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HomeMy WebLinkAbout0990 PHINNEY'S LANE - Health 990 4Phinney's Lane ° Hyannis," -�1 f" 0 w a Town of Barnstable �FfNE 1ph, Regulatory Services O Thomas F. Geiler,Director x aAMSTABLE, 9�A M6 39. a`0� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 7/20/07 Designer: Shay Environmental Services, Inc. Installer: Rodney Fisher Address: P.O. Box 627 Address: 585 Kelley Street East Falmouth, MA 02536 Harwich,MA On 7/20/07 Rodney Fisher was issued a permit to install a (date) (installer) septic system at 990 Phinney's Lane, Hyannis, MA based on a design drawn by (address) Shay Environmental Services, Inc. dated 3/20/07 (designer) XX I certify 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. T I certify that the septic system referenced above was installed with major changes (i.e. 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. AA OF P Inst 1 is Signature) � ��° CAR yGN� O a a 0 SHAY N , No. 1181 �fG18T���O Designer's Signa ure) (Affix Desi R TSta ere) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH 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:Health/Septic/Designer Certification Form I TOWN OF ARNSTABLE U 16 ATION 1�� q Ph���1ay s AA, SEWAGE# VILLAGE �� —� &SOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEP'1IC TANK CAPACITY Cts .S LEACHING FACILITY:(type) C¢, a) -f- f I—r (size) NO.OF BEDROOMS 3^�1 OWNER AA �ysoO ) PERMIT DATE: 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 fa ility) Feet FURNISHED BY T ils C -"� J on rot 0/ r J.A aA � ar►JC t- - I t I A B 4q� S3 3 Sob 3�b OWN OF BARNSTABLE LOCATION ( 07/7 SEWAGE#Z40' VILLAGE ®.1' ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY.(type) h4ize) NO.OF BEDROOMS OWNER PERMIT DATE: Q COMPLIANCE DATE: 7 3 IS 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 j` 1 N N � nL S TOWN OF BARNSTABLE9 , LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACII.ITY: (type) _ (siie) NO.OF BEDROOMS BUILDER OR OWNER 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 facility) Feet Furnished by i f'6 1^ ®7 (lam� W 7Wm: �� ,� � oQ ni �"" No. Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye .PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rpplication for Migo5al *patent Cungtructiun VErrait Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. %d s ) _ Owner's Name,Address,and Tel.No. Assessor's Ma arce Installer's a Address-er�d-Te. o. Designer's Name,Address and Tel.No. o ISti� vnrar� Type of wilding: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures 2�, Design Flow(min.required) S c7 gpd Design flow provided S50 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank � Type of S.A.S. Description of Soil j , Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental.Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H It . Signed Date Application Approved by ate Application Disapproved by: 7 Date for the following reasons Permit No. Date Issued ell No. ( ` Fee D THE°COMMONWEALTH OF MASSACHUSETTS Entered in computer: f PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE, MASSACHUSETTS Yes f Zipphration for Migpo!6a1 �&p!tem Construction Permit • I - �` Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon,( ) ❑ Complete System ❑Individual Components Location Address or Lot No.,�. Owner's Name,Address,and Tel.No. =Assessor's Map/Parc� �/}�L .7 n , L v w I I f . 111y Installer's Name,,Address,-and-Tel.No. a / Designer's Name,Addreland Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.'of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 37 O gpd Design flow provided 3 gpd Plan Date Number of sheets r` Revision Date -Title •^ Size of Septic Tank �� Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date1ast inspected: Agreement: i The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of e ]t . Signed ,, n i Date ' Application Approved by J !/A Date j" Application Disapproved by: - Date for the following reasons F Permit No. / �" Date Issued _ -.. _. _ _ ° THE COMMONWEALTH OF MASSACHUSETTS " BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, at the On-site Sewage Disposal System Constructed ( ) Repaired Upgraded ( ) Abandoned( )by at h been c. stryated•n ccordance with the provisions of Title 5 and the for Disposal System Construction Permit N . dated le Installer A f C4 T 1� Z,4— Designer #bedrooms Approved design flok gpd The issuance of this permit shall not be construed as a guarantee that the system will as de igned. Date -7/ /1-77 Inspector a Fee ` THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS t . Di5po5al 6p5tem Construction Vermtt I lbor6 Permission is hereby granted to Construct•( ) Repair ( " U grgule,.( Aban°d System located at ;a 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: Co Date //9 s 'ctionmu'st�b ompleted within three years of the date of thipe 'ii.6 / ks Approved by > > c. / Town of B 'arnstabYe _ Department of.Regulatory Services 16 Public Health Division Date � arA" ` , . M'�' 200 Main Street,Hyannis MA 02601 Time - Date Scheduled • ewa-ve Dry. al ,poi Suitability Assessment for S - Witnessed By:.. Performed By: LOCATION & GENERAL INFORMATION Owner's Name A Location Address .9 9 Q - Q Address 'Socy,-C c/,2s Engineer's Name S�1 En j •�2� Assessor's Map/Nrcel: O�S N _ NEW CONSTRUE I[ON REPAIR �//���' ! Telephone# S Surface Stones` A Land Use 04� Slopes Qt— ft Drinking Water Well �ft Distances from: Open Water Body—eft Possible Wet Area___�___ ft Pro lane Other to ft Drainage Way PAY dons of test holes&perc tests,locate wetlands in proximity to holes) SKETCH:($treet name,dimensions of lot,exact loca © Depth to Bedrock 't Parent material(gedlogic) i �—• ! Weeping ftvm Plt Face Depth to Groundwater. Standing Water in Hole: 1 Estimated Seasonal High Groundwater . .p DtTERMINATION FOR SEASONAL I9GH WATER TABLE Method Used: in, Depth td S011 mottles: ft Depth Observed standing in obs.hole: {n, orouttdwater Adjustment Depth tolweeping from side of obs.hole: A�,(Actor Adj.draundwflteY Level Index Well# Reading Date: Index Well level i i PER TION COL A TEST --1-- : � Observation Hole# • 'rime at 6,. �°1°2.•�-^----' Depth of Perc mn - 1• , Time(91'4) - Start Pre-soak Iime.(� �y -- End Pre-soak . L`Rate MinJlnch ^' Site Suitability Assessment: Site Pass Site Failed Additional Testing Needed(YIN) ed Public He$tth Division Observation Hole Data To Be Completed on origi nal: Back-------- ***If percola con testis to be conducted within 100' of wetland, must first notify the •. prior to beginning- one , Barnstable C4#servation Division at least one(1)week TI DEEP OBSERVATION HOLE O E LOG Hole#��-_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Strut re,Stones,Boulders. Consistencv. rav 1 P-3 N Sri Aa �aA C ,s >3 4Zby 5,r"" DEEP OBSERVATION BOLE LOG. HoleA Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. 7Consistency.% ra e Ow _ o - R •�o° 3.. L 'r ,3b-� h C s �, S� a•s� ' �� a b o - Cl- . .sYB. Lam 0 1 ;DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) {USDA) (Mansell) Mottling (Structure,Stones,Boulders. rConsisoncX,%Gravel) l � i ;DEEP OBSERVATION HOLE LOG Hole# ! Depth from Soil Horizon `."Soil Texture 'Soil Color Soil (Other Surface(in.) (USDA) rMunsell) M4ttling (Structute,Stones,Boulders. ons' encZ%Gravel t 0 Flood Insurantte Rate Map: Above 500 year flood boundary No._..._ Yes �-- Within 100 year boundary No ✓ Yes Within 100 year flood boundary No Yes 4 -.;Depth of NaWaRv Occurring-Pervious Material .•.,.Does at least fo feet of naturally occurring pervious material exist in all areas observed throughout the .��area proposed Or the soil absorption system? �. -not,what is the depth of naturally occurring pervious material? 4J t'S Certification I certify that on• (date)I have passed the soil evaluator examination approved by the 1 Department of*nviron ental Protection and that the above analysis was performed by rr�e consistent with . the required training, �rtise and experien s 'bed in 3.10 CUR 15.017. Signature Date 16 l �o Q:ISEPTICIPERCI ORMMOC ,ygYj�'f0 4'Q ®. O0 COMMONWEALTH OF MASACHUSETTS e EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET BOSTON MA 02108(617)292-3500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Govemor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Address of Owner: BOX 1606 PEMBROOK MA.02369 Date of Inspection: 4/26100 Name of Inspector: JOHN GRACI I am a DEP approved system inspector pursuant to Section 15.340 of Tide 5(310 CMR 15.000) Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02636 Telephone Number: 608-664-6813 FAX 608-664-7270 CERTIFICATION STATEMENT z ti. 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 inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: rrU Date:4/26/00 The System Inspector,shall sub a a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection.If th 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 Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS "The inspection is based on criteria defined in Title V code 310 CMR 15.303.My findings are,of how the system is performing at the time of inspection.My inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its component's useful life." THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING THE SYSTEM EVERY ONE TO TWO YEARS FOR PROPER MAINTENANCE.THE SYSTEM WAS NOT INSPECTED UNDER NORMAL USE.THE SYSTEM CONSISTS OF TWO 6'X6'BLOCK CESSPOOLS. Gee revised 9/2198 Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4126/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. 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. Indicate yes,no,or not determined(Y,;N,or ND).Describe basis of determination in all instances.if"not determined",explain why not. n& The septic'tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank, whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection If the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. n& Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). _broken pipe(s)are replaced _obstruction is removed _distribution box is levelled or replaced n& The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if (with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed I revised 9098 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4126/00 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 the public health,safety and the environment. s7N', 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 16.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis 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,Method used to determine distance nba(approximation not valid). 3) OTHER n/a revised 9/2198 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4/26/00 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet Invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Q. X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: 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: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No _ X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system Is located In afiiitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner: CHARLES LEAHY Date of Inspection: 4/26/00 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health. 11 X _ None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined.Note if they are not available with N/A. X - The facility or dwelling was inspected for signs of sewage back-up. X _ The system does not receive non-sanitary or industrial waste flow. X _ The site was inspected for signs of breakout. X _ All system components,excluding the Soil Absorption System,have been located on the site. X - The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X - Existing information,For example,Plan at B4O,H, X - Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)1 5.302(3)(b)] X - The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. r` revised 9/2198 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4/26/00 FLOW CONDITIONS RF_SIDENTIAI; Design flow: 110 g.p.d./bedroom Number of bedrooms(design): 3 Number of bedrooms(actual): Total DESIGN flow: 330 gpd Number of current residents:0 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no): NO Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage): n/a gpd' Sump Pump(yes or no): NO Last date of occupancy: 811/99 COM M ERG IALnNDUSTRIAL Type of establishment: n/a Design flow: n/a gpd(Based on 15.203) Basis of design flow:n/a Grease trap present:(yes or no): NO . Industrial Waste Holding Tank present:(yes or no): NO Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available: n/a Last date of occupancy:n/a OTHER: (Describe) n/a GENERAL INFORMATION PUMPING RECORDS and source of information: n/a System pumped as part of inspection:(yes or no):.NO If yes,volume pumped n/a gallons Reason for pumping:n/a TYPE OF SYSTEM X Septic tank/distribution box/soil absorption system _ Single cesspool _ Overflow cesspool _ Privy _ Shared system(yes or no)(if yes.attach previous inspection records,if any) II/A Technology etc.Attach copy of up to date operation and maintenance contract _ Tight Tank Copy of DEP Approval "Other:n/a APPROXIMATE AGE of all components,date installed(if known)and source of information: THE SYSTEM IS OVER 30 YEARS Sewage odors detected when arriving at the site:(yes or no). NO revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4/26/00 BUILDING SEWER:X (Locate on site plan) Depth below grade: 16" Material of construction: _ cast iron X 40 Pvc _ other(explain) Distance from private water supply well or suction line: n/a Diameter: 4" arf' Comments: (condition of joints,venting,evidence of leakage,etc.) THE SYSTEM HAS TOWN WATER. SEPTIC TANK: X (locate on site plan) Depth below grade: 6" Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other explain: n/a ` If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 6'X6'BLOCK CESSPOOL" Sludge depth: n/a Distance from top of sludge to bottom of outlet tee or baffle: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a How dimensions were determined: MEASURED Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet Invert,structural integrity,evidence of leakage, etc.) MAIN CESSPOOL AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY ONE TO PROLONG THE SYSTEM USEFULL LIFE.THE SYSTEM WASiEMPTY AT THE TIME OF THE INSPECTION. GREASE TRAP: _ (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other Explain: n/a Dimensions:n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a Date of last pumping: n/a Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) nla revised 9/2198 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4/26/00 TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,Inspection) (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other Explain: n/a Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallons/day Alarm present: NO Alarm level:N/A Alarm in working order:NO Date of previous pumping: n/a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n/a DISTRIBUTION BOX:_ (locate on site plan) N PIN Depth of liquid level above outlet invert: n/a Comments: (note if level and distribution Is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) n/a PUMP CHAMBER: _ (locate on site plan) Pumps in working order:(Yes or No): NO Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n/a revised 9/2/98 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4/26/00 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n/a Type: leaching pits,number:(n/a)n/a leaching chambers,number: (n/a)n/a leaching galleries,number: (n/a)n/a leaching trenches,number,length: (n/a)n/a leaching fields,number,dimensions: (n/a)n/a overflow cesspool,number: (1)6 X6'BLOCK CESSPOOL Alternative system: n/a Name of Technology: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE OVERFLOW CESSPOOL IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT WAS EMPTY AT THE TIME OF THE INSPECTION.THE SYSTEM WAS NOT INSPECTED UNDER NORMAL USE.IN THE PAST THE PIT HAS BEEN 8"TO THE PIPE. CESSPOOLS: _ (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer. n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO Comments: (note condition of soil,signs of hydraulic4ailure,level of ponding,condition of vegetation,etc.) n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a revised 9/2/98 " Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4/26/00 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) g 5� a AA 16 gg 51 revised 9098 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 990 PHINNYS LANE CENTERVILLE, MA 02632 Name of Owner CHARLES LEAHY Date of Inspection: 4/26/00 NRCS Report name: n/a Soil Type: n/a Typical depth to groundwater: n/a USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate_ Deep_ SITE EXAM _ Slope _ Surface water _ Check Cellar _ Shallow wells Estimated Depth to Groundwater 12 Feet+ Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions Checked with local Board of health _ Checked FEMA Maps Checked pumping records Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET revised 9/2/98 Page 11 of 11 w✓ o � u y „l 5 } t*i !a !1 i � 3 5 oar, �T W V :i b 07 -14 G ��, r e L7 - - :.T*-<.. sue.. _. � '� •.. - ._r:. - , 5 s 2 r �n � � r , . G 'Ij lit 4b l Go SAL Ni pf U, �house VENT PIPE_SO Least24kvdN,.ONOTE- ALL PIPES ARE TO BE a SCHEDULE 40 P.V.C. two `J � r _."Existing Foundation •to septic Schedub PVC •/Charcoal Odor Filter a �u ��°hi` _ t �e�, k TOP OF FOUNDATION = ELEV. 100.00 (Assumed) 6 in. of INS! Waft N�„ICover PROFILE VIEW OF ADDITION TO LEACHING SYSTEM rsa{,�: - µel } Graf ow smp%Tads-O&W OraM ever D-ew-91LOD over SAS-9eoo _ t 3"°�N-2o SECTION A --A n �, �r,990 Phlrirsays.N_n / aEh �c}, 'n r W r.7kff z n � 7P• M _�l�is 'f x,,.` t "go-0) 3' Ymdsesn �>yar ,n�tyF:r. ;�•. r .";� ,,.y... -•.{1 �.. NEW �001 a Cov Top OF Sin-Dec wW75 3" of 1/8' - 1/2' washed Pemt w r r j ,Oof �p� 1.500 GAL 'K /'4' to 1 1/2 ' washed Crushed Str ,FRn1 ExtsT.FfxNmATN71SEPTIC TANK 0 1S Qot' O'E7lYotM, b4•PVC(CAPPED)NISPWn[N PORT To NECONCRETE MALL FOIMDA„pp��/ o H-10 ; NISTAt1ID AAA 70 BE Y111FNN r OF GRADE 1D o N N 0 0.83 )' es(10 inch +sood.w"ew: Fc.vr3oovs Mae,teo.4w.roi ob .rwei =;' SYSTEM PROFILE a k,waf 3/r-1 1/2• > ` Not to ScaleS vac•d atom N it 5 Units a 6.25' _ 30' GENERAL NOTES ' ` Verification of Utilities -9 .5' 3.5' N 3' 3' 1. Contractor is responsible for Digsafe notification, 6 baf 3/4-, Ilr c Lk 3'-�-I o 31.25 and protection of all underground utTties and pipes. NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6' BELOW GRADE oor�atted Effeeelw Whitt 37 L 2. The septic"tank anRi� distri ution box shaft be set e a Effective Length level on 6 of 3/4 -1 1 p2 stone. m SOIL ABSORPTION SYSTEM (SAS) 3. Backfill should be clean sand or gravel with no i Bottom of Test Hae 2 Elev.- 88.00 stones over 3" in size. P E R C 0 LATI 0 N TEST IWILTATR13R HIGH CAPACITY (H-20 LOADING)/ GEORGE O'BRIEN 4. This system is subject to inspection during installation P 1 1514 Groundwater - NONE OBSERVED b Carmen E. Shay - Environmental Services, Inc. (OR EQUIVALENT) Not to Scale 5. The contractor shall install this system in accordance Date of Percolation Test: OCTOBER 25, 2006 NOTE: OVERALL HEIGHT OF INFILTRATOR IS Ir /EFFECTIVE HEIGHT IS 10' with Title V of the Massachusetts state code, the approved plan Test Performed By. CARMEN E. SHAY. R.S., C.S.E. and Local Regulations. Results Witnessed By. DON DESMARAIS (BARNSTABLE BOH) _ 6. If, during installation the contractor encounters any EXCAVATOR: Shay Env. Svcs. ALL OUILU ISM soil conditions or site conditions that are different Percolation Rate: Less Than 2 MPI A 30" RM Box�BE from those shown on the soil log or in our design SET REVEL FOR AT LEA5r 2 FT C014CRM COVER 17J installation must halt do immediate notification be Test Hole Test Hole "" j '' 3-r Ou1tET made to Carmen E. Shay - Environmental Services, Inc. No. 1 No. 2 oR"sT 7. No vehicle or heavy machinery shall drive over the DEPTH SOILS ELEV DEPTH SOILS ELEV - a,LET 1r NeET 3Q septic system unless noted as H-20 septic components. 0 98.00 0 98 00 : r 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. Sand sand ^+° r p i 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. Loamy Loamy 15!5- 4' _ SCH• 40 T ,�. i 10. All solid piping, tees do fittings shall be 4" diameter 10 YR 3/2 10 YR 3/2 A, 97. 0'-r Ap 97. PLAN SECTION CROSS-SECTION i QI Schedule 40 NSF PVC pipes with water tight joints. Lom _ ,/ Y 11. Municipal Water is Connected to ALL OF The Residence and Abutting Sand r sLomr 3 HOLE H-20 DISTRIBUTION BOX Properties- ~ f 10 YR SA To YR 3/6THE PROPERTY NES ARE Within 150 Feet. ATE AND 6'- 30' Be 95.50 6'- 30" Be 95.50 1 Vl C A COMPILED FROM uTHE ED KELL GG & ASSOC.. ENTITLED Coarse Coarse Y `11 ' ,lr `' f SUBDNISION PLAN OF MIDWAY SUBDIVISION, CENT., MA z San/+ Zs Sand 4 _____-40 FOOT RIGHT OF WAY i DATED FEBRUARY 1959 r, 3.ao 330"- 60- 3.00 -.♦ I AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN IT SHOULD BE USED FOR NO PURPOSE OTHER THAN Med. Sand Sand G I � \ i THE SEPTIC SYSTEM INSTALLATION. 2.5 Y 8/6 2.5 T B/S ' ``� 1 60'- 1 C' 6D'- t G eeLoo I: i 70.00 EXISTING CESSPOOLS TO BE PUMPED OUT AND REMOVED 11 -raj lam` 4(P'6+, `♦\ NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE ,�4• I I CPO ` 1 FROM THE EXISTING CESSPOOLS TO BE DISPOSED - -- Failed CESSPOOL I i Failed �6' \� �� OF AS PER BOARD OF HEALTH SPECIFICATIONS. Perc1 D-Box CESSPOOL � ♦� THERE ARE NO WETIJINDS ARE PRESENT WITHIN 200' OF THE PROPERTY Depth to Perc: 60" to 78' Perc Rate-- 2 MPI �„ �, ^ TEST" OLE "#1 "„`�\ h `♦` ASSESSORS MAP 252. PARCEL 057 Groundwater Not Observed q\ t I ELEV= 98.00 ♦\` No Observed ESHwr 4 b e i �, LEGEND ,:.. ADJUSTED H2O Elev. = None - _ TEST H LE #2 ►VENT�E� 98.00 � ---- 3-2r MW ACCESS VAARNOI.ES O �- `♦ ;�_ r.. , ` DENOTES PROPOSED PROJECT BENCH MARK } 1 ` 104X1 10 �- SPOT GRADE TOP OF FOUNDATION - ;� - _�-• -=•�; ELEV. = 100.00 (Assumed) ♦♦ 3-; i x 104.46 DENOTES EXISTING DECK "r• ' 1 5' G`♦� `� SPOT GRADE ' rr 1 `♦ e �� ♦ `� �� PL PROPERTY LINE PKALLJUEr • THE ACCESS COVERS FOR THE SEPTIC TANK, \ 1 9 PROPOSED CONTOUR ;. OISTRIBUnON BOX AND LEACHING COMPONENT f ♦ !p 1 ; �� SHALL BE RAISED TO WITHIN 6' OF ► ` ` `FINISHED GRAM --gq EXISTING CONTOUR s -'3..•. s •:•.: DE `♦♦ `♦ 'I --- - STEEL REINFORCED PRECAST CONCRETE INSTALL TUF-TITE GAS BAFFLES OR EQUALS 1 EXISTING ♦ `♦ 1 / I ON ALL OUTLET TEE ENDS I �' ♦ 1 ' DEEP TEST HOLE & PLAN VIEW 1 9 BEDROOM Pam♦ �- 3-2,C RDAOVrE COVERS-� SOUSE ` `♦ ; �i � PERCOLATION TEST LOCATION 990 \ `♦r` ��` e---. 6 FOOT STOCKADE FENCE INLET B'MIM fr niv.k"to mm or tT sNtT ♦♦ \ ; ♦` ♦` /',/ , . LkW depth �- P LOT P LAN _ �� , OF PROPOSED SEPTIC SYSTEM UPGRADE CROSS SECTION END-SECTION I PREPARED FOR ------------- - _ - �fo \ MR. ADILSON SEGOLINI TYPICAL 1500 GALLON SEPTIC TANK Q 1F , AT NOT TO SCALE �• �' P�, #990 P H I N N EY'S LANE (H-10 LOADING) �9by , \ \ �/ oF� CENTERVILLE, MA Design Calculations A F rA ' :,, ? PREPARED BY: Number of Bedrooms: 3 Bedroom EXISTING � �( '< Garbage Grinder. No y �' '1 y 00 o R EN ,' A /�� �j E. 0 uA �T Leaching Capacity Required: 330 Gd./Day (MIN. PER TITLE V) roy ' O� ij U`,; CARY El I .1.� a �J H l Septic Tank : - 2 x 330 Gal./Day = 660 USE NEW 1,500 GAL Septic Tank. rO ' SOIL ABSORPTION AREA: Using percolation rate of Q min./inch ` NVIRONMENTAL SERYICE3, INC. Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallons �F Sidewall Area: 0.74 gal./sq. ft. x 78 sq. ft. : 58 gallons iszE�` P.O. BOX 627 Praviding: = 331.8o gallons 0 20 40 50 StiNITA��P�� EAST FALMOUTH, MA 0256 TEL/FAX : 508-539-7966 Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, SCALE: 1"=20' DRAWN BY: CES DATE: OCT. 31, 2006 TO BE USED WITH 3-6 OFWASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE ��' ON THE ENDS. NO STONE UNDER. SCALE: 1"=20' PROJECT#SD984 FILENAME: SD984PP.DWG SHEET 1 OF 1