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HomeMy WebLinkAbout0289 MEGAN ROAD - Health as Megan Road Hyannis 5 A= 291 —251 , r� Commonwealth of Massachusetts .291-ate/ r� Title 5 Official Inspection Form f Subsurface Sewage Disposal System Form -Not for,Voluntary,Assessments 289 Megan Rd "- Property Address Dennis Ladino Owner Owner's Name information is X' required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection" flu till Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information sl# /3;/67— 1., Inspector: , Shawn Mcelroy T Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 Cityrrown State Zip Code 1-508-495-0905 S 13971 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 r r ❑ Needs Further Eval by the Local Approving Authority 8-3-18 spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 ) 0 �� Commonwealth of Massachusetts a ,w Title 5 Official Inspection-form rt Subsurface Sewage Disposal System form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. B) System Conditionally Passes: ❑ One or more system components as described in the "Co nditionalPass' section need to be t replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y . • ❑N ❑ ,ND (Explain below): t t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Oisposaf System•Page 2 of 17 Commonwealth of Massachusetts 1� Title 5 Official Inspection Form hi Subsurface Sewage Disposal System Form -Not for-Voluntary Assessments � 9 p y rY 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 .8-3-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or'high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are•replaced ❑ Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y [:IN ' ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑Y ❑ N `❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. ` 1 System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins.doc-rev.6116 Title 5 Official Inspecton Form:Subsurface Sewage Disposal System•Page 3 of 17 r Commonwealth of Massachusetts y ,w Title 5 Official, Inspection Form c�P Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection B. Certification (cost.) _ 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: f ❑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. f ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged'SAS or cesspool 0 ® 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 r or clogged SAS or'cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts fi Title 5 Official Inspection forin ! I-Q Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is Hyannis MA 02601 8-3-18 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: El ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑r ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ : ® , Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool:or privy is within 50 feet of a private water supply well. ❑ . ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water.analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ` ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to#15,000 gpd. For large systems, you must indicate either"yes' or"no"to each of the following, in addition to the questions in Section.D. , Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ' 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. t5ins.doc•rev.6/16 1 _ Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 c Commonwealth of Massachusetts - Title 5 Official Inspection Form x Subsurface Sewage Disposal System Form -Not for Voluntary Assessments !lr;. 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 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 f ® ❑ ' 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'inspectedifor signs of break out? ® ❑ Were all system components-, excluding the SAS, located on site? F ® ❑ 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? ,`z _ ❑ Wasthe 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. t . ® >- ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: r Number of bedrooms (design): 2 f Number of bedrooms (actual): 2 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 1 9 t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection , D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 8-2018 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR-15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ; t ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 c Commonwealth of Massachusetts ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments visr. 289 Megan Rd J Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) f Last date of occupancy/use: Date Other(describe below): General Information - Pumping Records: Source of information: Owner--pumped 6-2018 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: f gallons How was quantity pumped determined? Reason for pumping: Maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 f Commonwealth of Massachusetts , r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) ' Approximate age of all components, date installed (if known) and source:of.information: Tank 1970's with leach field in 2009 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: ' 24"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: 18"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 w Sludge depth:, + 12" t5ins.doc•rev.6116 _ Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts r� Title 5 Official Inspection Form rl Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 20' Scum thickness 0 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Tape 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 baffles installed and no sign of leakage. Zabel filter in outlet. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness , Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 c Commonwealth of Massachusetts . Title 5 Official Inspection .-Form I� w., �r1t Subsurface Sewage Disposal System Form -Not for Vol untary,Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.). Tight or Holding Tank (tank must be pumped at time of i nspectio n)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract,(required). Is copy attached? ❑ Yes ❑ No t5ins.doc•rev.6/16 a Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts r� Title 5 Official Inspection Form I� w_ I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . . Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Good condition with water at working level and no sign of back-up from field. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts 3 Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �.•-,• .:,, 289 Megan Rd _T Property Address Dennis Ladino Owner Owner's Name information is Hyannis MA 02601 8-3-18 required for every y . page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 8-infiltrators ❑ 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.): Field in good working order with no sign of back-up into d-box or surrounding stone. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc•rev.6116 - .. Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form w:• i�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments rr.T,, .>" 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is Hyannis MA 02601 8-3-18 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): f t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form h1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 11 i JS SJ l 1 1' f' w ~ J 1. r I .r t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts y Title 5 Official Inspection Form I'll Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is Hyannis MA 02601 8-3-18 required for every H y � 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: 12 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: - Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Fora C�4 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 289 Megan Rd Property Address Dennis Ladino Owner Owner's Name information is required for every Hyannis MA 02601 8-3-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 towCll�13AtS ABLE ocAorr 'vt.-, sEwAc # � �� �s AsVILL AME sssa �s r , �rasTn'si torn rco. T. ACAMOUCOLTI'Y'_(t7+ ) ND t�F3SlAo ON'S PBRMgT�DA'� :; cCPI►��C..IA,�TGE 1D�R'Tilr ,:.....:r.' . Sauruts`ua Dina Bs�uesn ice; Maximum;�d�us !Grou aciw�ter Tkjl .td�66 B61tarn ofWOW t4y �e 1�1 �'9�1'pt��:;ugly W��t a�►d l[:t�cdin�i�acdicy'�€f ms�Y s��ls adst an sate.ce*itlusn 21D 156t 6f iaaci~id fst�ill ).. Bsii:c���►1et9�nd snd 1leac�ttn Pacall�yt joy'wends east doe. ij&jl$ 300&dt f eat�s4ns�'uctllt�r W � 1- / O W � 0 TOWN OF BARNSTABLE LOCATION Me6a_ri fed SEWAGE# 200'1 z -VILLAGE A+(U 6 pt i S ASSESSOR'S MAP&PARCEL 491- ®?S-/ INSTALLER'S NAME&PHONE NO. do L h}' S1 Z gr- qq PTj SEPTIC TANK CAPACITY 1000 f I U IF%iS1 LEACHING FACILITY:(type) gyp J3 (size) (e0 3 K 2 0 NO.OF BEDROOMS o'1 OWNER PERMIT DATE: "2.001 COMPLIANCE DATE: 40 Z t 20 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 47'S Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) p ` Feet FURNISHED BYE^,U. ! G� 't—LL 1 A ft3 %a w o 44 �s:v 83 e�to.o No. O O I _.l t, ti, i Fee ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppYicatiou for �Digonl �&pztem Cow5tructiou permit Application for a Permit to Construct( ) Repair 61)/Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. M e5 Avi f&^j Owner's Name,Address,and Tel.No. L14- 140 04-.,K:� Assessor's Map/Parcel 2 C Z.S/ Installer's Name,Address,Address,and Tel.No.Cet,o&-)i 6tt QZ kJ' n fC� Designer's Name,Address and Tel.No. �� �/ N1i0 qOL� �D �i�� 7631 d�- ZZ 0319 ram•,�� rc ✓ 5, 3 . w►o.��,a .,.� Type of Building: Dwelling No.of Bedrooms ! Lot Size 1 2,3 ! sq. ft. Garbage Grinder ( ) Other Type of Building r No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ZZO gpd Design flow provided 230. 9 gpd Plan Date b- $-2005 Number of sheets I Revision Date Title $ 019AVL" Size of Septic Tank loon ey-;I ti Type of S.A.S. Description of Soil ✓-I'�1 r 3 a" Nature of Repairs or Alterations(Answer when applicable) C;4 b 1 k-� <,r ohL 1✓-%M L,_ t� 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. r� Signed Date G Application Approved by �' �� Date 10- Application Disapproved by: Date for the following reasons Permit No. 0 01 ^ Date Issued r'2G `y 07 441 No. Fee (" V THE CO " MONWEALTH OF MASSACHUSETTS Entered in computer:T PUBLIC HEALTH DIVISION' - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppricatiou for Di!6po!9ai *p!9tem Cowaruction Permit Application for a Permit to Construct( ) Repair(�Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Z'�C( rY1 e-5 A- 2 (� Owner's Name,Address,and Tel.No. t,a j, 4 J Assessor's Map/Parcel Installer's Name,Address,and Tel.No.Cy�i)fw•U(r 62;kr(l, ps Designer's Name,Address and Tel.No. 1 i z�' �h z, f� 3✓t-✓+ ) 2 3 Type of Building. Dwelling No.of Bedrooms l/ Lot Size ��`�L 3 sq. ft. Garbage Grinder ( ) 111 Other Type of Building 5,h i Y ✓� �1 No.of Persons Showers( ) Cafeteria( ) Other Fixtures.. Design Flow(min.required) —gpd Design flow provided Z 3 0 . 9 gpd Plan Date (p- r6 - a o C, Number of sheets I Revision Date v < Title Z`G`/ (V1.0_a y,n� - Size of Septic Tank I iDOJ �J�<<� , ti Type of S.A.S. f S j/{� r Description of SoilQ t Nature of Repairs or Alterations Answer when applicable) �'' - ,, n P ( ( \ PP ) �'� ` 1 t-' L �..� r�I ,L 1 ✓-I-t� �.. t a /� 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 ti i Compliance has been issued by this Board of Health. Signed Date 4 Application Approved by �' .S Date Application Disapproved by: Date for the following reasons Permit No. 02 0 o0l /01 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (1/ ) Upgraded ( ) Abandoned( )by lam,! Q �'.c.Q_.2 \�� LL L at %� W�(nl\, �1 /�-�n vt: , has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. °2 00 1 — /1�-- dated '1 r 0 I Installer yh, ,`,�.o C y) �U 0401.) LL( Designer #bedrooms Z Approved design •09 gpd The issuance oft is pe 1 sh 1 not be construed as a guarantee that the system All fun tiJon as designed. Date {Q� Inspector y ------------------------------- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS 1=igpogal *pgtem Covaruction permit Permission is hereby granted to Construct ( ) Repair (Y-) Upgrade ( ) Abandon ( ) System located at 7 pCl A%hQ ys, , (Leck-J Lacn Ain,,,,,, 1 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 must be completed within three years of the date of this per it. P Date j 2. Approved by 30M , TRANS. NO.: CITY/TOWN: Hyannis APPLICANT: Capewide Enterprises ADDRESS: 289 Megan Road, Hyannis, MA DESIGN FLOW: 220 gpd REVIEWED BY: DATE: N/A OK NO Legal boundaries denoted [310 CMR 15.220(4)(a)] X Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] X Locus Provided [310 CMR 15.2204(t)] X 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)] X System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] X Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)] X Location all buildings existing and proposed 310 CMR 15.220(4)(c)] X Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] X System Calculations [310 CMR 15.220(4)(0] X daily flow X septic tank capacity(required and provided) X soil absorption system(required and provided) X whether system designed for garbage grinder X North arrow [310 CMR 15.220(4)(g)] X Existing and proposed contours [310 CMR 15.220(4)(g)] X Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)(h)] X Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] X Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] X Percolation test results match loading rare? [310 CMR 15.242] X Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] X Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] X Address 289 Megan Road, Hyannis,MA Sheet 1 of 7 N/A OK NO Location of every water supply,public and private, [310 CMR 15.220(4)(k)] X within 400 feet of the proposed system location in the case of surface water supplies and gravel packed pub I lic water supply X within 250 feet of the proposed system location in the case X within 150 feet of the proposed system location in the case of private water supply wells X 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)] X Water lines and other subsurface utilities located [310 CMR 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) X Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] X Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2)] X 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 confirm adequate groundwater separation? [310 CMR 15.103(3)] X Benchmark within 50-75' of system [310 CMR 15.220(4)(q)] X 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 289 Megan Road,Hyannis,MA Sheet 2 of 7 F�PTTCTANJ ��„ , yNO N/A OK NO Size OK? [310 CMR 15.223(1)] X Inlet tee located ten inches below flow line [310 CMR 15.227(6)] X Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] X Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] X 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)] X Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 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)] X Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] X Access to within 6 " of grade - one port for systems<1 000gpd, two for systems>1000 gpd [310 CMR. 15.228(2)] X All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] X > 10 ft from building foundation [310 CMR 15.211(1)] X Buoyancy calculation Required/Done [310 CMR 15.221(8)] X H-20 Where appropriate? [310 CMR 15.226(3)] X Setbacks from resources [310 CMR 15.211] X MR t Campar Required when other than single-family dwelling or flow>1000 gpd [310 CMR 15.223(1)(b)] X First compartment 200%daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and (3)] X "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] X Address 289 Megan Road,Hyannis,MA Sheet 3 of 7 N/A OK NO B t FING�SE�VER" AND ®I`HER I' P,�l ,F ...la ....� Fir tea,_ u, ei, ,,,... ✓.z ,. .. ,. .n.+.. . < .n:. Located at least ten 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)[1]) X Cleanouts required/provided ? [310 CMR 15.222(8)] X Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] X Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] X Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] X Siphon problem/ (leachfield below pump chamber) X Endca s or vent manifoldspecified? 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)] X Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) X �DSTRI�BU TION BOA " .r Stable compacted base [310 CMR 15.221(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)(f)] X Inside minimum dimension 12" [310 CMR 15.232(2)(b)] X Minimum sum 6" [310 CMR15.232(3)(e)] X Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] X Capacity(emergency storage above working=design flow)? [310 CMR 231(2)] X Proper setbacks [310 CMR 15.211 (same as septic tanks)] X Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE [310 CMR 15.231(5)] X Service components accessible (not too deep with piping, disconnects accessible) X Alarm floats - alarm on circuit separate from pumps specified? X Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and (8)] X Stable Compacted Base [310 CMR 15.221(2)] X Buoyancy calculations needed ?Provided? [310 CMR 15.221(8)] X Address 289 Megan Road,Hyannis,MA Sheet 4 of 7 f N/A OK NO SOILBS�02PZ/Y® SYST' (SAS GE11rAL ' f� Calculations correct? X 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(1)] X Required separation to groundwater? [310 CMR 15.212)] X Aggregatespecified as double washed [310 CMR 15.247(2)] X System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.241] X Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] X Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] X GALLERIES-PUTS°CH IBSO 31O C 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 to grade) [310 CMR 15.253(2)] X Aggregate 1'minimum- 4'maximum. [310 CMR 15.253(1)(b)] X 2' sidewall credit maximum [310 CMR 15.253(1)(a)] X In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] X VTR+ THEE 310LYIR PF-, Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] X 100 feet- maximum length [310 CMR 15.251(1)(a)] X Minimum separation 2x effective depth or width whichever greater(3x if reserve between trenches) [310 CMR 251(1)(d)] X Situated along contours [310 CMR 15.251(2)] X Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] X AED SAS�(11Maximum�s�zeof� d or field 50050gpd '_ ., ,, •vn �.. ,,,., . ._ �or �.,,.... __ .. � v. , .. . minimum 2 distribution lines [310 CMR 15.252(2)(a)] X Maximum separation between lines 6' [310 CM R15.252(2)(d)] X Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] X Aggregate depth below discharge pipes 6" minimum, 12" maximum. [310 CMR 15.252(2)(g)] X Separation between beds 10' minimum. [310 CMR 15.252(2)(f)] X Bottom area used in calculations only [310 CMR 15.252(2)(i)] X Address 289 Megan Road,Hyannis,MA Sheet 5 of 7 N/A OK NO Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] X Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] X 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 (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] X Construction in fill - Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? X Impervious barrier and/or retaining wall ? [Guidance Document] X Impervious barrier installation must be supervised by designer [310 CMR 15.255(2)(b)] X Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] X Side slope not exceed 3:1 ? [310 CMR 15.255(2)] X Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] X At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] X �Gravelless, s`ystem�j �A�provalL ttersJ'�� � � �� � z Check DEP Approval letters for credits and design conditions X If used with pressure dosing do not allow pressure discharge to scour soil interface X , lterntcue,Sep is Sye� ftlA Approva` etlej 2„41, Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? X Is the technology being properly applied and does it meet all DEP Approval Conditions? X Is there a note on the plan regarding the requirement for perpetual maintenance agreement? X Any alarms involved on separate circuits X Did the applicant submit an operation and maintenance manual? X Has applicant submitted a copy of a maintenance X Are the variances listed on the plan? [310 CMR 15.220 (4)( )] X 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 310 CMR 15.414] X Address 289 Megan Road,Hyannis,MA Sheet 6 of 7 , N/A OK NO 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 ? [310 CMR 15.214(2)] X Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] X ltlzsceLl'aneous' � � `` Pum ing to septic tank ? [ 310 CMR 15.229] X Shared System [310 CMR 15.290] X Address 289 Megan Road,Hyannis,MA Sheet 7 of 7 DC3 e I f 1.17 y 467 06-26—'009 I��m 36 BARNSTABLE LAND COURT REGISTRY DEED. RESTRICTION . ,WH.ER4S, t of V1 /l o 4-�-j 3,)�,a 7 of 2$C( 44 (� ersd me) N-1, (address) is the owner of e-C Lvl located (address) at L�P"A VL MA (hereinafter referred to as. ? �`� '�� `,,ASS and being shown on a plan entitled"Subdivision of Land in �4�3 C,n-n i MA, Property of_ et al, duly recorded in Barnstable County Registry 4 of Deeds in Plan Book Page Or on.Land Court Plan Number Lo r 13, Plan �1'1o°i'l 6 (stier�r 3� WHEREAS, nn�, t'. ���� �c _ __as the owner.of said lot has (owners name) r c4 agreed with the Town of.Barnstable Board of Health to.a restriction as to the number of bedrooms which can be included in any home built;on said lot as a pre-condition to obtaining a disposal works construction.perrnt in compliance o�. with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for.Ahe Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as.a pre-condition to granting a disposal works construction permit for a septic system in.complianoe With 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing ahe.issuance of a building permit.for the construction of a single family home on this.property, is requiring that the agreement for the restriction on.the number of bedrooms in any house constructed on*the lot be put on. record with the Barnstable County Registry of Deeds by'recording this.document, deedr : 0 S vS M (,A;D�� NOW, THEREFORE, Dfont 5 f, , --does hereby place the (owner's name) :following restricti0h on his above-referenced land in accordance with his ;agreem t..with.the'town of Barnstable.Board of Health,.which restriction shall run-with e.land•and be binding upon all successors,in title:.. 1. ► M66 (2,oA-A g:: A^ may have constricted 4. (address) upon the lot'a house containing no more than Zwo (z) b'edrooms. ID- h A�5. C L";!I. Q agrees that this shall be permanent deed (owners name) ' . restriction affecting LoT lz •located on ArnsT 1 If. i MA, and being shown on the plan recorded in Plan Book , Paged ., Or on Land Court Plan '27o9q 6 For title of see the following deed: .Book . , :Page Or Land Court Certificate of Title.Number 5:7-2 3 6 u n to ys A n L. - ' .t3oA�olf ox oC To.,a,n of o ss nW \CPe". Execu as a sealed ihstr.um4nt 2L day of 2051,E). C crs signature `'Owner's signature Owner`s:signature - : OMMflNWEALTH OF MASSAGHUS:ETTS ss 2 20 ac�j Then personally OpReared the above,-named d�n6 known to me to be the person who executed the. foreg.oinq instrument and ackhowle.dged the same to be MAT>QVLfree act and'dee•d, :before me; _ bo" aaserr:�l'rrgnrrrrr,,r, . . 0 e �tio� Qreso'Y•% '' Notary j e �Ptbiie wo _ My commission expires: G � ' . �7's ON �e``���`� `date) rsArCrni dndr Town of Karnstame Regulatory Services Thomas F.Geiler, Director ''`"M Public` Health Division Thomas McKean, Director 200 Main Street,Hyannis, MA. 02601 Office: SU8•A62-4644 Fax SOf 7 i(j 63U4 IIng. er & Designer Certification Fnrm Date: 2`I 2.vo i ' Designer; _ ir)Ne.ccr► �16 c_ Installer: 'w4c6N. BhEer ;is Address; _Z a Y Ccanbz'T _tf >nwo Address: sgx Cask Worehaf» HA 62.53 Gr, 2c.JIle, 4��_e�ate) was issued a permit to install a septic system at aft 9 11 a y!n (lovxf based on a de:;ign drawn by (address)` :rG Erg�2 t�ne�CiP1 r`2 dated ""OOc 2,00 J.) .�..�..r....�.., (desig�ntrr);..__:�..----.....,�. .� �.,,_.____.....__._.� _✓__ I certify that the septic system referenced above was installed substantial) 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 is e.. greater than 10' lateral relocation of the SAS or any vertical relocation of any componcm Of the septic system) but in accordance with State & Local Regulations.. Plan revision. or certified as-built by designer to follow. (In a11eT'S Sl .. .-�..�.•"„ CMU f?."� lu tUt"E (Designer's Si esigner�a :amp Here) PLEAS TU ARi�IST pirmy.ye, HE T D J<�I ItTY CA't')E: BUILT F OMPL I I D D • p S_ . S ELM DVSI W, Q Heallh/5eptic/Designer Certification Form i A •"� J Q4GJ 9J 7 7R 91C L1M T?J77M T C1W-Z1 1 J` IJ_J GC 7 cn caa 7_c 7—Al rl r �- Submit by Email HIGH GROUND-WATER LEVEL COMPUTATION Date: June 5, 2009 Site Location: 289 Megan Road, Hyannis, MA 02601 Permit: Owner: Dennis E. & Susan M. Ladino Phone: Contractor: Capewide Enterprises Phone: Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. (depth is in feet below land surface) Date: 6/5/09 11.3 mm yy ee e ow s STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: A) Appropriate index well A1W-230 B) Water-level range zone D STEP 3 Using monthly "Current Water Resources Conditions" determine current depth to water level for index well. 05/27/09 22.42 m m/yy STEP 4 Using Table of Potential Water Level Rise for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment. 2.5 STEP 5 Estimate depth to high water by subtracting the water-level adjustment (STEP 4) from 8.8 measured depth to water level at site (STEP 1). NOTE* Tables 1-9 "Potential Water-Level Rise" are attached as worksheets to this file. monthly index well data: www.capecodcommission.org/wells.html Town of Barnstable P# /2 S�f/ , Department of Regulatory Services Public Health Division Date 200 Main Street,Hyannis MA 02601 / q f Date Scheduled S 6 ( Time 1 6 AM Fee Pd. � +� Soil Suitability Assessment for Se age isposal Performed By: r �a Z' v��� �4 r t y-T G Witnessed By:Sr UP, LOCATION'& GENERAL INFORMATION Location Address A O M 05 n A-d Owner's Name' _ Address Assessor's Map/Parcel: '20 0 ��I Engineer's Name ������ ��-erevf5� 3G 1r A511vtC. NEW CONSTRUCTION REPAIR Telephone# —1 Z Land Use f esI de w Il u I Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line 7-5—30 ft. Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) 25 i5 SHED 0 341, 4 �.� �ta�EU-t N fr ttt r Q 5 Kf9an R64 Parent material(geologic) Depth to Bedrock > 13 6 Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face A&� Estimated Seasonal High Groundwater few, 134 --1AoIS1 � 134 n 5 (rdV () c,c,5u��ecl= �V(oa �DgS DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: 'atCeck d<oserv-Aca/ [C C OVA .ad { Depth Observed standing in obs.hole: 21 In. Depth to Soil mottles: N0V" in. Depth to weeping from side of obs.hole: 7 l 3 6 in. Groundwater Adjustment z•5 ft. Index Well# pli✓-230 Reading Date: 5-21-01 Index Well level 22.Y 2 Adj.fhetor L, Adj.Groundwater Level, 10,o PERCOLATION TESL' bete ►'line L©'ca hid Observation Hole# Time at 9" Depth of Pere Time at 6" Start Pre-soak Time @ al __ 'lime(9"-6") --- End Pre-soak R ate MinAnch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Al Original: Public Health Division Observation Hole Data To Be Completed on Back----------- i i ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division afaeast one(1)week prior to beginning. Q:\SEPTIMERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, rave 9- 3a /6yk 7 -13 S-V61q i 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) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. el DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Cons e Flood Insurance Rate Man: Above 500 year flood boundary No.— Yes . Within 500 year boundary No V Yes Within 100 year flood boundary No Yes Death of Naturally Occurrinz Pervious Material Does at.least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? , Certification I certify that on 4 (date)I have passed the soil evaluator examination approved by the Department of Environ !ntal Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature. /�� Jw�° �" Date Q:\SBPTl0PERCFORM.DOC VILLAGE - 1W ST LPLLER 5 IJ&ME AD.DRq JS D®LLAWAt . CONTRACTOR - 4092 QW-9� Rea -- - - - Centerville, Mass. 02632' - -BUILDERS Q &MF- � -ADDRESS - ---- -- - - . - - Db,TE PER"VT ISSUED-DATE COMPLI.hJ A(ZE ISSUE]: .�C ��; V� y� �` C` �, � + I y a ��✓'p I a �' '� H -- u= ��m__����____ / - THE ComMowvvsAcrH OF mAsmAoxusErrs BOARD _^� ��~��`� � ' �= �� w~ / --- ��---�x�F' .�������-------_-- �.~� �� ������l»ra�.mw�» �x�4 ��mo ��xom� V^«rux*o Tonarur4�on Prrutit Application is hereby made {br a Permit to Construct (L_^T Repair ( ) an Individual Sewage Disposal System at: 49��5e - ........................ . .. ............... ......... ..... ........................ .............. .. ...... V........ ........................ 0. Dwelling—No. of Bedrooms------^�2_-----------------------Expansion Attic ( ) Garbage Grinder ( ) � Other--Type of Building ............................ No. of persons............................ Showers ( ) -- Cafeteria ( ) � Septic` - Tank—Liquid --p--r�&=Og-' ...,... Trench -,- - Seepage P� No._ _._--_�g t� �� (JthocI�o��mboobox ( ) ' Dosing tank ( ) jLeh ?,4, �~�- ~~ f`ecoolu600 Test ]%csnitu Performed by.......................................................................... Date........................................ Test Pit No. l................minutes per inch 'Depth of Test Pit.................... Depth to grouodnmter----_-----. � Test Pit No. 2 .minutes inch Depth of Test B1 Depth to ground water ~ Description of Soil �� �- ���' �^ ��a�=�w ----'----'--'-----~'----^' ---^*^~~-~--' --°'--~~-'~..^-~-'~~'^°�~`'~~'''��''�~�'~^---'--'---'---- U Nature of Repairs or Alterations—Answer when applicable-------.-.---------------.---.----_---.-----.. -------------------'----'-''---'''-----------------------'-----------------------------'----'------- Agreement - �� �� ��^ THE COMMONWEALTH OF MASSACHUSETTS cv � ^� Applirotmwu» �� y � Vorkfi Tu»mdrudmo*: ramit Application � is 6cz fo r a Permit to [ ( l<r Repairan Individual Sewage Disposal ­4 ....ATZ.� ��".eze . .............. ..................................... Lo ress Installer Address ZY" — 0- Type L/Uilding Size Lot.../ Ao-:C...Sq. feet P-1 Other fixtures Z Other Distribution box \ / ^,vvu*u u"u` ( ) ~~ Percolation Test Results Performed by:._------_.--_-------------------' Date........................................ 1.4 Test Pit No. 1................minutes per ioch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 3................uiontco per juc6 Depth of Test Pit.................... Depth toground water................... __ __ 0 Description of Soil ..... ere -'----'----------------------------------------------------------------------------------------- -------...----_--_--------_._'-_-^.-_'---_---..-.-..-------.--.----.--------------------'--'--. Nature cf Repairs or Alterations—Answer when applicable---.-._--.------.---.--------------------- ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article }[I of the State Sanitary Code--The undersigned further agrees not to place the system in operation oudl u Certificate of Compliance.has 6 � db ,`^_�_`�_ _ - -----'r===~-~-'�r'�-�7----------' --' -����'------ Aonl�ut�m� 8y--------__--.--�_'�-.----------_-----------~---" -------------'-.--- »"te Application Disapproved for the following.reasons:............................................................................................................... Dat Date � THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEAL H 4,0 774' ........ OF.... ........................ puntifurmuur of Tom�plu$turr THIS IS TO CERTIFY, That the Ind vrdua?l�S' at.................................. ... Zt has been installed in accordance with the provisio 7S- 7t4tir-IT XI of The Statd/Sanitary Code as described in the application for Disposal Works Construction Permit ---------_- dated.... ............. THE ISSUANCE OF THUS CERTIFICATE SHALL NOT BE CONSTRUED AS SYSTEM WILL FUNCTION SATISFACTORY. DATE---j-�'~~ �-��'��=�-------------- Inspector. -A~- ...... ' ----------------- � ` THE oowwowvvcAcr* or MAssAc*ussrra | BOARD � � � �� ���~~~�..�� x�__ ' ��'��`—� -- --'��~�^'�°"~�^—' -------� FEE._ ____ ( ) an Individual Sewage DJ al System Street as shown on the appli�ation for Disposal Works Constructi Perm t ....... Dated...2z.2.2L:�.7.1 ............ n,nm /000 xpoa� uwmnnsw. INC., ruaus*snS | 1, -- � Bi' ��• moo" s-v / . ��' � ®7 1 M F ? •, mil I 3 GoT .. Z2 �.r E R T I FIFD PL0 `(" PLAN � ,1 L O C AT 1 O N 7 •` SCALE: � 30' DATE ✓�,cy /o, �� �, R E F E R E N C E: D A T E 1 HEREBY CERTIFY THAT THE SUILDING REG. LAN DI. 5URVEYOR � SH0WN O N. . THI.S PLAN IS LOCATE D O N' i S-? E G`r°�t O U.itlD. AS S HO.WN HER' EO9V:' A ND . T H A T. .1 r. dG C O N .F OR M : T' O T H.,E . t; ZONING 5Y - LAW5 Ot= THE TOWN OF 9.2�c/s7 z?, -. W H E N C O N S T R U C T E D. Gtouc,E � CD � ARNSTAE3LE. SURVEY C0N;S`UL. T'ANTS, 4.N0. �,� r y y ST WEST' YARM0UTH, M ASS . 4 t , r - A-- o'T a� > I z ®7— p. Iz N � � `\ N L- cl /2 t . u ' rCERTI FIE ® PLOT PLAN L 0 C A T e 0 N 4 SCALE: / �30' DATE ✓..L�. /o, /p7s t� R E P £ R E N C E 3 .. , x DATE Qr d HEREBY CERTIFY THAT T .H.E 8 U I L D I N G REG• LAND 5URVEYOR^� SHOWN 0N. THI.5 PLAN IS L; C ATE D ON � yg TkE G ROUND. AS S HO..WN HEREON: AND .-. T �! !a T. .4 T . �4 C 0 N F 0 R M T O T H. E Z O N I N G 8 Y — L A W 5 O F- THE TOWN O F q ti-tLtisi ��:v���r. s 77?,BL -. WHEN CONSTR U C T E cis LOW,•Jk. n f 8A-RN-STA ® LE . :5URVEY- CONSULTANTS, INC . !rJ P ✓`/ r ' ,• E 5 T Y A R eu! O U T 6-4, M A S S . .:j•*�..s Id`�r ,4"R ..A..>-r tyyafaha»smrasamea PROVIDE PRECAST CONCRETE T.O.F. EL.= 45.4'± EXTENSION RISER WITH CONCRETE 4"SCHEDULE 40 PVC MIN. SLOPE 1 % GENERAL NOTES COVER TO WITHIN 6"OF F.G. OVER ox= 41 .8'± FINISHED GRADE OVER DIFFUSERS = 41 .7' - 41 .0' INISH GRADE OVER D-B 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS INLET AND OUTLET COVERS. SLOPE @ 2% MIN. INSPECTION PORT WITH ACCESS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE AND ANY FINISH GRADE REMOVABLE WATER-TIGHT COVER OVER BOX TO WITHIN 3"OF F.G. APPLICABLE LOCAL RULES. @ FND. EL.= 42.0 ± FINISHED GRADE OVER TANK EL. = 42.0+ RISER TO WITHIN 6"OF FINISHED GRADE (ONE PER TRENCH) 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 5"DIA. OUTLET(S) ------ ---------- EXISTING 4" PROPOSED 4" 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PVC SEWER PIPE 9"MIN. SYSTEM UNLESS OTHERWISE NOTED. SEWER PIPE 9"MIN. 36"MAX. TOP OF SAS B.O. 39.13' 4. TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN 3"DROP MAX 36" MAX. 6' 3" 3" 9.. ELEVATION =39.13'FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS 2- DROP MINMIN.SLOPE @ 1% A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 10" PROVIDE WATERTIGHT THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. J JOINTS(TYP.) 14 4" PVC IN FROM P.) 16"TYP 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SEPTIC TANK 4" PVC OUT TO 0.90, (TY10.75"TYP 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. O CONTRACTOR CONTRACTOR SHALLLEACHING FACILITY 1_� 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED PRIOR TO BACK FILLING WHEN SYSTEM IS CA- IN FR OM:J fl 0.7 TYP AN SHALL VERIFY SIZE 48" VERIFY CONDITION I - -6 37.80' (laid flat -2.876(34.5-)_� NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS NOT TO BE BACK FILLED I EXISTING TEES N OF OUTLET TEE 39.07 12" F 38.70' WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. AND CONDITION OF 22"ZABEL FILTER MODEL MIN. 38.90' (TYP.) EXISTING SEPTIC AND REPLACE AS #Al 801-4x22 5.0' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 44.00' ESTABLISH ON A NAIL SET TANK NECESSARY (GAS BAFFLE ON BOTTOM) 6"CRUSHED STONE (TYP.) 5'MIN. 11.50' IN A FENCE AS SHOWN ON PLAN. OVER MECHANICALLY COMPACTED BASE 20.0- (TYP FOR BOTH ROWS) 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT 1-888-DIG-SAFE 5 OUTLET DISTRIBUTION BOX GROUND WATER ELEV = 3267' AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES TO THE DESIGN EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK TO BE INSTALLED ON A LEVEL STABLE . . ENGINEER. BASE. FIRST TWO FEET OF OUTLET BIODIFFUSER (PROFILE) BIODIFFUSER END VIEW 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE STRUCTURES SHALL BE MADE PIPES TO BE LAID LEVEL. WATERTIGHT. *CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR SEPTIC TANK PROFILE CROSS SECTION VIEW *Adjusted GW level based on Cape Cod Commission Technical Bulletin 92-001 (revised 2006) 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TO ANY WORK& NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE DISTRIBUTION BOX DETAIL 8 - ARC 36HC (#3616BD) BiODIFFUSERS REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM NOT TO SCALE NOT TO SCALE APPROPRIATE AUTHORITY. ------ ------ 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED N. PROPERTY IS LOCATED WITHIN A DEP APPROVED ZONE 2. TEST PIT DATA UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING, OR AS INDICATED ON PLAN. CONSTRUCTION NOTES: PERC No. 12581 INSPECTOR: David W. Stanton, R.S. 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. 0 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE • EVALUATOR: Bradley M. Bertolo, E.I.T. 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. # C.S.E. APPROVAL DATE: 7/29/03 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. REPLACE I June 5, 2009 ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, FINES OR OTHER 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE DATE: UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). w. E. LOCATION OF THE PROPOSED LEACHING FACILITY TO ENSURE TEST PIT#: 1 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN SITE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. ZONE 2 ELEV TOP= 41.50' CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. M 17- •REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ELEV WATER 32.67'(see above profile) 16- PROPOSED PROJECT IS LOCATED WITHIN: W ARE NOT CONSISTENT WITH TEST PIT DATA. W PERC RATE <2 min./inch I ASSESSORS MAP 291 PARCEL 251 U) 11� - DEPTH OF PERC= 36"-54" FEMA FLOOD ZONE C ON PANEL# 2500010005 C TEXTURAL CLASS: 1 OWNER OF RECORD: DENNIS E. &SUSAN M. LADINO 0) ff o ADDRESS: 289 MEGAN ROAD 0. 41.50' HYANNIS, MA 02601 z Fill S. 6'A Loamy Sand 41.0' 17. PLAN REFERENCE: L.C. PLAN 27099-B(SHEET 3) b 1 OYR 3/2 i MAP 291 8' 40.83' PARCEL 250 B Loamy Sand 18. DEED REFERENCE: L.C.C. 170262 -)(-K-v 1 OYR 5/6 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. PROPOSED -EXISTING LEACHING PIT TO BE 30" 39.0' MAP 291 Z N81-36-30-W DISTRIBUTION BOX PUMPED, FILLED WITH CLEAN >;c 1 36" 38.5' 20. PROPERTY LINE INFORMATION IS APPROXIMATE ONLY. THIS PLAN IS TO BE USED ONLY FOR COARSE SAND & ABANDONED PARCEL42 144-63- Perc M-C Sand SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY FOR USES OF mIa. , THIS PLAN OTHER THAN ITS INTENDED PUPOSE. NIII, 0, 54" 2.5Y 5/4 37.0' SHED I 20%Gravel C1 Benchmark _44 -44 >< Nail set in Fence It Elev. =44.00' 4 78" 35.0' ` iu MAP 291 �D DRIVE V ESHGWCcD 106"Approx. M.S.L. C) PAVED 106" 32.67' EV 20 (0 0 PARCEL251 IfW K C2 Medium Sand 7 to GO 11,423 S.F.± LP AS S G CHIM LOCUS PLAN 2.5Y 614 GAS 136" Moist at 136" 30.17' J_GAS SCALE: 1"= 1000' PROP. TOTAL 8 ARC DECK No Mottling,Weeping or Standing Encountered 36HC BIODIFFUSERS 15C TP 1 0 #289 C, TEST PIT DATA (4 PER TRENCH) 41.5' 0 0 0 EXISTING ir >- DESIGN DATA X fn 0 N PERC NO. 12581 LEGEND TP 2& 2-BEDROOM m 0 41.5' .91 9V C; 1 1 DWELLING PORCH CO 00 LU INSPECTOR: David W. Stanton, R.S. 13.10. 0 %< a >,< B.H TOF 45.4'± co (D k NUMBER OF BEDROOMS(DESIGN) 2* EVALUATOR: Bradley M. Bertolo, E.I.T. x 50 EXISTING SPOT GRADES X1 HE LU DESIGN FLOW 110 _GAUDAY/BEDROOM f 00-4 C.S.E.APPROVAL DATE: 7/29/03 50 EXISTING CONTOUR PROPOSED INSPECTION PORT WITH -X-x _X_ TOTAL DESIGN FLOW 220 GAUDAY DATE: June 5, 2009 ACCESS BOX TO GRADE (TYP OF 2) X-X- - 40-- 4 DESIGN FLOW X 200 % TEST PIT#: 2 440 GAUDAY 50 PROPOSED SPOT GRADES - 2-- X X-X X PROPOSED CONTOUR _X_ _X uric USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP 41.50' _X_ OJH1W EXISTING OVERHEAD UTILITIES EXISTING 1,000 GALLON _X N81o36,I DEED RESTRICTION TO BE FILED ELEV WATER 32.6T(see above profile) E/T/C EXISTING UNDERGROUND UTILITIES SEPTIC TANK TO BE UTILIZED 40--- 140.97, J.P.#19 PERC RATE = AS PART OF THIS DESIGN INSTALL 8 - 16" HIGH ARC 36HC (#3616BD) BIODIFFUSERS GAS EXISTING GAS LINE LIJ DEPTH OF PERC UJ MAP 291 SYSTEM CAPACITY TEXTURAL CLASS: 1 EXISTING WATER LINE PARCEL 252 0 LL 41.50' on TEST PIT LOCATION LU (TOTAL L.F. OF BIODIFFUSERS)(7.8 SF/LF)(0.74 GPD/SQ.FT.)= GPD p (40.0')(7.8 SF/LF)(0.74 GAUSQ.FT.)= 230.9 GAL. LEACHING/DAY Fill 41.0' �OEXISTING 1000 GALLON SEPTIC TANK 6"A Loamy Sand PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE TOTALS: 8" 1 OYR 3/2 40.83' E3 PROPOSED DISTRIBUTION BOX B Loamy Sand TOTAL NUMBER OF BIODIFFUSERS: 8 1 OYR 516 PROPOSED 16" HIGH ARC 36HC(#3616BD)BIODIFFUSER TOTAL NUMBER OF COUPLINGS: 0 30" 39.0' TOTAL LEACHING AREA: 312.0 SQ.FT. TOTAL LEACHING CAPACITY: 230.9 GAL./DAY M-C Sand REV. DATE BY AP DESCRIPTION C1 2.5Y 514 20% Gravel PROPOSED SEPTIC SYSTEM UPGRADE NOTE: PREPARED FOR: EFFECTIVE LEACHING AREA OF 7.80 SF/LF OBTAINED FROM THE 78" 35.0' CAPEWIDE ENTERPRISES DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER 7 ESHGVV(a) 106" 1 "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO 106" 32.67' LOCATED AT DECK ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003(LAST C2 Medium Sand 2) 0 0 #289 MODIFIED JULY 23, 2008). TRANSMITTAL NUMBER=W000052. 2.5Y 614 289 MEGAN ROAD 0 o EXISTING 136- 1 _V Moist at 136" 30.17' HYANNIS, MA 02601 2-BEDROOM SWING TIE MEASUREMENTS -------- No Moftling,yye!Qinqqr Standing_Encountered ------ 4) DWELLING SCALE: 1"=20' BOARD OF HEALTH USE SCALE: I INCH = 20 FT. DATE: JUNE 5, 2009 B,H TOF =45.4'± 0 10 20 40 80 FEET 3) HL­ DESCRIPTION HC1 HC2 OF %I I I I JOHN L BIODIFFUSER CORNER(1) 40.5' 35.0' CHURCHILL PREPARED BY: JR. JC ENGINEERING, INC. BIODIFFUSER CORNER(2) 53.1' 54.9' No CI 7 2854 CRANBERRY HIGHWAY SITE PLAN BIODIFFUSER CORNER(3) 463 55.6' I EAST WAREHAM, MA 02538 BIODIFFUSER CORNER t4) 30.9� 36.1' 508.273.0377 SCALE: 1"=20' - Drawn By: MCP f Designed By: MCP I Checked By:JLC JOB#: 1624 ..........