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HomeMy WebLinkAbout0021 PAINE AVENUE - Health H�a iris i. 5; A�z�9 00 1' Commonwealth of Massachusetts 0289— Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments -, 21 Paine Avenue Property Address '�• r„.r Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is M i anns a 02601 8/5/2020 required for every Hyannis Yr page. CityrTown State Zip Code Date of Inspection Gl Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information 0,-/ on the computer, use only the tab Sean M. Jones key to move your Name of Inspector cursor-do not S.M.Jones Title V Septic Inspection use the return Company Name key. 74 Beldan Lane Company Address Centerville Ma 02632 City/Town State Zip Code 774-248-4850 smjonestitle5@gmail.com, SI4522 sean@smjonestitle5.com License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 8/5/2020 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to i the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . ; i 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The property located at is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box and 2 500 gallon precast,leach chambers. Although the system was found to be in proper working condition at the time of inspection this report does not guarantee future,performance under similar or increased usage. 2) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts �m Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments j 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y N Ej ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)'are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: Y ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR Ili 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ,A, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments {� 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to.an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than /2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ E Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a'surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] _ ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I,9 Subsurface Sewage Disposal System Form Not for Voluntary Assessments e 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health n f El ® Were any o 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? ® El Were as built plans of the system obtained and examined? Of they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts �m Title 5 Official Inspection Form =1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. CitylTown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: :desi 3 Number of bedrooms Number of bedrooms(design):g ) actual 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd Description: Number of current residents: 4 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ®'No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts s. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name in formation is required for every y H annis Ma 02601 8/5/2020 o page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping:. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts r. Title 5 Official Inspection Form l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information.(cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: Complete system installed 9/13/2006 per town records Were sewage odors detected when arriving at the site? ❑ Yes Z No 5. Building Sewer(locate on site plan): Depth below grade: 1.5 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.): Joints in good condition, no leakage, vented through roof. t5insp.doc•rev.7/26I2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is Hyannis Ma 02601 8/5/2020 required for every y page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 6. 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: 1500 gallons Sludge depth: 5" Distance from top of sludge to bottom of outlet tee or baffle 3' Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 7" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? Opened covers and took measurements 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 does not need to be cleaned now, water level was even with outlet, tank was not leaking and was structurally sound. Outlet tee intact t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form J, Subsurface Sewage Disposal System Form Not for Voluntary Assessments 21 Paine Avenue V Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is H required for every y annis Ma 02601 8/5/2020 page. CityTrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: I ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 •�ir u � 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owners Name information is required for every Hyannis Ma 02601 8/5/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? - ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box was video inspected and found level and in good condition with no rot. Water level was even with outlet invert with no signs of past backup. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 2x500 gals ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts �d Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G \ jl 21 Paine Avenue lJ Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): s.a.s. consists of 2 precast leaching chambers in a 24'x12.5'x2' trench. Leaching facility was video inspected from d-box anf found with 6" standing water and no stain lines higher. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 15insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 I Commonwealth of Massachusetts �m Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau• Owner Owner's Name information is Hyannis Ma 02601 8/5/2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc.rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form IP Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .�.�i 21 Paine Avenue V Property Address Scott Provencher, Antonia&Joanne Rocheteau Owner Owner's Name information is required for every Hyannis Ma 02601 8/5/2020 page. City/Town State Zip Code Date of Inspection D. System Information(cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately e � ® Q T 131 Z r� A2 Zy r3 3 f33 37 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is Hyannis Ma 02601 8/5/2020 required for every y page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12'+ 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 was established by accessing town of Barnstable groundwater contour maps. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface •Sewage Disposal System Page 17 of 18 P Y 9 L Commonwealth of Massachusetts 2 F Title 5 Official Inspection Form III Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 04: 21 Paine Avenue Property Address Scott Provencher, Antonia &Joanne Rocheteau Owner Owner's Name information is Hyannis Ma 02601 8/5/2020 required for every y page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Town ogtKE of Barnstable . ,Board of Health .sAnxarns�,;* 200 Main Street, Hasa Hyannis MA 02601 �p i639. 1 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi February 12,2013 Policy: Deadlines for Connections to Public Sewer Stewart's Creek Area Project • Failed Systems (60 Days or One Year Connection Deadline): Any septic system in failure shall be removed or abandoned properly and the facility served by the system shall be connected to public sewer within 60 days, one year, or in some cases, two years after the date of discovery. The sewer connection deadline is dependant upon the nature of the failure as per Section 360-44 of the Town of Barnstable Code (60 days for hydraulic failure or collapsed cesspool, one year for systems close to groundwater or wetlands, two years for a single cesspool, etc.). • Real Estate Transfers: Except as provided in 310 CMR 15.301(2), 15.301(3)and 15.301(4), a system shall be inspected at or within two years prior to the time of transfer of title to the facility served by the system. If weather conditions preclude inspection at the time of transfer, the inspection may be completed as soon as weather permits, but in no event later than six months after the transfer. The owner shall connect the home to public sewer within two years of the inspection date, unless a shorter period is required due to discovery that the system failed the inspection, due to the age of the system, or due to an environmental variance granted (see bulleted items contained herein). In those cases, the home shall be connected to public sewer within the established deadline as outlined in this policy. NOTE: Inspection of a system is not required at the time of transfer of title of the facility served by the system if the owner of the facility or the person acquiring title has signed an enforceable agreement with the Board of Health to connect the facility to public sewer within two years following the transfer of title, unless a shorter period is required due to the existence of a failed system, due to the age of the system, or due to an environmental variance granted (see bulleted items contained herein)and provided that such agreement has been disclosed to and is binding on the subsequent owner(s). • Environmental Variance Granted (Two Year Connection Deadline): The facility served by the system shall be connected to public sewer within two (2)years wherever an "environment variance" (i.e. setback to a wetland or groundwater)was previously granted by the Board of Health in regards to installation of a septic system component. • 20 Years Minus the Age of the Soil Absorption System (SAS): The facility served by the system shall be connected to public sewer within (X) number of years as determined by the following formula: 20—(minus)the age of existing SAS (Y)= (X)the number of years to connect to public sewer. For example if the soil absorption system is eleven (11) years old (is not currently in failure without any previous environmental variances granted, and is not being offered for sale/being transferred to another owner)the owner will be granted nine (9)years to connect his/her home to public sewer(20- 11 = 9). • Soil Absorption Systems 18 Years and Older(Two Year Connection Deadline) -The facility served by the system shall be connected to public sewer within two (2)years wherever the soil absorption system is 18 years or older, unless a shorter connection time period is required due to a failed system component. No. Folon -on THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RpPlication for IN-5poal *pztem Cott.5truction Hermit Application for a Permit to Construct( ) Repair K) Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. 0A l(1 qbW p r l4j Sj rX j Owner's Name,Address,and Tel.No. 7 7 5—0 4 7 3 AORL� Paine Ave, Hyannis recce,, June Rocheteau 'or'sMap/P arc el 10 4 Paine Ave, .Hyannis Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3 6 4—0 8 9 4 Wm E Robinson Sr Septic Eco-Tech PO Box 1089 Centerville Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (ri0) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ry Design Flow(min.required) 330 gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. 2 S71Ur4q Description of Soil /•2 1� 2.y j(,7 / Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 septic system to plans of Eco-Tech, #ETE-2414 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 Cod and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H ]t Signed Date �� Application Approved by PIA 44� Date Application Disapproved by: Date for the following reasons Permit No. 0-00C Date Issued 9'l z—U G � ��/'�, C ,. No., '' 9J �` .� w..4 Fe THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYicatton for Tigpogar *p.tem Construction Permit Application for a Permit to Construct O Repair(X) Upgrade O Abandon O Complete System ❑Individual Components Location Address or Lot No. d, 9(1 -4 Owner's Name;Address,and Tel.No. 7 7 5—O 4 7 3 AsJ�4' Paine Ave,, Hy_arinis cods, June Rocheteau s r'sMap/Parcel 98 4 Paine Ave, Hyannis Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. 3,6 4—0 8 9 4 Wm E Robinson Sr Septic Eco—Tech ' PO Box 1089 Centerville 43 TriAnqlp Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder (no) Other Type of Building No.of Pers_6iis ; Showers( ) Cafeteria( ) f Other Fixtures " Design Flow(min.required) ?,70 gpd Design flow provided gpd Plan Date Number of sheets ., Rlevision Date t Title Size of Septic Tank Type of S.A.S. / .1 371U a ( s Description of Soil 1_7.S71 2 q sX.? Nature of Repairs or Alterations(Answer when applicable) Install a new Title 5 septic system to plans of Eco-Tech, #ETE-2414 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal•system in l accordance with the provisions of Title 5 of the Environmental Code nd not to place the system in operation until a Certificate of Compliance has been issued by this Board of He th. Signed � e _ Date Application Approved by N1ai T _ Date 9 `/.2 `D . Application Disapproved b Date for the following reasons Permit No. ;!Dot -S q.- Date Issued — l a. _.p THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Rocheteau Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( X) Upgraded (' ) Abandoned( )by Wm E Robinson Sr SP_r)j7_1 n SArV 7 CA at a[�Paine Avenue, Hyannis _ has been constructed in accordance If with the provisions of Title 51-and the for Disposal System Construction Permit No. (,[7(� � ��'!� dated Installer Designer } #bedrooms 3 Approved design flow_,� U gpd The issuance of this permit sha not be construed as a guarantee that the syste will functi as es' d. Date q_I��r� Inspector No. ?U tl b - � ee 00.0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Rocheteau Migpogal,*pgtem Con5tructtou termtt Permission is hereby granted to Construct ( ) Repair ( X) Upgrade ( ) i Abandon ( ) System located ataV Y Paine Avenue, Hyannis and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of thir7i4_W Date 1 / Approved by i /C C Town of Barnst le P# y �tne r �y� $ Department of Regulatory ervic I Public Health Division Date � MASS h , . t6sy. 200 Main Street,Hyannis MA 02601 r - Date Scheduled ' Time Fee Pd. 6 0 Soil Suitab'�ility.Assessmentfor ewage Di osal Performed By:��T y l:o - 1J t�0 V 611 A�0W �� Witnessed Y. - - LOCATION& GENERAL INFORMATION 1� Location Address Owner's Name Not Address Assessor's Map/Parcel`j "t s/ 0, En 'neer's Name.I),i V 19 6." V" ' ty t;?8� � � � v rl 1�N NEW CONSTRUCTION REPAIR `, Telephone#. - p SG I':.Oc �25�GQP�i��Land Use Slopes(%) .Surface Stones~ 14 Oki e Distances from: Open Water.Body 10 D ft Possible Wet Area D� ft, Drinking Water Well ft Drainage Way ®© + ft Property Irne.- I _ft -Other - - ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands�n proximity to holes) -- - _ ----= 102.04 f't --- — - -- { TP-2® TP-1 .. 1 At I I� ff e 1 m I n _� t. - - ` GR-ro-_. -1DWAT,E_P. PAD L,STMENT f� EXISTING GROUNDWATER LEVEL r BASED ON TOWN OF BARNSTABLE R I GIS DEPARTMENT RECORDS. 1 1 INDICATED GW 7.00 j I I INDEX. WELL MIW-29 ! ZONE B READING DATE AUGUST. 2006 _— — —_ -- READING ADJUSTMENT 1.6 1.6 ADJUSTED GW B.6 102.04 � � v-�w�5ti--_ Parent material(geologic) PO e4 Depth to Bedrock K 0 Depth to Groundwater. Standing Water in Hole: V 't Weeping from Pit Nce t 0 L td T Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: S e Ct 6 vC Depth Observed standing in obs.hole: --_In.,_ in, Depth to sell mottles: Depth to weeping from side of obs.hole: in. ; Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor.�. Adj.`(Jroundwater level,, o PERCOLATION TEST gatp�+ G�o6 Tune ILL10 Observation , � Hole# _ Time at 9" ...,.,�..,_ Depth of Pere 4q ,I ti Time at 6" Start Pre-soak Time.@ - 'Time(9"-6") Ut End Pre-soak n ,` RateMinPubch Site Suitability Assessment:•Site Passed V Site Failed: Additional Testing Needed(Y/N) tit Original: Public Health Division Observation Hole Data To Be Completed 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:\SEPfICVERCFORM:DOC SOIL TEST LOG DATE OF TEST: SEPT 6. 2006 SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. NO TEST PIT 1 PAARENOTU MATERIAL:EPROGLACIRALD OUTWASH ELEVATION = 26.50 +- PERC AT 46 in : 2 MIN/INCH IN C SOILS I DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING 26.50 0-6 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE B-30 B LOAMY SAND 10 YR 4/6 NONE LOOSE 24.00 . 30-146 C MEDIUM SAND 10 YR 6/3 NONE LOOSE 14.33 GROUNDWATETEST PIT 2 PAOREN- MAATERIA EPROGLACIRALD OUTWASH ELEVATION = 27.30 +- 2 MIN/.NCH IN C SOILS DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING 27.30 0-10 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE 10-36 B LOAMY SAND 10 YR 4/6 NONE LOOSE 24.30 36-148 C MEDIUM SAND 10 YR 6/3 NONE LOOSE 14.97 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. o Flood Insurance Rate Mau: Above 500 year flood boundary No_ Yes „ Within 500 year boundary No Yes Within 100 year flood boundary No Yes . Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system:? e5 If not,what is the depth of naturally occurring pervious material? Certification U1)J 14 JJ S I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required fining,a rtise and ex erience described in 310 CMR 15.017. Signature �j Date cj P f (l W 0G i g —. Q:\.SEPTlCVERCFORM.DOC TOWN OF BARNSTABLE LOCATION SEWAGE i66 VILLAGE y ��9 ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. � SEPTIC TANK CAPACITY `-S 11Z)G< f LEACHING FACILITY:(type) �r &Ae"ize) ZZ;jtOK�� NO. OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Y Separation Distance Between the: eA4--��i t 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 � , K '� � � � � � � � �. � � � � Q � � � �. �� L,OCATIQ�I f SEWAGE PERrA1T NO. VILLAGE I N S T A CLER' A E & ADD ESS BUILDER OR OWNER 1 DATE PERMIT ISSUED/ �_� DAT E COMPLIANCE ISSUED �� � �J � n_ I �\ II � � i -�, aGz �` .� I J i. 441 r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ ..Town.---------0F..........Barns.tabl.e.----_...----..._........................... Appliratiou for Uiiposal Works Tomitrurtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at ..6...Pale..AAe...,..:UBU110 ia-•-----------------••--••-•------- ...................I...............----------..--... ........................................... Location-Address or Lot No. ..RalphAl chef-erau--------------------------------------------------- 4-. ....................... Owner Address a ..A...&...B...UA'p-4.Q1.._Service----------------------=--------- 128-_Biohops...Terrace, --�Iyannis, Installer Address U Type of Building Size Lot................. .........Sq. feet Dwelling—No. of Bedrooms.••----•------_---:-3--------------------Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons a YP g -•------•---------------- P �•---------•-------- Showers ( ) — Cafeteria ( ) Otherfixtures .•-----------••--••••-•••......-••••.............••---•••--•••-•--......-••-•---•---•----•......--•-................................................ Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity....---.....gallons Length................ Width................ Diameter----.---.----.-. Depth................ x Disposal Trench—No.....................Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------------_-- Diameter.----............... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) '. Dosing tank ( ) '-� Percolation Test Results Performed by----•---••......•-•-••-•-•-••-----•..................................... Date....................................... Test Pit No. L...............minutes per inch Depth .of Test Pit..................... Depth to ground water..--..........--.--..... Test Pit No. 2................minutes per inch Depth of Test Pit............c------- Depth to ground water........................ P4 -------------=---------------•----------••-•-------•--------------------•--•••••--•-...............__.......---..._....................................... Descriptionof Soil.. SaYJ.d - --------------------•-••-•-.....--••---•---------------------------------------------------------•---••-------------------------------------... x .. . W U Nature of Repairs or Alterations Answer when applicable In tallation...o;f...a...1;Q90....(Qne..... _..-.. thousand-) gallon-•stone packed_leach pit---(overflow) +-------•------•-----•.......................... .Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI:41, 5 of the,State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss d by th bo d of health. r Signed.. _. . _Y r ............................_. .1113/73........... Date ApplicationApproved By-•-•-•--•-....................................................:.................................. Date Application Disapproved for the following,reasons:------•-------•------------------------------------ ............................................................ Date PermitNo 7.8 .............................................. Iss,ued........................................................-----------------•--- Date ♦ 3 No.78...... .Y_ Fizz. THE COMMONWEALTH OF-MASSACHUSETTS BOARD OF HEALTH OF.......... l Town-- . 'Ba�2at-S�J�-6i------------------------------ tirfatton for 11hipavial Norkg Tomtrnrttun 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair (X) an,Individual Sewage Disposal System at - -----•--------•-------------•-----.- - or.$.ot No. .................._.... �e�: �'i- rGYbe'tBLt st ----------•-•--•-•---•-----•-•- 128'---nati-A-ps...TeF:K§ r s�s--HY nta;---Ka 0. V Type g g Expansion Attic ( Lot = Sq. feet Dwelling No. of Bedrooms................. Garbage Grinder ( ) T e of,Building ize. a Other fixtures ..: 3 -` I p1 —Type g ..................:......... No. of persons__.._. Show ( I—,Cafeteria ( )Other—T e of Building Showers i d W Design Flow _' '_____________:________..gallons per person per day.. Total daily flow .........................Ct ._._gallons. WSeptic-,Tank Liquid capacity............gallons Length................ Width................ Diameter -_- _.'_.--Depth...._.......... x Disposal Trencli—No. .................... Width..................... Total Length............:....... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter..............,..... Depth below inlet.............:....... Total leaching area...................sq. ft. Z Other Distribution box ( ) Dosing tank { ) Percolation Test Results Performed by-------------------------------------------'_--------•-'------ ciwl..___ Date..................................... ja Test Pit No. I................minutes per inch Depth of Test Pit..................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch - Depth of Test Pit...................._ Depth to ground water---_--_---_---_-__.-_-_- 5�=t - -- ......;-•-• ---•....... ....................•-.---..-.-.---.--..-.-.. O Description of Soil..... W U Nature of Repairs or Alterations—Answer when applicable--_ l rgtsllatfon of---a---1#10,0fl--f one----------- gr thnneand)---- llnn---•store-- ael�-ed-... eea-eh-- =�--- Qverf3�w Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL..; 5 of the State Sanitary Code The undersigned further,agrees not to place the system in operation until a Certificate of Compliance has been iss d by th bo d of health. Signed_. . ...........`,--------- 11/ -a8 Application Approved By.......................................... Date Application Disapproved for the following reasons:.................... .......................................--•---••--••-••---•------•--•---••-------•-•--•-•...-•••••..............•-•-----•-••......----`-----------------= -•-••----•-•-------••----•----••-•---------- ,`s Date PermitNo...78-.............................................. Issued---------- --••----.............----------------- - -- - Date,� _ .._. i THE COMMONWEALTH OFIIMASSACHUSETTS BOARD OF HEALTH OF...................ToWn....................... B stable---............................... J, �erttftra e of ,.ximphaure THIS IS TO CERTIFY, That the Individual Sewage.+Disposal System constructed ( ) or Repaired ( X) by--* ._B..fl-esepo©2 derv#c ,...2^8..Big s---Terraoe;..Hyannis.....Ma� (�2��Z..._... at-6...paj --Ave-i-�...Hyanrd-s-------Ralph Roehete-aur------------------------------------------------------------------`----------- has been installed in accordance with the provisions ofwTITIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.?8'------------------------------- dated_--------------------------------------........ i ." THE ISSUANCE OF THIS CERTIFICATE .SHALL NOT BE COTRIBE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. I DATE.......... ................................ ....... Inspector . THE COMMONWEALTH OF MASSACHUSETTS • 0 BOARD OF HEALTH OF r.. No.' $�...... Rarne-tabl-e------------------..................... FEE. Moppoal Wvrku Ton.5trurtion rrrmit Permission is hereby grantedA & B ,t-e.ssp.o.ol ervice... 12A3... la�1q $...' exrage,_..Hy$nnia to Cons (- or Re air (X an Indivi al Sewa e' a o al st aY.n.e Avep. c I annie,� a. - : a p ba�eteau atNo. ........... -- - ......--•--•. ...--•-----------•--• .-•----•--- -•--- •---•--• --...---•-----•••---•-••--••---••--......•.....-- Street 78- � �PiU as shown on the application for Disposal Wo Iks.Construction Permit No'....................�ated.._....__ ............__........__....._. Board of Health DATE............... ` FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS z � • •L....• i CONTOURS- -EXISTING �J HYANNIS. MA �' - - .- - - - 50 �� r _ wo BENCH MARK MINIMAL GRADING PROPOSED o�w _ PAINT -SPOT ON STEP r �lo G o N JN m E�_EVATION = 26.54 FERNw000 0 °m°n m 24 f t x 125 f t x 2 Ft BARNSTABLE GIS DATUM AVENUE Locus LEACHING GALLERY � LEGEND y a PAINS Ln PINEWOOD m AVENUE �. P, _. 102.84 ft 1500 GALLON AVENUE =w 292 28 2� SEPTIC. ,TANK m -- D-BOX US MAP ww<3 -- — 26 y. L 0 m c~no�" TP-2 w TP-1 LO,T 11�1 j/ TEST SPIT NOT TO SCALE �oD ., "� AREA = 9801 F.� w <0 1 +- < N « 29 �i I EXISTING' U CESSPOOL eUj �J Z w I >lU (A J r-i � 3 �. 1 p p lil= <W w TREE J V I W .z 1 > 0 � * 1 -NUMBER REFERS TO 12.4 ft m 125 DIAMETER IN INCHES. # I LETTER DENOTES TYPE. 1B-P (I✓ ❑ < (V'. 71) T 1/ O-OAK M-MAPLE P-PINE �O LCl 4-X a(] .< 'z I �r mF Lfjw' I I r . Kj Z�- w N � z 28 NA 1e k W ❑ w t - :.: LLJ W < : ;•:.;•;:, w . r v j 0� CONVERSION U' SHED CHART DI S T/, NCES p p J N I INCHES TO W zl z r:." :>.; 1 DECIMAL FEET TO LEACHING .GALLERY' n a .t E X - N ISTANCES ARE IN DECIMAL L0 I \� _ M. I in Ft FEETALL -NOT IN FEE AND INCHES. IJ w ,� m 1 _ STING �. 124 wW o m �I r L LL m N LD EDR"00 rn _ W N . "' r �' I A B C I� B � (e w w o 3 ING 2 .es . , w r DWELL w 1 11.8 29.3 .`41.3 v z W I _ '3 .25 2 s V �-to ]s-o FNDN 4 33 24.4 28 3 20.2 >� X zoJ Co� �` I Y* 'TOP .39 1-_ 1 3 32.3 40.1 30.0 m 2 O J wz w �< ��-� - EL - 27 < 1 .. 5 41 4 17P 19.1 19.9 J~ z u" cn m m I / m 6 .50 5 28.1 24.8 10.1 45 W T w cD I I 7 .58 4 c W a.z i s �� 3 z= -< 8 .67 13 �W / I 9 .75 e or ❑ w w I !v 1 p Jx w o + � N m 1 z °3�v / / J 11 .92 ew w m ? 0 N W �— ! 26�1�2.04 25.Ln f t 24 (n �( tA� H w ZV — w 1p w co O Z EDGE OF PAVEMENT SEWAGE DISPOSAL SYSTEM PLAN J L m J 5. QE -TO SERVE EXISTING DWELLING W LIE o A EN 3 / \ ANTONIA & JOANN ROCHETEAU m CD m z NE o P LLz °z o (� ►-� OWNERS OF RECORD c ED ZHOF/yyssq PAINE AVENUE W o� f c HYANNIS. MA + co DAVIDZLo o D. PROPERTY ADDRESS m m FL. N COUGHANOWR NASSESSORS MAP 269 PARCEL 130 No. 1093 43 TRIANGLE CIRCLE SANDWICH MA 02563 PLAN BOOK 456 PAGE 96 o J_. , � Sgro�TTE a� 50B 364-DB94 DATE: SEPT 6. 2006 ' W N w N m SCA L E: 1 1 n = 20 f t' JOB #E T E-2 414 PAGE 1 OF 2' VERSION.• THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED 20 0 20 40 SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM ' 7 DEPICTED HEREON. FOR ANY OTHER CHANGES TO PROPERTY INCLUDING 0 10 20 SC��f lv e �" PLACEMENT OF ADDITIONS. SHEDS, FENCES OR SWIMMING POOLS. OWNER SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. SOIL TEST ,LOG DESIGN CALCULATIONS-_ , :_ DATE OF TEST: SEPT 6. 2006 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD SOIL EVALUATOR: DAVID D. COUGHANOWR. R.S. SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS WITNESSED BY: DONALD DESMARAIS. HEALTH DEPT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) NO PAARENOTUMAATERIIARL:EPROGLACIRALD OUTWASH DISTRIBUTION BOX: USE 3 OUTLET D-BOX. TEST PIT 1 PERC AT 4B in 2 MIN/INCH IN C SOILS SOIL ABSORBTION SYSTEM: A 24 FE x 12.5 ft. x 2 ft LEACHING GALLERY CAN LEACH ELEVATION = 26.50 +- Abot = ( 24 x 12.5 ) = 300 sf Asdw n ( 24 + 24 + 12.5 + 12.5 ) x 2 = 146 sf Atot = 446 sf DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER Vt 0.74 x 446 = 330.04 GPD (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 26.50 USE A 24 Ft. x 12.5 ft x 2 Ft GALLERY. Vt = 330.04 GPD > 330 GPD REQUIRED 0-6 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE B-30 B LOAMY SAND 10 YR 4/6 NONE LOOSE 24.00 30-146 C MEDIUM SAND 10 YR 6/3 NONE LOOSE 14.33 L EA CHING GA L L ER Y SCALE N T TO ONO GROUNDWATER ENCOUNTERED USE SHOREY PRECAST 500 GALLON LEACHING DRYWELL (H-10 LOADING) TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH ELEVATION = 27.30 +- 2 MIN/INCH IN C SOILS CONSTRUCTION DETAIL 500 GALLON DRYWELL DIMENSIONS AND DETAIL DRYWELL UNIT STON USE H-10 LMT INSTALL ONE INSPECTION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER RISER TO WITHIN SIX (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 24.0 Ft INCHES OF FINAL GRADE 27,30 co OND INDICATE AS-BUILT PL NATION 0-10 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE 4 4 10-36 B LOAMY SAND 10 YR 4/6 NONE LOOSE N 07:11 N 33 24.30 mom, ��r�p 0 In 36-148 C MEDIUM SAND 10 YR /3 NONE LOOSE � o0 o r�000 14.97 E 000aOa000000o D000 8.5 F'_ 8.5 Ft .5 f t o00000 00 i� 2 4.0 f t IO2 1� NOTES CROSS SECTION VIEW 2 PEASTONE 2 1n PEASTONE 0 1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN 2 24 in 2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/B INCH PER FOOT MINIMUM. 1nIm EFFECTIVE 2 i 1n A 26 DEPTH 1-1/2 1n GRAVEL In 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES 461n 581n 461n BEFORE EXCAVATING FOR SYSTEM. 5) EXISTING CESSPOOLS TO BE PUMPED. COLLAPSED, AND FILLED. OR REMOVED 1501n 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE 7) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0- BEFORE PITCHING DOWN B) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OFy.LOW FLOW FIXTURES GROUNDWATER ADJUSTMENT SEWAGE DISPOSAL SYSTEM PLAN AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO "NOT EXISTING GROUNDWATER LEVEL -TO SERVE EXISTING DWELLING PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. BASED TOWN OF RNSTABLE 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. GIS DEPARTMENT RECORDS. ANTONIA & JOANN ROCHETEAU INDICATED GW 7.00 4 PAINE AVENUE HYANNIS. MA 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL INDEX WELL M1W-29 STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH ZONE B ECO-TECH ENVIRONMENTAL SIX INCHES OF CRUSHED STONE_ HAS BEEN PLACED- TO MINIMIZE UNEVEN SETTLING READING DATE AUGUST. 2006 READING 17.3 .6 ADJUSTMENT 1.6 43 TRIANGLE CIRCLE SANDWICH MA 02563 ADJUSTED GW 8.6 ETE-2414 SEPT 6. 2006 2/2