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HomeMy WebLinkAbout0143 FAWCETT LANE - Health 143 Fawcett Lane Hyannis F/R A = 269 082 'G p is u w' s TOWN OF BARNSTABLE � vklh LOCATION All L,✓ ISEWAGE # ?aW VILLAGE / ,addll ASSESSOR'S MAP& LOT A —(2 92- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /oOD 6,11E LEACHING FACILITY: (type) f eo 0) (size) Xa'f' >e�2 NO. OF BEDROOMS 3 BUILDER O OWNE lt,9 S PERMIT DATE: .1 19 COMPLIANCE DATE: 11-1 S'0.z Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 3 7' 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 rho Feet within 300 feet of leaching facility) ' Furnished by ���wv/ ld/z 9.i . 4 AL No. �"�� Fee� THE COMMONWEALTH OF MASSACHUSETTS Entered in compute�_� Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipphration for �Bigool *pgtem Con!6trurtion Permit Application for a Permit to Construct . )Repair(air( )Upgrade rade(+�)Abandon( ) O Complete System Individual Components PP ( P Pg Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/P lq3 /tinvice�l , azcel � -092. C1° !'l/ Installer's Name,Address,and Tel.No. �q/^ /`,q y— Designer's Name,Address and Tel.No. 7 Type of Building: Dwelling No.of Bedrooms 3 Lot Size//t�sq.ft. Garbage Grinder( � Other Type of Building A4,W6of No.of Persons Showers( ) Cafeteria( ) Other Fixtures 22 Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets / Revision Date Title lq3 / Size of Septic Tank �DD� •mil''/�5J`/�S Type of S.A.S. 4,.&P 4gV11 Description of Soil I Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b is o f Signed Date Application Approved by Date / Z/ O Z Application Disapproved for the following reasons Permit No. Z©02--qq ( Date Issued 10 2-1 D 2 "i.. Fee % THE COMMONWEALTH,OF MASSACHUSETTS Entered in computer. ✓.� Yes PUBLIC HEALTH.DIVISION -TOWN OF BARNSTABLE-MASSACHUSETTS Zipprtcatton for Mtgogar *pgtem Congtructiodpermit Application for a Permit to Construct( . )Repair( )Upgrade(w)Abandon( ) El Complete System R Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. l q3 1 q`4i elE L/�1 Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 77 Type of Building: Dwelling No.of Bedrooms Lot Size 7A11 sq.ft. Garbage Grinder Other Type of Building. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow / gallons per day. Calculated daily flow 3-30 gallons. Plan Date . 7 Number of sheets / Revision Date Title /-- / A Size of Septic Tank /D19/y �v. '/5 /�'�° Type of S.A.S. Description of Soil- Nature of Repairs or Alterations(Answer when applicable) Date last inspected- ' Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system '~ in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued Vhis oard-of He lth. Signed Date Application Approved by _ Date 21I01, Application Disapproved for the following reasons Permit No. tJ0 -q9( Date Issued to I x-/ A 2-- -----�------- ————————---——————————— --- �,�' THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS 4 -CSrtiftcate of Compliance THIS IS TO CERTIFY,that the On-site Se)`age Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by xl /-/`/1 s 6101 P.>;11-1 at /L/.3 ,�—a1,G '? //e9 � '/1L1��5 has been constructe/d in ccordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 24Qa•`lq/ dated J�J rI2/ .6 2 Installer _ Designer The issuance of this permit.shall not be construed as a guarantee that the sy m wil.1 nctio=asesigned. Date Inspector fin/ No. 2,002^L/9 ( Fee 10�..- THE COMMONWEALTH OF MASSACHUSETTS -t PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migogar bpgtem Construction Permit Permission is hereby granted to Construct( )Repair( + Upgrade( )Abandon( ) System located at r 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:Constru tioTust be completed within three years of the date of this pDate: v 2! 2 Approved by TOWN OF BARNSTABLE L LOCATION 141/3 r<�� G.✓ SEWAGE # VILLAGE Z2r1,w l,5 ASSESSOR'S MAP & LOT . bI—OkI INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /,aaw G�9L LEACHING FACILITY: (type) f ifo (size) /.X f�>01• NO.OF BEDROOMS 3 p BUILDER O OWNE f!o 4 PERMTTDATE: COMPLIANCE DATE: 1 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S 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 / o"Wo zzr �����••-�y s . IFC fbd 3y' d I 1 f COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ea F r m ' FpJLE® INSPECTION .� i�M SJev TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS . SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A -� G D CERTIFICATION Property Address: 143 FAWCETT;LANE HYANNIS,MA 02601 ? U 1 ('� DYZ Owner's Name: DAN KOCH k Owner's Address: 143 FAWCETT LANE HYANNIS,MA 02601 Date of Inspection: 8/26/02 AM Name of Inspector: (please print).. JOHN GRACI top Company Name: SEPTIC INSPECTIONS/A2) Mailing Address: ',, P.O. BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813;FAX$08-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as ofthextime.of.the inspection.The inspection was performed based on my training and experience in the proper function,and:mamtenance 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: J _ Pass`e`g> VN, 4/f _ Conditionally Pas.,S _ Needs Further E.r luation by the Local Approving Authority X Fails / Inspector's Signature: r ' Date: 8/26/02 The system inspector shall submit a cdpy 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 SYSTEM FAILED TITLE V INSPECTION. LEACH PIT AND OVERFLOW WERE FULL UP OVER ALL PIPES. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address'liiow the-system will perform in the future under the same or different conditions of use. ,b4; • i "fi + c •yyy.k4,! C 'r;tl, S I,...nrtinn r.nrm I Page 2 of 11 . OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ,;. PART A CERTIFICATION (continued) Property Address: 143 FAWCIETT•LANE HYANNIS, MA 02601 Owner: DAN KOCH Date of Inspection: 8/26/02 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 FAILED TITLE V INSPECTION. LEACH PIT AND OVERFLOW WERE FULL UP OVER ALL PIPES. 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. n/a 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. ND explain: n/a Q n/a Observation of sewage backup or breakout 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)lox is leveled or replaced ND explain: n/a n/a 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 Ita,:.o -.obstruction is removed ND explain: n/a Ii . , 7 Page 3 of 1 l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM i Ay PART A CERTIFICATION(continued) Property Address: 143 FAWCETT LANE HYANNIS,MA 02601 Owner: DAN KOCH Date of Inspection: 8/26/02 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 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 I of a public water supply. _ The system has a septic tank'anl 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". Methohsed,to'deierniine distance n/a "This system passes if the welfwater analysis,performed at a DEP certified laboratory, for coliform bacteria and 0".E: '+ ' volatile organic compoundsim icates'that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogenIis 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: n/a 'is F +�a 'F � Page 4 of 1 1 4 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 143 FAWCETT LANE HYANNIS,MA 02601 Owner: DAN KOCH Date of Inspection: 8/26/02 D. System Failure Criteria applicable to all systems: You mi t indicate"yes"or"no"to each of the following for all-inspections: t. Yes No X _ Backup of sewage into-facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent.to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped NO PUMPING INFORMATION. X Any portion of the SAS,'cesspool or privy is below high ground water elevation. X Any portion of ces'spooli or,privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspoo`I or,privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy:is within 50 feet of a private water supply well. ' feet from a private water supply well with _ X Any portion of a cesspool or privyq�s less than 100 feet but greater than 50 e p pp y no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP bacteria and volatile organic compounds certified laborator .for co.liform indicates that the well is free g laboratory, ,for 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.j�?' X _ (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 fai'Is."IThe 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 m addition to the criteria above) yes no s, X the system is within 40-O,feet of a surface drinking water supply X the system is within 200 meet of a.tributary to a surface drinking water supply X the system is located jnt 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 );k "yes" in Section D above the large�,sysleiii 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. iJ t Q Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 143 FAWCETT LANE HYANNIS, MA 02601 Owner: DAN KOCH Date of Inspection: 8/26/02' 1`t Check if the following have been done.)You must indicate "yes" or"no" as to each of the following: Yes No f X _ Pumping information was,pr'ovided by the owner, occupant,or Board of Health X Were any of the system'compone:ts'pumped out in the previous two weeks X _ Has the system received'4ormal flows in the previous two week period X Have large volumes of water been introduced to the system recently or as part of this inspection '? X Were as built plans of theysystem obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling,inspected for signs of sewage back up ? X _ Was the site inspected for signs of break out? X _ Were all system components, excluding the SAS, located on site? X _ 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? X _ Was the facility owner'(jnd occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems .x; The size and location of the Soil Absorption System (SAS)on the site has been determined based on: r; is Yes no X _ Existing information For example,a plan at the Board of Health. X _ 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)] 1 ,4 s Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 143 FAWCETT;LAN E;.HYANNIS,MA 02601 Owner: DAN KOCH -. Date of Inspection: 8/26/02 k FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 'Nu nhber'6f bedrooms(actual): 3 DESIGN flow based on 310 CMR_15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents:3 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or n'o): NO` 1�' Seasonal use: es or no : NO � (Y ) Water meter readings, if available(last 2 years usage(gpd)): u/.a, 00— L.)'Q—® Sump pump(yes or no): NO. [ Last date of occupancy: n/a 0 Z COMMERCIAL/INDUSTRIAL Type of establishment: n/a ' Design flow(based on 310 CMR(1.5..203)`nhigpd Basis of design flow(seats/perso'ns/sq$,etc): n/a Grease trap present(yes or no): NO. Industrial waste holding tank present.(yes or,no): NO Non-sanitary waste discharged to the Title 5'system(yes or no): NO Water meter readings, if available.: n/a Last date of occupancy/use: n/a OTHER(describe): n/a " a �:il,GENERAL INFORMATION Pumping Records Source of information: NO PUMPING INFORMATION Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution,box,soil absorption system _Single cesspool g _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 Attach a copy of the bEP approval Other(describe): n/a , Approximate age of all components ,date installed(if known)and source of information: RENOVATED IN 1983 BY AGENT Were sewage odors detected when arriving at the site(yes or no): NO I Page 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGEDISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 143 FAWCETT LANE HYANNIS,MA 02601 Owner: DAN KOCH Date of Inspection: 8/26/02 BUILDING SEWER(locate on site plan) Depth below grade: 22" Materials of construction:_cast iron, _40 PVC Xother(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) . Depth below grade: 16" Material of construction: Xconcrete metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age,,Confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6" H 5' 71 Wt4''1 off" Sludge depth:3" Distance from top of sludge to bottom of outlet tee or baffle:31" Scum thickness: 4" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 14" How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING NOW'AND THEN EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. RECOMMEND GETTING NEW COVER FOR SEPTIC TANK. GREASE TRAP:_(locate on site plan) Depth below grade: n/a ; Material of construction:_concrete_metal=fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a ,..�` ,: , Comments(on pumping recommendations,.inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage';etc'.): n/a , 51 e, ` 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 143 FAWCETT LANE HYANNIS,MA 02601 Owner: DAN KOCH Date of Inspection: 8/26/02 4. TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal._fiberglass_polyethylene_other(explain): n/a Dimensions: n/a >�. Capacity: n/a gallons Design Flow: n/a gallons/day § Alarm present(yes or no): N/A" Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a = Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: _(if present must;be opened)(locate on site plan) Depth of liquid level above outlet invert:,n/a 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.): n/a PUMP CHAMBER: _(locate on site plan) Pumps in working order(yes or no):'NO Alarms in working order(yes or no):NO Comments(note condition of pump,charnber,,condition of pumps and appurtenances,etc.): n/a R Page 9 of I 1 d OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE:SEWAGE DISPOSAL SYSTEM INSPECTION FORM Q. .<, PART C ` SYSTEM INFORMATION(continued) Property Address: 143 FAWCETT LANE HYANNIS, MA 02601 Owner: DAN KOCH Date of Inspection: 8/26/02 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a 6' X 6 BLOCK CESSPOOL overflow cesspool, number: 1 n/a ' i";_ x :innovative/alternative system l Type/name of technology: n/a Comments(note condition of.'did';-s'igns of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): LIQUID LEVEL IN BOTH LEACH PIT AND OVERFLOW WAS FULL UP OVER PIPES. DID NOT EXPOSE LEACH PIT. BOTTOM IS AT LOFT. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert:n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): .spy n/a PRIVY: (locate on site plan). .a Materials of construction: n/a `' `. Dimensions: n/a r Depth of solids:n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a Page 10 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 143 FAWCETT LANE HYANNIS,MA 02601 Owner: DAN KOCH - Date of Inspection: 8/26/02 s 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. 3 K �N . 0 AC A O BB ZS'3 4 i • in Page I I of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 143 FAWCETT LANE HYANNIS,MA 02601 Owner: DAN KOCH Date of Inspection: 8/26/02 4 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 10 feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record- If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local'excavators,'installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: HAND AUGER- IOFT. ' .p M `1.4 TOP FNDN EL. 25.2' SYSTEM PROFILE TEST HOLE LOGS ACCESS COVER TO WITHIN 6- OF FIN. GRADE (NOT TO SCALE) AH OJALA, PE ACCESS COVER (WATERTIGHT) TO ENGINEER: FLn WITHIN 6' Df FIN. GRADE DAVip STANTON ` MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM WITNESS: „ 25•0 9 30 02 MIICHELIS E 23.2' RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE DATE' / u -FOR FIRST 2' 3' MAX. PERC. RATE = < 2 MIN/INCH LOCUS 3 RY EXISTING 1000 4a GALLON SEPTIC gER 21,g';� 22.33' CLASS i SOILS P# 10343 TANK tH- 10 ) GAS FERNDA E BAFFLE21,75' �"ag 21.58' o © Q m � O E 0 nF-:-] 21.44' ED C-1 0 ED E ED ED 6' CRUSHED STONE OR MECHANICAL C] [� E� [� (� CI Ca E� ELEV, wE$r MAIN _ COMPACTION. (15.221 123) §88- 2' E E E� M M M E� 0 19.44' 01, 2AZ DEPTH OF FLOW = 4' ( 1 % SLOPE) ( 1 % SLOPE) A TEE SIZES: 3/4' TO 1 1/2' DOUBLE WASHED STONE LS INLET DEPTH IO" 6" 10YR 4/2 OUTLET DEPTH = 14" B LOCATION MAP NOT TO SCALE LEACHING FOUNDATION---- EXIST SEPTIC TANK 3' ----- D' BOX FACILITY LJ ASSESSORS MAP 269 PARCEL 82 FACILITY 5.14' 30 10YR 5/8" INSTALLER SHALL VERIFY THE LOCATIONS OF ALL UTILITIES AND BUILDING SEWER LOCATIONS AND ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM. CONFIRM EXISTENCE OF 1000 GAL. SEPTIC TANK AND THAT IT IS IN SUITABLE WORKING CONDITION C 14.3' MS 10YR 6/6 12" OAK25.4 i 6" OAK L).CIO' ?�� ?a TOP OF BANK A 126" TH L 1 19.0 AT TOWN DRAINAGE 14� TWIN 7" � IN 12" z� 19.1 POND CURRENTLY DRY) NO WATER ENCOUNTERED OAK x /24.5 AK 00, �ts�19/� NUTES: 18.9 BENCH MARK - CORNER OF CONC. r 2a.6 / �' ASSUMED q o T '''-- . SEPTIC DESIGN: (GARBAGE DISPOSER IS N. ALLOWED ) L DATUM IS y PATIO ELEVATION = 24.4' INS/ DC wgLL � 23. C' If _ 110- EXISTING 25, DESIGN FLOW: 3 BEDROOM. ( GPD) = 33Q GPD 2. MUNICIPAL WATER IS Q 3.2 !1 1 / USE A 330 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8' PER FOOT, - C_OT.. C. 2_ _...-....6",_ _ 1T-f-!` T 1- n il' 1-.!fl .... 10 r .1.;1�_.�1 I,.)I v L.L.J P-�1J I I V i_3 i.a T C_ _ l.!. _ 10 04f �Q. F SEPTIC TANK: 330 GPD I � ) 660- 2 o HED �ExlsT. DWELL. 25t ACRE 1s3.9 T _ T1500 _ _ 5. PIPE JOINTS TO BE MADE WATERTIGHT. _ / I TF = 25.2' o , USE A __ _ GALLON SEPTIC TANK 6, CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS, �-24_4 N 2 �' L`F_ACHING: ENVIRONMENTAL CODE TITLE V. 1 4,6PATI0 II fy 19.0 -'r _ 2(30 + 9,83) 2 (.74) - 118 7, THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE _ � a ``►J S1fDES: USED FOR LOT LINE STAKING. x 119.i 30 x 9.83 (.74) _ 218 " 23. ( �, �o BOTTOM: - - -- PE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC, I 24.2 '-- '` / rt,1 TOTAL: 454 S,F. 336 GPD 9, COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT 25.5 11 DI/ T DRIVE 1 � USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH, WITH 2.5' STONE AT SIDES, 4' AT ENDS AND 5' ;x W � �C' EQUAL) _ 10. PUMP & REMOVE (OR, FILL W/CLEAN SAND) FAILED SYSTEM 19.6 � BETWEEN UNITS I R r PARKIN ARE x 20.0 �� L E G.�N IJ T,� L.E ,�'I TE ,�.All l x � 100.99' , 2o,a 100.0 PROPOSED SPOT ELEVATION OF .� AN -___ ,X _ 143 F AWCETT LAME x 24.s �09 100x0 EXISTING SPOT ELEVATION 2N% I IN THE TOWN OF. b n N 22'9 N \�'21.1 0Q PROPOSED CONTOUR ( HYANNIS ) BAR 1 V S TA B L E N �` 100 EXISTING CONTOUR PREPARED FOR: BORTOLOTTI CONSTRUCTION/KOCHs 20 0 20 40 60 BOARD OF HEALTH �^ APPROVED DATE MA SCALE: 1 = 20' DATE: OCTOBER 10, 2002 off 508-362-4541 fax 508 362-9880 L1 K f t per• clown cape engineering, Inc. �� o Mgrs ``lw of ,i,ilARNE �a, •- � �Q. ARNE H. '��. F a1 1�.�� CIVIL. ENGINEERS o,Al_A �l } CIVIL a, LAND SURVEY Nu. azti ;a ,. ' F /��TF 939 main st. armouth ma 02675 - �P - "11 i.;;, A l0 112.E 02--3 `� y A µ , JALA, F. ,.; I'.L.S. DATE