HomeMy WebLinkAbout0106 FROST LANE - Health 106 Frost Lane
Hyannis
A= 289— 134
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is Hyannis,required for every y MA 02661 34-14
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 filling out forms A. General Information
on the computer,
use only the tab 1. Inspector:
key to move your U `1 cursor-do not Darrell Stone
keY y the return Name of Inspector
Cape Cod Septic Inspection
Company Name
P.O. Box 1466
Company Address
. Harwich MA 02645
Cityrrown State Zip Code
508-240-2500 S14995
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 16.340 of
Title 5(310 CMR 15.000).-The system:
® P se ❑ Conditionally Passes ❑ Fails
❑ e s urther Eval o by he Local Ap uthority i
3-4-14
n ector's Signatur '_ Date
The system ins ctor shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins•3/13 VO.ffi' n Form:Subsurface Sewage Disposal System•Page 1 of 17
Commonwealth of Massachusetts
AMMUM Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis, MA 02661 3-4-14
page. Cityrrown State Zip Code Date of Inspection
B. Ce
rtification, 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 septic tank was pumped during the inspection
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system,-upon completion of the replacement or repair, as approved by
the Board of Health,jwill pass. '
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and.if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for VoluntaryAssessments ents
M 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis, MA 02661
page. City/Town 3-4-14
State Zip Code Date of Inspection
B. Certification (cant.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes(cont.): r .
❑ Observation of sewage backup or break out or high static water,level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑- obstruction is removed ❑ •Y ❑ N
❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
I
' T
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.
t R 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•3113
Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 oil 7
4. S
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
wM 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is required for every Hyannis, MA 02661 3-4-14
page. Cityfrown - State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fall 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 **p ate 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
q '
11
® Backup of sewage into facility or system component due to overloaded or
• .clogged SAS or cesspool
E] ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than %day flow
t5ins•3/13 Title 5 official Inspection Form Subsurface Sewage Disposal System-Page 4 of 17
Commonwealth of Massachusetts -
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 106 Frost Ln. Hyannis MA ,
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis, MA 02661 3-4-14
page. Cityfrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped: `
❑ ® , Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool`or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis,performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑- ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
a A
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
y' ❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 20.0 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 15.30.4. The system owner should contact the appropriate
regional office of the Department.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts "
t
W Title 5 Official Inspection Form
Subsurface_Sewage Disposal System Form-Not for Voluntary Assessments
M 5 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis,• • MA 02661 34-14
page. City,Town state Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
'Yes No
® ❑ -Pumping information was provided by th'e owner, occupant, or Board of Health
® Were any of the system components pumped out in the previous two weeks?
❑ r .0 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?
El Were as built plans of the system obtained and examined?(if they were not
available note as N/A)
- ® Elk. Was the facility'or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for sigris of break out?
® ❑A' `Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions,`depth of liquid, depth of sludge and depth of scum?
Was the facility owner'(and occupants if different from owner) provided with
® ❑ information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has
been determined based on:'
® ❑ Existing information. For example, a plan at the Board of Health.
® • ❑ Determined in the-field (if any of the failure criteria•related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information . : .,
Residential Flow Conditions:
• Number of bedrooms(design): 3 _ Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15:203(for-example: 110 gpd x#of bedrooms): 330
` P
t5ins•3113 r Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal,System Form-Not for Voluntary Assessments
M 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis, MA 02661 3-4-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
3 Bedroom residential dwelling '
t .
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?(Include laundry system inspection
information in this report.) ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonaluse?
❑ Yes ® No
Water meter readings, if available(last 2 years usage(gpd)): 372.97 GPD
Detail: '
This property has a lawn irrigation system `
2013- 142,120 gallons
2012-130,152 gallons
Sump pump? ❑ Yes ® No
Last date of occupancy: 2 months ago
' - Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203)
Gallons per day(gpd)
Basis of-design flow(seats/persons/sq.ft., etc.):
Grease trap present?-
• ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M ,• 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is required for every Hyannis, MA 02661 3-4-14
-
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date.of occupancy/use: Date
Other(describe below):
General Information
t: y
Pumping Records:
Source of information: Discount Septic Pumping
Was system pumped as part of the inspection? ® Yes ❑ No
If yes, volume pumped: fi 1500
gallons
How was quantity Weight
q ty pumped determined?
Reason for pumping: Maintenance
Type of System:
® Septic tank, distribution box, soil absorption system
- ❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M s•'"� 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis, MA 02661 3-4-14
page. Cityrrown State Zip Code Date of inspection-
D. System Information (cont.)
Approximate age of all components, date installed(if known)and source of information:
2009 Per BOH
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 32"+/-
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.):
Apparent good condition
Septic Tank(locate on site plan):
Depth below grade: 26"
feet
Material of construction:
®concrete ❑ metal ❑fiberglass ❑ polyethylene
El other(explain)
If tank is metal, list age:
years`
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1500 gallon
Sludge depth:
71'
t5ins•3/13 Title 5 Official Insp
ection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
�M 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is required for every Hyannis, MA 02661 3-4-14
_
page. Cityrrown 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
25"
Scum thickness 1/2"
Distance from top of scum to top of outlet tee or baffle
6"
Distance from bottom of scum to bottom of outlet tee or baffle
16"
How were dimensions determined? 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.):
Grade to inlet and outlet covers 8" Normal liquid level No sign of leakage SCH 40 tees
The septic tank was pumped during the inspection
Recommended maintenance pumping every 2-3 years
Grease Trap(locate on site plan):
Depth below grade:
p
feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins.3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts 41
Title 5 Official Inspection Form .
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
106 Frost Ln. Hyannis, MA
Property Address
Mar aret Garrahan
9 ;
Owner Owner's Name
information is
required for every Hyannis, MA 02661 3-4-14
page. Cityrrown 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 El other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
' �••- �.f. gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order. ❑ Yes ❑ No
Date of last pumping: Date
Comments(condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17
r r.
Commonwealth of Massachusetts
Title 5 Official Inspection Form w
Subsurface'Sewage Disposal System Form Not for Voluntary'Assessments
106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is required for every. Hyannis, MA 02661 3-4-14
page. . Citylrown - State Zip Code Date of Inspection
D. System Information (cont.) E
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.):
'Grade to box 29" Cover 14" . - Good condition 5 Outlets with speed levelers
Normal liquid level No sign of leakage No scum No sign of failure
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes' ❑ No*
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
,
,
*If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If.SAS not located, explain why:
t5ins•3/13 , Me 5 official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
f
Commonwealth of Massachusetts
Title 5 Official Inspection ,Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments.
106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis, MA 02661 3-4-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number. 20
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
overflow
Elo 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.):
20 High ARC 36 Biodiffusers without stone(20'x14.375'X1.08')
Grade to Biodiffusor 36" Inspection port 11" Bottom 49" Dry
No sign of hydraulic failure
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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
b 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis, MA 02661 3-4-14
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owners Name
information is
required for every Hyannis, MA 02661 3-4-14
page. City/Town State Zip Code Date of Inspection `
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
A B
(0
2 (0
3 35--10 -
5
l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M s 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is required for every H Y annis MA 02661 3-4-14
-_
page_ Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check'Slope
® Surface water
❑ Check cellar
❑ Shallow wells t
Estimated depth to high ground water. >5
feet
Please indicate all methods used to determine the high groundwater elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: 2009
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: t
You must describe how you established the high ground water elevation:
Elevations from design plan
Bottom of SAS ELV. 34.0
Bottom of Test hole ELV. 27.0 NWE
Separation >5'
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13, rifle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
, 106 Frost Ln. Hyannis, MA
Property Address
Margaret Garrahan
Owner Owner's Name
information is
required for every Hyannis, MA 02661 3-4-14
page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D,or It 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
A
15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17
Town of Barnstable P# z�
Department of Regulatory Services
suwsreetE,
Public Health Division Date
200 Main Street,Hyannis MA 02601
Date Scheduled Time Fee Pd.
_10 .
Soil Suitability Assessment for Sew Di oral o
[Tkf�Performed By: fMiG4ltwl PtMe.'l�z� GTT CSIi Witnessed By:
LOCATION& GENERAL INFORMAT -0
Location Address A? frd��r
n 6Owner's Name � 6,���(��//�� L,� �y ,�/�//J Address f 0(0
Assessor's Map/Parcel: � /�'11 Engineer's Name C✓A(W__,?'&,e t �G D b 273-aEnd�te��✓��
NEW CONSTRUCTION REPAIR Telephone# - 7 7
Land Use StY%ke- (vmtty zmldcgtf ( Slopes(%) Surface Stones
Distances from: Open Water Body — ft Possible Wet Area — ft Drinking Water Well ft
Drainage Way — ft Property Line > 16 ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
S Sc� al{acl�G( �vl�
Parent material(geologic) Lk*'+r,*�A Depth to Bedrock _ ._ _
7132� II
Depth to Groundwater: Standing Water in Hole: 7132 i�_ _ Weeping from Pit Facr __. 713 2
Estimated Seasonal High Groundwater 7 13 2
DETERIVIYNATION FOR SEASONAL HIGH WATER"I-AU
Method Used: Fa�eGk 6��'U011
Depth Observed standing in obs.hole: `7 132 _ in. Depth to soil mottles: >i 3 2 in.
Depth to weeping from side of obs.hole: 7!3 2- in, Groundwater Adjustment_ ft•
Index Well# Reading Date: Index Well level __ Adj.factor Ad).Groundwater Level
PERCOLATION.'TEST l�4te 2 Z(s o� rime l 2_7 0f
Observation
Hole# Time at 9"
Depth of Perc 3 y-5 2 Time at 6"
Start Pre-soak Time @ I I I�rlt N Time(9"-6")
End Pre-soak j j; 2 2 A A
Rate Min./Inch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) A✓
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
` . i
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1) week prior to beginning.
Q:\SEPTIC\PERCFORM.DOC
DEEP OBSERVATION HOLE LOG Hole# 1.
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling
(Structure,Stones,Boulders.
Consistency,%Gravel
y- 3Y 13 GS l0Yr5 _ —
3y-132 C M S 1.� /oose
DEEP OBSERVATION HOLE.L'OG Hote# 2
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Grave]
y-3y 0 5-4
3 2 C- 11.S 2.5 i
DEEP'OBSERVATION HOLE I;OG Mel
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling
(Structure,Stones,Boulders.
Consistency,%Gravel
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency, o r v l
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes._ ✓._
Within 500 year boundary No'� Yes
Within 100 year flood boundary No ✓ Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? i'e,S
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on J6-2 7-f� (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required training,expertise and ex erience described in 310 CMR 15.017.
Signature Date 3-5-0 I
Q:\SEPTIC\PERCFORM.DOC
J
TOWN OF BARNSTABLE �.
LOCATION \DU \ To S�- SEWAGE# 1001 d 4%
VILLAGE 14 AAAIS ASSESSOR'S MAP&PARCEL 289- t3`-1
INSTALLER'S NAME&PHONE NO. CApew%cke. C-O COPrises LLC. WLS `10IV
SEPTIC TANK CAPACITY 1500 ct eA L 14-t
LEACHING FACILITY:(type) $Tonetess %0-A (size) 'Zoe 1��• 3"t`�
NO. OF BEDROOMS 3
OWNER MArc ACeT 64Xff A OA✓►
PERMIT DATE: 3- 1 t)-- o 5 COMPLIANCE DATE: 3 2 o -oat
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility OowAk-e it 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 L-aching Facility(if any wetlands exist
within 300 feet o/f�leaching facility). feet
FURNISHED BY
—,77777
."�Z ,9 s oz yo 3
.q3 3z.S
Of Ll0•U,
Ro yZ•o
G}? Ltq{ o
R� 1Z.s /01
32 �S•.o
B3 34.5 i
F 4
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961 8,a
C�wZ
CE/o 3 att.S
No. a —1 O r Fee 6P .
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes.
ftplitation for Misposal 6pstem (Construction permit
Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. i-Ir.a.,,?is Owner's Name,Address,and Tel.No. 342Y 6AC r A%'nAo
Assessor's Map/Parcel 2gq 1.3�( yt,w•
Installer's Name,Address,and Tel.No.ee; a;dt� Designer's Name,Address,and Tel.No.-3G 6n5
509—Cf 2L8 —LID � ,at.u U L. +(o q Se��2'► z 05Y C��s i(�,q .I
3--�3'7
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building Sins 1e Q,11 No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date 3-5-—22oo 1 Number of sheets / Revision Date
Title JOfo c—rOSi LArlF-
Size of Septic Tank !d 0 1 a-. ya l c� Type of S.A.S. 53_0y1 e-eSS L EI v t 3o dU.r l�rs c
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) q-/0 �1� I�b �—l3-x
Date last inspected: Z01q
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 He. h.
Signed Date i 0 —72-00-9
Application Approved by M Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
m-;,"-.:.. ....;,�.. ..:.:.�i.-...w .:� '.•r.q:3 �•'v .:1x.2"^"""" ..,., .Z..y�.3:'.r .. � .'n:,,....►..nro Y M "::r-�=='a�i,;,iX��:+lri"'•`'+: ...A� 'tom"'•'" _-
4
No. 0—l Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes y
ftpfication for 33isposal 6pstem Construction permit
Application for a Permit to Construct( ) Repair W/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. / (,� FecvS i L��r 6 �/r�.r r.j Owner's Name,Address,and Tel.No.
kr.:�: L�t✓7L
Assessor's Map/Parcel Z gq 13`( ? r��-7 g" 5 2 1 b �o e?yt(S
Installer's Namce,Address,and Tel.No. rl "�+ .r t, 1.a k�i s 4S Designer's Name,Address,and Tel.No.�"C Fr,S,n��:,/7
�l/�S'KZS YQ c (). o. �� 7(�3 Z0 y LrRii!t r (,
1G Cef,, kd i UC MA >vc ,-2"r3-'d3�? G/!s G✓r e��ryyy V 1 t �-
Type of Building: s
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building 6 i ns){ (Am Iv No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date J 5� 2 r)09 Number of sheets / Revision Date
Title 10to
Size of Septic Tank K-00 S✓x 14-1 y Type of S.A.S. 5i-LAi e I•PSG. o t 31'o d,lC4 y r
Description of Soil
��ez til t t �' c` 3q�r
t
Nature of Repairs or Alterations(Answer when applicable)
a 5\ 4-v� 3eA
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 Heal h. r
Signed _Date 3- to -1c oct
Application Approved by (V\ L D Cj Date � (c) U�
/1 r
Application Disapproved by U Date
for the following reasons
Permit No. Date Issued
- --_ - -- - -- - - - ------ - ---- -- --- - ' --- - - - = - - - - -------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
. Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(,A Upgraded( )
Abandoned( )by ck-e
at 10(o F✓OSi Ld�t-_e Jjn rti,. , �, has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Installer 1_to l r�o L C9-a (_3'i(P/,S r" (,(_C_ Designer
#bedrooms 3 Approved design flow gpd
The issuance of`this permit shall not be construed as a guarantee that the system wit function as des'gned.
Date 1 r)v 't) °( Inspector �,t 'ter% :�J
r V
No. cD O 1 Fee I b n
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS
Nsposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( t,.h) Upgrade( ) Abandon( )
System located at all
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date - V ` rX`1 roved pP b y �C�!//►W �il(� c 7
A
v
d
l'own of liarnstabie
Regulatory Services
= Thomas F. Geiler, Director
• BAR Aat.r.,
M"1"'
t� Public Health Division
r ��
° — Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508.862.4644 lax; 508.79( 630a
Installer & DesiQ.__air Certification Fgrm
Tate: 213 9
Desigper: ffe:- en�;nNeccn�_T,I c:T� 1p�statlar _ ''w _ L�nFer rtst �:>
Address: 28`�N C(cnbe c_rNr•hw Address -�PO ( ram -I(o ry.y
Cas} WcArah�rvt , 14 ft� 62,53.
an j di -_was issued a permit to install a
(di te) (installer)
septic system at Lo Ie :_._r0", r_ �- a.) e_ based on a design drawn by
__Gnc�►�ecial�_, :��c., _.._.. datedcrc� , dUO�
(desigzaer) ��'—�
X certify that the septic system referenced above war; installed sub&tantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
l 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 systein.) but in accordance with State & Local Regulations. Pura revision or
certified as-built by designer to fallow,
�\ C,.
1. Jc� �+.�. r
�a --stalk�r's Sigiaa iir<;) ._�.._. ;R.
ry is
Ii8C7
�7g �
(Ues,gner's Sig e) {AFfiw esigner a tamp Here]
PLY PLYABI RETU . TO BAMSEABLE LIC VISI C YPI ' "I'li;
QF COMP E &ILI, EM BE I B
AND AS-
BUILT C4W' AU RLCEIVEIDBY T ' BAB TP L TV SIUN�
THANK YOU.
Q• Health/Septic/Designer Certification Form
i0 'd L980 £LZ 80S DNI2133NI8N33r WO 9Z: 60 600Z—£Z—NOW
4"SCHEDULE 40 PVC MIN. SLOPE 1
TOP OF FOUNDATION = 39.9 '{' 38. -- _---_-----
WISH GRADE OVER D-BOX- 1 ± FINISHED GRADE OVER INFILTRATION= 38.08' - 37.80' GENERAL NOTE S
PROVIDE CONC. RISER WITH INSPECTION PORT WITH SLOPE @ 2% MIN.
COVER OVER INLET&OUTLET FINISH GRADE OVER TANK EL.= REMOVABLE COVER OVER RISER TO 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
FINISHED GRADE TO WITHIN 6"OF F.G. WITHIN 6"OF FINISHED GRADE ACCESS BOX PER
WITHIN METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
@ FOUNDATION = 39.0'± 38'91± 6"OF F.G. (ONE PER ROW)
_ 5" DIA. OUTLET(S) CODE AND ANY APPLICABLE LOCAL RULES.
20"MIN.ACCESS 36"MAX. } f
2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
COVER(3 TYP.) 9"MIN. I I DESIGN ENGINEER.
"^ ' 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
EXIST. SEWER PIPL 36 MAX. 36 MAX. TOP OF SAS/B.O. = 35.08
SYSTEM UNLESS OTHERWISE NOTED.
MIN.SLOPE ,% 6" 3" 2^ DROP MIN. " 9„ PROVIDE WATERTIGHT 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
3 DROP MAX. 3 -_ JOINTS (TYP.) ELEVATION = 35.08' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
PROP. PVC 10" 4"PVC IN FROM 1.08' Q 13" 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF
SEWER PIPE 14" _- 35.25' SEPTIC TANK • 4"PVC OUT TO 0.59' (TYP.) f7.13"(Np) THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
LEACHING FACILITYAM- I + 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
/*36.8'± 35.50' 12" „ I 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
OUTLET TEE 35.00' MIN. 34.83' 34.59' �- 34.00' (laid flat) 2.875 (34.5 )�I
48 5.0' (TYP.) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
22"ZABEL FILTER 6" CRUSHED STONE (TYP.) FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
MODEL#A1801-4x22 _ OVER MECHANICALLY 5'MIN. 14.375' NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
10.0'TO FND (GAS BAFFLE ON BOTTOM) COMPACTED BASE 20.0'(TYP FOR ALL 5 ROWS) AND DESIGN ENGINEER.
5 OUTLET DISTRIBUTION BOX 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 35.30' ESTABLISHED
6"CRUSHED STONE TO BE INSTALLED ON A LEVEL STABLE GROUNDWATER ELEV.= < 27.00' ON TOP OF A CB/DH AS SHOWN ON PLAN.
OVER MECHANICALLY COMPACTED BASE BASE. FIRST TWO FEET OF OUTLET 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
PROPOSED 1500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 20 - BIODIFFERS PROFILE BIODIFFUSER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
LENGTH 10' 6' WIDTH 5, 8„ DEPTH 5' 8" (Dimensions per Wiggin CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
�' TANK PROFILE Precast Corp.,Pocasset,MA) DISTRIBUTION BOAC DETAIL 20 - 13" HIGH ARC 36 ( 3613BD) BIODIFFUSERS TO THE DESIGN ENGINEER.
S E I �."CONTRACTOR TO VERIFY ELEVATION NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
_ _
_ 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
o TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
TEST 1 L.! APPROPRIATE AUTHORITY.
Lev.
rk
/DH I PERC NO. 12482 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS
❑ .30' INSPECTOR: Donna Z. Miorandi, R.S. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE
F .S.L. I THEY SHALL WITHSTAND H-20 LOADING.
--�, �-� FROST
ST i EVALUATOR: Michael Pimentel, E.I.T. 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
BEET j DATE: February 26, 2009
f `
-. E LAYO(jr) i 1 TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
/ �, ELEV TOP= 38.00'
�36� `- �� REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
J P ��EpGE OF p ELEV WATER= <27.00' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
- AVEMENT 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
/31 ----� LOCUS' PERC RATE _ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
S79o1 �1,10^E -`
�► „ DEPTH OF PERC = 34"-52" 16. PROPOSED PROJECT IS LOCATED WITHIN:
100.00' _ wQ • F TEXTURAL CLASS: 1 ASSESSOR'S MAP 289 PARCEL 134
coa.
- - OWNER OF RECORD: MARGARET GARRAHAN
Q � U.P. Yo �
3 I 00 ► • i C 0" 38.00' ADDRESS: 106 FROST LANE
Z . Fill HYANNIS, MA 02601
'Du FEMA FLOOD ZONE C
/ I } • • B Loam Sand
10Yr 5/6 COMMUNITY PANEL# 250001 0008 D
/ / X * • .+ 17. DEED REFERENCE: BOOK 20854, PAGE 169
Mca (4 I I 1 • 34
~ 35.17'
GUY WIRE Pen:;♦ ; -_ 18. PLAN REFERENCE: 1.) PLAN BOOK 84, PAGE 117
20.0� 5) x 2.) PLAN BOOK 382, PAGE 47
M 1 z 3 I • • 52" 33.67'
3 .0' o s �
19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
p PROP. 20 - 13" HIGH ARC 36
u� I/ 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
TP/ #3613BD BIODIFFUSERS
O I ( ) FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
® 01 I o I FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
Ulfi C Medium Sand
/ , 2.5Y 6/6
34-10.6' /7 p (Loose)
(3 O PROPOSED INSPECTION PORT (TYP OF 5)
(6 3 12p' LOCUS PLAN
o I
M ; SCALE: 1" = 1000'
N 3 132"L
27.00'
MAP 289 (2 } - _ - -- No Mottling, Standing or Weeping Observed
PARCEL 152
�-- __37 PROPOSED DISTRIBUTION BOX �
� DESIGN DATA TEST PIT DATA LEGEND
W � � o
ii)
Lo toHC-1 NUMBER OF BEDROOMS (DESIGN) 3 PERC NO. 12482 50x0 EXISTING SPOT GRADE
d' ni � PROPOSED CLEAN-OUT TO GRADE (TYP OF 5) INSPECTOR: Donna iorandi, R.S. - - - 0 - - -
EXISTING CONTOUR
_o o DESIGN FLOW 110 GAUDAY/BEDROOM HC- EVALUATOR: Michael Pimentel, E.I.T.
z I 50 PROPOSED CONTOUR
2 / TOTAL DESIGN FLOW 330 GAUDAY
PROPOSED 1,500 GALLON SEPTIC TANK
DATE: February 26, 2009
#106 z DESIGN FLOW X 200 % = 660 GAUDAY TEST PIT#: 2 - 0/HAW - EXISTING OVER HEAD UTILITIES
o USE PROPOSED 1,500 GALLON SEPTIC TANK EXISTING ELEV TOP= 38.00' W W-- EXISTING WATER LINE
/ �
3-BEDROOM CID - INSTALL 20 - 13" HIGH ARC 36 (#3613BD) BIODIFFUSERS ELEV WATER <27.00'= GAS EXISTING GAS LINE
/ DWELLING �39- PERC RATE _
�� TOF = 39.9'± z �^ TEST PIT LOCATION
o SYSTEM CAPACITY
MAP 289 DEPTH OF PERC=
PARCEL 3 (TOTAL L.F.OF BIODIFFUSERS&COUPLINGS)(4.6 SF/LF)(0.74 GPD/SQ.FT.)= GPD TEXTURAL CLASS: 1 LP EXISTING LEACHING PIT
(100.0')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 355.2 GAL.LEACHING/DAY -
O O PROPOSED 1,500 GALLON SEPTIC TANK
DECK j X X X- X X- 0" 38.00'
BH hx TOTALS: Fill
' 4^ 37.67' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE
�J TOTAL NUMBER OF BIODIFFUSERS: 20 B Loamy Sand 13PROPOSED DISTRIBUTION BOX
TOTAL NUMBER OF COUPLINGS: q 10Yr 5/6
k TOTAL LEACHING AREA: 480.0 SQ.FT. PROPOSED 13" HIGH ARC 36 (#3613BD)BIODIFFUSER
x TOTAL LEACHING CAPACITY: 355.2 GAL./DAY 34 35.17'
I
MAP 289 x ��
PARCEL 134 x � REV. DATE DESCRIPTION BY APP'D.
13,000 S.F. NOTE:
x PROPOSED SEPTIC SYSTEM UPGRADE
# �\ x '
CID x PREPARED FOR:
NOTE: ENTIRE PROPERTY IS LOCATED WITHIN AN APPROVED ZONE 2. EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE
x k�` DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER Medium Sand CAPEWIDE ENTERPRISES
"MODIFIED CERTIFICATION FOR GENERAL USE"ISSUED TO C 2.5Y 6/6
I \
x k ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003(LAST (Loose)
�/ \ x SWING TIE MEASUREMENTS MODIFIED JULY 23, 2008). TRANSMITTAL NUMBER=W000052. LOCATED AT
APPROXIMATE LOCATION OF EXISTING � \ DESCRIPTION HC 1 HC 2 106 FROST LANE
CESSPOOL TO BE PUMPED AND FILLED � �,.
HYANNIS, MA
WITH CLEAN COARSE SAND X-X-X X x / SEPTIC COVER IN (1) 25.2' 12.8'
/ 'X--X 1 SCALE: 1 INCH = 10 FT. DATE: MARCH 5, 2009
X-X _X X X X SEPTIC COVER OUT(2) 18.5' 15.6' 132" 27.00 0 5 10 20 40 FEET
X-X-X k BIODIFFUSER CORNER(3) 25.7' 25.9' No Mottling, Standing or Weeping Observed
PREPARED BY.
MAP 289 8 00.00, BIODIFFUSER CORNER(4) 38.9' 39.3' RESERVED FOR BOARD OF HEALTH USE cJ RC HiLL "°� JC ENGINEERING, INC.
PARCEL 2 BIODIFFUSER CORNER(5) 49.2' 38.6' 2854 CRANBERRY HIGHWAY
NOTE: BIODIFFUSER CORNER(6) 39.6' 24.8' EAST WAREHAM, MA 02538
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG SITE PLAN- 508.273.0377
THE TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. SCALE: 1" = 10' Drawn By: BSM Designed By:MCP Checked By:JLC JOB No.1571