HomeMy WebLinkAbout0027 KITSY LANE - Health 27 KITSY LANE,HYANNIS
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Oct 12 08 08: 36p Darren Meyer, R. S. 17815850293 p. 1
Town of Barnstable
EVE �. Regulatory Services
�. Thomas F. Geiler, Director
• f3ARM CAILL
t�,a �.g Public Health Division
p�f1639. ' Thomas McKean,Director
200 Nlain Street,Hyannis,IVIA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Dace: �qj� Sewase Permit# Assessor's MaplParcel
IlT
Designer: 1,ji(W , "` L/ Installer:
:address: _E�x '10/ address:
253�
On was issued a permit to install a
(date) (Installer)
septic system at 27 V-1-r5y L,�F_ based on a design drawn by
(address) e�
C, fillt''r dated l0 310 I
(designer)
l certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation or the
distribution box ands 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 o`any component
of the septic system) but-in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow.
OF
o IARNWt.
I' R
(In alle s tgnature) Y�lo. 1' 40
(Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARI ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
CONIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FOWY] AND AS-BUILT CARD .ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
Q: HealtitlSepticlDesigner Certification Form 3-26-Odoc
I
From: "jrogers@bwseptic.com"<jrogers@bwseptic.com>
Date:Mon,30 Nov 2009 00:17:38+0000
To:jrogers@bwseptic,com
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1 of 1 12/3/2009 8:14 AM
TOWN OF BARNSTABLE
LOCATION �ltS� SEWAGE #L
V[i,LAGE �-��� ASSESSOR'S MAP & LOTZS 1
INSTALLER'S NAME&PHONE NO. /
SEPTIC TANK CAPACITY l ��
LEACHING FACILITY: (type) ��C'C�-ft (size)
NO.OF BEDROOMS
BUILDER OR OWNER
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 anywedands exist,
within 300 feet of leaching facility) Feet
Furnished by
n
i
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TOWN OF BARNSTABLE
a
LOCATION L,,A e— SEWAGE# ZC09 3:546
rVILLAGE } CJ crew✓l„S ASSES SOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.\14,6e/L
SEPTIC TANK CAPACITY /CCC:> "
LEACHING FACILITY. (type) �Qc, a o S �� l�l)S (size)
NO.OF BEDROOMS -I � S5'��'
OWNER
PERMIT DATE: o"ICOMPLIANCE DATE: I a J
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 leach' g facility) Feet
FURNISHED BY
N �
e
I I I I t CO ri T
r_ N �` WallN dZ'
(A N
4 r
No. • *33 Fee
.100
Entered in computer:
THE COMMONWEALTH OF MASSACHUSETTS
'icPUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplication for & ) �a' 4§p5tem Congtruction Permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components
Location Address or Lot No. I�S`I 1�� �'�'�`S Owner's Name,Address,and �.Qyl Dv P e
.
C0 'RSA® 146 GQ-�,r�A'/J�-rJ ` o
Assessor'sMapiParcel MA9 ct51 LOr' 1%' `'`a.QS plsela A4A. 10161'C403-M— 700
S�U/1 0 q_VZ 13jj 70 2
Installer's Name;Address,and el.No. Designer's Name,Address and Tel.No. Q�� y
��a2w�o��► �0.►30`� q�l �.��ndv�:��
1'7$-y23- 2 47 Sib- 2l_L ZOVZ7
Type of Building:
Dwelling No.of Bedrooms Lot Size 2 Z I<6 11 fi— sq. ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 11Q gpd Design flow provided LA 4 0 gpd
Plan Date 1 d/13 0-1 Number of sheets `Z Revision Date
Title SQ .C• IIZt 4:2
Size of Septic Tank &4iS4 +-s 100v'�i��1I�TypeofS.A.S. ��ib��n� Leuc�!J.I�' PA IOpo 15t0,,
Description of Soil 0' `I-o cl" I_6AvAnA S ii,%cA 40 3Z" -5-,4J,( 10aw% 3Z" 4•v LI®�� Scon�t I jUGvv� �/D�I�o I Z 6"
m to
Nature of Repairs or Alterations(Answer when applicable) e4u5Q- 1141,E &4'% �oCo 9"110✓i Scp'�,C -4-vt �
(I_A.e,O Dt3-5(ii-10) DSe(U) (ZCW� 0P (G) 11" AhS i3�PvsevZ 14-20 uA%'AS
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction a Maintenance of the afore described on-site sewage disposal system in
accordance with the provisions f le 5 of the En m tal Code and not to place the system in operation until a Certificate of
Compliance has been issued b this card of H
e
Sign ® Date /U i(n O
Application Approved by Date
Application Disapproved by: Date
for the following reasons
Permit No. Date Issued
Nor
3 L. Fee d
THE COMMONWEALTH OFMASSACHUSETTSEmered.incomputer: Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
'2PPgication for �MP05aY 4p-tear Con#tiurtion Permit
Application for a Permit to Construct,(") Repair ) Upgrade( Abandon( ❑ Complete System ❑Individual Components
Address or Lot No.,-l-1 K I}S A l��'�- u-m`S IV be- Pe e
O' Owner's Name,Address,and Tel.No.
Assessor's Map/Parcei MA9 asi L(A 'ctx7 W*S+P,*c 1a AAA, Qlet�'a 7oo
1,S1�et
Installer's Name,Address,and el.No.\ 015ckA og'et Designer's Name,Address and Tel.No.
3sa wt�:n afi W.���.R�aAovfvt p0-t!SZ4
17-6-923 - 2,97,6 2VI2 74\2Z
Type of Building:
A DwellingNo.of Bedrooms L 2 Z 1
". � Lot Size � sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) I10 gpd Design flow provided (44 d gpd
Plan Date 10/13 1 C>-C Number of sheets Z. Revision Date
'Title 54 ;L IZA-eQ;4-
'
Size of,Septic Tank &4rS Iwo '?Q110A Type of S.A.S. & 5�,A7 Le,(cY:t� IOoo yatc,
Description of Soil p� '1 o el f;shag 5 a Arl+r V 4o 32" Sti ul�l )0am 3Z" 4c, LIU' Sun�1,{ It t41)1'�o I2 b"
�! 1'�'le� Su✓+t1�
Nature of Repairs or Alteration' s,(An swer when applicable) QQU50_ E+I�'s��ah 1000 gC,1100 GC_0(C 4-c,-A4.'�
(!� A}e� l�q_5(,i.�o> use(u� too is o �S) ` It".11�s �iioD�11^usev� N-2o 0ArA6
A)D 64o-A,9_ �a.��t -�}���nckQc\ 0.7S' Fi` tJ�4�n Gt>•/��oy�2erJl, W2dgQ. . F
Date last inspected: 1
1
Agreement:
The undersigned agrees to n�surelthe construction and-maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Tittle 5 of the En o�fetal Code and not to place the system in operation until a Certificate of
Compliance has been issued by this{Board of Hea -
/v i(n Jo
Signed l, i D /ln Date
-✓Application Approved by-T / / / i -Yf_ Date 119,///(�/ 0V
Application Disapproved by: / v V m i, » Date
for the following reasons'.». U y
PermitlNo /? / % ` ) Date Issued ( ^ /CAI
THE OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of C...ompliance
THIS IS TO CERTIFY,that-the On-site Sewage Disposal System Constructed ( ) Repaired ( " ) Upgraded
^� ( )
Abandoned(yy )by V 0
at l� t S�I I k"e. HL/G✓w1iS has been constructed in a cordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. / -5)V dated
InstallerL�CP5C%A 5 Designer be q-6Q✓, atAQ,4LVZ,
#bedrooms H Approved design flow U(� gpd
The issuance of this per m'shall not be construed as a guarantee that the syK em wi I fu~n to as de gned.
Date "'7 / Inspectgr`�
No. D(/ Fee /
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
liopo5a[ �&pgtem Con5truction Permit
Permission is hereby gianted to Construct ( ) Repair ( � Upgrade ( ) Abandon ( )
System located at (mil K %4" i um -Q a n vt t S
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
Provided: Construction Vustlbe
/coo �pleted within three years of the date of this If
feL_nfA. A
Date / � �/ � Approved by /
APPLICANT: DIKWv
ADDRESS: 'L'���.L(�Y 1,A/ N1S
DESIGN FLOW: gpd
REVIEWED BV: DATE:
N/A OK NO
Legal boundaries denoted [310 CMR 15.220(4)(a)]
Street, Lot, tax parcel number and lot number noted on plan [310
CMR 15.220(4)(u)]
Locus Provided 310 CMR 15.2204 t
Plan proper scale? (1"=40' for plot plans, 1"=20'or fewer for
components) [310 CMR 15.220(4)] ✓X
Easements shown [310 CMR 15.220(4)(b)]
System located totally on lot served [310 CMR 15.405(1)(a) for
upgrades]- i not, a variance is required 310 CMR 15.412(4.)] ✓�
Location of impervious surfaces (driveways,parking areas etc.)
[310 CMR 15.220(4)(d)] 1AX
Location all buildings existing and proposed 310 CMR
15.220(4)(c)] L �
Location and dimensions of system components and reserve areas
[310 CMR 15.220(4)(e)]
System Calculations [310 CMR 15.220(4)(f)]
daily flow
septic tank ca aci required andprovided)
soil absorption system (required andprovided)
whether system designed for garbage grindei
North arrow [310 CMR 15.220(4)( )]
Existing and ro osed contours [310 CMR 15.220(4)( )] X
Location and log of deep observation holes (existing grade el. on
each test) 310 CMR 15.220(4)(h)
Names of soil evaluator and BOH representative [310 CMR
15.220(4)(h) and (i)]
Location and date of percolation tests (performed at proper
elevation?) [310 CMR 15.220(4)(i)] X
Percolation test results match loading rate?-[310 CMR 15.242]
Certification statement by Soil Evaluator[310 CMR 15.220(4)0)]
Observed and Adjusted groundwater(method for adjustment j
given or indicated) [310 CMR 15.103(3) and 310 CMR
15.220(4)(n)] I x
Location of every water supply,public and private, [310 CMR-
15.220(4)(k)] X
Address 27 J "5Y. Lk)4FA NyAWAIIS)_ Sheet 1 of 7
L
within 400 feet of the proposed system location in the case
of surface water supplies and grAyel packed public water supply X ��
within 250 feet of the ro osed system location in,the case �C
within 150 feet of the proposed system location in the case
of private water supply wells k
Location of all surface waters and wetlands located up to 100 ft.
beyond setbacks listed in 310 CMR 15.211 and any catch basins
located within 50 ft. 310 CMR 15.220(4)(1)]
Water lines`atid oth&f-subsurface utilities located [310 CMR
15.220(4)(m) (if water line cross see 310 CMR 15.211 1) 1 )
Profile of system showing invert elevations of all system
components and the bottom of the SAS 310 CMR 15.220(4)(6)] X
Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)]
Stamp of Registered Land Surveyor(required if construction
activities within 5 ft. of lot line) [310 CMR 15.220(3)] x .
Test Holes adequate (two in each of the primary and reserve
unless trenches as permitted in 310 CMR 15.102(2)or as
approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] X
Test hole adequate to demonstrate four feet of suitable material?
310 CMR 15.103(4)] x
Test Holes adequate to cogfirm adequate groundwater separation?
[310 CMR 15.103(3)]
Benchmark within 50-75'of system [310 CMR 15.220(4)( )]
Materials specifications noted? [various sections of 310 CMR
15.000] X
System components not-> 36" deep(unless Local Upgrade
Approval or LUA requested) 310 CMR 15.405(1 b x
Address LW- HYi W—� -),S Sheet 2 of
r
Size OK? [310 CMR 15.223(1)]
Inlet tee located ten inches below flow line 310 CMR 15.227(6)] k \
Outlet tee 14" or 14" +5"per foot for increase ft depth [310 CMR
15.227(6)
Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)]
Note regarding installation on stable compacted base [310 CMR
15.228(1)] X
Separation between inlet and Outlet tees (no less than liquid
depth) 310 CMR 15.227(2) YG
Inlet/Outlet elevations at least 12" above high groundwater
(except as described 310 CMR 15.227(5))or permitted for
upgrades under LUA [310 CMM 15.405(1)(k)] X.
Minimum cover 9" (Tanks buried more than 9" must have risers
on all openings and on the d-box) [310 CMR 15.2228(1) and 310
CMR 15.232(3)(f)] �(
Three access covers (inlet and outlet must be 20" or greater) -
middle access at least 8" (b 7/07) [310 CMR 15.228(2)] �(
Access to within 6 "'of grade - one port for systerri9<1000gpd,
two fors stems>1000 gpd 310 CMR 15.228(2) �(
All at-grade covers secured to unauthorized access? [310 CMR
15.228(2)] X
> 10 ft from building foundation [310 CMR 15.211(1)]
Buoyancy calculation Required/Done 310 CMR 15.221(8)] �(
H-20 Where appropriate? 310 CMR 15.226(3)]
Setbacks from resources,[310 CMR 15.211] �(
ri
Required when other than single-family dwelling or flow>1000
d [310 CMR 15.223(1)(b)]
First compartment 200% daily flaw'Second compartment 100%
daily flow 310 CMR 15.224(2) and 3)] �(
"U"pipe through or over baffle, outlet of each compartment with
as baffle or approved filter[310 CMR 15.224(4)] X
i
Z-� �Gl � LAB NYAWV4
Address Sheet 3 of 7
Located atyleasi teri`feet from any water line? [310 CMR
15.222(2)] X \
Disposal piping at least 18"below water line (when water and
sewer cross, see 310 CMR 15.211(1) (I)ID
Cleanouts required/provided ? [310 CMR 15.222(8)]
Thrust blocks specified in force mains?310 CMR 15.221(6)(c)]
Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable
[310 CMR 15.222(6)]
Proper pitch on all runs?(.005 within gravity-distributed trenches
and beds) 310 CMR 15.251(9) and 310 CMR 15.252 2)(c)
Siphonproblem/(leachfield below pump chamber)
Endca s or vent manifold specified? x
Size and orientation of discharge holes specified?(not smaller
than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310
CMR 15.252(2)(h)]
Materials specified (310 CMR 15.251(5) specifies various pipe
types allowed) X
Stable compacted base [310 CMR 15.22](2) and 310 CMR
15.232(2)(a)] x
Splash plate or baffle tee required on inlet/provided?(when
pressure sewer to d-box or steep pitch of gravity sewer) [310
CMR 15.323(3)(a)] X,
Riser if deeper than 9"'[310 CMR 15.232(3)(0]
Inside minimum dimension 12'= 310 CMR 15.232(2)(b)] x
Minimum sum 6" [310 CMR15.232(3)(e)]
Watertight cover if<2000gpd);waterproof manhole if>2000gpd
[310 CMR 15.232(3)(d)] x
on
Capacity(emergency storage above working=design flow)?[310
CMR 231(2)] X
Proper setbacks [310 CMR 15.211 (same as septic tanks)]
Watertight 20-in minium access manhole at least 20"MUST BE
TO GRADE [310 CMR 15.231(5)]
Service components accessible (not too deep,with piping,
disconnects accessible)
Alarm floats - alarm on circuit separate from pumps specified?
Exceeds two units must have two pumps operating in lead-lag
mode. [3IQ CMR 15.231(6)and (8)]
Stable Com pacted Base [310 CMR 15.221(2)]
Buoyancy calculations needed ?Provided? [310 CMR 15.221(8)]
2� i<< 1S ;.
Address T��l L�_T�.�//�/A/ �1,e�� " �� � � Sheet 4 of 7
Calculations correct?
4 feet of naturally occurring material demonstrated? [310 CMR
15.240(1)]
Required separation togroundwater? 310 CMR 15.212).]
Aggregate,s ecified as double washed [310 CMR 15.247(2)]
System Venting required/provided? (system under driveway or
>36" deep) [310 CMR 15.241]
Inspection ports specified and within 3"final grade? [310 CMR
15.240(13)
Breakout requirements met?(No violation of breakout elevation
within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and
Guidance Document]
Chambers and Gal. in trench configuration supplied with inlet
every 20 ft. [310 CMR 15.253(6)] X
Each structure with one inspection manhole(if>2000 gpd must
be tograde) 310 CMR 15.253(2)] X
Aggregate I'minimum-4'maximum. 310 CMR 15.253( )(b)]
2' sidewall credit maximum [310 CMR 15.253(1)(a)]
In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] k
Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] ,
100 feet-maximum length 310 CMR 15.251 1) a
Minimum separation 2x effective depth or width whichever
eater(3x if reserve between trenches) [310 CMR 251 1)(d)]
Situated along contours [310 CMR 15.251(2)]
Breakout OK? [310 CMR 15.211(l)[4] and Guidance Document]
minimum 2 distribution lines 310_CMR 15.252(2)(a)
Maximum separation between lines 6' 310 CM R15.252(2)(d)]
Maximum separation between lines and outside of bed 4' [310
CMR 15.252(2)(e)
Aggregate depth below discharge pipes 6"minimum, 12"
maximum. [310 CMR 15.252(2)( )] ,
Separation between beds 10' minimum. [310 CMR 15.252(2)(f)]
Bottom area used in calculations only 310 CMR I5.252(2)(i)
Address W« I L�J` " l AWtJI5 Sheet 5 of 7
Pressure Dosed System ? Provided pump and piping
calculations as required 310 CMR 15:220 4 r)
Pressure dosing required on all systems>2000gpd or alternative
systems undmedial approval [310 CMR 15.254(2) and I/A
Remedial Use Approvals]
If used in gravelless system -make sure jet is directed as not to
scour soil interface [Guidance Document] x
Inspections once per year(systems<2000 gpd) or quarterly
(>2000 dgood to note on plan 310 C1V�1R 15.254(2) d ]
Construction in fill -Did the plan specify that the fill shall meet
the specification of310 CMR 15.255(3)? �C
Impervious barrier and/or retaining wall ? Guidance Document X
Impervious barrier installation must be supervised by
designer[310 CMR 15.25 5(2)(b)] x
Retaining wall must be designed by Registered Professional
Engineer[310 CMR 15.255(2)(a)]
Side slope not exceed 3:1 ? 310 CMR 15.255(2)
Breakout requirements met? [310 CMR 15.252(2) and
Guidance Document] - k
At least 5 ft. from impervious barrier to edge of SAS (10 ft.
recommended) 3J0 CMR 15.255 (2)(e)]
Check DEP Approval letters for credits and design conditions
If used with pressure dosing do not allow pressure discharge x to scour soil interface
Was DEP Approval Letter provided and/or have you
reviewed the letter for conditions?
Is the technology being properly applied and does it meet all
DEP Approval Conditions?
Is there a note on the plan regarding the requirement for
perpetual maintenance agreement?
Any alarms involved on separate circuits
Did the applicant submit an operation and maintenance
manual?
Has applicant submitted a copy of a maintenance
Are the variances listed on the plan ? [310 CMR 15.220
(�)( ) >C
RLS Stamp necessary on plan if a component is within five
Feet of property line [310 CMR 15.412(4)] x
New construction or increased flow proposed - [Refer to 3 10
CMR 15.414] -
Address Y Ln1 !A-�1 M Sheet 6 of 7
I
f
c
�S
Is the system in a Designated Nitrogen Sensitive Area(Zone II for
a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and
310 CMR 15.216 - also refer to Policy regarding upgrades of such `
existing systems] x
Is the system proposed on the same lot as served by private well ? x
[310 CMR 15.214(2)]
Are the nitrogen loads proposed in compliance? [310 CMR X
15.216(l)]
Pumping to septic tank? [ 310 CMR 15.229
Shared System [310 CMR 15.290
Address 21 �—lrsY LA` 1" ' ! _ Sheet 7 of 7
1
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��. -7
11ATown ofB -ns y .
',�N Department'URe ati Services
s�' • ,, ri'
• ; '� PubiceallfhFDivision -,Date
nnusMA'02Got.< ,-_
� � .f� : i e WN, Fee Pd� � °rs '
Date'Scheduled Tim _
•` -Y�� t�� �+->* N �6}s x�"-s y tau''•
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;Suitahility�Assehh, i4t f.,Sew4g, p
gyyy ;W w fr+Wl V�r.� �C:5 �W.Hip.. ,4/Ap.n"+f,?.'rf 1Y1e�•W':By �/I V
P.erform0,,By.-
LOCA TION S& MURAL
ORMATION
cper's Name tom. �6 Q�ti
"Locadon�Address
4
J k•� aw`' AddlfeSS" A•,A r +P-Q7,I •/��
AY
IA
I cssor s Map/P�rcel
1tEP I 362„
NEW CONSTRU�'I1ON +
Sudice>Stonas`�- �i ;
F
P '>
Iand:Use '.& $,t• � � }d ' t:. ls�t1�� � 7'��
..:; Drinking Nw,- well-�=._P_ft - -
Distances from. opmWater Body 7 2 `-ft Possible Wet Area i
r 1;�''°` {�..` Other'�..-•.....,�..�:�,,. � ..�._ '._{t.;r`a --1
Drainage Way;` ft Property�lane / 8
t �• f pere tests,locate wetlands m proxi holes) .o
SKE�CfI.($treetTamc.dunensions'of lot.enact locapons of te�§t holca& z r
pp y tie �.P S•YA4 . � y$A, :"y � .
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t matuial edlogtc)
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Depth to Bulroc
Partin. ;fig . w � max• ,, Plt Fbce All �Q
to'Ciroundwa�dr=Standing Watec'tn Hole
Depth ,�w�rr�w���wdi .wu�ac( f.�,+6+•:*•e:.aa» 4s••�,.a.:»� +. rM" .tc,.�� �. .-,«na....,.l.. -
Estimated SCaibnal O Groundwater
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tobeconducted=wi
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area proposed for the soil`abso tionps tem?
-If not,what is the depth of naturally occurring pervious material?-, /
Cei°tiHcation t
I certify that on d (date)I have passed'the,soil evaluator,' xamination approved by the•
"Department of Environmental Protection and that the above*analysis wa.#4 pt r�`formedby-ine.consistent withlM
the requi` t ,expertise and experience described in 310 CI��IIt 15 0V
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ti
Commonwealth of Massachusetts
Executive Office of Environmental Affairs
Dept. of Environmental Protection
One winter Street,Boston,Ma. 02108 John Gt•Septic
D.E.P. Title V Septic Inspector
kip
P.O. Box2119
Teaticket, MA 02536
WILLIAM F.WELD (508)564-6813
Governor
ARGEO PAUL CELLUCCI
Lt.Govemor
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: 27 KITSY LANE HYMNIS MAP 251 L 56 Address of Owner:
Date of Inspection: 11/23/98 (If different)
Name of Inspector: JOHN GRACI JUDY DIYESO
I am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000)
Company Name,Address and Telephone Number:
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate
and complete as of the time of inspection. The Inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems. The system:
x Passes This Inspection Is based on criteria defined InTttle V
_ Conditionally Passes code 370 CMR 16203.My findings are of how the system is
performing at the time of the Inspection.My Inspection does
_ Needs F th r Evaluation By the Local Approving Authority not Imply any warranty or guarantee of the longevityofthe
Fells septic system and any of its components useful life.
Inspector's Signature: f Date: 12l3198
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this
inspections. 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 Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority.
INSPECTION SUMMARY:
Check A, B,C,or D:
A] SYSTEM PASSES:
x I have not found any information which indicates that the system violates any of the failure criteria
defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below.
COMMENTS:
B] SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced or repaired. The system,upon completion
of the replacement or repair,passes inspection.
Indicate yes,no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If "not determined",explain why not.
The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of
CoThpliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or
the septic tank,whether or not Instal, Is cracked, structurally unsound, shows substantial Infiltration or exfiltration, or tank
failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank
as approved by the Board of Health.
(revised 007W)
One Winter Street 9 Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property AddreSS: 27 KITSY LANE NYMNIS MAP 25I L 56
Owner: JUDY DIYE80
Date of Inspection:11123/98
_ Sewage backup or.breakout or hiah.static water level observed.in.the distribution box is due to a broken.
or obstructed pipe(s)or due to broken,settled or uneven distribution box.The system will pass inspection if
(with approval of the Board of Health). Describe observations:
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
_The system required pumping more than four 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
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 the public health,safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS
NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND
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 APPROPRIATE) DETERMINES .
THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
— The system has a septic tank and soil absorption system and is within 100 feet to a
surface of water supply or tributary to a surface water supply.
— The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupply well.
The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well.
— The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well, unless a well water analysis 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. Method usedto determine distance (approximation not valid)
3)Other
D] SYSTEM FAILS:
You must indicate either"Yes"or"No"as to each of the following:
I have determined that the system violates one or more of the following failure criteria as defined in
310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be
contacted to determine what will be necessary to correct the failure.
Yes No
Backup of sewage in facility or system component due to an overloaded or clogged SAS or
cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an ovei loaded ur cluyyed
cesspool.
SAS is in hydraulic failure.
(revised 04117)9T)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 27 KITSY LANE HYANNIS MAP 251 L 5B
Owner: JUDYDIYE80
Date of Inspection:11123198
D]SYSTEM FAILS(continued)
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 1/2 day flow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Numbers of times pumped
Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
Any portion of a 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria,volatile organic,compounds,ammonia nitrogen and nitrate nitrogen.
E] LARGE SYSTEM FAILS:
You must indicate either"Yes"or"No"as to each of the following:
The following criteria apply to large systems in addition to the criteria:
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to
public health and safety and the environment because one or more of the following conditions exist:
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)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00.. Please consult the local regional office of the Department for further information.
(revlaed 04127)87)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECLIST
Property Address: 27 KITSY LANE HYANNIS MAP 259 L 5B
Owner: JUDY DIYESO
Date of Inspection:11123198
Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following:
,c_ — Pumping information was requested of the owner,occupant,and Board of Health.
x None of the system components have been pumped for at least two weeks and the and the system has been receiving normal
— flow rates during that period. Large volumes of water have not been Introduced Into the system recently or as part of this
inspection.
x As built plans have been obtained and examined. Note if they are not available with N/A.
x — The facility or dwelling was inspected for signs of sewage back-up.
x _ The system does not receive non-sanitary or industrial waste flow.
-x— — The site was inspected for signs of breakout.
x All system components, excluding the Soil Absorption System, have been located on the site.
x The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected
for condition of baffles or tees, material of construction,dimensions,depth of liquid,depth of sludge, depth of scum.
x _ The size and location of the Soil Absorption System on the site has been determined based on
The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of
Sub-Surface Disposal Systens.
x Existing information. Ex. Plan at B.O.H.
x Determined in the field(if any failure criteria related to Part C is at issue, approximation of distance is
unacceptable)[15.302(3)(b))
(revised 04J27MI)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 27 KITSY LANE HYANNIS MAP 251 L 55
Owner: JUDY DIYESO
Date of Inspection:11123199
FLOW CONDITIONS
RESIDENTIAL:
Design flow: "0 g•p•d./bedroom for S.A.S.
Number of bedrooms: 4
Number of current residents: i
Garbage grinder(yes or no): No
Laundry connected to system(yes or no): Yes
Seasonal use(yes or no): No
Water meter readings,if a'v ilable:(last two(2)year usage(gpd):
nfa
Sump Pump(yes or no): No
Last date of occupancy: n1a
COMMERCIAL/INDUSTRIAL:
Type of establishment: n1a
Design flow:U gallons/day
Grease trap present: (yes or no) No
Industrial Waste Holding Tank present:(yes or no) No
Non-sanitary waste discharged to the Title 5 system:(yes or no) No
Water meter readings,if available: n1a
Last date of occupancy: nfa
OTHER:(Describe) nfa
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
nla
System pumped as part of inspection:(yes or no)No
If yes,volume pumped:S gallons
Reason for pumping: rda
TYPE OF SYSTEM
x Septic tank/distribution box/soil absorptions system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no) ( if yes,attach previous inspection records,if any)
I/A Technology etc.Copy of up to date contract?
Other:
APPROXIMATE AGE of all components,date Installed(if known)and source Information:
THE SYSTEM IB 26 YEARS OLD,
Sewage odors detected when arriving at the site:(yes or no) No
(revised 00097)
v
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 27 KITSY LANE HYANNIS MAP 251 L 56
Owner: JUDY DIYESO
Date of Inspection:11123199
SEPTIC TANK: x
(locate on site plan)
Depth below grade: V
Material of construction:x concreate metal FRP Polyethylene—other(explain)
If tank is metal, list age rve . Is age confirmed by Certificate of Compliance No (Yes/No)
Dimensions: Le•5"H5'7"W4'10"
Sludge depth:5"
Distance from top of sludge to bottom of outlet tee or baffle:28"
Scum thickness:u
Distance from top of scum to top of outlet tee or baffle:2'
Distance form bottom of scum to bottom of outlet tee or baffle:0
How dimensions were determined: MEASURED
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,
evidence of leakage, etc.)
SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING NOW AND THEN MAINTAINED EVERY Two YEARS.
GREASE TRAP:_
(locate on site plan)
Depth below grade: rda
Material of construction: concrete metal FRP Polyethylene_other(explain)
Dimensions: rya
Scum thickness:rda
Distance from top of scum to top of outlet tee or baffle:rda
Distance from bottom of scum to bottom of outlet tee or baffle: rUa
Date of last pumping;1.
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,
evidence of leakage, etc.)
Na
BUILDING SEWER:
(Locate on site plan)
Depth below grade: 2'6^
Material of construction: cast iron 40 PVC_other(explain)
Distance from private water supply well or suction line:TOWN
Diameter: nla
Qmments: (conditions of joints,venting,evidence of leakage,etc.)
(revised 04127)81)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 27 KITSY LANE NYANNIS MAP 251 L 56
Owner: JUDY DIYESO
Date of Inspection:11123199
TIGHT OR HOLDING TANK:
(locate on site plan)
Depth below grade: rda
Material of construction:_concrete_metal_FRP_Polyethylene—other(explain)
Dimensions: Na
Capacity: We gallons
Design flow: rda allons/day
Alarm level:_nfa Alarm in working order?_Yes_No
Date of previous pumping:
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
rda
DISTRIBUTION BOX:
(locate on site plan)
Depth of liquid level above outlet invert: nla
Comments:
(note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box etc.)
roe
PUMP CHAMBER:
(locate on site plan)
Pumps in working order:(yes or no)No
Alarms in working order(yes or no)_Yes
Comments:
(note condition of pump chamber,condition of pumps and appurtenances, etc.)
rda
I
(revised 04127197)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Addres5: 27 KITSY LANE HYANNIS MAP 251 L 55
Owner: JUDYDIYE60
Date of Inspection:11123199
SOIL ABSORPTION SYSTEM (SAS):x
(locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods)
If not determined to be present,explain:
rda
Type:
leaching pits,number: 10DO GALLON LEACH Prr
leaching chambers, number:nla
leaching galleries,number: nla
leaching trenches,number,length: rda
leaching fields,number,dimensions:rda
overflow cesspool,number:nra
Alternate system: rJa Name of Technology._nra
Comments: (note condition of soil,signs of hydraulic.failure,level of ponding,condition of vegetation, etc.)
THE LEACH PIT IS STRUCTURALL SOUND AND FUNTIONING PROPERLY.THE PR HAD 4'OF WATER IN IT.PIT HAS NOT HAD MORE THAN 4'OF WATER IN IT.
CESSPOOLS:_
(locate on site plan)
Number and configuration: nra
Depth-top of liquid to inlet invert: nla
Depth of solids layer: nia
Depth of scum layer: rda
Dimensions of cesspool: nla
Materials of construction: nra
Indication of groundwater: ^ra
inflow(cesspool must be pumped as part of inspection)
rda
Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.)
rds
PRIVY:_
(locate on site plan)
Materials of construction: rda Dimensions: rya
Depth of solids: rya
Comments: (note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation,etc.)
rda
{
(revlaed O4rl7187)
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
27 KITSY LANE HYANNIS MAP 251 L 50
JUDY DIYESO
11123/99
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references, landmarks or benchmarks
locate all wells within 100'(Locate where public water supply comes into house)
I
n
Deck
oA
o (�
r
AA /�V
A9 0 o C
V�fi4
(revised0Al2T197) Page ! of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
27 KITSY LANE HYANNIS MAP 251 L 55
JUDY DIYESO
11123199
Depth of groundwater 12•
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from design plans on record.
Observation of Site(Abutting property,observation hole, basement sump etc.)
Determine it from local conditions
Check with local Board of Health
Check FEMA Maps
Check pumping records
Check local excavators, installers
x Use USGS Data
Describe in your own words how you established the High Groundwater Elevation.(MUST be completed)
USGS MAPS AND CHARTS
ti
(rev1eed04W197) 1Ngol IQ all 34
` LEGEND �L, SITE KITSY LN.
n
L_L i I PROPOSED CONTOUR o z
PROPOSED SPOT GRADE.
— 98 —— EXISTING CONTOUR o W
Vl LC
0 ,
+ 96.52 EXISTING SPOT GRADE
W_WATER
_ EXISTING WATER SERVICE
GATE
_ — ——S F O G E TEST PIT 9
_
`�'. I �� `�- LOCUS MAP N.T.S.
GENERAL NOTES:
\ 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
BOARD OF HEALTH AND THE DESIGN ENGINEER.
r I I \ 1 _ I' 1ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
L (�� j OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
I I LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW:
j C ^ _ � I 2 c c . I - 310 CMR 15.405 (1) (B):
1) A 0.76 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING TO BE
C WE' I
I_ 3.76 FT BELOW GRADE VS REQ'D 3 FT. (H20/VENT PROVIDED)
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
it I` / / 1 DESIGN ENGINEER.
I j T o OF- j; / l / 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
EL - f I 1 D(;! / I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
j L ---`� - ti 9.r;9 i �'; / I ENGINEER BEFORE CONSTRUCTION CONTINUES.
I 1 / / j 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
1 ------- I / 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
J I L6 - - - / / �� 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED
i / TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.
9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
EXlStl/1 g 11,OOC'g THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
Septic Tank / / �` CONSTRUCTION.
10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND FILLED.
°°D Pad 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY
AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
13. NO PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING
14. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPEC. OTHERWISE)
15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW
T1^ __ FOR THE USE OF A GARBAGE GRINDER
�i l i 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING
_ l I 1.7. PROPERTY IS IN ZONE II.
i _.._ , _ 1/ 18. CONTRACTOR MUST VERIFY WITH THE SUPPLIER THAT PRODUCT
BEN T I ( 1A�
SPECIFIED IS CERTIFIED FOR H2O LOADING PRIOR TO INSTALLATION.
PAINT SPOT ON
G'ULKHEL,,G CORF•1E.R
ELE';,�;-nJi'.I — . 1 ? OF
- _i- ' PROPOSED SEPTIC SYSTEM UPGRADE PLAN
GARNSTABLE oATU FBI �y� Exis tin Leach Pit -
DME M. �� -(Note 10) ' � �'� � - 27 KITSY LANE, HYANNIS, MA
No. 1140 "' # MAP.•251 Prepared for: Blue Water Septic
SURVEY REFERENCE: r LOT.' 185. Engineering by: Surveying by: SCALE DRAWN
LCA#772207 OARRENM.MEYER,R.S. zoo-Teeb Abrimnmente! 1"=20' DMM
PLAN OF LAND BY THOMAS K. KELLEY, PLS NITA��p� I PO BOX981
DATED: APRIL 10, 1970 EAST SANDWICH,MA02537 (508) 364-0894 DATE: CHECKED SHEET NO.
' 508-3s2-2s22 10/13/09 DMM 1 of 2
}. Rev, ij/y/oq.. mv/Se teach,119
,
NOTE, TO PREVENT BREAKOUT, THE PROPOSED
NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS It FINISH GRADE SHALL NOT BE < EL:65.74
FOR A DISTANCE OF 15' AROUND THE
PERIMETER OF THE S.A.S.
SEPTIC TANK PROPOSED D-80X PROPOSED SAS
T.O.F. EL.=69.69 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER 6F MgS,p
OUTLET
AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3' OF F.G. VENT $ DAIR E M.9�yGn
1/-F.G. F.G, EL.=69.Ot F.G. EL: 69.5t F.G. EL: 69.50t " No. 1140
L 10'"t 9" MIN COVER/ ! L a 40' L = 15'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) I�E �
® Sm1X (MIN.) 36" MAX COVER : ® g®196 (MIN.) 5�1% (MIN.) 1
4"scH4o PVC 4"SCH40 PVC 4"SCH40 PVC I N I MO.
10' 6 11.3" TO (� L4 IC
14'
INV.= 68.23 48" uoulD INVERT
tEVFc INV.=67.98
GAS BAFFLE PRIED INV,=65.80 4 ROWS OF 5 UNITS!AT 6.25'/UNIT + 0.75' WEDGE 32.0'/ROW
DB-5 10) INV.= 65.35
INV.=66.00 - - SOIL ABSORPTION SYSTEM (PROFILE)
EXISTING 1.000 GALLON SEPTIC TANK i
RESTORE VEGETATIVE COVER
EXISTING SEWER OUTLET
• 6ACKFILL WITH CLEAN PERC SANG 75"
TO TOP OF CHAMBERS
NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING r,•• :. ;. . .. •: .
PIPE INVERTS PRIOR TO CONSTRUCTION
BREAKOUT=TOP ELEV.=65.74
2) D-BOX SHALL BE SET LEVEL AND TRUE TO
'`. :;'., .;•..;..:. ...:. .: :..`;:f.'...;;...;,.•..
GRADE ON A MECHANICALL COMPACTED SIX INV. ELEV.= 65.35 ,
INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.= 64.82 EXISTING SUITABLE
310 CMR 15.221(2) 2.83' MATERIAL _
3) REPLACE EXISTING 1,000 GALLON SEPTIC 5' MIN. ABOVE BOTTOM OF li 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 LESS THAN 1,000G IN CAPACITY. (6.14 PROVIDED) USE 4 ROWS OF 5-HIGH CAPACITY PROFILE
4) INSTALL INLET & OUTLET TEES AS REQUIRED BOTTOM OF TESTHOLE EL.=58.68 -_ AOS BIODIFFUSER 160OBD UNITS-NO STONE
W/ CONTOURED WEDGE
SEPTIC SYSTEM PROFILE TYPICAL SECTION �-
16"
N.T.S. HAS 11
DESIGN CRITERIA SOIL LOG . P#: t2714
DATE: SEPTEMBER 28, 2009
NUMBER OF BEDROOMS: 4 BR EXIST. (property is in Zone II) �
34"
SOIL EVALUATOR: DARREN M. MEYER, R.S., CS.E. #1614 SECTION END CAP
SOIL TEXTURAL CLASS: CLASS I WITNESS: DAVE STANTON, BARNS B.O.H.
DESIGN PERCOLATION RATE: <2 MIN/IN Elev. TP-1 D Elegy. TP-2 Depth 16 " HIGH CAPACITY (H-20) BIODIFFUSER UNIT
epth ,
DAILY FLOW: 110 G.P.D./BR 68.68 0" 68.90 A 0"
A DESIGN FLOW: 440 G.P.D. LOAMY SAND LOAMY SANG MODEL 16" HICAP '
GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 67.93 e 9 68.23 9 8"1OYR 3/2 10YR 3/2 LENGTH 76" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT
"_
PROPOSED SEPTIC TANK: USE EXISTING 1,000 GALLON CAPACITY TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY
EFFECTIVE LENGTH 75'
'
SANDY LOAM f SANDY LOAM DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE.
LEACHING AREA REQUIRED: (440) = 594.59 S.F. IOYR 5/8 l IOYR 5/8 SIDE. WALL HEIGHT 11.2"
74 66.01 C1 32" ' 66.15 C1 33" OVERALL HEIGHT 16"
DISTRIBUTION BOX: 5 OUTLETS (MINIMUM) SANDY LOAM 40" ' SANDY LOAM OVERALL WIDTH 13. "CF =is
a HI LIARD, OHIO 43026
PRIMARY S.A.S. 65.35 LVD
10YR 6/8 10YR 6/8
65.65 39" CAPACITY
USE 4 ROWS OF 5 - 1 " ADS BIODIFFUSER 160OBD UNITS-(H20 LOADING) c2LIA
c2 (101.7 GAL) ADVANCED oRaNACE srsTEMs, INC.
NO STONE AND EXTENDED 0.75 FT WITH CONTOURED WEDGE, MEDIUM SAND MEDIUM SANG
2.5Y6/6 Lef4 PERC 063.93 2.5Y6/6 PROPOSED SEPTIC SYSTEM/SITE PLAN
BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.70 SF/LF OF BIODUFUSER)
(BIODIFFUSERS) 20 UNITS x 6.25 LF x 4.70 SF/LF = 587.50 SF 58.68 120"� 58.90 120" 27 K ITSY LANE, HYAN N I S, MA
(BIODIFFUSERS) 4 UNITS x 0.75 LF x 4.70 SF/LF = 14.1 SF PERC RATE <2 MIN/IN. ("C" HORIZON) Prepared for: Blue Water Septic
DESIGN FLOW PROVIDED: 0.74GPD/SF(601.6 SF) = 445.18 GPD > 440 GPD req'd NO GROUNDWATER OBSERVED Engineering by: Surveying by: SCALE DRAWN
DARRENM.MEYER,R.S. Eco-Tech FAvirommentel. NTS D.M,M.
" I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 pO BOX 981 (508) 364-0894 DATE: CHECKED
to conduct soil evaluations and that the above analysis hog been performed by me consistent with the EAST SANDWICH,W 02537 F2o
requirements of 310 CMR 15.017. 1 further certify that`I have passed the Soil Evol. Exam in October, 1999. 1 O 13 09
508-362-2922 / / D.M.M.
Rev. Tl tilo 9 : revile 7��c h q