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0593 OLD STRAWBERRY HILL ROAD - Health
593 Old Strawberry Hill Road _ ----- Hyannis A=273 — 007 o u 0 o t. o �I Q o o I 1 u a� TOWN 0O'F BARN JSTA13U LOCATION J 61d s1 I}aw�m n_11SfV;AGE# VILLAGE N`1/ ASSESSOR'S MAP&PARCEL -7 INSTALLER'S NAME&PHONE NO. �.� 5 � � �� SEPTIC TANK CAPACITY ,IJO'l1 LEACHING FACILITY:(type) (size) N`1 S- g- NO.OF BEDROOMS . OWNER bS. Q,W LLC. PERMIT DATE: COMPLIANCE DATE: v Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY � C�AII� � G� � � l/� �� � �' �� �i �► 1i �� � 7� :. ® __ ►� o w No. 0/9 3 0 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes f ltll.tat.on for .sposal 6pstem ConstrULt.on Permit Application for a Permit to Construct( ) Repair( ) Upgrade(�/Abandon( ) ❑Complete System N/ndividual Components Location Address or Lot No. (Z"Gt � ,� Owner's Name,Address,and Tel.No. f JJ 00-7 Assessor Map/Parcel Mill { Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 0jq)342 gner�e ► 1AC L -,) Type of Building: 22 Dwelling No.of Bedrooms�o) Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures !!�� Design Flow(min.r uir,d) &30 gpd Design flow provided gpd Plan Date Number of sheets � Revision Date_�.99 Title S7 S 1 ,1 Size of Septic Tank be of S.A.S. 2 a Description of Soil Nature of Repairs or Alterations(Answer when applicable) Z (f 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 Boar of Ith. r Signed Date I d" Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ICI I y —c y q Date Issued u No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpfication for43isposal *pstem (Construction permit Application for a Permit to Construct( )" Repair( ) Upgrade of Abandon( ) ❑Complete System Individual Components Location Address or Lot No. (� Owner's Name,Address,and Tel.No. Assessors Map/Parcel Lf(AAA,1`i l l Installer's Name,Address and Tel.No. + Designer's Name Address and Tel.No. u XC�vIG�Id�, k � 0jq)3q2- fir , h iht '► Address, Inc Type of Building: DwellingNo.of Bedrooms g 7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S30 gpd Design flow provided A C � gpd Plan Date Number of sheets A2 Revision Date fr( 1/Title YyU r� L JG - a 6 1� r1 W �1' ` , c/� y Size of Septic Tank Jt(/l { pe of S/.A.S. � ( ,4)rl Description of Soil (1 ( J !1(�� , Al , _6 Kd Nature of Repairs or Alterations(Answer when applicable) UJAJ WO N 2- S-60 V 6L i Lot, 11 VA { Date last inspected: 41 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 BoardPof•.ealth. Signed Cf�✓� 5 Date I( 5L d Application Approved by ) (n,, A Date Applipatig�t Disapproved b-y _{... yi:w _ .,. _�. .. >. - 4_ _ -Date 4 V for the following reasons z Permit No. 7? '(307 Date Issued /y l i►b y THE COMMONWEALTH•OF MASSACHUSETTS BARNSTABLE;'MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by .4 p , at 1�. 0{11 . W6 LA L_k t"I 1 I I Nl(. has been constructed in accordance with the provisions �of�Title 5 and the !for Disposal System Construction Permit No. d(r- 0 t dvtatted �t Installer .�•,}�UI 1�N k)qa ano r i Designer A 1 N lA-I�'i,to I.� e V s / „ ,1. - #bedrooms _� 4 Approved design flow ����• gpd N. The issuance of this permit shall not be construed as a guarantee that the system will function;as designed: Date A // Inspector No. C� 0lP" U� Fee If C.'� 60 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction jermit Permission is hereby granted to Co struct( )!! 44(( Repair( ) f Upgrade( ) Abandon( ) System located at ,� D ( c�" J']i�►[ /2'1 t y( and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction'mus'be completed within three years of the date of this permit. ' Date f ! °1 � Approved by r c �\e� Town of Barnstable i i Regulatory Services s Richard V;,Scali,Interim Director • BmwsrABM + MASS. Publieflealth Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601. Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Sewage Permit# Assessor's..Map\Parcet 2�3_CjC-? Designer: Lrg+r�ee('�n:o� Wo,-its, 1;nc-. Installer: �vt,nv► 5 E�Cc,vcL a t` _ Address: IZ W, Crt,s��e (� 4 Address: Nk 'b restate _1MiA 026�y ) JAL 6 On y S �xCaya�t--was issued a permit to irisMl'l a (date) (installer) j septic system at _13 014 -94r clew Lx dry 14 l/ based on a.design drawn by lei er i IM C.l✓.�+tee t L (address) Eytcj _P_r, ny LU rLu bI C , dated l I 1 ✓, t o, ) cC 1 IJ (designer) �ertify that the septic system referenced above was installed.substantially according to the design, which may include minor approved changes!such as lateral relocation of the distribution box and/or septic tank.. Strip out (if required) was:"inspected and the soils' were found satisfactory. 5k I certify that the septic system referenced .above was installed with major .changes (Le,.. greater than 10' lateral relocation..of the SAS or any vertical relocation of any component of the.septic system) but in accordance with State &.Local Regulations. Plan revision or certified as-built by designer to follow: Strip out (if recl iced) was inspected and the.,soils were found satisfactory. 1 I certify that,the system referenced above was constructe ` `rice with the terms of the IAA approval letters if applicable) HOF M*"E C11M (Installer's Signature) No:35los RFC/&TER�� (Designer's Signature) (Affix Designer tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEAT TH DIVISION: CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD.ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Dcsigncr Certification Form Rev 8-14-13.doc f J - Town of Barnsta P# 'r'�� py THE Department of Regulatory Services Xc Public Health Division r 3 `,� ttrtrs Date �A i639 �e� 200 Main Street,Hyannis MA 02601 IECt w ati. 1 04, Date Scheduled / / Time / V Fee Pd. 4 6o Soil Suitability .Assessment for age Disposal �Za Performed By: /L k'- t��/4�ee s r-157y2 , ,, K� Witnessed By: LOCATION& GENERAL INFORMATION LocationAddress S9 3 S�-aro wt�t ��:`� _ pwner's Name � S` d N'i 5 h h s Address �t-d0`A LV- Assessor s Ma /Parcel 'Yq f-Vq o �� �� M p 2-7 3 — o o ? Engineer's Name fnej t v`Pr2 l2�G (J�1�6r S 1 Vl NEW CONSTRUCTION REPAIR �' y, Telephone# SQ�- -7�7 S �1 -3 Land Use tZe$�J.f A�\cry \ slopes(%) l Z Surface Stones Ncl^-( Distances:from: Open Water Body 00 ft Possible Wet Area /J0/t ft Drinking Water �S t 1 Drainage Way AJO^X- ft Property Line Other ft SKETCH:(Street name,dimensions of jot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) t{ ._, ___ _ _ _ r _-__ _.T _ ... _ _ P Parent material(geologic) �Jf-c� 5 Depth to Bedrock ' 17 Depth to Groundwater. Standing Water in Hole: �O Weeping from pit Fnee AJ zo N-- Estimated Seasonal High Groundwater. C � DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in, Depth to soil mottles: in. Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level.�...m.�. Adj,factor Adj.Crdundwater l cvel,P PERCOLATION TEST Daie Pltrte �� Observation , Hole# ` V Time aC4 Depth of Perc. rtl Z- "'1 Time at 6" Start Presoak Time @ .. �• 'rime(9"-6") End Pre-soak � 5 Rate MinAnch Site Suitability Assess incnt: Site,Passed ✓ site.Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Bole Data To Be Cotnpleted on..Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:1S EPTICIPERCFORM.DOC i DEEP OBSERVATION HOLE LOG Hale#. i ,Depth from Spit Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling, (Structure,Stones;Boulders.. Consistency,% ravel' ©-� A t 'Fine Set 5 DEEP OBSERVATION HOLE LOG Hole# 1, Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,:Bouldets. Consistency,% rave 3 0 0 a� 5�,.�1 toy r2.sl l o 7d r�.� L DEEP OBSERVATION HOLE LOG Hole# Depth.from Soil Horizon-� Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel), DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon Soil Texture Soil Color Soil other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, - ,onsl ten ra. Flood Insurance Rate Man.: Above 500 year flood boundary No— Yes ___ Within 500 year boundary No CW, Yes— Within Within 100year flood boundary No:K Yes Denth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious.inkorial;exist in all areas observed throughout the area proposed for the soil absorption system? Yet — If not,What is the depth of naturally occurring pervious material?, Certification I certify that on IS Q S (date)I have passed the soil evaluator examination approved by the Department of Environmental Protecfion and that the above analysis was performed by me consistent with . the required trami expertise and experience described in. 10 CMR 15:017. F Signature. _— Date 1 QASEPTICTERCFORM.DOC I v : j Town of Barnstable Barnstable cA' Of T ° Regulatory • Re ulatorY Services Department caCftv BARNSTAHL- 1 6 9. ,. Public Health Division ��rfibMA+s, 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 9958 September 14, 2018 DS DEVELOPERS LLC 32 GORDON LANE YARMOUTH PORT, MA 02675 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 593 Old Strawberry Hill Road, Hyannis,MA was inspected on 08/30/2018 by Sean M. Jones, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360-20h). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH XasMcKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\593 Old Strawberry Hill Road Hyannis.doc Town of Barnstable , �uvsrns 9� " r.e F Regulatory t•'n Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) Q.I,eaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts a::T3 -00- - l� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments (Y) rri 593 Old Strawberry Hill Road h�l Property Address Deutsche Bank r� Owner Owner's Name - ' information is required for every -eeftfier the n 'S Ma. 02632 8/30/2018 c,r page. City/Town State Zip Code Date of Inspection k�) i� Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. filling out forms A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. S.M.Jones Title V Septic Inspection �y Company Name 74 Beldan Lane Company Address r�R Centerville Ma 02632 Cityrrown State Zip Code 774-2484850 smjonestitle5@gmail.com S14522 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 16.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Appro 'wtg Authority 8/30/2018 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original 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. t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown 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: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old' or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �a 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) El Pump Chamber pumps/alarms not operational. System will ass with Bo ard of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑' Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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, safetyn and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The.system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 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 '/day flow t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts �a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public 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 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown 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 up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: 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): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: original system installed 1984 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 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.): Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallons Sludge depth: --- t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 1' o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 0 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness -- Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Measurements not taken 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 was located but not opened. 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 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. CitylTown 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.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: I ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 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 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form f° Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert N/A 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.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page U of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit was dry at time of inspection but showed signs of past overloading when system was in use. Dark stain lines and buildup on top of inlet pipe. Cover is on a riser to grade. 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 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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.): t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately `vv A ( Z7 p v 33 z t5ins.doc•rev.6/16 Title 5 official Inspection Form:Subsuftoe Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown 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: 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: Groundwater elevation was not established. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 a Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 593 Old Strawberry Hill Road Property Address Deutsche Bank Owner Owner's Name information is required for every Centerville Ma. 02632 8/30/2018 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc`rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 l 1 � 4 5 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED AUG 2 8 2003 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. ' OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 593 Old Strawberry Hill Road Centerville, MA 02632 Owner's Name: Louis Onnembo Owner's Address: Date of Inspection: July 29, 2003 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 Map:273 Osterville,MA 02655-0049 Parcel. 007 Telephone Number: (508) 862-9400 Lot: 20 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Need urther Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: August 4, 2003 The system inspector shall sub a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments- ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 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 310 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 distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 D. System Failure Criteria applicable to all systems: You must indicate either"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. ✓ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria-apply to large systems in addition to the criteria above) Yes No 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 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 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 up? ✓ _ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ _ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ _ Existing information. For example,a plan at the Board of Health. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 �- Number of current residents: 2 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] oQ Laundry system inspected(yes or no): No �J Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIALI NDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:Never pumped-per owner Was system pumped as part of the inspection(yes or no): 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) ' Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: May 9184-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 i j Page 7 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 593 Old Strawberry Hill Road Centerville, AM Owner: Louis Onnembo Date of Inspection: July 29, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 4" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 1" Distance from top of cum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 13" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There were no signs of leakage. GREASE TRAP: None (locate on site plan) Depth below grade: 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 r Page 9 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 -6'x 6'(1000 gal.) leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): The pit had 2'6"of water on the bottom. The scum line was at the same level. There were no signs offailure. The bottom to grade was 10'. The cover was to grade. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 Map:273 Parcel: 007 SKETCH OF SEWAGE DISPOSAL SYSTEM Lot.20 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. ( GG 1 � I ;n a0 O 10 „ Page I 1 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 593 Old Strawberry Hill Road Centerville, MA Owner: Louis Onnembo Date of Inspection: July 29, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 50 +/- 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: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You most describe how you established the high ground water elevation: Using the Barnstable topographic map and the Cape Cod Commission water contours map,the maps were showing approximately 50'+/-to groundwater at this site. f I This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. I 11 TOWN OF BARNSTABLIi1 (a LOCATION �� A6✓�G�rY SEWAGE # VILLAGE C� J - ASSESSOR'S MAP & LOT oZ7 3 O07 INSTALLER'S NAME&PHONE NO. L err aD SEPIX TANK CAPACITY I UUU LEACHING FACILITY: (type) ( X p,-r (size) l Uv0 ��- C'. NO.OF BEDROOMS CLr BUILDER OR OWNER �--o�f Dn�►�-rnJD PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching ffcility) Feet Furnished by =1 S (-0 )On ev w Q ®�LOCATION SE AGE PERMIT 0. / `� r4 ur -err 17j/1 ( � VILLAGE I N S T A LLER' N ME i ADDRESS 1 BUILDER OR OWNER Py, rt;m (� 4 DATE PERMIT I S S V E 0 DATE COMPLIANCE ISSUED �� �l " e 1 No. 3. FEs..... �. ........ THE COMMONWEALTH-OF MASSACHUSETTS BOARD OF HEALTH ................. .Town..........0F.....Barns.tabl.e.........----....................-•-.................. Appliratiou for Disposal Works Tonstrnrtinn rrmit Application is hereby made for a Permit to Constr air ( ) an Individual Sewage Disposal System at: - 3 r� Zot #20 ; Old_ Strawberry_Hill Road, , Mass. -••--_.... ..................................................... Location-Address or Lot No. _Nicholas Onnembo .......... . .............. 601.._Qld_..Strawberr„y-,Hill-•_Rd:xCenterville, ------•. ---....•---..•--- •- Owner Address asS . a .....Arch...Canatm c i-wa.. •••-- Installer Address dType of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.....3....................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ... a.P.e.............. No. of persons............................ Showers ( 2) — Cafeteria ( ) a Other fixtures .. ....... . W Design Flow.................5.5.....................gallons per person per day. Total daily flow--........3.3Q.........................gallons. WSeptic Tank—Liquid capacityl.O.O.O.gallons Length.$...?...... WidthA..10... Diameter................ Depth.S_-8._..... x Disposal Trench—No. .................... Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No.-.1................ Diameter.......6-- --..... Depth below inlet.........6....... Total leaching area.......26Lsq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed b Eldredge Engineering CO - Date........9Z26.183- Test Pit No. 1.....2.,4D...minutes per inch Depth of Test Pit.....1 `........ Depth to ground waterEDne....eI7eountee GL,0-4 Test Pit No. 2.....�I//.minutes per inch Depth of Test Pit.....NI&...... Depth to ground water....N/ ............ Rr' -•--••-••...•••••----•-••-•-•-•-•••.......-•••••-•-•••--••-•••••-••••-•........................••••................................................ 0 Description of Soil------....1Q.........-.........2.`..........LIIam...and--.aps.Q-il..---•--------------------------------------------------------------------- v --------•-•--------------------- �. -.. 1C Medium•••yellow---Sand-----------------------------------.........---.......-------------- 10.'--------••••--12-'-•.... Diedilazy..wbdte-••.aand/txaces..of_. , W gravel/np Vgtt' 24t UNature of Repairs or Alterations—Answer when applicable....................................................................... ....................... ..................................-..................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hatsbeen,issu_e/d by the board of health. Signed...• 1/�%� 4. 9/1/8 Date Application Approved By••--•••---• � '' D ���t........ Efate Application Disapproved for the following reasons:••••-••••••---•-•...•-•.................••--•-•••-••-••...•--•••......••-••-......-••••-•....._......--•------- -----------------------------------------------------------------•-------••------•----..........-----•--•...........-•---•------------.....--•-•-•••---••-••-•-•-•••••- Date PermitNo.......................................................- Issued....................................................... Date ------------- --------------------------------------------------------- ------------------------------------- ---- -- y THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH sown..........OF.....Barnstablc-........------------------------------------------- Appliration for MivviiFal Works C9omitrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: L ...Old Strawberry..H 11 Road.. i�Yann:'.s.1... �Tass. ................................................... Location.Address or Lot No. MichQ ; ...Qxemo----------------------------------------------- 6-Q1---QLd--Strawberry...Hill---Rd.,��Centervill Owner Address lYla►�i►�• a .....Arch...Canst.Z'L1C:i;.1=............................................ .................................................................................................. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.._...3....................................Expansion Attic ( ) Garbage Grinder ( ) p`4 Other—Type of Building ...C.aP.e.............. No. of persons............................ Showers ( 2) — Cafeteria ( ) a' Other fixtures -------------------------------- -. .. .... W Design Flow.................55.....................gallons per person per day. Total daily flow----------33Q...._..................dons. 11 WSeptic Tank—Liquid capacitya.QO.O_gallons Length_$___6..:.._ Width.. }..1Q.__ Diameter________________ Depth. .........._. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---I.......-------- Diameter.........1....... Depth below inlet.........k.r..... Total leaching area.......2g..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) EldredB.P. n rineer i Co . Date._.....2/26/83_........... Percolation Test Results Performed by......_________________..._....... ......_._._._.__.? ..... aTest Pit No. 1.....pt.&._minutes per inch Depth of Test pit.....12>'.....__ Depth to ground water Npn/e__.encount, f=, Test Pit No. 2.....W!..niinutes per inch Depth of Test Pit...... Depth to ground water...N/__A.........__. ----•-------------------- --------------•-••...... ..--------------------........... ......................................................................... O Description of Soil-----------Q '......... t.0p Q�� -----------------••------•----------------------..........-•---------•---• x 2-'--•-•--'------14-.......-•.&.4ium..Y.ellow sand w Q_'._--.--.---.1.2_�---------l�i�dium..white_ sand traces of ravel no Ovate tat x - ----------- -•--•--------------------• -- ------......_......... 1 U Nature of Repairs or Alterations—Answer when applicable............................................................................................... •-----------------------------------•----------...--------------------------------------------_.....-•-••---....•-••••----------------•-----••-•----•--•-•--•-•••-•-•-------•----•-•--....__._.......... Agreement: Tile undersigned agrees to install the aforedescribed. Individual Sewage Disposal System in accordance with the provisions of TI'11Z 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed Application Approved By.............. 1..�r'....... ................ Date Application Disapproved for the following reasons----------------•------•--------•----------------------......------------------......-•--._...•-•...........--- -------------------------------------------------------------•-------------------•--.........-----------.._.....---.........-----•---------•-----••---------•------._...---------------------••--•------- Date Permit No......................................................... Issued....................... ................................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................Z`Own.........OF........4a.m•atable............................................. Trrtifiratr of Tampliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.............Arch...Conatruo.t Qll----------••......----•--•-•----------------•-•-...........-•---•---•...----------•-....--•---....-•----.............---............ Insta er at_.....Lot_.#20I Old Strawberry Hill Roa gr Hyannist l,iass. ................ ................................. been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__'?.? :._—421 da . ............................................. THE ISSIIA C F THIS CERTIFICATE SHALL NOT BE C ST A GUARANTEE THAT THE SYSTEId�✓1N`lG NCTION SATISFACTORY. DATE._7. ...0.. Inspect ..............•---................................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH town OF... Barnstable o No.. FEE.................... �i��ro�itl ork� �ona��riion rrini� Arch Construction Permission is hereby granted ----- -----------•---•-•--- to Construct or Re air an Individual.Sevt age Dis osal S stem at No......Lot _20,� O d St rawberry Hill Road, Hyannis, t�liass . -••••.-----•-------_. ......--•••-------•-•--•................................... Street as shown /thelira 'on'for Disposal Works Construction Permit No..................... Dated..___.._____.__..._.._.................... -- . . ---------.•...----_-•••.................' Board of Health DATE--S ...........•---...---- FORM 1255 A. M. SULKIN, INC., BOSTON f/--X 1 t �ZS nrlE C /0h S / SUl3DrUlSror' p „1 1 1 _.,. I1 6Z o Ass Unk� $)zE ©Of) 4-Ai—: p ei7a:a-7 R�z ?�r✓,�G ° T•Yic /Q'*� c D:� o . T.lQr, G.�E, (i ` p pD 1� ; sr. .� 1 t 13 Z,�N� ` /3 y c.gr,�S (� I �H OF M� lo0,� �l'. P No. 10951 w0 Ago FG l f 5 27-2 - � /2 �FSSIptJ!,l�� f(U�< /fRS /ht3P Z�3 Go-t /3 �O.woaL c.S� 7b Rove A.w Q LEGEND `• EXISTING SPOT ELEVATION OxO �tNOF, ASS CERTIFIED PLOT PLAN EXISTING CONTOUR —�— O -- �� 40 �v al-,: —577,'c,: 0 4: / FINISHED SPOT ELEVATION ate' ROBERT rU: � ,_ FINISHED CONTOUR 0 eRucE /-1 i'1r� `� �4 . � �tDRED � I N .APPROVED , BOARD OF HEALTH ., DATE AGENT SCALE'. 10 DATES 'lA—1 r�L DREDGE ENGINEEFNNG CO. ING� �' CLIENT.._. I .CERTIFY THAT THE PROPOSED EGISTERE REGISTE-REO JOW NO. _��' 7--� BUILDING SHOWN ON THIS PLAN CIVIL LAND -- CONFORMS TO THE ZONING LAWS %ENGINEER URVEY R - -------- OF BARNSTA,BLE, MASS. � .-7�) 712 MAIN STREET CH. BY; -, ! / HYANN I S, MASS. i z ' _ W --' _ SHEET—' Of ATE REG, LAND SURVEYOR �• 20 FT MIN /0 rE = /F c=/7"NG•4 f ::,rE S=r7T�C :.4 y.f OR x'ACw//vG P/T .4RE /O PT. IWLV. /''10RC .THA.'/ /2" 9ELvN C:ONGetCr•E O/ SNAL B T- L F 0 APOUG,N OE• � 4�PYC Pt � T O G,�A r /_L / 'Z D COYERs MIN. PITCH tsEAYy CA57- i.40/Y G_nYE.� Y' -: - ���o twit • _ . - - ; l-- � - . - _ �.- S�'PAR rT, SFPT/G T.w�l D/ST. I a • .• • • • a �+�; a EaX o • • • • . • • • • • :,a '•) iY"ASh=0 S7✓.y'E ' 7 v • • o • 1 • s i off I . . 1✓ASr,EJ STJ,4'E -76 1 ,Fi �� � � � •�• • • • e • • • • •` off • ll6/Y�"d�7� �.L�4�+�T/®U�l P 1 r G�i�r4�=/ C 1 f�'"- ;i. • • • e o • a • • o • r PREG45 T SEE.RRG F ►• • • • • e pot • •� P/7C.4 4fQ4J/Y 100.D - • • • e CL_ �� O IXYFJ�tT A?' i►NJ�+D®IVQr __ �X S rr. D1Atf. lAILL�T S TI1G' 7�6A/It.-' fj 7,Ad4lL-A770AV) NPC /1ddLE 8 C� -� •41��' ' S��TJQ�► �F' . ' GR04UNO P44rFR TALE ;. 00'lZ+�TIJ✓STRI�(IFI®d1I�.,�?� `',.=: '.. .. � IN[1 r tE.a 2=._.._9.0 ®140A It SY.S7'4&/M! 7A49114AT/OM 4.4: ..D.ES/6IK �lT��l�i �se.a�. : 'f�� z• !=O� _ . DINEX-EX Z �T INtlklBER OF6�E"OOVS 3 e D/M�JI/SION G : l FT_ ' R�,4G,E p/SPOJArL IJAIIT - '✓ SOiL` .LOa TOTAL E.rrIl-14rEo /-LO#V 3 3 0 6.+c/D.ty SO/L TEST.0/ $0/4 7g's7-,02 SD/L TE37' f ,V::1M8,rR 0F LEACX/NG P/T.3 L_ fLLY. SIDE LGACH/NG PER PIT �� rT: D— Z ' � LEY, QATtr OF SO/G T&ST 9 t � �,� ' -3. 3.'GTTOM 4JSACWING /a1•R P!T so. A � L��+ > � •4Est/LTS W/7--vC'SSED. 0j�, ✓sgc;c,,51 07AIL 4Z4C'N/NG AREA � �b SQ f� :j 5ur ��1= P�`RCGtAT/O/v.ilAT��E.j LEss .M/�iNGN.: zESE.4/ELEACR-',Yd ARE/ 54. FT ' 4%— b PEhCO[..,T/ON R,4TE�2 r ��' .�IN.`I,IVCIY Sur / z ( ELDRED(((`,`,`j��111�� ti J ' `v MORSE N No. 109S1 O ��� 1 L OREDG c.VG/N .�Tih"G G0,11/G. �. V� 712 )wA 11Y ST �ASJ. '- �'%�'aF3S/ONAD�� Q ND G.TOUNJ .Y,4TG'P I3 GTOU/V0 kVATER AT s/_zv LL/EJVT U�/, �• e DF!'s : �'t/s ur'�fi �' i'• .JOD .1I0.• 7'3`:i SHEET?-Of z 1 593 Old Strawberry Hill rd,Centerville,Ma 02601 New Look inside of 2°nd Floor. -39'.5- ------------------------------------ `_ --- -----------------------------IT—-------------------------8'------- ------------- 91 A I•� i 1 I •� � 1 1 1 1 I , I I 1 I 1 8' Bedroom, �5' ft Exist windows I ----� 18' i 6.1 8' I I i► 26'.4 I I 1 1 1 1 1 1 15' 12' ; I i Y Exist step ; �►6'2 UP 1 , • 1 1 I 593 Old Strawberry Hill rd , Centerville,Ma 02601 Look inside of 1°nd Floor .-------------------------------------------------------------------------------------------------; O Kitchen O II II Bedroom Living room Bedroom I I II ————— Exist step Down{Basement steps Up 2°d Floor steps ——97——EXISTING CONTOUR z x 100.98' EXISTING SPOT GRADE N 97 PROPOSED CONTOUR °Mon W EXISTING WATER SERVICE wOy LCP 32g49 A I �H. bI—OVERHEAD WIRES ti �6 TEST PIT BENCHMARK �� s N 12.58'49" E LEGEND '¢ �°N � �3 LOCUS 98,73 9 •0 stdckcdX fence x 0,29ix x 99,74 ("/ 0 0. Qa = p 25 21 .....-� -,- + 100.14 EXISTING LEACH PITS '00 y' (COVER EXPOSED) nj ;'" O O ?• . q� �: LOCUS MAP TO BE PUMPED, FILLED ':J ;;:. . ^�. •;:; ....WITH SAND & ABANDONED TP-2 x 100,12 NOT TO SCALE — ::,�:_,,._ _ x 99,71 EXISTING SEPTIC TANK x I (TO REMAIN) 99 3I1 I 0_� x 100,07 TOP OF TANK, EL.=99.38f GENERAL NOTES: ._ SHED I INV.(OUT)=98.05f 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BM BOARD OF HEALTH AND THE DESIGN ENGINEER. 100.18 BENCHMARK 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS x� ORANGE DOT/CONC.FTG. OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 99.89 DECK EL.=1OJ 71 LOCAL RULES AND REGULATIONS. 0 99.88 N 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR i� CK TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 0 1 r DESIGN ENGINEER. ® (A o I 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 100.37 I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN Z - o I ENGINEER BEFORE CONSTRUCTION CONTINUES. GARAGE ml/ 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. EXISTING 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF HOUSE(#593) + 100,4 I THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 99,90 PORCH T.O.F.=101.75' j HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. I 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. I l i 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. ` I 9 ,95 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 99,63 + 00,14 100A2 DIRECTED BY THE APPROVING AUTHORITIES. PAVED.:,:;: 21L'' 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING DRIVEWAY.—.: i z � CONSTRUCTION. 100.16 1 1. WHERE REQUIRED, CONTRACTOR-SHALL REMOVE ALL UNSUITABLE SOILS 99.60 \ : �00 ; x, IN .THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE!y = ✓` 1� .. j�•.•,�:F.00. .,•�: WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). LOT 20 .. 99,8� 10,762 ±SF STONE.:•::;' 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE I INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. CB 90.28' Df?lVEWAY : ��� OF �Ass9�y 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND S 17'2g'27" o PETER T. NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. " W McENTEE 98,27 98,55 edge 98 93 of` 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC pavement CB CIVIL "' SYSTEM COMPONENTS NOT SHOWN ON THE PLAN 99,41 No. 35109 99.57 I PROPOSED SEPTIC SYSTEM UPGRADE PLAN OLD STRAWBERRY HILL ROAD j611 /9 593 OLD STRAWBERRY HILL ROAD, CENTERVILLE, MA PLAN REVISION 10/9/18 Prepared for: DS Developers, LLC, 32 Gordon Ln, Yarmmouth Port, MA 02675 ADD WATER SERVICE Engineering by: SCALE DRAWN JOB. NO. OWNER OF RECOED DS Developers, LLC 9.En ineering ,WOYkS Inc.. 1"=20' P.T.M. 214-18 PARCEL ID: 273-007 32 GORDON LANE 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. YARMOUTH PORT, MA 02675 (508) 477-5313 9/11/18 P.T.M. 1 Of 2 NOTE: TO PREVENTI BREAKOUT, FINAL GRADE 25_---I SHALL NOT BE AT, OR BELOW, EL.=97.0 OPTIC TANK PROPOSED D—BOX FOR A DISTANCE OF 15' FROM THE EDGE -00 T PROP. S.A.S. OF THE PROPOSED S.A.S. �i INSTALL RISERS & COVERS OVER INLET & I'NSTALL*RISER & WATERTIGHT OUTLET AND SET TO 6" OF FINISH GRADE COVER SET TO 6" OF GRADE PROPOSED S.A.S.INSTALL RISER & COVER OVER ONE CHAMBER AND 12,6� —�--� --� T.O.F.=101.75t SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT 37.5' F.G. EL.=100.Of F.G. EL.=100.0t F.G. EL.=99.5f F.G. EL.=99.5t I �. s MAINTAIN 2% SLOPE OVER S.A.S. SHED % _ _ �. S=1%2(MIN.) SL 1% (MIN.) 2" LAYER OF 1/8" TO 1/2" \ DEC :=T 4"SCH40 PVC 4"SCH40 PVC 6" DOUBLE WASHED STONE ill 10"1 g aBaSaae (OR APPROVED FILTER FABRIC) DECK t 4" B89a BBB 6aa6aaa �-3/4" TO 1-1/2" DOUBLE EXISTING 48" LIQUID LEVEL ADD 4' 4.8' 4' WASHED STONE GAS �FFL INV.=96.77 PROPOSED INV.=96.60 INV.=98.05f D-BOX EFFECTIVE WIDTH = 12.8' EXISTING INV.=96.50 2-500 GALLON LEACHING CHAMBERS GARAGE EXISTING EXISTING SEPTIC TANK SURROUNDED WITH STONE AS SHOWN HOUSE,95 H-10 RATED PORCH T.O.F.=101.751 NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP CONC. ELEV.=97.3t INVERTS, PRIOR TO INSTALLATION. BREAKOUT ELEV.=97.00 INV. ELEV.=96.50 aBaa SEPTIC LAYOUT 2) D-BOX SHALL BE SET LEVEL AND TRUE TO aaaaB aaaaaaaaaaa GRADE ON A MECHANICALLY COMPACTED SIX KIM aaaaaaataaaB INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.=94.50 310 CMR 15.221(2). 4' I 2 x 8.5' = 17.0' 4' 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 4' OF NATURALLY OCCURRING PERVIOUS MATERIAL EFFECTIVE LENGTH 25.0' _ 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 5' (MIN.) ABOVE G.W. ®®®® 0 AS MANUFACTURED BY TUF—TITE, ZABEL OR EQUAL. LEACHING SYSTEM SECTION - ®®®®®® ® ®®® NO G.W., EL=88.3 z It w ®®®®®® ® ®®®® 33" SEPTIC SYSTEM PROFILE N Z ®LU-E3za N.T.S. 102" DESIGN CRITERIA SOIL LOG DATE: SEPTEMBER 11, 2018 (REF#15,772) 4" KNOCKOUT NUMBER OF BEDROOMS: 3 BEDROOMS SOIL EVALUATOR: PETER McENTEE PE(SE#1542) 20" DIA. COVER SOIL TEXTURAL CLASS: CLASS I WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT ELEV. TP- 1 DEPTH ELEv. TP—2 DEPTH 4" KNOCKOUT / 4" KNOCKOUT 58" DESIGN PERCOLATION RATE: <2 MIN/IN 99.8 A 0" 99 9 A 0" DAILY FLOW: 330 G.P.D. LOAMY SAND LOAMY SAND 0 10YR 4/2 10YR 4/2 DESIGN FLOW: 330 G.P.D. 99.3 B B 6" 99.4 6" 4" KNOCKOUT GARBAGE GRINDER: NO—not allowed with design LOAMY SAND LOAMY SAND 10YR 5/6 10YR 5/6 LEACHING AREA REQUIRED: (330) = 445.9 S.F. COBBLES & COBBLES & 500 GALLON CAPACITY, H-10 LOADING BOULDERS BOULDERS 74 97.1 32„ 97 4 30" EXISTING SEPTIC TANK: 1000 GALLON CAPACITY CI FINE SAND CI FINE SAND PERC CHAMBERS PROPOSED D—BOX: 1 INLET, 3 OUTLETS, H-10 RATED 1OYR 5/4 10YR 5/4 31"/49" N.T.S. 20% GRAVEL 20% GRAVEL & COBBLES & COBBLES PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 2-500 GALLON LEACHING CHAMBERS IN SERIES 92.5 88" 92.4 go,, SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES C2 C2 593 OLD STRAWBERRY HILL ROAD, CENTERVILLE, MA MED. SAND MED. SAND SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. 2.5Y 6/6 2.5Y 6/6 Prepared for: DS Developers, LLC, 32 Gordon Ln, Yarmmouth Port, MA 02675 12.8' x 25.0' = 320.0 S.F. <5% GRAVEL <5% GRAVEL En meerin b SCALE DRAWN JOB. NO. BOTTOM AREA: g' g y: TOTAL AREA:.............................................................. 471.2 S.F. 88.3 _ 138" 88.4 138" Engineering Works, Inc. N.T.S. P.T.M. 214-18 DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD PERC RATE <2 MIN/IN. "C" HORIZON 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. NO GROUNDWATER ENCOUNTERED (508) 477-5313 9/11/18 P.T.M. 2 Of 2