLa
Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain)
nLa
Dimensions: nLa
Capacity: nLa gallons
Design flow: nLa gallons/day
Alarm present: NQ
Alarm level:jiL& Alarm in working order:Yes—No—: NO
Date of previous pumping: nLa
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
nta
DISTRIBUTION BOX: _
(locate on site plan)
Depth of liquid level above outlet invert:Wa
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
Jt
PUMP CHAMBER: MO
(locate on site plan)
Pumps in working order:(Yes or No): MQ
Alarms in working order(Yes or No): DLO
Comments:
(note condition of pump chamber,condition of pumps and appurtenances.etc.)
nLa
Y
revised 9/2/98 - Page 8 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20/99
SOIL ABSORPTION SYSTEM(SAS): X
(locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods)
If not located,explain:
nLa
Type:
leaching pits,number: 1000 GALLON PIT
leaching chambers,number: ,n/a
leaching galleries,number: j3La
leaching trenches,number,length: nLa
leaching fields,number,dimensions: Wa
overflow cesspool,number: 6'X6'BLOCK
Alternative system: Wa
Name of Technology: jiLa
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
THE LEACH PITS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY THE PITS ARE EMPTY PITS HAVE BEEN 3/4 FULL.
CESSPOOLS: _
(locate on site plan)
Number and configuration: n(a
Depth-top of liquid to inlet invert: nLa
Depth of solids layer: Wa
Depth of scum layer. n&
Dimensions of cesspool: DLa
Materials of construction: n&
Indication of groundwater: n& inflow(cesspool must be pumped as part of inspection)WA
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
n/a
PRIVY: _
(locate on site plan)
Materials of construction:nLa Dimensions:Wa
Depth of solids: nta
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
n&
revised 9/2/98 Page 9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20/99
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 100'(Locate where public water supply comes into house)
n/a
VAJ 4A G)
Ir .18 Q
�c y�
aC
�c
K
revised 9/2/98 Page 10 of 11
�1 :Y
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 70 DUNNS POND RD.HYANNIS MAP 270 PAR018
Owner: n/a
Date of Inspection:1/20/99
i
NRCS Report name: nta
Soil Type: Wa
Typical depth to groundwater: nLa
USGS Date website visited: nLa
Observation Wells checked: MQ
Groundwater depth:Shallow _ Moderate _ Deep _
SITE EXAM _ Slope
_ Surface water
_ Check Cellar
_ Shallow wells
Estimated Depth to Groundwater 12 Feet
Please indicate all the methods used to determine High Groundwater Elevation:
_ Obtained from Design Plans on record
X Observed Site(Abutting property,observation hole,basement sump etc.)
_ Determined from local conditions
Checked with local Board of health
_ Checked FEMA Maps
_ Checked pumping records
_ Checked local excavators,installers
X Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
USGS MAPS AND CHARTS
f� '
revised 9/Z/98 Page 11 of 11
f 1
------- --�---�----_----�- GENERAL NOTES
T.O.F. EL.= 44.5'± PROVIDE EXTENSION RISER FINISH GRADE OVER D-BOX= 41 .9'± FINISH GRADE OVER CHAMBERS = 41 .9' - 42.4'
WITH COVER OVER INLET& REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED
OUTLET TO WITHIN 6"OF F.G. RISER TO WITHIN 6"OF FINISHED GRADE STONE TO CROWN OF PIPE 1• UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
FINISHED GRADE F.G. OVER TANK EL. = 41 .5' - 41 ,8' 4" SCHEDULE 40 PVC ACCESS BOX WITH COVER TO GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
�- @ FOUNDATION= 43.3 J _ 5" DIA. OUTLET(S) MIN SLOPE 1% (SEE NOTE#21) 2' OF 1/8' TO 1/2"DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES.
_ STONE OR GEOTEXTILE FILTER FABRIC
20" MIN. ACCESS 9"MIN. F - - - - -- 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
COVER (3 TYP.) 36"MAX. } DESIGN ENGINEER.
PROP. SCH. 40 9"MIN. I TOP OF SAS= 39.43' PLACE RISERS ON ALL
PROP. SCH. 40 CHAMBERS WITH
PVC SEWER PVC SEWER 4"PVC TEE 36"MAX. � 9„MIN' INLET PIPES TO 6"OF 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
2" DROP MIN. 38.60 36 MAX. BREAKOUT EL= 39.10' SYSTEM UNLESS OTHERWISE NOTED.
FINISHED GRADE
MIN.SLOPE @ 1% 6" 3" 3" 9" 4, TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
3" DROP MAX. MIN.SLOPE @ 1 i L=29±
PROVIDE WATERTIGHT o ELEVATION =39.10' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
T1
10" 4" PVC IN FROM JOINTS (TYP.) o � 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF
14 39.35' SEPTIC TANK O 4" PVC OUT TO O o o O _ THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
LEACHING FACILITY p 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
39.60' Too 00 � 0 00 °° � 0 � � 0
48" OUTLET TEE 38.97' M N. 38.80' 2� pp o o ppp pp� 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
GAS BAFFLE 6" CRUSHED STONE 00 p o CD
FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
15.9'OFFSET TO FND OVER MECHANICALLY po 00 _ NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
COMPACTED BASE 1 -
6" CRUSHED STONE 5 OUTLET DISTRIBUTION BOX 4.0, 8.5 (TYP) 4.0' 4.83' 4.0' AND DESIGN ENGINEER.
OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE (�,P) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 44.00'
25.0' ESTABLISHED ON A NAIL SET IN TREE AS SHOWN ON THIS PLAN.
COMPACTED BASE ZUJR8 C ZVR8C BASE. FIRST TWO FEET OF OUTLET = < 30.90'
PROPOSED 1 ,500 GALLON H-10 CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 36.50 GROUND WATER ELEV. 12 83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
(Dimensions per Wiggin 5'MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
RIFY EXISTIC�� LENGTH 10'-8' WIDTH 5'-8" DEPTH 5'-8" Precast Corp., Pocasset, MA) CROSS SECTION VIEW 2 - 500 GALLON H-10 CHAMBERS lrI-iAWIbEK LIND VIEvV 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
*ck-']1 71f11.+1 V'' ' " V L TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER.
ELEVATION PRIOR TO ANY WORK & SEPTIC TANK PROFILE DISTKiI�Q SON L)�A ��TAIL H-10 CW , ER DETAILS
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.
- - 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
U.P. #389lE/
' ` �,/• ". • • i TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM+ • '$
• 15333 APPROPRIATE AUTHORITY.
► • � .�"Y'° • . PERC NO.
SWING-TIES a, ,I/• !���¢ ,. 00V r. � toINSPECTOR: Donald Desmarais, R.S. 12, ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED
11" s• + UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR
. :. • • EVALUATOR: Michael Cr\ Pimentel, C.S.E DESCRIPTION HC-1 HC-2 HC-3 • , TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
i
O • {'" �, ,,, -- C.S.E. APPROVAL DATE: Oct. 1999
SEPTIC TANK INLET(1) 18.7" 26.2' -- ■;.> f ► 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
••+r . 3 DATE: April 25,2017
SEPTIC TANK OUTLET(2) 19.2' 22.8' -- . • + . -' , ` �.10• ' TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
• .` g` MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
Q CORNER OF STONE (3) • �. ' . • l+` +► °' ELEV TOP= 41.90' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
Q pis • . -t I• • « r ' , a ° FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
CORNER OF STONE (4) - 34.7' 51.0' 3 , •; ,. ELEV WATER=
�, C �� h 'ch • sQ • ,• - 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
O �OO� CORNER OF STONE (5) _- 43.3' 57.2' Y" e� ` PERC RATE - < 2 mpi SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
�� Cys CORNER OF STONE (6) __ 32.8' 39.3' �`• � - DEPTH OF PERC= 36" -54" 16. PROPOSED PROJECT IS LOCATED WITHIN:
■•# * • • ► ASSESSOR'S MAP 270 LOT 18
J� t
mow,. TEXTURAL CLASS: 1�O \��� Cq� �••+ •• d� +�• � r .• : `•..,v...
O S O \ + • T�• I OWNER OF RECORD: GEORGE W. & MICHELLE M. COLE
*t .co S�� �'� / -43 --- .I' .• 0„ 41.90'
z " p MAP 270 � *- LOCUS , ZONE 2 Fill ADDRESS: HYANN S, MA 026010AD
p� / .�i Ir j
g J� h� \ \\C LOT 17FEMA FLOOD ZONE X
0
J `'���� �� S I `•• •• r,• • • �'\' COMMUNITY PANEL# 25001 C0564J
729 g?70 , •'.�;•` ± . est`, 1 Y Loam Sand
17. DEED REFERENCE: L.C.C.#159416
/ B 10Yr 5/8
MAP 270 �' }� 16+. F t:` • •♦ • f • ••
' • 18. PLAN REFERENCE: L.C. PLAN#10614-E
OR k / ?"�i r • .
LOT 18 N\ }/} A • • .• s �fi > s ` �-A �` ! 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
/ 12,916±S.F. / t� `'r4 + •• 36" 38.90'
'��'� /} ° • •, i + ' • 3 ' Perc 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
+ ' '.11 • •. FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
�( N • : `s!t :• • 54" 37.40' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
#70 I ' • r• • •; . r Coarse Sand 21 A 4" PERFORATED SCH 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A
EXISTING \ 1 , •• ' �� - , •'�� . _ �. • ,� 2.5Y 6/4 2-BEDROOM C (variegated colors, DEPTH OF THE BOTTOM OF THE SAS AND EXTEHD TO WITHIN 3"OF FINISH GRADE. A DWELLING EXISTING LEACHING PIT TO BE some gravel&
REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS.
\ (
TOF = 44.5'± PUMPED, FILLED WITH CLEAN boulders) 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL
4/ \ COARSE SAND, AND AS" '-)ONED LOCUS PLAN REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT.
w
i I BH \ -ram SCALE: 1" = 1000'
EX. I NV =41.6'± f"�� 132" 30.90' LEGEND
No Mottling, Standing or Weeping Observed
SOxO' EXISTING SPOT GRADE
BIT. �2- �-� DESIGN DATA TEST PIT DATA 50 EXISTING CONTOUR
DRIVEWAY \ / �
I , / ��\ i -�,1-- PROPOSED CONTOUR
� PERC NO. 15
C-3 _0
333
w� \ HC- �s PROPOSED 1,500 GALLON NUMBER OF BEDROOMS (EXISTING) 2 INSPECTOR: Donald Desmarais, R.S. 50 PROPOSED SPOT GRADE
DECK 8' SEPTIC TANK 4.. NUMBER OF BEDROOMS (DESIGN) 3 (MIN. PER TITLE V) EVALUATOR: Michael Pimentel, C.S.E
i HC-2 > J LP 7 C.S.E. APPROVAL DATE:
k DESIGN FLOW 110 GAUDAY/BEDROOM Oct. 1999 EXISTING
DATE: April 25, 2017 ---- D/H/W EXISTING OVERHEAD WIRE
TOTAL DESIGN FLOW 330 GAUDAY
/ DESIGN FLOW x 200 % 660 GAUDAY TEST PIT#: 2 �„/ �„/- EXISTING WATERLINE
USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV TOP= 42.40' TEST PIT LOCATION
MAP 270 ELEV WATER= <31.40'
CID / LOT 257 PERC RATE = LP
\ /}/ J EXISTING LEACHING PIT
\ /} a2x4' INSTALL 2 - 500 GAL. CHAMBERS w/ AGGREGATE DEPTH OF PERC= CP EXISTING CESSPOOL
/�Q1 SHED / TEXTURAL CLASS: 1
SIDEWALL CAPACITY
\ C,�� 3) (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY - O O O PROPOSED 1,500 GALLON SEPTIC TANK
�,_ (25.0' + 12.83') (2) (2') (0.74 GPD/S.F.) = 112.0 GAUDAY
< 41x8' 0" 42.40' PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE
I/~\ /ass o �►} X _ �ry 42x3' / L-EXISTING CESSPOOL TO BE BOTTOM CAPACITY Fill 0 PROPOSED DISTRIBUTION BOX
\4 }/ 42 6 PUMPED, FILLED WITH CLEAN (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY 6" 41.90'
MAP 270 '? \gip„ COARSE SAND, AND ABANDONED (25.0'x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY PROPOSED 500 GALLON H-10 LEACHING CHAMBER
s- F \ o
LOT 19 \\_L
(6 42x3' . . O 4� ^oo o
Loamy Sand
'�. ATOTALS: B10Yr 5/8
TP2, 10 42x0 MAP 270 REV. DATE BY APP'D. DESCRIPTION
\ 42x4 I DTP 1 7' LOT 256 TOTAL NUMBER OF CHAMBERS 2
18" ?S0, TOTAL LEACHING AREA 472.2 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE
41 x9'
42xa' . 36' 39.40'
Benchmark ?�?0, TOTAL LEACHING CAPACITY 349.4 GAL.fDAY ►1►►��11/4 PREPARED FOR:
Nail Set in Tree �, �a 0H OF 10gSS
Elevation =44.00' \, 42x4'
PROP. D-BOX ,� �, CAPEWIDE ENTERPRISES
Approx. M.S.L. N.
7, 5) Coarse Sand CNUR NN JIILL JR.
2.5Y 6/4
C (variegated colors, NI 07 LOCATED AT
PROPOSED TWO (2) 500 GALLON o some gravel&LEACHING CHAMBERS W/ � 41x9' boulders) °`, E 70 DUNN,S POND ROAD
SURROUNDING AGGREGATE 117 HYANNIS, MA 02601
42 �zG
SCALE: 1 INCH = 10 FT. DATE: APRIL 26, 2017
132" 31.40' 0 5 10 20 40 FEET
PROPOSED INSPECTION PORT \ NOTES: No Mottling, Standing or Weeping Observed
. . 1.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF
PREPARED BY:
THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY NTH TEST -- - - ----- JC ENGINEERING, INC.
PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL RESERVED FOR BOARD OF HEALTH USE 2854 CRANBERRY HIGHWAY
�,' BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT NTH TEST PIT DATA.
SITE PLAN �� EAST WAREHAM, MA 02538
2.) ENTIRE PROPERTY IS LOCATED WITHIN A STATE DESIGNATED ZONE 11, 508.273.0377
SCALE: 1"= 10' AND THE WELLHEAD PROTECTION OVERLAY DISTRICT.
Drawn By: BJW Designed By: BJW Checked By: MCP JOB No.3797