HomeMy WebLinkAbout0256 OCEAN AVENUE - Health 256 Cact. ,42venu-e - a
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Town of Barnstable
Inspectional Services Department
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Public Health Division
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NIP. 200 Main Street, Hyannis MA 02601
Office: 508-862-4644
FAX: 508-790-6304 Thomas A.McKean,CHO
March 2021
Patricia Fallon
625 Main St.
Apt. 237
New York,NY 10044
RE SEWER CONNECTION DEADLINE EXPIRED
256 Ocean Ave, Hyannis A= 306.-01
Dear Property Owner,
Your sewer connection deadline has passed.
Please contact the Public Health Division Office to provide an update relative to the
status-of property's connection to public sewer (i.e. contractor name, DPW sewer
connection permit number, anticipated connection date.)
If you would like to request an extension, such request must be in writing addressed to
the.Board of Health (200 Main Street Hyannis, Massachusetts) or e-mail Sharon Crocker
at:-sharon.ekocker@town.Barnstable.ma.us within fourteen(14) days.
Sincerely yours,
r�
Karen Malkus-Benjamin
Town of Barnstable Health Division -
Coastal Health Resource Coordinator
karen.malkus(a)town.barnstable.ma.us
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TOWN OF BARNSTABLE �C
LOCATION .Ss 4 O C SA AI A ✓ e SEWAGE # ao ;�-�3,
VILLAGE YA A//S ASSESSOR'S MAP & LOT 3o6s0a l i
INSTALLER'S NAME&PHONE NO. If Ad A C O In 8,'6- SS O A/
SEPTIC TANK CAPACITY Q O
LEACHING FACILITY: (type) W e L l s (size)
NO. OF BEDROOMS S
BUILDER OR OWNER
PrRMIT DATE: �421//02 '.COMPLIANCE DATE: U 0 -
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
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No 2vo2- 3 Z r
Fee$50. 00
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zipprication for lkgozal 6petem Congtruction Vermit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( )Xf]Complete System O Individual Components
Location Address or Lot No. 256 Ocean .Ave Owner's Name,Address and Tel.No.5 0 8—7 71 —7 0 7 3
Hvvani� �V(ags. 02601 Patricia Gibney
ASsessorsMa /Parcels 270 Ocean Ave Hyannis,Mass. 02601
306-21
Installer's Name,Address,and Tel.No.5 0 8-7 7 5-3 3 3 8 Designer's Name,Address and Tel.N5.0 8—2 7 3—0 3 7 7
J.P.MaCOMBER & Son Inc. JC Engineering, Inc.
Box 66Centerville,Mass. 02632 5-Round Hill B1VD East Wareham,Mass.
Type of Building:
Dwelling XXXNo.of.Bedrooms 5 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 5 5 0. 5 GP D gallons per day. Calculated daily flow 5 X 1 1 0=5 5 0 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank 1 500 gallons Type of S.A.S. 4-500 gallon chambers-
Description of Soil 0"-8"=loamy sand;8"--36" loamy sand; 36"-96"=Medium coarse
sand; 96"-132"=Fine meduim -Coarse sand.
Nature of Repairs or Alterations(Answer when applicable) Omitting leaching pit.I n s t a l l i na
1 -1500 gallon septic tankl1 -Distribution hnx;4-500 cIA11nn learhing
chambers packed in 4 ' of 1 :1�" ctnnP 42 'X12 ' 10"X2 '
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issfied by th' Bar Health.
Signe Date 9 2 4 0 2
Application Approved by c Date U U a
Application Disapproved for following reasons
Permit No. 2002,_ Date Issued 9 Zg a Z
3.
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: '
PUBLIC HEALTH DIVISION', TOW OF BARNSTABLE., MASSACHUSETTS ±Yes
Zipprication for Os spool *potent Construction Permit ;
Application for a Permit to Construct( )Repair( )Upgrade( ),Abandon( )XIC Complete System ElIndividual Components
Location Address or Lot No. 256 ocean Ave Owner's Name,Address and Tel.No.5 0 8—7 71—7 0 7 3
Hyannis Mass.02601 Patricia Gibney ,
Ass ear's Maffarcel 279. Ocean Ave Hyannis,Mass.02601
306-21
Installer's Name,Address,and Tel.No.5 0 8-77 5-3 3 3 8 Designer's Name,Address and Tel.N5.0 8—2 7 3—0 3 7 7
J.P.MaCOMBER & Son Inc. JC Engineering,Inc.
Box 66Centervillre Mass.02632 5-Round Hill B1VD EastWWareham,Mass.
02538
Type of Building:
+� Dwelling XXWo.of Bedrooms 5 Lot Size sq.ft. Garbage Grinder( )
Other 'I�pe�of Building No.of Persons Showers( ) Cafeteria( )
{ ' Other Fixtures
Design Flow 550.5 GPD gallons per day. Calculated daily flow 5 X 1 1 0=5 5 0 gallons.
. Plan Date Number of sheets Revision Date,
Title
Size of Septic Tank 1500,41 a1lon6? Type of S.A.S. 4-5 0 0 gallon chambers
f
Description of Soil 0" . =loamy said;8"--36" loamy sand:36"-96"=Medium coarse
sand;96"-132"=Fine meduim�'4coarse sand.
Nature of Repairs or Alterations(Answer when applicable) Omitting leaching pit.Installina
1-1500 gallon septic tanks 1 -Distribution box;4-500 oraillonllAa nhi nrr
chambers packed in 4 ' of' W' stone_4203021101132'
Date last inspected.
Agreement: 4
The undersigned agrees to ensure the construction andmaintenance of the afore described on-site sewage disposal system
in accordance with the-provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate ofCompliance has befen is ed by t ' B ar o Health.
Signed Date 9/2 4/0 2
Application Approved b Date 0/-7 0-
Application'lDisapproved for t e following reasons
V
Permit No. Date Issued 9 25 G Z z
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS .. k
�ARNSTABLE, MASSACHUSETTS
certificate of Compliance ,
THIS IS TO CER e—at--the(On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded)(XX)
Abandoned( )by J.P.Macomber & Son Inc.
at256 Ocean Avenue Hyannis,Mass. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.1-0(1 2 -43 2- dated
Installer J.P.Macomber & Soxi xnc_ DesignerJC Engineering,Inc.
The issuance of this p t shall not be-construed a a guarantee that the system will f notion a sig ed.
Date 177175. 4h Inspector
i
No. 2UCaZ-�,22 50.00 Fee
THE COMMOC�j ALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
1=ie;po5al *p!9tem Congtruction 3permit j
Permission is hereby granted to-Construct':KX)Repair( )'Upgrade( )Abandon( )
System located at 256 Ocean Avenue Hvannis.Mass.
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:Co struction must be completed within three years of the'date of this p
Date: 2Jto Z Approved by
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TOWN OF BARNSTABLE
'C , vr��—y32
LOCATION 0 C
v' P SEWAGE #
S Y A iiVf ASSESSOR'S MAP &LOT 3! b
VILLAGE �
INSTALLER'S NAME&PHONE NO. M C 4'f`' SON
SEPTIC TANK CAPACITY �' 60
v U (size)
LEACHING FACILITY. (type_) R�--J
NO.OF BEDROOMS
BUILDER OR OWNER
f z
COMPLIANCE DATE
PERMItDATE:
Separation Distance Between the: Feet
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility
I Private Water Supply Well and Leaching Facility (If any wells exist Feet
on site or within 200 feet of leaching facility)
exist
Edge of Wetland and Leaching Facility(If any Feet
within 300 feet of leaching facility)
Furnished by
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COMMONWEALTH OF MASSACHUS
EXECUTIVE OFFICE OF ENVIRO N A r AIRS
Z F DEPARTMENT OF ENVIRONMENT P ' s
jq Y
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OW
1 9 2004
TITLE 5 TOWN or BARNSTABLE
HEALTH DEPT.
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A`
CERTIFICATION
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021 �2
PARCEL,
Owner's Name: GEORGE GARCIA
Owner's Address: 257 VERNON ST.OAKLAND CA 94610 ?.(� _ _...
Date of Inspection: 9/28/04
Name of Inspector: (please print) JOHN GRACI,INC.
Company Name: SEPTIC INSPECTIONS
Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536
Telephone Number: 508-564-6813 FAX 508-564-7270
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 to Section 15.340 of Title 5(310 CMR 15.000). The system:
X Passes
_ Conditional asses
_ Needs Furt r valuation by the Local Approving Authority
Fails
Inspector's Signature: Date: 9/28/04
The system inspector shall submit a y of this inspection report to the Approving Authority(Board of Health or DEP)within
30 days of completing this inspection. f the system is a shared system or has a design flow of 10,000 gpd or greater,the
inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be
sent to the system owner and copies sent to the buyer,if applicable,and the approving authority.
Notes and Comments
SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE
SYSTEM'S USEFUL LIFE.
""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.
Title 5 In-mertinn Fnrm 6/15/')OnO 1
Page 2 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310
CMR 15.304 exist.Any failure criteria not evaluated are indicated below.
Comments:
SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE
SYSTEM'S USEFUL LIFE.
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.
n/a 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.
ND explain: n/a
n/a 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
_ obstruction is removed
_ distribution box is leveled or replaced
ND explain: n/a
n/a 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: n/a
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all-inspections:
Yes No
X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged
SAS or cesspool
_ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool
X Liquid depth in cesspool is less than 6"below invert or available volume is less than'/2 day flow
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times
pumped nLa.
X Any portion of the SAS,cesspool or privy is below high ground water elevation.
X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
X Any portion of a cesspool or privy is within a Zone 1 of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well.
X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with
no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP
certified laboratory,for coliform bacteria and 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.]
NO (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in
310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd.
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
X the system is within 400 feet of a surface drinking water supply
_ X the system is within 200 feet of a tributary to a surface drinking water supply
X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat
under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner
should contact the appropriate regional office of the Department.
4
f
Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
C. Further Evaluation is Required by the Board of Health:
_ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to
protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is
not functioning in a manner which will protect public health,safety and the environment:
_ Cesspool or privy is within 50 feet of a surface water
_ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
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 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 n/a
"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:
n/a
Z
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
Check if the following have been done.You must indicate"yes"or"no" as to each of the.following:
Yes No
X _ Pumping information was provided by the owner,occupant,or Board of Health
X Were any of the system components pumped out in the previous two weeks
X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X _ Was the facility or dwelling inspected for signs of sewage back up?
X _ Was the site inspected for signs of break out'?
X _ Were all system components,excluding the SAS, located on site'?
X _ 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?
X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance
of subsurface sewage disposal systems
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes no
X _ Existing information.For example,a plan at the Board of Health.
X _ 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 VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 5 Number of bedrooms(actual): 5
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550
Number of current residents: n/a
Does residence have a garbage grinder(yes or no): NO
Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required]
Laundry system inspected(yes or no): NO
Seasonal use:(yes or no):NO
Water meter readings, if available(last 2 years usage(gpd)): WX 0 3 - m o o o
Sump pump(yes or no):NO rl
Last date of occupancy: 9/19/04 V 2 - [S-Voo
COMMERCIALANDUSTRIAL
Type of establishment: n/a
Design flow(based on 310 CMR 15.203): n/agpd
Basis of design flow(seats/persons/sgft,etc.): n/a
Grease trap present(yes or no): NO
Industrial waste holding tank present(yes or no): NO
Non-sanitary waste discharged to the Title 5 system(yes or no): NO
Water meter readings, if available: n/a
Last date of occupancy/use: n/a
OTHER(describe): n/a
GENERAL INFORMATION
Pumping Records
Source of information: n/a
Was system pumped as part of the inspection(yes or no); NO
If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a
Reason for pumping: n/a
TYPE OF SYSTEM
X Septic tank,distribution box,soil absorption system
_Single cesspool
_Overflow cesspool
_Privy
_Shared system(yes or no)(if yes,attach previous inspection records,if any)
_Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from
system owner)
Tight tank Attach a copy of the DEP approval
Other(describe): n/a
Approximate age of all components,date installed(if known)and source of information:
1952,SYSTEM 2 YRS. PER OWNER
Were sewage odors detected when arriving at the site(yes or no): NO
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
BUILDING SEWER(locate on site plan)
Depth below grade: 9"
Materials of construction:_cast iron X40 PVC_other(explain): n/a
Distance from private water supply well or suction line: n/a
Comments(on condition of joints,venting,evidence of leakage,etc.):
TOWN WATER
SEPTIC TANK: X(locate on site plan)
Depth below grade:3"
Material of construction:Xconcrete metal_fiberglass_polyethylene other(explain)n/a
If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate)
Dimensions:H 10'6" H 5' 7"W 58....
Sludge depth: 1"
Distance from top of sludge to bottom of outlet tee or baffle:33"
Scum thickness: I"
Distance from top of scum to top of outlet tee or baffle:6"
Distance from bottom of scum to bottom of outlet tee or baffle: 17
How were dimensions determined: MEASURED
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related
to outlet invert,evidence of leakage,etc.):
SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.
RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE.
GREASE TRAP:_(locate on site plan)
Depth below grade: n/a
Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a
Dimensions: n/a
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of outlet tee or baffle: n/a
Date of last pumping: n/a
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related
to outlet invert,evidence of leakage,etc.):
n/a
7
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: n/a
Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a
Dimensions: n/a
Capacity: n/a gallons
Design Flow: n/a gallons/day
Alarm present(yes or no): N/A
Alarm level: N/A Alarm in working order(yes or no):NO
Date of last pumping: n/a
Comments(condition of alarm and float switches,etc.):
n/a
DISTRIBUTION BOX:X(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert:LEVEL WITH BOTTOM OF PIPE
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.):
D-BOX WAS VIDEO INSPECTED AND APPEARS TO BE STRUCTURALLY SOUND.
PUMP CHAMBER:_(locate on site plan)
Pumps in working order(yes or no): NO
Alarms in working order(yes or no):NO
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
n/a
R
Page 9 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required)
If SAS not located explain why:
n/a
Type
n/a leaching pits, number: n/a
500 GALLON DRYWELL leaching chambers, number: 4
CHAMBERS leaching galleries, number: nla
n/a leaching trenches, number, length: n/a
n/a leaching fields, number: n/a
n/a overflow cesspool, number: n/a
n/a innovative/alternative system
n/a Type/name of technology: n/a
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.):
DRYWELL CHAMBERS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SYSTEM SHOWS
NO SIGNS OF FAILURE.THEY HAD 2" OF LIQUID IN THEM AT TIME OF INSPECTION.STAIN LINES
INDICATE THEY HAVE NEVER HAD MORE THAN 2" OF LIQUID IN THEM. BOTTOM-516".
CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration: n/a
Depth—top of liquid to inlet invert::n/a
Depth of solids layer: n/a
Depth of scum layer: n/a
Dimensions of cesspool: n/a
Materials of construction: n/a
Indication of groundwater inflow(yes or no):NO
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
n/a
PRIVY: (locate on site plan)
Materials of construction: n/a
Dimensions: n/a
Depth of solids: n/a
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
n/a
4
i
Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.
Locate all wells within 100 feet. Locate where public water supply enters the building.
v
0
43
in
Page 11 of 11
Y .
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 256 OCEAN AVE.HYANNIS,MA 02601 M306 P021
Owner: GEORGE GARCIA
Date of Inspection: 9/28/04
SITE EXAM
_Slope
_Surface,water
_Check cellar
Shallow wells
Estimated depth to ground water 12 feet
Please indicate(check)all methods used to determine the high ground water elevation:
YES Obtained from system design plans on record-If checked,date of design plan reviewed: 9/28/04
NO Observed site(abutting property/observation hole within 150 feet of SAS)
NO Checked with local Board of Health-explain: n/a
NO Checked with local excavators,installers-(attach documentation)
NO Accessed USGS database-explain: n/a
You must describe how you established the high ground water elevation:
PLANS- 12'4" FT.
tt
r FAILED INSPECTION
DATE: 8/26/02
PROPERTY ADDRESS: 25-6 Ocean Ave
-- --------------------
Hyannis,----
02601
------------------------
On the above date, I inspected the septic system at the above address.
This system consists of the following:
RECEIVED
1 . 1 -1000 gallon precast leaching pit.
SEP 3 2002
Based on my inspection, I certify the following conditions: TOWN OF BARNSTABLE
HEALTH DEPT.
2 . This is not a title five septic system.
3 . This is a sewage system. r
4 . The leaching pit is in hydraulic failure.
5'. A new title five septic system needs to be installed, .
6. Pumped the leaching pit at time of inspection.
7. Waste water was up too the invert pipe.
SIGNATUR
Name:- J .- P . -Macomber-jr .
-- -- ------- -------
RECEIVED
Co►Tipany: Joseah Pam- Macomber & Son, Inc .
Address:__Box _F.k___________
_ AUG 2 8 2002
TOWN OF BARNSTABLE
Cen-t il1e,_b��_Q2632-0066 HEALTH DEPT.
Phone: 508-775-3338
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY
JOSEPH P. MACOMBER & SON, INC.
Tan ks-Cesspools-Leachflelds
Pumped & Installed
Town Sewer Connections
P.O. Box 66 Centerville, MA 02632-0066
775-3338 775-6412
•
r
COMMONWEALTH OF MASSACHUSETTS
r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address:256 Ocean Ave
Hyannis,Mass.
Owner's Name: Patricia Gibney
Owner's Address543 Ocean Street
Hyannis,Mass _ 02Fi01
Date of Inspection: 8/26/0 2
Name of Inspector: (please print) Joseph P.Macomber Jr.
Company Name: J.P.Macomber & Son Inc.
Mailing Address: Box 66
Pnt-ervi 1 1 e ,Mass _ 02632
Telephone Number: 50E1`775-313,g
CERTIFICATION STATEMENT
1 certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true. accurate and complete as of the time of the inspection. The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
Passes
Conditionally Passes
eeds Further Evaluation by the Local Approving Authority
Fails
Inspector's Signature: Date:
The system inspector shall ubmit 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 10,000
gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time. This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
Paee 2 of l I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:256 Ocean Ave
Hyannis,Mass.
Owner: Patricia Gibney
Date of Inspection: 8 26 02
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes-ID
yes I have not found any information.which indicates that any of the failure criteria described in 310 CMR
15.303 or� C°in 310 —R 15.304 exist: Any failure criteria not evaluated are indicated below.
Comments:
The 1 a hind nit is in hydraulic failure A new title fi p
septic system needs tn b i nst-a 1 1 ed
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.
stJJVfhe eptic tank s 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.
ND explain:
,d,(-_ Observation of sewage backup or break out or high static water level in th distribution bo ue 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
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 I I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Propem Address: 256 Ocean Ave
Hyannis,Mass .
Owoer: pai-ri ni a Gibney
Date of lospection; Rf 9002
C. Further Evaluation is Required by the Board of Health:
_,d& Conditions exist which require further evaluation by the Board of Health in order to determine if the system
:s fading to protect public health, safety or the environment.
I. S.stem will pass unless Board of Health determines in accordance with 310 CM'R 15.303(1)(b) that the
system is not functioning in a manner which will protect public bealtb, safety and the environment:
4 Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is witbin 50 feet of a bordering vegetated wetland or a salt marsh
?. 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:
,4"'0 The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a
surface water supply or rributary to a surface water supply.
The sys(em has a septic tank and SAS and the SAS is within a Zone I of a public water supple
/f42 The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
• /jj,)The system has a septic tank and SAS and the SAS is less than 109 feet but 50 feet or more from a
private eater suppl\ -ell" 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 facilir) ant .
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other
Failure criteria are rtiggered. A copy of the analysis must be anached to this form.
). Other-
The sewage system consists one 1000 gallon precast
leaching pit.The pit is in hydraulic failure.ANew
RP in system needs to be installed.
3
Page 4 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 256 Ocean Ave
H annis,Mass _
Owner: Pa i ri a Gi hney
Date of Inspection: 812 /n 2
D. System Failure Criteria applicable to all systems:
You must indicate "yes"or"no" to each of the following for all inspections:
Yes No
_ �ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
4/ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
'clogged SAS or cesspool
Static liquid level in thee,stribut ion box bove outlet invert due to an overloaded or clogged SAS or
cesspool Al Jcb6
_ iquid depth in,cesspoo is less than 6"below invert or available volume is less than 'A day flow
equired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number
of times pumped J--.
/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.
y portion of a cesspool or privy is within a Zone I of a public well.
y 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 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.)
(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design now of I0,000 gpd to 15,000
gpd•
You must indicate either"yes or"no" to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
_ the system is within 400 feet of a surface drinking water supply
lf'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 11 of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered
"yes" in Section D above the large system has failed. The owner or operator of any large system considered a w a
significant threat under Section E or failed under Section D shall upgrade the system in acco-dance with 310 CMR
15.304. The system owner should contact the appropriate regional office of the Department.
4
r-
Page 5 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 256 Ocean Ave
Hyannis',Mass_
Owner:pai-ri r•i A (;i hnPy
Date of Inspection: R 19r to)
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
Yes No
_ P mping 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 ?
✓ r
Were all system components, ex"'cluding the SAS, located on site ?
Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition
ofJhe 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:
Yes no J ,
Existing information. For example, a plan at the Board of Health.
_411�_ 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 1 I
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 256 Ocean Ave
Hyannis ,mass.
Owner:Paticia Gibney
Date of Inspection: 8/2 6/0 2
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design):( gn): Number of bedrooms (actual):
DESIGN flow based on 310 CMR 15.,;03 �for example: 1 10 gpd x # of bedrooms):y'e/l0
Number of current residents Q,
Does residence have a garbage grinder(yes or no):/11
Is laundry on a separate sewage system�es or no):V6 (if yes separate inspection required]
Laundry system inspected yes or no):
Seasonal use: (yes or no):
Water meter readings, if available (last 2 years usage(gpd)):2 0 0 0—168, 000 gallons=460 . 28 GPD
Sump pump(yes or no): 2001 -1T7,UUU gallons=361 . 65 GPD
Last date of occupancy-
COMM ERCIALIMUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): _gpd
Basis of design flow(seats/persons/sgft,etc.): AIM
Grease trap present(yes or no): Vd
Industrial waste holding tank present (yes or no):, i9
Non-sanitary waste discharged to the Title 5 system (yes or no): .0
Water meter readings, if available:
Last date of occupancy/use:
OTHER (describe): >/f
GENERAL INFORMATION
Pumping Records
Source of information:None available
Was system pumped as part of the inspection (yes or no):
If yes, volume pumped: gallons -- How )vas quantity pumped determined?
Reason for pumping: T !1/flj
TYPE OF SYSTEM
,e Septic tank, distribution box, s?il absorption system
Single cessl
Overflow cesspool
Privy
Shared system(yes or no)(if yes, attach previous inspection records, if any)
AGp Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
�Ot Tight tank ,fi Attach a copy of the DEP approval
,L0 Other(describe):
Ap� m to are of all components, date installed (if known) and source of information:
Were sewage odors detected when arriving at the site(yes or no):,e-r)
it
6
Page 7 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:256 Ocean Ave
Hyannis,Mass .
Owner: Patricia Gibney
Date of Inspection: 8/2 6/0 2
BUILDING SEWER(locate on site plan)
Depth below grade:
Materials of construction: cast iron 40 PVC.ZJAthei(explain): Al 4
Distance from private water supply well or suction line:ldg T-
Comments (on condition of joints, venting, evidence of leakage, etc.):
Joints appear tight.No evidence of leakage.The system is
vented through the house vents.
SEPTIC TANKv4Vdlocate on site plan)
Depth below grade: 11lw .
Material of construction concrete,fj�metaWfiberglass4/4jolyethylene
4l other(explain) '01iA
If tarn: is metal list age: i' is age confirmed by a Certificate of Compliance (yes or noy�/�(attach a copy of
certificate)
Dimensions:
Sludge depth: IV19
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: .lf�
Distance from bottom of scum to bottom of outlet tee or baffle: jt,40
How were dimensions determined: 14?4
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of.leakage, etc.):
Septic tank is not present.
GREASE TRA> G (locate on site plan)
Depth below grade:
Material of construction: concrete-e/W meta l i>4frberglass4//1polyethylene/J49other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle: 4 pl
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping: oW
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert, evidence of leakage, etc.):
C,r•PacP tra j i C not nrPCPnt
7
Page 8 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Propert? Address:256 Ocean Ave
Hyannis.,Mass
Owner: _
Date of Inspection: 8 26 Ong'
TIGHT or HOLDING TANY4,�-L.(tank must be pumped at time of inspection)(locate on site plan)
Depth below glade:
Material of construction: V19 concretekf,4 metal,&O fiberglass /Ypolyethylene de other(explain):
Dimensions
Capacity: AW gallons
Desien FloA gallons/day
Alarm present (yes or no): -.d&
Alarm level: —,a)A Alarm in working order(yes or no):,,V
Date of last pumping: _ 4�4
Comments (condition of alarm and float switches, etc.):
Tight or holding tanks are not present.
DISTILIBUTION BOXeI��(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert:
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of
leakage into or out of box, etc.):
Distribution box is not present
PUMP CHAMBEFW�v(locate on site plan)
Pumps in working order(yes or no):X
Alarms in working order(yes or no):�
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Pump chamber is not present
,y
8
Page 9 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 256 Ocean Ave
Hyannis,Mass .
Owner: Pat-ri ci a Gi hney
Date of Inspection: 8.426/02
SOIL ABSORPTION SYSTEM (SAS): Zlocate on site plan, excavation not required)
1-1000 precast leaching pit.Pit is in hydraulic failure
If SAS not located explain why:
Located; Seepage 10
Type
leaching pits, number:
leaching chambers, number:
1 leaching galleries, number:
, leaching trenches,number, length:
leaching fields, number, dime l ions:
overflow cesspool, number: CJ ,
innovative/alternative system Type/name of technology: �!^i
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,
etc.):
Loamy sand to medium fine sand.Leaching pit is in hydraulic
failLrP waste water is 3" below the invert pipe Soils are
damp.Vegetation is normal .A new septic system needs to be installed.
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: AM
Depth of scum laver:
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.):
Cesspools are not present.
PRIVY4,,a (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.):
Privy- is not present.
9
Pav 10 0( 11
OFFICLAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL, SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(condnvc0)
Properry Aoorc,,:256 Ocean Ave
H�Tanni ,Mass
OHocr:P ricia Gibney
om of In,Pc<uoo: 87TI77 2
SKETCH OF S£WACE DISPOSAL SYSTEM
Pro*ioc I Ikcich o(,hc ,cw,(( O'IPolll ,yllcm 1nc1vftS dca to al Icw rwp perm�ncnt rc(crcncc IrnCmarz, o
OcncNnvki Lo<c,c ,II w<II, �.iihin 100 Ncl. LOC1,< what pvblic wa,cr IvpPly cnlcn the bviloinj.
25ra
/ I
1
v)
I
10
i
Page I I of I 1
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAG
E DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 256 Ocean Av -
I3Vanni stmass
Owner: Patricia Gibney
Date of Inspection: s 126/02
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
i
Estimated depth to ground water feet
Please indicate (check) all methods used to determine the high ground water elevation:
NO Obtained from system design plans on record - If checked, date of design plan reviewed: A,�O
yZa Observed site (abutting property/observation hole within 150 feet of SAS)
-Na Checked with local Board of Health-explain: 1414
Checked with local excavators, installers- (attach documentation)
y Accessed USGS database-explain: http: // town,barns table.ma.us.
You must describe how you established the high ground water elevation:
Jsed:Gahrety & Miller Model 12/16/94 Ground water elevations above
sea 1eye1_
Jsed:USGS_'_Qbservat-inn wPl1 data Tune 1992
Jsed:USGS•Tarrhnir-,-J hill 1 -tin 92_171 0_1 Platp #2 Anmial rangPc; of c1rcnind
water elevations.
t, Leaching
Pit eet
Groundwater: tees Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method
Therefore, the vertical separation distance between the bottom
Of the leaching pit and the adjusted J groundwater table is
• feet. '
11
i"r..T^I T-rtl... •T•f-1TTT. lTT rTR t"T..T'.ITR.TT...T'T4IT..!'T�}11'ITZt TTM. RRT. .. '
1 f
TOWN OF Barnstable BOARD OF HEALTH
0 SUMURFACF SFWAGF DISPOSAL SYSTF,M INSPECTION FORM - PART D .- CERTIFICATION a
•.•-••••T••••.:T-�.1[^.�T.T.!T•T;:l'TI T Tf TT1T STT.T1'.T'.'I Tf tTri T.'IT1RT�"PR'•TRl1"JT 1"lT'CRRi"iTRT1
.. t>tTn r'TmrrtrarnTrrrrr�.•.—.r rT— r•-. —..
-TYPE OR PRINT CLEARLY-
PIlOPERTY INSPECTED
STREET ADDRESS 256 Ocean Ave Hyannis,Maass.
ASSESSORS MAP , BLOCK AND PARCEL
OWNER' s NAME Patricia Gibney
0
PART D - CERTIFICATION L
NAME OF INSPECTOR Joseph P.Macomber Jr.
COMPANY NAHE J. P.Macomber & Son Inc:'"r
COMPANY ADDRESS Box 66 Cen_t_P_rvi1le,mass 02632
Street Town or C,ty S t a t a tip
COMPANY TELEPHONE ( 508 775 - 3338 FAX ( 508 ) 790 - 1 578
rS.
S
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at
this address and that the information reported is true , accurate , and
omplete as of the time of :inspection . The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on-
site sewage disposal systems ,
Check one :
Systetri PASSED
The inspection tihich I have conducted has not found any information
which indicates that the system fails to adequately protect public
health or, Lhe environment as defined in 310 CMR 15 ' 303 , Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form .
-/.—/
System FAIL,Ell*
The inspection which I have con ,cted has found that the system fails to
Protect the p�ttblic health and the environment in accordance with Title
5 , 3.10 CMR 15 . 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection form ,
Inspector Signature Date
n copy of this certification must be provided to the OWNER, the BUYER
( where applicable ) and the 130ARD OF IIZAL'1'lI,
* If the inspection FAILED , the owner or"'operator shall upgrade the system
within one year of the date of the inspection , unless allowed or required
otherwise as provided in 3.10 CMR 16 , 305 .
partd . doc
r
r TOWN OF B�AR�NSTABLE
LOCATION 2SL 0 C�,�s`�� SEWAGE #
VILLAGE � xa� `/► V�/ ASSESSOR'S MAP & LOT.326v�—C-6?
INSTAiLLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY D
LEACHING FACILITY: (type) (size) f Uu
NO.OF BEDROOMS —
B UILDER OR OWNER Il Y n a=
PERMITDATE: COMPLIANCE DATE:
4 <
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) d�rab
Feet
Furnished by `� !�
S'� t
�3y .
i
�.
LOChTION SEWAGE PERMIT NO.
VILLAGE�� II
I N S T A, LL 'S NAME i ADDRESS
e U I L D E R OR OWNER
U h `+rue. LAJ R-t!� n+
DATE PERMIT ISSUED
DAT E COMPLIANCE ISSUED P�_��
h, i
�ck��� �,��-�
�����
��
��
\ _ ���,
��
J � � - -
r � �
c.,
.�
_,
' ; !,,
No.EL-... z::. Fizz..... ...5..00.......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH a,
Town.......-..oF......-.B..a.rnatab,16--------------------------------------------------------
Appliration for Diipniial Worku t ilmitr rtivit Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal
System at:
...... 256 Ocean-,Ave.. ..Hyannis_,__ A026.4.1........
Location-Address or Lot No.
...... hitney_Wright.............................................•-•------•-• 256 oesan._�Ve, .. iyanxLl a..:MA.....Q 6Q1.........--•-•---
Owner Address
W A &_B_Cesspool_Service
----•--...--- ....................................... 12_....Bishop::T.e=ace.,...Hyanxla.s.....�-----Q2.,QI.....
Installer Address
dType of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms-----4....................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons------------�k------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures .........................----•- .
W Design Flow...............................:...........gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity------------gallons Length................ Width................ Diameter................ Depth................
Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No_____________________ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft.
Z Other.Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by...............................................................---•------ Date........................................
Test Pit No. 1................minutes per inch—Depth of Test Pit.................... Depth to ground water-----------------__-___.
Gz, Test Pit No. 2................minutes per inch Depth of Test Pit_________.-.____.--. Depth to ground water________________--_-___-
---------------•-----...----------••--- ---------------------------------------------------------........---------------------------------------•--..-----
0 Description of Soil-•-------•------Sand-------
----------------------------
.---------
------------------------------------------------------------------------------.-..........
V •.........-•-------------------•----------•-------•-•••--•-------•--••------------•--•-----•••••------------•-•-----•---•••-•-----•---------------•---...-•------•----•--••-•--...........--•-•-••---•-•--
W
-- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------•--•-----------------•---
U Nature of Repairs or Alterations—Answer when applicable___installation-_of.-a-of. --ga114n__px�-caBt,
stone packed leach pit to replace_a-_cave--in_________________ __ _ _ ___________________________________
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of'T
p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board o health.
Signed-----4a4n,--- ..f. ------------ 81.......
--
� Date
Application Approved By---•------- ... /_Val---------
Date
Application Disapproved for the following reasons---------------------------------------------------------------•-------------•--------=-•--• --------••--------.
...................s.....................................................................................,............_.........._........................................................................
/ / Date
Permit No..81............. ------------•----.. Issued---•-6 -1`81
Date
No.81r.._....:"a_:..... Firm& $.....50.0........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............ .._..Town..........OF......Barnstable-------------------•-----_-.........................
X
Appliration for Biipniial Works Tontitrnrtion Famit
Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal &
System at:
.....X1..256..Qce=...AxfiL.,..1iyannis,..lYlAO261U.........
Location-Address or Lot No.
lib it h ...........................•.............----------•------- 2,56..9cea .A�rs�,. .ann�s}.. A....D26D1----••----•----...
Owner Address !I�
a A B-. a pooh..S x�t3.ce 12 .-2iaho�..Te=&ae.�...Hy_.nnia¢.-kA....02601...... ;1��
Installer Address \ a
dType of Building Size Lot............................Sq. feet f
V g— _Expansion Attic ( ) Garbage Grinder ( )
Dwelling No. of Bedrooms___.4____________________________________
aOther—Type of Building ---------------------------• No. of persons...........4.............. Showers ( ) — Cafeteria ( )
P.I Other fixtures ------------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow..............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................. Width................ Diameter-_- ............ Depth................
x Disposal Trench—No..................... Width_.---__-_-_-______-- Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water....................,...
G% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water----------.-_-_---_-_---
C4 -----•-••-•------- ----------------•-•--•--•-•------------•••--•-•--•-•---•-•-•----•......--•-•••---------•-••.....-----...---•--•-•••-•...---••••••--.-----
DDescription of Soil................. 4 ----•---•••--•--•-••-••-•--•-•------••-•••••-••-•--•--•-•-•---------••------•------
x
W -•-•---------------------------------------•---••••----------------•---•-•----------•-------------------------..-_---------_-_----_--------•••--••---............-•--••-••---•-•••-•----•-- ......
UNature of Repairs or Alterations—Answer when applicable__121sta11ation--of--a-.�,.OQq•.g��,],o
stone packed_leach pit (overflow) to replace..a-cave_in.--------------------
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 been,issued by.the board 9fj health.,
Signed---a%CCcGvc� z` ` - . 6� 1�$�••---
Dat
Application Approved BY K <. � ---•--------------------- 6l 1 81
---------
Date
Application Disapproved for the following reasons------------- ------------------------------------------------------------------------•••. •--•••----••--.-----
----••••••..............•••••---••----•-•-•---••---•-----••••...-•-----•-......-•-•--•--•-••-••-•••••••-•--------•------•--•----•-•-...--•-•••-•-•-•--•-•---------------------------••••--••-•••----•---
/ Date
Permit No 1................................................. Issued...2/.... SI---------•--•-••----•---------•----
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......................T.own.........OF.......Barns table.................................._.........
Trrtifiratr of T> mptian>e u
THIS IS TO CERTIFY, That the .Individual Sewage Disposal System constructed ( ) or Repaired ( X)
b,, A&-B Cesspool Service..••l28:B shops.Terrace,---)Iy h ,--NIA-----02C01...........................................
Installer
at_2 6 Ocean-Ave___e..Hy_annis, � Installer
Bright.
has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit N4-...11.9_-,.................. da.ted-....... �.._�,���........................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.....................61.118 .......................................... Inspector.....- � 1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
El ' ......I—............Town.........OF............13arnstabl:e..............................................
No..•-•-•.................. FEE......5.00.......
Raposa1 Vorhg Tullmitrnrtion amit
Permission is hereby granted_.&_.B.Ggsspool Sea'yice,-.12 --Eishos__TeacE-,--Hyannis•,--Tom••••02601
to Construct ( ) or Repair (X ) an Individual Sewage Disposal System
at No....z -•-•-Uc ean-Ave., H,ya.nnis� MA 02601..:� Whitney Wright...._..
. . . ......
Street
as shown on the application for Disposal Works Construction Permit No._.g1. .......... Dated......6�.1�g1...................
�
DATE----------6/--1/81 Board of Health
----- --------•-•----•---------------•-•--------•--------------------
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
TOP OF FOUNDATION = 51 .27PROVIDE PRECAST CONCRETE EXTENSION 5" DIA. OUTLET(S) FINISH GRADE OVER CHAMBERS = 49.55 - 49.2 G RISER WITH CAST IRON FRAME AND COVER TO o GENERAL`� ����`�°°C
REMOVABLE COVER SLOPE @ 2/o MIN. OVER SYSTEM
FINISHED GRADE OVER OUTLET FINISH GRADE OVER D-BOX= 49.3 4" SCHEDULE 40 PVC MIN SLOPE 1% 3/4" TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE
FINISH GRADE @ FIND. EL.= 50 80' FINISH GRADE OVER TANK EL.= 50 50' 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
2" OF 1/8"TO 1/2" DOUBLE WASHED STONE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE
---------------- -- - -- - --- - ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES.
20" MIN. ACCESS COVER T OF SAS - 46.55' PLACE RISERS ON ALL CHAMBERS
(TYPICAL FOR 3) 36"MAX. TO 6" OF FINISHED GRADE
EXISTING 4" 9" MIN. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD
_ 45.72' 36" MAX. BREAKOUT EL = 46.22� OF HEALTH AND THE DESIGN ENGINEER.
PVC PIPE -'
3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL
-- i 6„ 3„ 2" DROP MIN. _ PROVIDE WATERTIGHT BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED.
- --- -- - --- --- -•--1 � r 3" DROP MAX. 3" 9 JOINTS (TYP.)
o ' 4" PVC IN FROM 0 O oo ❑ ❑ ❑ ❑ o0
4. TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN
14" ~'`' 46 76 SEPTIC TANK 4" PVC OUT TO o 0 0 0 o ELEVATION =46.22' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS
46.93 f LEACHING FACILITY T oo < 0 ❑ oo A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
(CONTRACTOR o i THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
MI ' 2 0 ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ o0 0 ❑ oo 1 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
SHALL VERIFY) OUTLET TEE 46.10 MIN. 45.93 � � �48"
23.5' 0 o0 0 ❑ o0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
6" CRUSHED STONE o 0 0 0
22"ZABEL FILTER o 0
VARIES MODEL#A1801 HIP OVER MECHANICALLY 4
(GAS BAFFLE ON COMPACTED BASE �,rl � 8 5' I� � 7. LOCAL BOARD OF HEALTH TO BE NOTIFIED
4' 4' PRIOR TO BACK FILLING WHEN SYSTEM IS NEARLY COMPLETE AND
BOTTOM) 5 OUTLET DISTRIBUTION BOX 25.0' 4.9 ~� READY FOR INSPECTION. SYSTEM IS NOT TO BE BACK FILLED
TO BE INSTALLED ON A LEVEL STABLE 38 3' 7 (2 9,) WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH.
BASE. FIRST TWO FEET OF OUTLET 43.72' GROUND WATER ELEV.-
PROPOSED H-20 1500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL.
LENGTH 11'T WIDTH 6'2" DEPTH 6'0" 2 - 500 GAL. CHAMBER.:: 5' MIN. 8. ELEVATIONS BASED ON ASSUMED DATUM OF 50.0' MSL OBTAINED
CROSS SECTION VIEW FROM NAIL IN POST AS SHOWN ON PLAN.
�� PTIC TANK. PROFILE (H-20) DISTRIBUTION BOX DETAIL TYPICAL CHAMBER PROFILE CHAMBER DETAILS CHAMBER END VIES
NOT TO SCALE NOT TO SCALE NOT TO SCALE 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
.___.-__..__-___.___....______.___ THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE
AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY
- TEST PI TA
DISCREPANCIES TO THE DESIGN ENGINEER.
1 ��� , `. 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE
N. INSPECTOR:
STRUCTURES SHALL BE MADE WATERTIGHT.
$ y} SOIL EVALUATOR: John :hurchill Jr. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR
1,4
r , d �` ZONING REGULATIONS. OWNER/APPLICANT IS TO OBTAIN
DATE: Augu?6. 2002 I
k " �q i SUCH DETERMINATION FROM APPROPRIATE AUTHORITY.
� a TEST PIT#: 1
. �kc
12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H 10 LOADING UNLESS
LU
ELEV TOP = ).31'
" ��� w i z �: LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH
` 0 ,� :, CASE THEY SHALL WITHSTAND H-20 LOADING.
'��� «�., � �..�� �<�.� ),� . ,,,�,y ELEV WATER= >11GS
� T _
� � PERC RATE = < 2 Min/IAssumed) 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND
O .- Pi : • M i,,. � FINES.
�, m + ) � DEPTH OF PERC= A.
RAC z ) " (��_ 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND
K R ROADQ � � �„ „ �`� TEXTURAL CLASS: 1
s. i UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES
d. �' "' '� °'""°' 4 ' _
(2p_FT W�� .. .'w. ( f � OF LEACHING FACILITY. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN
wAY) EXISTING CESSPOOL TO BE -� COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN
PUMPED AND FILLED WITH 4
ACCORDANCE WITH 310 CMR 15.255(3).
- CLEAN SAND " ,A 0 49.31'
" Loamy Sai
_ � . r...0 t� ��' '�''��;�� gym.,: �, � 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES
EXISTING1 � �„. .,�. � � � : e � � � r� �� �; _ A
aS77�/ �, �* ! / :ti - 8„ 10YR 3/� 48.6'
BEDROOM { f k FOUND IN SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
DWELLING / 52 E14.99, 16. PROPOSED PROJECT IS LOCATED WITHIN:
B 10,
Loamy Sal ASSESSORS MAP 306 PARCEL 21
10YR 5/E
OCUS1
S 36" 46.3' 17. OWNER OF RECORD: PATRICIA GIBNEY, TR
SAS �` W� � ADDRESS. 270 OCEAN.AVENUE
� S }('X,...-X�,. _ C1 2 5Y 6/4
S X� HYANNIS MA 02601
5 G4'S GG H Y NNI H'A"', R 96" 41.3' 18. PLAN REFERENCE: BOOK 74 PAGE 13
S `''-��''�
X 'X #256 S � C P �I F-M-C Sd
+ I
�t ,; C2 2.5Y 7/2 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
EXISTING 4 BEDROOM
DWELLING No Groundwer
'FI1.6' ,� �% EncounterE 20 FOR SEPTIC SYSTEM UPGRADE.1 PROPERTY LINE INFORMATION JOC ENGINEERING WILL NOT ASSUME ANY LIABILITY NLY
N/F RYDER, WARREN B & h� �- ' LOCUS PLAN 132" 38.3' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
CYNTHIA J T.O.F. = 51.3 z} �� r1
< p`� SCALE: 1" = 1000'
MAP 306 PARCEL 020
r �� is DATA
AZEBO TO'$E ff _
LEGEND
REMOVED/ i r� x s EXISTING SPOT GRADES
RELOCATE
,k
fl,� -� �L f ...... psi
ar --- . -... EXISTING CONTOUR
t iff NUMBER OF BEDROOMS 5 S0 PROPOSED SPOT GRADES
PLANTER TO BE ` ROPOSED H-20 1500-GAL NUMBER OF PERSONS 5
REMOVED/ 50 SEPTIC TANK PROPOSED CONTOUR
- DESIGN FLOW 110 GAUDAY/BEDROOM
RELOCATED
cv � TOTAL DESIGN FLOW 550 GAUDAY -- ---- /C ---- EXISTING ELECTRICAL UTILITIES
�. J DESIGN FLOW X 200 % = 1100 GAL/DAY
` . 42 GAS -- EXISTING GAS LINE
0) ................ p 71. USE NEW 1500-GALLON SEPTIC TANK
....................... _.... EXISTING WATER LINE
1p TEST PIT LOCATION
0 P
--- ......... Cj ��� INSTALL 4- 500 GAL. CHAMBERS
<:=........: :::'._:_... ) ::_: :::_ '�w�ELOCATE WATER LINE Q JP U O O PROPOSED SEPTIC TANK
v10 "�` f" SIDEWALL CAPACITY
�:
B.M. 36.7, `,, SLEEVE WITHIN 10-3 l OF (LENGTH + = 4" SOLID SCHEDULE 40 PVC PIPE
O:=: ::::=: ( GTH WIDTH) (2' HIGH) (.74 GPD/S.F.) GAL/DAY
Nail in Post 49.31 t. S ItEI PIPE CROSSING (42.0' +12.9' +36.7' +7.0' +8.4') (2') (0.74 GPD/S.F.) = 158.4 GAUDAY
Elev. = 50.00' 9if DISTRIBUTION BOX
Assumed OUR-500-GAL CHAMBERS
o r ISTRIBUTION BOX BOTTOM CAPACITY i 500 GAL. LEACHING CHAMBER
(LENGTH x WIDTH -CORNER) (.74 GPD/S.F.) = GAUDAY
[(42'x12.9') -(0.5 x5.3' x4.5')] (.74 GPD/S.F.) = 392.1 GAUDAY
N77.151 p p„w _4-' ,
� g TOTALS: REV. DATE BY APP'D. DESCRIPTION
lg fl0 - --
TOTAL NUMBER OF CHAMBERS 4 ' PROPOSED SEPTIC SYSTEM UPGRADE
TOTAL LEACHING AREA 743.9 SQ.FT. PREPARED FOR:
TOTAL LEACHING CAPACITY 550.5 GAL./DAY PATRICIA GIBNEY
LOCATED AT
STUD 256 OCEAN AVENUE
LEyROA
(4p_FTLAY D I HYANNIS, MA 02601
OUJ-)
SCALE: 1 INCH = 10 FT. DATE: SEPTEMBER 6, 2002
0 5 10 20 40 FEET
TH OF y�
SEEM— MMME11
? JOHN L. 0 PREPARED BY:
CHURCHILL
C,ML a JC ENGINEERING, INC.
NO 41807 5 ROUNDHILL BLVD.
- - --- - -- - EAST WAREHAM, MA 02538
SITE PLAN 508.273.0377
SCALE: 1"= 10'
_-`•„-___.__��____ ______�_ _ _-�_�.4___._ _ Drawn By: SPJ Designed By: SPJ Checked By: JLC JOB No.280