HomeMy WebLinkAbout0099 OAKVIEW TERRACE - Health 99 Oakview Terrace
Hyannis
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Commonwealth of Massachusetts atog- aqq
+n Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
c � 99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is Hyannis I� MA 02601 04/07/2021
requi y red for every
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When filling out forms A. Inspector Information Sltr S 3(3
on the computer,
use only the tab Michael T Bisienere
key to move your Name of Inspector
cursor-do not Cape Septic Inspections
use the return Company Name
key.
52 Rivers End Road
rQ Company Address
Teaticket Ma. 02536
Citylrown State Zip Code
508-280-3356 S13938
Telephone Number License Number
B. Certification
I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5
(310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address
listed above; the information reported below is true, accurate and complete as of the time of my
inspection; and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined
that the system:
1. ® Passes
2. ❑ Conditionally Passes
3. ❑ Needs Further Evaluation by the Local Approving Authority
4. ❑ Fails
04/07/2021
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to
'the buyer, if applicable, and the approving authority.
Please note: 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.
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
<r� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary
Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6.
1) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
This 3 bedroom home has an H-10 1000 gallon septic tank with an H-10 D-Box feeding a 25'x 12'
leaching trench with infiltrators. At the time of the inspection no visible failure criteria was found.
2) 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.
Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
I
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
e 99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis annis MA 02601 04/07/2021
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
2) System Conditionally Passes (cont.):
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
3) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
a. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
❑ 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
b. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must
be attached to this form.
c. Other:
4) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
El ® 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
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18
I ,
cam, Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
� 99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
4) System Failure Criteria Applicable to All Systems: (cont.)
Yes No
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
,El ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/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:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply
well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd-
10,000 gpd.
❑ ® 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.
5) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section CA.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18
cam, Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is Hyannis MA 02601 04/07/2021
required for every y
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.)
If you have answered "yes" to any question in Section C.5 the system is considered a significant
threat, or answered "yes"to any question in Section CA above the large system has failed. The
owner or operator of any large system considered a significant threat under Section C.5 or failed
under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner
should contact the appropriate regional office of the Department.
6. You must indicate"yes" or"no"for each of the following for all inspections:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18
1
c Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. City/Town State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 plus
GPD
Description:
Number of current residents:
0
Does residence have a garbage grinder? ❑ Yes ® No
Does residence have a water treatment unit? ❑ Yes ® No
If yes, discharges to:
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d town water
9 ( Y 9 (gp ))�
Detail:
In 2020-56,100 gallons were used and in 2019 -63,580 gallons were used.
Sump pump? ❑ Yes.® No
Last date of occupancy: few months agoDate
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18
cam, Commonwealth of Massachusetts
Title 5 Official Inspection Form
t' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
2. Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203):
Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Water treatment unit present? ❑ Yes ❑ No
If yes, discharges to:
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
Last date of occupancy/use: Date
Other(describe below):
3. Pumping Records:
Source of information:
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
1.- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. CityfTown State Zip Code Date of Inspection
D. System Information (cont.)
4. Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed (if known) and source of information:
2013
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. Building Sewer(locate on site plan):
Depth below grade: 29"feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line. town water
feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
i
Commonwealth of Massachusetts
i Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�n
99 Clakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade: 20"feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No.
Dimensions:
H-10 1000 gallon
Sludge depth:
5" I
Distance from top of sludge to bottom of outlet tee or baffle
31"
Scum thickness
5"
Distance from top of scum to top of outlet tee or baffle
4"
Distance from bottom of scum to bottom of outlet tee or baffle
13"
How were dimensions determined? sludge judge
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
I recommend the new owner put the septic tank on a maint. plan with a local septic pumping co.
based on the future use of the home. At the time of inspection the liquid level was at working level
and the tee's were in place.
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
7. Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow:
gallons per day
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18
c Commonwealth of Massachusetts
Title 5 Official Inspection Form .
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
8. Tight or Holding Tank(cont.)
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
9. Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
0"
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
At the time of the inspection the liquid level was at working level and there were no visible signs of
leakage or solids carryover.
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
Commonwealth of Massachusetts
1, Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. City(rown State Zip Code Date of Inspection
D. System Information (cont.)
10. Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No*
Alarms in working order: ❑ Yes ❑ No*
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
* If pumps or alarms are not in working order, system is a conditional pass.
11. Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® Teaching trenches number, length: 1 -25'X 12'
w/infiltrators
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
11. Soil Absorption System (SAS) (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
At the time of the inspection no visible failure criteria was found.
12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
I
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
13. Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
14. Sketch Of Sewage Disposal System:
Provide a view of the sewage disposal system, including ties to at least two permanent reference
landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters
the building. Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
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Terra«
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t5insp.doc•rev.7126=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
>r�
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021 .
page. Cityrrown State Zip Code Date of Inspection
D. System Information (coat.)
15. Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: 10 plus feet
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
I augered a hole at a lower elevation and shot it with a transit to show 4 plus feet of seperation.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
99 Oakview Terrace
Property Address
Robbins View LLC
Owner Owner's Name
information is required for every Hyannis MA 02601 04/07/2021
page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
Complete all applicable sections of this form inclusive of:
® A. Inspector Information: Complete all fields in this section.
® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked
® C. Inspection Summary:
1, 2, 3, or 5 completed as appropriate
4 (Failure Criteria)and 6 (Checklist)completed
® D. System Information:
For 8: Tight/Holding Tank—Pumping contract attached
For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached
For 15: Explanation of estimated depth to high groundwater included
4
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18
TOWN OF BARNSTABLE
>-'lOCATION `"1� ( RVV J$i-J -�«N LZ SEWAGE#
VILLAGE ¢ - '-� ASSESSOR'S MAP&PARCEL )M&
INSTALLER'S NAME&PHONE NO. 9JL---M- %6U TP C-
SEPTIC TANK CAPACITY ® '�d ci is L-
LEACHING FACILITY.(type) rJ.FILi'rift �'o r e (size)
NO.OF BEDROOMS.
OWNER Rt CIA R r a C
PERMIT DATE: a D 11 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) N Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) 411 !" I A Feet
FURNISHED BY
a is
Al
oq I
o +
JV
No. -� � Fee �
THE CO_ EALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIV9SION - TOWN OF BARNSTABLE, MASSACHUSETTS
Zipplitation for Disposal Opstem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.G'j Cj Q AV V 1 w re('c.di G� wner's NaTe,Address,and Tel.No. G1� �— �C�a,- C.3
1 C.11 AtGC (F nlk-%l
Assessor's Map/Parcel a,tp� 4q 3 S�1e�ta(;Q LAwZ- (,G�� �-pCGQ /Yl Q 0199.11
Installer's Name,Address,and Tel.No.Qo6c rT 6,60 v' C0. Designer's Name,Address,and Tel.No.Cl-eoAv/ A- hifiP C
Qd - r,D 2
�f�W1c.L1 Ar � A-L1'3a- CAS L ,v tjC _ $�3a-
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) / gpd Design flow provided 3 ry gpd
Plan Date a 1 � 3 Number of sheets Revision Date
Title
Size of Septic Tank T,ven- O L. Type of S.A.S. ito /A C bT u t, I-C,r'S
Description of Soil D �6)� L 6AAA�l &.-3 1 l
Nature of Repairs or Alterations(Answer when applicable)-U 9 &'iSki±2q /000 00zL TjQNf( . PuA e/ A la010,v
C V-V&�),oc LeAoxa 91 1� 2,vS'Ca)i 4b� 6T21hu how Ate' /6 16,01, CAS 1 S'�J� —
N �IC��)a�o� ' Arw�le_sS (w �ncp f7dTA+G¢'s')®^y-
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Healt .
S' Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. ��3 Date Issued
j
No. Fee
# e' THE COkN -
EATH Off' MASSACHUSETTS Entered in computer: Yes
PUBLIC HEALTH DIVISWN 01 BARNSTABLE, MASSACHUSETTS
application for disposal *pstrm Construction Vermit
Application for a Permit to Construct(,,) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.qci o A k V i 1=W -re rr 42 Qwner's Name,Address,and Tel.No. G I� C_ l�5 a
KtC,hArd I r, —1 D
Assessor's Map/Parcel e d L r O/ 1/
Installer's Name,Address,and Tel.No.(ZO�X CT gp r, CO, Designer's Name,Address,and Tel.No. C epAe,V A• 11,9 S
a 4 6('2AT ci V3 R i E6-P
"t o -L - L n G -36a$)3a-
Type of Building:
'r Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( ) "
Other Fixtures
j Design Flow(min.required) n gpd Design flow provided t ?7,, gpd
Plan Date Number of sheets Revision Date
i
Title
Size of Septic Tankr 1«�_'6 aka L Type of S.A.S. 14-) M
Description of Soil ly«�(�t� 4 OAA6 Q �Cpp I ,!' a t, L SAiry XL,
Nature of Repairs or Alterations(Answer when applicable) rA
I 1W,I Ir e iwn �S. T�
e" Date last inspected:
Agreement: _
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
i
i
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
_ Si _ Date 3
Application Approved by Date /
Application Disapproved by Date
�r for the following reasons
r� mo�tt,,.,, 2
-Permit No. ,.may� 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 c--fj' U I- CC) , 17^)C
at �'C� (�G 6f 1/1 t" �l�r C'A(lie has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated �«
Installer 1 .->r� Designer
#bedrooms �j Approved design flow gpd
The issuance of this permit shall not be construed as a guarantee that the system w' l fun io as igned.
Date Inspector
4 ------ ------f----- - -- - -. s�-----------
No. 0 5 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal *pstem Construction 3permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( )
System located at C1,1
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be co^plete w d ' in three years of the date of this permit.
Date -� / l D Approved by
{
I
To,goof Barnstable
aft"E T Regulatory Services
Thomas F. Geiler,Director
• BARNSrABIA
MASS. � . Public Health Division
rec iae�" Thomas McKean,Director
200.Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
C
Date: o f3 Zv13. Sewage Permit# 013 -'b S, Assessor's Map\Parcel 7—w
Designer: Ham`"' 11,4-AS PE Installer• 6�ZC T R .60 C' C(9,3:N C--
Address: P Xvu-,-a=-7 GA Address: Aq. Grcic,,� ue6'sz-rij fzo/-
On 00.1 2Gh_ �� Q. �' G b;i'was issued a permit to install a
(date) (installer)
septic system at based on a design drawn by
(address)
A . 14,+A5 dated 6ZA P,A' ►i3
(designer)
VI.I. 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.
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 & Local Regulations. Plan revision or
certified as-built by designer to follow.
��dr.
v y
or
(Installer IFS
s Signature) L
ydIG{k�MS Ala 9b
C tl9.L
(Designer'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 YO.U. ..
Q.\Septic�Designer Certif cation Form Revised.doc
Town of Barnstable P# / c7
Department of Health,Safety,and Environmental Services
Public Health Division Date
367 Main Street,Hyannis MA 02601
• HARNSTABM • .
y_ MASS.
i6.3q.
V"rF4ttvr" Date Scheduled � ��� tom✓ Time I Fee Pd. D
Soil Suitability Assessment for Sewa e Disposal
Performed By: —� Witnessed By:
LOCATION & GENERAU. FORMATION
Location Address Owner's Name �C
Address
Assessor's Map/Parcel: Engineer's Name
NEW CONSTRUCTION REPAIR Telephone# J`Z>0 36 Z- 3
Land Use A6-5.1 � a"�.4-C Slopes(%) 2 Surface Stones
Distances from: Open Water Body ft Possible Wet Area ft . Drinking Water Well ft
Drainage Way ft Property Line ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
vas
Parent material(geologic) Depth to Bedrock
Depth to Groundwater: Standing Water in Hole: A—�IA Weeping from Pit Face
Estimaied Seasonal Hig i Groundwater
. .
DETERMINATION F+( R SEASONAL �iATEYZ't`ABLE
Method Used: ,[:er:cy� �C'e�
Depth Observed standing in obs.hole:' ' in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater.Adjustment ft.
index Well#_ Reading Date:..____Index Well level.-___ Adi.factor Adj..Groundwater Level
_,
PEILCULATI(l�N TEST nat� Ttme �+x+
Observation
Hole# Time at 9"
t�
Depth of Perc Time at 6"
Start Pre-soak Time @ Time(9"-6")
End Pre-soak �/S
Rate Min./Inch
I
Site Suitability Assessment: Site Passed ✓ Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back j
Copy: Applicant
DEEP OBSERVATION HOLD;LOG H41t# j
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,° el
I 2 L
DEEP OBSERVATION HOLE LOG Hole:: ..
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,° ravel
Z L S Vol
DEEP OBSERVATION HOLE.LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
C n istenc %Gravel
i
.: :: . ..
DEEP OBSERVATION HOLE LOG Mole#;#
Depth from Soil Horizon Soil Texture__.:; Soil Color Soili Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency,° Gravel)
Flood Insurance Rate Maw
Above 500 year flood boundary No. Yes
Within 500 year boundary No Yes
Within 100 year.flood boundary No Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? 4��5
If not,what is the depth of naturally occurring pervious material?
Certification '
I certify that on tr i g-1 (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required trainin , e pertise and experience described in 310 CMR 15.017.
z zo�3
Signature ___ ____ Date��
LOCATION �f�G SEWAGE PERMIT NO.
_
VILLAGE
INST -A-�LLER'S NAME i ADDRESS
N UILDE R OR OWNER
'FR» IV C 0 �e n L-r X
lA)\iv ► �9
DATE PERMIT ISSUED '�) --e�-l - ��
DATE COMPLIANCE ISSUED a,l_
i
. .
f''
� �
f
i _ r
_�,
o................%:�
THE COMMONWEALTH OF MASSACHUSETTS
� ' BOARD OF HEALT l
- 10Z.&II-i............o F'.......� ��� ........ / 'ems=---------
AUK
Appliration for Dispaaial Workii Towitrurtion Fautit
Application is hereby made for a Permit to Construct ( ) or Repair (. ) an Individual Sewage Disposal
System at:
L._. ion-Addres .... ^-. c.......
or Lot�N
. .
O ner ddress
W
nstall r Address
.Lot.-2/K �.�,
Type of Building Size -----Sq. feet
Dwelling
�., No. of Bedrooms.._.......•...,_..g— . ...................Expansion Attic ( ) Garbage Grinder
`a4 Other—Type of Building --------•--•----•-••------- "No. of persons............z
- -- Showers (`/) — Cafeteria ( )
Other fixtures ............ ..............................
Design Flow.............%�-. ..................gallons per person per day. Total daily flow...............3312...............-gallons.
WSeptic Tank 4-Liquid'capacity,.f4 o..gallons Length................ Width................ Diameter._._.___-____- Depth................
x Disposal Trench—No..................... Width_._.... _... _. . Total Length....... Total leaching area....................sq. ft.
Seepage I._...... Diameter ___ .. epth below inlet........
Total leaching area_v.A .t�.....sq. ft.
See e Pit No....._..... G
Z Other Distribution box (� ) Dosi g tank ( ) �^ �L�/%
'-' Percolation Test Resul Performed b .....:..
� Y ��.,- - ........................................... Date--��..-•��-�--------
Test Pit No. 1..�t_.,�-_._minutes per inch Depth of Test Pit.................... Depth to ground water........................
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
1_ <... ............ .. -----
,� J f
x escripti ofSoi -- - . �OD
-------------------------------
l z
w
UNature 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 TITS:, 5 of the State Sanitary Code—The,undersigned further a ees not to place the system in
operation until a Certificate of Compliance has been ' d by th oar f healt .
s/00 Signed . ....... ..... .....-A Or
Date
ApplicationApproved By................................----------------------------------------------------------------
Date
Application Disapproved for the following reasons:------•--------•-----------•----------------•-------•-----------------------------------------------------•-•---
...................••--••----•-••------•••-•----....•--•••---......•-••••••-----••••••-••-••-•••••-•-••-•--••••••••••••-••-•-••••••-••-••••--•-•-••---------••-••••••••-•----
Date
Permit No Issued i{----••......-'-____a..------.
Date v
THE COMMONWEALTH OF MASSACHUSETTS
-- BOARD OF HEALTH
/.0a------ r1-..!.----- ...OF...... �X ....fV ��.--....... �.. ,...
rr lir �i�a�t for Eliopm a1~' orks T#hstrurtinn rruti#
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
Lo ion Addres or Lot Nq
--• tom. . ' . .. ........ ............. .c ----------- •---------------=� .
/
Owner ddress
W .....-....---•--•............................................. ......•........................
Installer Address
Type of Building ...Sq. feet
Size Lot__ � �� :_.
Dwelling—No. of Bedrooms..............3......................Expansion Attic ( ) Garbage Grinder
Other—T e
a yp of Building ____________________________ No. of persons................. ....... Showers (�') — Cafeteria ( )
Otherfixtures ............... ..---------------------•--------------.----------------------------------------------...-----•--......-------.........................
W Design Flow..............' ",�_-----------------gallons :per person per day. Total daily flow...............3310................gallons.
WSeptic Tank 4 Liquid'capacity. }.gallons Length ... .. Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width _.._._. _ Total Length .___ ._ Total leaching area....................sq. ft.
3 Seepage Pit No:..........�.__..... Diameter..... . ... epth below=inlet.._... .. . Total eaching area.r=46__sq. ft. ,
Z Other Distribution box (J ) Dosil"ig tank
~' Percolation Test Result Performed by.____. ,> _..,c'.............................. Date.- =:n./4.::,�—d..-----
Test Pit No. 1.. ___.,�-._.minutes per inch . Depth of Test Pit......°............. Depth to ground water________________________
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
p `" `.. / 3 G� .s c
Descn do f Soil . `" `� � ---------- �� y *�
W s:N,
UNature of Repairs or Alterations—Answer when applicxbl"e........................................ ".._....._.__......_....._._._.__::____..__._._...__.
------ -------------------------------•------.
Agreement
The undersigned agrees to insta rtiefgrtescribed Individual Sewage Disposal System in accordance with
the provisions of TITILS 5 of��the,Stlt am .tary —The undersigned further a ees not to place the system in
operation until a Certificate J eqm' janeA, -s' dbyh
h oar f health.
LOP7 �
.....Signed . . w_.rtJ�
Date
ApplicationApproved By..................................................................................................
Date
Application Disapproved for the following reasons---------------------------------------------------------------•------------....................................
--.......-•---•-----•--------------•----_....._.....-•--------------.......----------........-------------------------------••--------......--------------------------•-----•----------•-•-------------
Date
PermitNo........................................................ Issue d-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH I--
......7 ...........OF...... .
1.................................
rr#i�irtt�.e���a� ft�unt�li�anrr
THIS OISTER , , the Individual Sewage Disposal System constructed ( or Repairedby . . --.. - -----.
Installer
at.. y1_... .:.
' st-
.has been iriftalled in accordance with the provisions of T 5 of The State Sanitary Code as Acribed n the
application for Disposal Works Construction Permit No __ _..__.��_;�`_......_.. dated-...._�.n T.._��_.-�.d..........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM \MILL FUNCTION SATISFACTORY.
DATE.................................................................................. Inspector....................................................................................
-THE COMMONWEALTH OF MASSACHUSETTS
�� I BOARD OP
HEALTH
No.... ..' . FEE-Z
RoposFa irk ndinat autit
Permissions bemby granted...-----. .._. •. ---- ---- --------• ..................... .........................................
to Constryq (l�or Repair ( a dividual ew e Dispos P st
oe
Street
as shown on the application for Disposal Works Construction Per o......j...... ._ 4a .,1--'.� 'd' ' ......
554 ` "
DATE_ ..........................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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S i} No 22162-0
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E.4. Q .8POTx ELEVATION Ox .CERTIFIED . PLQT PLAN
E iB?f.AfO 'C0NTO.UR — — 0 —,— F;
— ..�.� :. .. ci cverinN�„I.O 0 L oT � DH �<c/� Gt/ T y
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�APPR01lED'= BOARD OF HEALTH
.4 !
ti `b ;DATE r� AGENT '~; SCALE: 1 "=40 DATE
t DREO•GE ENGINEERING CO
CLIENT
.. IN
•
_ I CERTIFY THAT THE PROPOSED '
- --- ----- - ------ ----
R�yn. EGFSTERE REGISTERED JOB NO. 00 47_. BUILDING SHOWN ON THIS PLAN! _
K a CIVIL LAND CONFORMS TO THE ZONING LAWS * a
. EIdGIN1cER s SURVEYOR D I BY! A,A, OF BARNS B S
712 MAIN ST CH. BY: }
} ; ,r HYANNIS; MASS. SHEET_L_ OF DATE REG. LAND SURVEYOR,
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CCSEE'n9D!/L�ITION,
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INLET DISTR/B!/T/D/!/ BOX FP �E�/0�,� O,c GROLNo JITER 7A6LI�=
O.�ITLETD/S'TIq!®UT/ON BAX `95,9 FT
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TOTAL E3T/MATEG JAL 3 30 GAL.1DAT SO/L TEST pO/ SO/L 7ESTO2 I /� -
NUMBER 0,9 LOACMIMG P/TS AL&rY, ;DATE OA- SOIL-T#-s1r
S/®E LPACH/A/G PON P/T .7_9,7 jq PY. RESL AX5 PW.TNESSED dY R -71
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` 9XI§TlN'( CONTOUR O - - 4 .
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= CRPRQk1jED = BOARD OF HEALTH s
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CO. IN G4T�1�7 cot�N
------ - ---------- CLIENT I CERTIFY THAT THE PROPOSED 'Y
> ,', EGLSTERE REGISTERED JOB N0. U 0 4 ' BUILDING SHOWN , ON THIS PLAN
'� r r':VIVIL LAND> CONFORMS TO THE ZONING LAWS
ENIGINEER .SURVEYOR DR.BY _ ,OF BARNS B S '
712 MAIN ST CH. BY
,
SHEET_.L OF DATE
`HYANNIS• MAS$.
REG.. LAND SURYEY>JR.
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D/ST.
%4 PON P'r. o • e • • • • • ea ,
SEPTIC : TANK • q y
:•: BOX m o 4 � i ® • a o • • � ,°a, e
e •° e e • •EFFECT/✓E • or e _.
.� .'•�, � o ° p e e r DPPTN ° • • • o 0 o W � ASHED .STONE '
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/NLET .SiEPT/C TANK q�s -FT, ;
OeJTLET SEPTIC TANK -FT
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N//AIQER OF BEDu?OOMS
aAReAaE D/SPOSAI L l/.ar/r .SOIL LOG
TOTAL E3T// TED frLOmV 3 3(} GAL./DAV SO/L TEST A/ SOIL TEST*2 e�'®/`L ',TEEST
/4([JM�ER l.LsACAIlN+l. P/T,S �`LsGLsY. , v �.0.4TE OF' SOIL T;$7'
S/DE�,rOCHIN6 PER P/T =�3 PT. i_ 'ay ' VI
RESI/d.TS de/ITNEED
-7� l:=a PEsRCOLs lr#'oN ItATi� MI INCH
®OTTOM LEE/1CI°r/M6 PAR P/T �$Q. FT. ,�w J�
.SQ. FT. /t1,�? /�'P I�eNCOLAT/ONRA7-002 77. H-2 M/N.IINCN
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LOCATION ,, SEWAGE PERMIT NO.
if
VILLAGE
I N S T A LLER'S NAME 'i ADORES.S
17
7
aUILDER OR OWNER
l VA)v1U !S
DATE PERMIT ISSY E O —'
0 -d--1
j DATE COMPLIANCE ISSUED
Ap-
D
V
f 1
ACCESS COVERS MUST BE WITHIN INSPECTION MINIMUM.
6" OF FINISH GRAD PORT 3 3. MAXIMUM COVER INVERT ELEVATIONS : DESIGN CR I TER I A : GENERAL NO TES :
E
FIRST.2' TO INVERT OUT SEPTIC TANK: 93.5 DESIGN FLOW:
BE LEVEL INVERT IN DIST. BOX: 93. 17 3 BEDROOMS AT /10 G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION
INVERT OUT DIST. BOX: 93.0 BEDROOM EQUALS 330 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY,
d DIAM PIPE CLEAN SAND BACKFILL INVERT IN LEACH CHAMBER: 92.92
AROUND AND 2" OVER CHAMBERS BO T TOM OF LEACH CHAMBER: 92.0 NO GARBAGE GR/NDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS
93.5 93.0 /l " SET. SEE 51 TE PLAN.
""' ,� � 92.0 'ADJUSTED GROUND WATER: N/A
BAFFLE 93• l7 92• 2 SEPTIC TANK REQUIRED:
16 HIGH CAPACITY INFILTRATOR OBSERVED GROUND WATER: N/A
EXISTING 5 OUTLET 330 G.P.D. X 200% - 660 GAL. J. ALL CONSTRUCTION METHODS AND MATERIALS AND
D-BOX CHAMBERS /N BED FORMATIQN BOTTOM OF TEST HOLE #2: 86.5 SEPTIC TANK PROVIDED: 1000 GAL. EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL
1000 GAL CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL
COMPACTED BASE
SEPTIC TANK CRUSHED STONE OR SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS.
CO '
DES l GN PERC RATE C 5 M/N/l NCH
p
/- ROF I L E : NOT TO SCALE SOIL TEXTURAL CLASS - I 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER
` EFFLUENT LOADING RATE 0.74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER
T 330 GPD / 0.74 GPD/SF - 446 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF
WITH-STANDING H-20 WHEEL LOADS.
p N PROVIDED: 16 HIGH CAPACITY INFILTRATOR
CHAMBERS. 100'x 4.73 SF/FT - 473 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR
a v 473 S.F. x 0.74 - 350 GPD APPROVED EQUAL.
R 6. SEPTIC TANK AND 0-BOX SHALL BE REINFORCED
x 5�,86 SOIL TEST PIT DA TA PRECAST CONCRETE OR APPROVED POLYETHYLENE.
\ N TA.00 00 INDICATES �_ INDICATES BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER
PERCOLATION OBSERVED TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE
c TEST - GROUNDWATER OUTLET.
a
UP " TP #1 P#I3843 TP #2
_� Y 7. BEFORE CONS TRUCT/ON CALL "D l G-SAFE".
\\ HORIZON TEXTURE COLOR HORIZON TEXTURE COLOR 1-888-DIG-SAFE AND THE LOCAL WATER DEPT.
\ RAMP 0" 97.0 0` 96.5 FOR LOCATION OF UNDERGROUND UTILITIES.
A LOAMY I OYR A LOAMY !OYR
\ SAND 2/2 SAND 2/2
\ �� 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE
�\ 6" - - - - - - - - - - - - - - - - - - - - 96.5 7' - - - - - - - - - - - - - - - - - - - 95.9 DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION
\\ L OAMY I OYR LOAMY I OYR
B OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE
/� SAND 5/6 SAND 5/6
1 26" - - - - - - - - - - - - - - - - - - - - 84.4 24` - - - - - - - - - - - - - - - - - - - -
B 94.5 CONSTRUCTION INSPECTIONS.
i EXISTING THREE / M1 C / MED-COARSE JOYR C/ MED-COARSE IOYR
I BEDROOM DWELL I NG l• 9. EXISTING LEACH P l T TO BE PUMPED DRY AND
CHAIN LINK FENCE SAND AND 6/6 SAND AND 6/6
of GRA VEL GRA VEL BACKFILLED.
/0. ALL UNSUITABLE MATERIAL (A & B HORIZONS)
SHED
►"� `� \ DECK - �\ i 48" ENCOUNTERED BELOW THE INVERT OF THE LEACHING
,T� FACILITY TO BE REMOVED FOR A DISTANCE OF 5'
`\ BM.I CORNER eH ! AROUND AND REPLACED W/TH SAND IN ACCORDANCE
co
N 7.0 /I M Et- 7.65\
WITH TITLE 5.
-------------
�_19 97.6
EXISTING
/ \\ 247 OAK k\ SEPTIC TANK NO WATER NO WATER
\ 120" 87.0 120" 66.5
96.6 1 y
TP#2 s\ - - - + 1 o
\ DATE: JANUARY 28. 2013
--r'6'OAx ✓, � % m TEST BY: STEPHEN HAAS
co 22' `�arxtsTlNG l / WITNESSED BY: DONALD DESMARA l S
LEACH PIT PERC RATE: C 2 MIN/INCH
95.8 �
c= + 16 HIGH CAPACITY // g��tr''
/0-04K INFILTRATOR CHAASBERS
v
18"OAK
A # > a
8'OAK
1`
LOT 49 �R��� S E7P T l C S YS TEM DES / ON
5
2/ . 527+ S.F. 99 OAK V l EW TERRACE . MAP 268 PARCEL 20-4
s �00�90� B A R N S TA B L E . t HYANN l S ) MA
PREPARED FOR
� LEGEND
N_ R l C H.A RID G R ,A Y
LOCUS a ■ GB CONCRETE BOUND
, HYDRANT 1 NE ..
ti ao SCALE : l 20 FEBRUARY 8 2013
GAS L l NE
OHW-- OVER HEAD WIRES STEPHEN A . H A A S
g LIGHT POST•#•
-E- UNDERGROUND ELECTRIC LINE _ ENGINEERING , I N C
D _--T-- 1 UNDERGROUND TELEPHONE LINE i�\, 923 Route 6 A
CRAIGVlL E B CH RD -CTV-- UNDERGROUND CABLEVISION LINE ��! '��� Ya rmo u t h p o r t , MA . 02675
-,�- �iIII/1�II�
+40.4 SPOT ELEVATION R �� -.�- �� � �` \ ( 508 ) 362--8 1 32
........40------- EXISTING CONTOUR
LOCUSO�l 1 c ��JA p 0 i 0 20 40 � PROPOSED CONTOUR
L V v I ( I JOB NO: 13-006
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