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HomeMy WebLinkAbout0018 GOAT FIELD LANE - Health 0 1,8 Goatfield Lane. Hyannis f A= 247=20.2 ------ _ _ _ --- -- 164 Winter Street Hyannis A= 309—258 i t ti I I e 1 ; S M EAR Nm Ma= snmtdLwm • uado in USA Commonwealth of Massachusetts Title 5 Official .Inspection Form Subsurface Sewage Disposal System Form'-Not for Voluntary Assessments ,. 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is H annis MA 02601 March 31, 2011 required for y every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:, A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your David B. Mason cursor-do not Name of Inspector use the return key. David B. Mason Company Name VQ 4 Glacier path Company Address East Sandwich MA 02537 City/Town State Zip Code 508-833-2177 S1287 Telephone Number License Number B. Certification � trr 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 r. = was performed based on my training and experience in the proper function and maintenance of on site cam: sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of C:) Title 5010 CMR 15.000).The system: C) ® Passes ❑ Conditionally Passes ❑ Fails t— C . t ❑ Needs Further Evaluation by the Local Approving Authority March 31, 2011 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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•09/08 Title 5 Official Inspection Form:Subsurface Sew a Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments G M 18 Goat Field Lane Property Address Bradley Owner. Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Observations stated in this report represent the condition of the system on March 31, 2011 at 2 PM only and does not guarantee the or represent the future operation of the system. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 18 Goat Field Lane j Property Address Bradley Owner Owner's Name information is Hyannis MA 02601 March 31, 2011 required for _ every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) -B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ •N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: i ❑ 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 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for 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 El ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool El ® Discharge or ponding of effluent to the surface of the ground or'surface.waters due to an overloaded or clogged SAS or cesspool ❑ ® 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•09108 Tifle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is H required for annis MA 02601 March 31, 2011 Y every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply Well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2bOOgpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑. ❑ the system is within 200 feet of a tributary to a surface drinking water supply El ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or an "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 CM 15.304.The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for yH annis MA 02601 March 31, 2011 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Tide 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 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d yes 9 ( Y 9 (gp ))� Detail: 2008- 75,000 gallons and 2009 111,000 gallons Sump pump? ❑ Yes ® No Last date of occupancy: currentDate 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-09/08 Tide 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 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): I General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): 15ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for yH annis MA 02601 March 31, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed (if known)and source of information: January 14, 2009 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): j Distance from private water supply well or suction line: Not Applicablefeet . i Comments (on condition of joints, venting, evidence of leakage, etc.): Appears in working order I Septic Tank(locate on site plan): 2 Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) 1000 gallon tank If tank is metal, list age: years j Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 � every 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 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 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): i . I Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness i 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 assachusetts Commonwealth of M Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 4 Tight or Holding Tank (tank.must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 15ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level with outlet inverts 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.): No evidence of solids carryover. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: SAS exposed. Approx. 36 inches below grade with rise to within 10 inches of grade. Approx. 11 inches of effluent holding in leaching area. l5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 117 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ 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.): 2-500 gallons chambers with 4 feet of stone around. Approx 11 inches of effluent in leaching chambers providing approx 13 inches of effective leaching area. No signs of staining above effluent elevation. 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 0 Yes ❑ No l5ins•09/08 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 M 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for. Hyannis MA 02601 March 31, 2011 every page. City/Town 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•09/08 Title 5 Official.Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every 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 i t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 . New Page 1 Page 1 of 1 TOWN OF BARNSTABLE y LOCATION _[ti? �,',j� �... SEWAGE#Q7M-vo7 VILLAGE ASSESSOR'S MAP&PARCEL dy7-QW INSTALLER'S NAME&PHONE NO.L.1w,e.QJbnt M 5 C Stitt S7JQ 275-77fs SEPTIC TANK CAPACITY /ton LEACHING FACILITY:(type) A _W dyv&..dJfi(size) dYtI3 X NO.OF BEDROOMS .3 OWNER PERMIT DATE:_tob' on COMPLIANCE DATE: f�y+�aoc•; TT_ Separation Distance Between the: / Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 1 g; 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 C,LSi Yf'a� tl«�c.� tI T4,u - i d M' i l D-DOW, A-3= 40 • - -Q 3 3-3: ss' ' SA•S ° ° H http://www.town.bamstable.ma.us/assessing/2011/HMdisplay.asp?mappal=247202&seq=2 3/31/2011 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water Check cellar ❑ Shallow wells Estimated depth to high ground water: 25 feet Please indicate all methods used to determine.the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: March 2005 Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Engineered plan on file - ❑ Checked with local excavators, installers -(attach documentation)- _ ❑ Accessed USGS database-explain: _ You must describe how you established the high ground water elevation: Used engineered plan on file based on test hole data. Used groundwater elevation map, . Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 18 Goat Field Lane Property Address Bradley Owner Owner's Name information is required for Hyannis MA 02601 March 31, 2011 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All System s)'completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE LOCA,.ON _> (, bl,'��� (, SEWAGE# Q1202- vo'7 VILLAGE i ASSESSOR'S MAP&PARCEL d517 Q!qJ INSTALLER'S NAME&PHONE NO. 3ci Stof►e ScrWie SO? 775-Y?lb SEPTIC TANK CAPACITY /per LEACHING FACILITY:(type)? X -SW .(J fs (size) dy;d 3 X A NO.OF BEDROOMS J OWNER `, L.y PERMIT DATE: _ IT 1400 y COMPLIANCE DATE: /' qr��P Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility l S feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). // feet FURNISHED BY de-sq, PLv G—i day" A-3; -- 13-3 S-'' 5�S 0 0 ram. (fG :a . No. .26Qq —00 `� ,� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Z(pph.catiou for ;ff3iqoga1 *pgtem Cottgtructiou Permit Application for a Permit to Construct( ) Repair X) Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address of N Owner's Name, dress,a dTel.No.so g'�-7�' p o IT Goa.+ �e,i� � l ley Assessor's Map/Parcel a a &Oct* F%el d La-Q-j �- Installer's Name�+dd[ess,and Tel.No.5o9--77S-�7(a Designer's Name,Address and Tel.No.50 3(14-69` A Wr,l � —0b��f bo— Sty e �— co —-reC � X ( 'M C v-,4CXV► Type of Building: Dwelling No. of Bedrooms Lot Size sq. ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min. required) 3 gpd Design flow provided ?j `�[�, gpd Plan Date Number of sheets Revision Date Title > Size of.Septic Tank Type of S.A.S. Z- S4" t4l4(. e%f,9 6,564 c„ Description of Soil S r Pl1�N Nature of Repairs or Alterations(Answer when applicable)_T n s+"Q_.GA, oeto `r1 T►e, 5 k eacA-\ 15 -- Ay I lags o, io-R Lt L/\� 4L ETC- - 36 T3 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 He th. Signed i l Date — O Application Approved by e .S• Date Application Disapproved by: Date for the following reasons Permit No. ZO0 0 tj Date Issued ��—d�--- --- — - ---- ————————— No. .L d0 q Inn. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for �Di5pg5ar 6p5tem Con0truction permit Application for a Permit to Construct( ) Repair X) Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components • Location Addressor Lot No. QX�✓�'t5 Owner's Name,Address,and Tel.No.So g-•--77 S qop D Assessor's Map/Parcel p�y7/a o a ig &oc i F�o�_ lq_-4, nts N9�- -ltnsya�r'�ame AO�+,�d Tel.No� r Designer's Name,Address and Tel.No.50 3(.�! IIYY JV Q `6 Lv I o sc� Cevx4(_rQ 1 I I e- LI-;5 6 M n e-. CG r o e Snnc i CS1 Type of Building: r� �/ Dwelling No.of Bedrooms J Lot Size sq.ft. Garbage Grinder tit? Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S 3.0 gpd Design flow provided "2s !2,1). gpd Plan Date Number of sheets Revision Date Title Size of.Septic Tank Type of S.A.S. Z- SLb .44 L rle,,o d..,r"F4s Description of Soil K,i PLc-.v Nature of Repairs or Alterations(Answer when applicable) r),S+0,_U a- otoj_J 'T'1 c4 �- U - 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 Health. Signed _ Date1/i 0 Application Approved by F Date Application Disapproved byw-:77 Date for the following reasons Permit No. ?_001 - ac, tj Date Issued �'R ----- __---- --- — ---_----=------ --- ----•----- THE COMMONWEALTH OF MASSACHUSETTS ,2>�1 (('.��• BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, � re that the On-site Sewage Disposal System Constructed ( ) Repaired (�O Upgraded C ( ) Abandoned( )by W(M a\�..f�`o_', t'�SU1� � SPY RC� !at p C-©C.�+ �l e L� � \.Q (1 1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NOZOaq—GO ( dated /7 p Installer Z061 a SGt.] Designer ¢_,/�,_ T 6 C-k #bedrooms 3 Approved design flow ?z�j gpd The issuance o/�this -eR/mit shall not be con /ru d as a uarantee that the system w/'Il function as designed' © Date ( r / / 1( Inspector/ J44,// .���� • e ✓ - vase�,- ,� — ��� ----------------------------------- No. 24V I—W" Feet/ )CO, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS B IB =igponl *p.tem Construction permit `J Permission is hereby granted to Construct ( ) Repair () ) Upgrade ( ) Abandon ( ) System located at 1 a0a_' �7i e.ld LC)- k_�UC}._. / .J and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: nstr ction must be completed within three years of the date of this/��' it. �j Date Z O�j Approved by / • . �'. Town of Barnstable °FtME Regulatory Services P� C s Thomas F. Geiler,Director enatasTaeM 9 '"^SS• i639• Public Health Division ♦e p'fD"t°�A Thomas McKean, Director I 200 Main Street,Hyannis,NIA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certification Form Date: �� `� Sewage Permit# Assessor's NIaplParcel Designer: ( O-VG VIA-PO Vk Installer: b Address: Sc� 1 Zi 9-NGU-: Gt1Z Address: �-bf to Gm,�@ry On �Ga j o i C b t wS d h was issued a permit to install a (date) (installer) septic system at t(6 `,gff_,'eW L, 14W"' 11 f based on a design drawn by (address) Zvi � Cagfk qWowv dated - / (designer) I certify that the septic stem referenced-above was installed substantially according P Y o dmg to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. (Installer's Signature) G (Designer's Signature) ( :A `^�p r�► n p ` ere PLEASE RETURN TO B_AMNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CONIPLUINCE WILL I\iOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BAR\'STABLE PUBLIC HEALTH DIVISION. THANK YOU. '3 Q: HealthiSeptic/Designer Certification Fomn 3-26-04.doc Town of Barnstable P# [A� N Department of Regulatory Services ,,,AN�,� t� r Public Health Division Date �J ' 03 h� 200 Main Street,Hyannis MA 02601 - ~ `Date Scheduled Time Fee Pd. 1 Soi Suitability Assessment for Sewage Disposa o Performed By:Q`rV�1, 1)- C6U , 1:14✓��� C✓�f'_ Witnessed By: L 410 l LOCATION&GENERAL INFORMATION Location Address .. / Owner's Name 6nT geld LR hbuw►ga 9tgk ey `����w r S Address (� ��i F;,e,d �4 Assessor's Map/Parcel: 2-4--7 Z Engineer's Name to{�hll I S Nt d cv.-OG1�18tw4 NEW CONSTRUCTION REPAIR Telephone# . R65 tDl~Wf(RL Slopes Surface Stones 0 4C4 : Land.Use G ( ; t Distances from: Open Water Body too V fi ft Possible Wet Area )�0 ft Drinking Water Well `©D r ft + Drainage Way (J ft Property Line Q .t ft Other SKETCH:(Street name;dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) GROUNDWATER ADJUSTMENT ry 4 / P, EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE / GIS DEPARTMENT RECORDS. INDICATED GW 16.00 INDEX WELL M1W-29 / ZONE C READING DATE DEC. 2009 / READING. 8•0 7- / ADJUSTEDNGW 21.1 Parent material(geologic) k0cl_1 e i rfx- 00i W H Depth to Bedrock Depth to Groundwater. Standing Water in Hole: �V�l �% Weeping from Pit Face r C� H Estimated Seasonal High Groundwater �I(� DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: 'a e 4I'AaVa- Depth Observed standing in obs.hole: — in, . Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor— Adj.droundwater level, ,e PERCOLATION TEST Date i it G' Time u -m Observation Hole# 1 Time at 4" AL— Depth of Perc )i��� Time at 6" #11 Start Pre-soak Time @ "'�/ lime(9"•61 End Pre-soak 6� n RateMinJlnch r ' 1 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) I Original: Public Health Division Observation Hole Data To Be Completed on Back----------- a**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:ISEPTICIPERCFORM.DOC 7Uo ct -ou DATE 'OF TEST: JANUARY B. 2008 ' SOIL TEST L O G APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR. s,461 WITNESSED BY: DONNA MIORANDI. HEALTH DEPT. PERC NUMBER: 12452 TEST PIT 1 NO PAARENTUMAATERIA ENCOUNTERED LD OUTWASH - PERC AT 66 in - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 44.60 0-3 O-- WOOD-LOAM - 7.5 Y 3/3 NONE FRIABLE -3-5 - E LOAMY SAND _ 10 YR.4/1 NONE _ _FRIABLE 5-9 A LOAMY SAND 10 YR 3/4 NONE FRIABLE -9-42 B-__. -- LOAMY_ SAND _ _. 10 YR .4/6 NONE- FRIABLE 41.10 . •---; . . _ - - 42-13B C ' MEDIUM SAND 10 YR-6/3 NONE LOOSE 33.10 GROUNDWATER ENCOUNTERED PIT SH 1 2 MIN/INCH IN C SOILS-- ELEVATION DEPTH SOIL USDA-SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 44.40 0-2 O WOOD LOAM I 10 YR 2/2 NONE FRIABLE 2-5 E _ LOAMY SAND 10 YR 4/1 NONE FRIABLE 5-10 A - LOAMY SAND 10 YR 4/4 - NONE -FRIABLE 10-36 _B LOAMY SAND 10 YR 4/6 NONE FRIABLE ' 41.23 - 3B-132 C - MEDIUM SAND -- - 10 YR 6/3 NONE LOOSE 33.40 -uepm-rrom -- aon-tionzon-'soil"t�orrrtonzon-'sotf"t"extare-Soil Color Soil -" TOther Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistengy. a Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi to yell I i I Flood Insurance Rate Mau: Above 500 year flood boundary No_ Yes _ Within 500 year boundary No Y' Yes Within 100 year flood boundary No_t/ 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? If not,what is the depth of naturally occurring pervious material? Certification 1 I certify that on )V W7 5 (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,ex(�ertise and experience described in 310 CMR 15.017. Signature .�+� �J. Date T,►� g, 200� , QAS.EPTIMERCFORM.DOC W v � � N 10 ✓ iR i W 4K F W S v+ W ac to a W 01 W O V W t C W t —. ^5 W Im C . fr ' l4� I d3 r _ /'7 -7 /"Z,o 7� LO{'CAT10NZ4- /f� + ] ` SE-WAGE PERMIT NO. VRLLAGE INSTALLER'S NAME & ADDRESS 'l'J� I�c'IScot I � won mil 0/ ,1 R UILDER OR OWNER .DATE PERMIT ISSUED r �� DATE COMPLIANCE ISSUED t ,. K i �«�, Fl:s..... ..................... N V .._...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HEALTH ............. ... . .. Appliration' for 11ispaiial Work vnt trurtion Prrutit Application is hereby made for a Permit .to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ....................../ :... .............. .................................... ............................................-.......... Location ddress or Lot No. =, s . ...... .................... .... .._..... Owner Address . ......... . �......................... .........................-------..................... Installer Address Type of Building •' Size Lot..J. .....rSq. feet Dwelling—No. of Bedrooms...........................................Expansion Attic (� Garbage Grinder (/fj Other—Type of'Building .__... .. No. of persons....... Showers — Cafeteria 04 Other fixtures . ..... -. . -:�. ... W Design Flow............... gallons per person per day. Total daily flow.._._... 3,.C�.....................gallons. WSeptic Tank—Liquid capayc�ity./6V.gallons Length---�l�...... Width....._._... Diameter................ Depthrr.. �._..__. x Disposal Trench—No._._.. 1/J�... Width.................... Total Le .... Total leaching area._9? .1P..:.sq. ft. Seepage-Pit No..................... Piameter.................... Depth below inlet.................... Total leaching area...................sq. ft. Z Other Distribution box ( Dosing t 2�_ _ Percolation Test Results Performed by -------_.----- Ifate--••------deer--30-1 Test Pit No. I-_-Z.�minutes per inch Depth of est P>t.....f ..�... Depth to ground water.. .��...... _. i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •---•••..••. lf - �O I r � - - -- -- - - --Soil : � cx� •••••-•..._..-•--••------••••-••••--•f$`.'..-.1 _.!.. .�tA�r�.. ......�.....--•-•-=----•------ W ......... UNature 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. / Signed.....f--- _ 2 "� ..C__ lIjt 3 . UU g Application Approved By............................ ------------ ----- //j .... t --•-•--...---• - -Date Application;Disapproved for the following reasons-----------------------------•--•------------•---.........--••---------------•--•-......---=-••••---------....-- -••••-----•---••••---•----•--•••••-----•--•--•---•-•••••...............••-...........---•-----------.................................-•••-•-••--•---•••-•---•••-•-----...:.•••••••••••-•---•.------.----- Date PermitNo......................................................... Issued-........................................................ Date t - . No........................ FEB.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......OF Aplifirativa, for Di_qvviial 1U Tonstrartion Frrmit Application is hereby,,made for a Permit to Construct or Repair an Individual Sewage Disposal System at: . ....................... ....... ...... ...................................zzza.. ........................................................ L ti -Addless, ............................ ....... . .. ...................................................... ...... .............. _,�.or Lot.No. -6w----------- .". ;�j Owner IV Address 14 ............... ------- .......................... ..... .................. U Installer Address Type of Building Size Lot..../....CITZo!L.ri-Sq. feet Dwelling— No. of Bedrooms.................. Expansion Attiwe)l) Garbage Grinder W------------------­­ P4 Other—Type of Building ......:6(!Vf:?R........No. of persons........6................ Showers Cafeteria 04 Other fixtures ....... ......7........................................................................................................................ Design Flow..................__..._......__gallons per person per day. Total daily flow..........:�X_d....................gallons. /V�gallons Lengt ...1:4 Septic Tank�Liquid'capacitv.-/( h.... Width.. ... Diameter................ Depth_..i�(........ Disposal Trench—No......�... Width.................... Total Length_.................._ Total leaching area.: ....sq. f t. Seepage Pit No...................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. f t. Other Distribution box (viol- Dosing t nk Percolation Test Results Performed by..... Z . ...... ................ Date._._-_.....:....7........71 ---------------- Test Pit No. I...Z.�minutes per inch Depth of Test Pit....../.cz!........ Depth to ground water--- 44 Test Pit No. 2................minutes per inch Depth of Test Pit.__................. Depth to ground water...................._._. 1:4 ............ -------- ............................ 0 --- .................................7­��................------------------------- Description of Soil...........Z)..:- ..................... ............ .... ......... ........................... ......... lr��Z'.. �A' ..................................................................................... ...............................................:----------------------------------- ------------------------------------------- ------------------------------------------------ --------------------- 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed ZT0 ., 4........... (.. ............ �S A D W ........................4-114------- Application Approved By......................... ........... 0 Date Application Disapproved for the following reasons:.................................................................................................................. ................... .........................................................7........................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE,*COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............................OF............ ............................................... Ter fifiratr of Tant;tRatta THIS I T Repaired ,� .1 OIGERTIFY'a Teat the Individual Sewage Disposal System constructed (L_4 by..............7�.Cr XAA�2.........................................................................................................."........­*...................................... VWt- Ins taller _ _T__1t9j6/- /_4 ............................................................................. ........ ...............I.......... ........./?LZ... has been installed in accordance with the provisions of TITLE, 5 of--The State Sanitar 'Code as described in the application for Disposal Works Construction Permit- ............. dated.'::;.,_:__.___._.._......__..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. .. .................................................................... DATE......................................... ........... Inspector....._ THE COMMONWEALTH%OF MASSACHUSETTS BOARD OF HEALTH ..........0 F.......... ........................ N o....dj.::2yt� FEE...... .......... Dispolial Ivor g Tong u0iolt pamit Permission is he by granted-----------41 .................................................................................................. to Construct L,41"or Repair an Individual 'Sewage Disposal Sy t at No..., ........(1&11-4 .. . ...... ...... ..... . .......... .. ................... ..................................Ij Street as shown on the application for Disposal Works Construction Per=t No------------------- Dated..........._.___.._.:_.................... 1, ... .................................................................. Board of Health DATE....................................................... ........................ FORM 1255 A. M. SULKIN. INC., 130STON iA OF .•. /moo u' ;•`r,',' ° ;',f 3 xc 1 N�8T6a�p r r SURD 1 OOOc. �,pT•�3 100' wt �•r� ./ Q r om + ~`!13f• f `ty 100.7•��s6,a F STt)5SE a tom., r `. .,�TI�cO.iAIYNKTF+i1G .. 0' Io e r Nk— r Qu`.rrf ii►RAQ.0 °C ' s.R ol L pT; .I ,.,. L D T Z 8 -FbPZ) DATA- IS LEGEND lb E . .S 0C>CL N I,tl HI-T)J ,* EXISTING SPOT ELEVATION 0A0 :. P��HQfM CERTIFIED PLOT PLAN .�.. .....+ s y�F EXISTING CONTOUR p FINISHED SPOT ELEVATION �• ` P -', �a i FINISHED CONTOUR o.yase GQ• � I N .. APPROVED # BOARD OF HEALTH )NA .51 ` -.� .�-t k DATE AGENT L {, , • `` SCALE, /� �d' DATES DREDGE ENGINEERING Ca INC) 'NT;. s/ I CERTIFY THAT THE PROPOSED EGISTERE REGISTERED ; JON NO, 8-T0. Z BUILDING SHOWN ON THIS PLAN CIVIL LAND :;3 ,=J,a,. CONFORMS TO THE ZONING --LAWS ENGINEER 7 OR.BYt �-- OF GARN3TA8 MASS. 712 MAIN STREET CH, By'. NYANN I S, MASS. . SHEET. OF' 2— A E R 0. t.AN� SURVEYOR 20 FT. M/N. J1lOTF /F E/TNER TA,,e SEPT/C TAIV/< OR 7�EAG.yI/vG P/T .4/sE MORE BELOw /O PT. M/N 5RA OEM A 24�O//1 M E TER CONCRETE CO iiER L gE 9 RO UG H T TO 4,TA O E.6,v ,EXTR�4 CONGRE•7•E 4�PYG' P/PL HE.4VY CAST /RO/Y CO{/ER Sf/.QLL DE USEO 2 COYE/CS Nf/.V. P/TCN /F/N OR/✓EJtiA Y Aim FT. 2� Mi/y, CO/VCRL�TE A G .�oLr Cd VER CL EA/V SANG - BACIC�/L L IRON P/PE MIN.o/TtX • • . . • • r r e • SEPTIC TANK V4•PtR P7. Dl ST. •�• v •• • • • • . r r • e INA SHEO S777NE BOX . • � 8 • . • • • r .�� • a •• • •EFFECT/VC r • , 314 `'�; • a • • • AP5071 • ,o WASNED STGNE 47r i a. r • • • • • • • r P •0 .ST PREG4 SEEPAGE /Ni�G/!'T !'LENAT/aYs 7fr • •• • • • • • • • • • o P/T OR EOU/V rfl vs INVERT AT AMILOI'N6 �.5 G l v4ET. SEPTIC Ti4NK •3 PT,: . _. �Q_ FT. O/AM. `C(SEE 7�ID[/L.4770/V� OL/TLET SEPT/C IrANM Pr. +` } /INLET DIST)vB!/T/ON BOX 15.9 /c . SECTION OF GROuNo WA7ZR 7i10LE O&/TLETD/3TR/BUT/ON'BQX `i S -7 FT. INLET L.EACN/N6 /PJT `t 9.5 FT. SEWAGE 01SPASA J. SYS`TEM TA NAI-AT/DN • - • LEACHING PIT DESIGN CRITERIA TCAL_E : %s _ =o' olMfNs/oN A o !wT. -VVAfJER OF 6EOROOJNS � DMENS/ON C. _ T. Ali&J GARQAGED/SPOSAL-UN/r tiec SO/L LOG SD/L TEST TOTAL EST!/►NTED FLOW 310 G.4L.IDAY SOI L. TEST At/ SOIL TFS77**2 / ,VUMBER AF 4rAC/lav4 P/TS 1 �e�te�Y. 100.4- -ELEY. DATE OF SOIL TEST -/I `6 / e 3 S/DE L.CACH/NG PER P!T / 4)a PT. // w� RESULTS h/JTNESSED dY J•L• , �le�cc 6 i 0TTOM AAA PER PIT K,S so. FT. VIC � -I'S LOA PER COL AT/ON RATE e �/ L �_ M/NCl/NGN 70TA1. LEACH/NG AREA a67 SQ. FT. o g PENCOLAT/ON RATE A2 MJN.�/NCN RESERVE GEACN//V6 AREA X4 7 SQ. FT. ��L ��sr QEF p- 2045 r` /.S— /a21 me4 of� - L U T °L,Mv i3 4 a�/y �VZH s— Of low, y� � s SANS 60117 L b R b O l P y L o BERG ELOREDGEENGINEER/NG Co /NG. -lip \ �p �tE' o. 366 � 7/2 MAIN ST. HYANN/S. MASS Hp SUR�� S��.;e �NO GROUND YY�4TL•R ENCOUNTER- O CL/ENT:�/ r • L _ u J0B ND.' 10 6 2- SHEE7"•�OF � ALL PIPE SPECIFIED ARE INVERT ATIONS E L O W PROFILE EXPRESSED INV DECIMAL FEET NOT FEET AND INCHES.TIONS RAISE COVERS TO WITHIN SIX INCHES OF FINAL GRADE TOP OF FOUNDATION ONE INSPECTION RISER FOR LEACHING GALLERY TO EL = 46.58+- WITHIN 3 INCHES OF FINAL GRADE AS INSPECTION PORT. 44.75 3 Ft� ALL PIPE ,/D-BOX MAX SCHEDU ET40BPVC 3" DROP AND TO PITCH AT T VFLOW LINE 4175 1/8 to/Ft MIN. 10-' - 14' PRECAST 48" GAS�� DRYWELL 'vr BAFFLE 6 in ' BOTTOM OF ...... ... ................ \41.95 +- STONELEACHING EXISTING 41.30 41.13 LEACHING GALLERY EXISTING EXISTING BASE GALLERY EXISTING 1000 GALLON 4100 (END VIEW) 39.00 5.00 Ft + SEPTIC TANK SEE DETAIL ON REVERSE EXISTING 25 Ft e) 5 Ft 12.5 Ft bl 13 Ft ADJUSTED SEASONAL 21.1 HIGH GROUNDWATER B m m �o co z M �z M n a �m Z rn W 00o I W a 0 3 rn � o / � � m � _ Mof n� o r'' c co (�m I X I 01 / w \LINE .Q � 'N p t ojo- 01 d / I � die / 1 \ co N I _ N 1 1 o co (n r m ��! 3 X 2rON= p >W r O Z— O y p0 �7 3� Orn�o>nrrn-- 0 I M f Z r o a m o� ��� (n rn >� O omm-<r- rn Zy O FZ o-Zi�oz � _z ® (fl M F�m�cn rn am � —o > I O �aOZm � � O oz(> � I9n � Z I C �O��rn & m N� �. =o0ro (DLTI 41 I r.ZnJ W I v, Dm9Do rn I (> Z> ° Z m COMM I cn=o o Z c� D cn ►-� O oti >o=z- m m z m ° M m y OLn �cn o cn > o Ul m c m �1 L p 2 � 1n y M rn s o o <Z o `2 Z y O -I C rIl (n m rn rn mzn=� O cAn Q O Z �I c �Do < -n 023 mn co ~ �� mmx O Im>m3 �) Z = < O m oz � m� r y(n �m mZ m fV 3 a -< Fl 9 o o �3 �nr,� RlO ;U o m x N y M zc:j _X D Z FO <"'� ��a�� � m m o-00 0 n� 2 0 0-u c N m Z 71 co U S1 s�s� �m r7bb C y r j z O 2 cQ z fo o (o y r A A ^' O p (n I� �r � O -U, a -41 p L -� r mom a ® �RlZ <mzoo c um> m �� � U� 5 coMMo �zo �O pn �Z ' po <F � o���o O N Ti n 30 Z ON �\o: oc �� moo mtl r= O z oo .. m CO � ^' G) o s m a Rl co � � � r or_�(n r F M M < m = o a o n �� O F) a� d1 0 NOmoz co N (- 3 N Z . _< T m �A O X O O y p N �� yd0 <0r-c-nm D s Z p v�`�0 0 ° m2 O ❑ I l 3 �Ol� oMzmo N m r 1 °R s��'a 03m0 rn Z S11'� DATE OF TEST: JUARY, S. SOIL TEST LOG APPROVED SILEVALUATOR: DAV D D. COUGHOANOWR. #461 DESIGN - CALCULATIONS WITNESSED BY: DONNA MIORANDI. HEALTH DEPT. PERC NUMBER: . 12452 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD TEST PIT 1 NO GROUNDWATER ENCOUNTERED SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS PARENT MATERIAL: PROGLACIAL OUTWASH USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL PERC AT 66 in - 2 MIN/INCH IN C SOILS CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) ELEVATION DISTRIBUTION BOX: USE 3 OUTLET D-BOX. DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING SOIL ABSORBTION SYSTEM: A 24 ft x 12.5 ft x 2 ft LEACHING GALLERY CAN LEACH 44.60 Abot = ( 24 x 12.5 ) = 300 sf 0-3 O WOOD LOAM 7.5 Y 3/3 NONE FRIABLE Asdw = ( 24 + 24 + 12.5 + 12.5 ) x 2 = 146 sf 3-5 E LOAMY SAND 10 YR 4/1 NONE FRIABLE Atot = 446 sf Vt 0.74 x 446 = 330.04 GPD 5-9 A LOAMY SAND 10 YR 3/4 NONE FRIABLE USE A 24 ft x 12.5 ft x 2 ft GALLERY. Vt = 330.04 GPD > 330 GPD REOUIRED 41.10 9-42 B LOAMY SAND 10 YR 4/6 NONE FRIABLE 42-13B C MEDIUM SAND 10 YR 6/3 NONE LOOSE 33.10 NOO GROUNDWATER PARENT ND OUTWASH LEA CHI/ Vn ' G GALLERY L ER Y TEST PIT 2 MIN/INCH IN C SOILS USE SHOREY PRECAST 500 GALLON NOT TO 1000 GALLON SEPTIC TAW DRYWELL (H-10 LOADING) SCALE ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER DIMENSIONS AND DETAIL NOT TO (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING CONSTRUCTION DETAIL USE EXISTING H-10 LMT SCALE 44.40 DRYWELL UNIT 0-2 O WOOD LOAM 10 YR 2/2 NONE FRIABLE � STON SEPTIC TANK IS TO BE PUMPED DRY 2-5 E LOAMY SAND 10 YR 4/1 NONE FRIABLE 24.0 Ft- AT TIME OF INSTALLATION AND IS TO BE EXAMINED FOR STRUCTURAL 5-10 A LOAMY SAND 10 YR 4/4 NONE FRIABLE m TEE EQUIPPED WITH A GAS BAFFLE. INTEGRITY. INSTALL NEW PVC OUTLET 41.23 10-3B B LOAMY SAND 10 YR 4/6 NONE FRIABLE m 14- 1 in 38-132 C MEDIUM SAND 10 YR 6/3 NONE LOOSE to m N TAPER 33.40 cV i c-41 m4 o O co 3.5 Ft B.5 f t B.5 FL .5 ('t o GROUNDWATER ADJUSTMENT 24.0 Ft- EXISTING • y�"� GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE 500 GALLON DRYWELL eGIS DEPARTMENT RECORDS. DIMENSIONS AND DETAILQ INDICATED GW 16.00 USEH-10 LMT INDEX WELL M1W-29 INSTALL ONE INSPECTION INLET OUTLET ZONE C RISER TO WITHIN THREE COVER COVER READING DATE DEC. 2009 INCHES OF FINAL GRADE • , READING 6.0 AND INDICATE LOCATION ,. .x.z I ADJUSTMENT 3.1 ON AS-BUILT PLAN _� �3 IN LINE ADJUSTED GW 21.1 FROM TO BUILDING 101n 14!n O-BOX 48 1n NOTES 000 o0p 133 LEIEID GAS ' O BAFFLE D INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. o0000000000 �00�0 0000a0000 00 2) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED o0000 0 ................................... <•. ,•,,,.•••.•,•, ••••: FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. 102 5g CROSS SECTION VIEW 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS 1n OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES CROSS SECTION VIEW BEFORE EXCAVATING FOR SYSTEM. SEWAGE DISPOSAL SYSTEM PLAN 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. 2 in PEASTONE 2 1n PEASTONE 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE. o o -TO SERVE EXISTING DWELLING 7) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES 28 26 AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. 1n DEPTH 1'�'^ � in NORMAN AND JEAN BRADLEY B1 SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT 18 GOAT FIELD LANE HYANNIS, MA C 1n PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. 46 1n 58 1n 46 91 SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL ,� 1501n ECO—TECH ENVIRONMENTAL L STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND' ON TO WHICH INSTALER MAY UBSTITUTE AN APPROVED GEOTEXTILE 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE 'UNEVEN SETTLING. FABRIC IN SPLACE OF THE 2 1n. PEASTONE LAYER SPECIFIED. ETE-3083 JANUARY 9. 2008 1 1212j