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0054 MELBOURNE ROAD - Health
( 54 Melbourne-Road .,r w ( Hyannis P a A = 268 233 i i 0 . r YOU WISH TO-OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1`FL,367 Main Street,Hyannis,-MA 026111 (Town Hall) DATE: 5- 6900 . Fill in please: APOLICANTS YOUR NAME: /7(J /7��/lfZ �!f1t�� BUSINESS YOUR HOME ADDRESS: TELEPHONE # HomeTelep hone Number NAM9.0F NEWBI SIN SS TYPE OF QW.SIIUESS 1; rives A.'mbME OCCUP41. , 1-lave yciu been gnren.oppro al#riai [.the pui di p.dii� ys and YES T N j AD»1 ESS pF QU51N S MAP,/PANCEL,NOMBER Z3 When starting a'new business there are several things you must do in VcleP to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd.&Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFI This individual has n informe 7o any permit requirements that pertain to this type of business. Au orized ignature* Ru COMMENTS: a < u �e 5 14' 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER-AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: I Town of Barnstable oF�f i� Regulatory Services P`' o Thomas F.Geiler,Director sARNSTkBLE, Building Division + � - - v� 9 � Tom Perry,Building Commissioner ArE 200 Main.Street Hyannis,MA yanm , 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Approved: Fee: _3 Permit#: HOME OCCUPATION REGISTRATION Date: O 5 — Name:' P? J P Phone# 0 `c Address: 25^1 �f%� �� �1��� ;C 0 Village: !j 4 A P U I S Name of Business: -r 1 (� Type of Business: GLU i C;-� Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies-no mor-e-than 400-square feet o€space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. 0 Any need for parking generated by.such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. I- • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the. dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. --- ..._._�.. Apphc _ .._ Date: - �'020� Homeoc.doc Rev.5130103 " _ ti' �� 1 � t �� s ,5}z",�� ,� �-� i �1 J a � 4 �, TOWN OF BARNSTABLE r_C �Q0L� �(U�`� LOCATION Y f 1�n10 v 15-A L= SEWAGE VILLAGE Z)& ASSESSOR'S MAP &LOT���� ' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) /45,7t e--,Ps j (size) 4 NO.OF BEDROOMS BUILDER OR OWNER�Z:2 �k 6L:L PERMITDATE:/� —'OL/ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom pfLeaching 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 4n/y wetlands exist within 300 feet of leaching facility) Feet Furnished by �g i •W VA, Lgg _1_l y,. 1 No. goo-/ '��" �"� FeL 5 0 .0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Migool bpetem Construction Permit Application for a Permit to Construct( . )Repair(X)Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 9 5 8—5 4 3 4 A5 KqA�ne. Rd. W. Hyannisport John Merlesena so 268-233 54 Melbourne Rd W Hyannisport . Installer's Name,Address,and Tel.No.7 7 5—8 7 7 6 Designer's Name,Address and Tel.No.3 9 8—8 31 1 Wm E Robinson, Sr. Craig Short PO Box 1089 Centerville, MA PO Box 1044 S. Dennis, MA Type of Building: �(64 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder1�o ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Install Title 5 leach system to plans of Craig Short — #1 -974 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 E ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has b issued by thi ar Heal igned Date 0 Application Approve Date Application Disapproved for the following reasons Permit No. gnoo`1—pa-14Date Issued Q5`a I --- — ----- -- — ------ -- _ ... ..�..ya, v., _ _,_ ""�'.�..:.i'a.'...�':'ni+.+.•V_..+�sY'..-+:'Yr"v. wvp'.... ....s..ter-+ _ -...w..e. �. - _ ._ �-vo--.- -..'.�.. `r -..-.... .. >�. .... ,.. No. GG-I Fee$50.00 s rtg THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes 2pprication for Mtgaar bpgtem Con!6truction Permit Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) 0 Complete System 0 Individual Components - 1 Location Address or Lot No. Owner's Name,Address and Tel.No. 9 5 8—5 4 3 4 4 arclr Hyannisport ne Rd. W. H annia ort ` John Merlesena Asessorlp268-7_33 54 Melbourne Rd W Hyannisport . Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 9 8—8 31 1 Wm E Robinson, Sr. Craig Short PO Box 1089 Centerville, MA p0 Box 1044 S. Dennis, MA Type of Building: N 64 Dwelling No.of Bedrooms )�of Size sq.ft. Garbage Grinder Flo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil t Nature of Repairs or Alterations(Answer when apple ble) Instai,l Title 5 leach system to plans of Craig Short - Al -974 r 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 Certifi- cate t cate of Compliance has been issued by this bazd:6t Health. F Signed�` Date//,�+ 0 Application Approve Date 111610 Application Disapproved for the,following,reasons Permit No. o.GO q`0cn-4 Date Issued / �/ O q Merlesena THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired (X )Upgraded( ) Abandoned( )by Wm Robinson Septic Service at 54 Melbourne Rd. , W. Hyannisport, MA has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ao Oy"6.)N dated 1 J 21 0 q Installer' Designer The issuance of this permit shall not be construed as a guarantee that the sy§ttmlwill function 6 designed. Date 1 I a l t<0 Inspector t�7 !.X Ml. . i No. —ioo yT na FeC5n T Merlesena THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS liopo0al *pztem Congtruction Permit Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( ) Systemlocated at 54 Melbourne Rd. , W. Hyannisport, MA 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. Cbyy Provided:Constru tio``n mmust be completed within three yeazs of the date t. Date ��t0/ `7� Approved i •. TOWN OF BARNSTABLE r L Q(C)0 � .01� y LOCATION .�i �� ��41 P/el 4, "l= SEWAGE VILLAGE �ya �, �"!�2/ ASSESSOR'S MAP & LOT���� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FA'CII.IT'Y: (type) ���4 (size) 4 r i NO.OF BEDROOM'S BUILDER OR OWNER PERMITDATE:,/77,-& -'D L-/ COMPLIANCE DATE: Separation Distance Between-�e� Maximum Adjusted Groundwater Tablle to the Bottom eaching Facility Feet Private Water Supply Well and Leaching Facility -any wells exist on site or within 200 feet of leaching facili Feet Edge of Wetland and.Leaching Facility(If y wetlands exist within 300 feet of leaching facility) Feet Furnished by i 6• i^ r �M - I... -...� COMMONWEALTH OF MASSACHUSETTS l EXECUTIVE,. FFICE OF ENVI RONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTIOMAP `oT t _ 2'33 TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property hAddress- John Merlesena REC21 = D Owner's Name- FlyannTs Owner's Address: _ JAN 2 2004 Date of Inspection: — TOWN OF BARNSTABLE � .. HEALTH DEPT. Name of Inspector:(please print) Wi 1 1 jam E .Robi nson Sr. Company Name: . William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville': 'MA Telephone Number: (_508) 775-8776 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and.that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed-based on my training and experience in the,proper function and maintenance of on site sewage disposal systems.I am-a.DEP approved system inspector,pursuant toStion 15340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: - Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heatihlor' DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit.the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. I Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 r NO FOR.VOLUNTARY`ASSESSMENTS OFFICIAL INSPECTION FORM SUBSURFACE SEWAGE DISPPOSAL ART SYSTEM INSPECTION FORM CERTIFICATION (continued) Address: 54 Melbourne Rd Property anni s -4forn—Tler esena Owner. 1 Date of Inspection: Inspection Summary Check A,B,C,D or E/ALWAYS complete all of Section D A. Sy tem Passes: the 1 have not found any information which indicates that any at d are,indi atederia below described in 310 CMR 15.303 or in 310 CMR 15.304 exOf ist Any failure criteria not evalu Comments: -� 8J B. System Conditionally Passes: One or more system components as ere placement or repair.as app oved by the Board of Health.,wi I pass: reps' d.The system,upon complet►on of thep Answ yes,no or not determined(Y,N,ND)in the for the following statements,if"not determined"please expla' . e septic tank is metal and over 20 years old*or the septic tank is.(whether metal or not)is structurally unsoun exhibits substantial infiltration or exfiltration or tank approved bfailure the B and of Health unnimint.system Will pass inspection if the existin tank is replaced with a complying septic tank as y •A me 1 septic tank will pass inspection if it is i�available.trallysound,not leaking and if a Certificate of Compliance indicati g that the tank is less than 20 years ND ex lawn: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstru ed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with appro al of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND ex lain: The system required pumping more than 4 tm es a year due to broken or obstructed pipes) The system will pass in pcction if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND a ain: I Page 3 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL:'SYSTEM INSPECTION FORM PART- CERTIFICATION(continued) Property Address: 54 Melbourne RdHyanlits L Owner: e a Date of Inspection: L 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 fa ling to protect public health-safety or the environment. 1. System will pass unless Board of Health determines m accordance with'310 CMR 15.303(i)(b).that the system.is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water -- Cesspool or privy is within 50 feet'of a bordering vegetated wetland or a salt marsh. . 2. Sy em will fail unless the Board of Health(and Public Water Supplier,if any)determines:that the system s functgoning in a manner that protects the public health,safety and environment: The system has a.septic":and soil absorption system(SAS)and the.SAS is within 100 feet of a sur ace water supply or tributary to-a surface water supply: The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank'and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well••.Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and,.. the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 54 Melbourne Rd y a nnnis Owner: o n Merlesen - Date of Inspection: 1 fJ D. System Failure Criteria applicable to a systems:. , , You ust indicate"yes"or"no"to each of the following for all ins' Yes o _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or, cesspool flow Liquid depth in cesspool is less than 6'1 below invert.or available volume►s less than day Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s):Number of times pumped P P ground water elevation. Any portion of the,SAS,cesspool or privy is below high gr 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 grater supply well _ Any portion of a cesspool or privy is less than 100 feet,but greater than 50 feet from a private water supply well with no acceptable water quality analysis.[This.system passes if the well.water analysis, performed at a DEP certified laboratory,for coliform bacteria and vo the Ilatile organic'compounds onia indicates that the well is free from pollution from that facility ti that o cother failure criteria nitrogen and nitrate nitrogen is equal to,or less than 5 ppm,provided are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. Large Systems: o be'considered a large system the system must serve.a facility with a design [low or 10,000 gpd to 15,000 g d- ou must indicate either"yes"or"no"to each of the following: e following criteria apply to large systems in addition to the criteria above) es no water supply the system is within 400 feet of a surface drinking PP Y the system is within 200 feet of a tributary to a surface drinlang 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 . significant threat,or answered I you have answered"yes"to any question in Section E the system is Considered a;►gne system considered a " es"in Section D above the large system has failed.The owner or Operator of any $ Y si nificant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15 3 4.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of l l ' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM -' PART B CHECKLIST. Property Address: 54 Melbourne Rd Hyannis Owner: John Merlesena ,.:. Date of Inspection: �- Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Yes o Pumping information was provided by the owner,occupant,or Board of Health LWere any of the system components pumped out in the previous two 'weeks.? l/ Has the system received normal flows in'the previous two week period,.? I/Have large volumes of water been introduced to the system recently or as part of this inspection.T. _ Were as built plans of the system obtained and examined?(If they were not available note as,N/A) l✓ — Was the facility or dwelling inspected for signs of sewage back up? 41 Was"the site inspected for signs of break out? Were all system components,excluding the SAS,located on site? Were the septic tank manholes uncovered;opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Z�_ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems.? The size and location of the Soil Absorption System(SAS)on the site has been determined based on:. Yes no _V Existing information.For example,a plan at the Board of Health. 1/ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)J 5 Page 6 of I 1 r OFFICIAL INSPECTION FORM , NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION b Property Address: 54 Melbourne Rd Hyannis Owner: John Merlesena Date of Inspection: 14 Z__G V FLOW CONDITIONS RESIDE,N..TIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x of of bedrooms): Number of current residents: Does residence have a garbage ' der(yes or no): /uO Is laundry on a separate sewage system(yes or no):4 (if yes separate inspection required) Laundry system inspected(yes or no):w Seasonal use:(yes or no):� 0 Water meter readings,if available(last 2 years usage(god)):09/01 thru 0 3/0 2 5�7 000 gals.. Sump pump(yes or no):�CI 0 3/0 2 thru 0 3/0 3 176, 000 gals Last date of occupancy: O COMMERCIA NDUSTRIAL Type of establis ent: Design flow(bas d on 310 CMR 15.203): "Qpd Basis of design ow(seats/persons/sgft,etc.): Grease trap pr ent(yes or no): Industrial was holding tank present(yes or no): Non-sanitary aste discharged to the Title 5 system(yes or no): Water mete readings,if available: Last date occupancy/user OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: e✓ '� �—" Was system pumped as part of the inspection(yes or no): 1f yes,volume pumped:_gallons=-How was quantity pumped determined? Reason for pumping: %,tJ S h S TYP OF SYSTEM _Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: Vb`/�Dez.�� Were sewage odors detected when arriving at the site(yes or no): AL 6 f Page 7 of 11 OFFICIAL INSPECTION FORM NOT-FOR:VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION.{continued). Property Address: 54 Melborne Rd Hyclinits Owner: o n e Date of Inspection: BUILD ING SEWER(locate on site plan) Depth b flow grade Materia s of construction:_cast iron _40 PV.0 ._other(explain): Distance from private water supply well or suction line: omm is(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: !s(locate on site plan) Depth below grade: Material of construction: ✓concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed-by a Certificate of Compliance(yes or no):_.(attach a copy of certificate) 1 p Dimensions: �` `� rJ+�► Sludge depth: g Distance from top of sludge to bottom of outlet tee or baffle:_ p1 g Scum thickness: 0 Distance from top of scum to top of outlet tee or baffle: t Distance from bottom of scum to bottom o outlet tee or baffle: 1�/ How were dimensions determined: /Z w tvcsaz S Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of-leakage, tc.): v GREAS>; P:_(locate on site plan) Depth below ade:_ Material of co struction: concrete metal_fiberglass_polyethylene_other.= (explain): Dimensions: Scum thickne s: Distance fro top of scum to top of outlet tee or baffle: Distance fro ottom of scum to bottom of outlet tee or baffle: Date of last p ping: Comments(o pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to tlet invert,evidence of leakage,etc.): 7 Page 8 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM'. PART C SYSTEM INFORMATION(continued): Property Address: 54 Melbourne Rd yannis Owner: John Merl sena Date of Inspection: TIGHT or HO DING TANK: (tank must be pumped at time of inspection)(locate on.site plan), Depth below gra e: Material of cons coon: concrete. metal fiberglass__polyethylene other(explain): Dimensions: allons Capacity. Design Flow: allons/day Alarm present es or no): Alarm level: Alarm in working order(yes or no): Date of last p ping: Comments( ndition of.alarm and float switches,etc.): DISTRIBUTION BOX. (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 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.): PUD4P C BER: (locate on site plan) Pumps in w rking order(yes or no): Alarms in orking order(yes or no Comment (note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION.FORM-NOT.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 54 Melbourne Rd Hyannis Owner: John ft lesena Date of Inspection: /✓'�—��p SOIL ABSORPTION SYSTEM(SAS):-4/—(Iocate on site plan,excavation not required) If SAS not located explain why: Type aching pits,number:leaching chambers,num_ber. 'o leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/altemative system .Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): J G,s'S S L 1 CESSPO LS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and onfiguration: Depth—top liquid to inlet invert: Depth of soli layer: Depth of scum layer: Dimensions of csspool: Materials of c struction: Indication of oundwater inflow(yes or no): Comments(n a condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (1 cate on site plan) Materials of cons ction: Dimensions: Depth of solids: Comments(note c ndition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 1 l o OFFICIAL,INSPECTION FORM—NOT FOR VOLUNTARY SUBSURFACE SEWAGE DISPOSA ASSESSMENTS L SYSTEM IN, FORM TS PART C SYSTEM INFORMATION(continued) Property Address: 54 Melbourne Rd Y� Owner. Date of Inspection, L SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. g o� 3 o a a J - 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 54 Melbourne Rd Owner. aehn ^~ Date of Inspection: �Q SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You mustescr ibc h av ou established the high ground water elevation: 11 Natural Gas Page 1 of 6 PHI LLIPS - Material Safety Data Sheet NATURAL GAS March 31, 1995 PHONE NUMBERS PHILLIPS PETROLEUM COMPANY Emergency: (918) 661-8118 Bartlesville, Oklahoma 74004 General MSDS Information: (918) 661-8327 For Additional MSDSs: (918) 661-5952 A. Product Identification Synonyms: Residue gas; Raw gas Chemical Name: Natural gas Chemical Family: Mixture Chemical Formula: Mixture CAS Reg. No. : 8006-14-2 Product No. : Not Established Product and/or Components Entered on EPA's TSCA Inventory: YES This product is in U.S. commerce, and is listed in the Toxic Substances Control Act (TSCA) Inventory of Chemicals; hence, it may be subject to applicable TSCA provisions and restrictions. B . Components CAS o OSHA ACGIH Ingredients Number By Wt. PEL TLV Methane 74-82-8 60-95 NE Simple Asphyxiant Ethane 74-84-0 2-15 NE Simple Asphyxiant Propane 74-98-6 1-10 1000 ppm Simple Asphyxiant Butane 109-97-8 0-4 800 ppm 800 ppm Isobutane 75-28-5 0-4 NE NE Nitrogen 7727-37-9 0-15 NE NE Carbon dioxide 124-38-9 0-5 10000 ppm 5000 ppm Pentanes plus, includes Various 0-8 NE NE Pentane 109-66-0 NE 600 ppm 600 ppm Isopentane 78-78-4 NE NE NE Hexane 110-54-3 NE 50 ppm 50 ppm Isohexane 107-83-5 NE 500 ppm 500 ppm Hydrogen sulfide 7783-06-4 0-30 10 ppm 10 ppm Normal composition ranges are shown. Exceptions may occur which would invalidate data on this form. http://sewebl.phillips66.com/hes/msds.nsf/362b26131218f5ac862565b400559859/7cica4a84z 3/3/2004 Natural Gas Page 2 of 6 C . Personal Protection Information Ventilation: Use adequate ventilation to control exposure below recommended levels. Respiratory Protection: For concentrations exceeding the recommended level, use NIOSH/MSHA approved air purifying respirator. If conditions immediately dangerous to life or health exist, use NIOSH/MSHA self contained breathing apparatus (SCBA) . Eye Protection: Use chemical goggles. Skin Protection: No special garments required. Avoid unnecessary skin contamination with material. NOTE: Personal protection information shown in Section C is based upon general information as to normal uses and conditions. Where special or unusual uses or conditions exist, it is suggested that the expert assistance of an industrial hygienist or other qualified professional be sought. D . Handling and Storage Precautions Proper personal protective equipment must be used when handling this chemical. Do not get in eyes, on skin or on clothing. Do not breathe vapor, mist, fume or dust. May be harmful. Wash thoroughly after handling. Launder contaminated clothing before reuse. Use only with adequate ventilation. Store in tightly closed container. Store in well-ventilated area. Keep away from heat, sparks and flame. Bond and ground during transfer. E . Reactivity Data Stability: Stable Conditions to Avoid: Not Established Incompatibility (Materials to Avoid) : Oxygen and strong oxidizing materials Hazardous Polymerization: Will Not Occur Conditions to Avoid: Not Established Hazardous Decomposition Products: Carbon oxides and various hydrocarbons formed when burned. Sulfur oxides may be formed if hydrogen sulfide is present. F . Health Hazard Data Recommended Exposure Limits : See Section B. Acute Effects of Overexposure: http://seweb l.phillips66.com/hes/msds.nsf/362b26131218f5ac862565b400559859/7c 1 ca4a8.... 3/3/2004 Natural Gas Page 3 of 6 Eye: May cause irritation including pain, blurred vision, redness, tearing and superficial corneal turbidity. Skin: May cause slight irritation. Inhalation: Toxic by this route of exposure. May cause nausea, diarrhea, loss of appetite, dizziness, disorientation, headache, excitation, rapid respiration, drowsiness, labored breathing, anesthesia and other central nervous system effects. Hydrogen sulfide may cause lung paralysis and asphyxiation. Extreme overexposure may cause rapid unconsciousness and respiratory arrest. Ingestion: Not Applicable. Subchronic and Chronic Effects of Overexposure : Exposure to 1000 ppm propane for eight hours a day, five days a week, for approximately two weeks produced no abnormal reactions, including cardiac, pulmonary, and neurologic functions in humans. Chronic high level n-hexane exposure damages the nervous system initially producing a lack of feeling in the extremities and possibly progressing to a more severe nerve damage. Inhalation of high levels (1000 and 5000 ppm) of n-hexane has produced testicular damage in rats. Mice exposed to the same dose levels showed no testicular effects. Carbon dioxide exposure may cause acidosis and imbalance of electrolytes in the blood. Other Health Effects : A Toxicity Study Summary for Methane, Pure Grade, is available upon request. The odor of hydrogen sulfide may not be recognized after prolonged inhalation due to paralysis of the sense of smell. Effects from inhaling the fume may lead to chronic bronchitis, respiratory irritation, increased loss of pulmonary function, and tearing of the eyes. Health Hazard Categories : Animal Human Animal Human Known Carcinogen Toxic _X_ Suspect Carcinogen Corrosive Mutagen Irritant Teratogen Target Organ Toxin _X_ _X_ Allergic Sensitizer Specify - Nerve Toxin; Blood Toxin Highly Toxic Lung-Simple Asphyxiant First Aid and Emergency Procedures : Eye: Flush eyes with running water for at least fifteen minutes. If irritation or adverse symptoms develop, seek medical attention. http://seweb l.phillips66.com/hes/msds.nsf/362b26131218f5ac862565b400559859/7c l ca4a8.... 3/3/2004 Natural Gas Page 4 of 6 Skin: Wash skin with soap and water for at least fifteen minutes. If irritation or adverse symptoms develop, seek medical attention. Inhalation: Immediately remove from exposure. If breathing is difficult, give oxygen. If breathing ceases, administer artificial respiration followed by oxygen. Seek immediate medical attention. Ingestion: If illness or adverse symptoms develop, seek medical attention. G . Physical Data Appearance: Colorless gas Odor: Mild to rotten egg odor, if hydrogen sulfide is present. Boiling Point: -285F (-161C) (Estimate) Vapor Pressure: Not Applicable Vapor Density (Air = 1) : 0.8 (Estimate) Solubility in Water: Negligible Specific Gravity (H20 = 1) : 0.5 (Estimate) Percent Volatile by Volume: Not Applicable Evaporation Rate (Butyl Acetate = 1) : Not Applicable Viscosity: Not Applicable H . Fire and Explosion Data Flash Point (Method Used) : -292F (-180C) (Estimate) Flammable Limits (% by Volume in Air) : LEL - 5 UEL - 15.8 Fire Extinguishing Media: Dry chemical, foam or carbon dioxide (CO2) Special Fire Fighting Procedures: Stop flow of gas. If possible, let fire burn until flow of gas can be shut off. Evacuate area of all unnecessary personnel. Wear appropriate safety equipment for fire conditions including NIOSH/MSHA self-contained breathing apparatus (SCBA) and protective equipment and garments described in Section C. Water fog or spray may be used to cool exposed equipment and containers. Fire and Explosion Hazards: Very dangerous when exposed to heat or flame. Containers may explode violently in the heat of a fire. Vapors may travel to a source of ignition and flash back. If hydrogen sulfide is present, respiratory equipment specified above must be used. http://seweb l.phillips66.com/hes/msds.nsf/362b26131218f5ac862565b400559859/7c 1 ca4a8... 3/3/2004 Natural Gas Page 5 of 6 I . Spill , Leak and Disposal Procedures Precautions Required if Material is Released or Spilled: Evacuate area of all unnecessary personnel. Wear protective equipment and/or garments described in Section C if exposure conditions warrant. Shut off source, if possible and contain spill. Protect from ignition. Keep out of water sources and sewers. Absorb in a dry, inert material (sand, clay, etc) . Transfer to disposal drums using non-sparking equipment. Waste Disposal (Insure Conformity with all Applicable Disposal Regulations) : Incinerate or place in permitted waste management facility. J . DOT Transportation Shipping Name: Natural gas, compressed Hazard Class: 2.1 (Flammable gas) ID Number: UN 1971 Packing Group: Not Applicable Marking: Natural gas, compressed/UN 1971 Label: Flammable gas Placard: Flammable gas/1971 Hazardous Substance/RQ: Not Applicable Shipping Description: Natural gas, compressed, 2.1 (Flammable gas) , UN 1971 Packaging References: 49 CFR 173.302 and 173.306 K . RCRA Classification - Unadulterated Product Waste Ignitable .(D001) Prior to disposal, consult your environmental contact to determine if TCLP (Toxicity Characteristic Leaching Procedure, EPA Test Method 1311) is required. Reference 40 CFR Part 261. L . Protection Required for Work on Contaminate Equipment Contact immediate supervisor for specific instructions before work is initiated. Wear protective equipment and/or garments described in Section C if conditions warrant. M. Hazard Classification _X_ This product meets the following hazard definition(s) as defined by the Occupational Safety and Health Hazard Communication Standard (29 CFR Section 1910.1200) : _ Combustible Liquid Flammable Aerosol Oxidizer _X_ Compressed Gas Explosive Pyrophoric X Flammable Gas X Health Hazard (Section F) Unstable Flammable Liquid Organic Peroxide Water Reactive Flammable Solid http://seweb l.phillips66.com/hes/msds.nsf/362b26131218f5ac862565b400559859/7c 1 ca4a8,... 3/3/2004 Natural Gas Page 6 of 6 Based on information presently available, this product does not meet any of the hazard definitions of 29 CFR Section 1910. 1200. N . Additional Comments SARA 313 This product contains the following chemical or chemicals subject to the reporting requirements of Section 313 of Title III of the Superfund Amendments and Reauthorization Act of 1986 and 40 CFR Part 372. (See Section B) . n-Hexane Phillips Petroleum Company(references to Phillips Petroleum Company or Phillips includes its divisions,affiliates and subsidiaries)believes that the information contained herein(including data and statements)is accurate as of the date hereof.NO WARRANTY OF MERCHANTABILITY,FITNESS FOR ANY PARTICULAR PURPOSE OR ANY OTHER WARRANTY,EXPRESS OR IMPLIED,IS MADE AS CONCERNS THE INFORMATION HEREIN PROVIDED. The information provided herein relates only to the specific product designated and may not be valid where such product is used in combination with any other materials or in any process.Further,since the conditions and methods of use of the product and information referred to herein are beyond the control of Phillips, Phillips expressly disclaims any and all liability as to any results obtained or arising from any use of the product or such information.No statement made herein shall be construed as a permission or recommendation for the use of any product in a manner that might infringe existing patents. http://seweb l.phillips66.com/hes/msds.nsf/362b26131218f5ac862565b400559859/7c 1 ca4a8,... 3/3/2004 Product Name: Natural gas MSDS# E-4550-A Date: 11/1/2001 Praxair Material Safety Data Sheet 1.Chemical Product and Company Identification Product Name: Natural gas Trade Name: Natural gas Product Use: Heating fuel. Chemical Name: Natural Gas,compressed Synonym: Methane natural gas Chemical Formula: Mixture of CH4, C2116, C3H8,&C4H10 Chemical Family: Hydrocarbons Telephone: Emergencies: * 1-800-363-0042 Supplier Praxair Canada Inc. /Manufacture: 1 City Centre Drive Suite 1200 Mississauga,ON 1_513 1 M2 Phone: 905-803-1600 Fax: 905-803-1682 *Call emergency numbers 24 hours a day only for spills, leaks,fire, exposure, or accidents involving this product.For routine information, contact your supplier or Praxair sales representative. 2.Composition and Information on Ingredients INGREDIENTS % (VOL) CAS LD5o LC50 TLV-TWA NUMBER (Species& (Rat,4 hrs.) (ACG" Routes) 1) Natural gas(predominantly 100 8006-14-2 Not Not available None established. methane) applicable. 3.Hazards Identification Emergency Overview DANGER! Flammable, high-pressure gas. May form explosive mixture with air.Can cause rapid suffocation. May cause dizziness and drowsiness.Self-contained breathing apparatus may be required by rescue workers. ROUTES OF EXPOSURE: Inhalation. Eye contact. THRESHOLD LIMIT VALUE:TLV-TWA Data from 2001 Guide to Occupational Exposure Values(ACGIH). TLV-TWAs should be used as a guide in the control of health hazards and not as fine lines between safe and dangerous concentrations. EFFECTS OF A SINGLE(ACUTE)OVEREXPOSURE: INHALATION: Asphyxiant. Effects are due to lack of oxygen. Moderate concentrations may cause headaches, drowsiness,dizziness,excitation,excess salivation,vomiting and unconciousness. Lack of oxygen can kill. SKIN CONTACT: No harmful effects expected from vapour.. SKIN ABSORPTION: No evidence of adverse effects from available information. SWALLOWING: An unlikely route of exposure. This product is a gas at normal temperature and pressure. EYE CONTACT: Vapour may cause irritation. EFFECTS OF REPEATED(CHRONIC)OVEREXPOSURE: None. OTHER EFFECTS OF OVEREXPOSURE: None known. MEDICAL CONDITIONS AGGRAVATED BY OVEREXPOSURE: None known. Copyright©2001,Praxair Canada Inc. Page 1 of 6 Product Name: Natural gas MSDS# E-4550-A Date: 11/1/2001 SIGNIFICANT LABORATORY DATA WITH POSSIBLE RELEVANCE TO HUMAN HEALTH HAZARD EVALUATION: None. CARCINOGENICITY: Not listed as carcinogen by OSHA, NTP or IARC. 4.First Aid Measures INHALATION: If inhaled, remove to fresh air. If not breathing,give artificial respiration. If breathing is difficult,give oxygen. Get medical attention. SKIN CONTACT: Abrasions: clean with soap and water then bandage. Burns: seek medical attention. SWALLOWING: Not applicable(gas). EYE CONTACT: Flush with water. If irritation persists,call a physician. NOTES TO PHYSICIAN: There is no specific antidote. Treatment of over-exposure should be directed at the control of symptoms and the clinical condition. 5.Fire Fighting Measures FLAMMABLE: Yes. IF YES,UNDER WHAT CONDITIONS? Forms explosive mixtures with air and oxidizing agents. FLASH POINT AUTOIGNITION 482°C(899.6°F) (test method) Not applicable. TEMPERATURE FLAMMABLE LIMITS LOWER: 3.8 UPPER: 17 IN AIR,%by volume: EXTIGUISHING MEDIA: CO2,dry chemical,water spray or fog. SPECIAL FIRE FIGHTING PROCEDURES: DANGER! Evacuate all personnel from danger area. Immediately cool cylinders with water spray from maximum distance taking care not to extinguish flames. Remove ignition source if without risk. If flames are accidentally extinguished. Explosive re-ignition may occur;therefore,appropriate measures should be taken;e.g.,total evacuation. Re-approach with extreme caution. Use self-contained breathing apparatus. Stop flow of gas if without risk while continuing cooling water spray. Remove all containers from area if without risk. Allow fire to burn out. UNUSUAL FIRE AND EXPLOSION HAZARD: Extremely flammable gas in presence of open flame and sparks. Slightly flammable in presence of heat. HAZARDOUS COMBUSTION PRODUCTS: These products are carbon oxides(CO, CO2). SENSITIVITY TO IMPACT: Avoid impact against container. SENSITIVITY TO STATIC DISCHARGE: Possible. Copyright 0 2001,Praxair Canada Inc. Page 2 of 6 Product Name: Natural gas MSDS# E-4550-A Date: 11/1/2001 6.Accidental Release Measures STEPS TO BE TAKEN IF MATERIAL IS RELEASED OR SPILLED: DANGER! Flammable, high-pressure gas. Forms explosive mixtures with air. Immediately evacaute all personnel from danger area. Use self-contained breathing apparatus where needed. Remove all sources of ignition if without risk. Reduce gas with fog or fine water spary. Shut off flow if without risk. Ventilate area or move cylinder to a well-ventilated area. Flammable gas may spread from leak. Before entering area,especially confied areas,check atmosphere with an appropriate device. WASTE DISPOSAL METHOD: Prevent waste from contaminating the surrounding environment. Keep personnel away. Discard and product, residue,disposable container,or liner in an environmentally acceptable manner, infull compliance with federal, provincial, and local regulations. If necessary,call your local supplier for assistance. 7.Handling and Storage PRECAUTIONS TO BE TAKEN IN STORAGE: Store and use with adequate ventilation. Separate flammable cylinders from oxygen, chlorine, and other oxidizers by at least 6 m or use a barricade of non-combustible material. This barricade should be at least 1.5 m high and have a fire resistance rating of at least'/2 hour. Firmly secure cylinders upright to keep them from falling or being knocked over. Screw valve protection cap firmly in place by hand. Post"No Smoking or Open Flames"signs in storage and use areas. There must be no sources of ignition. All electrical equipment in storage areas must be explosion-proof. Storage areas must meet national electric codes for Class 1 hazardous areas. Store only where temperature will not exceed 52 C. Store full and empty cylinders separately. Use a first-in, first-out inventory system to prevent storing full cylinders for long periods. PRECAUTIONS TO BE TAKEN IN HANDLING: Protect cylinders from damage. Use a suitable hand truck to move cylinders;do not drag,roll,slide,or drop. Never attempt to lift a cylinder by its cap; the cap is intended solely to protect the valve. Never insert an object(e.g., wrench, screwdriver, pry bar) into cap openings; doing so may damage the valve and cause a leak. Use an adjustable strap wrench to remove over-tight or rusted caps. Open valve slowly. If valve is hard to open; discontinue use and contact your supplier. For other precautions, see Section 16. For additional information on stroage and handling, refer to Compressed Gas Association (CGA) pamphlet P-1, Safe Handling of Compressed Gases in Containers,available from the CGA. Refer to Section 16 for the address and phone number along with a list of other available publications. OTHER HAZARDOUS CONDITIONS OF HANDLING,STORAGE,AND USE: Flammable high-pressure gas. Use only in a closed system. Use piping and equipment adequately designed to withstand pressures to be encountered. Use only spark-proof tools and explosion-proof equipment. Keep away from heat,sparks,and open flame. May form explosive mixtures with air. Ground all equipment. Gas can cause rapid suffocation due to oxygen deficiency. Store and use with adequate ventilation. Close valve after each use; keep closed even when empty. Prevent reverse flow. Reverse flow into cylinder may cause rupture. Use a check valve or other protective device in any line or piping from the cylinder. When returning cylinder to supplier,be sure valve is closed,then install valve outlet plug tightly.Never work on a pressurized system. If there is a leak,close the cylinder valve.Vent the system down in a safe and environmentally sound manner in compliance with all federal, provincial, and local laws;then repair the leak.Never place a compressed gas cylinder where it may become part of an electrical circuit. 8.Exposure Controls/Personal Protection VENTILATION/ENGINEERING CONTROLS: LOCAL EXHAUST:An explosion-proof local exhaust system is acceptable. See SPECIAL. MECHANICAL(general): Inadequate. See SPECIAL. SPECIAL: Use only in a closed system. OTHER: None. PERSONAL PROTECTION: Copyright©2001,Praxair Canada Inc. Page 3 of 6 Product Name: Natural gas MSDS# E-4550-A Date: 11/1/2001 RESPIRATORY PROTECTION: Use respirable fume respirator or air supplied respirator when working in confined space or where local exhaust or ventilation does not keep exposure below TLV.Select in accordance with the provincial regulations or guidelines.Selection should also be based on the current CSA standards Z94.4,"Selection,care and use of respirators". Respirators should be approved by NIOSH and MSHA. SKIN PROTECTION:Wear work gloves when handling cylinders. EYE PROTECTION:Wear safety glasses when handling cylinders. Select in accordance with the current CSA standard Z94.3,"Industrial Eye and Face Protection",and any provincial regulations, local bylaws or guidelines. OTHER PROTECTIVE EQUIPMENT: Metatarsal shoes for cylinder handling. Protective clothing where needed.Cuffless trousers should be worn outside the shoes.Select in accordance with the current CSA standard Z195,"Protective Foot Wear", and any provincial regulations, local bylaws or guidelines. 9.Physical and Chemical Properties PHYSICAL STATE: Gas.(Compressed Gas.) FREEZING POINT: Not available. pH: Not applicable. BOILING POINT -164°C(-263.2°F) VAPOUR PRESSURE MOLECULAR WEIGHT: 17.66 g/mote Not applicable. SPECIFIC GRAVITY: Not applicable. SOLUBILITY IN WATER, Very slightly soluble in cold water. LIQUID(Water=1) SPECIFIC GRAVITY: 0.55 EVAPORATION RATE Not available. COEFFICIENT OF WATERIOIL Not applicable. VAPOUR (Butyl Acetate=1): DISTRIBUTION: (air=1) VAPOUR DENSITY: 0.615 %VOLATILES BY 100%(v/v). ODOUR THRESHOLD: 0.001 ppm VOLUME: APPEARANCE&ODOUR: Colourless. Odour: Faint,disagreeable.(Slight.) 10.Stability and Reactivity STABILITY: The product is stable. CONDITIONS OF CHEMICAL INSTABILITY: Not available. INCOMPATIBILITY(materials to avoid): Oxidizing agents in the presence of ignition source. HAZARDOUS DECOMPOSITION PRODUCTS: Thermal decomposition or burning may produce carbon monoxide/carbon dioxide and possible trace amounts of sulphur dioxide and oxides of nitrogen. HAZARDOUS POLYMERIZATION: Will not occur. CONDITIONS OF REACTIVITY: None known. 11.Toxicological Information See section 3. Copyright©2001,Praxair Canada Inc. Page 4 of 6 Product Name: Natural gas MSDS# E-4550-A Date: 11/1/2001 12.Ecological Information No adverse ecological effects expected.This product does not contain any Class I or Class II ozone-depleting chemicals.This product is not listed as a marine pollutant by TDG regulations. 13.Disposal Considerations WASTE DISPOSAL METHOD: Do not attempt to dispose of residual or unused quantities. Return cylinder to supplier. 14.Transport Information TDG/IMO SHIPPING NAME: Natural gas,compressed HAZARD CLASS: T D G C I a s s 2 . 1 : IDENTIFICATION#: 1971 PRODUCT RQ: 100 L Flammable gas. SHIPPING LABEL(s): Flammable gas PLACARD(when required): Flammable gas SPECIAL SHIPPING INFORMATION: Cylinders should be transported in a secure position, in a well-ventilated vehicle. Cylinders transported in an enclosed, nonventilated compartment of vehicle can present serious safety hazards. 15.Regulatory Information The following selected regulatory requirements may apply to this product.Not all such requirements are identified.Users of this product are solely responsible for compliance with all applicable federal,provincial,and local regulations. WHMIS(Canada) CLASS A: Compressed gas. CLASS B-1: Flammable gas. International Regulations EINECS Not available. DSCL(EEC) This product is not classified according to the EU regulations. International Lists No products were found. 16.Other Information MIXTURES: When two or more gases,or liquefied gases are mixed,their hazardous properties may combine to create additional, unexpected hazards. Obtain and evaluate the safety information for each component before you produce the mixture. Consult an Industrial Hygienist,or other trained person when you make your safety evaluation of the end product. Remember,gases and liquids have properties which can cause serious injury or death. HAZARD RATING SYSTEM: HMIS RATINGS: HEALTH 0 FLAMMABILITY 4 REACTIVITY 0 STANDARD VALVE CONNECTIONS FOR U.S.AND CANADA: THREADED: 0-3000 psig: CGA-350 PIN-INDEXED YOKE: Not applicable. ULTRA-HIGH-INTEGRITY CONNECTION: Not applicable. Use the proper CGA connections. DO NOT USE ADAPTERS. Additional limited-standard connections may apply. See CGA pamphlets V-1 and V-7 listed below. Copyright©2001,Praxair Canada Inc. Page 5 of 6 Product Name: Natural gas MSDS# E-4550-A Date: 11/l/2001 Ask your supplier about free Praxair safety literature as referred to in this MSDS and on the label for this product. Further information about this product can be found in the following pamphlets published by the Compressed Gas Association, Inc.(CGA), 4221 Walney Road,5th Floor, Chantilly,VA 20151-2923,Telephone(703)788-2700, Fax(703)934-1830,website: www.cganet.com. AV-1 Safe Handling and Storage of Compressed Gas P-1 Safe Handling of Compressed Gases in Containers P-14 Accident Prevention in Oxygen-Rich,Oxygen-Deficient Atmospheres SB-2 Oxygen-Deficient Atmospheres V-1 Compressed Gas Cylinder Valve Inlet and Outlet Connections V-7 Standard Method of Determining Cylinder Valve Outlet Connections for Industrial Gas Mixtures --- Handbook of Compressed Gases, Fourth Edition PREPARATION INFORMATION: DATE: 11/1/2001 DEPARTMENT: Safety and Environmental Services TELEPHONE: 905-803-1600 The opinions expressed herein are those of qualified experts within Praxair Canada Inc. We believe that the information contained herein is current as of the date of this Material Safety Data Sheet. Since the use of this information and the conditions of use of the product are not within the control of Praxair Canada Inc., it is the user's obligation to determine the conditions of safe use of the product. Praxair Canada Inc. requests the users of this product to study this Material Data Sheet (MSDS) and become aware of product hazards and safety information. To promote safe use of this product, a user should(1)notify its employees, agents and contractors of the information on this MSDS and any product hazards and safety nformation, (2) furnish this same information to each of its customers for the product, and (3) request such customers to notify their employees and customers for the product of the same product hazards and safety information. Praxair and the Flowing Airstream design are trademarks of Praxair Canada Inc. Other trademarks used herein are trademarks or registered trademarks of their respective owners. Praxair Canada Inc. 1 City Centre Drive Suite 1200 Mississauga,ON 1_513 1M2 Copyright©2001,Praxair Canada Inc. Page 6 of 6 ass, 6r 2 3 3 Lb CAT ION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S GAME i ADDRESS B U I L D E R OR OWNER a DAT E,/ - PERMIT ISSUED - �q _Q� . DATE COMPLIANCE ISSUED b \^� 'VA S �d - THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........................................OF.......................................................................... ApplirFation for Dhipoii al Works Tonotrnrtinn rumit Application is hereby made for a Permit to Construct ( °) or Repair ( ) an Individual Sewage Disposal System at: t..�. /: .. .. l?. — C �'�� ................. '..1. 3 s •--. Ro..----•..............................:.... -- ------- - Location-Address or Lot No. ..._....1:�.,e�Jt!' E..I.C� - ....: [.ff..11 .-I..--•--h-;. ..... Owner ✓ 'h•.Al 0.4/k— Address a -•-- -�l.l.1.�1..z��s s...._....G'.'.f?r.!.�tr�}. JL.,.d.-..A6....11.............may.. ...._....... ....._...__--...._._........_....... Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................L....._.................Expansion Attic 0-) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons.-----.--.-----.---.-------- Showers ( ) — Cafeteria, ( ) PL' Other fixtures ............................ W Design Flow....- a..........................gallons per person per day. Total daily flow.........:3 3_®._____................gallons. WSeptic Tank—Liquid capacity.L.`.0 .gallons Length................ Width................ Diameter.............--. Depth................ x Disposal Trench—No. .................... Width.................... Total Length.....-.............. Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.............--..... Depth below inlet.................... Total leaching area..................sq. ft. ' Z Other Distribution box (�O Dosing tank ( ) - Percolation Test Results Performed by........................................................................... Date.......................-................... a Test Pit No. 1---. ,.....minutes per inch Depth of Test Pit-------/-.Z. ...... Depth to ground water. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---.--.............---.. a ...............-...................................................•----.. .----=------------------ O Description of Soil......../Ij r /„.....---.--`����-------------------------.....---------------------.................--------------.........----__ . t4 .....-•-------------•-------•------------------------•-•---------------------------.............---•-----•-•------------------•-------------•-•---•----------------•------•-----.........------•---_ W ---------------------------------------------------------------------------------------------•---•----------------------...----------------------------------------• ................................ U Nature of Repairs or Alterations—Answer when applicable...................................................................................:........--- -------•-----•----•--------------•----------•--•-------------------------•-•-----..._...--•--------------------•--•--------------------•-----•-•--•-----•-•----------------------------.........•-•---. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System*in accordance with the provisions of TITL U 5 of the State Sanitary Code—The undersigned further agrees not to'place the system in . operation until a Certificate of Compliance has been issued by the board of health. Signed .................. - •- CA lr K to APPlication Approved By----.-- '-------'-•---•-•............................................................. ........ �.-�Sy...---•-- Date. Application Disapproved for the following reasons-------------------------------------------------------------------------:-------•--•-------------......_....--_. .............................•---•-•----.........------------•-•-----•--------------.....---------.....--------------------------------•--------•--------•----------••---•--------•----•----•----------- Date PermitNo......................................................... Issued-------------------------•-•---•-•- - ------------------ Date ' FEic...................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................................OF.....................................I.................................................... Appfir4fiou for Disposal Works Tonstrurtion frrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ................................................................................................ .................................................................................................. Location-Address or Lot No. .....................................................................7........................ .................................................................................................. Owner I 1 00.1 Af 11.4 0,tu_ Address ............ !WMVFr_.=.X.............................. .................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................. .Expansion Attic Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................. Showers Cafeteria ( ) 04 Other fixtures .......................................... W ............................................gallons ........................................................................ ................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid*capacity............gallons Length--_---_------ Width................ Diameter____.___.._..... Depth...._........... Disposal Trench—No. ...................4 Width.....__._._..__._... Total Length.................... Total,leaching area....................sq. ft. Seepage Pit I No________________ _}Diameter'--- --___-_______ Depth below inlet.._................. Total leaching area..................sq. ft. Z 0(ih istril�utidfi'b im D, dX'(_ ')' Dosing tank Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.__.__............._ Depth to ground water.......__............._. fi Test Pit No. 2................minutes per inch Depth of Test Pit................_... Depth to ground water.._.._..._..........___. ........................................................................*...."-------------------------------*--------------------"--------------------- 0 Description of Soil........................................................................................................................................................................ U ........................................................................................................................................................................................................ W ............... ....................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ....................................................................................................................................................................................................... Agreement: The undersigned agrees-to I install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5-Ahe Stat6'Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate,,,of Compliance has been issued by the board of health. Signed...................................................................................... ........................... . ......C....... . Da te Application Approved By ........ . .... ................................ .........Q)JL5 1......... a e Application Disapproved for the following reasons:............................................................................................................. ..................................................................................................r..................................................................................................... Date PermitNo......................................................... Issued-..........----------------------...._..........._...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............................I..........OF..................................................................................... upwrtifiratr of Toutpliana THIS Isi,,10 CERTIFY, That the Individual Sewage Disposal System constructed ()r) or Repaired arkAraw ................................ by-------------7 ..........................I.........................................................7------------------------------------------------------------ Installer .......................... ... .....................................................................................................at. ..... .........I % has been installed in accordance with the provisions of TITLE 5 of ThSState Sanitary Code as described in the application for Disposal Works Construction Permit ........ dated------ ................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONA RUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................... ............................... Inspector. .'-----I.... . ....... .......................................... THE COMMONWEALTHS OF.MASSAC SETTS BOARD OF HEALTH 4 ................... ......:.........OF.......... 0 ............. ............................................... No261................... FEE. ............. Uisposat Permission is hereby granted-..-.. ..........................4.......j .",-,<. ....................................................... to Construct or.Repair an Individual Sewage Disposal System atNo..-.:tn.................... ............................................................................................................................... .1e Street k-fl q—L!�' I as shown on the application for Disposal Works Construction Permit No..................... Dated... q-1,4 - --------------------- K 0 . a02N,u" ................... .............................................................. Board of Health DATE....- 7- ......................................................................... v, FORM 1255 A. M. SULKIN. INC.. B -Da��Y�F'�ow @ �►� x� = 3 � v 7I4-1 • 1, 5E IObO (��.L 9�•5\ _.._. -'art oPr s E L� 91 'S , 36'= 33* � `LEI s a c. � Y�'� ter•,- 3��c�w�•, �;�r �c� 4 x8 k%-Co C I IZ" Tizow1 i tNU6i.T -M tlK) C� 'Gloc wa�� AaEfa (off s �n i oofEx� 51•Or. WA�.�, t..aP«►-cr,( 17 3 � ��vw �L►oTTOH �,r4?�•+t'�( 22��.,� t.Q = _22� uP� _ � _ 71.71� f f Q r f L a V �„ lr'1�t1 uF -.�_ 8 t�LFt4yL B C's u7 s.Z �� t, r\ 9 .> TL "Z,isUI i luv ez'D 2' F`I Y � J4TF i► Jl JiAL l^ ;` z �KauT GI, t�J -i'Es c }�o�E� ?323008• 6• Sur, r. � " LGv�ATt ` �( �In�T�T'A�it�:cry�'•eC�i 1 a..p TSw-69- 'T't�rntp v�QO•� 93lo So. �. � 7Es4�- �-- . �� SlEv FCx=83.5 'r(ll 92,0 ge.c Ft,E. A► $Z.S LNV 00Q)&A< ► '4 5 tii�• I 1 NV j �•A, _ 73 2 -.... SS.Z '�''•� III 88•`3 A. U-7 _ ►� 3-qK5 1 u MAIN, WITH ZOF Bq Po ��..WASe EJ Srrs►i� A-I- AICOUNp.2°Owvw..iw j 3.U 12� _ _._ .... _ 4._ C•F Q T a F I E'C•7 '��.�'�' 'P 1.-stilt • . . —1 z or i Lm =;=M� VkYAN 1A 1S No ScA.LE L .CEeT 1 F Y -T+1aT T 7090L'� Vice`• •� I w► LA, E"Zr-"CZ- �F '�.�a STAB 4.E ,►.►•cP ,6 tycs'c t_bv.: �� �r rr�;►N T�►E 't.odv ��,a rJ. �' t, FJl oa,C 2 j Q K 3 Z. 4. N Y E -TIJ 0 Tv.N 10 NCM -BA VP 0$1 A,N ► U(he i.►T �L�,S ra~r��t7 t.,tircV Sc���11D 7 E Z>TT6ET6 61AoULO, KGT-TvZ UeI v 4!:�"sTc VILLZ ca LOT �1�zs. �;GAN'T' �, �,��-`��3L�N►1 . TOWN OF BARNSTABLE LOCATION .54 `MjVpm nmg- ` ng,, SEWAGE # 9L S70 a .a33 VILLAGE ASSESSOR'S MAP & LOT 26!g Aq `t3� INSTALLER'S NAME & PHONE NO. •v` -SEPTIC TANK CAPACITY 1000 q4LP- LEACHING FACILITY:(type) � QQa", „d (size) 6.3L i NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATE BUILDER OR OWNER CYA,, �� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED "" VARIANCE GRANTED: Yes No `/ 4J Ll o d � f NAA) No�/ Rs— .�` F 11.. _. ............�`.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratilan for Ui_n.pnml Works Tomitrnrtion Permit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at- ...---5` ..�...... - 2�1� �.s �' - Location-Address U or Lot No. _...... ........ ............................... Owner ress a .....a__)4 .. .� .R b............ Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedroom�s.___-�r�-------------------------------___Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building �t7!?1�,QKk 454k. No. of persons---------------------------- Showers ( ) — Cafeteria ( ) f-t, Other fixtures -_-----------_---------- .......................... W Design Flow.................................'? .--gallons per person per day. Total daily flow............._______..__....q—!? '--....gallons. WSeptic Tank—Liquid capacity.l �-`.gallons Length----- Width_._q A$____ Diameter._._._......._. De th__14_!--__..._. x Disposal Trench—No. .... ............ Width......3----------- Total Length-----5_ ....... Total leaching area.... G? Seepage Pit No---------_-_-------- Diameter___-___.--_-.---_- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water---__._.-_.-----_---_._. Gi, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 04 -------------••---------•-------------•--•-•--•----------•.................................................................................................. 0 Description of Soil........................................................................................................................................................................ U ---------------------------------------•--•-------------------------------------------------•-----------------------------------------------------------•---------------•-----------.......------.------ W -----------------------------------------------------------------------------------------•-- ----------,-�----------- -----------•------------------------------------------------...............---- U Nature of Repairs or Alterations—Answer when ap licable._ /�_tAX&VA. X___&- . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. -Y �. Signed . ............- - ------- ----v----------- -----�' ASS . .... 7 Daze _ Application Approved By��' ✓ .l�i...�.......... r ................................ ... � `4F Dare Application Disapproved for the following reasons: .................................. ........................................ . .................... ............................................................................... ..... ............................................................................. . ............ --------------------------- Permit No. �j.!'......... ---------- Issued .................. F� =..� Dace ......... � No.- •---._._....� Fri$...... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE , pphration for Diopoottl Warkii Tonstrnrtion runtit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: ......ram 4.. ?X .dYIQ.... 1!! �J"r, r1r-' ...................................................... •--•- r - Location-:\dress or Lot No. C��.a.!_•....... ------•-----•-------------------•.._........-•--------•-•-•-,-..........•...............----.....--- Owner rA dress/`�J 1J -- Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms._...----_-____ -_ ---_-Expansion Attic ( ) Garbage Grinder ( ) per, Other—Type of Building 12¢ W_. No. of persons---.•----------------------- Showers ( ) — Cafeteria ( ) QI Other fixtures ---------------------------------- w Design Flow.................................'_Q5_-_gallons per person per day. Total daily flow...................._.._....�� ._..gallons. WSeptic Tank—Liquid capacity.1400galIons Length....._I_-___ VVidth.._4 Diameter_---.-__.___._. Depth___- x Disposal Trench—No. ....-Z............ Width..... ........... Total Length-----5®.------- Total leaching area..._�s`�c� Seepage Pit No---------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. l................minutes per inch Depth of Test Pit------_-_---____.__. Depth to ground water--._-.-.-----_-_-------- (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ C� ....-•-••-----------•--•--•-•---•-----•---••--------•------••-------•--•-•-----------•----•.........................•-•-•----••-•••-----...................- 0 Description of Soil----------------------------------------------------------------••-------------------------------------------------------------------------------••------...••---.-•--- x U •-•-•-•-•------•----•---•-•••-•••-•._.....--••------------•--•---••------•---•-----•-•--••----•----•--•••••-•-----•••-----------•-•---•---•-•---••--•--•--•------•----------•--•---•----••......--•-••-- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alteratios—Answer when ap�1lica�ble.- .!± c ._: _.. 5'_. a ; s'AIL( ......f • '° �t Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .�� ��'0 ......... ..... .......... .... Application Approved Q"��---�,- ... ............. ...:.......................... ....: „ V . Date Application Disapproved for the following rea.ronr: .................................... . .............. . . .......................... . .................... .... ... --................................ .. . ........-------------------------------- Permit No. '" ..... -.�.:.... - � Issued --- -��.......�`....�r.:..a.,r....1/. Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWNOF BARNSTABLE Certificate of V�IImplianre THIS 1 T) CER�TI , That the Individual Sewage Disposal System constructed ( ) or Repaired by ---------� � "--� Y ........p -.�c' ----......_------------------------------------------------------------------------------------------------------------------------...__----- Installer at .. 5 4-- m .... -- --------------------------------------------------------------- has been installed in accordance with the pro ions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No.,�P.'r" ------ dated':.— THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ......... Inspector-_. .f DATE. �� �, v ----------------------------------------------------------- ------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _.- TOWN OF BARNSTABLE 7 No..... 1....��..�® FEE--- . Uioposal orko �(u)notr uan �rrntit eIx Permission is hereby granted V- .: C � " •My^ J1!I........................................................................ to Construct ( ) or Re air (� an Individual Seage Disposal System atNo...... -. "1'1• Nl!lt .:_-- ---- ........ ---------•-------------- -------------------------------------------------------- Street as shown on the application for Disposal Works Construction Perrmit� ��__`��Dated_�'j-------------`-�... ty Board of Health DATE---- ''_. -._' � .......... FORM 36508 HOBBS a!t WARREN.INC..PUBLISHERS cxM�tx SOIL TEST � BEN 20 FT. MINIMUM FROM CELLAR DATE OF SOIL TEST 121191 2003 _�_ TOP OF FOUNDAT{ON ELEV. _ /00.00 10 FT. MINIMUM 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE SOIL TEST DONE BY 0AIG Ra i P- _ _ CLEAN SANG WITNESSED BY -ME Q!LQu21►JN (ASSUMED) OBSERVATION PIPE CONCRETE LEGEND: OBSERVATION HOLE 1 ELEV.-_ � COVERS 4" SCHEDULE 40 PVC PIPE LOAM AND SEED EXISTING SPOT ELEVATION 00,0 PERCOLATION RATE _< 2 MIN./INCH AT _-48=¢Q INCHES MIN. PITCH 1/8" PER FT. EXISTING CONTOUR ----00---- 2` LAYER OF DEPTH HORiZ TEXTURE COLOR MOTT, OTHER l 1 j8" TO 1 j2" FINAL SPOT ELEVATION WASHED STONE 4 FINAL CONTOUR CAST IRON PIPE �l �� SOIL TEST LOCATION " " j I E L 9L_ Z UTILITY POLE C? I S�! (OR EQUAL) MINIMUM _ ------ A LOAMY SAND NO PITCH 1 j4" PER FT, I TOWN WATER >�W.=,,..�Wo� ZABEL FILTER { i CATCH BASIN :\®� l 1O yle FLOW LINE E c BG.?a cn CLEAN OUT C Y ( E G�i 8-180 LOAMY SAND _ . NO _ PLUMBING TO B£ RAISED ELEV. _ _ 7 ° ° - _ .. .__..__ Q 10" CESSPOOL C.P. ~�-- MIN. I �_•_ �-- ! /��.;� { AND RE-PIPED BY A 22 V c LICENSED PLUMBER AS i LEV" �G•S� LEVOEL ° ' - i J 7a ° �f"s;2,s s{(�/1vi i L f ! , NEEDED >�p ELEV. 8`• 78 GAS ELEV. 8G• !? 6" SUMP ELEV. 86 ° - '~ E V. _ ___._� I V r A.r y4 ! 18-42• __ I MEDIUM SAN �fGNo BAFFLE _ ----- _�. DISTRIBUTION jo � ,..� ,z ELEV. f ! LIQUID OUTLET BOX 8'r-83 .4Vrr-P QIr' -SrCWE' /N 4 -1 »�_,-_,MEDIUM SAND / NO !EL 7.� 4 ET 14 INCHES DEEIH TEE (EXISTING) TO BE WATER TESTED //`X �.� 7'~'TRENCH FORMA TION S•� 5 FEET 19 INCHES IF MORE THAN ONE OUTLET WATER ENCOUNTERED AT _ 7.7' _ ELEv. = 7 7. 4- 6 FEET 24 INCHES 1500 GALLON WELL M �9 7 FEET 29 INCHES (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION 8 FEET 34 INCHES SEPTIC TANK ZONE 3/4" TO 1 1/2" CLEAN -_ O« a 3 DOUBLE WASHED STONE SYSTEM (SAS) INDEX ADJUST . DESIGN CALCULATIONS FREE OF FINES & SILT NUMBER OF BEDROOMS �r t� J GARBAGE DISPOSAL UNIT NO, NQI_ACLOWED USGS PROBABLE WATER TABLE ELEV. - 0. 2 TOTAL EST/MATED FLOW SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. - (110 GAL/HR./UAY X 5 fiR.) -M_ GAL./DAY NOT TO SCALE BOTTOM OF TEST HOLE ELEV. - 7�`r- REQUIRED SEPTIC TANK CAPACITY 1500 GAL. ACTUAL SEPTIC TANK CAPACITY 1500 GAL. EXIST. SOIL CLASSIFICA TION -L_ DESIGN PERCOLATION RA TE _ <5 _ MIN./INCH E'FFL LIEN T L OADING RA TE _Q_ GAL-IDA Y/S.F. LEACHING AREA !f I "x �J'T)r 9/,a j 'AS'g SQ. FT. LEACtim.G CAPACITY fi►'/J"Q n , 'j4' 41>3 GAL./DAY i RESERVE LEACHING CAPACITY GAL./DA Y NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. J. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH i DETERMINATION FROM APPROPRIATE AUTHORITY. 101 1.8 -�, ,T,.-S A"� a ononv�e��Tr ONLY, EXCAVATION. CONTR gCTO R IS TO C. U1,L� �LJ rl, vrrt. �� n, ,�vnnr�. :,.. CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO 1 COMMENCING WORK ON SITE. 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SITE I 99.gg' CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IMMEDIATELY. 4b ZONE r 9.8. CL IS IN FOD POT IS SHOWN ON ASSESSORS MAP -- IN- AS PARCEL 2M 102.0•-• D2 2 1 10. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER, AND FOR A 102.1 O� 0�• MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEM, AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3) (I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT. Q 817-4SPHAL T ---- Q F 9�.#-�`i ti S.�.S 11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND OR REMOVED. 0 �; 12. A ZABEL A1800 FILTER IS TO BE INSTALLED. a �4 - DECK i I V i • 13 CONTRACTOR TO PROVIDE SHORING AS NEEDED TO PROTECT BUILDING AND p� ���" 91• I I W I ,r. PROPERTY LINE. (j5 1D2.7 - I I Q1 i 40 '. . 4. Pk0P0,Se LES/Gam+ / S %-6 %2 � T I •./•` v'�/ 7"t( f-2 r+'� i �.'/ ...7 .J r"T Ca F- _S'_7'"'"G1/l,J,�C' .,� ..�' T'e o v,wxz APPROVED: BOARD OF HEALTH Q r go. I -- a J#2462 DATE AGENT �- 1h I ' " s PROPOSED SEPTIC DESIGN �7 FOR I 97.9 I ! 4 � dIT-ASPHALT 07 3 94.0 E JO HN_ P. MERLES ENA i 102.41 9a. L I 0 I 1 .� A i . I Loc. 9�. 103.2 1 3. 54 MELBO URNE ROAD 5� BARNSTABLE, MASS • 4 ' 02.5 LOT 35 1 I Wi N"ANNISPOR7 AREA 10,048 t S.F 1 r CR&G R SHORT, P.E. 508- 235 GP E 0.j BOX 1044 STERN ROAD laws v 398-8311 SOUTH DENNIS, MASS. 02660 1 A,1 c4ACA.'r =AN2004 SCALE � = 20' 8, REV. JOB N0. 1 --974 j LOCATION MAP ! F REV. SHEET 1 OF 1 01-0974 Marleseno.dwg 02004 CRAIG R. SHORT, P.E.