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HomeMy WebLinkAbout0277 OAKLAND ROAD - Health }r 94,Arrowhead. Drive 1� t' { Hyannis P • ___ .. A 271 089 7A� c4 a � p ° a wo ° ` e TOWN OF BARNSTABLE LOCATION `�y d`/�a O �J, F H rJ' �4 'y SEWAGE # a `::_•LAGE y .A �I-✓'-� ASSESSOR'S MAP & LOTa-7 D INSTALLER'S NAME&PHONE NO.)09P-e-/-1 SEPTIC TANK CAPACITY LEACHING FACILITY: (type)-3 38-;�'e1Wr11 ►e4,oTD ize)a.S X/Q2„f-"X NO. OF BEDROOMS �t z� tS9 R�GTt d �✓ BUILDER OR OWNER PERMITDATE: /1 O 2 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 1 I n y ® cu max ` d` o �`r I TOWN OF BAD%H-V& SE)AiAGE# RNSTABLE � LOCATION r ZG)-°'-V U)L VILLAGE n ASSESSOR'S MAP/&PARCEL 2 Dqq INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1 aQ� LEACHING FACILITY.(type) p, . oG,l (size) NO. OF BEDROOMS OWNER S PERMIT DATE COMPLIANCE DATE: Separation Distance Between the: — — Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching f c' 'ty) '` Feet FURNISHED BY . , / � _.. i � � .� *� - i' 4o i ,� 1 -. � ' �� � �- . . � _ .. .ram _ - _-_ _ i � ._ t ,{ , / 1 __� WNW - .� � � �� � .. � �1 . No. FEE COMMONWEAilH Of MASSACHUSETTS Board of Health, MA. APPLICATION F®I, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( - ❑Complete System dividual Components LocationRMA � l hflOwner's Name S r Map/Parcel# Address b Lot# Telephone# Installer's Name Designer's Name G Address Address 12 .t<t Telephone# Telephone# Type of Building �1 fVtw� Lot Size sq.ft. Dwelling-No.of Bedrooms °� Garbage grinder ( ) Other-Type of Building No.of persons Showers( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) gpd Calculated design flow Design flow provided 3 3Q gpd Plan: Date _1 Number of sheets I Revision Date Title -1 Description of Soils) C Soil Evaluator Form No. ` n Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS NkW (z) sm a a l The unde i ed agrees install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further ee not to ace the sMem in operation until a Certificate of Comp'ance has been issued by the Board of Health. Signe Date Inspections j...m FEE No COMMONWEALTH OF MASSAC1 USETTS .~Board ofHealth, � ,1 � I1 UL ; MA. : APPLICATION FOR,DISPOSAL SYSTEM CONSTRUCTION PERMIT , Application for a Permit to Construct( i Repair Upgrade(//�/[1/,'A ❑bandonO - Complete System Os�j4dividual C ( omponents LocationAMWkj e Owner's Name }r 1A A Map/Parcel# 2-1 1.-�� Address /A� . �,1` k V/--I' Lot# Telephone# � � Installer's Name -Designer's Name Address �j�A 7�� fd"Atr A 8l6r�1 i lef � Address Telephone# aj ( Telephone# k Ar) 11 C4 19 Type of Building U _ Lot Size sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building No..of persons Showers( ),Cafeteria( ) Other Fixtures tDesign Flow (min.required) 2-7 gpd Calculated design flow Design flow provided n gpd �Plan: Date.. e�C ��� b gNumber ofpsheets� /� Revision Date Title PYO K/�S�l �y� �' ''tla� 1� 'd !1/fl KiA k ��� �°7 i�a1 �Ll�p �!r'• �l�f� 1t 6 C Description ofSoil(s) A"' (�A0A 11_��" - Il Y �y 1� - ,�►A!� ,`r� �r� '9. f,r`f'CY . Cr/A /� n y • Y • 4\ V Y Soil Evalt ator.Form No �i r Y Name of Soil-Evaluator rinl 61,Or Date of Evaluation 17 i f7 nrl DESCRIPTI64OF REPAIRS OR ALTERATIONS t ) D BA `(2) 17N) 11 ra f - r r(I C L►4�q b. Ji v n The undersiS ed agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITI:E 5 and further agrees to of`to place the system'�n operation until a Certificate of Compliance has been issued by the Board of Health. 3 Signed ' at p) I I�_ i i Y r>wh .Inspections` # E O'C 000OC[J C O C O 000.)C.00 C 1GU•00 .;UGGCGOCGOL:(:.O C'C'Gu 0,G GO.O O C O 0:( :44 eo'0 )00 C, OCC.. )C•J,.01)C:o b00'.J..n.:,..^ci%111)C t",GO 0.00:J{.: p007.000('4)00 '�" No. h FEES ,'COMMON LTH OF MASSACHUSETTS t Board of Health, ' h rA& ,MA. CER Tit ICATE Of COMPLIANCE Description oWork: OtIndividual Component(s) ❑Complete System The undersigneile@e-yeby certify that the Sewage Disposal System; Constructed,( ),Repaired,( ),.Upgraded ( ),_Abandoned by: gwirnbi� at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application%No ✓ t�, dated 1 ,��7 Approved Design Flow (gpd) Installer 4 V F VA Designer: , hr r�,QJ�lt ��4�16G'S Inspector: t • Date: . 4Z') The issuance of this permit shall not be construed as a guarantee that the system will function as designed. .. 1000 01Co l:CCn CG0 C CGCf.J J'J"O CCC o O o C Oc J:`C O CCC Cc 00000;;^c ovo Ot.]C•.o O.:J n OoJ6'G.:0 0 0,.0004-„000 j Or,'10 0 1U C"..- C •O^�)• No. FEE COMMONWEALTH OF MASSACHUSETTS �. Board of Health, MA. �Y1w DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ' Abandon( ) an individual sewage disposal system, at C1 4 1A1 as described in the application forPt­ �'r9 Disposal System Construction Permit No ` 3 4 ;dated rrg Provided: Construction shall be completed within three.years of the date of this, •erinit. AlPlocal conditions must be met. Form 1255 Rev.5196 A.M.Sulkin Co.Chadeslown,Ma Date.' �rf� ,�B�oard of Health ��td- Town of Barnstable °f` FOk•1. Regulatory'Services ..� °.. Richard V.Scali,Interim Director �nerrsrtisr:e; _ qMASS ,eg Public Realth Division Thomas McKean,.Director 20014Itrin Street,Hyannis,AU 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 12,156 f 7r-0 Sewage Permit# �Z_Assessor's MaplParcel Designer: r.1e@r.` -Utt(t(fdS (yiC Installer: Address: Address: :39 On Ca,_~ s &66SA, ` l" vas issued a permit to install a: (date) (installer) septic system at gAM W"q a4 Pc' AVr(AW i based on a design drawn by (address) Ava r�t cs,Jk c dated t L(� (designer) 1/. I certify that the septic system,referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box. and/or septic tank. Strip out.(if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation.of the SAS or any vertical relocation of any component of the septic system,)but in accordance with State.&i Local Regulations. Plan.revision or certified as.built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in with the terms of the AA appro al letters-(if applicable) N PKN6AR E taller's Signature) CIVILos Na 35 0 (Designer's Signature) (Affix Designe ere) PLEASE RETURN TO ,BARNSTABLE PUBLIC HEALTH DINgSION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- ; ' BUILT Ci4RI?ARE RECEIVED BY THE BARNSTABLE PUBLIC HEAL"l'H DIVISION. THANK YOU. Q:`.Septictuesigner Gertifrsadon'Fonn Rev 8-14-13,doc i Engineers note;This certification is limited to an as-built inspection of system components as installed prior to backfill_The. engineer did notsupervise construction of;the system.The installer assumes responsibility for all materials,workmanship,backfilling to specie grades vath proper.compaction and setting dsersicovers as shown on the design plan. ..:k....`..-�...`f. ...�-. .. .._,�. ..-.a......................�.-.� .-_.. ..._..-«.-« ... �...-.... .- __ .. .....-... _ ... _ .. .. .. .. .. .. ..max .. } ,. No. 5 6-.1 } Fee •7 THE COMMONWEALTH OF MASSMCHUSiETTS Entered in computer: Yes PUBLIC H ITH DIVISION - TOWN OF BARNSTABLES.MASSACHUSETTS 0[ppYication for Oi5pogal �bp.5tem Cottgtruction i3ermit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. ? Owner Name,Address and Tel.No. `i`f Ae2.ocv41rdev ; � *w '. .�iZg 8iz7 2,9 ,ee®se, Assessor's Map/Parcel Installer's Name,Address,and el.No. Designer's Name,Address and Tel.No. S o � 7 �.3'- end �G � 3s" � � 5a2 • Type of Building: Dwelling No.of Bedrooms 1�),— Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow C2 �D _ gallons per day. Calculated daily flow 3 3 �� Sr'1� gallons. Plan Date 3 Number of sheets Revision Date Title _ Size of Septic Tank F X. s 7 /D Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicab 1 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 t-o place the system in operation until a Certifi- cate of Compliance has been issu s Board of Health. n % Date Application Approve t✓ _ _ Date Application Disapproved for the following reasons Permit No. s 5 Date Issued No. a00 S 6 /00 Fee rx�s .,THE COMMONWEALTH OF MASSAt�ilr'3�� S Entered in computer: k a _ PUBLIC HE DIVISION, =TOWN OF BARNSTABLE., MASSACHUSETTS Yes Zfpplicat on tor M g�pogar *pgteiu Congtruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. JJ// Owner's Name,Address and Tel.No. l ( ;ny w`d�irJi f `j 41 A2 2O k///l r i9 Gr'"r �� a /i Z A �E T� i Assessor's Map/Parcel Installer's Name,Address,and el.No. Designer's Name,Address and Tel.No. Type of,Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow _ O gallons per day. Calculated daily flow `�, �- gallons. Plan Date 1! /J �� Number of sheets Revision Date Title Size of Septic Tank Z-,-,k 2) Type of S.A.S. Description of Soil M "" `Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title,,5 of the'Environmental Code and not-to place the system in operation until a Certifi- 1 cate"of Compliance has been issued-by, s;Board of Health.,.,---- Af Signed f' _ c`.�- � . __ __ Date- Y.5 'Application Approve Date _._''Application Disapproved for the following reasons Permit No. 1-400 S 5 Date Issued -- -----_---- THE COMMONWEALTH OF MASSACHUSETTS ; BARNSTABLE, MASSACHUSETTS Certificate of Compliance � THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( ) Abandoned( )by u f 1f �; • g —>_ at 2 d -) vA ,.lias been constructeo in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.a)O S 56--q dated e Installer ©) 9; - // Designer./ 2 6? r= •a/ /'/. t (2._ The issuance of this permit shah not be construed as a guarantee that the system ill fu�nNtion as designed. Date G! f Inspector No. %,Do S T& Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS DIgpogal *pgtem Con!5truction Permit Permission is hereby granted to Construct( )Repair.( )Upgrade )Abandon( ) System located at �/ /'��' -2 v 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 tlu" —"--- Date: � Approver by ---� / 11/17/2020 ShowAsbuilt(1700x2800) TOWN OF BARNSTABLE / LOCATION �'`l/� �"JLae, j 6Asn be SEWAGE VILLAGE- ASSESSOR'S MAP&LOT�•7/ o- INSTALLER'S NAME&PHONE NO.A e OH ST S O F Y%r/.3 6;X SEPTIC TANK CAPACITY i t s T /.P a d} LEACHING FACILITY:(type)3 - 3di 01�✓Fi//'Q✓°To'e(Siu1 a!X/a...f—X Z NO.OF BEDROOM /�i 80 ES7/.t ic -,tr W I.BUDEROROWNER E�tRdE>•.r d-a220ro PERMTTDATE:/�LQio COMPLIANCE DATE: Separation Distance Between the: . Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wedand and Leaching Facility(if any wetlands exist within 300 feet of leaching facility) Feet Furnished by I Gal e eX�6f /qC 13GJr /9 . oa N��'- 3�' .p13•x � 081iQpnrie , E D= i https://itsqldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=271099&sq=1 1/1 T.oWh of Barnstable Regulatory Services R .. S Thomas F.Geiler,Director BAMSrnsXAW.r.e. + 4� .•�q Public Health Division arEoA Thomas McKean,Director 206 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: Wpj W Designer: J�✓� Y V �/ �� Installer: Address: . E D- / Address: R a k 5' //,y/-)/V/-�/ Y/I On was issued a permit to install a (da e) (installer) se tic system at V &,le i lh ea d based on a design drawn by (address) - _. .-� (� . ' � dated J1 (designer) certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I'certify that the septic system referenced above was installed with majoi changes (i.e, greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. RAN OF Atis � S,yC o� DARREN y�N o M R , (Installer's Signature SgNI TAR\Pa esigner's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE.BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form Notice: `IThis Form Is To Be Used For the Repair Of Failed .v Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, eM U',hereby certify that the engineered plan signed by me dated [ ,concerning the property,located at -`+ A -Iwo hL&-P--o D P-L`U-r,- meets all of the following criteria: • Two soil evaluations excavated for detailed examination(no hand augering) and two percolation tests shall be conducted.. • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There,is no increase in flow and/or change in use proposed • There are no variances requested or.needed. • The bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable], Please complete the following: A) Top of Ground Surface Elevation(using GIS information) �� • S B) G.W. Elevation �� +adjustment for high G.W. 4 , = 32 2 O DIFFE BETWEEN A and B 7 •� �� 2 I1 �J a SIGNED :v DATE: l ( w� NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. gASeptic\percexemp.doc Bk `0457 PsS -MBr-79090 1 1` 09' 213e:05 a 138 0 33ot iN DEED RESTRICTION The Barnstable Board of Health has determined that based on State Environmental Code, Title V; 310 CMR Section 15.203(2) and 15.214, the following restriction(s): - Existing dwelling restricted to 2 Bedrooms be placed on the property located at 94 Arrowhead Drive, Hyannis, MA 02601, Assessors Map: 271 Parcel: 099, as property referenced in the Deed File in Book 15336 Page 148 at the Barnstable County Registry,of Deeds, as it deems those restrictions necessary to protect public health and safety and the environment per the State Environmental Code, Title V: 310 CMR Section 15.413 (1). as owner of the property referenced above acknowledge the deed restriction(s)being placed on the property. Owners Signature Date The person named above: �� Acknowledges the foregoing instrument to be his/her free act and deed, before me. ary Public c�` My Commission Expires: = COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL. PROTECTION V TITLE.5. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY:ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A MAP �-� CERTIFICATION PARCEL • O� LOT Property Address:. 1e® - c. .4 Owner's Name: � � Owner's Address: ' Date of Inspection: RECEIVED Name of Inspecto (plea a rint). D] � J � OPkA Company Name ,IUN 4 4.2002 Mailing.Address: . O Q CAI�" . TOWN OF BARNSTABLE HEALTH DEPT, Telephone Number: (�� CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information,reported below is true, accurate and complete as of the time.of 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 t Section 15.340 of Title 5(310 CMR 15.00.0). The system: Passes Conditionally Passes Needs.Further Evaluation by the Local Approving Authority Fa'1s - Inspector's Signature: A Date: The system inspector shall submit a copy of this inspection report to.the Approving Authority(Board of Health.or DEP)within 30 days of completing this inspection. If the system is.a.shared system or has a design flow of I0,000 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. RECEIVED JUN 3 2002 Title 5 Inspection Form 6/15/2000.. page 1 TOWH�L.TH DEPT BLE t , Page Tof 11 J OFFICIAL'INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION.FORM PART A CERTIFICATION (continued) 0 Property.Address: A404 `Owner. ` Date of Inspection: lnspeefiori Summary: 'Check A,B,C,D or E/ALWAYS complete all of Section D 9AM ""A:" yste-° Passes: a33�a9 I have not:found ariy information which indicates that any of the failure criteria.described in 310 CMR ;•°l--5-30,3•,orin'3'1'0"CMR 15.304 exist.Any failure criteria not evaluated are indicated'below. Comments: B. System'Conditionally Passes: One`or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair, as approved by the Board:of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please . explain. The°septic tank is metal-and over 20.years old*or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a.complying septic tank as approved by the Board of.H.ealth. *A metal septic tank:will:pass inspection.if it is structurally sound,not leaking and if a Certificate of Compliance indicating that`the'tank is less than 20 years old is available. ND.explain: Observation of-sewage backup or break out or high static water level in the distribution box due to broken or bbstructed::pipe(s)or.due to a broken,settled or uneven distribution box.,System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed 'distribution box is leveled or.replaced ND explain: The.system'required pumping more than'4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with.approval of the.Board of Health):. broken pipe(s)are replaced obstruction.is removed ND explain: 2 Page 3 of l'l OFFICIAL INSPECTIONTO.RM.-.NO.TTOR VOL.UN.TARY`•ASSESSMENTS SUBSURFACE,SEWAGE DISPOSAL.SYSTEM IN FORM PART A (`/ CERTIFICATION(continued). Property Address: p Owne e Date o*Inspection: O 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 Ts failing to protect public health, safety, or the environment.. 1. System will.pass unless Board of Health determines in accordance with 31.0 CMR 15.303.(1)(b)that the system is not'fuiictioning.in a manner which,will,protect public health,safety and.the environment: _ Cesspool or privy is within 50 feet of a surface water 'Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will.fail.unless the Board of Health (and Public Water Supplier,if any)-determines that the system is.functioning in a.manner that protects the.public health,safety and environment: _ The system has a septic tank and s.o.il absorption system(SAS)and the.SAS is within 1.00 feet of a surface water,supply'or tributary to a surface.water supply. The system.has a septic tank.and SAS and the SAS.is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and.SAS and the SAS is less than 100,feet but 50 feet or,more from.a. private water supply well*"..Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the.presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided..that no.other failure criteria are triggered.A•copy of the analysis must be attached to this form: 3. Other: 3 Page 4 of I OFFICIAL,INSPE�CTION FORM-NOT FOR.VOLUNTARY ASSESSMENTS `'SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION;FORM' PART A CERTIFICATION(continued) Property.Address: Owner: Date of Inspection: D. S.ystein Failure Criteria applicable to all systems: You must indicate".yes"or"no"to each of the.following for all inspections: Yes N Backup of sewaee 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 Statii:liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool V/Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2day flow _ �/ Required:pumping more than 4 times in the last year NOT.due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS, cesspool or privy.is below high ground water elevation. Anyportion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface / water.supply. 1/ Any portion da' 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.. t/ Anyportion of a cesspool or.privy is less than 100 feet but:greater than.50 feet from a private water supply well-with no acceptable water quality analysis. [This system passes if.the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic.compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen.is equal to or less than 5 ppm, provided that no other failure criteria are'friggered.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 1.5.303;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*systemahe system must serve a facility with a-design flow of 10,000 gpd to.15,000 .gpd• You must'indicate either"yes"or"no"to each of the following: (The following criteria apply to large system:.in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of-a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—I WPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the sy"stem 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 ur:der Section D shall upgrade the'system in accordance with 3 10 CMR 15 304..The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 1.1 OFFICIAL.INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAI SYSTEM INSPECTION FORM CHECKLIST Property Address: Owner: Date of Inspection: el 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 ere.any of the system components pumped our in the previous two weeks? _V as 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?(I.f'they were not available note as NIA) tzf-- Was the facility or dwelling inspected for signs of sewage back up? 6, — Was the site inspected for signs of break out? _ Were all system components, excluding the SAS;located on site T Were the septic tank manholes uncovered;opened; and the interior of the tank inspected for the condition ��thb`affles or tees,material of construction, dimensions,depth of liquid',depth.of sludge and depth of scum? Was.the facility owner(and occupants.if different from.owner).provided with information on the proper maintenance of subsurface sewage disposal systems.? The size'and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes l/ no /Existing information.For example, a plan.at the Board of Health. v— Determined in the field(if any of the failure criteria related-to Part C..is at issue.approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page.6 of 11 OFFICIAL INSPECTION-FORM=NOT FOR VOL'UNTARY'ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM PART C SYSTEM INFORMATION Property Address: a Owner:. Date of Inspection: 200 FLOW CONDITIONS RESIbtNTIAL1..---­� Nuniber'of b''dr"6oms(:design):,: Number of.bedroonts(acttial): DESIGN flow based*on`310 C1vIR 15.203 (for e)6mple: 11:0 gpd x 4 of bedrooms): Number of current residents. , Does'residence.'have.a garbage grinder(yes or no)�-4L Is laundry on a separate sewage`system`(yes or o);< if ves separate inspection required] Laundry system inspected(yes or no): � Seasonal use: (yes or no)— // y Water meter readings; if available(last 2 years usage(gpd)): of"D 3i 7,o 0Z -0/14I00111 Sump pump(yes or n — Last date of occupancy: ��0� Au ✓ COMMERCIAL/INDUSTRIA-j, Type'of establishment: Design flow(based on 310'CMR.15.203): gpd ' Basis of design flow(seats/persons/sgft,etc,): : Grease-trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged fo the Title'5 system'(yes or no):-_ Water meter readings, if available: Last—date—of—occupancy/use: OTHER(describe): GENERAL;INFORMATION Pumping Records Source�of information:W,) Was system.pumped as.part'ofthe in pection Yes.orno)- If yes,volume pumped: gallons--'How was quantity pumped determined?. Reasori'for putriping: . TYPE OF SYSTEM V"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 front system ownei) Tight tank _Attach a copy:of the DEP.approval _Other{describe): proximate a e of all eompone s,date installed if known nd source f information: Were-sewage-odors,defected when arriving at the site(yes'or no): 6 Page 7 of 11 OFFICIAL INSPECTTON FORM,-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Z26/ Owner "ry Date of Inspection: BUILDING SEWER(locate on site plan)✓, '/"v Depth below grade: Materials of construction:_cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTICTANK: a' (locate on site plan) Depth below grade: Material of construction:Jefconcrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:- Is age confirmed by a Certificate of Compliance(yes or no):—(attach a.copy of certificate) Dimensions: . Sludge depth:,, [o_�/ Z Distance from top of sludge to bottom of outlet tee or baffle: 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 paffle'. How were dirriens10. determined:- Comments(on pumping recommen'cf6tions, i et and outlet tee or baffle.condition; structural integrity, liquid levels ra,s related to outlet invert,a idence of leak ge,etc.) e ` r. GREASE TRAP: sate on.site lanC �i' IZCP� Depth below grade: Material of construction:_conuete_metal_fiberglass polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet.tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage;etc.): Page 8'of71 'OFFICIAL JNSPE:CTION FORM—NOT:FOR VOLUNTARY`ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .PART C -SYSTEM'INFORMATION*(continued) Property Address: 9�2AA_Q( lGiG4/1� . Owner:- Date.of Inspection: . TIGHT or HOLDING TAN&._&'(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass__. polyethylene other(explain): Dimensions: Capacity: gallons Design Flow:_ gallons/day Alarm.present(yes or no): y Alarm level: . _ Alarm in working order(yes or no): Date of last*ptimping: Comments(condition-of alarm and float.switches, etc.): DISTRIBUTION BOX: (/(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distributicn to outlets equal,any evidence of solids carryover, any evidence of leakage into 0 out f box, LyV ,lo Ocl� /Ilts PUMP CHAMBFtRlocate onsite plan) Pumps In working order(yes-'or no): Alarms in'working order(.yes or no):.___.:_ Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):_ _ 8 Page 9 of 11 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM. PART'C SYSTEM INFORMATION(continued) Property Address: Owner: Q Date of Inspection: SOIL ABSORPTION SYSTEM (SAS):. V (locate on site plan,excavation not required) If SAS.not located explain why: Type - - leaching.pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number, dimensions: overflow cesspool;number: innovative/alternative system Type/name of technology: Comments(note condition ofsoil,signs of hydraulic failure level of ponding, damp soil;con ' ion of vegetation, s (� 0 / ARJ c /1 i, 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 or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition.of vegetation,etc.): PRIcate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 p. OFFICIAL:INSPECTION FORM=NOT FOR-VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEMINFORMATION'(continued) Property,Address.: . Owner: Date of Inspection:.: SKETCH`OFSEWAGE DISPOSAL.SYSTEM Provide a sketch of the sewage disposal syst:m 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. f ll Ig �0 � 00 10 . Page 11 of 1 I OFFICIAL- INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . SYSTEM.INFORMATION(continued) Property Address: Owner: Date of Inspection: 00a 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 U.SGS database=explain You must describe how you established the high ground water elevation:. S, it Permit Number: Date: Completed by:. HI'GH•GROUND-WA.T ER LEVEL COMPUTATION Site Location: G G i _� Lot No.. Owner: 57/iJ0 Address:. &,;? A/ Contractor:_ i?� ly�f�lj C�a/�,5� Address: Notes:. STER• 1 . Measure depth so-water table ` to nearest.1./10ft. Date_ Z } month/day/,year ST. P 2 Using.Water-Level.Range Zone and Index WeIL.M:a.p:locate • site•an.d determine: OA APpro.priate.index well........................................... OWater-level range zom,:..................................................Y' S:TP:,:3:: Using monthly.repo.rT•'"Curren•t Water Resources-Conditions" determine current-de:ptn to . water level for index well ........................... month/year STEP. 4.. � .. Using:Table.oa Wate.r;lwel Adjustments for index well (STEP 2A),:current depth' to water'level for. index well (STEP 3}, and waterdevel zone (STEP•2B) determine water-lev.el•adjus•tmen.t .................. ( �l S.T•U: 5 stimate depth to:high water by subtracting the*water- level adjustment.-(STEP 4) from measu.red.depth to-water level•at.site.•(STEP 1)'............._............................:. ......................................... �IJure 11—,Seproducible.computation icr,Ti: %.SZs `t i 3 a Y•. r I) � A7 � n BORTOLOTTI CONSTRUCTION,INC. f vGZ Taw 765 WAKEBY ROAD,MARSTONS MILLS,MA 02648 508 771-9399 508429-8926 FAX: 508428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION PART A to CERTIFICATION Property Address: Date of aL G o Inspection: I pector's e: Owner's ame and Address: 0a 0 / CERTIFICATION STATEMENT- I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true,accurate and complete as of the time of inspection. The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal stems. The System: Passes Conditionally Pass Needs Further Ev� uon ocal Aproving Authority Fails Inspector's Signature: Date: The System Inspector shall,submit.a copyof this inspection report to the .-kpproving authority within thir- ty(30)days of completing this inspection. If the system Iis a shared'system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department.of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. PISPFCTION SUDDIA Rv• A)SYSr TAM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CIMR 15.303. Any failure criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system,upon comple- tion of the replacement or repair, passes inspection. Indicate yes,nor,or not determined(Y,N,OR ND). Describe basis of determination in all instances. If not determined",explain why not. The septic tank is metal,cracked,structurally unsound,shows'substantial infiltration or exfiltration,or tank failtire is imminent: The system will pass'inspection if the existing sep- tic tank is replaced with a conforming septic tank as approved by The Board of Health: Sewage backkup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or.uneven distribution box. The system will pass inspection if(with approval of The Board of Health): -1- b SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of The Board of Health): Broken pipe(s)are replaced Obstruction is removed C)FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 Feet of a surface water Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh. 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank-and soil absorption system and is within 100 Feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm.. D)SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent 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 clog- ged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s)'. Number of times pumped -2- 'I J ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . .PART A" . .7 CERTIFICATION(continued) Any portion of the Soil Absorption System,cesspool or`privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 Feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well Any portion of a cesspool or privy is within 50 Feet of a private water supply well. Any portion of a cesspool or privy is less than 100 Feet but greater than 50 Feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 systerim is located'in a nitrogen sensitive area Interim Wellhead Protection Area. (IWPA)or a mapped Zone II of a public watersupply.well. The owner oroperator of any such system shall bring-the system and:facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Check if the following have been done: ✓ Pumping information was requested of the owner,occupant,and Board of Health. ✓ None of the system components have been pumped for adeast two weeks and the system has .been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As-built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _-LAll system components,excluding the Soil Absorption System,have been looted on site. The septic,tank manholes were uncoyered„opened,and the interior of the septic tank was in- spected for condition of baffles or tees, material of construction, dimensions;depth of liquid; 'depth of sludge,depth of scum. v The size and location of the Soil Absorption-System;on the site has-been determined based on existing information or approximated by non`=;intrusive methods -3- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL:. Design Flow: . D allons Number of Bedrooms: --R Number of Current Residents: Garbage Grinder: ILIV Laundry Connected To System:—Ye Seasonal Use: Water Meter Readings, if availa le: Last Date of Occupancy: 92 COMMERCTALmvD rSTRTAI s Type of Establishment: - Design Flow: gallons/day Grease Trap Present: (yes or no) Industrial Waste Holding Tank Present: _ --••• i Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings, If Available: Last Date of Oc6pancy: OTHER: Describe) Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System Pumped as part of inspection: If yes,volume pumped: gallons Reason for pumping: TYPE OF SYSTEM: r/ Septic Tauk/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,attach previous inspection records, if any) Other(explain): APPROXIMATE AGE of all components,date instilled(if known)and source of information: 8� Sewage odors d6t6cddwhen arriving at the site: , A) -4- _ J SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' 'PART C GENERAL'INFORMATION (continued) SEPTIC TANK: ✓ - . Depth below grade: 5" Material of Construction: ✓concrete metal FRP Other (explain) — Dimisions: ' X S Sludge Depth: Scum Thickness:_ Distance from top of sludge to bottom of outlet tee or baffle: y�� Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of�', 'level 'n relad n to uti t invert, structural inlegri ,evidence of leakage•etc.) /pro y„ GREASE TRAP:fig O Depth Below Grade: btaterial of Construction: concrete . metal FRP Other (explain) — — — — Dimensions: Scum Thickness: Distance from top of scum to top of outlet tee or baffle: , Comments:,.(recommendation for pumping;-condition of inlet and.outlet-tees.or baffles,depth of liquid `' level in relation outlet invert, structural.integrity,"evidence oPleakage;etc.) ' ' - TIGHT OR HOLDING TANK: Depth Below Grade: Material of Construction:—concrete metal FRP Other(explain) Dimensions: Capacitv: ,zalIons Design Flow: o Alarm Level: - — allons/dav Comments: (condition of inlet tee. condition of alarm and float switches. etc.) DISTRIBUTION BOX: I Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of 1' carryover, evidence of leakage into or out of box,etc.) PUMP CHAMBER:AIC) Pump is in workizig order: _ Comments: (note condition of pump chamber,condition of pumps.and appurtenances,'etc.) SUBSURFACE SEWAGE•DISPOSAL SYSTEM INSPECTION FORM PART C 'SYSTEM INFORMATION'(continued) SOIL ABSORPTION SYSTEM(SAS): (Locate on site plan,if possible;excavation of required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: Leaching pits,number: - / Leaching chambers, number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure level of ponding,condition of vegetation, etc.) g lAnn CESSPOOLS: TNG 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(cesspool must be pumped as part of inspection) Comments: (note condition of soilk, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: / b Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) -6- .-SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION,(continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to adeast two permanent references, landmarks or benchmarks Locate all wells within 100 Feet I �aN \ Or 14L,U S - C 14, < < iu 'ty 6 DEPTH TO GROUNDWATER ' Depth to groundwater: 2 Feet Method of Determination or Ap rommation: IIW1141X1 11Ito w7e;4eV� �- s —q a L,0 C A"T10 l7 SEWAGE PERMIT NO. _LoT -*// a VILLAGE l Y4"vt S I N S T A LLER-S NAME A ADDRESS P0,C- -D ry,5:t oo/►-e:,T Cato, 90l .q,v G7- - S U IL�L D E R OR OWN ER ( T�GGlUE �cA-�Fcy DATE PERMIT ISSUED A DAT E COMPLIANCE ISSUED t , T t � � q- �o g, v p1 9�5. I -S f)0!-� n No -q'-95 Fss ...�.�......... THE COMMONWEALTH OF MASSACHUSETTS BOARD - OF HEALTH ...........%©w ..........OF.....:. /3r�nisT�-3G�.. ............. Appliratinn for Dispaii al Works Tatuitrn.rtion runfit Application is hereby made for a Permit to Construct (LT or Repair ( ) an Individual Sewage Disposal System at: w� ... �... --''!!5---------------- ----------------------------�T�//.------------------------------------------- Location-Address or Lot No.' l' �� ......................................... T .......1- ---•---------............. r ............. - ._...... w er W . ddress ---------------- Type - - ............... ......••. ........-- -------.-.......----------.•-.............. Installer Address d of Building Size Lot.._9-35......... feet Dwelling-No. of Bedrooms........... ...........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ........................•............................................................................................................................. W Design Flow............. .-��.._.....................gallons per person per day. Total daily flow..........Z.zo......................gallons. WSeptic Tank—Liquid'capacity.!?gi?..gallons Length-8�. Width_.`�'�."._ Diameter................ Depth.S�8`/.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........!........... Diameter...... Z ___. Depth below inlet.... Total leaching area...z _....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 04 Percolation Test Results Performed by 4W.c✓��....Gr._.�-��4G'Y........... .a Test Pit No. 1_.G__Z.....minutes per inch Depth of Test Pit.-Z .... Depth to ground water..__..'............. 44 Test Pit No. 2--- _Z___.minutes per inch Depth of Test Pit... _... Depth to ground water........................ P4 ....--------•--•--•-----•---••-•-••-•••••------------------•--------...-•------------•----•-•-•••----...............-•---......---•-----.......... --------- O Description of Soil........ ....40!Y-7.... C-..------- - `SGr x w x ------•--•---•----------------•--...-------••-•----------•--•--•••••--•----...-----•••--------.....•--•••-••-•-------------------•-----••--•--------••---------•--••----••••-•---.......--•------------- 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be d b eabof health. Signed-- ------------- Date Application Approved By.. c= ... .- .... . ----•--• • ----•--------- __ Date Application Disapproved for the following reasons:....................................................................................= -----•----------------------•--•--------..........----•--------•...------------.......•••------..........._......_....•--•--•--•-----_......-•--------•----•------------••---•_._..•••-------•--------•-- Date PermitNo......................................................... Issued....................................................... Date 1 N - FE ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .... Wn/...........OF.......� nis..T.. �`.��ZL..:..... Appliration for Disposal Works Tonstratrtion Vernfit Application is hereby made for a Permit to Construct (cif or Repair ( ) an Individual Sewage Disposal System at: Location-Address t or Lo No. ............. c iz�c� 3c',,-_: y .� �sr! .; t s s........................... __ .................................... - " -- Owner Address a ........ tom- ice................ --------•------•••-••-------------••---•......._.............----- Installer Address Type of Building Size Lot.. ,3 ..........Sq. feet �.4 Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a - d Other fixtures ------------------------------------•-••---------------••-----•••-••-----•-•----•-----------•--•---•...••-------•------••......•-----............--- -13 Design Flow............................................gallons per person per day. Total daily flow.........Z ......gallons. Septic Tank—Liquid'capacityLen�q...gallons Length.�.�.:...... Width..4_�G.".... Diameter................ Depth. "e_'.:._. x Disposal Trench-No..................... Width.................... Total Length.................... Total.leaching area....................sq. ft. Seepage Pit No_....l............. Diameter......ZZ........ Depth below inlet...3• .... Total leaching area...2 ...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a . Percolation Test Results Performed by..... ?a!�!M�!�.....4.......... z«Y........._.. ............. --- Test Pit No. 1_.4f...........minutes per inch Depth of Test Depth to ground water..... ............... 44 Test Pit No. 2..G_Z:.....minutes per inch Depth of Test Pit..Z�`?........ Depth to ground water........................ M -----------------------------•-•--................---------........----•--•-•--••---••-•--•--•-----...-----•---•-------••-•----••-••-•----•-•-•------•-•--••- D Description of Soil...... o ry Sv3'So c_ / 4.:. ..... zs.s S n...... x V W V; 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in, operation until a Certificate of Compliance has be s d b e bo f health. Signed. ........ ................••----••-•--••-.••... --------•--•.............-- Application Approved By....• ....: ::�:. ? - te r .......................... ..................--Date-----....-: Date Application Disapproved for the following reasons-....................0............................................................................................ .......---•---------•--•--------•....----•----•-••-••-•.................••-----••--•---•-------........_..__........----••---•------------•-•----•-•-•-••----••--•-•----•-•--••--•------•-----•-.... Date PermitNo..............•-•---•---.......--•---....-•-•----------. Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........T.Y!!i ...........OF...... ?. cuSTl�3L.�., (Inrtif irFatr of ToutpliFanrr T IS1 IS TO CERTIFY, That t1_r,_Individual Sewage Disposal System constructed or Repaired ( ) by------- - -- i.)ftcl. . --------------------------------•--.....................----•-----...............---•--............-•----•---.... t stauer at_....... —e �_....._. .�.�,.r..f '3A :Y., ............................................................... has been installed in accordance with the provisions of TITLE p 5 0ijThe State Sanitary Codes described in the application for Disposal Works Construction Permit No...... ......... dated...... 9S................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON TRUE® AS A GUARANTEE THAT THE j SYSTEM WILL F NCT ON SATISFACTORY.. . -•--• DATE.............. ••----......•-••-•--------•----•--•----- Inspector........--- . ...... ......................... . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r� (.! ..........0F.......... .............................. ? No........................ FEE--, :Z ......---- DispooFal Works Tonstr ' n rrntit Permission is hereby granted.......... � ;`f,< -'-'!•^ to Construct (4--) or Repair ( ) an Individual�Se,%y age Dis osal System at No.............!,:!t.----(A..... �``�r�v1�'?��:�.....� 'C.1.►?�'.--• ,( treet as shown on the application for Disposal Works Construction, ermi No. s_.1�r� Dated.­-*-)...a( ................. �. k• ' a t, ..---------------------- TON •....,, wr.,.J"�, � ..� ... W Q P/2upo SE'D D/L Vt I VOL".' F i0 Disc. O p P�zowasEv v / y 3s 20 ,QFSE7LVc4 a�. V LoT /Z. 391 No7�''- E-2�Y�tr��•vs /,�/�s�-v aN -S/TG /�L•�1 LOCATION SCALE . Zo..�. . . DATE /ape!G iB �y�S PLAN REFERENCE . .Z-Fl?'uG Lo7'`y// 11 c rwY P�46 4/ E. No. 26100 des C ST I CERTIFY THAT THE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF WHEN,CONSTRUCTED. DATE . . . . . . .. . . . .. REOISTERED LAND SURVEYOR Z a F L S// ZI-Ts" ✓rFEL. . �'SOO. . . ... . TOP OF FOUNDATION e„ CONCRETE COVER •;° CONCRETE COVERS 4,33 'e a 4"CAST IRON 12��MAX. �T ' OR SCHEDULE 40 12"MAX. • P.V.C. PIPE 4 SCHEDULE 40 P.V.C.(ONLY) • PITCH 1/4"PER.FT. PIPE - MIN. LEACH PITCH 1/4"PER.FT. PIT PRECAST C •'•• LEACHING o.' INVERT a EL. ..•�7... INVERT INVERT e� tw q:. PIT ORSEPTIC TANK Z DIST. .;( EQUIV. ° INVERT EL..'f?r. 9 . . BOX EL.......... ' : >x /oo o.. .. GAL. INVERT 3 S►=a O: •'�' INVERT ;;' w w �. :;i; 3A TO 11/2 EL404. EL3f'80. :.' WASHED _ I •;01•' w .;'� STONE /of a• . . �' / X. Z' D I A. ENca�.vstau a PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE -4Z o Z SOIL LOG WITNESSED BY.: DATE !rt'8-?i�f TIME. 9: .'�'� T�HCS w"� ^�. BOARD OF HEALTH TEST HOLE I TEST HOLE 2 .�� ENGINEER ELEV. . 44--4- . . ELEV. .4.(- . . Z4i ;CS�B-Soi�- f DESIGN DATA : " NUMBER OF BEDROOMS TOTAL ESTIMATED FLOW . . .�'?4 , , GALLONS/DAY lot, A&Z, BOTTOM LEACHING AREA ��3 . . . SO.FT. /PIT/G',PJ>. etc q 9a� Ce p SIDE LEACHING AREA SQ.FT./ PIT/3,'Y.9C om Cogns�� GARBAGE DISPOSAL .Nan!C •(50% AREA INCREASE) TOTAL LEACHING AREA . ? '�'�? SQ.FT A$ql" eZ. 30"ory / 4_rZ.32.3o PERCOLATION RATE VIAP`!?3419. MIN/INCH LEACHING AREA PER PERCOLATION RATE ' �8 SQ.FT/,:RD, .NA .WATER ENCOUNTERED O.vG P/T GdiTJ/ NUMBER OF LEACHING PITS . . . . :'. . . . . APPROVED-.-- BOARD OF HEALTH - S�a�'s, DATE . . . . . . . -. . . . AGENT OR INSPECTOR ��L111 OF ,?�S qua '^ I OF '. Z )) ^� u KELLEY �O v AL - FIO..'20100. ` 0 C4 v V6 'ter �FGtST§R�O, =� ,t. SiQ�AL •/• SgNRA\P PETITIONER y t t 1 LEGEND -x 100.98 EXISTING SPOT GRADE J' Barnstoblestructures© A. i 90 EXISTING CONTOUR 7JJJ JJ 8 GrounG ' =Gym lV F moat y Lt TING S.A.S. 100 PROPOSED CONTOUR EXIS ervicesr� ( �! ;: s TO BE ABANDONED W EXISTING WATER SERVICE :redit_I r a ` SeaMeadoi1.\ ege® STRPOUT AS REQUIRED 1� a �:- y SEE NOTE 11 G EXISTING GAS SERVICE EXISTING D-BOX 6.H W. OVERHEAD WIRES a PER RECORD AS-BUILT ( ) N 12'02'10" E TEST PIT REMOVE / ?;' + •t �94Arrowhead)Drive 7 51' $ BENCHMARK / a "ww" SHED PLAY r7 92.54 AREA •D' r 95.48 / ' N TP-1 FIB t91,P� 47 LOCUS MAP PROPOSED SEWER CONNECTION / O ;' ° NOT TO SCALE INV(IN)=91.3f (VERIFY) L /� �, .54 0 X93. / 1 \J � TP-2 r I 11 GENERAL NOTES: BENCHMARK X 95.6 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL DECK FOOTING FTG/B 92.16 BOARD OF HEALTH AND THE DESIGN ENGINEER. EL.=95,60 95.60 X 93.91 X 92.61 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. iv •98 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR N DECK N TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE N EXISTING N v DESIGN ENGINEER. r �97.65 HOUSE#94) N 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING T.O.F.-9 9f t FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN Z CELLAR FLOOR, EL.=92.4f 92.30 ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. x 98, m 3 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF X 0.48 / r THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 98.87 95. 6 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 99.47 EXISTING SEPTIC TANK 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 100.26 .; ` 8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED S.A.S. TOP OF TANK, EL.=97.78 Q INV.(OUT)=96.45f 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS 2,47 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE .`: I ;� •; = DIRECTED BY THE APPROVING AUTHORITIES. W 9.21 95,6� :. ; . R 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 102,3 Y THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING G X I .93.3.8 t CONSTRUCTION. �.:..; .: 98.65 I \ :.:J:':;•'. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND .. '-K- ; Q� s9c REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE :: . < <.,•`: 77.50' o PETER T. ✓� McENTEE INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. N 02, S 12'47'36" L 13. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC 7 :. ..:,.., ;:;.`: :,:.:,. CIVI No. 35109 SYSTEM COMPONENTS NOT SHOWN ON THE PLAN. SD edgef rm 93,03 , PARCEL ID: 271 -099 101.46 100.49 98J9 o povement/be 94,61 1, t --7 PROPOSED SEPTIC SYSTEM UPGRADE PLAN ARROWHEAD DRIVE 94 ARROWHEAD DRIVE, HYANNIS, MA Prepared for: Quinn's Excavation, 39 Bog River Bend, Mashpee, MA 02649 [ OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. ABREU, FAUSTO Engineering Works, Inc. 1"=20' P.T.M. 235-19 t 20 SKATING RINK ROAD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. HYANNIS, MA 02601 (508) 477-5313 12/7/20 P.T.M. 1 Of 2 Y� NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL. 96.0 FOR A DISTANCE OF 15' AROUND THE SEPTIC TANK PROPOSED D-BOX PERIMETER OF THE S.A.S. INSTALL RISERS & COVERS OVER INLET INSTALL RISER & COVER PROPOSED S.A.S. l AND SET TO 6' OF FINISH GRADE. ! EXISTING SET TO 6" OF GRADE INSTALL RISER & COVER OVER ONE CHAMBER AND HOUSE#94� T.O.F=99.9t SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT /T.O.F.-9 ,9 F.G. EL.=99.4f F.G. EL.=99.2t F.G. EL.=92.6t F.G. EL.=92.5t CELLAR FLOOR, EL.=92.4t MAINTAIN 2% SLOPE OVER S.A.S. DECK ' L = 33' L = 16't iy rn ® S=1% (MIN.) p S=1% (MIN.) qj' p 0' 4"SCH40 PVC 4"SCH40 PVC 2" LAYER OF 1/8" TO 1/2" ,� �j1• 6" DOUBLE WASHED STONE , io l �4" 6 2' EFF. aaaa aeaa (OR APPROVED FILTER FABRIC) 401 aaaaaaa EXISTING 48" LIQUID DEPTH -3/4"WASHED STONE DOUBLE ' � �' LEVEL ADD GAS PROPOSED 2.6' 4.8' 2.6' ^ o, BAFFLE INV.=89.17 INV.=89.00 w D-BOX EFFECTIVE WIDTH = 10' 3 OUTLETS INV.=88.50 EXISTING SEPTIC TANK PROPOSED SEWER CONNECTION 2-500 GALLON LEACHING CHAMBERS WITH STONE co (POSE =9 WE (VERIFY) AROUND AND BETWEEN CHAMBERS AS SHOWN INSTALL PIPE H-20 RATED BETWEEN CHAMBERS 1 TOP CONC. ELEV.= 89.6t BREAKOUT ELEV.= 89.00 6' INV. ELEV.= 88.50 ease aB NOTES: aaaaa aaaB. MUM a SHED 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & BOTTOM ELEV.= 86.50 ease eases ease \�15 INVERTS EXITING HOUSE, PRIOR TO INSTALLATION. 4' ENDS 8.5' 4' 2) D-BTTRUEOX SHALL TO GRADEEONET LEVEL AND A MECHANCALLYUE TO COMP COMPACTED 4' OFPERVIOUS NATURAL MAOCCURRING EFFECTIVE LENGTH = 29.0' SEPTIC LAYOUT STABLE BASE OR 6" CRUSHED STONE BASE, AS 5' ABOVE GROUNDWATER SPECIFIED IN 310 CMR 15.221(2). LEACHING SYSTEM SECTION 3) INSTALL INLET & OUTLET TEES AS REQUIRED. NO GROUNDWATER, EL.=80.9 - 3/4" TO 1-1/2" DOUBLE 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE WASHED STONE AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. ®®®® 0 3" LAYER OF SEPTIC SYSTEM PROFILE DOUBLE WASHEDHEED STONE,ONEE ®®®®®®®®®® 37" (OR APPROVED FILTER FABRIC) N > ® Z ®QT®®®®®®®®® SOIL LOG 102" DESIGN CRITERIA DATE: DECEMBER 2, 2020 (REF#TPT-20-259) SOIL EVALUATOR: CHRISTOPHER McENTEE SE#14012 4" KNOCKOUT NUMBER OF BEDROOMS: 2 BEDROOMS (DEED RESTRICTED) WITNESS: DAVID STANTON R.S. , HEALTH AGENT 20" DIA. COVER SOIL TEXTURAL CLASS: CLASS I (LOADING RATE=0.74 GPD/SF) ELEV. TP- ) DEPTH ELEV. TP-2 DEPTH / DESIGN PERCOLATION RATE: <2 MIN/IN 92.5 A 0" 92.4 A 0" 4" KNOCKOUT 4" KNOCKOUT 58" DAILY LOAMY SAND LOAMY SAND 0 FLOW: 220 GP 10YR 3/2 10YR 3/2 DESIGN FLOW: 330 GPD 91.7 B 10" 91.6 B 10" 4" KNOCKOUT GARBAGE GRINDER: NO-not allowed with design LOAMY SAND LOAMY SAND LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 89.1 10YR 5/6 41" 89.1 10YR 5/640" 500 GALLON CAPACITY, H-20 LOADING 74 GPD/SF C1 C1 PERC CHAMBERS EXISTING SEPTIC TANK: 1000 GALLON CAPACITY MED. SAND MED. SAND 36"/54" PROPOSED D-BOX: 1 INLET, 3 OUTLET (MIN.), H-10 RATED 5YR 4/6 5YR 4/6 USE 2-500 GALLON LEACHING CHAMBERS IN SERIES WITH 87'8 C2 ss" 87.7 C2 56" PROPOSED SEPTIC SYSTEM UPGRADE PLAN STONE AROUND AND BETWEEN CHAMBERS (10.0' x 29.0') COARSE SAND COARSE SAND 94 ARROWHEAD DRIVE, HYANNIS, MA SIDEWALL AREA: 2(10.0' + 29.0') X 2 = 156.0 SF 2.5Y 6/4 2.5Y 6/4 BOTTOM AREA: 10.0' x 29.0' = 290.0 SF Prepared for: Quinn's Excavation, 39 Bog River Bend, Mashpee, MA 02649 TOTAL AREA:.........................................................I....446.0 SF 81.0 1 1 138" 80.9 138" Engineering by: SCALE DRAWN JOB. NO. PERC RATE <2 MIN/IN. "C" HORIZONS Engineering Works, Inc. N.T.S. P.T.M. 316-20 NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 GPD/SF(446.0 SF) = 330.0 GPD (508) 477-5313 12/7/20 P.T.M. 2 Of 2 r i I r Z.Z- , Qoi1c-2-�� C � off' • ._; 1 ozoOvy 10, A I 4 , � r 1V ' 1 r r ' { ' MX Igo I -------------- I � , , I ' rPo w / , 1 / a i ;l0 DR— NOTES: If L6 Z� � ASSESSORS MAP : TEST HOLE LOGS Bq LAA 00 f PARCEL : O�� 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH S1 SOIL EVALUATOR ��•N�f.11t� R-S C�� THIS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF p PAS FLOOD ZONE : ND _ NS1ti9�3tk BOARD OF HEALTH REGULATIONS. WITNESS : NOT (�Q�l�i� Hyannis anis 32S REFERENCE: 'P IL. I�33 DATE- KovEm a_ 7 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, ms L SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO PERCOLATION RATE: 2 Mr►J rNGt yCB ` 5m, — INSTALLATION. OR5 -= , i LT:�- o, F114-k 011 TH- I E(,,: 4,° 61 TH-2 eL; 4'7�b 3) THIS PLAN SHALL BE USED FOR SEPTIC. SYSTEM INSTALLATION pp ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE Barnstable W. LOAM A Low DETERMINATION. es', Hs s aR �� �,� ltrl(�`H'y 6� 1; s� �oyfz`Hti � Rp Mg 4 5b q _ _ 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 118 "/ FOOT. (UNLESS LAAMy �-S/ g SPECIFIED OTHERWISE) E 8 SAID _S �� ��h LOCATION MAP ,� Or� �h�i 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A 4-7 '(�'l- 40 �4,07 GARBAGE DISPOSAL. �III,E'D111J�1 �. �A� t.. 1V� 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) A4ZSF- '� �$ �O�j-{Z��' '� (L MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON 2 �`l7� �_ll _ GI 0 2• I C 2 10 A BASE OF 6"OF CRUSHED STONE. I o 5,�0 7� sn� __t � + -err __PI/,+✓L 6I�� ��. I 3 144 = �u,�b Pia- _T� -___ �. No ANownl_ -1>< �i vu� ► I_5U �PaC�,r► _ I SEPT I C SYSTEM DES I GN 9� lbw_ yft1 . 0 OF FLOW ES t 1 MATE v , --� 4- BD_ OF- Hr �-1 �ft'I . - - LOOMS AT HO GAL/DAY/BEDROOM - 330 GAL/DAY BEQI I a SEPTIC TANK ` 12-) u, ! I o • ''I� 330 GA`_/DAY x 2 DAYS - 660 GAL oWc USE DOD GALLON SEPT I C TANK E�C ISTI 0R�Y'C-ttt� t�/ / �lbY► SiD DF W � N� I ---- ------ - 6 {t 56pl C-7RN 9- I F /L c q, DA✓�cif SOIL A63ORPT I ON SYSTEM --I Y N 1,3 �,;- aU �NVi LIS!L t2_t!, wx �. D S DE AREA:;E(25)2- 2.16)21 XZ X 0,?q 9 TING BOTTOM AREA: Z5 x IZ-16EXIS 2� . 3 # CIADWELLING �' - f, o '- Uo VIA o J TOPEvr= Ion. 5 3rvoN SEPT I C SYSTEM SECT I ON �� x o - ` S2.1 0 srr _of _ �7 �f6,e u) o N gejr� cevvcp s to r✓/, ft 10 N , Baffle �'' Y6. 62 to IF DAOX q3, _ l \ I- - 0 p� � 3 � v - D00 GAL �n� _ E- a i= w w SEPTIC C TANK ° n (.0( le�elhcss� 42-v z a W o 3 " 0 77.50 f t v� EX IST?r , m �w vEMENT \ / ! fig' 3 , 25�L Y 12.i6 W W ---OF PP` E C.�''\�'�[ C/Z(17s C7?al�l ( J�Zbt,OAoin1 6' ti EDGE v e✓ D D j�ublP RR � ��NOFMg0S SITE AND SEWAGE PLAN � 9 o. o N L� c4� Sfi�t LOCATION : q4 &,eo�bW �}-l� blely� o f' 11 m 1140 c,� E� 4g, �S ;sT wGIP PREPARED FOR : ELI ZABEV� BAr,'vP-050 1AR\P Irk WASH"'► SCALE : DARREN M. MEYER, R.S. W - �r 7 aS P.O. BOX 981 DATE J z EAST SANDWICH, MA 02537 w DATE HEALTH AGENT Ph: (508) 362-2922 Z