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HomeMy WebLinkAbout0142 GREENWOOD AVENUE - Health 142 Greenwood Avenue Hyannis A = 288 - 146 1' No. ! ' 1 J !3 7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for Bisposal *pstem Conetructfon permit Application for a Permit to GensW }_ e ' de( ) Abandon( ❑Complete System ❑Individual Components Location Address or Lot No.'92 (9 r ae nu_)cct Atw. Owner's Name,Address,and Tel.No. 5V%-' CtO ' lr)'a-1 U Nao 9(hL&I-eenuaaoc9 Aesr Assessor's Map/Parcel a$S /q4, _laa/ / �� y Installer's Name,A�dd�ress,and Tel.No. 4A' - �8'- 69� Design is Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms MA- Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided A 1& gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alter tions(Answer when applicable) C l Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environment e an t to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si a _. Date Application Approved by Date Application Disapproved by 41Z Date for the following reasons Permit No. 2 Date Issued No. 2,0 Feed THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: r Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ' application for Disposal *pstrm Construction VPrm t Application for a Permit to Construct t(_) Repair_( Upgrade(WLz�01 ! )(,Abandon( ❑Complete System El Individual Components Location Address or Lot No./9�Z c en t� fA� Owner's Name,Address,and Tel.No. Lk5U_6ZL h)a Geer'uaez,:� A4A, Assessor's Map/Parcel ;,$g A;, Installer's Name,Address,and Tel.No. 5 g• qa T, Designler's N_ / ,A dress,and Tel.No. M-)c/ 1�pe of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) 4k A Other Fixtures Design Flow(min.required) Alk gpd Design flow provided A/M. gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) f --� 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 de and bt to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sig a Date t— ,�9 f w Application Approved by ' r Date ^- Application Disapproved by Date for the following reasons Permit No. :2. 4 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned by t��+ � �_! rj g,L t at JtJ? /,.,.„ t 4.,Ae ) , �, ,__has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.` dated I Installer ."S e s j,, Designer a #bedrooms Ain Approved design flow gpd The issuance of this permit shall n t be construed as a guarantee that the system willt�t t as design d. Date Inspector �n ' t - - - ----------- - - - - - - No. Fee4 v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal Opstem Construction Vermit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon System located att 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 permi. Date���,� Approved by l� p Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Greenwood Ave. Property Addresses Grace Conleyw� Owner Owner's Name Y information is required for every Hyannis ✓ Ma 02601 5/16/2019 11%� page. City/Town State Zip Code Date of Inspection 7 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. Inspector Information SIB 130114 on the computer, use only the tab Sean M. Jones key to move your Name of Inspector cursor-do not S.M.Jones Title V Septic Inspection use the return Company Name key. 74 Beldan Lane Company Address Centerville Ma 02632 City/Town State Zip Code 508-658-3456, 774-248-4850 SI 4522 sean@smjonestitle5.com License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 5/16/2019 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts - �a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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 dwelling at 142 Greenwood Ave Hyannis is served by a Title V septic System consisting of a 1500 gallon septic tank, distribution box and 3 precast leaching chambers. The system is in excellent working condition. 2) 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): l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �a 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis . Ma 02601 5/16/2019 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc•rev.7/26=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owners Name information is required for every Hyannis Ma 02601 5/16/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts fo Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: 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)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. Cityfrown State Zip Code Date of Inspection D. System Information 1. 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 gpd Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste.holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. 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: t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. Cityr'rown State Zip Code Date of Inspection D. System Information (cont.) 4. . 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): Approximate age of all components, date installed (if known) and source of information: system installed 5/22/2008 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 1 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.): Joints ok, no leaks or blockages. Vented through roof t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: .5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallons Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 3' Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 11" How were dimensions determined? opened covers and took measurements Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank does not need to be cleaned now but should be done soon and again every 2 years for proper maintenance. water level was even with outlet, tank was not leaking and was structurally sound. l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for.Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is Hy annis required for every Ma 02601 5/16/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: 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 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �.� 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. 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.): Distribution box was level and in good condition with no rot. Water level was even with outlet invert with no signs of past backup. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: U500 gal ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): s.a.s. consists of 3 precast leaching chambers. Leaching facility was found dry with clean sandy bottom and no stain lines inside. Cover is on a riser. 12. 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 Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Titi6-5 Official` Inspection Form t Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. 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 a8AP_ o` NAME 34 (�ds OF A 3: ;5s,� 54s „ 15nsp.doc-rev.7128/2018 Title 5 Official Inspection Form:Subsuface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form R (r< Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4' 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells . Estimated depth to high ground water: 12'+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: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater elevation was established by accessing Town of Barnstable groundwater contour maps. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments s 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma 02601 5/16/2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable_sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 Commonwealth of Massachusetts upTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 page. Cityrrown 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: "ff�� lIISSS�//VV�Y key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. �� Capewide Enterprises V�I Company Name 153 Commercial St. Company Address Mashpee Ma. 02649 Cityrrown State Zip Code 508477-8877 SI 4522 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. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority c1-s 9/27/2011 Inspector's Signature Date ;r r Tfe-system inspector shall submit a copy of this inspection report to the Approving Authority(Board e- of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or o has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the re`,9rt to the appropriate re ional office of the DEP. The original should be sent to the system owner p9Y w3 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-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 142 Greenwood Ave. Property Address Grace Conley Owner Owners Name information is required for every Hyannis Ma. 02601 9/27/2011 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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): cling•11110 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 142 Greenwood Ave. Property Address Grace Conley Owner Owners(dame information is required for every Hyannis Ma. 02601 9/27/2011 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cunt.): ❑ 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: ❑ 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•11/10 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 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than Y2 day flow l5ins•11/10 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 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 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 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. 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 ❑ 0 the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well 1f you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins-11110 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 �t 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 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? . 0 ❑ 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): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 446.3 gpd provided t5ins-11110 Title 5 Official Inspection Forth: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 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 page. CityFrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 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 years usage(gpd)): Detail: 2009=48750 total= 136 gpd 2010=42750 total= 117 gpd Sump pump? ❑ Yes ® No Last date of occupancy: current 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): 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): t5ins•11/10 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 y� 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 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: new system installed 5/22/2008 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints ok, no leakage, vented through roof Septic Tank(locate on site plan): Depth below grade: .5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallons Sludge depth: 5" t5ins•11/10 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 '< 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 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 3.5' Scum thickness 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 10" How were dimensions determined? opened covers and took measurements Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank does not need to be cleaned now but should be done soon and again every 2 years as maintenance. Water level was ok, tank was not leaking and was structurally sound. Inlet and outlet tees intact and in good condition. Grease Trap(locate on site plan): Depth below grade: 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•11l10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �< 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 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 ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments N ' 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 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 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.): Box was functioning as intended.Water level was at bottom of outlet invert, no soilds carry over, box was not leaking. 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: t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Jy< 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3 33.5'x12'.5x2' ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): s.a.s was found to be dry with no signs of past hydraulic overloading. 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•11l10 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 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 page. Citylrown 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•11/10 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Assessing As-Built Cards http://www.town.bamstable.ma.us/Assessing/RMdisplay.asp?mappar... TOWN OF BARNSTABLE LOCATION SEWAGE# ;�jpD8 ' �J VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. IA 1 .E. Stahe jtrp,te SDC 77SY771 SEPTIC TANK CAPACITY �S LEACHING FACILITY:(type) 3 x SUJ (size) 3?• NO.OF BEDROOMS OWNER (anit y PERMIT DATE: COMPLIANCE DATE: -5— ac3�0� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility, �a{� 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 " S b'$ S Se =f,-V 8 d/�d 5,6IL° e !�l e Jho 1 of 1 9/15/2011 1:07 PM Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yt 142 Greenwood Ave. Property Address Grace Conley Owner Owners Name information is required for every Hyannis Ma. 02601 9/27/2011 page. Cityrrown State Zip Code Date of Inspection D. System Information (cost.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20+ 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: 5/8/2008 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local-excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Design plan dated 5/8/2008 indicates that no groundwater was encountered at 132"and system is designed to have 5'+of seperation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11/10 Title 5 Official Inspection forth:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Greenwood Ave. Property Address Grace Conley Owner Owner's Name information is required for every Hyannis Ma. 02601 9/27/2011 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 Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file i t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BARNSTABLE LOCATION Greer-wood. tAv0- SEWAGE# PD d F" o�)y VILLAGE J J ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 3bV775- 776 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 3 X S0) Ory,.'115 (size) NO.OF BEDROOMS L� OWNER Co^It PERMIT DATE: `J.��9�8S"l COMPLIANCE DATE: &a 40 Separation Distance.Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �a 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 of leaching facility). feet FURNISHED BY _De3 WOE LLJ ' y rAIJ 35 �f,, r No. .2 O®f� 260 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIpplication for � gpooal 6pgtem Con.5truction i3Crmit Application for a Permit to Construct O Repair Upgrade O Abandon O ❑ Complete System ❑Individual Components Location Address or Lot No. O ner's Name,Add ass,and Tel.No. —7'7' - Assessor's Map/Parcel Installer's Nam Address,and Tel.No. p�—� Desi ner's Name Address and Tel.No. xj Type of Building: Dwelling No.of Bedrooms i-f Lot Size sq. ft. Garbage Grinder tip Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �(b" gpd Design flow provided `7C.6 3 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank l SHOO Type of S.A.S. 3 — 5"D v 6c-c.-4 Description of Soil Nature of Repairs or Alterations(Answer when applicable) J:7n5 neuD i t jr SP 'c/ 5YSyy-, =1-e� ���C s c.®_,i ems, a 1q 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 Y`' /G--�-�--' Date Application.Approved by Date 1�' /g — 2017 Application Disapproved by: Date for the following reasons Permit No. 2GG g^ 20 o Date Issued S %s ZD 1•:T".....�a. ..1.+,.Arif'�+lY/'•�,rin.ar"I.Tf�.s'.A'A,SI�a"µ�',.S{{A'7��` •. --.-....+v .;�'gy,.�.p,�...�; ,;,Y:k�..t.,,,,..1�r:w-•c�y�y g,�.`T,�,riyy�^t-s�.:r,k.......+..b{any.,.•�'+, .- Fee`/ THE COMMONWEALTH OF MASSACHUSETTS ' Entered in computer: � � PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yess �2pplicatton for 3N!6poal *pgtem Congtruction Permit- Application for a Permit to Construct O Repair(X) Upgrade O Abandon O ❑Complete System ❑Individual Components Location Address or Lot No. `� ,n Owner's Name,Ad ess,and Tel.No.--LJ -775' 3 14 a y`t.+ 1s-tiAV Q j1lJC, Q.n n i S Q CQ 1 H Assessor's Map/Parcel g� I t4 a G�( O. l _A ,4 1 5 5©FS=175-5"1�tp g t pcil-Installer's Name,Address,and Tel.No. Designer's Name Addre s and Tel.No. E co u x I 890Y i(fin Cb[ L' (` ( s�cA uJ Type of Building: A' Dwelling No.of Bedrooms Lot Size. sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ). Cafeteria( ) I l Other Fixtures Design Flow(min.required) �1 �(C� gpd Design flow provided Z ZIK. 3 gpd Plan Date Number of sheets Revision Date r Title Size of Septic Tank / S-D 0 Type of S.A.S. .F 1 Description of Soil � f Nature of Repairs or Alterations(Answer when applicable)_17g5�Q 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 (? 'G-�-�- / Date Application Approved by a Date �" /� r 2G off, Application Disapproved by: Date for the.following reasons t Permit No. 2G0 0" 206 Date Issued S ' /9" Zoo's --------------------------------------- - -- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired OC ) Upgraded ( ) 1 fl �>�Abandoned( )by Uo(n >v, �. at 7-MP0 QMC^ f-,1 S has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2.0 0 mob- 2 OQ dated S ' 1 41- 2 Oo Installer W lZo b i N<,a4 Designer GO_ I F-C.VA #bedrooms Approved design flow 44440 gpd The issuance of this permit shall not 9e constr ed as a guarantee that the system wi•ll`func L d'esj 1 Date Inspector i ——————---——————————————---—— ———' ——————— ———— No. ZGO 6- 2.no Fee S too, r THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS j Iwigpogal *raem Congtruction Permit Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon ( ) " System located at , a. C7 rpC_,tr\ A A�nue_. and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permi_ Date ��" Z O Approved by P- Town of Barnstable 4 ,. r Regulatory Services Thomas F. Geaier9 Director * EAMPIWAM4 MASS PubRe Health Division ° Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: J'" 2-L 6 Sewage Permit# $ Assessor's Map\Parcel Designer: ('O— �C�'� Installer: Se "i L. Address: `A S I rj'" )L Cri r e Address: `�O Q CA on Ste/6`. WP �, �1�150 S L was issued a pe€mit to install a (date) (installer) septic system at 1 Ha G1 PjN )CCr ��J(tf,n� Sbased on a design drawn by (address) dated (designer) f •/ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box an&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 pia accordance with State&Local Regulations_ Plain revision of certified as built by designer to follow_ DAVID COUGHANOWR (Installer's Si a) No. 1093 $1GISTER,O SgNI TARS Pa (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSrABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CaMTLLANCE WILL NOT BE LWM U-N-ML BOTH THIS FORM RIND AS-BUILT CARD. ARE RECEIVED BY THE.BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. r Q:.Health/SepticJDesiper Cerrification Farm 3-26-04.doc . - - Town of Barnstable P# I . I S Department of Regulatory Services : .net�azsr a Public Health Division Date i63p �� 200 Main Street,Hyannis MA 02601 Date Scheduled= \v ,R �, 20n Time << t� Fee Pd. l 00 •�� Soil Suitability Assessment for Sewage Disposal Performed By: D V 1 D 6006 H I-N0 w IZ Witnessed By: D N/}-l.D D 6 5 0-k h l S LOCATION& GENERAL INFORMATION Location Address l 42 G re_e_ Uo_ +,/e Owner's Name &. ,C�, � y Address tL�Z LreeIiwdl kv + Assessor's Map/Parcel: Engineer's Name ' der .l1 NEW CONSTRUCTION REPAIR Telephone# 5o en V t - 1�'SIdelkC ' °l1 Land Use Slopes(%) Surface Stories ©14 Distances from: Open Water Body w. ft Passible Wet Area ft Drinking Water Well j f ft Drainage Way ft Property Line V t ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) iI' I Z r � 6 �!i GROUNDWATER ADJUSTMENT 0 I EXISTING GROUNDWATER LEVEL O ` BASED ON TOWN OF BARNSTABLE GIS DEPARTMENT RECORDS. INDICATED GW 6.00 I I m INDEX WELL . MIW-29 W 1 ZONE B READING .DATE APRIL. 2007 ® TP-2 I READING 7.7 I TP-1 ADJUSTMENT 2.0 ADJUSTED GW 8.0 _ C Parent material(geologic) ��!I I V�} Depth to Bedrock 40 14 Depth to Groundwater. Standing Water in Hole: �� Weeping from Pit Face �14'C Estimated Seasonal High Groundwater ISee �O Q DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: 4>--f? ,9 i1 Q 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.Groundwater Level,R PERCOLATION TEST Date 5 11 D� Thne 11 OA,q- ervation Hole Hole# I Time at 9" Depth of Pere 66 ►vt Time at 6" h L ti Start Pre-soak Time @ l ^ r Time(9"-6") Vf ei End Pre-soak '07 Rate MinJlnch a • P 1 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back=---------- - ***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:\SEPTICIPERCFORM.DOC SOIL TEST LOG DATE OF TEST: MAY 7. 2008 APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR.-#461 - - - WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. PERC NUMBER: -12185 ! T TEST P 1 T POARENOUMDATER AL EPROGLACA LD OUTWASH _ PERC AT 60 in - 2 MIN/INCH IN C SOILS �3 i ELEVATION DEPTH ' SOIL USDA SOIL SOIL COLOR SOIL OTHER + _ (INCHES) HORIZON _ TEXTURE (MUNSELL) MOTTLING 27.00 '�• 0-B Ap LOAMY SAND I 10 YR 3/2 NONE FRIABLE O 23.67 B-40— B _,: _ .LOAMY_SAND. 10 YR 4/6_ NONE - FRIABLE 40-124 C - MEDUIM SAND -- • 10 YR 5/4 s ' NONE-. LOOSE 16.67 _ 1 TESTC r S T T T` M1 NO-GROUNDWATER-'ENCOUNTERED'---- 1 PARENT MATERIAL: PROGLACIAL OUTWASH -2 MIN/INCH IN C SOILS ELEVATION DEPTH ' SOIL USDA SOIL SOIL COLOR SOIL OTHER �y (INCHES) .HORIZON TEXTURE. (MUNSELL) MOTTLING s ' 26.95 0-6 Ap LOAMY SAND 1 10 YR 3/2 NONE FRIABLE 23.78 B-36 . I B LOAMY SAND 10 YR 4/6 NONE FRIABLE I i 3B-132 'TC _ MEDUIM SAND 1 10 YR 5/4 NONE LOOSE 15.95 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 vel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones:Boulders. o s' n .t Flood Insurance Rate May: 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? �Q5 - If not,what is the depth of naturally occurring pervious material? Certification I certify that on o� (date)I have passed the soil evaluator examination approved by,the Department of Environmental Protection and that the above analysis was performed by me consisten with . �ytH OF 44f4SS the requiretraining,expertise and experience described in 310 CMR 15.017. q _ no 'DAVID oyG� Signature S L Date�q o 0 D. N COUGHANOWR 00 41C ENS 10 F VA L Q:4SEPTICIPERCFORM.DOC /� P�0 ALL PIPE SPECIFIED ARE INVERT ATIONS FLOW PROFILE EXPRESSEDLINV DECIMAL FEET NOT FEET AND INCHES.TIONS RAISE COVERS TO WITHIN SIX INCHES OF FINAL GRADE P TOP OF FOUNDATION ONE INSPECTION RISER FOR LEACHING GALLERY TO EL = 28.79+- WITHIN 3 INCHES OF FINAL GRADE AS INSPECTION PORT. Qp �/ 27.00 3 FL ALL PIPE D-BOX MAX SCHEDULET408PVC 3" DROP AND TO PITCH AT T -FLOW LINE 24 25 1/6 to/ft MIN. I10"' 14 48" GAS�V' PRECAST BAFFLE DRYWELL 25.00 6 in BOTTOM OF STONE LEACHING 26.'�0 23.63 LEACHINGJ21.50 GALLERY If EXISTING B A S E 25.25 6 in STONE BASE 23.80 GALLERY 1500 GALLON 23.50 (END VIEW) 5.00 ft + SEPTIC IC TANK NK SEE DETAIL ON REVERSE 26 f L �l 16 FE a1 5 Ft 12.5 ft b) 13 Ft ADJUSTED SEASONAL Y 8.00 HIGH GROUNDWATER ~o (n r~n zmm � GREENN OOD -i� c) z A VEN m � EDGE uE w o Z 3� � �; GOOF P�9 V_ E��- m m - 10225 FE /C u1 ® 13 2 N �r- w MZ 1 111JsWN vq c Nvcn � Na rnw wm �� wmm :(No I z z CD � , rnUi p) (ONV1m N 4 q c0 I 1 w � -: ....Y.,. \J TING �o� DWELLING C I co TOP OF FNDN EL - t n o o w m I o In m o (ri —I n ; z o Imnz N ' y • Ocor �' d L� 14 COO m I\qr W 111.35 ft - I 2 > > W X oo� ® 'rm >CO cf) Z z_ Y 3 m O ro �r > O G Z` ,z�� m � O> �zo-AZ G ® f m 0c Z D O Ym —I cc) i O ct- ,oz2m N 6 mn X p M > zCD i .(J =.�oro -N c.0 rnn o D >oXro p ck)F- -� 3 X �0 >cn-<�> y -0 O i Cn ccnn m,Oz z m m z m O ~ Z O COMMp 00 g(on=oz cn m y '1'iy �l m o m m (!) .a o z Z -10 -I C 81 (n V p crn��-� 3 0 0 N N mm a� '� zo <� ooc �m Rl -1 nx mUI cn rn m 0 �J a o 0 o z a 2 3 el n (n Rl mz =c O O > 03 _ mm r O m NocZi�z CO a D �� rnU) c� � m czPv ark C -1 (n� � O 2 m MM N p G) 0 �� m rn mM '�� wO ) 3 "�A 000O 4 �Z ny ' I F > >z m�N o n X O Z O a`' a y c7 C� C y � O n f I z r�oo; r U m o Z Z 2 3 ) Sll�s��� m A� 3� ® O r V J p O IZ N4- .9 d O o Z O -i A3� m 3 0 0 m o O (� Z f z o O n Z SHIdw rnz A m m O O O d � o R1z o mmz O a O O 5 coMyo Z mo n` O Q rn388 v y o (� n 3❑ z O O �� n �� m �'3 m U) V J88MN3 zoo-n� r m I l m ci 0O n ac�ncnz rn 3 In z s ea n o o m� ro C r 3ly <<ZCO In rn O) rn Z \ G (� A oMzmo r o � cn "3o Z SOIL TEST LOG DESIGN CALCULATIONS DATE OF TEST: MAY Z. 2008 l DESIGN FLOW: 4 BEDROOMS X 110 GPD = 440 GPD APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR. #461, SEPTIC TANK: 440 GPD X 2 DAYS = 880 GALLONS WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) PERC NUMBER: 12185 DISTRIBUTION BOX: USE 3 OUTLET D-BOX. TEST PIT I NO GROUNDWATER ENCOUNTERED SOIL ABSORBTION SYSTEM: A 33.5 ft x 12.5 Ft x 2 Ft- LEACHING GALLERY CAN LEACH PARENT MATERIAL: PROGLACIAL OUTWASH A b o L = (33.5 x 12.5 ) = 416.75 sf PERC AT 60 In - 2 MIN/INCH IN C SOILS A s d w = ( 33.5 + 33.5 + 12.5 + 12.5 ) x 2 = 16 4.0 sf Atot = 602.75 sf ELEVATION DEPTH SOIL USDA SOIL- SOIL COLOR SOIL OTHER Vt 0.74 x 602.75 = 446.03 GPD 27.00 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING USE A 33.5 Ft- x 12.5 f t. x 2 ft GALLERY. Vt = 446.03 GPD > 440 GPD REOUIRED 0-6 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE 23.67 8-40 B LOAMY SAND 10 YR 4/6 NONE FRIABLE 40-124 C MEDUIM SAND 10 YR 5/4 NONE LOOSE 16.67 LEACHING GALLERY CONSTRUCTION 1500 GALLON SEPTIC TANK J DETAIL DIMENSIONS AND DETAIL NO T TO NO GROUNDWATER ENCOUNTERED SHOREY PRECAST CONCRETE USE SHOREY ST-1500-H-10 SCALE TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH LE GALLON ITORDRYWELL 2 MIN/INCH IN C SOILS EQUIVALENT OR STON ELEVATION DEPTH SOIL USDA SOIL.F SOIL COLOR SOIL OTHER 33.5 f t TAPER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING m z6.95 � 0-8 Ap LOAMY SAND �' 10 YR 3/2 NONE FRIABLE 4- c, o 23.�8 8-38 B LOAMY SAND t 10 YR 4/6 NONE FRIABLE to O O O N o U 8 FL 38-132 C MEDUIM SAND 10 YR 5/4 NONE LOOSE N 15.95 N m L] 4.0' 8.5' 8.5' 8.5' 0• GROUNDWATER ADJUSTMENT 33.5 FL 10 EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE LEACHING GALLERY GIS DEPARTMENT RECORDS. CROSS SECTION VIEW INLET CENTER OUTLET END COVER END INDICATED: G W 6.00 USE SHOREY PRECAST 500 GALLON LEACHING DRYWELL (H-10 LOADING) 'INDEX WELL M1W-29 ;4 .:....:.......:.. . .:. ZONE. B 2 in PEASTOW r2 In PEASTOAE DATE IN DRO FLOW LINE.. READING DAT APRIL., 2007 _ -► READING '.s °Z.Z o o FROM 10 In 14 TO 24 InBUILDING ADJUSTMENT 2.0 28 3/4 In T EFFECTIVE /4 In TO [-ln6 InD-BOX ADJUSTED GW 8.0 in -1 2 In GAVEL DEPTH 1-1 2 In GRAVEL 48 In ^1 LIQUID GAS LEVEL BAFFLE ^ •" _• ,�•r 46 in 58 In 46 In 150 in + ' "'` INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE FABRIC IN PLACE OF THE PEASTONE LAYER SPECIFIED CROSS SECTION VIEW NOTES 500 GALLON DRYWELL DIMENSIONS AND DETAIL 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. USE H-10 UNIT INSTALL ONE INSPECTION RISER TO WITHIN THREE 2) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT ^ INCHES OF FINAL GRADE PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. AND VA s BU�TECARDATION 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). SEWAGE DISPOSAL SYSTEM PLAN 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. o0 00� 33 -TO SERVE EXISTING DWELLING 51 EXISTING CESSPOOLS TO BE PUMPED. COLLAPSED. AND FILLED OR REMOVED. o000 o a 00 00 00 0000 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE. 00000a00000 �00 GRACE M. CONLEY 000aoo 0 ��` 142 GREENWOOD AVENUE HYANNIS, MA 7) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES -'AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. �g ECO-TECH ENVIRONMENTAL 9) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL 10, 1n STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING. ETE-2914 I MAY 8. 2008 1 1212