Loading...
HomeMy WebLinkAbout0025 FRANKLIN AVENUE - Health rAH 5 l=ranklin Avenue yannis PI 292�G 036 5 i� a p 4 i l I' a V f TOWN OF BARNSTABLE LOCATION 7 5 QAP 1G(_Jd AVE SEWAGE# 'ZOZO Z(p I VILLAGE P}hI r4 1 S ASSESSOR'S MAP&PARCEL Z9Z -4- INSTALLER'S NAME&PHONE NO. E-O�'r�Fj. (7uQs SEPTIC TANK CAPACITY ZOOO LEACHING FACILITY. (type) 50oct a1. 04Aw�EMS (size) q0 I sy 'CT. C> NO.OF BEDROOMS (� -q M OWNER w'i(.t15E PPE -J- LEJ410E ZICrhmu 5 O ' PERMIT DATE: ( I q I ZO COMPLIANCE DATE: J'1 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility f110 NZd Q 10•6Feet 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 <<-Q( �'f = .O'e- Co. A-1 = s.2; O A_1 -Z t9 � A -3 - 37.3, 3 /TOOWN OF BARNSTABLE LOCATION S `��y L SEWAGE # -d ,e 0VILLAGE ASSESSOR'S MAP & LOT �� 3 r` f lv s P£c7oe's' ✓ n n 8R4ftAEi:fR'S NAME&PHONE NO. M SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r �O tl r 1 ' i M A t f9,Lj c? ty 0 4% -Ib Z-z' v', Ot `'N 1 rz n No. �� Fee t� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes � 01ppYication for Misposai .6pstetn Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ;L (--RA#J ILL.(N Av67 Owner's Name Address,and Tel.No. n Assessor's Map/Parcel D-9 3 `� ` I FMsj 4-✓ t Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel No. '�7"�'-0�'j 60 iL eo sc_ cmcilnvi�a-x mac_ Lejqtrz< AS54 CovW "fa L L= Lu Type of Building: Dwelling No.of Bedrooms t� Lot Size q,amt,+- sq.ft. Garbage Grinder( ) Other Type of Building ( 4Sx-PTe A-!-No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ` Q gpd Design flow provided 662619 gpd Plan Date 9 >I"I Number of sheets )1 Revision Date Title- AS EeAA;«Gt&; &VG tf YA"&1l S Size of Septic Tank a`000 L(j0& Type of S.A.S. � — G� Description of Soil �Z Nature of Repairs or Alterations(Answer when applicable) �S� � (SC(� A, coo C,4&Lory scrkric. ._' Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of ' ned Date � — O Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued �U No. Fee 4 THE COMM NWLTH OF MASSACHUSETTS Entered incomputer: coor PUBLIC HEALTH DIVISION I TOWN OF BARNSTABLE, MASSACHUSETTS Yes 3pprication for Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. -XS (CR A40 KW&J AVC-7 Owner's,Name Addre§s,and Tel No. � Ct �54aPPq ¢ t.ENtccg At QATJ5o Assessor's Map/Parcel �•9 3 � � traA1jtL• 4-V4 !j Installer's Name,Address,and Tel.No. 77 Designer's Name,Address apd Tel.No. -50 -;L1'3-0*$l Roga�t� �, Oc�+;t. ep 3'c, �c►.�rMCz-�a.Gc srv�• -f I A85 4 C, AV I. l cc Type of Building: Dwelling No.of Bedrooms Lot Size 0 oil - sq.ft. Garbage Grinder( ) Other Type of Building 12 F_!S t n d JTf#+L-No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 440 gpd Design flow provided gpd Plan Date S -(I Number of sheets ( Revision Date + Title ;L5 FP.A& cc.l&-,) ADF dY/4'+l�/Nri�' Size of Septic Tank �A l 000 (544LCr0A2C Type of S.A.S. (&4 C 14A-9e9!j)2-S Description of Soil 4 M Nature of Repairs or Alterations(Answer when applicable) �sL ��(�Tlrh f l�L 61'!9V_LC ! Date last inspected: Agreerdent: 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 w Compliance has been issued by this Board of Si ed Date Y_. 1 r .-` Application Approved by Date Application Disapproved by Date for the following reasons PermitNo -' Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compfiante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by R&GL--XT 1?3 Qop=�) at X5 F(Z AL)!, .. J Q /k)t` tf sq has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No;x dated Installer gt39.'f Ps QO111- 410 Designer xw uss-mx-_ #bedrooms Approved design flow--, 44 Q gpd The issuance of this permit shall not a construed as a guarantee that the sytst m will' a i de' ed. Date Inspector fi -- --------------------------------------------------------------------------------------------------------------------------------------- No. Fee j `"`.;����� � � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal ,pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty,-to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be compleied within three years of the date of this permit. Date �'i / Approved by `� Town of Barnstable r. t1H9Erow,o Regulatory Services Richard V. Scali, Interim Director aniwsenaM h., 9� ' �0� Public Health Division C_ '°rfntu�° Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 rt Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 8-25-20 Sewage Permit# Zo2o-Zlvl Assessor's Map\Parcel 292/36 Designer: SG Eon jtneeecf 5. 'Tvic._ Installer: Robert B. Our Co., Inc. (RBO) Address: ZSS l Cranberry �iq�lul� _ Address: 363 Whites Path South Yannouth, MA rn54 uyareJna,,n HA 62-538 On Sim I Z0 RBO was issued a permit to install a (date) (installer) septic system at_ 25 Franklin Avenue based on a design drawn by (address) -SC C qio�Ci.Q TO dated 8-17-20 (designer) X 1 certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed 1 iance with the terms of the AA approval letters (if applicable) Ih OF q . r JOHN L OfURCHILL Jit N ;(D aller's tore) CML .41 A F ner's Signature (Affix De t p Here) PLRETURN TO ARNSTABLE PUBLIC HEALTH D . SION. 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:\Septic\Designer Certification Form Rev 8-14-13.doc 1 Town of Barnstable Health Inspector �t Office Hours Regulatory Services 8:00—9:30 Thomas F.Geiler,Director 1:00—2:00 sniwsTna�.E Only 9� '� ,0 Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: IQ V Map�2. ParcelQ- Name: U 5 E P lD E 'l TV,>hone: ���' 7 010 ° 2 7 Z 2. How many bedrooms exist on your property now? 2a. Please include a copy of your floor plans for the entire property. 3. Is the dwelling connected to public sewer? YES or 1V0 If the dwelling is connected to public sewer, skip questions -9 below. 4. Location of dwelling is INSIDE or OUTSIDE ' Zone of Contribution to public supply wells? 5. Is the dwelling connected to an ONSITE WELL or to PUBLIC WATER? 6. Is a disposal works construction permit on fil ES or NO 6a.If yes, how many bedrooms were approved accor mg o this permit? y"_) Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or 8. Is there an engineered septic system plan on file at the Health Division? YE V or NO Av J-1- 9, he septic system been inspected by a DEP certified inspector within the last two years? or NO FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY The Public Health Division has no objection t edrooms at this property. �-1 J Signed. _ i � Date: 3 Inspector(Print): Q:PT/AMNESTY/PUBLCHLTH.doc LRIVED 8 2003 COMMONWEALTH OF MASSACHUSETTSRNSTABLEEXECUTIVE OFFICE OF ENVIRONMENTALDEPT. d DEPARTMENT OF ENVIRONMENTAL PROTECTION , p�M SV o� 350 MAIN STREET WEST YARMOUTH,MA 508-775-2800 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP 292 PAR 036 Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner's Name: RIGATUSO,GUISEPPE Owner's Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Date of Inspection APRIL 24,2003 Name of Inspector:(please print) JAMES D. SEARS Company Name: A&B Canco Mailing Address: 350 Main Street West Yarmouth,MA 02673 Telephone Number: 508-775-2800 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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 Needs Further Evaluation by the Local Approving Authority ails Inspector's Signature: Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent tot he buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 1 Page 2 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 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: B. System Conditionally Passes: N/A _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined" please explain. _ The septic tank is metal and over 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 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 obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health)" broken pipe(s)are replaced obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 1 I OFFICIAL INSPECTION FORM—NOT FORVOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 C. Further Evaluation is Required by the Board of Health: N/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(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 salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of 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 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. 3. Other: Title 5 Inspection Form 6/15/2000 3 Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 D. System Failure Criteria applicable to all systems: N/A 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 J Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool J Liquid depth in pits is less than 6"below invert or available volume is less than '/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped J Any portion of the SAS,cesspool or privy is below high ground water elevation N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply N/A Any portion of a cesspool or privy is within a Zone 1 of a public well N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well N/A Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this fonn.) NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 15.303,therefore the system fails. The system owner should contact the Board of Health to detennine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No 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—1WPA)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 is 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 CM 15.304. The system owner should contact the appropriate regional office of the Department. Title 5 Inspection Form 6/15/2000 4 Page 5 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 Check if the following have been done. You must indicate"yes"or"no"as to each of the following Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in.the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS,located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)has been determined based on: Yes No ✓ Existing information. For example,a plan at the Board of Health. ✓ Detenmined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CM 15.302(3)(b)] F ,y Title 5 Inspection Form 6/15/2000 5 Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION 'Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 FLOW CONDITIONS RESIDENTIAL Number of Bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms: 440 Number of current residents: 4 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 no): YES Seasonal use(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): N/A Sump pump(yes or no) NO Last date of occupancy: PRESENT COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CM 15.203): Basis of design flow(seats/persons/sqft,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: N/A—TANK PUMPED AFTER INSPECTION Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: gallons—How was quantity pumped detennined? Reason for pumping: TYPE OF SYSTEM ./ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: AROUND 1990 Were sewage odors detected when arriving at the site(yes or no): NO Title 5 Inspection Form 6/15/2000 6 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 BUILDING SEWER(locate on site plan): N/A Depth below grade: Materials of construction: Cast iron _ 40 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): ./ Depth below grade: 12" Material of construction: ✓ concrete metal fiberglass polyethylene other(explain) If tank is metal list age: Is age contnned by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 2,000 GALLON PRE CAST Sludge depth: 3" Distance from top of sludge to the bottom of outlet tee or baffle: 28" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 12" Distance from bottom of scum to bottom of outlet tee or baffle: 16" How were dimensions detennined: PLAN AND TAPE Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): MAIN TANK AT WORKING LEVEL. INLET TEE,INLET COVER 18"CEMENT AT GRADE.OUTLET BAFFLE,OUTLET COVER 12"BELOW GRADE.NO SIGN OF OVERLOADING OR LEAKAGE. GREASE TRAP(located on site plan) N/A Depth below grade: 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 TIGHT or HOLDING TANK: N/A (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/day Alarm present(yes or no) Alarm level: Alann in working order(yes or no): Date of last pumping Comments(condition of alanm and float switches,etc.): DISTRIBUTION BOX: ./ if present must be o ened locate on siteplan) 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.,): DISTRIBUTION BOX IS 16"x16",24"BELOW GRADE.ONE LINE IN,TWO LINE OUT. BOX IS GOOD. NO SIGN OF OVERLOADING OR SOLID CARRYOVER. PUMP CHAMBER: N/A (locate 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.): Title 5 Inspection Form 6/15/2000 8 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: 25 FRANKLIN AVENUE HYANNIS,MA 026001 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 SOIL ABSORPTION SYSTEM(SAS): ./ (locate on site plan,excavation not required) If SAS not located explain why: Type ./ leaching pits,number: 2 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.) LEACHING IS TWO 1,000 GALLON PRE CAST PITS.PITS AND COVERS ARE 34"BELOW GRADE.30' WATER IN PITS.STAIN LINE AT 3'.NO SIGN OF OVERLOADING OR SOLID CARRYOVER. CESSPOOLS: N/A (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: N/A (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.) Title 5 Inspection Form 6/15/2000 9 �' Page 9 of' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two pennanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. A C 3 �- A b ° 15 v 8 00 - Title 5 Inspection Form 6/15/2000 10 Page I 1 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 25 FRANKLIN AVENUE HYANNIS,MA 02601 Owner: RIGATUSO,GUISEPPE Date of Inspection: APRIL 24,2003 SITE EXAM Slope Surface water Check cellar Shallow wells i Estimated depth to no groundwater 12 feet Please indicate(check)all methods used to detennine the high ground water elevation: ./ Obtained from system design plans on record-If checked,date of design plan reviewed: Observation site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high ground water elevation: TEST HOLE ON PLAN. NO WATER AT 12'. BOTTOM OF PIT ABOUT 9'. 1 1d PiT .3 Title 5 Inspection Form 6/15/2000 11 No..............._ .. FEE....l. . ......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 'TOL`09) OF......j3.,�9:0!P94'A..V`.'e ............................................... Appliration for Bispos al W,ark Tonstr ion rumit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at ....19.VFN✓r------------ ------•- ......... �------......•--._....................-----•------•----•------. o at o ,A or Lot No. ------------------------------TT caner ` 1 A ess // Installer Address d Type of Building Size Lot.. 1..................Sq. feet - Dwelling—No. of Bedrooms.._./Y....................... .Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ----------------------------•--• . ' -------------------- ------- w Design Flow............................................gallons per person per day. Total daily flow............................................ 1:4 Septic Tank—Liquid'capacity....._......gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area_...................sq. ft. 3 Seepage Pit No.................:... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... fTq Test Pit No. 2.............:..minutes per inch Depth of Test Pit.................... Depth to,ground water........................ P •---•-••-•-•-----------------------------------------------------------------------•----•--•-•------......................................................... 0 Description of Soil................................................................................................................. ~:« w ............................................................................................................................................................................................... ... U Nature of Repairs or Alterations—Answer when applicable....................................................................... ' --------•------------------------------------------••---•--•----------------------------•--•-•----------••-•------------------------...---........---------------------------------------------•-_••---- Agreement: ' The undersigned agrees to install the afo:edescribed Individual Sewage Disposal System in accordance with the provisions of'Ll-ITILE 5 of the State Sanitary Code—The undersigned further agree {of to ce the system in operation until a Certificate of Compliance has been issued by the board of health. yG Signed_._..... _._ __f<\/11� ..� - 3-�_ . __. ., Ge- Date Application Approved By.... ... Cti .... ........� .�-P-�.6------ Date Application Disapproved for the following reasons---------------••------•---------......-•----------------------•--------------------------------------..._---.._ -------------------------•------••••••---•--•-•.....--•-----•------•---••••...••--•-•--•-•-••-------.................--=•------------------------...---------------•-----•------------------------------- Date PermitNo---q.0--- y8--•------------------•---•--- Issued........................................................ Date Cl.----_------I Fss.......................... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD O VE I ALTH ............. ..............o"#..�w 5............... ....-----------..............._...........----...----- Appliraition for Uispoiitt1 If rkii Tantratrtion rranit Application is hereby made for a Permit to Const (, }J,o��pair ( �an Individual Sewage Disposal System Y/�'V �1 `L at � C 1 Al A V C A/✓ C ................__ - _... ....... .. ...... -----------------------------r"Lo.'No.'.---------------------------. -......_. 7, o - s O or Lot No. --•----------------------------- ..............._.... _......... ........... ,............. .-...._----- b H n /� -f— W � AG/I/Owner �S U K/p�tia.o7 f� �Cl/j/o5 ��//lf Installer Address Type of Building / Size Lot.s......................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q, 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 ( ) Percolation Test Results Performed bY.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... f14 Test Pit No. 2................minutes per. inch Depth of Test Pit.................... Depth to ground water........................ a --•---------------------------------------------------------------- -------------------- •--•--------.--------------- -............. .--------- ------------ --••-- 0 Description of Soil........................................................................................................................................................................ x U •••-------------•••••-••--•--•---••••••-••-••-•-•--------•---------•-••----------•--••--------•----•------•---••--•••-.......-•-----•-------••......--•••------------------•----•-------....-•--......._ w ...................................................••••••••-•--------••--•••----•••-•-••.....•----------•------•-•---••-•--•-••--•--•--...•---•-•-•••--•••--••••--....•--._...--••--••--•-------..__..... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... - ------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITU 5 of the State Sanitary Code—The undersigned further agr no t ce e s tem in operation until a Certificate of Compliance has been issued by the board of e4lth. � �D Signed.... ••-................... ..................... ..................... ----_---- an"L"'7— Date Application Approved BY. -•--- -------------------•---••-•--------•--------------.-••-- Date Application Disapproved for the following reasons-------------------------------------•-----------------••--------•--------------...---------••-••--•--•-••-...._ ............................•---------------•--------------.....---------•-------•------.....------------....................-•--....••. •••-•-...•---•---•-•---•---••-••---•••-----•••••••.......--... ` Date Permit No90.- .3-`/9•L4............................. Issued_..........=...............................- ate..----- Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ................ . .. ....................................................................... Trrtif irtttr of TuntpliFatta THIS IS rK FY,,Pat Wndividual Sewage Disposal System constructed ( ) or Repaired ( ) Cc by --------------••---------------------------------------•.......................................... .............. .--------- n Installer at............... -•••-••••---...•••••--........................................................................................................................................................ has been installed in accordance with the provisions of TWY 35-peThe State Sanitary (�id'e3a`s 3e32ribed in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 6 DATE.........��':.�,,�'�.-�`.:.....ln. ._.. Inspecto THE COMMONWEALTH OF MASSACHUSETTS da 7-,,,,BOARD P�F F�IF1at'i r AC 0 No._.... ..3--.... FEE........................ �i o at1 0 � 1i r ion rrn it Permission is eby granted-----------••. C .............--•.. tfs i----qo 3 to Construct ( or Repair ( an In,4j ddual age is �sz1-System at No. Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... o /G ................................. _ \/ Board of Health DATE -------------------•----- ----- ---• .......... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS TOWN OF BAR`'4STABLE LOCATION fHGrdi ��ih S7 --SEWAGE # r VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME &t PHONE NO. �r�j'.'-' Ige, SEPTIC TANK CAPACITY 0,n LEACHING FACILI'.Y:(tyPe) 2= i 000 (size) �U r NO. OF BEDROOMS PRIVATE WE1.). OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No � i _ __ _ _ e / � .� 4' `. .. .✓ .. �� ' � ,. 1 � _, �� � � ���: . e"u� _-_ :sue ,. pv �$it 'i ffff l /�Y�� '� 6 � '� 1 i ' J t1AY. -G-.2003 2:46PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.2i12 350 MAIN STREET & WEST YARMOUTH,MA 508-775-2300 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORAM PART A CERTIFICATION MAP PARCEL C.0, Property Address: ,,�° 3�/�A A✓r-Li a ,4 ✓ OV_. h./ Owner's Name: _ �,1 �•3 L, (e+V t S TD Owner's Address: S' r�►,g,��-� /� i� Date of Inspection -'03 Name of Inspector: (please print) V7; s° S 'D ZJ:Zo"S Company Name: A&B Canco Mailing.Address: 3501Main Street West Yannouth.Mrs 0203 Telephone Number: 503-775-2300 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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 CiVIR 15.000). The system: /' ✓ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: ' — Date: The system inspector shal;submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10.000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent tot he buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 1 MAY. 5.2003 2:41PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.3i12 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner: Data of Inspection: Inspection Summary:Check A,B,C,D or E/AL AYS 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: B. System Conditionally Passes: One or more system components as described in the"Conditional Peas"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined" please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltmtion or tank failure is imminent, System will pass inspection if the existing tank is replaced with complying septic tank as approved by the Board of Hcalth. *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 obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health)" broken pipe(®)are replaced obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 MAY. 6.2003 2:41PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.4i12 Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: Owner: Date of Inspection: C. Further Evaluation is Required by the Board of Health:I✓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(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 bothering vegetated wetland or salt marsh 3. 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 sur�tace water supply or tributary to a surface water supply. The syste n has a septic tank and SAS and the SAS is within a Zone I of 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 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. 3, Other: I Title 5 Inspection Form 6/15/2000 3 MAY. 6.2003 2:41PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.5i12 Page 4 of i 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: Owner: Date of Inspection: D. System Failure Criteria applicable to all systems: You mint,indicate"yes"or'ho"to each of the following for all inspections: Yes Ng � �/ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool (/ Discharge or pending 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 A/T Liquid depth in I is less than 6"below invert or available volume is less than ''A day flow t./ Required pumping more than 4 times in the last you 1=due to clogged or obstructed pipe(s). Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply Any portion of a cesspool or privy is within a Zone 1 of a public well Any portion of a cesspool or privy is within 50 feet of a private water supply well Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis performed at a Df P certified laboratory,for collform 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 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 falls. 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 service a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No 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 I 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 is 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. Page 5 of 1 1 I Title 5 Inspection Form 6/15/2000 4 MAY. ,6.2003 2:41PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.6i12 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: Date of Inspection: Check if the following have been done. You.must indicate`yes"or"no"as to each of the following Yeses 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? 4 Was the site inspected for signs of break out? col Were all system components.including 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 v Was the facility owner(and occupants if different*om owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)has been determined based on: Yea No _ Existing infonradon. For example,a plan to 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)(3 10 CMR 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 MAY. ;6.2003 2:41PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.7i12 Page 6 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspection: i W CONDITIONS RESIDENTIAL K Number of Bedrooms(design); Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example; 110 gpd x#of bedrooms:�C Number of current residents: Does residence have a garbage grinder(yes or no); !VO Is laundry on a separate sewage system(yc or no); [if yes separate inspection required] Laundry system inspected(yes or no); £S Seasonal use(yes or no); Water meter readings,if avail last 2 years usage(gpd)): Sump pump(yes or no) �V d Last date of occupancy: oxrj;I'"r-1, COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 3.10 CM IS.203): Basis of design flow(seats/persons/sgft,eta): 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): iWater meter readings,if available: Lost date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: �✓ _ /U7f '�i��'+� Pam '��� Was system pumped as part of tho inspection(yes or no); If yes,volume pumped; gallons---How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy _ Shared system(yes or no)(if yes,attach previous inspection records,if any) lnnovadve/Altemative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ^� Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: A '?P VA,D / 97a Were sewage odors detected when arriving at the site(yes or no): P Title 5 Inspection Form 6/15/2000 6 MAY. 6.2003 2:41PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.8i12 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: BUILDING SEWER 0ocate on site plan): Depth below grade: Materials of construction: Cast iron 40 PVC other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): ar Depth below grade: 14 Material of constructions !/concrete metal fiberglass polyethylene other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: ®O® o4/4L Me r f4 S� Sludge depth: i, Distance from top of sludge to the bottom of outlet tee or baffle: Scum thickness: ,,'j Distance from top offs m to top of outlet tee or baffle: a Distance from bottom of scum to bottom of outlet tee or baffle: /�e How were dimensions determined: 4-- j + Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet i Vert,evidence of leakage,etc.): 1A4Z-7-(TvL�fi� Y' CLa £ ow-r049'T ere;T LdT GREASE TRAP(located on site plan) Depth below grade: 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: Comments(on pumping recommendations,� inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 MAY. _G.2003 2:41PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.9i12 Page 8 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: TIGHT or HOLDING TANK: )VA (tank must be pumped at time of inspectlon)(locate on site plan) Depth below grade; Material of construction, concrete metal fiberglass polyethylene other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no) Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: V (if present must be opened)(loeatc on site plan) Depth of liquid level above outlet i 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.,)' �• a ., �$ vX / .S 1� "ge .BgeLadv yc i&S,L A ® X 11' 4 .) Jmr jz 04 ti e/s r t: r.< L i,j ZIA, L e-e i3 PUMP CHAMBER: /V/r (locate 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.): Title 5 Inspection Form 6/15/2000 8 MAY-6.2003 2:41PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.10i12 r Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of lnspection: SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) i If SAS not located explain why: Type beaching 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,) � �A)C iti� / 5 '� Q - �e o00 �,�� �i2 £ ��Si ®iTS p u.� 00 s 'T t iv CESSPOOLS: A//) (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.); I PRIVY, /V/0 (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.) Title 5 Inspection Form 6/15/2000 9 MAY. 6.2003 2:42PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.11i12 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner; Date of Inspection: 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 -C 3 `� A :D ;I � A-£ VV I 4- WE G . O 0- 0 - Title 5 Inspection Form 6/15/2000 10 MAY. 6.2003 2:42PM BARNSTABLE COM/ECO.DEVELOPMENT NO.543 P.12/12 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Lsdmated depth corroundwater feet Please indicate(check)all methods used to determine the high ground water elevation: r Obtained from system design plans on record-If checked,date of design plan reviewed: Observation site(abutting property/observation holo within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attaep documentation Accessed USdS database-explain: You must describe how you established the high ground water elevation: 'l //' IV yto 4 No w.4 l 7— r 7y 6 44J < i �a Bo?T� PST 3- /v e4/ArC c_ Title 5 Inspection Form 6/15/2000 11 5# FEc� ' x 10� l("0' c. F. I �- I , I �N�11TJ1 t1JG — — — -may�.--- ---•• VA Fr�RS Wit C,,A R A G L I I -..; NSUUiT�N Crz ING SoL J _ I Zx(r.�lCSTu g F s c ? x ra Z• 1 fir.G. LNsu14Tlo.v Vcntr Z �X SllEAW1liJ(- 3 NG,q-DRoo .,I•. I ? '= . . -' `- E jj C �►R SIJ!�b 1� �'('L �' ;4G,CJ.`. j . } I I P!� 30 � �TIN Four (e) ' i 1i �IRST.FcaorZ '41 g/0 H F-A bR aM Ml!J- I I , (JNUCA gyp VA7ED x� ; ? PORTLAND C�MENr I - P SILC r�r�- FoyµbA7�ONCr�,TrNiv "T`l!c �:oNCAETr 5LJU �' Ilrret1'1rs►? I ` _ _ _ �OU N DAT1 ON PLAT. 1J rND�7o�Xo,Gcl�r 0 , P�I�Fo�;r� �`iAIN ' ,',.- . .'- „{ ,. Fco71t��,25[X�P..�-r•l''+1�� - PIAk&Buu'PIP", I-tA►45roN "'� E�v£ v°•.s [�-e' j'}II!. 'rJ_; J Fily►�`I vi'k'v - -. ¢tiDRso I �� }�� I G AT U S c) H O La S L I i i _`•�' CNTRy E I o. I � OF .X O •.-7A R AGE to 5 .A13 S"*,Rs up I - q M .R.f I ` . FIRST FLaoR I up < L.DG,. Io r�rRy ov RAN&E-) 4-1 T-�cvRooM ►} h 1 K tNo I -rCHE- N � � I 'I x II j 1- I Is SH FI-1 Fti RoJ I i �'a i SflOw�� oo ,� • FINISH) a � � o I i� 10 ,a 13AT14 . I LINE mF S 49 Li �� �� N z r ►moo v � O Liv/w& -ROOM CpNCRETlE SLAS i 3/ I �L'o — 9A �. I I I (A n I `��l` n �J IIII Cs Li U! r � - � woota� o �� �1S X S. I I � I �'1 �3 i I ` _ / 6,0� I I� z -._ ..._ _ _:._. ---- x DO —oar, �-7 n00 _ I h x II ' I ' Avld 41 ?�,� NMI •; I 0-1171 V0073 I QN0�7S .I.. I I T.O.F. 5� 4'EL.= . + FINISH GRADE OVER D-BOX= 48.11± .FINISH GRADE OVER CHAMBERS= 47.6' - 48.2' � � `�PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE g�+ 0 3/4"TO 1-1/2" DOUBLE WASHED PROVIDE H-20 EXTENSION RISER SLOPE @ 2/o MIN. OVER SYSTEM STONE TO CROWN OF PIPE REMOVABLE WATER-TIGHT H-20 COVER OVER 1. UNLESS OTHERWISE NOTED ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& RISER TO WITHIN 6"OF FINISHED GRADE 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS FINISH GRADE OUTLET TO WITHIN 6"OF F.G. 0 2"OF 1/8"TO 1/2" DOUBLE WASHED METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL. 49.0 F.G.OVER TANK EL. = 5'I .0'i- 5" DIA. OUTLETS) MIN SLOPE 1 /o BOX TO F.G. (SEE NOTE 21) CODE AND ANY APPLICABLE LOCAL RULES. STONE OR GEOTEXTILE.FILTER FABRIC ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE PLACE H-20 RISERS ON DESIGN ENGINEER. TOP ol= sqs=45.40' PROPOSED 4" 9" MIN. ALL CHAMBERS WITH 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL EXISTING 4 r� 9 MIN. SCH. 40 PVC 36" MAX. 44.40' 36 MAX. ' INLET PIPES TO 6"OF SEWER PIPE \ / \ BREAKOUT EL= 44.90 SYSTEM UNLESS OTHERWISE NOTED. " SEWER PIPE FINISHED GRADE 6„ 3" 3" DROP MAX _ �+ 1 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN - 2" DROP MIN 3 9 _ L 16 PROVIDE WATERTIGHT ELEVATION =44.90' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLOPE @ 1% o 0 13" 4" PVC IN FROM ,.-� JOINTS (TYP.) oo�o 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF ILE 14" �*t5 'j'-F SEPTIC TANK 4 PVC OUT TO 0 0 0 O 0 0 0° 0 0 O THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE LEACHING FACILITY o0 00 0 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. SPECIFIED DROP BETWEEN o0 0 0 0 0 D O D O INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL , 12" 6" , 2' oo 00 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE 44.80 IN. 44,63 0 0 0 0 °° ono 0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE o 0 0 o� FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS o 0 0 0 0 0 0 0 0 0 0 0 0 0 OVER MECHANICALLY o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 4.0' _ ( 4.0' AND DESIGN ENGINEER. � 8.5' (TYP} 4.0' 4.0' 5 OUTLET DISTRIBUTION BOX SEE PLAN (4.83' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 49.54' TO BE INSTALLED ON A LEVEL STABLE ESTABLISHED ON TOP CORNER OF RETAINING WALL AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET 42.40' GROUND WATER ELEV= G 37.10' 12 83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 2,000 GALLON CONCRETE SEPTIC TANK 5 - 500 GALLON CHAMBERS 5' MIN. CHAMBER END VIEW CROSS SECTION VIEW - 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES *CONTRACTOR TO VERIFY EXISTINGSEPTIC �"' PROFILEr TION BOX DETAIL TYPICAL CHAMBER` PROFILE 20 (� TO THE DESIGN ENGINEER. ELEVATION PRIOR TO ANY WORK& ' H-'�OST 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TESTPITDATAREGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM 0 APPROPRIATE AUTHORITY. SWING-TIES w , a. PERC NO. David W.T-20-147 W INSPECTOR. Stanton, IRS (BOH) 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED HC-1 HC-2 � � v � �� n, UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR DESCRIPTION �, .r p EVALUATOR: Brian Wallace EIT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. CORNER OF STONE (1) 22.2' 32.1' �, �� } I C.S.E. APPROVAL DATE:' Oct. 23, 2019 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. DATE: July 23, 2020 CORNER OF STONE (2) 21.9' 43.3' 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE r TEST PIT#: 1 &2 CORNER OF STONE 3 54.9' 64.9' 8 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. O ELEV TOP= 47.60' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, CORNER OF STONE (4) 59.T 52.5' O .. FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). � ELEV WATER= <37.10' g 4t 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN CORNER OF STONE (5) 48.2' 40.0' PERC RATE_ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. CORNER OF STONE (6) 42.4' 47.0' DEPTH OF PERC= 36"-!A 16. PROPOSED PROJECT 1S LOCATED WITHIN: l F _' * �' ASSESSOR'S MAP 292 LOT 36 4 TEXTURAL CLASS: I - \X\ a LL � OWNER OF RECORD: GUISEPPE& LENICE RIGATUSO MAP 292 TRUSTEES OF THE RIGATUSO FAMILY TRUST LOT 35 a +� =_ ��++ Off 47.60' W `n' / FIT X 15p �++� LOI�Us ��j to ADDRESS: HYANN S MA 02601 N�qo pp�k\ Benchmark f 4 Fill/Gravel 47,27 19,1S"w ``k\k� Top Corner of Wall q Loamy Sand t GAS Fri` k\X\X� Elev. =49.54' 8�� 10Yr 3/1 46.93' FEMA FLOOD ZONE X GAS -, ,w C am ` Approx. MSL COMMUNITY PANEL# 25001 CO566J r Gqs �\ x\ \ \k 17. DEED REFERENCE: BOOK 27283, PAGE 124 r \ Gqs EXISTING 2,000 GALLON t5 , ► ': g Loamy Sand dpr C \ _ '� , r. Z ';: 10Yr 5/6 18. PLAN REFERENCE: PLAN BOOK 65 PAGE 101 Gq `\ Q - 49 k\k` SEPTIC TANK TO BE , G USED IN THIS DESIGN „ , 44.60 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. zo Perc o d G y\ e 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY 54 43.10 EXISTING LEACHING PIT TO ,., FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY BE PUMPED, REMOVED & F!!w� Medium Sand FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. FILLED WITH CLEAN SAND B C-1 w „ 2.5Y 5/6 co / MAP 292 ,�9. �4 �;'�••";' � `� `°. '�J �'� 21. A 4 PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A Q� 1 8 "~ - y. 2C� ti . .;.� (10% gravel) DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A ® � rn LOT 36 Wq�C o REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. i 9,000±S.F. (2) i r f� 99, 39.60' 1. (�� 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE �``'�1. LOCUS PLAN\I Medium Sand SPONSIBLE TO OBTAIN ANY AND ALL F G HC- � �' C-2 2.5Y 5/4 REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. qR � 33.5 , �✓ t ,� k X` k� l AGE UNp� I 47x9 SCALE: 1"= 1000' #25 R o ( 3) 126 37.10 j k�ke EXISTING .w P ` TP 4 ' 4-BEDROOM (� 47x6' No Mottling, Standing or Weeping Observed O (ASSESSED) / 45.8 r� g g 0 / / DWELLING / ✓" a E T TEST PIT DATA LEGEND 22.1' o PROPOSED FIVE(5) PERC NO. TPT-20-147 \ 500-GALLON H-20 1 NUMBER OF BEDROOMS (ASSESSED) 4 50xO' EXISTING SPOT GRADE j TOF=51.4±J ( :. : 6.;. LEACHING CHAMBERS INSPECTOR: David W. Stanton, RS (BOH) 47x6' c w/STONE NUMBER OF BEDROOMS(DESIGN) 6 EVALUATOR: Brian Wallace, EIT, CSE --- 50 - - - EXISTING CONTOUR DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 23, 2019 r-1 PROPOSED CONTOUR Q 47x5'o o TOTAL DESIGN FLOW 660 GAUDAY DATE July 23, 2020 `o 0 50 PROPOSED SPOT GRADE \ DESIGN FLOW x 200 /o - 1,320 GAUDAY TEST PIT#: 3&4 `� � I � ^• ` ' TP 2 2 PROPOSED 4" PVC VENT 47x6' ELEV TOP= 47.60' GAS EXISTING GAS LINE o / / / PIPE; EXACT LOCATION USE EXISTING 2,000 GALLON SEPTIC TANK 50.00 19,1 49, -, \ �� \\ / PER OWNER ELEV WATER= <37.10' E/T/C EXISTING UNDERGROUND UTILITIES HC-2 ` / PROPOSED PERC RATE_ (5 1 TP 1 INSPECTION PORT INSTALL 5 - 500 GAL: CHAMBERS W/ AGGREGATE w w EXISTING WATER LINE x'X` FCC •8 47x6' �c DEPTH OF PERC= j SIDEWALL CAPACITY TEST PIT LOCATION = TEXTURAL CLASS: 47x8 47x6 / (PERIMETER) (2' HIGH) (0.74 GPD/S.F.) GAUDAY MAP 292 �k\� -k-}�\ 1 .5, (126.7') (2' ) (0.74 GPD/S.F.) = 187.5 GAUDAY EXISTING 2,000 GALLON SEPTIC TANK LOT 37 X, k\ (4) 0" 47.60' PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE PROPOSED H-2o - k\k\ - _ _ � BOTTOM CAPACITY _ _ Fill/Gravel DISTRIBUTION BOX \k \k 48 SHED MAP 292 (FOOTPRINT AREA) (0.74 GPD/S.F.) = GAUDAY 4" 47.27' INC' PIT T '�.>f LOT 99 (647.9 S.F.) (0.74 GPD/S.F.) = 479.4 GAUDAY q Loamy Sand PROPOSED H-20 DISTRIBUTION BOX EXISTING LEACH O 10Yr 3/1 ` 47xT / 10" 46.7T O PROPOSED 500 GALLON H-20 LEACHING CHAMBER BE PUMPED, FILLED WITH �`. �v,�, �`` \ ` \ TOTALS: B Loam Sand GLEAN SAND &ABANDONED �- PROPOSED RESERVE AREA k, y (comprising 36 ARC 36 _J / TOTAL NUMBER OF CHAMBERS 5 10Yr 5/6 REV. DATE BY APP'D. DESCRIPTION chambers &6 couplings) TOTAL LEACHING AREA 901.2 SQ.FT. DESIGN FLOW=664.9 GPD TOTAL LEACHING CAPACITY 666.9 GAL./DAY 38" 44.43' PROPOSED SEPTIC SYSTEM PLAN PREPARED FOR: Medium Sand ROBERT B. OUR CO., INC. NOTES: C 2.5Y 5/6 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF (10%_gravel) LOCATED AT EACH SEPTIC SYSTEM COMPONENT. 25 FRANKLIN AVENUE 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE HYANNIS, MA 02601 PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF 126,, SCALE: 1 INCH = 10 FT. DATE: AUGUST 17, 2020 HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. 37.10' ZN OF y 0 5 10 20 40 FEET No Mottling, Standing or Weeping Observed 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A MASS DEP ZONE II, JOHN L ���, PREPARED BY: GROUNDWATER PROTECTION OVERLAY DISTRICT, WELLHEAD PROTECTION RESERVED FOR BOARD OF HEALTH USE 0 CHURCHILL JR. OVERLAY DISTRICT OR THE ESTUARINE WATERSHEDS. CIVIL JC ENGINEERING, INC. NO. 41807 2854 CRANBERRY HIGHWAY 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY �I a �'� EAST WAREHAM, MA 02538 FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS SITE PLAN r 508.273.0377 IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. SCALE: 1"= 10' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.5223 54et4ST b;3t.,I- d.s-less. ►"Irup 29 Z , LOT __�-- LT�1K : B�pIZoOMS 110 C-xbL /tab,`,'/ ,tZ U�aGb.Lft�d.Y S I NG Cd�f`1K�:G�oGXL./C�1�Y x I,s t:;,4XS 9 9 04 �LLLo�ts sus to � If�G F6.cIL.ITY : 05M 200© �drrIwT1c �-�.1�4G QE�t2 1 a T '------------ t-Se �2� (�'�6' PITS W/ 2' O1= 1a770N'E 640 IF`P',Za. . A Ca' OC"MI- S(C7E d12E c) yr- 4. = 1Se,s (2,5) - 4,Jo, 2. 6LL b'Y P30,770M 5ZTr- _- ?B -18.S Gb.L /OAIY r v549,-i (5rLL1t��.Y Q -rt r74t-; X Z i'ITS 70 B E. PUMPS.t�� fZtxMOYEC. �t2�P• 2Gr'�O�l- � `��� I I D l�l '"� � �� I � � � � ~70 LTO YE H-Z,- tF ZOWJe.CTTo W4EF_l. ]"oP/FDUN 5o t.ol.os El_. Sl.o 4." s o p c+:c u 4Yc i/4" B¢P ter. 150• 1 � -, 1':-MltiliGovB¢, Elso GILT 8f=1JcuM1Lt?k. r 14 0� c�•oc�6,k1 �� b co14G, Souw1� \ �� T41-1 SE�LC—�1sNIG 2'OF° 3/¢" TO i 1/Zti ra tes ? 'Z �Q v!►�t dv t.EY. go.'12 0 I M vda -�----� 1ST. 20'MIN. ��S( � � 7E� g���S WtiS�+ED SToN� _-�---- I 94 �1Z0 ro_ EDE 20 �K gm00 Sf= ,� INt.-@.T;IG a "Ur ,1a� t:*4 goTE., otST. v5m To eE Ip � I ovTLRtT:26" (o up,Zo" pu W4M?- TUMSTWO ;Tor- J ^Jrr VcpuA.l_ F�-O�/. �2� (S'K I-rs w/ 2' or' ST-o4E t 13t ' T 13 Ylo' MtN, 48 ''(� -i + � � �` ` •WIThIESs : �', l..liNC��CTS C3.p.�, ro CU 1+ i LI441 � / / � I x'�.2G. k'-,t►''"� : �- 2 M f M � I IJ . � 2 LEACG 4 , P ITS I v' F C)i x Co, E c= _ a Soma ' I F G 2d�/►x�. I t i i i j '1-10 wb,TE1z. FiJCcouw-rEtzet> IL PQEPbee~b 'Forte SCLLE ; I " = 201 1)1L7-E ' I?�irE'_21=NGlW ARNEH. yr o I q ALA �� $ OJnLA`-7 ! ��— 79?ctvtL " I ' I o 70 °n n2G348 0 No. !6 1 T EAR L7�..TUM 1S tSS�UT�IEL 1=P.vM C'UdD SL}EE."i', �X.IS'(� , GDN,ToIl{ZI� Fss�Or�nl Er'� ' " Z, 7 OW H W dT W V- I� L.YA.1 L 4.'% L E . p Cv+�1To a rz. -t=3 L o p ' .3 . DE'SICaN L,01MIt.46 F02. 1z12:ECb5'T UNITS ; ,d,Q.SµO- 41-Ib-¢¢. '. PIPE JOINT% 'S4A.U- as Tnd.I;:-E w4l,-rura -nca T _ 5 , CoNGTi2UCTlOf�1 UE t-b.1Ls Ta 8>= tK b.Cc.DEc�bhiGLt WIT I+ C�owr� came �r�y�ir�eer�in9 , i�c-. coMM . CODE `M-f'4-S SC, CIVIL I=NGI NEL 6z� Co .T4�1S PL4LN Foe 'Poo'oSEU WOIZIG ONLY , &`14P SNbtll.t� , SU�'Ye-f Oits N07 BE USE't] "Or-0W- PZOP1'r- 'Y'LINE 'STA.►GINCTa. q ,