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0131 OLD CRAIGVILLE ROAD - Health
131 Old, Craigville Road Hyannis A= 248-112 O 0 a TOWN OF BARNSTOABLE LOCATION �.3I 01G0/ �rf5��V�/l/I%> 2�( SEWAGE # ZOG/ — yZ VILLAGE /'L�1 ASSESSOR'S MAP & LOT fE- INSTALLER'S NAME&PHONE NO.��0�•c/Z D-q73� c�a�e�� �, � rro� SEPTIC TANK CAPACITY /cSd O LEACHING FACILITY: (type) Z I K64 7:/S (size) ?T,2 S X 2,95 NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: r!O ^ 23 " !/ COMPLIANCE DATE: J_2 G/ 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 leachi g facility) Feet Furnished byG�G w 0o N GS' ,C W 00 O � C a y 11 a _ TOWN OF BARNSTAB E LOCAiort 1 3 614 `4 �� SEWAGE # -- Vil LACE -0 GI n c S ASSESSOR'S A+"&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACM 1500��► LI LEACFUNG-FACILITY: (type)r�h �-v 1 I�S (Size) NO.OFBEDROOMS� .� BUUMER OR OWNER PERMITDATE: COWLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility - ---_Feet Private Water Supply Well and Leaching Facility (if any wens exist • on site.or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetUds exist •within 300 feet o leaching facility) Feet Furnished by �k44/0 —`7" i q bl\- ^ C � aZb i TOWN OF B STABLE LOCATION :�'1/ Ql C j e C,� SEWAGE #�f VILLAGE n in p, Is ASSESSOR'S MAP & LOT L�)l 2 INSTALLER'S NAME&PHONE NO LL 19 2 7 4 SEPTIC TANK CAPACITY a a FACILITY:LEACHING ��, size (type) � � ( ) /. Ve�HayJn NO.OF BEDROOMS 4dm P S uv BUILDER OR OWNER "''! b2,6 4 l�' o^ rvm:F PERMITDATE: /`2 � `of COMPLIANCE DATE: Separation Distance Between the: .Maximum Adjusted Groundwater.Table and 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 V_ 4. � I `h ^X `r� � �� • J // ! ,j1' � � � o� / � � � � �� '� O 1 v � �� T , ' n ,ZP -p/�-// � Y�'� �, ..,, . : , ', � F�a �� - q r; 4 Fee r a, THE � NWEALTH OF MASSACHUSETTS, Entered in computer: e PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS K: _ M y1 ftPficatiou for Misposal 6pstrm Construction 3permit Application for a Permit to Construct(vy—Repair(/_)--Vp_grade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /3/ L121W 6rwy 1///�/_= Rd, Owner's Name Address,and Tel.No. Nyr¢��is l9hr Assessor's Map/Parcel I y$- //Q S!q/YJ Installer's Name,Address,and Tel.No. J-,08-1 70^ 7752, Designer's Name,Address,and Tel.No.sp$- 3(,Q_ 2�j'22 Ose 12 c /2� �rStO�I s %/s- �sT J V4, 11e-4 Type of Building: 2 Dwelling No.of Bedrooms y Lot Size l �$oZ• sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures y� Design Flow(min.required) 4/�/ gpd Design flow provided_ _ y s La r /„j gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 15o o ex Type of S.A.S. 54�CL \OeA C4) Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1'nSr,k911 N- y ai Z /G hr^ 20' A05 6,6Df� L'y rare Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in'operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued ________________________sue ... 1'� i L ��. •,� �4� 1..''{`R ,.tea �P .. - i` .. .. �.#' �_ yi A .-. _mow.+..w--n-. ...+r--.. - - - . c u Fee THE l:O"*)I NWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS es .�.. . ,r` �I�IYILat1011 for"�18�lD�aY �pstellt �o1C�trUct1011'�PrlTllt - , �,"` Application for a Permit to Construct(:i)' Repair(,,_�>'Jpgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. C/r.419 i/i/�j= Owner's Name„Address,and Tel.No. f Assessor's Map/Parcel " Installer's Name,Address,and Tel.No. -0Z-1 .'U 77S 2 Designer's Name,Address,and Tel.No. U�' /�'d�'--' f�t�l�^Glil IZ�r l�i�r tag?a �// / ��r j g 1Mb� avi�� Type of Building: Dwelling No.of Bedrooms V Lot Size f $�o� sq.ft. Garbage Grinder( ) Other Type of Building a G No.of Persons/ Showers( ) Cafeteria( ) Other Fixtures ` Design Flow(min.required) gpd Design flow provided "I:5 0• 65 gpd .,.Plan Date Number of sheets Revision Date Title Size of Septic Tank 150 C - 6x Type of S.A.S. 5.,w- \a-- `` 1 Description of Soil J Nature of Repairs or Alterations(Answer when applicable) �\L-"i OL+4T� (=X/STI p7cl /5 UU C:'x/ J;G`J j/G 7:,'d/k Zl'IS'Ty�/�' /!//:u✓ />-/�'ox �vry u/= y /` „ /714 rz- Zo r DS l3,oUlh%ors/=�' .r r. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of ` { 4 Compliance has been issued by this Board of Health. r Signed .dt r //� =Yi �u!,�rr>✓" Date Application Approved by, AA_ (,(Y,4 77.f y Date 42 —� - Applicaiion'Disapproved 6y — - Date for the following reasons ' Permit No. Date Issued - -- ----- --= ` THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired(L} Upgraded( ) Abandoned( )by 05 h at / �/ (�� �d��/iil/�-' /�GI" Nt�tc N/'i�5 has been cona, ) d i J,�d, qwith the provisions of Title 5 and the for Disposal System Construction Permit No. ated 3 Installer ";"",S Designer /I,,I lv #bedrooms Approved design flow gpd The issuance of t ' erm' shall not be construed as a guarantee that the system will + ncti n as designe Date Z ! Inspector Q c -- ----Fee------------------- No. ���� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal &pstrm Construction Permit Permission is hereby granted to Construct( ) _ Repair Upgrade(G) Abandon( ) System located at /3/ O, �'✓1/lp Vi��� /`c�� Y lfu�h�iS i and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions2 Provided:Construction must be completed within three years of the date of this permit. Dat, tea/ Approved by Vvv,Y-h-e tGL� S a Darren Meyer, R. S. 17815850293 P. 1 Town of Barnstable '"& Regulatory Services .i Thomas F. Geller,Director � Public ]health Division �TFa Thomas iVIcKean Director 200 Main Street,Hyannis,INTA 01-601 Office: 508-862-4644 Fa:c: 508-790-630,� Installer& Designer Certification Form Date: �.S l 1 Sewage Permit- Assessor's NlapTarcel tAl �v ) t Designer: l�Y'�',��� lU�.� �� installer: Address: To 1 j n rib Address: On vi as issued a pen—nit to instal- a (date") (installer) n septic systerr. at d `� OLID C'1zk,6Vtt.Q__ k0 based on a desian drawn bv k (address) v /'/ f�.�1 `i ifY"` dated -7 j( Z It (desi,aner) X I certify teat the septic system referenced above was installed substantial y according to 'he desio-m which may: ;r.clude minor approved cha aes such ,s lateral reiocat:un cl' G!' distribution box an6cr septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or ar,: vertical relocation o:`any corr-ponen: of the septic system) but in accordance with State LPc Local Regulations. Plan revision or certified as-built by designer to follow. o DARRE ME) {I talier's �narure o. 1 4 } S1 SAN I TAM1'� 1 (Designer's Signature) (Affix Desi;ner's Stamp Here) PLEASE RETURN TO BARM1STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CO:NIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: HCalthiSepticiDesigner Certittcat:on Fom 3-264�dec Town of Barnstable Pit Department of Regulatory Services xxerASM. ' Public Health Division Bate 3 u 165�9. $ 200 Main Street,Hyannis MA 02601 _ �rFD IM't� - i• 3 ; U/� Fee P/ d. t D o - Date Scheduled Time : oil Suitability Assessment fog- ,Sewage ispTar Performed By: �vY��4^. > ! Witnessed By: �` . i LOCATION & GENERAL INFORMATION Location Address `3 (d �a f) �' Owner's Name 13 ffl jq A it.! A(e- i�,� ,fir) - Address- ' . Oa,/1 cti Assess is Map/P4tcel: 'Z�(7_j I Engineer's Name r�^ M�a�g� CC�I 'ti_e NEW CONMRU I(` i',ION REPAIR X Telephone# S 0 7- Z9 LZ Land Use ? t �.F��L Slopes( L o��'. Surface Stones, �--� Distances from: Open Water Body > -D D ft Possible Wet.kea ft Drinking Water Well 2M ft Drainage Way 7fJ ft Property,Linc '' ft Other ft SKETCH:(Street name,dimensiods%f lot,exact locations'd,test hole' - s) r.rr . C���4J rrri'rr •; rr • rr r rrrr• rirrrirrr. G #131 4—BEDROOM ist) rrrr ,rrr• rr: DWELLING "t', rr:r r, (FULL) r. r •rrrr (SLAB) ' ENZ' ! rrrirrrr i rr .r r. rrr TOP OF FND. '� r, •rr ,w..,.w. _ ...• - � ry P.E.. r r. 49.31' PSpHP0 O,,\VroP tX ;/ ' 257 N87'52'30"E 135.09 i FENCE i G JQ --------- - ----------- - - -------------------------------- -- - - EDGF (1F PAVFAdFN7 Parent material(geologic) o. t,5 I Depth to Bedrock ) n _-1 /v Q I Wee i Pit FAce /�l 2 Depth to Groundwakdr. Standing Water in Hole: i Weeping from — T. Estimated Seasonal High Groundwater D TERM NATION FOR SEASONAL HIGH WATER T"LE Method Used: standing in obs.hole: _ ' in. Depth to sall mottles: Depth t bperved stand ln. Depth toiweeping from side of obs.hole: ! in, oroundwater Adjustment it• ! ! f►etor,� ____ Adj.Groundwater Level ,,,e Index Well#_ Reading Date: Index Well level --- Ad. ' i _ PERCOLATIiION TEST' ' Date Uwe Uwe Observation Time at 9" �N Hole# i Time at G" Depth of l'erc 4 , o o Slart Pre-soak Time.@ i I Time(9"-V) End Pre-soak ! Rate MinJInch Passed_-� Site Failed:. Additional Testing Needed(YIN) Site Suitability Assessment: Site Original:.Public ile'aith Division Observatioti Hole Data To Be Completed on Back---- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable C41iservation Division at least one (1) wedk prior to beginning. r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulders. G J� Consistent %Gravel ��II v`► l 4► Jam" t�)� !1 9`►- 3`► a►vt o✓� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) ;Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) 16''- S�• DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel i DEEP OBSE TION HOLE LOG Hole# Depth from Soil Horizon Sot exture Soil Color Soil Other Surface(in.) (USDA (Munsell) Mottling (Structure.Stones.Boulders. Consistency. ra I Flood Insurance Rate Map: Above 500 year flood boundary No— Yes _ Within 500 year boundary No I/ Yes Within 100 year flood boundary No_, Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the area proposed for the soil absorption system? r?S If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Departmen Environ ental Protection and that the above analysis was performed by me consistent with the required tr n`g,expertise and experience described in 3.10 CMR 15.017. Signature Date 3 �� J Q:\SEPTIC�PERCFORM.DOC CJ r. Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way. A. General Information A 1. Inspector: (.� Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number B. Certification 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:. ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evalu 'on by the Local Approving Authority 11-2-10 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system 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. ****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. W f 'ram I { j t5ins official document•03l08 Title 5 Official Inspection Form:Subsurface Sewage D osal S stem•Pa�e t of 15 P P 9 Y 9 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 210 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined,"please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of 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: ❑ 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 t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 I, Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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: 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, 's 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 f-- 'supply. " ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 131 Old Crai9 ville Rd Property Address Bank Owned (Contact Da ryII PerryD.B. Enterprise Services 1-508 776_ 8916 ) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page_ City/Town State Zip Code Date of Inspection B. Certification (cont.) C Further Evaluation is Required b the Boar q y d of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: * This system passes if the,well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6°below invert or available volume is less than ',z day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. t5insp official document-03/08 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Fora _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No I ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ 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. For large systems,you must indicate either`yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well 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 CM 15.304. The system owner should contact the appropriate regional office of the Department. t5insp official document•03/08_ Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes"or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week.period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back u ? 9 9 p ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existirg information. For example, a plan at the Board of Health. ® ❑ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 129gal/day 2 yrs 9 ( Y 9 (gp ))� Sump pump? ❑ Yes ® No Last date of occupancy: 9-2010 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): canons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): t5insp official document a 03/08 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 _ _ nt Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's(dame information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection D. System Information (coot.) General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 1998 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): .. > 24'r Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints,venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 16 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -----------------------------------------------7------__:----------------------------------------------------------------- Dimensions: 1500 gal Sludge depth: 16" Distance from top of sludge to bottom of outlet tee or baffle 16" Scum thickness 6 Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? Tape t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffes installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box in good condition with water at working level,and clear stain lines above inlet invert. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 3 t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 s. Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why.: Type: ❑ leaching pits number: ® leaching chambers number: 5-infiltrators ❑ leaching gallerie3 number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil., condition of vegetation, etc.): Infiltrator leach field shows signs of failure with back-up into d-box and surrounding stone. t5insp official document-03/08 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Fora " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 131 Old Craigville Rd Property Address Bank Owned (Contact Daryl[ Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. Cityl-rown State Zip Code Date of Inspection D. System Information (cont.) Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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. d O . C t5insp official document•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �,M a 131 Old Craigville Rd Property Address Bank Owned (Contact Daryll Perry @ D.B. Enterprise Services 1-508-776-8916) Owner Owner's Name information is required for every Hyannis MA 02601 11-1-10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 10, feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers-(attach documentation) ® Accessed USGS database - explain: You must describe how you established the high ground water elevation: Original design plans on file show no groundwater at 10'. i t5insp official document-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 t. \ COMMONWEALTH OF MASSACHUSETTS � EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS . -DEPARTMENT OF ENVIRONMENTAL PROTECTION mAP PARCM, 1 I L LOT ; TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 131 Old Craiciville. Road Hyannis, MA �E® Owner's Name: - Mari P Champ-agne Owner's Address: APR 2004. Date of Inspection: r `' TOWN OF BARNSTABLE HEALTH DEPT. Name of Inspector:(please print) Wi 1 1 i am 1 _ •Rohi_nson Sr. Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville—MA Telephone Number: (5081 775-8776 CERTIFICATION STATEMENT i certify that 1 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 j approved system inspector pursuant to Secttti in 15.340 of Title 5(310 CMR 15.000). The system: . (/Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: 4�z Date; The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heanh-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 ofthe DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approxing 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 S Inspection Form 6/15/2000 page 1 tk.. t.. Page 2 of 1 I ' OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 131 Old Craiqville Road Hyannis, MA Owner. Marie Chan a ne Date or inspection: 4 Inspection Summary: Check A,B,C,D or E!ALWAYS complete all of Section D A. System Passes: � - I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in R 310 CM 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: Ca G® Ca 0 ,fiJoa B. stem Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repave .The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass: i Answer es,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. e septic tank is metal and over 20 years old'or the septic tank(whether metal or not)is structurally unsoun exhibits substantial inf Itration or t xf ltration or tank failure is imminent.System will pass inspection if the existing is replaced with a complying septic tank as approved by the Board of Health. •A me 1 septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicat g that the tank is less than 20 years old is available. ND a lain: Observation of sewage backup or break out or high static water level in the distribution box due to-broken or obs cted pipes)or due to a broken,settled or uneven distribution box..System will pass inspection if(with appr vaI of Board of Health): broken pipe(s)are replaced obstruction is removed distribution tdion box is leve led or replaced ND ex lain: e system required pumping more than 4 times a year due to broken or obstrtx1ed pipe(s).The system will ass in ection if with approval P P of the � PP Board of Health): broken pipe(s)are replaced obstruction is tzmovod ND exp ain: Page 3 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 131 Old Craidville Road Hyannis, MA Owner: Marie Champacrnev Date of Inspection: O C. urther 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 fail g 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 . Z. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the , sy tem 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 aseptic tank and SAS and the SAS is less than 100 feet but 50 feet or more frortl a private water supply well- Method used to determine distance . "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other, failure criteria are triggered.A copy of the analysis must be attached to this form. 3. O her: 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:131 Old Craigviville Road Hyannis, MA Owner: Marie !;hdinpagney Date of Inspection: r �G D. ystem Failure Criteria applicable to all systems: You ust indicatc"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground orsurWe waters due to an overloaded or clogged'SAS or cesspool Static liquid level in the distribution box above.outlet invert due to an overloaded or clogged SAS or. cesspool _ Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100.feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or.privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. This system asses if the well water analysis,P P q h' Y l Y P Y + performed at a DEP certified laboratory,for coliform bacteria and votatlle 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 S ppm,provided that no other failure criteria are triggered.A copy or the analysis must be attached to this form.l (Yes/No)The system fails.I have determined that one or more of-the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. Large Systems: To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 f;P 4(Th must indicate either"yes"or"no"to each of the following: 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 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 yo 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 arry large system considered a signi rcant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.3 4.The system owner should contact the appropriate regional office of the Department. 4 . i Page 5 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART.B CHECKLIST Property Address:-131 Old Craiaville Road Hyannis, MA Owner: Y Date of Inspection: Check if the following have been done.You must indicate-yes"or"no"as to each of the following: Yes No umping information was provided by the owner,occupant,or Board ofHealth. ✓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 7. Were as built plans of the system obtained and examined?(If they were not-available note as N/A) �✓— Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components,excluding the SAS,located on site? _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles ortees,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 _ Existing information.for example,a plan at the Board of Health. Z"T Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)13 10 CMR 15.302(3)(b)) i 5 u Page 6 of 11 i OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 131 Old Craigville Road Hyannis, MA Owner. Marie Cha a ne. Date of Inspection: 41 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):.-�� l Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: 1L— Does residence have a garbage grinder(yes or no):A:,�U. Is laundry on a separate sewage system(yes or no):, [if yes separate inspection required] Laundry system inspected es or no Seasonal use:(yes or no): Water meter readings,if available(last 2 years usage(gpd)) .2003 58, 500 Sump pump(yes or no):,_,&/O 2uu29b,- Last date of occupancy: t G LI COMME CIAUINDUSTRIAL Type of es blishment: Design flo (based on 310 CMR 15.203): gpd Basis of de gn flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial laste holding tank present(yes or no):_ Nop-unit#ywaste discharged to the Title 5 system(yes or no): Water m9ter readings,if available: Last date f occupancy/use- OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: 16-114 Was system pumped as part f the inspection(yes or no):_ If yes,volume pumped:_gallons--How was quantity pumped determined? Reason fo pumping: TYP OF SYSTEM _Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval —Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 Old Craictville Road Hyannis, MA Owner: Marie ChamDAagne Date of Inspection: %� "J BUIL ING SEWER(locate on site plan) Depth low P grade: Materi s of construction:_cast iron _40 PVC—other(explain): Distan a from private water supply well or suction line: Comm nts(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_(locate on site plan) ) Depth below grade: f Material of construction:_cv oncrete metal fiberglass —other(explam) — --polyethylene. If tank is metal list age:— is age confirmed-by a Certificate of Compliance(yes or no): (attach a co of certificate) / i ► 1 —( PY Dimensions: (b Sludge depth: Distance Gom to of sludge to bottom of outlet tee or baffle:- ?�p Scum thickness: Distance from top of scum to top of outlet tee or baffle: i Distance from bottom of scum to bottom of outlet tee or baffle: ! �t' How were dimensions determined: ® I��w ® u L'2 3 Comments(on pumping recommendations,inlet and outlet tee or baffle conditicn,structural integrity,liquid levels as related to outlet invert evide nce of leakage,etc.): n % GREASE T P:_(locate on site plan) Depth below ade:_ Material of co struction:_concrete metal fiberglass_polyethylene—other (explain): — —. Dimensions: Scum thickne s: Distance Go. top of scum to top of outlet tee or battle: Distance fro bottom of scum to bottom oroutlet tee or baffle: Date of last umping: Comments n pumping recommendations,inlet and outlet ice or baffle condition,structural integrity,liquid levels as related t outlet invert,evidence of leakage,etc.): 7 Page 8 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 O.ld Craiaville Road Hyannis, MA Owner: Date of Inspection: L/ 9— t TIGHT or OLDING TANK: (tank must be pumped at Lime of inspection)(locate on site plan) Depth below de: Material of con truction: concrete metal fiberglass_Polyethylene other(explain): . Dimensions: Capacity. allons Design Flow, allons/day Alarm present es or no): Alarm level: Alarm in working order(yes or no): Date of last p mping: Comments( ondition of alarm and float switches,.etc.): DISTRIBUTION BO X: if��( Present must be opened)(locate on site plan) Depth of liquid level above outlet invert: e) 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.): 014 PUAIP CHAMBER: (locate on site plan) Pumps in working rder(yes or no): Alarms in�iorki order es or no (Y ) Comments(not condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 Old Craiayille Road Hyannis, MA Owner: Marie hamga�ney Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): "ovate on site plan,excavation not`required) If SAS not located explain why: Type aching pits,pits,number:_ ./leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow.cesspool,number: innovative/altemative system Type/name of technology: Comments(note condition of soil„signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and confi oration: Depth—top of liq d to inlet invert: Depth of solids la r. Depth of scum lay r: Dimensions of cc spool: Materials of con ction: Indication of gr undwater inflow.(yes or no): Comments(no condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (I cate on site plan) Materials of co struction: Dimensions: Depth of sol' s: Comments Ootc condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 1 I OFFICIAL INSPECTION..FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 Old Craiaville Road Hyannis, MA Owner: ne Date of Inspection: 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. 1 � b c{ V a 3� s 10 Pagel 1 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 131 Old Craicrville Road Hyannis, MA Owner: Marie Champa ney Date.of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water _5 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: 11 4. 1 - No. FEE THE COMMONWEALTH OF MASSACHUSETTS //y.0 P?I'//S , MASSACHUSETTS ,�kyyftrativn for Pisposal Sgs#erc (gans#rurtion jJermit Application is hereby made for a Permit to Construct( ) or Repair(i.�an On-site Sewage Disposal System at: Location Address or Lot No. 1-0 2 Owner's Name,Address and Tel.No. /3/ O/d Craig vi e R., Ch�•y,�aQg n tY 131 O/d C e a;l v-Ile po. d Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 7e 4Zn/g j011+4 Sot_✓e-LCoSYT1S� 1 Klri �ph Type of Building: Dwelling No. of Bedrooms 410 Garbage Grinder( ) Other Type of Building No. per Persons Showers ( ) Cafeteria( ) Other Fixtures Design Flow /i0 gallons per da Calculated daily flow -44 a gallons. y�064►oa r„ Plan Date /3 9 7 Number of s eets `O Revision Date Title gaaw do p6 .te 1 -o-on 0 ,*rlt P r+ a.-f i_ ♦A44 C P-at; ffi Ow'gr Description of Soil `I v ►► `t� �F Mgsf�� 'vrs, fG .ror S•c. 5 r► • SAG 9 11 RUSSELL ► j O tilv H Nature of Repairs or Alterations(Answer when applicable) d�c��T/ors o a " No.36043 ► N_X i3 tin �wG//�n ♦ A 9 �� �.° s Date last inspected: ►��♦ Agreement: l2-2-9 7 The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has b en issued by this oard of Health. Signed Date Application Approved b Date Application Disapproved for the following reasons Permit No. � `S' Date Issued No. 1 -s 4 - FEE o THE COMMONWEALTH OF MASSACHUSETTS ✓71/ah/'J/ 5 _,MASSACHUSETTS �kpyfirntivn for Pisposal ,,"iVeitent Cfuustrurtton ]Jermit Application is hereby made for a Permit to Construct ( ) or Repair(1,.,<an On-site Sewage Disposal System at: Location Address or Lot No. 6 ? Z Owner's Name,Address and Tel.No. 78/-ASS- O 79� / 1,31 Old Croix vz'/e 'IF, h'/e.7 Ch0rr,Po9 reY /3/ O/d C r tt i* v, Ile Ipo'.C� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tell.No. 7$/ 1 S V - SOv7�! 5h0�'e, SurVP�( Cpy7SCVJ� rSI C S fo en -3 6 4' Type of Building: Dwelling No. of Bedrooms Q Alo Garbage Grinder( ) Other Type of Building No. per Persons Showers( ) Cafeteria( ) w Other Fixtures Design Flow 11O gallons per da BPS Calculated daily flow r4 4 a gallons. Plan Date �/" / 9 7 Number of sheets J Revision Date Title se*w a+ P6.pos. i a-f A Description of Soil C ♦> P v rn �"c� Gr t 5 G�'► ♦ �' 6ARY Of ; > Nature of Repairs or Alteratio s(Answer when applicable) No.36043 A )e S /� e/6 h Date last inspected: Agreement: f The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Poard of Health. r Signed Date :j�rt. t✓,� }` Application Approved Date Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS MASSACHUSETTS C�>ertifirate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System installed ( ) or repaired/replaced( ) on by for at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. This Certificate expires on DATE ) .L� Inspector q THE COMMONWEALTH OF MASSACHUSETTS No. f ttsCrt _ 0,. G , MASSACHUSETTS FEE '5© r Ptsposal $Votem fiv-11,onstrurtion 1hrmtt Permission is hereby granted to to construct ( ) or repair( ) an On-site Sewage System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within three years of the date below. DATE Approved by FORM 1255 Rev.3/95 A.M.SULKIN CO. BOSTON,MA A TOWN OF BARNSTABLE LOCATION s` SEWAGE # VILLAGE ASSESSOR'S MAP&LOT d y_, Z INSTALLER'$NAME PHONE NO. � ���' I 7, 7 SEPTIC TANK CAPACITY/��-'y ` LEACHING FACILITY: (type) lilt-A+ S (size) Y +' NO OFEE.DROOMS j BUILV kt'0R.'OWNER G od-1 PERM DATE: COMPLIANCE DATE:3"a 11�� Separatibif.PWance Between the: Maxtmd.60 Miusted Groundwater Table and Bottom of Leaching Facility Feet Private Witer,.$upply Well and Leaching Facility (If any wells exist on sita:or�rithin 200 feet of leaching facility) Feet Edge of''VVetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) •Feet Furnished b� v' 4. S)ds +. N�o s : f: t did F )boo 'j}�1� cj a S 'a O 3 GENERAL NOTES: LEGEND HYANNIS E 1• ALL CHANGES TO'THIS PLAN MWST BE APPROVED BY THE LOCAL PROPOSED CONTOUR BOARD OF HEALTH AND THE DESIGN E►OINEER. -. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS ; PROPOSED SPOT GRADE OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPUCABLE LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: 4 —— 98 —— EXISTING CONTOUR — 310 CMR 15.405 (1) (B): L + 96.52 EXISTING SPOT GRADE M9/ti S 1) A 1.38 FT. VARIANCE FROM 310 CMR 15.221(7) TO ALLOW LEACHING TO BE 4.38 FT (MAX) BELOW GRADE VS REQ'D 3 FT. (VENT/1-120 PROVIDED) i W— EXISTING WATER SERVICE PINE ST. TRFFT 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE PARCEL ID: ® TEST PIT s LOCUS DESIGN ENGINEER. 248/109 r 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING r FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN �O ENGINEER BEFORE CONSTRUCTION CONTINUES. O 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 8 ENGINEERTHE DESIGN IS T RESPONSIBLE THE CONTRACTOR OROWNERTONOTIFY E LOCA Li OF BOARD OF �P\G rON'N HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. O RL) 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. LOCUS MAP 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING ( N CONSTRUCTION. PARCEL ID: s5r PARCEL ID: LOCUS INFORMATION 10. EXISTING LEACHING TO BE PUMPED AND REMOVED, REPLACE WITH CLEAN MED. SAND 248/112 248/113 PLAN REF: 165/41 6''11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION PARCEL 10: TITLE REF: 24871/68 � � , 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 248/110 AREA=13,882t S.F. F PARCEL ID: MAP 248 PAR. 112 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY IS IN ZONE II 13. NO PRIVATE-WELLS WITHIN 150 FT. OF PROPOSED LEACHING U- FLOOD ZONE: "C" 14. ALL PIPING TO BE 4" SCH 40 0 1/8-/FT (UNLESS SPECIFIED OTHERWISE) /„/ COMMUNITY PANEL 250001-0008—D DATED:07/02/92 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW CO ,,,;"✓ 1 FOR THE USE OF A GARBAGE GRINDER ✓ ;, ,. SEPTIC SYSTEM 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING �0. REPAIR PLAN 17. INSTALLER TO CONFIRM H2O LOADING OF LEACHING. c.o. 18. INSTALL CLEAN OUTS AS SHOWN IN EXISTING SEWEW LINE CO ✓ 00 LOCATED AT: ' +'"' 131 OLD CRAIGVILLE ROAD ,,,,,, • I`; ;, HYANNIS, MA. #131 `,t C, PREPARED FOR TOP OF SPIKE ��• •�•, 4—BEDROOM FEDERAL NATIONAL ELEV.=47.00'(GIST) „� � �"' . ,,,; DWELLING �, ;; �' �� MORTGAGE ASSOCIATION ' c.o. // //// /. (FULL) //Y// , ' P (SLAB) ENS /../ �/ — i' MARCH 12, 2011 REV: JULY 12, 2011 — TRENCHES ' TOP OF FND. Existing Leaching 49.31''Sh ✓ '✓ ✓ ✓'✓✓ \ \ O OF // //// i,, ' (Note 10) 1 s9� tX p DAf h� M, IMan� � Al P�' \ PIS ' \ ,' tijh !��� 114'0� PARCEL ID: 248/111 O10. ---------vent �/� \,,�va � \C) DARREN M. MEYER, R.S. msp po I --- ----- G P.O. BOX 981 r N87' 30 EFENCE ! ; ;'� / ---------- ———— — O F. `----- ---------------------------------------------------------- -----__ �e!� Q EAST A. 02537 - ----- ---- -- ----------------------------------------------- - ------------------------------------- - --- --- SANDWICH, M --------------------------EDGE OF.P,p VEMENT - (508)362-2922 CARLOTTA AVENUE E. �' SHEET 1 OF 2 J 1311 NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:43.50 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. T.O.F. EL.=49.31 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER,INSPECTION PORT OVER OF Mq OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET. TO 3 OF F.G. V NTH E Ss9� F.G. EL.=48.Of F.G. EL.=47.50t F.G. EL: 47.0t F.G, EL: 46.'50° = 47.50(MAX.) , AR• R M h M 9" MIN COVER/ No. 1140 L = 95't 36" MAX COVER L = 10' L = 5'(MAX) INSTALL,,INSPECTION PORTS RECISfE � 0 S=1% (MIN.) EL. 44.90 0 S=1% (MIN.) 0 S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC I f�NITAR��� . 10' A. 14 6 11.2" TO INV.=43.30 4a"uou/o INV = 4305 INVERT . . LEVEL PRROPOSED GAS BAFFLE BOX INV.=42.78 2 TRENCHES OF 6 UNITS AT,6.25'/UNIT + 0.75' WEDGE = 38.25'/ROW DB-5 INV.= 42.73 INV.=42.9 SOIL ABSORPTION SYSTEM (PROFILE, EXISTING 1,500 GALLON SEPTIC TANK jH2O)5 EXISTING SEWER OUTLETS RESTORE VEGETATIVE COVER OR PAVEMENT G) ELEV. 44.31 COMPACT MINIMUM OF 18" OF MATERIAL (ED ELEV. 44.50 ABOVE CHAMBERS FOR VEHICULAR TRAFFIC 75" USEjEXISTING SUITABLE MATERIAL. NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION 2) D-BOX SHALL BE SET LEVEL AND TRUE BREAKOUT=TOP ELEV.=43.12 I TO GRADE ON A MECHANICALLY COMPACTED INV. ELEV.= 42.73 ! SIX INCH CRUSHED STONE BASE, AS SPECIFIED BOTTOM ELEV.= 41.79 IN 310 CMR 15.221(2) 2.83' I 3) EXISTING 1,000 GALLON SEPTIC TO BE REPLACED 76" WITH NEW 1500 GALLON SEPTIC TANK IF FAILED, 5' MIN. ABOVE BOTTOM OF DAMAGED, OR UNDERSIZED. T.P. EXCAVATION OR G.W. , PROVIDED) 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TEST HOLEEL35.9 _ PROFILE GAS BAFFLE AS REQUIRED _ SEPTIC SYSTEM PROFILE TYPICAL SECTION N.T.S. N.rs � 11 16' DESIGN CRITERIA SOIL LOG P#: 13210 NUMBER OF BEDROOMS: 4 EXISTING BEDROOM - NO INCREASE IN FLOW PROPOSED �----34"-� DATE: MARCH 16, 2011 SOIL TEXTURAL CLASS: CLASS I SOIL EVALUATOR: DARREN MEYER, IRS, CSE 1614 SECTION END CAP DESIGN PERCOLATION RATE: <2 MIN/IN WITNESS: DAVID STANTON, BARNSTABLE BOH TP-2 Depth - DAILY FLOW: 440 G.P.D. Elev. TP- 1 Depth 16" ADS 160OBDH-20 BIODIFFUSER UNIT� Elev. ( DESIGN FLOW: 440 G.P.D. 47.10 0" 46.90 0" NOT DESIGNED FOR GARBAGE GRINDER A A MODEL 16" HICAP GARBAGE GRINDER: NO ( ) LooAf��D LOONY �D LENGTH 76" PROPOSED SEPTIC TANK: 440GPD X 200% = 880GPD USE EXIST 1,50OG CAPACITY NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT 46.35 9" ' 46.07 10" EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY LEACHING AREA REQUIRED: (440) = 594.59 S.F. B B DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. 74 LOAMY SAND LOAMY SAND SIDE WALL HEIGHT 11.2" 10YR 6/8 tOYR 5/6 OVERALL HEIGHT 16" DISTRIBUTION BOX: DB-3 (3 OUTLETS (MINIMUM)) OVERALL WIDTH 34" 4640 TRUEMAN BLED 44.35 33" 44.32 31' 13.6 CFEme HILLIARD, OHIO 43026 PRIMARY S.A.S. - C � C USE 2 TRENCHES OF 6- 16008D ADS BIODIFFUSER H-20 UNITS-NO STONE MED-COARSE MED-COARSE CAPACITY (101.7 GAL) ADVANCED DRAINAGE SYSTEMS, INC. AND EXTENDED WITH 0.75' W/ CONTOURED WEDGE SAND I 2.5Y 7/4 / 2.5Y 7/3 PROPOSED SEPTIC SYSTEM/SITE PLAN TRENCHES: (GENERAL USE APPROVAL FOR 7.88 SF LF OF BIODIFFUSERS :j. PERC ® 43.0 0(BIODIFFUSERS) 12 UNITS x 6.25 LF x 7.88 SF/LF = 591.0 SF 132" 132" 36.10 35.90 1 OLD V 13 CRAIG ILLE ROAD, CENTERVILLE, MA (WEDGES) 2 UNITS x 0.75 LF x 7.88 SF/LF = 11.82 SF Prepared for: FNMA TOTAL AREA = 602.82 SF PERC RATE <2 MIN/IN. (Cl" HORIZON) DESIGN FLOW PROVIDED: 0.74GPD/SF(602.82SF) - 446.08 GPD>440 GPD req'd NO GROUNDWATER OBSERVED Engineering by: Surveying by: SCALE DRAWN DARRENM.MEYER,R.S. MacDougall Survey NTS D.M.M. • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currentiyl approved by MADEP pursuant to 310 CMR 15.017 pO BOX 98, a to conduct soil evaluations and that the above analysis has been performed by me consistent with the (508) 419-1086 DATE: CHECKED EAST SANDWICH,MA 02537 SHEET N0. rgrluirsmentq of 310 CMR 15.017. I further certify that I have,possed the Soil Eval. Exam in October, 1999. T 1 508-362-2922 03/12/11 D.M.M. 2 of 2 REV: JULY 12, 2011 - TRENCHES ir- lk r i vo . 3 f_ _ r �. L 61 Ln S" �, � ..a. n M �' !r�"` ,i '�'t: `,,ic+wta% 7a",„ r + .•,,,�...,.b,y.,awlp.+�.4+.,.� (R �, vFA�'�z,,�{L�i� �'e��A' t t :'� air ,�� r•y�J da�`�:'Yr"k !S� ''R9 '� � � r.•. y r, � ,}key� ��, +tiP H �rr{,�., IX Al / 5A jig bA17 I in i i x 1 N t O a SOIL TEST PIT DA TA- SEPTIC TANK DETAIL- 1500 GALLON N/ GAS' BAFFLE DL5TRIBUTION BOX DETAIL- LEACHING CHAMBER DETAIL' NOT TO SCALE' REVISIONS.• TEST PIT PERC TEST Ob�S'ERVED NOT TO SCALE INDICATES INDICATES _� INDICATES 4. INLET AND OUTLET TEES TO BE CAST MON NOT TO SCALE No. DESCRIPTION DA TE - - GROUND HATER NOM 1. SE'P77C TANK SHALL BE STEEL SCHED. 40 PVC OR CAST-LTV-PLACE CONCRETE' 8-5- OV71iris No. OF OUTLETS- 5 HIGH CA PA Cl �Y INFIL_ TRA TOR G,�VAMBE R TEST PIT _ 1 TEST PIT RENMRCED CONCRETE WITH TEES' TO UNDER .MANHOLE COVER WITHIN 12" RAWOVABLS 2- WALLS OF END FALL NOTES: fTV15HED GRADE GRD. EL 46 8 GRD. EL THREE (3) '20" MANHOLE Y 5. RECOMMENDED MANUFACTURER-RO TONDO OR CO V" �mV 1. D1ST BOX TO Wn HSTAND H 10 LOADB V GW EL NONE' Glf' EL - Z. SZPM TANK 7V W1T7B7AND H-10 LOADDVG APPROVIRD EQUAL a . 2" UNLaSS U11�DSR PAVaifZ7VT DRIi S OR \ O _ _._.__ _ &W "SS MWAR PAVEI�IVT DRn9W OR 6. TANK SHALL BE EMBOSSED WITH SEAL T 7RAVM" WAYS WIAWJMV H-20 LOADVC fT M VELED WAYS WHSRBIN H-20 LOADBVG - I SHALL APPLY GENERAL NOTES' FILL .SAND <' 5 Y ', T SHALL APPLY. L�VD1CA77NG CONft�RYANCE WITH AS7N 4 STANDARD C 1227 93. 15" 2 PROVIDE' DVLaT ?2'Lr' OR BAFl1.Lr WXaRS SLOPE 10" 2' EFFECTIVE OUTLET MANHOLE COVER BROUGHT OT PIPE axes 0.06 F7,117 OR LN LEV�'L ,. . . � �TTt7M o• 14-� DEPTH � Tt1IS PLAA IS FOR DESIGN' AND 9» LOOSE, SINGLE GRAINED _ 3. ALL APE CONNEC770N3 AND CONC- 6" 3-5' IIVLE75 ? ° `�' i1 T LOAM}' SAND 10YR 5,%4 RETE CONSTRUCTION SHALL BETO 6" OF FLASH GRADE' 3R l PUYPaD sYSTEi[ - / C0.'V'STRUC,ION OF 7'11E SEWAGE WATERTIGHT. �� d 24R 12" YIN. -3' MAX ¢" . ' , o ' 3 FIRBT TAU FSB?' OF PLUS OUT OF D14T 3' 5 UNITS 31.25' 3' DI, �POS'.9L F'�CII.I7'Y O �'LY A, , " COVER Q`gap� 'a�a��o d aoo a ava a ! BOX 70 BS L!ID LE'M 25' 7 FRIABLE - 10 -6 L-- z' �'. �aLl. CONSTRUCTION MF, HODS A,•'�I� 16" -� Ia .. i� BOTMN ON L17M (4iC 4. RW0Ja lMM .YV&7ACn0M-R07VAW MEASURE SLOPE AT THIS POINT END CAPS MUST BE _ ATF RIAI S SHA I,I, CO V110-RAI TO :IJASS. 10'-0 BASE OR APPRCJVID 3T�UAL ELEV = 44,50 LOAM}' SAND 10}R 6 NORMAL HATER e' PROf7LE' _ PSRtY1R�lTED ft7R LEACHING D E:P TTTLI::' S _A.'�'D LOCAL BOARD B w - -_-- y 13" 1 3" LEVELL P1,AN VIEF _ 6' AOV 3/4' 7YJ 5. ALL P)PV CONNECTIONS AND CODNCRE'IS 15' MI - CLEAN FILL OF I1F„A L T11 RFG 1_7,A TIO IVS. FRIABLE 1¢ 1 1/2' S7VNE CIDJ UMUC770N SHALL BE WA7TR?1GHT --� f LOAM & SEED 36' - PRECAST SEPTIC TANK i } 2a H GRADE 3. ALL PIPES SH.�fLL HE 4 " PVC A INLET TEE 90 lam"- SC'H 40 OR EQ r,'.AL. C AfEDl r.M TO COARSE -';A VD - - - �o ,i F - _ .MAX 3 ': RX, 4. THE'RF' A R�' .'V O ,�i•'V'0 WV WFL I S ' _ h . ;� ¢'-0' ,� GAS BAFFLE h 3-5" INLE75 LOCATED W1THI V 150 F'7' Of' THE LI UM DEPTH 2" YIN O l/B" 7l7 , Q PRb1Cd57 5-5" 007:E75 _ 2 5 `�j� � ��; 2' 1/2" WASHED STONE PROI'OSFD LF..96'If �G F.�CII,IT} STRATIFIED S'A,4D, 10- 20,% GRAVEL 20' 1z� 4 '- ''� : . . . .,• olu/, A:VY' 1HELLS PROPOSED WITHIN 150 FT �` Dar. �x �' I I - ;.. o 48 SOME COBBLES ---1T��-- I 19' ��� ��'' � �, nF tt �'}' K�V'O Tf?V LEA CHI FACILITY' :� `�: L - - J e' 4' 7YJ 1-1 " DOUBLE 5 THIS SY STFhf V' ' FO60' 6" MIN. 314" TO 's°a Bo7�n.K ON LEVEL STABLE BASE ' a 3" 6' HIGH CAPACITY 4 0, 4" ASHND S7VXN IS NOT DFSIG ED R PLAN VIEII 1-1 2 S70NE � �" �� �- f-� INFIL774A71'IR CHAMBER , 66 ���daC..`al� «c`dJ94<C� 7I�" T ® 6'-3" LONG PER UN 10.63 THE L'S"F OF' A C ,RBAGE' GRI,VDFR C, MF,DI�A! TO COARSE' " 5)- �;�4 OR CROSS-SVCHON VNIr (5 UNITS REDUIRED) � 6' W/THL'V 1,1111T OF F,XCA 1'4 T10'�' RE,A101' SAND MECHANICALLY - CROSS-SECTION CROSS-SECTION .ALL TOI'5'011, SURSOII, A1VD OTHER COMPACTED - I,41PLh'110LS .M.4T[;'RIAL INVERT ELEVATIONS- RF,PI.ACE WITH CLE'A NASHFD SAND 5-10� GRA VEL ,STRATIFI 120" - -- - -- OR OTHER CIXIA' (,le-I VUL.tR RC'TTOM OF PIT PXOPO.SF,L) 45. 02 AJA7' ,RbAL 1b C'O tiF0R.bIA:VC'F,' WIT11 t L� �'FRT =� T HL.'1LDL�'G 310 LAIR 15 .-'.j5 1.1 I EI�T .a T .�F'I'TIC T I. K (LNG 44- 61_ 8 FXISTI�'G UTILITIES AS SHOWY O.V NO ,NOTTLE:S OR WATER OBSER[�ED THIS DR,aWi:vG(.S) ARE APPROXI�1ATf:' 1.1'i E'K7' T SEPTIC' 7: Nh" (O I,'T)44.36 THE CONTRACTOR SHALL RF, RF,SPON EXISTING CESSPOOLS TO BE ABANDONED I 1 V IT"RT AT 1)15T HOX 44.20 SIRI.F FOR PROPER LOC,� TIOA AA'D T'H1' COORD1ti;4 TIO.�' OF PROPOSED TEST BY WITNESSED BY. TEST BY WITNESSED BY AS PER 15. 354 AND/OR B. O. H. I 1\ l 1{RT .4T PIFT HOX (0L,'T) 44. 03 Y711' OORD1 AA 4CT1 t7TY WITH DD JAMES DONO VAN JERRY DONNING .S.AI F' AND TIE -11'PI,IC.1;BI.I' L'TII,j'T}. COMPANY(S). THE CO.'V I R.f L- 'TOR SHi�L L DATE PERC. RATE.• DATE• PERC RATE INVERTS AT LEACHING FACILITY 11.-4 L%T AIN ANY F,17S71'V ' L r'11J7Y 11 4 9 7 < 2 S Y,STF.M IV SERVICE' DIG 4 FE WI1?. MIN./INCH MIIV/INCTI 4 �� 1.N 11;'1?7' .4 7' BFCI 1 .V11 G IIE' NOTIFIED PER OF .{1ASS ASC11b.5FTT, .ST,ATU/F, CHAPTER 8,2, /AII1,7R. f '10R V 1' 44. 00 _SECTION 409 AT T1,.. 1 Borg--13ti� its 5 INFIL TRA TOR CHAMBERS WITH 4 OF STONE � � � �- • ON EACH SIDE AND 3' OF STONE ON EACH END. LOT LOT 25 4844 711E h'.'VGLVFFA DOES' MOT INFILTRATOR CHAMBER ENDS MUST BE PERFORATED. 4 " IN I1,'RT -i7' E;'�D GUARANTEE THE A('( ' R4C}. OF o LOT S 1.V171,7R. , TO L.�.N7'T 44_00 THAT ALL UTILITIES' 4 4,D SLBSI'RFAC' STRI CTURES :,'RF. 5110 WA' ''OCA7ID,V5 _ N 47 43 35 " E STOCKADE' FENCE \, ! ;,1;'I :17 'O� -�T 1307;Oat AND EI,EV4T10,"YS, IA tVY, oF' - OIL" TO �F _._`�' ._00 U.ti'Dhf?GRUL,ID L'TILIJIF: .ARFJ' T.4hF'V' V FRO V RFCO RD PIA VS THE C ONTR \ 198. 55' Of1ti 1 R l F D G1�01. :11�6�A 1'1:R NONE ACTOR 5 1ALL VFRIF}" SIZE LOCA77 '` o -- - -- - - - - , - PLANTED AREA -----�, AND Iv 1 FRTs of r;f O FI.L'I ;_i 710.�' STRUCTURES' AS RF'QU RE'D PRIOR 110TT0a1 OF P7t,1 36' 8 TO T�-IF. START OF CO.'VS;''Rt)CT1'0.V' 0 IY 9 ,VO C1 4.VGES ARE TO BL' UADE 1: 771F FIELD WITHOUT THE APPRO V4 HF� \ ' L m '-1 01' T BARNS'rAB1X BOARD OF `,, T - I ( HEALTH AND TNF. DE SIG 1 E NG . f F R 10. 0 I �, - SLAB ��'� j F Dod p p (loM�v)21. 0' �. (zO; ) PRo sED FULL �i s .I)ESIGN CRITERIA.• _- s; , � ADD177ON BASEMENT f \ � ' �A,,N n�H�� o� osr� ,q �0 20.2 Cb DESIGN FLO A' ��" ,,, w - 4 111,'U�'O(� Il a IIOC P B , G F B • '' (10 MIN) _ ' 440 any . •, 5' LIMIT OF EXCA VA TION O 0 'f °'s��� D-BOX \- �t o F?s,oN �►G��SI - - -- GARDEN 00, 1500 GAL f �C S ICI,Q L IR1.'D S13-7IC 77.4 AA. PREPARED BY SEPTIC TANK 88 440_ X- 2. 0 0 __ -- 0 O� d�oO 1D.F T-ItiK PRC 1 1500 CG 4�L, 0�, . O u y .,I?A 0/ I.F4C7-11�G IACIL1TY RFQLIRFD- > SIGA" f'1;'RC RATE, /[A' � 0 r'�' s 440 = 0_74 = 594. 6_S F - Survey � _ASSU1i�F INFILTRATOR_- - 594 6 -- ENDS = 551. 3 SF. Consultants, Inc. C� LOT 26 ►� REGISTERED LAND SURVEY ORS ;'1F, 01, PRO WIDE'13 925 '-S. F & CIVIL ENGINEERS _ USE• 5 INFILTRATOR UNITS WITH 4' OF STONE 01V SIDE 167 R SUMMER STREET AND --- 3' OF' S7i0NE ON_EACH EACHLL�'ND_. KINGSTON, MA. 02364 ? END CAPS JNFILTRA PO SHALL BE MYCM M PERFORATED _ _.-- __--_ _----- 781-582-,2185 PROFILE.• N T. S s , COR BOTTOM STEP WOOD FENCE - - \ \ TOTAL SIZE = 1_0.&7X ELEV =48. 73 TOTAL LEACHING = 596.2 SF -_- PROJECT TITLE' TOTAL GALLONS = 441.2 GALIDA Y C� 87 7VIOR W �� SEWAGE DISPOSAL N T S SYSTEM UPGRADE' 52.70 FIRST APE' LENGTH � , � LOCUS MAP. DESIGN mp mum � BE ��LEVEL � ' �" -- ---- -----� A T 4 EL= 47'2t MIN. EL= 46.0E �S 131 OLD CRAIG VLUE' ROAD 2" 1lDV YIN. EL-- 45.5E �� l� � ^' i SCR 40 PYC HYAN.NIS, MA. `'SY 4' PYC �d/ �drlt\�d�� � \ � `' t SCH 40 �/� drLC�d�IC�d.1C.� �d4<� d/LC� d � `--- S �2 \ cS' SCH 40 \ 60. 00' � LOT 26 4 P� 10.&4' X 9725T R' RC MUMM a GALUY \�� !I S 4 7 4335" W � PREPARED FOR. 1= 44.02 c.�s aArrLs' Cl1 1 LOCUS I= 44.38 1- 4481 I= 44.20 6" = z 'X CQ3 NORAAN � HAY .S BOTIDM EL_ 42.oo I= 44.03 _ �� b. \ I,IND A 4� 131 OLD CRAIG YtI l.F,' ROAD D BO 1500 GALLON o EDGE OF PA VEMENT z HYANAW,, MASS. ;� P CONCRETESEPM HIGH WATER AZ-- NONE 1 C=] C A08 p� BOT7t7Y OF 7Pj 1= 36.B G.RUSSELL DATE. 11113197 Wll'R GAS BAFfZE � a G4 P. DESIGN.• A�ROAD � OLD CRAIG VILLE r, p� COMP. CHECK W R SYL VIA DATUM.• SCALE' 1 �� = 10 ' DRA W1v C.HATCH �� FIELD* M BOSQUIN P. CO WLEY VERTICAL DATUM N. G. VD FEET b o� APPRO VED.• G.RUSSELL BENCHMARK USED- COR. BOTTOM STEP (SEE PLAN) ELEV. - 46 73 0 5 10 15 20 25 �� DWG No. 7054SEP SHEET JOB No. 7054 of 1