Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0253 FAWCETT LANE - Health
253 FA E�LANE, HYANNIS A = _ e II i { _ TOWN OF BARNSTABLE 4 L OCATIGN SEWAGE # VILLAGE ASSESSOR'S MAP &LOT UNSTALLER'S NAME&PHONE NO. SerlitZe 77S—E7)6 SEPTIC TANK CAPACITY 100© 6—Ams lv� LEACHING FACELUY: (type) OrYwe11s (size) NO,OF BEDROOMS BUILDER OR OWNER PERMITDATE: LO.O6 COMPLIANCE DATE: Separation Distance Between the: ;p Maximum'Adjusted Groundwater Table to the Bottom of Leaching Facility o ¢l Feet Private Water Supply Well and Leaching Facility (If any wells exist Noy 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) 'ti1�. Feet Furnished by ` ?13 6 f5 r LJ lr 1 W x W � May 01 2017 21:15 Jim The Inspector Man 5085349919 page 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 263 Fawcett Lane Property Address "`t -r� Matt Baecker Owner Owner's Name W information is Hyannis MA 02601 4-26-17 1'3 required for every w f 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:When A. General Information ,��tlllrllllN fillip out forms N OF on the computer, �,,,•��pat ASsq 4•,,, use only the tab :�2� c key to move your 1. Inspector: =��; JAM ES . tiN cursor-do not James D.Sears use the return U. SEARS C* Name of Inspector o *. key. Capewide Enterprises ` .• o Company Name 4 F 5 INS? C, _153 Commercial Street /��r/ni Company Address I Mashpee --- - MA 02649 City/Town State Zip Code 508477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 4-29-17 Apector's signature Date . The system inspector'shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the.DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority, ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.dcc•rev,6116 TiUe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 VS i May 01 ,2017 21:15 Jim The Inspector Man 5085349919 page 2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owners Name information is Hyannis MA 02601 4-26-17 required for 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: The system is a 1000 Gal Tank D Box and two chambers. Note: Old block c. pool tied into tank. 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, wilt 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): I t5ins.doc•rev.6116 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 May 01 2017 21:15 Jim The Inspector Man 5085349919 page 3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is Hyannis MA 02601 4-26-17 required for every Cit (Town State Zip Code Date of Inspection page. Y 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 pipes) 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.cicc ray.6116 Title 5 Official lnspeatbn Form:Subsurface Sewage Disposal System•page 3 of 17 May 01 2017 21:15 Jim The Inspector Man 5085349919 page 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is required for every -Hyannis annls MA 02601 4-26-17 paw City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well*,'. Method used to determine distance: "This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6 below invert or available volume is less than'/2 day flow¢d_1,4CNIN6 t5ins.doc•rev.6116 Title 5 official Irspedion Form;Subsulface Sewage Disposal System•Page 4 of 17 I May 01 2017 21:15 Jim The Inspector Man 5085349919 page 5 Commonwealth of Massachusetts Title 5 official Inspection or Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is Hyannis MA 02601 4-26-17 required for every page. Cityffown 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. E] ® 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 1CO 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 faills. 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 16,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a`significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304,The system owner should contact the appropriate regional office of the Department. t5ins.doc-ray.5116 Title 5 OfrycW Inspection Form:Subsurfa®Sewage Disposal System-Page 5 o1 17 May 01 2017 21:16 Jim The Inspectror Man 5085349919 page 6 c Commonwealth of Massachusetts v, Title 5 Official Inspection Form t Subsurface Sewage Disposal System Form •Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is Hyannis MA 02601 4-26-17 required for every /Town page Cit y 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? ❑ Z. Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information, For example, a plan at the Board of Health. ❑ ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins.doc•rev.6/16 Title 5 Official Inspection Forth:subsurface Sewage Disposal System'Page 6of 17 May 01 2017 21:16 Jim The Inspector Man 5085349919 page 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is Hyannis MA 02601 4-26-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal. Tank D Box and two chamber's. Note: Old block c. pool. 2 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): 2015-53,00OGaIs2016-62,900Ga1's Detail: Sump pump? ❑ Yes ® No Present Last date of occupancy: Date CommerciaUlndustrial 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 6 system? ❑ Yes ❑ No Water meter readings, if available: 15ins.doc-rev.6/16 Title 5 Official Inspeclion Forth:subsurface Sewage Dlaposal System-Page 7 of 17 I .May 01- 2017 21:17 Jim The Inspector Man 5085349919 page 8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is required for every H anniS MA 02601 4-26-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancyluse: Date Other(describe below): General Information Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping:' i 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, I 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): t5irts.dot•rev Mfg Title 5 Offldal Inspection Forth:Subsurface Sewage Disposed System•Page 8 of 17 May 01 • 2017 21:17 Jim The Inspector Man 5085349919 page 9 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owners Name information is required for every Hyannis MA 02601 4-26-17 page, CityfTown State Zip Code Date of Inspection D. System Information (cant.) Approximate age of all components, date installed (if known) and source of information: Tank NA - D Box and chamber's 2006 permit#2006- 128. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2, Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage,etc.): Pipeinc is 4" PVC SCH -40 Septic Tank(locate on site plan): 14" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 1000 Gal. Precast H-10 Dimensions: 3" Sludge depth: t5lrn.doc•rev.5116 Title 5 Official Inspecllon Form:Subswfece Sewage Disposal System•Page 9 of 17 May 01 •2017 21:18 Jim The Inspector Man 5085349919 page 10 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is required for every Hyannis MA 02601 4-26-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 27" 2" Scum thickness 8 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Asbuilt- Plan-Tape _ Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank and inlet cover at 14"wloutlet cover at 11. Inlet tee w/two outlet tee's No sign of leakage or over loading Tank should be maint pumped. Grease Trap(locate on site plan): Depth below grade: feet I Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6116 - Title 5 OPoelel Inspedon Form:Subsudace Sewage Disposal System•Page 10 of 17 May 01 .2017 21:18 Jim The Inspector Man 5085349919 page 11 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owners Name information is Hyannis MA 02601 4-26-17 required for 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.): 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.doc•rev:6116 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 May 01 2017 21:18 Jim The Inspector Man 5085349919 page 12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owners Name information is required for every Hyannis MA 02601 4-26-17 page. Cityrrown State Zip Code Date of Irmpection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any, evidence of leakage into or out of box, etc.): D Box is 16"X16"-3' below grade wlcover at 1'. Box is clean and solid. No sign of over loading or solid carry over, 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: i t5ina.doc•rev.6116 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 12 of 17 ,May 01. 2017 21:18 Jim The Inspector Man 5085349919 page 13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is required for every -Hyannis annis MA 02601 4-26-17 page City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: 2 ® leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 1 ❑ innovative/alternative system Type/hame of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,etc.)_ Leaching is two chambers and one c. pool. Old block c.pool full. Newer leaching is two 500 Gal. Dry well chambers w/3 1/2'stone. Chambers are 33"below grade w/cover at 1'. 8"water in chambers. No high stain line or solid carry over wall's are clean like new. 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.doc-rev.6116 7me s o(ricial irweetion Form:Subsu?ace Sewage Disposal System•Page 13 or 17 May 01 2017 21:18 Jim The Inspector Man 5085349919 page 14 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is required for every H annis MA 02601 4-26-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) level of ndin condition of vegetation, Comments(note condition of soil, signs of hydraulic failure, a po g, e9 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.000•rev.&18 Tdle$Official Inapeabn Form:SuD6urface Sewage Oieposal System•Page 14 of 17 May 01 2017 21:19 Jim The Inspector Man 5085349919 page 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name Information is required for every y_H annis MA 02601 4-26-17 page. CityTrown 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 R • � 13-1=3s- O i Q R 4-33,/' a o 0 0 Y s. I Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 15ins.doc rev.6n6 Title 5 OKcla nspe 9e Po May 01 2017 21:19 Jim The Inspector Man 5085349919 page 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owner's Name information is Hyannis MA 02601 4-26-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells No Estimated depth tol r4h ground water: 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 Ian reviewed: 3-28-06 g p Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Plan on File. ❑ Checked with local excavators; installers- (attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: T.H. on Design plan 11'-8". G.W. off plan. Barn maps. ADJ G.W. at 24'. Bottom of leaching at 5'below grade f Before filing this inspection Report, please see Report Completeness Checklist on next page. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subst rface Sewage Disposal System-Pape 16 of 17 May 01 �2017 21:19 Jim The Inspector Man 5085349919 page 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Fawcett Lane Property Address Matt Baecker Owner Owners Name information is reqquireduired for every Hyannis annis MA 02601 4-26-17 o 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 15ins.doc rev.6116 Title 5 Offfdal Iispection form:Subsurface Sewage Disposal System•Page 17 of 17 YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1s` FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. DATE Fill in please: APPLICANT'S YOUR NAME/CORPORATE NAME F L�g4�r`4 ;r BUSINESS YOUR HOME ADDRESS: SS ^'��Cc G U ' J 0j&UWj TELEPHONE # Home Telephone Number 77 - -? I NAME OF NEW BUSINESS Ct r(,-A4 i, ; 01---S Have you been given approval from the building division? YES NO � 2 ADDRESS OF BUSINESS U c 8"� w wCJ �YN��d ( dhc, CG c,{ MAP/PARCEL NUMBER t/O r' L When starting a new business there are several thing's you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of v Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSION R'S OFFICE This individ al ha be, n infc5rm o y p mit r .quirements that pertain to this type of business. zw� cS CeCC..�` -PA A Mtt�T COMPLY WITH HOME OCCUPATION `AuXho iz Signature* RULES AND REGULATIONS. FAILURE TO MMENTnC)MPLy .Pd3AY RESULT IN FINES. -leE i ' 2. BOARD OF HEALTH This individual has peen irsfQ a p1 the permit requirements that pertain to this type of business. MUST 4MPLY WITH ALL Vi17ARDOUS MATERIALS REGULATI01`!S Authorized Signature COMMENTS: ' n 3. CONSUMER AFFAIRS (LICENSIJWG AUTHORITY) This individual has n inf r f the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: F 1' e Date: 1/ 13 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: Re k,'t H flr0fRj,-, 13 BUSINESS LOCATION: f- n, C C,( INVENTORY MAILING ADDRESS: 0 & v<, llcrrmFwf`1,. me (�,�(,�? TOTAL AMOUNT: TELEPHONE NUMBER: _?)� - J-71— o CONTACT PERSON: 1' G1&V- 0-c-a -ram EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: G\< Ir,( C(fca,�,S INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt&roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes P , �(L Laundry soil &stain removers (Including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initial UTE YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates COST $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO BY M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1" FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. DATE:v � Fill in please: APPLICANT'S YOUR NAME: ( r rr BUSINESS YOUR HOME ADDRESS: 4 y G e L4 aann-� MS U� (,yl �a97 TELEPHONE # Home Telephone Number: NAME OF NEW BUSINESS A+„ 264 ,►, c) S TYPE OF BUSINESS L G S / V;(< IS THIS A HOME OCCUPATION? YES NO Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS v ' t MAP/PARCEL NUMBER 70 11o9y When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. .1. BUILDING COMMI ER'S OFFICE MUST COMPLY WITH HOME'OCCUPATION This individu hag b e i r d y p mit requirements that pertain to this type of bu �S AND REGULATIONS. FAILURE TO COMPLY MAY RESULT IN FINES. ,hut ocized Si ems* CO ME TS. 2. BOARD OF HEALTH This individual has be med oft p r�it u'r ments that pertain to this type of business. MUST COMPLY WITH ALL HAZARDOUS MATERIALS REGULATIONS Authorized Si r COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** Iva COMMENTS: TOWN OF BARNSTABLE Date: 31 TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS:�^�v BUSINESS LOCATION: INVENTORY MAILING ADDRESS: 40 Fq4 CKI J- In M TOTAL AMOUNT: TELEPHONE NUMBER: :7 7<<� CONTACT PERSON: M`'t-t ye"1 5is10'a EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: dQGn i h s INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous.waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor&furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS NO.. F41 00 .00 i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIPPrication for �Digpo!6al *pftem Cow5truction i3erm t Application for a Permit to Construct( ) Repair ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 2 21 —0 6 8 7 253 Fawcett Ln, Hyannis Alecia Fahy Assessor'sMap/parcel 270/AK 99 Union St, Rockland, MA 02370 Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr Septic. Eco-Tech PO BOx 1089 Centerville 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder Vo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs orAlterati s(Answer when applicable Install a new Title 5 leach system to pans of Eco-Tec , OEEE-2254 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 thi rd-ef-Iffealth. � igned :' Date J 3 Application Approved late �3 ,3/ Application Disapproved by: Date for the following reasons Permit No. 4)-w& Date Issued 3j 00 ? No. tin F100. � Entered in computer: THE COMMONWEALTH OF MASSACHUSTS Yes ' PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for Migpogar 6p5te ,COugtruction Permit Application for a Permit to Construct(`) Repair ) Upgrade O Abandon O ❑ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 2 21 —0 6 8 7 253 Fawcett Ln, Hyannis Alecia Fahy Assessor'sMap/parcel 270/ki-4 99 Union St, Rockland, MA 02370 Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr `Septic Eco—Tech PO "BOX 1089, Centerville 43 Triangle Cir, Sandwich Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (o) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design-Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i ` Install a new Title 5 leach Nature of Re airs or Alteratiops(Answer when applicable) + g sypstem to plans of Ec —Teen, #ETE-2254 Date last inspected: '°' Agreement:. r �" 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,iss ed by thi ard-of-Health, igned Date Application Approved Date 3 3� Application Disapproved by: Date for the following reasons Permit No. t!D ' Date Issued 3 3/ ———————————————————————————————————————————— THE COMMONWEALTH OF MASSACHUSETTS Fahy BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed (t ):t Repaired .( X ) Upgraded ( ) Abandoned( )b Wm E Robinson Sr Septic Service 253 Fawcett Lane, Hyannis at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �-00 60 dated 13 / Installer Designer e",-y #bedrooms ] ., Approved design flowd gpd The issuance of this permit shall not be co -strued as a guarantee that the system'willl'fun t6h as designed. Date '7 / > Inspector'e ---. No. Q',fo r a g' F 10 0.0 0 _. e - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION —BARNSTABLE, MASSACHUSETTS Fahy ' lwigpogal *pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair ( X) Upgrade ( ) Abandon ( ) System located at 253 Fawcett Lane, Hyannis and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her'duty to comply with Title S and the following local provisions or special conditions. Provided: Constructio�, must b completed within three years of the date of=peDate 3 3 � Approved by �� Town of Barnstable ti. THETp�O Regulatory Services Thomas F. Geiler, Director BARNSTABLE, 9�A b9. � Public Health Division leontAi° Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: (, (]S__'o6 Sewage Per mit# dC� - �kAssessor's Map\Parce?7 0/1 21 Designer: Eco-Tech Installer: Wm E Robinson Sr Septic Address: 43 Triangle Circle Address: PO BOx 1089 Sandwich Centerville On Wm E Robinson Sr Septkms issued a permit to install a • (date) (installer) septic system at 253 Fawcett Ln, Hyannis based on a design drawn by (address) Eco-Tech dated 03-29-06 (designer) i° I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. (N OF MAssq t moo`' DAVID cy�N �� o D. � (Instal er s Signature) COUGHANOWR N No. 1093 ,�G/STE��O (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Healtii/Septic/Designer Certification Form 3-26-04.doc Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, N v 1 o D . CDV&NW CW hereby certify that the engineered plan signed by me dated M°tC4 Zq 1 2-006,concerning the property located at l,S3 f�w CE°f 1- LQ nc meets all of the following criteria: • Two soil evaluations excavated for detailed examination(no hand augering) and two percolation tests shall be conducted. • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: �,SH OF A) Top o '`t s u vation(using GIS information) moo` DAVID B) G. s i rZ 'ustment for high G.W. •� = 2�q No. 1093 I l DIFFEREN BWEEN n S AR%NN SIGNED :� �� DATE: ►r1 oC 4 NOTICE Based upon the above information,a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. gASeptic\perccxemp.doc -\ COMMONWEALTH OF MMSACHUSETTS 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: 253 Fawcett Lane Hyannis Owner's Name: Alecia Fah o��G Owner's Address: 99 uni nn StrPPt Rnckland, MA Date of Inspection: Name of Inspector:(please print) W i 1 1 i am E_ • Robinson Sr. Company Name: William E. Robinson Septic Service - Mailing Address: P O Box 1 089 Centerville, MA Telephone Number: (508) 775-8776 CERTIFICATION STATEMENT 1 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 training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to ction 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes r �" Needs Further Evaluation by the Local Approving Authority P . Fails , . r Inspector's Signature: Date: A' t..w rid The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health DEP)within 30 days of completing this inspection.If the system is a shared system or has a de ign flow-of 10,OVO gpd or greater,the inspector and the system owner shall submit the report to the appropriate re tonal off ce of the .DEP.The original should be sent to the system owner and copies sent to the buyer,if applicabl ,and the-approog 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 s Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 253 Fawcett Lane Hyannis Owner. Alecia Fahy Date of Inspection: Inspection Summary: Check A,B,C,D or E l ALWAYS complete all of Section D A. Sy m Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CM 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as escribed 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"piease 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. 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: The system required pumping more than 4 times a year due to broken or obsut�cted pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)arc replaced obstruction is rtt moved ND explain: r Page 3 of I OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 253 Fawcett Lane Hyannis Owner: Alecia Fah Date of Inspection: . 3 i2co b C. Further Evaluation is Required by the Board of Health: ,l V A 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(l)(b)that the system is not functioning in a manner which will protect public health,safety and the cnvironment: _ 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 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 frotA 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 and volatile organic compounds indicates that the well is tree 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. 3. Other: * 3 Page 4 of 11 , OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 253 Fawcett Lane Hyannis Owner: Aleeia Fahy Date of lospection: v?3 ro D. System Failure Criteria applicable to all systems: You must indicate"yes'.'.or"no"to each of the following for all inspections: Yes N 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 J Static liquid level in the distribution box above.outlet invert due to an overloaded or clogged SAS or cesspool _ J Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number _ Jof times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within I00.feet of a surface water supply or tributary to a surface Jwater supply. Any portion of a cesspool or privy is within a Zone I 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 front 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.) (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 now of 10,000 gpd to 15,000 gpd- You must indicate either"Yes"or"no"to each of(lie following: (The following criteria apply to large systems in addition to the criteria above) 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 ll of a public water supply well If you have answered"yes"to any question in Section E the system is comsidered a significant threat,or answered "yes"in Section D above the large system has failed.The uAmer or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system to accordance with 310 CMR 15.304.The system o%%wr should contact the appropriate regional office of the Department. 4 Page 5 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 253 Fawcett Lane Hyannis Owner: Alecia Fah Date of Inspection:_ a3 3006 Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Yes /Pumping information was provided by the owner,occupant,or Board of Health 71were 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? , 7�/ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _77 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? fi _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of th baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? 7 f _ 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: Yet.no JJ _ 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 Page 6 of 1 I ` OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 253 Fawcett Lane Hyannis Owner: Alecia Fah Date of Inspection: 3 o6 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):.3 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x li of bedrooms): . U.0 Number of current residents: b Does residence have a garbage grinder(yes or no):1-00 Is laundry on a separate sewage system(yes or no).4111. f if yes separate inspection required] Laundry system inspected(yes or no): /V Seasonal use:(yes or no): Na , --- Water meter readings,if available(last 2 years usage(gpd)): 2 0 0 5 - [ 5.9:R 2 5 0 j Sump pump(yes or no):wD 2004 - 120, 000 Last date of occupancy: ` COMMERCIAIANDUSTRIAL IVJ A_ Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):_,,n�ID If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYKE OF SYSTEM _/Septic tank,. tien be*,-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) _Tight tank Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: l°lam-I �P)LC- c.,r T03 3c,,,ld o< Pe,144, Were sewage odors detected when arriving at the site(yes or no): 6 • Page 7 of I I OFFICIAL INSPECTION FOI1M—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Properly Address: 253 Fawcett Lane Hyannis Owner: Alecia Fahy Date of Inspection: �3 J00oG BUILDING SEWER(locate on site plan) Dcpdt below grade: Materials of construction:_cast iron _40 PVC_other(explaut): Distance Gonf private Water supply well or suction Wte: Comments(on condition of juutts,venting,evidence of leakage,etc.): Afu eULaLO CC r �alCcr�SC 0 Zoocatc SEPTIC TANK: on site plan) 0 Depth below grade: Material of construction:Aconcrele metal fiberglass_polyethylene _odur(explain) — — If tank is metal list age:_ is age confinned•by a Cenificate of Compliance(yes or no): certificate) —(attach a copy of Dimensions: Sludge depth: Distance from lop of sludge to buttons of outlet tee or baffle: 9 Scum thickness: 4/°` Distance from top of scum to top of outlet tee or baffle: (pir Distance Gom bottom of scum to boUom of outlet tee or baffle. 3 ej Ilow were dimensions determined: tfell-e (aye_fs anp/ tiaee ylne4jwew.e,,1z Comments(on pumping rcconunendations, mlct and outlet Ice or 6afllc condition, structwal integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): J j n anc� JH�i¢ Ttf /ery4K lrkJ _ vc�,.r�ir'y >O��o� _�ViC o►t, /h) GJ.c gAc2 QF L Cie lrt ho o rOcJ+— o f?arc t� GREASE TRAP:_(locate on site plan) Depth below grade:— Material of construction:,_concrete_metal_fiberglass pol)•ethylene _outer (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 purnping: Conunenls(on pumping reconunendations,mile(and outlet tee or bafnle conditio:, structural integrity, liquid levels as related to outlet invest,etidence of leakage,etc.).- 7 'age 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ProperlyAddress: 253 Fawcett Lane Hyannis Owner: Alec' Fahy Date or Inspection:_ ?-312cofo T1C11T or HOLDING TANK: !V (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction:—concrete metal_fiberglass�rulyethylene other(explaut): Dimensions: Capacity: gallons Dcsign Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no):_ Date of last pumping: Comunents(condition of alarm and float switches,etc.): DISTIUUUTION BOX:_(if present must be opencd)(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.): PUMP CHAMBER: / �(ocatc on site plan) Pumps in working order(yes or no):— Alarms in working order(yes or no): — Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 253 Fawcett Lane a ; Hyannis Owner: Alecia Fahy Date of Inspection: a3 6 SOIL ABSORPTION SYSTEM(SAS): " (locate on site plan,excavation*not required) If SAS not located explain why: Tyge' i/ leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): 1 n / / J 11 /h16n3 Dry , LA12t'f/z+�7Tvw.. w' c.s NOf. - Lea P, lNGci 7S�i� T�v�l Gf' 77.rG )✓tS�:GTrC/`, �G�h yl�" '!F � �JQf-I�kk�w�c7tt' o� # � GHoQ iwiGs D/'V G^� 'T14�G C)� aLHSwGE-!i0 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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY:d-11110-cate 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.)- 9 Page 10 of i I T OFFICIAL,INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 253 Fawcett Lane Hyannis Owner: Alec'Alecia Fall Date of Inspection: a 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. A, 4 �Ep�¢ OF 1-I�USL l G4P1'- i ArJ 4 3 oa t3-1 _ 37' � a t-CAcH Pir # t � a y (,C-ACW .PIT -4 3-3 30' 1„ L-"3 : 1 S`3 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 253 Fawcett Lane Hyannis Owner. Alecia Fah Date.of Inspection: a 3 eo 6 SITE EXAM Slope Surface water Check cellar. Shallow wells Estimated depth to ground water v feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: 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: JCn i9ti Crounc'(.2 +cr- We Lie—-1 2,, W,,s �c{tl.�i�t<1' (xI G�CCfStl�e �w•, OF /�NJ�z1.Je 6 Coan+vui ✓tiG�• 11 � LOCATION— SEWAGE PERMIT NO. k- 21C3 E-A0 c� V?,fLLAGE Yr A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED ev DATE COMPLIANCE ISSUED 1 f Q� f CS i c M w r n PI o t No.....::.84 1�.1. '' 4i F�$..�...15'.00.....- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................Town..........OF............Barns table Applirution for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: 2 j Faucet_Lane,_,Hyannis, MA .02601 Location-Address or Lot Alo. .Wesley_Wright_ ._„ 253 Faucet Lane, Hyannis , MA 02601 Owner Address W A & B_Cesspool Service,_ Inc-. . 128 Bishops Terrace, Hyannis, MA 02601 ,-� -•-----•--- ........................•••-.........•--- Installer Address Type of Building Size Lot----------------------------Sq. feet aDwelling—No. of Bedrooms--------------------------------_----__--__Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons..............___.__________ Showers ( ) — Cafeteria ( ) � Other fixtures ...................................................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank.( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ri,, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ---•----•---------------------------------------------------------------------------------------•---.........---•------•--•----...............•-••--•-••---- ODescription of Soil.............Sa.n&.......................................................................--------•------------------------------------------------------•--....._.. W U •--------------------------------------------------••----------•-------•---•...---•--------•-•---------....---------------------...-----•-------•-------------------•-----....-•---••----•-------------- W -----------------------------------------•-------------------------------------------•-•------------------- --------------------------------------•------------------------...---------------......... U Nature of Repairs or Alterations—Answer when applicable__nstallat.],on... _-pre--cast, --stone--packed..leac-li-Pit---(-Que_rf low.)..................•----•-------------------------------------------------------------------------------•-......-••----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T ITLI 5 of the State Sanitary.Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bbeep issued bytthe board of t ign ...-- -••- ......... QV8 .... D to Application Approved BY -- -------------- C �� G.. G-�- —12 --76 4 ............ Date Application Disapproved for the following reasons-------------•--------------------------------------------------------------------.............................. ... .. ............... ...................••--------.......•-----.........•----------•----•-----•-----------------------•-------------------------------...------- ......---------- Date Permit No............84.71.1-f 5............•.............. Issued.............12/04/84 Date 6- - - - - -- yi No. --8--I I 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ---------------------T.aw-n.........OF............. -----------....----------...........------ ApplirFatiun for Disposal Works Tonstratrtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: .2.5.3..Faucet_Lmq:..J.iY�xI . .+ NA......QZCQ3-... ...... -- -- Location-Address or Lot No. _Wesley.....LCht.....................................•-•------•-------•---------- 253-..+aucat.-laze,..�J_yarzafs-r-•�A-----02-6at..---.....---- Owner Address A & B_Cesnool.-Service_,--. x1�................................ i?_ __ ishaps_.T.esraca,.._;?,va=is,_. P.A.._..II2bII1•.... Installer Address Type of Building Size Lot............................Sq. feet �., Dwelling—No. of Bedroofns...........................2_..._.........Expansion Attic ( ) Garbage Grinder ( ) '4 Other—Type of Building No. of persons .................... Showers a YP g ---------------•------------ P - ( ) — Cafeteria ( ) d Other fixtures � I W Design Flow............................................gallons per person per day. Total daily flow........................................... WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter...-----........ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.........---........ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) �. Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit..-.----------.----- Depth to ground water----........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.---..............------ � 9 --•------•----------••-----------•------.....-•-----•---•••••--------------------------------•--•........................................ ------ ------------ D Description of Soil............Sana....................................................................................-----------------•-••••-••--- V ....-•--••-••-•--•••---•---•••---------•••--------------------••••-----------......--••.......---•-••-•-----•-•--•--------••------------------•------••--••. UW ------•------------------------------••----•-----•••--••-••---.....•-••••---•----...........-••-••---------•-•••------------•-•---•--•••---•---•----•-------•---------------------•-----•-....---------• I, Nature of Repairs or Alterations—Answer when applicable-insta-l-lat�i:or+•-af••a-- Z y©04 ��,a1�c3lq;- pm—east, son pa cked_.1 e Y._n3 . (otre ].o1rr-)-................=..................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with t,\ the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has e issued by.the b and L Date of 1 t a gVy \ ApplicationApproved BY.................................................................................................. -----------_-1-2/04/24•--•-- ate 1 Application Disapproved for the following reasons----------------•-•-------------------•-----------------------------------------•----------------------......--- .............................••-•----•-•--•-•- •-•-••---•-•...-•-•-----•-•---------••-••-•---•-•-•----- Ills Date Permit No. ` '----.-.......................................... Issued_...........-12/'Q4/84-•-•----•--•-------•---- \ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 .......................Town........OF.....Pans .l e.................................----.........------• Tnrtif irtt#r of TontpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (C ) b A .. B Cesspool Service, -Inc. 23 Bishops ..Br ace.:...)iY�x1 ...rrA_...0?��91----..---•-------------------- \Y . ........•-•-•-- Installer 53 Faucet Lane, Hyannis - Installer alter has burl installed in accordance with the provisions of TITLE p 5 o T& State Sanitary Code as described in the application for Disposal Works Construction Permit No..-_84-............................ dated------12/Q4/ _----------_------•-:- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE ILL SYSTEM. V12/ FUNCTION SATISFACTORY. Inspector..............�.�C�—.................................................... ' DATE........12I.0�4�£ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 84 O F........ Ills Town .I arnstable w, ............................ .. .......................................................................... . No.... .-.......... FEE...... ...0...... Disposal Works Tontriun rrntit 1, Permission is hereby granted......A &r Cesspool ServiCp, Inc to Cos ruct ( ) or Repair (X ) an Individual Sewage Disposal System at —._.....Fauce- Lane,_ Hyannis - Wesley_ Wright ................... ----------------------•••--- ..................................................... Street as shown on the application for Disposal Works Constructiort`-Per"it-l __. _ 24, 8?1......................... ----........•-•-...-----•------•---------------------------------------•------•-•-----•••-••••-•--•••--- 12/014/84 Board of Health DATE------------------••----•...=................................................... __ FORM 1255 A. M. SULKIN, INC., BOSTON FLOW PROFILE ALL PIPE ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS VENT PIPE TOP OF FOUNDATION y RAISE COVERS TO WITHIN 6 to OF FINAL GRADE / a- - 55.34 +— ONE INSPECTION RISER FOR m LEACHING GALLERY Aell _ 2" LAYER OF 1/8' �D-�X r3inx t/2- STONE- 3- DROP FLOW LINdl t0 ta' 46- sAs� ?rnr PRECAST .s � 3ia•-t tia- BAFFLE rXr�" ORYWELLy �- STOVE r ,..,.. 'z---BOTTOM OF SL96+- STONESOIL ABSORPTION 52.84 EXISTING BASE 5►.38 LEACHING SYSTEM EXISTING EXISTING 5t.ss GALLERY 51.25 5.00 F1 EXISTING 1000 GALLON (END VIEWI 4925 / EXISTING SEPTIC TANK 7.5 Ft e1 5 Ft 12.S Ft / 61 14 Ft ADJUSTED 24.90 SEASONAL HIGH � GROUNDWATER 1 n rn N\j - QJs 1�� n / ri NZ 9'A /�`4 ,=k �-d\ D r to a tn z Ln c \ oo z fx ruin ;u r 'EDGE P,q-mev T � tvNz 'V N Z / 0 co z 'm �� cn n s A m N T ` gym co -0 Q, / < Z 3 m py0 zx 3zo rz Z 1 frnZi fT► N lil0 3 k Z �. . i w (Tl cn cn D > o O I A z m (--) w 1 (Tl 3 1 n o-0 1 -I -� fTl X(n > fV �] > > p OAG a N Z 00 t acn In_ cn � � G7 �0N -N Z --I n F- m rn c � a n 3 M m U1 f- m �'+ (Tl � �' 3 r X m ci com X , Ln000 > m _ n rCTt 0 1m� M �� Gj �m� F m� -I>�o n '-' m :�' -I n X O rn o ml�0 �>Z _ rn Z -� R�hy1N � �1 f rn r CD I C '_ �— t p O > r ml z O mz 2 A,ZoZZ3 cc) a s 3 F,I ti,CET r N r —� y (,1I�) ❑ O (� S2i3H011d t zom� 3 r rn m� mot' O ® O N " ' AVM Z -� 3 m z Z D y - M 7 s m > B � Ul p � frrl � mz < ? lam` m rn o Z IJl -<M to O IV cy) 3 T � Z �G rn LJJ I > Z V (npo r ' 1 SOIL TEST Logy DESIGN CALCULATIONS , t, DATE OF TEST: MARCH 28. 2006 SOIL EVALUATOR: DAVID D. COUGHANOWR, RS DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD WITNESS REOUIREMENT WAIVED - NO VARIANCES SOUGHT SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS NO TEST PIT 1 PARENT UMAATER AL NDWATER ENCOUNTERED PROGLAC AL OUTWASH PERC AT 54 Ln 2 MIN/INCH IN C SOILS USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL ELEVATION = 54.40 *- CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWEDI DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER DISTRIBUTION BOX. USE 3 OUTLET D-BOX. (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 54.40 SOIL ABSORBTION SYSTEM: A 24 Ft:- x 12.5 f E x 2 Ft LEACHING GALLERY CAN LEACH 0-8 Ap SANDY LOAM 10 YR 2/2 NONE FRIABLE A 6 o t = ( 24 x 12.5 1 = 300 s F 8-32 B LOAMY SAND 10 YR 4/8 NONE LOOSE A s d w = ( 24 + 24 + 12.5 + 12.5 1 x 2 = 146 s F 51.73 ALot. = 446 sF 32-140 C MEDIUM SAND 10 YR 6/4 NONE LOOSE V L 0.74 x 446 = 330.04 G P D 42.73 USE A 24 Ft x 12.5 Ft x 2 Ft GALLERY. Vt. .= 330.04 GPD > 330 GPD REQUIRED NO TEST PIT 1 PAARENOTU MATERIAL: PROGLAC ALD OUTWASH ELEVATION = 54.50 +- PERC AT 56 to : 2 MIN/INCH IN C SOILS DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHESI HORIZON TEXTURE (MUNSELLI MOTTLING LEACHING GALLERY 500 GALLON DRYWELL 54.50 DIMENSIONS AND DETAIL 0-6 Ap SANDY LOAM 10 YR 2/1 NONE FRIABLE CONSTRUCTION DETAIL USE H-/O UNIT 6-32 B LOAMY SAND 10 YR 4/8 NONE LOOSE 51.83 DRYWELL UNIT STONE RSERLTOONE WfTHININSPECTION 32-140 C MEDIUM SAND 10 YR 6/4 NONE LOOSE e'-2 aEFF. DEPTH INCHED IC FINAL GRADE 2 Fk. EFF. DEPTH AND INDICATE LOCATION 44.50 24.0 F(< ON AS-BUILT CARD o NO , TES 0 33 N 0001: ocz) oo Opp�4 1n 11 GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN CZ) 000 21 ALL LINES TO BE SCH 40 PVC AND PITCH AT I/8 INCH PER FOOT MINIMUM. 31 ALL COMPONENTS '`INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS 3.5 8.5 8.5 3.5' OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) 24.0 Ft NOT TO 102 to 41 INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES SCALE BEFORE EXCAVATING FOR SYSTEM. 51 EXISTING LEACH PITS TO BE PUMPED, COLLAPSED, AND FILLED. OR REMOVED 61 ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON, FINES AND DUST IN PLACE 71 LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0" BEFORE PITCHING DOWN 81 ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES GROUNDWATER ADJUSTMENT AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK EXISTING GROUNDWATER LEVEL SEWAGE DISPOSAL SYSTEM PLAN 91 SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT BASED ON TOWN OF BARNSTABLE PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. GIS DEPARTMENT RECORDS. -TO SERVE EXISTING DWELLING 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. INDICATED GW 23.00 Ill SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL INDEX WELL AIW-230 ALECIA FAHY STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH ZONE D 253 FAWCETT LANE HYANNIS. MA SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING READING DATE FEB 2006 21.9 121 SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED READING 1.9 FOR STRUCTURAL INTEGRITY_ INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. ADJUSTMENT .9 ADJUSTED GW 24.9 ECO-TECH ENVIRONMENTAL 43 TRIANGLE CIRCLE SANDWICH MA 02563 ETE-22991 MARCH 29. 2006 1212