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HomeMy WebLinkAbout0032 ERIN LANE - Health 32 Erin l ane Fiyannis,t— ~ - 291 017003 T I I �>I n e i� L� ry a Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments _c rD 32 Erin Ln C-E) Property Address WEINTRAUB, JACOB & SHERI 'h Owner Owner's Name information is = , required for every Hyannis Ma 02601 5/2/18 .-P4 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 way. Please see completeness checklist at the end of the form. Important:out forms A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain Company Name 35 Content Ln Company Address Cotuit MA 02635 City/Town State Zip Code 508-364-9587 S113522 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 5/3/18 .Ospector'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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Formo -- Subsurface Sewage Disposal System Form Not for Voluntary Assessments 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is Hy Ma 02601 5/2/18 Hyannis required for every State Zip Code Date of Inspection page. City/Town 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: System contains a 1,000 gallon septic tank. As well as a concrete distribution box and a 12' x 32' field. 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 page. Cityrrown 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 9.' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 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 %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 wM 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 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 1:1 El 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 f M h o Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 y 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) ® ❑ 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): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 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 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 page. City/Town State Zip Code Date of Inspection D. System Information Description: 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 ears usage 218 GPD 9 ( Y 9 (gPd))� Detail: 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 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: Not provided 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 °M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 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: Installed 8/8/08 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5feet 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: 2feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 J If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 page. Citylrown 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 24" 3,. Scum thickness Distance from top of scum to top of outlet tee or baffle 42" Distance from bottom of scum to bottom of.outlet tee or baffle Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 page. City/Town 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 32 Erin Ln M Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is H required for every annis Ma 02601 5/2/18 y 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 Level and at normal level 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.): 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: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ;M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 13'x32' ❑ 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.): Inspection port was dry down to level of leach field. 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 Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 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-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 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is Hyannis Ma 02601 5/2/18 required for every y page. Cityrrown 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: 1+ft 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: 8/8/08 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: Test hole data on 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 J 5/4/2018 Assessing As-Built Cards TOWN OF BARNSTABLE �� p LOCATION SEWAGE v VILLAGE ASSESSOR'S MAP&PARCE D INSTALLER' NAME&PHONE NO. SEPTIC TANK CAPACITY IC700 LEACHING FACILITY:(type) -Q�S//lj�i` (sine) NO,OF BEDROOMS OWNER r.h PERMIT DA COMPLIANCE DATE: &Jg0k Separation Distance getween the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY A7 ` 1 � A S g y0 http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar-291017003&seq=1 1/2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 32 Erin Ln Property Address WEINTRAUB, JACOB & SHERI Owner Owner's Name information is required for every Hyannis Ma 02601 5/2/18 page. Citylrown 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 TOWN OF BARNSTAELE rc LOCATION 42 SEWAGE �U VILLAGE e -� , ASSESSOR'S MAP&PARCE O INSTALLER' NAME&PHONE NO. Li{,r�i�, /' f'Y( /IV SEPTIC TANK CAPACITY LEACHING FACILITY:(type) �� i/ (size) NO.OF BED OOMS OWNER trv� PERMIT DA E: COMPLIANCE DATE: eflOg Separation Distance. etween the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY c7C1 03 17 7 P �� I'. — Va �aatxatilU1L' P# Department of Regulatory Services t MAU Public Health Division >b�as Date 200 Main Street,.Hyannis MA 02601 Date Scheduled Time Fee Pd.Ja2::�� Soil Suitability Assessment for Sewage Disposal Performed By 4 Witnessed By: tS Location Address LOCATION&GENERAL,INFORMATION J t"1 IJ I " Owner's Name r g A I I A N y AJ)j is K/\A Address 3 �1 v Assessor's Map/Parcel: 2q,l/ l r -0 3 Engineer' �s Name / • ��n► L>J� qv'p'I"N is NEW CONSTRUC7TON REPAIR ,/� a Telephone# Land Use—11 f�6'I/�t�M�� Slopes('Yo) .0 $`'' r Distances from: 0 Surface Stones Open Water Body /�' � R possible Wet.Area '--�--`�ft DrinkingWat��yell,��{t Drainage Way `>,I b rJ fit Pro � 1� Perry Line —_R Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes& perc tests,locate wetlands Sin proximity to holes) Se P • N ® .- 2 ram- Q)) a - 1 UD N UD r- rn Parent material(geologic) l'.I/ -VfN Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from pit Face Estimated Seasonal High Groundwater L Method Used; DETERMINATION FOR SEASONAL HIGH WATER TABLE Depth Observed standing in obs.hole: Depth to weeping from side of obs.hole: In. Depth to soil mottles; Index Well# Reading Date; In tn, Groundwater Adjustment Index Well level Ad.factor ft. j �- Adj,(lroundwater level,ie Observation PERCOLATION TEST Hole# bete> Time _ t J y. . Depth of Pere J Time at 9"7 -- p Start Pre-soak Time @ Time at 6"f l 1� f, Time(9"•6") End Pre-soak � 17 ^'--�---�— x RateMinJinch AA, Ivl, Site Suitability Assessment: site kissed SiteFailed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conduc first noted within 100'of wetland,you must ' ry Barnstable Conservation Division at least one(1)week prior to beginning, notify the Q:1SHMOPERCFORKDOC J • t DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon 3 Soil Texture Soil Color Soil Other Surface(in.) '.(USDA) (Munsell) Mottling (Structure,Stones;Boulders. Cousist= ravel) +� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% 0,A,L I d Cq DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color. Soil Other Surface(in.) (US A) (Munsell) Mottling (Structure,Stones,Boulders. Co si tency.%G DEEP OBSERVATION HOLE LOG Hole# N Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. • consist f Flood Insurance Rate Mai): Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No yes.'— Denth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring peryious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material?,._.._...._...._. Certificati In I certify that on ® o (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 requir in ,expertise and experience described in 310 CMR 15.017. Signature Date � b� No. �, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIppgicatiou for Th5pogal i§pgtem (fon5tructiou Permit Application for a Permit to Construct( ) Repair VKUpgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Locati n Address or Lot No.51 F RI a'v f"` I/V Owner's Name,Address,and Tel.No }^ Assessor's Map/Parcel 6171063 -^ Installer's Name,Address,and Tel.No. ���¢�.7 esigner's Name,Address and Tel.No. A00V Type of Building: Dwelling No.of Bedrooms /' Lot Size 1125 i�� sq. ft. Garbage Grinder ( ) Other Type of Building o.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �r�' � gpd Design flow provided � gpd Plan Date Number of sheets Revision Date Title C / Size of Septic Tank /� � , Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ` r ,. , ,/F_ 4Z,— `'ShIna / 0 _ 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 notto-place the system in operation until a Certificate of Compliance has been issued by i?/this Board of He ,It . ter p Signed �d 7Date Application Approved by �^ Date d Application Disapproved by: Date for the following reasons Permit No. Date Issued �.d 1. No. .9009 -5" Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Migogar 4§pgtem Con0truction permit Application for a Permit to Construct( ) Repairll�) Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No1�,,P 1 - Owner's Name,A dress, nd Tel.No. Assessor's Map/Parcel Q� Ob Installer's ame,Address,and Tel.No. Designer' Name,Add ess and T.el.L�Io. �4 �tiT/4G � oo, d f f-.S,1r/r�r-u Type of Building: / Dwelling No.of Bedrooms T Lot Size//25 � • sq. ft. Garbage Grinder ( ) Other Type of Building o.of Persons Showers( ) Cafeteria( ) Other Fixtures /• //� C/ �j Design Flow(min.required) y T gpd Design flow provided gpd Plan Date Number of sheets Revision Date C Title /� j Size of,Septic Tank //00 'EX� Type of S.A.S/� lr (//-/^7- — Description of Soil Nature of Repairs or Alterations(Answer when applicable) j'� /y�Qc D�-�`� 7 t� / 06a 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 Hea•Ith. Signed / %�'// !� Date Application Approved by Date / —4 Q Application Disapproved by: Date for the following reasons 0. Permit No. W � Date Issued --------- ----------- ------- —.�` —_ --_------- THE COMMONWEALTH OF MASSACHUSETTS , BARNSTABLE,MASSACHUSETTS ` Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewagge,Dnisposa System Constructed ( ) Repaired ( ) Upgraded ( ) ` Abandoned( )by Ik Norm n��� f at �K I LA "�- �1)N has been co trru tell in�ordance Q ' -oC/ with the provisions of Title 5 and.�th or Disposal System Construction Permit No. �009 dated v' L j� Installer ///'f� �� Designer f #bedrooms' r % Approved design flow L/ gpd The issuance of this permit shall not be construed as a guarantee that the system will function as dessi'gn'ed.� Date Inspector r#-� lti/' f 1 � No. ©� 3 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE, MASSACHUSETTS lwizpoaz i§p.5tem Conotruction permit Permission is hereby granted to Construct ( ) Repair /Upgrade ( ) Abandon ( ) System located at 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 in be completed within three years of the date of this pe i`t Date v r G��y (6j Approved by Town of Barnstable Regulatory Services I/ Thomas F. Geiler, Director t3ASNSrAISM Public Health Division Thom-as McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Dq Sewage Permit# 2JC0a 327 Assessor's Nlap\Parcel 42�? r 6171003 Designer: Y Y 46 1?11 Installer: UV) Address: 0 Address: 2 AlVt- On R • 7 1 i t1j) °C j�`✓V� `1N Vas issued a permit to install a (date) (installer) s tic System at � lV (,.lv �+ based on a desi��n drawn b� (add rr ss) dated 0 (designer) l certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation o' he distribution box and,or septic tank. I certify that the septic system referenced above was installed with major changes i.e. greater than 10' lateral relocation of the SAS or ant- 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. OF Mgss9� DA E.' M. E.� (I staller's Signature) \ o. 1140 1 UvI 'AFC/STE�� SOI TP,\I �g • fl (Designer's Signature) (_affix Designer's Stamp Here) PLEASE RETURN TO BARN ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE B ARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Heal th/Sepric'Designer Certification Form 3-264&oc COMPLETE . COMPLETE ■ Completeitems 1,2,and 3.Also complete A. ' ure item 4 if Restricted Delivery is desired. ❑Agent is Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printl Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, 12-`9 or on the front if space permits. D. Is delivery address different from Rem 1? ❑Yes 1. Article Addressed to: if YES,enter delivery address below: ❑No 3. Service Type ❑certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail 0 C.O.D. 4. Restricted Delivery?(ExtT-Fee) ❑Yes 2. Article Number - �: ; ill ; �7D06 2152 2.002 ] 041 `7552 (Transfer from service label) i t i; PS Form 3811,February 2004 Domestic Return Receipt �n2�ss o2.M-tsao UNITED STATE3`'P A, :°"rs:blt..:t; >� as'" .T`tl. ��0...aY:.: c:��.�.'�� yf''?�'e??y j •T �y„e."`*tttan� �.�..�"F"�we., �3uwiwiw:P" I • Sender: Please print your name, address, and ZIP+4 in this box • I _ I I I + TOWN OF BARNSTABLE. LOCA'i,ION �r° L f SEWAGE V LAGp- 6/ JA4 it(S ASSESSORS MAP& & INSTALI-ER'S NAME&PHOINE NO. sliPIIc TAN CAPACrry /d a00 O/ 1 LF,ACf.�r€c FACF-A=:(om) f',a' (om) Ce/ 1-10.OF BEDROOMS BEER OR OWNER. RIvTDATE: COMPL1AKCF— DATld Se aration Distance Between the: Maximum Adjusted.Groundwater Table to the Bottom of Leaching Facility feet Private Ter Supply Well and Ding Facility'(If any weUs exist on site or within 200 feet of leaching facility) lit Edge of Wetland and Leaching facility(if any wetlands exist within 300 feet leaclun facility Feet Furnished by c� 1✓�'► SC<e' i , 1 � Q i Q� �`''` 1 �1 14 PT- , n v � � - � 0 �. (� ,�. .W . ,� -h .y SEWAGE INSPECTIONS L^CA710N 32 Erin Lane DATE 1 /31 l 0 3 Hyannis,Mass 02601 ASSESSOR'S MAP & LOT a /"'0/ '00 -IIISPFCTOR Joseph P MaQomber Jr SEPTIC TANK CAPACITY 1 000 gallons 'Plus "iox i LEACHING FACILITY: (type) 1 -LP-1 000 6 ' X1 0 ' (size) yr)nn gal 1 nn NO. OF BEDROOMS BUU-DER OR OWNER Dominic T�arros OWNER MAILING ADDRESS Same - J ca s w o 'h S c / / O 1 L«! C. A"T ION 3 SEWAGE PERMIT NO. T 3 21 N A F 3 -F 76 It:LAGE I N S T A LLER'S NAME i ADDRESS 8 UILDER OR //O7�WNER DATE PERMIT ISSUED /eZ7/�� DAT E COMPLIANCE ISSUED "t � .. �G � � 0y �'t _�;>: . w '�,' w� oFzKE T� Town of Barnstable Barnstable Regulatory Services Department NAmedcaCft BAEW BILE, 1 1 4 MASM& Public Health Division i63q, ♦� m Aff° A 200 Main Street, Hyannis MA 02601. 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO July 21, 2008 Nationwide REO Brokers c/o David Holt 1533 Falmouth Road Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 32 Erin Lane, Hyannis, MA was last inspected on June 25, 2008,by Shawn Meelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Leach pit had clear signs of hydraulic failure with stain lines above inlet invert. Distribution box shows signs of being filled beyond it's capacity with water back-up from pit. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. (ii;scKean, ZRS., OARD OF HEALTH HO Agent of the Board of Health CERTIFIED MAIL 47006 2150 0002 1041 7552 Q:\SEPTIC\Letters Septic Inspection Failures\32 Erin Lane.doc Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 32 Erin Ln ILI Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448) Owner Owner's Name information is Hyannis MA 02601 6-25-08 required for every 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 way. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number f f B. Certification - I certify that I have personally inspected the sewage disposal system at this addres and t"the information reported below is true, accurate and complete as of the time of the insp ction. hp insp`'etion was performed based on my training and experience in the proper function and m taa'enance-,6f on Orllp sewage disposal systems. I am a DEP approved system inspector pursuant to tion 16 0 of Title 5 (310 CMR 15.000).The system: ❑ Passes . ❑ Conditionally Passes. ® Fails ❑ Needs Further Evalua 'A by the Local Approving Authority 6-26-08 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. o ****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. 32 erin hyannis-03/08 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts 9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Erin Ln Property Address ` Nationwide REO Brokers (Contact David Holt@Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis _ MA 02601 6-25-08 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: 4 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. Answer yes, no or not determined (Y, N, ND)in the ❑ for the following statements. If"not determined,"please explain. ❑ The septic tank is metal and over 20years 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 Boardof 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. ND Explain: ❑ 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 i ❑ obstruction is removed 32 erin hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 II Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City[Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: 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 mannerwhich 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 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. `. 32 erin hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 15 _ Commonwealth of Massachusetts N W Title 5 Official Inspection F®rrn - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448).` Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cost.): ❑ 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 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 El ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ®. ElStatic 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 'h day flow El ® 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. El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 32 enn hyannis•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601' 6-25-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): . Yes No ❑ ® 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 r 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. 32 etin hyannis-oma_ Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts ' W Title 5 Official n Insp ecti0 Form rm a Subsurface Sewage'Disposal System form -Not for Voluntary Assessments ^M 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis - MA 02601 6-25-08 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 R ❑ ® this inspection? ® ElWere 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? r ® ❑ 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 facilityowner and occupants i i( pants f 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 CM 15.302(5)] 32 erin hyannis•03/08 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real.Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 for example: 110 d x #of bedrooms): 220 ( P 9P ) Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if.available (last 2 years usage (gpd)): , Sump pump? ❑ Yes ® No Last date of occupancy: 5-08 Date Commercial/Industrial Flow Conditions: ,+ Type of Establishment: Design flow(based on 310 CM 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: Last date of occupancy/use: Date Other(describe): 32 erin hyannis-03/08 i Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate~1=800=966-2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information PumpingRecords:- Source of information: N/A 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): ' Approximate age of all components, date installed (if known) and source of information: 1984 Were sewage odors detected when arriving at the site? ❑ Yes ® No 32 erin hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts = Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form Not for Voluntary Assessments. , 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 24 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.): Good condition. Septic Tank(locate on site plan): Depth below grade: 16"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 Sludge depth: 15" Distance from,,top of sludge to bottom of outlet tee or baffle 1 - Scum thickness 4 • 5 Distance from top of scum to top of outlet tee or baffle ' Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Tape 32 erin hyannis-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 t , Commonwealth of Massachusetts - Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Erin Ln Property Address Nationwide RECI Brokers (Contact David Holt @Today Real Estate 1-800=966-2448) Owner Owner's Name information is required for Hyannis f" '` MA 02601 6-25-08 every page. City/Town 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.): Tank in good condition with all baffles in place. Recommended pumping for solids. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete El-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 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): 32 erin hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection . Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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 Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 6 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 shows signs of being filled beyond its capacity with water back-up from pit. Pump Chamber(locate on site plan):' Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 32 erin hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 16 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt@Today Real Estate 1=800-966-,2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): i Soil Absorption System (SAS) (locate on site plan, excavation not required): If Sl S not located, explain why: 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 ( g y c failure, level of pondmg, damp soli, condition of vegetation, etc.): Leach pit had clear signs of hydrolic failure with stain lines above inlet invert. 32 erin hyannis•03/08 , Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 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.): 32 erin hyannis 03l08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments. t ,M 32 Erin Ln ' I Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800=966-2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town State Zip Code Date of Inspection D. System Information(cont.) Sketch Of Sewage Disposal System: Provide a sketch 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. o o P 970_ X' ry ri A A 32 erin hyannis•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 32 Erin Ln Property Address Nationwide REO Brokers (Contact David Holt @Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 6-25-08 every page. City/Town 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:, 20 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: ® Checked with local excavators, installers—(attach documentation) ® Accessed USGS database - explain: You must describe how you established the high ground water elevation: Town maps show groundwater at 20'. 32 erin hyannis•03/08 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 r ( `rye'( o egulatory Services BARNSTABLE, Thomas F. Geiler, Director 9�A 6 9. Public Health Division rfa►u..�a Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 REGARDING SEPTIC INSPECTIONS BY PRIVATE CONTRACTORS DISCLAIMER This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original or copy of the report; this Division does not warranty the functionality of the septic system in the future nor does this.Division agree with any technical observations and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would be listed on the "Disposal Works Construction Permit".. If you should have any questions regarding this report, please contact the certified. Septic System Inspector who conducted the inspection. Q:ISEPTICOisclaimer Private Septic[nspections.DOC i DATE : 1 /31 /03 PROPERTY ADDRESS32 Frin Lane H annis,Nfass. - 02601 ------------ On the above date, I inspected the septic system at the above address. This system consists of the following: 1 1 -1 000 gallon septic tank;1 2" below grade. RECEIVED 2. 1 -Distribution box. 18" below grade 3. 1 -1000 gallon .precast leaching pit. ( 6 'X10 ' ) Based on my inspection, I certify the following conditions: FEB 1 3 2003 _ 4. This is a title five septic system. ( 78 Code) TOWN OFBARNSTABLE 5.' The septic system is in proper working order HEALTH DEPT. at the present time. 6.•-Pumped septic tank at time of inspection. 7. Waste water is 24" below the invert pipe of the leaching pit. SIGNATUR / Name : _ J_- P_-Ma comber_Jr _ �7 ___- Corripany :29aQPh 8 Son, Inc . MAP Address @Qx _��_____ PARCEL o ®® rT _-/c-e-n-r2LYtL � _22-632-0066 Ph one : 508- 775_ 3338 -------- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools-Leachtlelds Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville. MA 02632.0066 775.3338 775.6412 I COMMONWEALTH OF M,ASSACHUSETTS = EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:32 Erin Lane Hyannis,Mass. Owner's Name: Dominic 13arros Owner's Address: Same Date of Inspection: 1 /31 /0 3 Name of Inspector: (please print) Joseph P.Macomber Jr. Company Name:J.P.Macomber & Son inc. Mailing Address:Box 6 6 Centerville,Mass. 02632 Telephone Number: 5 0 8—7 7 5—3 3 3 8 CERTIFICATION STATEMENT I certify that 1 have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my traiping 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 Conditional]%Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 'A,V_d5 The system inspector shall bmit 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. Notes and Comments ****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. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 32 Frin Lane Hyannis,Mass. Owner: Dominica 22 ros Date of Inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A� System Passes: 1 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: -Tht= sPDt -C system is in roper working order at the pror B. System Conditionally Passes: /L 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. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined"please explain. :4L 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 scpac 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. ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: XJJ 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 obstruction is removed ND explain: 2 J Page 3 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL, SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) PropeM Address: 32 Erin Lane Hvannis.Mass. Owoer:Dotninic 13arros Date of lospectioo: 1 /11 /03 C. Further Evaluation is Required by the Board of Health: Ab Conditions exist which require Nnher evaluation by the Board of Health In order to determine if the system , is failing to protect public health,.safety or-the environment. I. 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 wbich will protect public bealtb,safety and the environment: �d Cesspool or privy is within 50 feet ore surface water .f� Cesspool or privy is witbin 5o feet ore bordering vegetated wetland or a salt marsh 01 2. S)stem 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: �d The system has a septic tank and soil absorption system(SAS)and the SAS is within Ioo feet of a surface water supply or rributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 ore 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 0 feet or more from a private water supple well'' Method used to determine distance 'This system passes if the well water analysis, performed at a DEP certified laboratory, for eoliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facoiry 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 anached to this form. 3. Other: 3 i Page 4 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 32 Erin .Lane HYannis,Mass1 _ Owner: nr)m i r i r a R rrnS Date of Inspection: 1 4 31 .1 n'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 — �ogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or /cesspool f 1-4 .d��o 6"A-)Oi 'A Liquid depth in cesspeol'is1ess than 6"below invert or available volume is less than '/2 day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number f times pumped). y portion of the SAS, cesspool or privy is below high ground water elevation. /A: ny portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface o/;water supply. y portion of a cesspool or privy is within a Zone 1 of a public well. y 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 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, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) .ely (Yes/No)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. 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) yes no �he system is within 400 feet of a surface drinking water supply G system is within 200 feet of a tributary.to a surface drinking water supply the system is located in a nitrogen sensitive area(interim— — Y g ( m Wellhead Protection Area—IWPA)or a mapped Zone 11 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. 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 32. Erin Lane HYannis'Mass. Owner:Dominic Rarros Date of Inspection: 1 31 0 3 Check if the following have been done. Yod 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 ere any of the system components pumped out in the previous two weeks Z_ 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 ? y 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? c/ Were all system components,"cluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of tljee 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: Yes no / ✓ 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(3)(b)) 5 I Page 6 of 1 1 OFFICIAL INSPECTION FORM — NOT,FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 32 Erin Lane Hyannis.Mass. Owner: Dominic Rarros Date of Inspection: 1 j'31 j n-i FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CM I� 15.203 (for example: 1 10 gpd x # of bedrooms): Number of current residents: P Does residence have a garbage grinder(yes or no):-VO Is laundry on a separate sewage system yes or no):;!/d [if yes separate inspection required] Laundry system inspected (yes or no):,/ Seasonal use: (yes or no):X;b Water meter readings, if available (last 2 years usage (gpd)):2001 =1 70, 600 gallons=467. 40 GPD Sump pump(yes or no): .116 2 0 0 2=1 s 3 7 0 0 gallons=503. 29 GPD. Last date of occupancy: Dispute over water useage. COMMERCIAL/INDUSTRIAL A new meter has been installed Type of establishment: AO Design flow(based on 310 CMR 15.203): lan d Basis of design flow(seats/persons/sgft,etc.): /JJ Grease trap present(yes or no):" Industrial waste holding tank present (yes or no):4 Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: 160 Last date of occupancy/use: y��C OTHER (describe): X1110 GENERAL INFORMATION Pumping Records Source of information: Pum ed tank at time of, inspection. Was system pumped as part of the inspection (yes or no): If yes, volume pumped:/ oL9 ga!„ons -- How was qualttity Bumped determined? Reason for pumping: //y �VC���'I �a,/,�a� XfK ,,�'s TYPE OF SYSTEM ,/Septic tank, distribution box, soil absorption system ill$ 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) Tight tank ,)Q Attach a copy of the DEP approval Ad Other(describe): zw Appro2jimats,age of all compon�tt date installed (if known) and source of information: Were sewage odors detected when arriving at the site (yes or no):�� 6 Page 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 Erin Lane t-tyanni s,Mass. Owner:Dominic Barros Date of Inspection: 1 31 03 BUILDING SEWER(locate on site plan) Depth below grade:4 Materials of construction: cast iron /- 40 PVCA other(explain): ,GJ,� Distance from private water supply well or suction line:,0'A Comments(on condition of joints, venting,evidence of leakage, etc.): Joints appear tiaht.No evidence of leakage,The sytem is vented through the house roof vents./ SEPTIC TANK: 1�(locate on site plan) Depth below grade: /X J/ Material of construction: oncrete,00 metaW,# fiberglass.y�'aolyethylene .t/Jd other(explain) 14)? If tank is metal list age:.00 is age confirmed by a Certificate of Compliance(yes or no)�-� (attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness:— a Distance from top of scum to top of outlet tee or baffle: 0 Distance from bottom of scum to bolt m of outlet tee or baffle: How were dimensions determined: &ryl0fdr ,Ooir Ti.93t° O •.1.iL>�A'�' _J'�i� Comments(on pumping recommendation's, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of.leakage, etc.): , the septic tank ever 2-3 years. Inlet & outlet tees are in place. The- tank is ' structurally- sound and shows no evidence o ea age. Pumped the septic to k at time of inspection. Heavy scum & solids layers G ARA; �cate on site plan) SI� Depth below grade:4/q Material of construction:yLconcretW,-Imetal�fiberglass*Opolyethylenef/0 other (explain): �J,Q Dimensions: AJ4 Scum thickness: llt� _ Distance from top of scum to top of outlet tee or baffle: efW Distance from bottom of scum to bottom of outlet tee or baffle:_ 40 . Date of last pumping: ,!60 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): r_Aaarz trap i c-, nnt- praGPnt 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAddress-32 Erin Lane Hyannis,Mass. Owner:Dominic 13arros Date of Inspection: 1 31 03 TIGHT or HOLDING TANKt.)Vje- (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: ,4JA Material of construction: concrete A1,4 metal A.40 fiberglass polyethylene!_other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day, Alarm present(yes or no): x4� Alarm level:1_ Alarm in working order(yes or no): ,LG� Date of last pumping: W,,f Comments(condition of alarm and float switches,etc.): 'igt or holding tanks are not present. DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of leakage into or out of box, etc.): Qi;5tribution box has one lateral.No evidence of solids carry over.No evidence of leakage into or out of the box. PUMP CHAMBERfl"(locate on site plan) Pumps in working order(yes or no): 44 Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Pump chamber is not present. 8 I Page 9 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 Erin Lane Hyannis,Mass. Owner:Dominic Barros Date of Inspection: 1 /31 /0 3 SOIL ABSORPTION SYSTEM (SAS): Zlocate on site plan,excavation not required) 1-1000 gallon precast leaching pit ( 6 ' X10 ' ) If SAS not located explain why: Locate: See pane 10 Type leaching pits,number: leaching chambers,number: 42C leaching galleries,number: (3 /_)leaching trenches,number, length: d ,t2p leaching fields,number, dimensions: 6 . overflow cesspool,number: D innovative/alternative system Type/name of technology:/ /1(�r j�j� C 77 Comments(note condition of soil, signs of hydraulic failure,level of ponding, damp soil,condition of vegetation, etc.): Loam sand to boney sand to fine sand.No signs of hydraulic failure. Soils are dry. Waste water is 2 e ow the invert pipe Vegetation is normal. CESSPOOLU�L'L(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: __ Q Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: r9 Indication of groundwater inflow(yes or no):l Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Cesspools are not present, PRINIY,4�) (locate on site plan) Materials of construction: Dimensions: # Depth of solids: dlE Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Privv iG not present 9 Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 Erin Lane Hyannis,Mass, Owner: Dominic Barr Date of Inspection: 1 /31 /0 3 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. 32 Erin zra.. \ \a �\ B 10 Page I I of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:32 Erin Lane Hyannis,Mass- Owaer Dominic Aarros Date of Inspection: 1 /-11 /o 3 SITE EXAM Slope Surface water Check cellar Shallow wells i Estimated depth to ground water feet Please indicate (check)all methods used to determine the high ground water elevation: N Obtained from system design plans on record-If checked,date of design plan reviewed: NA =Observed site(abutting property/observation hole within 150 feet of SAS) pip._Checked with local Board of Health-explain: NA YFS Checked with local excavators, installers-(attach documentation) YF,S Accessed USGS database-explai$tttp: //town.barns table.ma.us. You must describe how you established the high ground water elevation: Used: Gahrety & Miller Model. 12/16/94 Ground water elevations above sea level. Used: USGS' nhRervation well data, June 1992 Used: USGS: Technicall hiillPttin g2_000-1 Plate #2 Annual ranges of ground water E-1 n anttia'y 99_2 Leaching Pit 9,�. - .eet PGroundwatc TFeetBelow Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore,the vertical separation distance between the bottom of the leaching pit and the adjusted groundwater table is feet. ll >'rrRTSTI.—rs r•rsr-T7—t�frrarnnfn.rRn ts*T.rsr1rr.•rP►T.�eRtslRfnAn.R1+t•Y/1�'R�at rn+ TURN OF Barnstable BOARD OF lIEALTII + -••'-Trr�_SU()SU[iFACF 9F,H�AGTDISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION I -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 32 'Erin Lane Hyannis,Mass. ASSESSORS MAP, BLOCK AND PARCEL * _291 /017/003 OWNER' s NAME Dominic Bdrros PART D - CERTIFICATION i NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J_P_Macomber & San In6`. COMPANY ADDRESS Box 66 Benterville,Mass. 02632 Street Town or City State LIP COMPANY TELEP14ONE (508 1 775 - 3338 FAX ( 508 .) 790 - 1 578 R CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate, and omplete as of the time of -inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one: y/Systeiri PASSED 1 The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have con tcted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature < Date .au ne copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALTH, * If the inspection FAILED, the owner or"'o" orator shall u d within one year of the date of the inspection, unless allowed ort required he m otherwise as provided in 3.10 CMln 16 . 305 . partd.doc Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: 5a,/ , o S ("0 X)s R i�:" BUSINESS LOCATION: I-,v7,-i. ODD/ Mail To: MAILING ADDRESS:C3` Board of Health TELEPHONE NUMBER- Q5D Town of Barnstable CONTACT PERSON: D a r'"/ d S P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: ��6rr�e o2"13-� 76.5_ Hyannis, MA 02601 TYPEOFBUSINESS: i .".t1 a./Lr/5 . Veer Lj Does your firm store any of the toxic or hazardous materials listed below, for sale or for you own use? YES 1// _ NO f This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address:n47ALI�- ADDRESS: zVd_X�'a15 Me- S'kg" a•f Me 1`0L,3,'�_--e 46e_ ►-e_Seo,J TELEPHONE: j � �,�,'��t%i' LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. 6 l Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners �r Automatic transmission fluid Disinfectants Engine and radiator.flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar c/sh Fertilizers Paints, varnishes, stains, dyes�l PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids /1•2�rI;���� l (.-fPW 6n, ,To (dry cleaners) �(�'�� � iv o ) s, f C Other cleaning solvents /moo r�,� a-74 Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS i LEGEND % ) N� xiOF - � PROPOSED CONTOUR ? f t •� mi f / I�a1 I ! --" aunt r^ a i f 7 1 { t DA �R ✓+ ® PROPOSED SPOT GRADE .t ��! �-� 'hl t, j f :gyp � j r--•-c M H BENCH MARK — 98 —— EXISTING CONTOUR �' � f$� l?v L i v\l I � Skaten0�nk N 11 0 i _ etitswa„ .._ PAINT SPn " ON pia,' TOP OF ,SOI IOTUBE + 96.52 EXISTING SPOT GRADE 7o 1& I t..- ( fci"j I G/ E V ;$i 1-7 F y Yt o a t V" i / I 7 3r , ,2 l m�4� 111 Q SANIWWI\ 1 ELEVATIOPs �= C�. 40 W— EXISTING WATER SERVICE ir't' �( �� i. u SIlE ` _''% i'Q EARNSTABLE GIS DATUM s l Z Existing Leach Pit TEST PIT L`. C' \t'�E iSw�Y! (See Note 10) 7 3G.62 ft 46 � v ` N �I i 1 w. on ` F 4t TH-1 \ LOCUS MAPN.T.S. V \ O GENERAL NOTES: / \ '1 �_ ) 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 5 BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS p p VEG / 2D I % / OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE \ 1 / y LOCAL RULES AND NEGULATIONS. \ \ 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE lye sp. Port;' DESIGN ENGINEER. � � �� �N ��� 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING i FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 't1 �wdte Iservice \\ o C // q ENGINEER BEFORE CONSTRUCTION CONTINUES. P 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. CP 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF ➢ O n HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. '� \ I i 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE \ yh THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING \ ! CONSTRUCTION. \•.\ \ \ L O T i i 10. EXISTING LEACHPIT TO BE PUMPED, CRUSHED AND FILLED \\ \1 AREA = 1 1 8 5 6 S f F — i� PER TITLE V. 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION \ \ 1 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY \ \ \ �----�•-46 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING PLA ( 14. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING 15. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPECIFIED) �U ,\•' \\ \ 2 Q) f t �� �.•\\\ �� �� SCALE: 1 in = � f o, `.\ o 0 20 ( 40 t \ \ 45 - - �/ 0 10 20 q - -- 9 lr 2' 59 ft Kit. Bth BR Bth PROPOSED SEPTIC SYSTEM UPGRADE PLAN BR BR 32 ERIN LANE, HYANNIS, MA Liv. Rm BR MAP: 291 Prepared for: Mike Dedecco SURVEY REFERENCE: LOT.0171003 Engineering by: Surveying by: SCALE DRAWN JOB. NO. PLAN OF LAND BY DOYLE ENGINEERING ASSOC. PLAN BOOK.'22013 DARRENM.MEYER,R.S. 'Eco-Tech Env/ronmenis] 1"=20" DMM FIRST FLOOR ICONO FLOOR PLAN PACE. 11s EASTS,oWICH,MA02537 (sob) 364-0894 D DATE CHECKED SHEET N0. DATED: MARCH 16, 1983 508-W22s22 08/01/08 DMM 1 Of 2 ELEV. TOP NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FOUNDATION INSTALL RISERS W/IN 6" OF FINISH GRADE (Existing) - - - - -' FINISH GRADE=45.75-46.0 -' 48.10 F.G.EL: 46.6 F.G.EL: 46.0 F.G. EL: 4610 A MAINTAIN 2% MIN SLOPE OVER LEACHING AREA MAX. COVER OVER S.A.S. = 36" a INSPECTION PORT TO PLACED ON END UNIT 6" 4" SCH 40 PVC ' 4" SCH 40 PVC 10"I ® S= 1% (MIN.) 6 3" To (MIN.) TEE'S ARE TO BE 14' 0 S= 1% (MIN.) INVERT - "� X 4" SCH 40 PVC INV. 43.0 - 16 INV.43.26LINV.42.80ROWS OF' 4-CULTEC C-4 UNITS x 8'/UNIT-32' • #' INV.ELEv.=42.70 GAS PROPOSED — SPLASH PAD TO CONSIST F EXIST. OUTLET � OSED DB 3 co s o BAFFLE '' UNDERLAYMENT OF FILTER FABRIC SUIL ABSORPTION SYSTEM (PROFILE) H—;10 DISTRIBUTION BOX EXTENDING 16' IN FROM START v.Ts OF ROW ESTABLISH VEGETATIVE COVER INV. 43.51 CULTEC NO. 410 FILTER FABRIC R EXISTING 1 ,000 GALLON SEPTIC TANK BACKFILL CLEAN S, {NATIVE O OR PERC SAND)) GAS BAFFLE TO BE INSTALLED ON 12" MIN. : .;s::.; :, ' '• BREAKOUT OUTLET TEE AS MANUFACTURED BY —4�' TOP OF CHAMBER ELEV.=43.37 f TUF—TITE, ZABEL, OR EQUAL INV.ELEV.=42.70 SEPTIC SYSTEM PROFILE BOTTOM ELEV.=42.45 — " - EXISTING SUITABLE 48" (TYPICAL) 6"f-- MATERIAL N.T.S. 5' MIN. ABOVE BOTTOM OF — T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH= 13.0' BOTTOM OF TESTHOLE EL. 35.17 USE 3 ROWS of 4-CULTEC C-4 FIELD DRAIN UNITS WITH 6" F SE ARATION BETWEEN EACH ROW & NO STUNS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING 3) INSTALL INLET & OUTLET TEES AS REQUIRED. Q F PIPE INVERTS PRIOR TO CONSTRUCTION. 4 GAS BAFFLE TO BE INSTALLED ON OUTLET TEE SOIL ABSORPTION SYSTEM SECTION 2) REPLACE EXISTING 1,000 GALLON SEPTIC AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. TANK WITH 1500 GALLON SEPTIC TANK �� o Dr' N n IF FAILED, DAMAGED, OR UNDERSIZED. - DESIGN CRITERIA a No. 1140 N SOIL LOGS NUMBER OF BEDROOMS: 4 BEDROOM SOIL TEXTURAL CLASS: CLASS I ,/ t DESIGN PERCOLATION RATE: <2 MIN/IN SANITAR�P� CULTEC CONTACTOR FIELD DRAIN C4 DATE: AUGUST 1, 2008 DAILY FLOW: 110 G.P.D./BR ,j(•�( UO SOIL EVALUATOR: DARREN MEYER, R.S., CSE DESIGN FLOW: 440 G.P.D. (M(N REO'D) vu MODEL FD C-4 R STARTER 4" DIA. INSPECTION PORT WITNESS: DONALD DESMARAIS, BANRSTABLE B.O.H GARBAGE GRINDER: NO SMALL R/B LARGE RIB LH— 1 PROPOSED SEPTIC TANK: 440 x 200% = 880 GPD a/�^/� Elev. Depth Elev. TH—2 Depth (USE EXISTING 1,000 GALLON SEPTIC TANK) 45.41 A 0" 45.75 0" LEACHING AREA REQUIRED: (440) = 594.59 S.F. MODEL FD C-4 E MIDDLE/END L�OYR 3/2 AMY 0 A LOAMY 3�2 D 74 SMALL RIB LARGE RIB 48 45.17 B ` -3" 45.5 e 3" USE. .3 ROWS OF 4 CUL.TEC G--4 UNITS WITH NO STONE ama A (1NOUUUMN 1 LOAMY SAND LOAMY SAND FOR AN S.A.S. HAVING THE DIMENSIONS: 13.0' x 32.0'. rj tOYR 6/8 10YR 6/8 „ BOTTOM AREA: (GENERAL USE APPROVAL FOR 6.7 SF/LF OF C­4 UNIT) 12 43.08 C1 28" 43.33 29" 12 TOTAL UNITS x 8.0'/UNIT = 96.0 FT C1 i 96.0' x 6.7 SF/LF = 643.2 SF rd 4" D/A. 8.5' MEDIUM MEDIUM S.F.)DESIGN FLOW PROVIDED: 0.74( .43. S.F.) = 4i5.96 G.P.D. vs. req'd 440 GPD 3�� � SAND PERC 0 40.91 SANG 5.0�.5' . . . . . . < • . . . " O O e o o • " 2.5Y 7/4 2.5Y 7/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN _ _ _ _ SMALL RIB LARGE RP/ 32-SKIN LANE, H1',ANNIS, MA ��- --- Prepored for: Mike Dedecco - -� CULTEC CaNTACIOR MD DRAIN C-A CHAUM STORAGE-raga a/rr Engineering by: -�` Surveying by: Y ' SCALE DRAWN T JOB. NO. ALL CaNTACMR MD DRAIN C-I00 WAVr DUTY 1IVITS ARE YARNED WITH A CIXQ4 STRIPE rOW!£D BVTC ME PART ACGWC THE LLWCTN Cr THE GUMB£R. 3cJ 1•] 1•23" DARKEN M.MEYER,�4.S. Sury Tech .En vironmectal 35.5. 123" D M M PO BOX961 N.T.S. PERC RATE <2 MIN/IN. ("C" HORIZON) EASTSANDWiCH,MA02537 (508) 364--0894 DATEy-� CHECKED SHEET NO, NO GROUNDWATER OBSERVED 508-362-2922 08/01/08 DMM 2 Of 2 i M SOIL LOG I EL N0. 1 O N0. 2 SITE PLAN 1� ann ` 4 — j TOP OF FOUNDATION EL.: /w :i �-� i --- g —----- -- G}f • '" • � �' M � � t' o� C o�E 2 'Z. % SzD?r: Lz Ac..+i N Gr Alz t A---, _ - f . • - s 0 rt IN,EL. 7 , G L p 10 e IN.EI �._� ... IN.EI. ���_ _- _ EL 17 - 11 2' COVER 1/8 3/8 WASHED STONE r— --- .. IN. EI . i o,f a e, 0 0 n �r;h-'�.� ` • D/B W/ 6 SUMP a ° ' ° - 3/4 1 1/2 WASHED STONE ' LIQUID LEVEL o ��'� ° ' 14 o. OVA 6'EFF. DEPTHf� ° .��°,� 15 PRECAST SEPTIC T WITH ; �. PERC TEST RESULTS I RECAS S P IC TANK IT �° 0�3 ; ' PRECAST LEACHING PITS P E R C RATE : ° ° WHITNESSED BY: � y------- CAST IN PLACE INLET AND EL. � �� �o� � t_. _ _ __ ° � NO.: �. _ SIZE : �` �Z�` r�t:�� ��n%11` E OUTLET T "S PER TITLE Y , �,r a .,trN .�hi�-_r___— BOARD OF HEALTH SIZE 3:,lo"L.f):uC 1r ,c � '/6 ;,.J, T �a C� DIA . ----- r; Csrr • DATE: l boo G,t.�DNS �- -- D I A . i PROFILE OF PROPOSED SEWAGE SYSTEM I SYSTEM DESIGNED BY THE TOWN Of REGULATIONS AND / STATE TITLE V FOR SUBSURFACE DISPOSAL OF SEWAGE . SCALE 1/4"= 1 ' D "* LoT 3 i lf"' 1/, SF ` N . B . N �, i 1. ALL PIPES SHALL BE SCHEDULE 40 P.V.C. SEWER PIPE 2. ALL PIPES SHALL BE SLOPED 1/4" PER FOOT EXCEPT FOR � THE FIRST 2 FEET OUT OF THE O / B WHICH SHALL BE LEVEL 3. DESIGN FLOW 2 BEDROOMS AT 110 GALDAY PER BR. GAL/DAY aa' f'e'`���j 30 1� SEPTIC TANK SIZE Xis = GAL . SePn�7,'V a USE GAL. W/ GARBAGE DISPOSAL LEACHING SYSTEM: USE r)i x ' F-F t EFFECTIVE AREA: SLOE BOTTOM�r .' x �.� = 3/ 4 G � � �s�sc S, � Er-Tu R� EL00 ���. ovs MA-, �r.. „w �� �' • TOTAL FLOW 6,4_ $ , TOTAL REQ'O FLOW __L X 1 GARBAGE DISPOSAL — co RESERVE FLOW— GAL/DAY -- _ _-_---- � �- REFERENCE PLANS : Lo�� f I-j N t d 1� 1, - �6�Z ----- --- -- -- _ - ----- - APPROVED BY : ----- - ---- - -- -- BOARD OF HEALTH , _y DATE : PROPERTY OWNER : ____ __ SITE AND SEWAGE PL A N p` OF 2 EKED(ZOOM *M&M F**A►X DWELL I WJ G LLT' ..1 fV L Iti t a Fz q DA TE- r6 � . �F W ILLIAM �._1E E,12MAN : tia o;r'Ai��`' 2 3 .5 71 mu 1.�1 If