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HomeMy WebLinkAbout0086 HAMDEN CIRCLE - Health ,6 Hamden Circle Hyannis P �— — - Q = 290 171 1 �I 1 a �i 1 No. �(J`�l 161 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[ppYfcation for ]0igpoga1 *pgtem Cougtructiou Permit Application for a Permit to Construct( ) Repair vr-upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. ��l°�Q�I Owner's Name,Address,and Tel.No. Assessor's Map/Parcel /'/�71jj f`' /1/� �•-C�/'� v� ( �- Insler's Nye,Add3ess, nd TeI.jN W1�',�I " Des k©'s Ndr7d Tel. Type of Building: Dwelling No.of Bedrooms Lot Size/ �D sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided �y 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) 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. e, Signed Yo Date Application Approved by p& Date p Application Disapproved by: Date for the following reasons Permit No. / / Date Issued 2fj No. 2_6_ e_ `A /V r " Fee /W °t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppiication for Digooal *pgtem Construction Permit Application for a Permit to Construct( ) Repair Wr Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. ii ��f C Owner's Name,Address,and Tel.No. ! Q Assessor's Map/Parcel t A Installer's ` SNow Desig%giAd GS% ner's Na e,Address jnd,T el � �o, � � 7� Type of Building: Dwelling No.of Bedrooms Lot Size/ D sq. ft. Garbage Grinder ( „)" i Other Type of Building No.:of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) —j j Q +• gpd Design flow providedJ�� �� 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) P 126ir Date last inspected: j 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 .� Date / Application Approved by Date / � 01 Application Disapproved by: Date for the following reasons Permit No. d d Date Issued 1Z� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site SewWe-Disposal System Constructed ( ) Repaired Upgraded ( ) Abandoned( )by at X10 ���y2 ���jj has been constructed in accordance with the provisions of it le 5 and the te�6 r Disposal System Construction Permit No. G..�_`q `O , dated 28 O Installer Designer P wZ_eu,.A `��r:`I E�• • �•S• #bedrooms 3 Approved design flow Q gpd The issuance of this permt shall not be construed as a guarantee that the system wil function as designed. Date tDj ;.}G! Inspector r No. 2 ej-0 © ' Fee loo -- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migo!gal *pfstem Construction Permit Permission is hereby granted to Construct ( ) Repair (� Upgrade ( ) Abandon ( ) System located at ��_ ,� R 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: Co:struct'on must be completed within three years of the date of this pe fit. Date 7 2� �DQq Approved by , L 0 C A Y T '� S E W A G E PERMIT NO. VILLAGE 11 INSTA LLER'S NAME & ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED _ ��� /7? o e 6 G -- C Q\} 0 TOWN OFBARNSTABLE LOCATION SEWAGE# O VILLAGE ASSESSOR'SS,vM�A�P&PARCEL D INSTALLER'S NAME&PHONE NO. W/4 01-/'4� °� SEPTIC TANK CAPACITY d47-V LEACHING FACILITY:(type)/� DSt9"5 (size) NO.OF BEDROOMSp OWNER l�L� T ` . . ;r PERMIT DATE: COMPLIANCE DATE: Separation Distance etween e: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and L,aching Facility(if any wetlands exist within 300 feet of leaching facility). feet I— FURNISHED BY - �J L ` o .Y.71'AII\1V OF s TABLE .oCA��ION e-� SEWAGE # T%J�LA�E V •0A t S ____.ASSESSOR'S ASAP &LOT NSTALILER'S NAME&PHONE NO. iEPTIC TANK CAPACrrY .EACHNG FACILrrY: (type) to`r T (size) / 40.OF'BF.DROOMS WILDER OR OAR DATE, ieparation Distanct Between the: vlaximu n Adjusted Groundwater fable to the Bottom of Leaching Facility Leet private plater Supply Weil and Leaching Facility (If my wells exist on site or within 200 feet of leaching facility) ;Age of Wedand and Leaching Facility(if any wet} exist within 3(ip fe�a�lca�ung facility, �t feet ,'urnished by .� -AI r i C G Ct� � � 6.► • � R I � � � � �� p, r 4 N � �. '� b � �'1� r, TOWN OF BARNSTABLE LOCATION ?�f 44PV t C�^ Cl r(A SEWAGE # VILLAGE I-��/�^�tl ASSESSOR'S MAP & LOTa40" INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /UIl�O LEACHING FACILITY: (type) X Y ,T (size) h NO. OF BEDROOMS 3 BUILDER OR OWNER rAeftJ PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leac ng facility) Feet Furnished byTcn un T �di W � .. �. .'fl 4� a �' -� `� � _ _ ` � �- iv o '- - o �- �-- LZ 9� R i O W . _ , -� Town of Barnstable �'E'�' Regulatory Services Thomas F. Geiler, Director • BABNBTABL& MASe. Public Health Division i639. �� Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: 2 Sewage Permit# QD ` c' ( ��Assessor's Map\Parcel Designer: 7-)avl°>✓^ installer: z 111: l� I Address: F 7�/ Address: On pwas issued a permit to install a (dat (installer) el septic system at 96 gft,,O� C`&66 based on a design drawn by (address) (i` ✓�✓2� /''`"%(� k5 dated 2197 (designer) xl certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or an 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. / Nov �\ D RR InL'sture) \ o 1140 o l q RFc/STE� SO FA%\P� o4 1 l l (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARY- BLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CONIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-2641doc I Town of Barnstable. oF�� •``�� Department of Regulatory Services Public Realth•Division Date Y61_t-2 grABLA Miss s$ 200 Main Street Hyannis MA 02601 (� I Fee Pd. D t7 Date Scheduled I Time o�i SrxatabrlitY Assessm'ent for Sewage isposar r �I' e � `M �.d ! Witnessed By: Performed By: l i . LOCATION& GENERAL INFORMATION rj V woe S Locatinn Address' �j G ,L,y Owner's Name IJTC �� D - Address 4%z L o OYhN 1J IJ� m� Koo&vo,Tx 77K 3�-` Assessor's Map/P4rcel: J-0(�/ 1? I Engineer's Name jJ .� M M� Q µtj NBWCONSIRU(�1lON REPAIR i Telephone# CL'�ACA- Land Use I`- �'� �� Slopes(9/6) i Surface Stones - > i > t Drinking Water Well >?�Dft Distances from: Open Water Body ft Possible Wet Area /�(� ft Drainage Way y "- ft Property Linc ___� Other SKETCH:(Street name,dimensiodsV lot,exact locations of test holes&Pere tests,locate wetlands in proxitnity to holes) • i 194. .—_.._.._.._.. .............—______� • ��� SHED j O N % to .�� ♦ i I 00 i srk ,�-y EXISTING X�.. y Zo „ DWELLING gig . S TOP OF FNDN I v 1 y j �.\• \\ I m, ID A m i • \� �I L1 m O 1I IC M -- �. m1-io -< 82.60 rl Parent material(geologic) l e" '"o-rS N It I Depth to Bedrock Depth to Groundwaidr: Standing Water in Hole: b I Weeping from Pit Face tj ------ Estimated Seasonal tHigh Groundwater l att i DtTERNIIN TON FOR SEASONAL HIGH WATER TADLE Method Used: C-e- nAt't t to 106 !n, Ia. Depth to sell motths; Depth apperved standing' obs.hole In, ©roundwater Adjustment Depth to�fweeping from side of obs.hole: A {actor iJ, - Adj.droundwater Lsyc — I' � Index Well# f W' Reading Date index Well leer l. �• PERCOLATION TEST Date 'x �---- Observation I Time at --- Hole# Time at L" •--�---� Depth of Perc Time(9"-In Start Pre-soak Time.@ End Pre-soak . Rate MinAnch Site Suitability AssOsment: Site Passed X Site Failed; Additional Testing Needed(Y/N) Observation Hole Data To Be Compl original:.Public Health Division eted on Back-- ercola ion testis to be conducted within 100' of wetland,.-YOU must first notify the ***If P _I ; TA.�c;nn at least one(1)wedk prior to beginning. 0 /a/ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel 0 g`� A LOqrA 5�19 t o fZ4� N g"- 37 g LoLyln SN-o Lo rLS g 3.7 .o 2oSY 7/ DEEP OBSERVATION HOLE LOG Hole#_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel �vA* 3,-", l qq'' G W1e Ja e10{ 2"'5T DEEP OBSERVATION HOLE LOG Hole# Depth from' Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsistenc o Gravel 4 I � I DEEP OBSERVATION HOLE LOG Hole# NIA Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. I t Flood Insurance Rate Map: Above 500 year flood boundary No Yes _ Within 500 year boundary No^ Yes Within 100 year flood boundary No^ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the y area proposed for the soil absorption system? S _ If not,what is the depth of naturally occurring pervious material? Certification I certify that on 0 (date)I have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with the require trai ' ,expertise nd experience described in M CMR 15.0M J Signature ` �_ Date Z� Q:1SEPrlCU'ERCFORM.DOC Town of Barnstable Barnstable Regulatory Services Department A ea Chy sARN.InABV, q$ 6'4 Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 70081830000205008390 4/15/2009 Litton Bank c/o David Holt, Today Real Estate 1533 Falmouth Road Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 86 Hamden Circle Hyannis,MA was last inspected on March 4, 2009,by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health I Commonwealth of Massachusetts Title- 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 ' State Zip ode City/Town!Town C Date of Inspection ever page. Y P P YP 9 Inspection results must be submitted on this form.Inspection forms may not be altered in any way. A. General Information 1.' Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ .Conditionally_Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 3-5- 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. L� 3 b t5insp official document-03108 Title 5 Official Inspection Form:Subsurface ewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is H required for annis MA 02601 3-4-09 y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: : �- - I - ❑ 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. Answer yes, no or not determined (Y, N, ND)in the ❑ for the following statements. If"not determined,"please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or breakout or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will - pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed t5.insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year.due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: 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: ❑ t 'Cesspool or privy is within 50 feet of a surface water '❑ "Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh ' 2.�System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 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. t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 L , Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today'Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 ® ❑ 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 El ® Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/ 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. t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes -'No ® 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- r. 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 Y ❑ �❑ the system is within 400 feet of a surface drinking water supply ' ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA).or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5insp official document*03/011 Title 5 Official Inspectlon Form:Subsurface Sewage Disposal System•Page 5 of 15 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 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 El ® 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 c available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of breakout? ® t ❑ 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 CM 15.302(5)] t5insp official document-03/08 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GSM 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): 440 Number of current residents: 0 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)): Sump pump? ❑ Yes ® No Last date of occupancy: 1-09 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 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: Last date of occupancy/use: Date Other(describe): t5insp official document•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments ,M 86 Hamden Cis Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: N/A 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): Approximate age of all components, date installed (if known) and source of information: 1977 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 _ every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 4 16 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.).- Good condition. Septic Tank(locate on site plan): Depth below grade: 10"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: 1000 Gal .. 20„ Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle, 12" Scum thickness 8" Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Tape t5insp official document•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966=2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every 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.): Tank is in good condition with baffles installed and no sign of leakage. " 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.): 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): t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) - Owner Owner's Name information is H annis MA 02601 3-4-09 required for y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: r 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 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.): Good condition with stain lines above inlet invert. Pump Chamber(locate on site plan): Pumps in working order:, ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every page. City/Town , State Zip Code Date of Inspection D. System Information (cont.) 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: Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology.- Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit has clear signs of hydrolic failure with stain lines above inlet invert. t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every page. City/Town State Zip Code Date of.Inspection D. System Information (cont.) 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.): 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 official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. LA Qac k F 75 -a ' t5insp official document-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 86 Hamden Cir Property Address Litton Bank (Contact David Holt @ Today Real Estate 800-966-2448) Owner Owner's Name information is required for Hyannis MA 02601 3-4-09 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: 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: 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: Town maps show groundwater at greater than 20'. t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ,. SYSTEM INFORMATION �� v� Property Address: 86 Hamden Circle ) Hyannis, MA Owner: Estate ofJames Walker Date of Inspection: August 21, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4-per design plan Number of bedrooms(actual): 3 (Revised from original report) DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): .Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: sallons--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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Sep. 15178-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 i Page 9.of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued)' Property Address: 86 Hamden Circle Hyannis. MA ! Owner: Estate ofJames Walker Date of Inspection: August 21, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: I-6'x 6'6"(1000 gal.)with P stoneper design plan (Revised from original report) leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): The pit was dry. There were no signs of failure. The bottom to grade was 8. The cover was 20"below grade. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of.cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL P OT CTION RECEIVED SEP 2 3 2003 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 86 Hamden Circle "V11�~ Hyannis, MA 02601 MAP 1 Owner's Name: Estate of James Walker pARCEL - Owner's Address: c%Gene Walker LOT Box 59, Swartswood, NJ 07877 Date of Inspection: August 21, 2003 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 Osterville,MA 02655-0049 Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs F er Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: August 26, 2003 The system inspector shall sub * 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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 f i, Page 2 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 86 Hamden Circle Hyannis, AM Owner: Estate of James Walker Date of Inspection: August 21, 2003. Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes, no or not determined(Y,N,ND) in the for the following statements. If"not determined", please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: I 2 I i L Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 86 Hamden Circle Hyannis, MA Owner: Estate of James Walker Date of Inspection: August 21, 2003 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 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 and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 86 Hamden Circle Hyannis, MA Owner: Estate of James Walker Date of Inspection: August 21, 2003 D. System Failure Criteria applicable to all systems: You must indicate either"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 '/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes[No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area- IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 I Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 86 Hamden Circle Hyannis, MA Owner: Estate of James Walker Date of Inspection: August 21, 2003 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ _ Pumping information was provided by the owner, occupant, or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection ? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? ✓ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ Existing information. For example, a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION 00 / Property Address: 86 Hamden Circle -' Hyannis. M,4 Owner: Estate ofJames Walker Date of Inspection: Au-aust 21, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4-per design plan Number of bedrooms(actual): 3 (Revised from original report) DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAVINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable Was system pumped as part of the inspection(yes or no): 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Sep. 15178-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 s Page 7 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 86 Hamden Circle Hyannis, MA Owner: Estate of James Walker Date of Inspection: August 21, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 10" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 15" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There were no signs of leakage. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: - Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 I ` Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 86 Hamden Circle Hyannis, MA Owner: Estate of James Walker Date of Inspection: August 21, 2003 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. No solids were present. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C b SYSTEM INFORMATION(continued) Property Address: 86 Hamden Circle ' Hyannis. MA Owner: Estate of James Walker Date of Inspection: August 21, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 -6'x 6'6"(1000 gal.)with ]'stone per design plan (Revised from original report) leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): The pit was dry. There were no signs of failure. The bottom to grade was 8'. The cover was 20"below grade CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 86 Hamden Circle Hyannis, MA Owner: Estate of James Walker Date of Inspection: August 21, 2003 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 1 a 3 a �a � C O 3 19 0-01 10 r , a 7 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 86 Hamden Circle Hyannis, MA Owner: Estate of James Walker Date of Inspection: August 21, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 25 +/ feet Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record- If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You mast describe how you established the high ground water elevation: Using the Barnstable topographic map and the Cape Cod Commission water contours map,the maps were showing approximately 25'+/-to ground water at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. ]1 PAS• C7? 122- No.......... .. 2 ® , , Fss... ............... THE COMMONWEALTH OF MASSACHUSETTS .0 BOARD OF HEALTH -•................_... ........-----...O F...-..--.-.-.........--...._.....-...... ...-..._... Appliration for Ditymi al 10orkg Tnnotrnrtiun rnmit Application is hereb ade for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal �� System it: AM D HYA Ott �S ........- / - J _ ... ... 0 ,f ------------------------- Location- dress Z*. 7- `Jo t No. It./ / — owner ^Addre s / Installer Address // U Type of Building Size Lot__L_/__ .._Sq. feet Dwelling—No. of Bedrooms_______3______ _______________________Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building _�_�_ _ _ o. of persons_________ Showers ( ) — Cafeteria ( ) p' Other fixtures _ .......................... W Design Flow..............._ .___.__.____gallons per person per day. Total daili flow.......... � _t).................gallons. 04 W Septic Tank—Liquid'capacity_�- allons Length____r--•--• Width-- ---------- Diameter________________ Depth................ x Disposal Trench—No_ ____________________ Width___9_fr.---------- Total Length............�:..1. Total leaching area....................sq. ft. Seepage Pit No----------/-------- Diameter........ ......... Depth below inlet_____ ,.. _____._ Total leachingarea_ s ft. Z Other Distribution box ( ) Dosing tank ( ) ,� q '_4 Percolation Test Resul Performed by---- � ?...(6-�C� w--- Date...... ,aa Test Pit No. 1_ - _'Z_____minutes per inch Depth of Test Pit____________________ Depth to ground water_____ _._....____�_./ _. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground waterf�.�.F! C7:7 ..........................-----_...-- Description of Soil................ ; = .. = -- x �/L �`� (� = �... -f .__•-_ ___- = (der -------•---------------•---------------•--------------- W U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ---------------------------------------------------••••_._..•-•--•---••-----•-•-•••-...---------•••--•---•••---••-••---•-----••------------••-•-•--••••--••----.........................-............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITi U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been sued by the board of la l[- s Signed- = ....... Dat Application Approved BY = ... v-7'�••-•••---••- --•------•---..___Date•............. Application Disapproved for the following reasons___________________________________________________________________________ _ _..._..---•-------•-••---...-----•---------------•-••--------.._..-------••----.........._............................................................................................................. / Haze�/-� <J - Date Permit No........................-................................ Issued._....Ll_ ^_ � .----- No................_....... FEB............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... .... OF.......................................................................................... ° Appliratiun for Disposal Works Tontrnrtion romit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal r system.a: r=.E ......1. `, �,�`�` pry ..... ........S::_...__ ....... .r_ ... ...£. ..... ..........._.._...__._....... ` Location-Address '` -• os,� t o...............` -- ... ' 7.�_.w 2 � ... .... .� _ _.........-- ----------- Ad dres Installer Address / U Type of Building Size Lot_aC yP g ...Sq. feet ►. Dwelling—No. of Bedrooms____•_C __-_. �_____ _______________Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building �,� 2� No. of persons_ -,l�_- Showers ( ) - Cafeteria ( ) Q 1 Other fixtures ............................. W Design Flow................tS ......gallons per person per day. Total dai� flow......... ..................gallons. WSeptic-Tank—Liquid capacity -gallons Length.... .......... Width_. .......... Diameter ____________ Depth................ x Disposal Trench—No ____________________ Width.......t_----------- Total Length.............__-_.,.. Total leaching area....................sq. ft. Seepage Pit No_________ ________ Diameter____.__ _.__._.._ Depth below inlet.... Total leaching area..``�....sq. ft. z Other Distribution box- ) Dosing tank ( ) 10 '—' Percolation Test Resu Performed by. ...��� :� f=..... _ : � ' ?�-_ Date_____ ' °` •: a Z 1 Test Pit No. 1 ..___minutes per inch Depth of Test Pit.................... Depth to ground water____ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water a_1_ __•_W .....,. r ..- .... DDescription of Soil i r .............. F`---'•_ �"" -_•--�---` -• -_____"______ -------__---_-_-_-_-_-__----_--------_--•__-------_--•-- W .... ____________________________________________________________________________________________________________________________________________________________________________________________• -.-_--_.. VNature 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 TITLL 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 { Signet._:".�r 1 ..:. :: - }_+'d L� l t Dattp Application Approved B == / PP PP y "'------------- .t'` "'y Date Application Disapproved for the following"Yeasons:-----•-------•-•••-•---•••-•--••-•••---•----••-•----•--•-------•-•-----•-•••---•-•--•--••-• -•---••-•..•..... .-•----•------•---........-•-•-------•-------------•-------...._..........-•-----._...---------------•-•.-•--•-•----••-•----•-------•-•--•--••---•-------••-------••---•--------•-----------------•-•--- Date PermitNo...................................................... Issued....................................................... ` 'Date THE COMMONWEALTH OF MASSACHUSETTS - .BOARD OF HEALTH ?....... ..OF.... . t ... .............. ............. _ Tntifiratr of Toutplionrr THIS IS 0 CERTIFY, That the Ind vldual Se a e ispo 1 System constructed -) or Repaired ( ) by r� `:_ ..... _: .� ..-•- .......................................................... y at. been installed in accordance with the provisions of r of The State Sanitary Code as describlad in the application for Disposal Works Construction Permit t o._-. .i' �'�--:_.__.__.___•___ dated-.._r .'r "��" THE ISSUANCE OF THIS CERTIFICATE SHALL NO;$ BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.......................... FEE........................ Disposal Works snot , ' it Permit Permission is hereby granted__ .................... ..... to Construc ) or Repair ( ) an Individual Se " e Disposal System w. at No. ..- 1 r 7 --- .#?tr '` L - ` --- -----------------•--•--•--•--........ j` Street T as shown on the application for Disposal Works Construction Pe mi 0.____!f�__.____ _ Dated2--R: "`_7. ..._._,_.:.:.... .. d y Board of Health DATE---- f ........................................ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS LOCAJ1O SEWAGE PERMIT NO• V I L AGE INSTA L ER'S NAME & ADDRESS '4�` 77 !_ t V B U I'L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE. ISSUED , :__. 1�`'� 1 V 1 Y e i e e 1 f i 1 3 9 � 4 i - i c `g BENCH MARK LEGEND PAINT SPOT ON _....'�� ^• CONC 'DECK SUPPORT PROPOSED CONTOUR © "Al ELEVATION = 33, 40 ® PROPOSED SPOT GRADE // `.� BARNSTABLE GIS DATUM 98 __ EXISTING CONTOUR + 96.52 EXISTING SPOT GRADE c1$ tt`1i � � f 1 L .- 77 I I { I� Denver5l t W— EXISTING WATER SERVICE i `�? •.� cue, TEST PIT ��e i /33 �'.� �ritcJheilS Vl7ay _ PC- LOCUS MAP N.T.S. SOIL ABSORPTION SYSTEM (SECT , 32 IONS GENERAL NOTES: ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL � BOARD OF HEALTH AND THE DESIGN ENGINEER. C9 O / 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS C) �j� / / OF THE STATE ENVIRONMENTAL CODE. TITLE V. AND ANY APPLICABLE F� / / LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR APPROX. LOCATION OF % \/ O Gy\ \S % TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE EX15T. LEACH PIT i/ -�\ �� Fes^ 9IF.\ \//� // ii DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING (SEE NOTE I O) / O O�'`j� �\' T. // FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF w O j• AR THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF / ry \. C'� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. �0 k* /%� (TI 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING TH_2 CONSTRUCTION. i 10. EXISTING LEACH PIT TO BE PUMPED AND REMOVED FILL WITH CLEAN MED. SAND j' ° mpppd\ `_ /- 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION / -0- TH$' °°/ � /` 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY / ��• / \ m AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 6 \j ,•� w \ 13. NO ADDITIONAL PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING LOT 7 / I _ ' - 14. ALL PIPING TO BE 4" SCH 40 ® 1/8-/FT (UNLESS SPECIFIED OTHERWISE) / - - 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW AREA = 11700 S f +— _ �_� FOR THE USE OF A GARBAGE GRINDER 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING p.Zg It 32 i Lam! N 17. PROPERTY IS NOT LOCATED WITHIN ZONE II OR NITROGEN SENSITIVE AREA. LLL--- / \ i SCALE: 1 in ` = 20 ft er[ / - - 20 0 20 40 OF �t4ss9 O 10 20 DA�1 f PROPOSED SEPTIC SYSTEM UPGRADE PLAN M 1140 "' 86 HAMDEN CIRCLE, HYANNIS, MA MAP. 290 ' S1E� i Prepared for: Mike Dedecco LOT.' 171 Engineering by: Surveying by: SCALE DRAWN JOB. NO. SURVEY REFERENCE: 2')/ LCP.-#C171274 DARRENM.MEYER,R.S. Bo_T eeb ab9tronmenw 1"=20 . DMM PLAN OF LAND BY S.R. SWEETSER, SURVEYOR 't(L� ((( Poeox9et E4STSANDWICH,M402537 (508) 364-0894 DATE: CHECKED SHEET N0. DATED: APRIL 10, 1972 508-W-n22 04/27/09 DMM 1 Of 2 NOTE: 'TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:29.59 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. T.O.F. EL.=34.17 INSTALL OUTLET ANDERS SET8 COVERS OVER INLET & INSTALL TO 6" OF FINISH GRADE SET TO 6"I OF GRADE ONE ONE CHAMBER (M N)IINSTALL A 4" EAND SET CTO 3 TION POFT F.G. F.G OF S�9�yG F.G. EL.=32.5t F.G. EL.=33.1 t F.G. EL: 32.1 t F.G. EL: 32.4(MAX.) ARREE M. try / . 1140 -. L = 10-+ 9' MIN COVER/ L = 35' L = 8'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) t ® S=19r (MIN.) 36" MAX COVER 0 S-IX (MIN.) O S-IX (MIN.) � 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC NITAl��1' • 6 11.3" TO v`Tl 14 INV.=31.39 4B'UWID INVERT tEvtz INV.=31.14 - GAS BAFFLE) ' .40 4 ROWS OF 4 U}NITS AT 6.25'/UNIT = 25'/ROW jrD-BOX SOIL ABSORPTION SYSTEM (PROFILE) DB 5 INV.=29.20 INV.=29.60 - EXISTING 1.000 GALLON SEPTIC TANK RESTORE VEGETATIVE COVER EXISTING SEWER OUTLET BACKFILL WITH CLEAN PERC SAND TO TOP OF CHAMBERS 75" NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION BREAKOUT=TOP ELEV.=29.59 •�� �• 2) D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.= 29.20 GRADE ON A MECHANICALL COMPACTED SIX BOTTOM ELEV.- 28.26 INCH CRUSHED STONE BASE, AS SPECIFIED IN EXISTING SUITABLE 310 CMR 15.221(2) 2.83' MATERIAL 3 REPLACE EXISTING 1,000 GALLON SEPTIC 5' MIN, ABOVE BOTTOM OF �. 76" TANK WITH 1500 GALLON SEPTIC TANK T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 4 x 2.83 = 11.32 IF FAILED, DAMAGED, OR UNDERSIZED. PROVIDD) USE 4 ROWS OF 4-HIGH CAPACITY PROFILE 4) INSTALL INLET & OUTLET TEES AS REQUIRED ADJ. GROUNDWATER TER EL.=21.37 = ADS BIODIFFUSER UNITS-NO STONE SEPTIC SYSTEM PROFILE TYPICAL SECTION I S N 16" • N.T.S. n.tt 11� DESIGN CRITERIA SOIL LOG �2�, $ NUMBER OF BEDROOMS: 3 BEDROOMS DATE: APRIL 27, 2009 f� 34" � SOIL TEXTURAL CLASS: CLASS I SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE. SECTION END CAP WITNESS: DAVE.STANTON, BARNS. BOH DESIGN PERCOLATION ATE: <2 MIN/IN 16"" HIGH CAPACITY (H-20) BIODIFFUSER UNIT DAILY FLOW: 330 G.P.D. Elev. TP-1 Depth Elev. TP-2 Depth 32.50 DESIGN FLOW: 330 G.P.D. A LOAMY SAND 0" 32.2 A LOAMY SAND 0" " IOYR 4 2 tOYR 3 2 " MODEL 16 HICAP GARBAGE -GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 31.83 B a" 31.37 B 10 LENGTH 76 NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT PROPOSED SEPTIC TANK: USE EXISTING 1,000 GALLON CAPACITY LOAMY SAND t LOAMY SAND EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY 10YR 5/8 10YR 5/8 DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. LEACHING AREA REQUIRED: (330) = 445.94 S.F. 29.42 37" r 29.2 36" SIDE WALL HEIGHT 11.2 • I .74 C OVERALL HEIGHT 16" DISTRIBUTION BOX: 5 OUTLETS (MINIMUM) OVERALL WIDTH 34" 4640 TRUEMAN BLVD PERC ®27.92 HILLIARD, OHIO 43026 PRIMARY S.A.S. MED. SAND MED.SAND 13.6 CF am, c 1` USE 4 ROWS OF 4 - 16" ADS BIODIFFUSER H-20 UNITS-NO STONE 2.5Y 7/4 2.5Y 7/4 CAPACITY (101.7 GAL) ADVANCED DRAINAGE sysTEMs, iNc. BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.70 SF/LF OF BIODUFUSER) 18.67 166" 20.2 144" PROPOSED SEPTIC SYSTEM SITE PLAN (BIODIFFUSERS) 16 UNITS x 6.25 LF x 4.70 SF/LF = 470 SF PERC RATE <2 M114/1N. ('Cl' HORIZON) 470 GPD SF = 347.80 GPD > 330 GPD re 'd GROUNDWATER OBSERVED AT 166' EL 18.67 86 HAM D EN CIRCLE, HYAN N I S, MA DESIGN FLOW PROVIDED: 0.74(470 / ) q INDEX WELL- AIW-230 ZONE C LEVEL: 23.2 ADJUSTMENT: 2.7 ft. Prepared for: Mike Dedecco AWUSTED HIGH GROUNDWATER AT EL 21.37 Engineering by: Surveying by: SCALE DRAWN JOB. NO. DARRENM.MEYER,R.S. Nbo-Tech Abvimnmental NTS D.M.M. • 1, Darren M. Meyer, R.S.. CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 POBOX961 (508) 364-0894 to conduct son evaluations and that the above analysis has been performed by me consistent with the EAST SANDWICH,MA02537 DATE CHECKED SHEET NO. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Evol. Exam in October, 1999. 50 3B229= 04/27/09 D.M.M. 2 Of 2 AW*t;a ,.,--.'" I, ., .,. - .�. '�!.: •,., - .� ".'.t rIrrw _ n e O X a �T Fi�V f S N C.�t?�a D F■ 1/Y 3 r f`t N 4SN G�C'�9 i?� �►AfA�I G!?A I» - �._,..._. TaP of FavxO. 1� l�T� +�1t-- ti»y7i7!'ht��;� ti'�t✓.f� �1yU._ __ ceVverN,Ey,Rtaslc CGitFIf.E DWe"rMG _- -- - -- - G. '. ---, ,•6�C\.. nse +r 3a'EA�Ti�Yi E'L t✓ a Sx 1 -. t 04L• / / a © o a o / 1 r"/a'R to i ,P�rwt tta '�o,1�1c. t D IS 7 b o x / �o s a # c eus�v r> .s-'��•� ,S',E P7-!C TANK ..— A N n .9r.40 E / a 1 , �ftr Af O or RIT 1 /Yo- of .t3•Ez�k'ao�?3 � �_ GAL. PEA a.�t y : 33p LEACH/NG ��EA F'.Pa�r.�,� 19 4•Z! SAMWA.LL_ bra,. 401 LoT iik \n 7aG d t SO J {G �� yt -Tai"�s-- 45'� Ft/a►- _ 4_: i�o t , p pti:OIQ 0 �0 511Q�Qil., `3 n.r � LSAT kCAO ElZ•t: t.A14 Ee S AM DEt.1 E MEp��M 1ox� 144 W.fCllr AOISIMOS44 S) /NG rvsp,�c,Ev AS : PAL. 1��� y 1 �l, �3v 1 t AsT�,3:. Ca.N�.� /''�'.4.Ss• V114 ��(, 2cj= taj`t� 2M►0// ►..1C_H SCAL6 w t11= 30= t�ArE i e. S� ��3-r-T *�H DF �LtiN Gf a�pstiy, �� �C.t2v AJ.-t T��"C" w�w."CA i Mossm N "',� /VrOrP/'?i4N Fr7F'o.S.S/r1�4J1r` RCr, 410 so c 2z4 11a1-4y PD%VT