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HomeMy WebLinkAbout0062 OCEAN DRIVE - Health ,.Hyannis . A. =.:245..116 - - - t� o i i � o l T , TOWN OF BARNSTABLE • /') LOCATION �/ T � V SEWAGE # �'+ '2 VELLAGE GU t/ �� �- E ASSESSOR'S MAP & LO`T r P INSTALLER'S NAME&PHONE NO. 9 Dn /r—S D t-/ �`? '7Z- SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �—.�`� �'� �- G (size)�1 `rl`✓' NO. OF BEDROOMS BUILDER"OR OWNER PERMTTDATE�/0�J D Z- COMPLIANCE DATE:,/©-//)—O 2, Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bott of Leaching Facility Feet Private Water Supply Well and Leaching Fac' i (If any wells exist an on site or within 200.feet of leaching fac ty) Feet Edge of Wetland and Leaching Facility y wetlands exist within 300 feet of leaching facility Feet Furnished by f t _ .��` • Vim\ � a t No. Fed 5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplitation for 30tgpooar 6pztem Comaruaton Vermtt Application for a Permit to InsTuct( . )Repair(xY-Upgrade( )Abandon( ) R1 Complete System El Individual Components Location Address or Lot No. Fourth, Ave: Owner's Name,Address and Tel.No. Assessor's Map/Parcel W• Hvan ort" Joe McDonald L --fly - Installer's Name,Address,and el.No. Designer's Name,Address and Tel.No. Wm. E. Ro inson Septic Servic Craig R. Short P.E. P.O. Box 1089 . P.O. Box 1044 Centerville MA 02632 S. Dennis MA 02660 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building residential No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) we will install a new Tit 1 e-5. septic system to the plans of Craig R. Short #1 -932 dated- 10/4/02 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 issued by this ar f Health. Signed Date Application Approved by Date Application Disapproved f r the following reason Permit No. Date Issued No. I Fee 5 0.00 9L THE COMMONWEALTH OF MASSACHUSETTS F' Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, S MASSACHUSETT Yes yl _ Zipprtcation for &5pogai 6pgtem Cow6truction Permit Application for a Permit to ns ct( , )Repair(X*Upgrade( )Abandon( ) ®Complete System El Individual Components Location Aldress or Lot No. 649' Fourth Ave. Owner's Name,Address and Tel.No: Assessor'sMap/Parcel why Port Joe McDonald Installer's N e,A ss,and at,No. Designer's Name,Address and Tel.No. « - 4m. Ro. inson Sep�iic Servic Craig Sort P,E. i P.O. Box 1089, P.O. ) 1044 Centerville, MA 02632 S. Dennis MA '02660 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building residential No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. - •Description of Soil we will install a new title-5 se ti Nature of Repairs or Alterations(Answer when applicable) P septic sy$tem to the plans of Craig .R. Shott #1-932 dated 10/4/02 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 issued by this ard/of Health. Signed 12 Date A0'�! 4Application Approved by M Date Application Disapproved for the following reason v _ SV.. Permit No. Date Issued t THE COMMONWEALTH OF MASSACHUSETTS McDonald BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal-System Constructed( )Repaired(XX)Upgraded( ) Abandoned(( )by WIC."'E. Robinson Septic Service at 1 69 Fourt Ave. , W. Hyannis'port has ee constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No ated Wm E. RobinsonSr. .-E. Installer S Designer C aig orb, P The issuance of this permit hal of be con trued as a guarantee that the sys din will function as desi�gned/ /ems Date Ins ector Al 4 aT NO- McDonald THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'igpogal *pgtem Cortgtruction Permit Permission is herebyl�ayteg too Co�t�truc„F(e )Repair(H XX ail i spor)Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must fe/coJm fetedAvithin three years of the date of this pe. 't. ! 1 ( A roved b Date: ( PP Y ,. _ TOWN OF BARNSTABLE LOCATION T� A SEWAGE # �' / 20 VII,LAGE �(/ �/ pis 2 d ASSESSOR'S MAP & LOT INSTALLER'S NA &PHONE NO. Dh /w<O z✓ '7 'D ME ; ? Z. SEPTIC TANK CAPACITY S(� LEACHING FACILITY: (type) (size)j� NO. OF BEDROOMS l BUILDER OR OWNER PERMTTDATE-/D COMPLIANCE DATE: ®—��� 2� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bott of Leaching Facility Feet Private Water Supply Well and Leaching Fac' ' (If any wells exist on site or within 200 feet of leaching fa ty) Feet Edge of Wetland�and Leaching Facility any wetlands exist within 300 feet of leaching facility Feet Furnished by S DATE: . 2/.22/97 PROPERTY ADDRESS: 4 4fh -Ave West .H.yannisport Mass . On the above date, I Inspected the septic system at the above address. This system consists of the following: 1 ._ 1 -4 ' x5 ' •block cesspool 2 .. 174. 51 7 ' block cesspool. Based on my Insrwction, I certify the following conditions: 1 . This is not a title five septic system. 2 . This is a sewage system installed in 1951 . 3 . Both cesspools are dry. 4. The sewage lines are badly rooted and should be repalced 5 -'The ,se.wage system is in prope-r working or„der at the p ,e,sent,time SIGNATURE: G`%( Name: J . P .Macomber Jr., r ------ --------------- Company: J. P_Macomber &— Son•_Inc . .. Address:_•-Beac-bg-----=-�-- -- Centerville LMass__02632 Phone:---508z7_7-5�.3338------- - t THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY 2 1 � i q� F4/ O JOSEPH P. MACOMBER & SON, INC. P-1 l% � i°r�s �99 arm- Tan ks-Ceupools-Leachflelds Pumped & InsUlled Town Sewer Connections P.O. Box 66' Centerville, MA 02632-0066 775-3338 775-6412 Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection WUOam F.Weld Trudy Coxe c3ownor 8wwary A WPaul Celluccl David B.Struha mot Corrrr"rw • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Prope,gAdd,.. 49 4th Ave W. Hyannisport Mass Address of Owner.Dora thy Stern Date of Inspection: 2/2 2/9 7 (If different) 50 B r o u n e Street Name of Inspector.Joseph P.Macomber Jr . Brookline ,Mass . Company Name,Address and Telephone Number. 02146 J. P�,(M�ac'o7'm75ber�& Son Inc . Box 66 Centerville ,Mass . 02632 CERTTF'IATTdN S AMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate anal complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-sits sewage disposal systems. The system: '„]�Pasaei _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: ol— The System Inspector&hall submit a oopy of this inspection report to the Approving Authority within thirty(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 oM a of the Department of Environmental Protection. The original should be sent to the system owner.-md copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A. B, C,or D: A) SYSTEM PASSES: •^ ^I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection Indicate yet,no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not) VOiT,, Ths se'_ptic tannk-is metal,cra-.ked,structurally unsound, shows substantial infiltration or exilltration,.or tank failure L irnm;n"nt. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street a Boston,Massachusetts 02108 a FAX(617)556-1049 • Telephone(617)292-55W ��Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontinued) Property Address: 49 4 t h Ave West Hyannisport ,MaSS. Owner. Dorothy Stern Date of Inspection: 2/2 2/9 7 B)SYSTEM CONDITIONALLY PASSES (continued) ,"e- Sewage backup or breakout or h0h static water level observed in �boa.is due to broksa or obstructed pips(s) or due to a broken,settled or uneven distribution bout. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution boat is levelled or replaced Qj) The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:- Conditions cast which require further*valuation by the Board of Health in order to determine if the system is failing to protect the public beahh,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A )BANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENTr a Cesspool or privy is within 60 feet of a surface water APCeespool'or privy is within 60 feet of a bordering vegetated wetland or a salt marsh. 3) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT The system has a septic tank and soil absorption system and Is within 100 feet to a surface water supply or tributary to a surface water supply. .V44 The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 60 feet of a private water supply we1L The system has a septic tank and soil absorption system and is less than 100 feet but 60 feet or more from a private water supply wall,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the'well is &00 from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 6 ppm 3) OTHER The sewage system consists Of 4=41x5 ' block cesspool. This acts as a septic tank. 1 -4. 5101 blockcesspoo This acts a over o . All no ' s to . paragraph C section 2 (revised 11/03/95) 2 L- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) PropertyAddreaa: 49 4th Ave West Hyanni sport,Mass . Owner. Dorothy Stern Date of Inspection: 2/2 2/9 7 DJ SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. &0 Backup of @swage into facility or system component due to an 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. N041. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is leas than 6"below invert or available volume is less than L2 day flow. A)4 Required pumping more than 4 tunes in the last year NOT due to clogged or obstructed pipe(,). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. N4 Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. A2P Any portion of a cesspool or privy is within a Zone I of a public well. �Q Any portion of a cesspool or privy is within 60 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 60 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,.attach copy of well water analysis for coliform bacteria,volatile organic•compounds,ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: 4)6 The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: L,4 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 . Q the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone H of a public water supply well) The owner or operator of any such system shall bring the system and facility into Rill compliance with the groundwater treatment program requirements of 314 CMR 6.00 and 6.00. Please consult the local regional office of the Department for fluther information.. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST PropertyAddr.es: 49th 4th Ave West Hyanni sport,Mass . owner. Dorothy Stern Date of Inspection: 2/2 2/9 7 e Chock if the following have been dome: „ Pumping information was requested of the owner,occupant, and Board of Health. done of the system componu}ts have boon pumped for at least two weeks and the system has been receiving normal flow rota during that period. Lame volumes of water have not been introduced into the system recently or u part of this inspec:tioa. built plans have been obtiiaod and asamiaad. Note u they era not,aVaslabla with-N/A._. L�~• r7W facility or dwelling was inspected for aims of sawage back-up. system does not receive non4anitar9 or industrial waste flow , The site was inspected for sips of breakout. _All iystam oomponants,��u&4 the Soil Absorption System, have been located on the site. �JcA/�Tom. a maaholw ware uaoovesed,opened, cad the interior of the septic tank wad inspected for coaditioa of baffles or toee,malarial of coastrtutioa, dimaasfons,depth of liquid, depth of sludge,depth of maim z'The sise,and location of the Soil Absorption System on the site has bean determined based on szisting information or appr=imated by non•intrusivo mathods. _The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) 5 SUBSURFACE SEWAGE DISPOSAL'SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION PropertyAddre.a 49 4th Ave West Hyannisport ,Mass . Owner. Dororothy Stern Date of Inrpeotiuu: 2/22/97 FLOW CONDITIONS RFSIDENCIAU _1l Design mW: na a � s Number of bedroom,: Number of currant re=: Garbage grinder(yes or noi. VD Laundry connected to system(yes or no):_� Seasonal use(yes or ao):ILS Water meter readings, if available: PA-Z2 A us Last data of occupancy: COMM ERCIA.LD ND USTRIAL- Type of establishment: Design flow:_.,d2&gallons/day Grease trap present: (yes or no)Ao Industrial Waste Holding Tank present: (yea or no),a Non-sanitary wart discharged to the Title 5 system: (yes or no),�,& Water meter readings, if available: 429 Last data of occupancy: OTHER. (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS d source of' rmation: .% J System pumped as part of inspection: (yes or n If yes,volume pumped: ) f Reason for pumping: �o fJ/// SJj/ TYPE OF SYSTEM Septic tank/distrilyution box/soil absorption system Singie cesspool Overflow oevpool Privy Shared system(yea or no) (if yes, attach previous inspection records, if any) Other(explain) AP = AGE of all components, date installed (if known)and source of information: Sewage odors detected when arriving at the site: (yes or no) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C• • • SYSTEM INFORMATION (continued) PropeMAddress: 49 4th Ave West Hyanni sport,Mass . Owner: Dorothy Stern Date of Inspection: 2/22/97 SEPTIC TANK:&ewe— (locate on site plan) Depth below grade: & material of constructionA:&concrete _metal _FRP _other(explain) Dimensions:_ Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle:,LV/Q Scum thickness:- _AL _ Distance from top of scum to top of outlet tee or baffle:1 Distance from bottom of scum to bottom of outlet tee or baffle._ Comments: (recommendation for pumping, condition of inlet and outlet tees or baffle,. depth of liquid level in relation to outlet invert, structural riry, evidence of leakage, etc.) ep i tanK is not present GREASE TRAP. (locate on site plan) Depth below grade:,41l 01 material of constrnwnion-�--7'a.onae►e _metal _FRP _other(explain) 'oh Dimension;- IV Scum thickness. A Distance from top cat scum to top of outlet tee or baffle:-Az Distance from bonom nl from I^honnm of outlet tee or 6111e: Comments: (recommendation for pumping, condi1,^n of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integray, evidence of leakage, elm Grease trap is not present t y trev:asd 1/15/951 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(000tlnuod) propertyAddroa.; 49 4th Ave West Hyanni sport ,Mass . Owner. Dorothy Stern Dais of Iaspeotioa: 2/2 2/97 TIGHT OR HOLDING TANK"A'P- 00cats oa cits p1w • Depth below V-ads:-A2 Mat.rial of coastnidioa:��=cVt•_Zotal_FRP_oth•r(apILw AIW Dimsnsiow: AA Cspadt7 as D.slp now. as/day Alarm level: Commsats: (ooa&tioa of Inlet t,se,`condition of alarm Lad float switcbu, etc.) lignt or o ing anZ: Not present. DISTRIBUTION BOX&PAV- (locats on nits plan) Depth of liquid level above outlet invert: Cammaa4: (nee if kvsl Gad distribution is equal, rvidsaa of solids carryover,evideacs of lo-%,o iato or out of bos,etc.) Distribution box is not present PUMP CHAM E -bve.._ (locals oa sits plea) Pumps in working ordar.(Yes or Commsats: (cots ooaditioa of pump cumber, oondWoa of pumps Ladtappurtenaaoes, etc.) Pump unamber is not pri�sent. (revised 11/03/95) T - - -- - U SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(ooutinued) Property Addreeso 4 9 4 t h Ave West H y a n n i s p o r t ,Mass . Owner. Dorothy Stern Date of Inspection: 2/2 2/9 7 BOIL ABSORPTION SYSTEM(SASk,1 -7 Clooate an site plan,if possible;cmvatiou not requi:vd,but my be approximated by non-intrusive methods) If not deurminad to be prevent,explain: T'PK pits,number . tossing chambers,number. lwching trenches,numbar,loagth. leaching fields,number,dime us: overflow cesspool, number Commsats:(sou condition of signs of hydraulic(ailure,1eye1 of ndim condition ) Medium sand to fine coarse sand: lqo signs of�ytraual Dondine: all vegetation is normal. CESSPOOLS: (locate on site plan) Number and configuration Depth4op of liquid to inlat Depth of solids layer Al Depth of acu=layer: Dimensions of -6 MataiaL of construction: e _ Indication of groundwater:_ inflow(cesspool must be pumped as part of inspection) Pnm=p(j an(j removed all solids from the in ow cesspooi. Co M 2 d 1� s m ition d t o�I 1 n e f �d 8.T c e fi S d n Ci of ponding,condition of vegetation,etc.) ns of hydraulic failure or- ren4j, �m All veae a ion is normal . - PRIVY. ,(/' (locate on site plan) Matui.l.of _ it/ Days• il/.� Depth of solidsc - Comments:(note condition of aoi] signs of hydraulic failure, level of pondiag,condition of vegetation,ete) _ Privy is not present (revised 11/03/95). 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION .FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L:SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' Hyannis -Water Company 775-0063 C 7 DEPTH TO GROUNDWATER 131 +. depth to groundwater r+,;kthod of determines ion or approximati,on: Have' ins led:.sys'tems::.th u& !.oat_ t.he, aeftuues . d system-At 2-1�rdve. a .er 'was ebcountered at 11 1 Permit # 95-& '0. r. a•I•.r..r,^n r�,T'.A►raw•nT.rrwR w7,s�frM1,rrw1l.►(,nn•.nn.•r nRR\Y++�w+�1 w,+ TOWN OF Barnstable BOARD OF HEALTH SUI;ISURFACE SEWAGE DISPOSAL ,SYSTEM INSPECTION FORM - PART D •- CERTIFICATION I :_.t„-.••.•: .—..rrn-.-.,,...,n•nn.,,.�,.,,..,,..,n•r.—•,.,....�,....r-.T,.....n.•r.n...r..-.... ...,. .•-.r.•r.,--„ _...1 -TYPE 09 PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 49 4th Ave West H,yannisport ,Mass . ASSESSORS MAP, BLOCK AND PARCEL 0 246-116 OWNER' s NAME Dorothy Stern PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. , COMPANY NAME J• P.MAcomber & Sc1h' Inc . COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or Clty state LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 1 790 - 1 578 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 complete 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 : :'X.X-XXxYY XXSyste'PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public healLh or the 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 FAILED* The inspection which I have con lcted has found that the system fails to protect the public health and the environment in, accordance with Title 5 , 310 CMR 15 . 303, and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date 2/24/97 One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEAL1'll. If the inspection FAILED, the owner or" ` erator ehall up grade pgrade • the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 CFIR 16 . 305 . partd .doc W THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. Junc 8, 1995 Acting Director of the -ion of Water Pollution Control TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR I 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE ELEV. = 10O00_ 10 FT. MINIMUM CLEAN SAND (ASSUMED) -lE 4" SCHEDULE 40 PVC PIPE LOAM AND SEED MIN. PITCH 1/8" PER FT. 2" LAYER OF 1/8" TO 1/2" 1 17, G WASHED STONE b NIA • 2• 4" CAST IRON PIPE C4 r,L- M A X.-.1-7 q` rsa b yAX 7.00 MIN. (OR EQUAL) MINIMUM r PITCH 1/4" PER FT. _ FLOW LINE i • Ir 000 © 00 ❑ 0000 l00 00" } ELEV = �= `�MIN. c�3.3s 2 p LEV _ _ LEVEL °°° ° 00000000000 ° �....� ELEV .. .G GAS ELEV = .�.�iJ-c7r�� 6�"pSUMP ELEV. � 9�-8� °° °° 00000000000 ° 2'° ° 102.0 1 1 BAFF� �S 1 nIBU � p E4U ° ° 00 ❑ ❑ 00 ❑ ❑ ❑ ❑ ❑ ° i.: 10 .5 ( LIQUID OUTLET --'_� G70X !•�'f °° ° ELEV. .• �1+2.?1" QFPTH TEE_ (TO BE PLACED ON FIRM BASE) 2 500 GALLON DRYWELLS WITH 4 FEET 14 INCHES TO BE WATER TESTED STONE IN AN 5 FEET 19 INCHES rC IF MORE THAN ONE OUTLET 13 X 25 X 2' 1RENCH FORMATION 4 r,may WELL- LOT 274, 276, 278, 280, 28� F8'� 1 7 FEET 24 INCHES i�1WtJ GALLON (TO BE PLACED ON FIRM BASE) ----_-� 1- 7,TZONE_ N/A I AREA 24,000f S.F. 8 FEET 34 INCHES SEPTIC TANK 3/4" TO 1 1/2" CLEAN solL AesaRpTION ;� INDEX ` J • DOUBLE WASHED STONE YCJ'T`�� CJACJ ADJUSTS FREE OF FINES & LT I SYSTEM ( --AS)__ USGS PROBABLE WATER TABLE ELEV. _ -A/A-- SEWACE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. _ _NIA NuT TO SCALE BOTTOM OF TEST HOLE ELEV. - ■ 100.7 - ��� ■ 103.E I `-y NOTES: SOIL TEST 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. DATE OF SOIL TEST 09j05/Q2 TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE SOIL TEST DONE BY DISPOSAL OF SEWAGE. WITNESSED BY _yt I1Q0hSON ___-__- ��� 1 1.2 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO OBSERVATION HOLE 2 ELEV.=__AQ_ ' WITHIN .6" OF FINISHED GRADE. PERCOLATION RATE _4_�.__ MIN./INCH AT �?Q INCHES 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF /1 WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN DEPTH HORIZ TEXTURE COLOR MOTT OTHER 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE \ USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 1w Ap LOAMY SAND JOYR3/2 NO ROOTS 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. 33' 8 LOAMY SAND 10YR5/8 NO ROOTS 101.4 / 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH I DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO 78' C1 COARSE SAND 2.5Y7/6 NO c,4 J k OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. + 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR LOAMY/ /3 NO tkiSWTAB,�,E IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS 102 C2 NNE SAND 2.5Y6 {O PRIOR TO COMMENCING WORK ON SITE. Ed. 101.2 I 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS 1560 C3 FlNE SAND t0YR8/2 NO C2 �� � ?, ■ 1 .1 C J SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION� IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER IMMEDIATELY. 8. PARCEL IS IN FLOOD ZONE G S p 11 9. LOT IS SHOWN ON ASSESSORS MAP __245_ A5 PARCEL ---__--- QS -- - ' 10. ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER, AND NO WATER ENCOUNTERED AT __],.'�__ ELEV. 0., �� FOR A MINIMUM OF 5 FEET FROM AROUND THE SOIL ABSORPTION SYSTEIv • AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255: (3) DESIGN CALCULATIONS (I.E. TITLE 5) IF ENCOUNTERED BELOW S.A.S. PIPE INVERT. 3 - 11. EXISTING SEPTIC SYSTEM TO BE PUMPED AND FILLED WITH SAND NUMBER OF BEDROOMS - -�� OR REMOVED GARBAGE DISPOSAL UNIT _ NO _ TOTAL ESTIMATED FLOW ( 110 GAL./BR./DAY X _3 SR.) _ _ GAL./DAY ' 97.5 S.A.S. �` 9 .g REQUIRED SEPTIC TANK CAPACITY _ _ GAL. ACTUAL SIZE OF SEPTIC TANK _1 GAL. j SOIL CLASSIFICATION 38._-.---- DESIGN PERCOLATION RATE MIN./IN EFFLUENT LOADING RATE _Q,I-4- GAL/DAYS/S F 1 LEACHING AREA G 3�,,t Lx)f ]4 jt 2'� SQ. FT. • LEACHING CAPACITY (AREA X RATE GAL./DAY RESERVE LEACHING CAPACITY _ GAL./DAY SHED APPROVED: BOARD OF HEALTH a 96 G PAD j 99.8 _ 1 I4 2't DATE AGENT sEP _ D£cx LEGEND: - - ---- TAW EXISTING SPOT ELEVATION ^0,,0 PROPOSED SEPTIC DESIGN EXISTING CONTOUR ----a0---- FOR ,(Ace, FINAL SPOT ELEVATION .O �' _ Trd� 6.4 r l FINAL CONTOUR ;� AO� ACE JOE MCDONALD t „ i EXISTING SOIL TEST LOCATION t A/C J; G�� / DWELLING UTILITY POLE `� R .5 TOWN WATER =WSW==•-- v CATCH BASIN (®j LOC. 189 FOB T'pT�1 AVE. 4 9 1 UO GAS LINE GAA i VV ii�Z 1�l g, CLEAN OUT C.O. W. IffANMPORT, MA --74& J PORCH CESSPOOL CPGRAWLI o DAYWI Sn.S 99.3 + - I CRAIG R SHORT, A X .. 235 GREAT WESTERN ROAD moo, 508- P. 0. BOX 1044 F0051 SOUTH DENNIS, MASS. 98.9 9 9 .a �;, ,;- g� 398-8311 02660 AN SCALE - r; DATE OCT. �, 2002 �1 - 20 ORAIG p� �•. 1 x N � \ " 978 SHORT 2 ■ 97.0 96J�/' \ w C REVISED JO$ NO. 1--932 STREET T Orpr--AIV .`�.� '� � ®�.�/ LOCATION h�1 AP � REVISED F!iiqT 1 11 0 2002 CRAIG R. SHORT, P.E.