HomeMy WebLinkAbout0925 PITCHER'S WAY - Health 925," itcher,'-s Way
Hyannis ;-lk
A =272 - 141
a
TOWN OF BARNSTABLE
LUCA'FION 7-If Gy��s G�si4y SEWAGE # 3/,Z,
VILLAGE ASSESSOR'S MAP & LOT ' ��''��
INSTALLER'S NAME&PHONE NO. �� e�'oC'�i°-� 7 7 r G 7
SEPTIC TANK CAPACITY �Xi✓'T'�'' oo®�9��
LEACHING FACILITY: (type) (size) iaex a e'"X a
NO. OF BEDROOMS 3
BUILDER OR OWNER ���� D�DPJ'To s•�
PERMITDATE: 2' �� COMPLIANCE DATE:
Separation Distance Between the: Xr _47Z ,v
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. L ;-,
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c Commonwealth of Massachusetts
f - Title 5 Official Inspection Form
FII Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,
,u 925 Pitchers Way
Property Address t
PRESTON,DAVID H ESTATE OF t 5
Owner Owner's Name
information is
required for every Hyannis MA 02601 3/28//20
page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When filling out forms A. Inspector Information 67/ Lf 9
on the computer, .
use only the tab Robert Paolini
key to move your Name of Inspector
cursor-do not Robert Paolini
use the return
key. Company Name
67 Tanbark Rd.
" —v Company Address
__- Marstons Mills MA 02648
�I City/Town State Zip Code
(508)280-9499 S14454
Telephone Number 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
J
'f 3/28/20
Inspector' , i ture 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
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.systemwill perform
in the future under the same or different conditions of use.
t5imp.doc•rev.7128@019- TrUc 8 Official Impaction Form:eulvourface eavrage Dlopoeul eyetam•Page 1 of 10
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments J
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every yH annis MA 02601 3/28//20
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:
. l
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
- o
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. cityrrowrl 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 ❑ 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 Ej ND (Explain below):
i
3) 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.
a. 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:
t5insp.doc-rev.7/26P2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
I Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is H
required for every y annis MA 02601 3/28//20
page. City/Town 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
El` ® 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 to c g ed SAS or cesspool
9 P
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
FII Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. city/Town 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:
❑ ® 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 11 of a public water supply well
t5inspA=•rev.7126t2018 Title 5 Official lnspantion Form:Subsurface Sevrage Disposal System•Page Sat t8
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
4 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. Cityfrown 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 aff inspections:
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)]
t5insp.doc-rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. Cityrrown State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 4
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330.
Description:
Number of current residents: 0
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)): r
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: - NA
Date
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
1; Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
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.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts
F Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. City/Town State Zip Code Date of Inspection '
D. System Information (cunt.)
f
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:
2007
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. Building Sewer(locate on site plan):
1'
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.):
Joints appear tight. No evidence of leakage.System vented through house vents.
t5insp.doc-rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
FI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade:
1'
feet
Material of construction:
® concrete r ❑ 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 GI.
Sludge depth: 4
Distance from top of sludge to bottom of outlet tee or baffle
46"
Scum thickness 2»
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
12"
How were dimensions determined? Measured
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Pump every two years.Inlet and outlet tees in place.No signs of leakage.
it
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
c° Commonwealth of Massachusetts
Title 5 Official Inspection Form
I; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
7. Grease Trap(locate on site plan):
r
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping:
Date
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
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
cZ Commonwealth of Massachusetts
Title 5 Official Inspection Form
I Subsurface Sewage Disposal System Form -;-Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
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: pate
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
No c
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.):
Box is level.Box has two outlet laterals with equal distribution.No signs of leakage.
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
'~ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
V
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. Cityrrown 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: 2 LC 500s
❑ 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
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. Citylrown 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.):
Sandy soil.No signs of hydraulic failure.
12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration M
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.):
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18
r
c Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
I� Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF '
Owner Owner's Name
information is H
required for every y annis MA 02601 ' 3/28//20
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
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.):
1 `
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. Citylrown State Zip Code Date of inspection
D. System Information (cunt.)
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
A J - aa. A
z_ I a, "r----
s a �.
MICE
40, 31
�. 3 P
r _
If Commonwealth of Massachusetts
Title 5 Official Inspection Form
11. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
V 925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. Cityrrown 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: 20
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:
As- Built
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Used USGS observation well data.Used technical bulletin 92-0001
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
r
c Commonwealth of Massachusetts
Title 5 Official Inspection Form
k
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
925 Pitchers Way
Property Address
PRESTON,DAVID H ESTATE OF
Owner Owner's Name
information is required for every Hyannis MA 02601 3/28//20
page. CitylTown 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
I
No. 0200�' ' Fee
THE COMMONWEALTH OF MASSACHUSETTS
Entered in computer: ko
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes
9ppYication for Disposal 6pstem Construction permit
Application for a Permit to Construct VQ Repair( ) Upgrade( ) Abandon( ) ❑Complete System--Individual Components
Location Address or Lot No.9.2 5— 4,�d y'4x Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel �L j I y/
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms R> �^ Lot Size "tl 3 lD 9S sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) -S gpd Design flow provided gP
d
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
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 it c� q
Signed Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. 0O Date Issued 'a 3—
No. Fee, '
THE COMMONWEALTH OF MASSACHUSETTS Enteiedincomphter: V
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS. Yes
�,. ftpfication for ]Disposal Opstem Construction 3permit
Application for a Permit to Construct 9y Repair( ) Upgrade( ) Abandon( ) ❑Complete System Individual Components
'Location Address or Lot No.9U S j",v Owner's Name,Address,and Tel No.
Assessor's Map/Parcel 1 7j I y/
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size 3 S sq.ft. Garbage Grinder( )
Other Type of Building r. No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) -��� — gpd Design flow provided 3 yQ gpd
Plan Date Number of sheets Revision Date
Title ,
Size of Septic Taiik Type of S.A.S.
Description of Soil
U. . J
Nature of Repairs or Alterations(Answer"when applicable)
Date last inspected: q y
Agreement:
The undersigned agreesFto ensure-the construction and maintenance of the afore described on-site sewage disposal system in ry'
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 It q
Signed Date
Application Approved by � '' ( Date Q'
Application Disapproved by! Date
for the following reasons
Permit No. aaO ��- Date Issued 1 -a 3— 0
r
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded X.)'
Abandoned( )by �T�r� 4B474**: e %.
at 93-S /J'Cjj/�Ql f' fTj�t'�/ has been constructed in accordance q
with the provisions of Title 5 and the for Disposal System Construction Permit No.900"3/1 dated t '
Installer 1- '- �►s G G��OFI/F Designer 40.W V p &RU_r.9 ,J'
#bedrooms Approved design flow gpd
The issuance of this permit shall not be construed as a guarantee that the system will fimctioVasdesigned.
Date q �.� i Inspector
------------------------------ --•----------
No. 3 1�_ -=--------Fee=----- - _
(rO =-
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS
Misposal 6pstem Construction J)ertnit
Permission is hereby granted to Con tract( Repair( ) Upgrade ) Abandon( )
System located at d S
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 must be completed within three years of the date of this permit
£ Date 3- 6 Approved by (�7
r
Town,of Bar astcl able
� y Regulatory Spices
Thomas F.Geiier,Director
p Public Health DIVIs on
_ "ThDmas McKean,Director
'200 Main Street,Hywwis,to 02601
Office: 50$-862-4644 Fax_ 508-790-004
jasta-Her&Designer Certification iForin
Date:
Aesi er.: Vi 12
Address: - b�t� t -- Addaesse
r
was issued a penmit to iaa WI a
se c syst :at F ased cat a desip drawn Icy
,r d date .- 7�9 �l
(deee)
I c=tifY that the aep6c sysstew xefm=red above waas uzstaUed substwitirily aecnrdang to
%tic idwiM wbich tray jut a mmioyapprovcd charges=cb as later miocation of the
dian-b tion box auftr septic tank.
_ I certify, that the septic xefmw=d above was instanrd witli'maaim chaffs (i,
i It}' lateralrelocatiort of the SAS or any vcrficd jalomIjon of a y wuponmt
of the sepic:.py )but in nee with State&Local Itegdlat iow. Rest rmszon cox
cestai&ed as-bu lt'by demS nc r to f6IIu ►.
P63SSYT
� $MTV- �
er s g teare.� _ a' Here)
i FORM A" AS-
-BUMT LA"AM RE91MID UY TM IC
TELANKYOU.
Q: H6adtW8sptielDcsignrs Gern6canou Font
-0 CAT ION S E W A G E PERMIT NO.
vIL-AGE '
I STA .L`LER'S-;" NAME- i ADDRESS
R`O I L,D E R` OR OWN ER
D'A T E VERMIT ISSUED
DATE COMPLIANCE ISSUED I
:y
I
(n
tc- 0
-i �,i
N .. .----..�.... F .�,...............
� w
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
............. � .�s......oF.-......., - f ll. ------......_..._...---- &�� s
ApplirFation for Diipuga1 Wurkfi (filtw ndion Frratit
Application is hereby made for a Permit to Construct _(>< or Repair ( ) an Individual Sewage Disposal
System at
..................-........ - --------_�f ...411,4- ----------------------ZcX_/ - ---------------------------------.--..-----
Loca,on- d es o jAt No
w er dress
--------------
Installer Address
U Type of Building !� Size Lot...IR3._._.._._._.Sq. feet
Dwelling—No. of Bedrooms........,eJ___..............................Expansion Attic ( ) Garbage Grinder ( )
pa, Other—Type of Building ............................ No. of persons--•..__--___--.____________- Showers ( ) — Cafeteria ( )
Other fixtures .................................
----•-----------------------------
W Design Flow..................... .. ......p.......gallons per person p�r�day. Total daffy flow............. Q............._gallons.
WSeptic Tank—Liquid capacity__..l_�agallons L ength................ Width__._ ._........ Diameter________.._..._. Depth.__._.._.---_-.
x Disposal Trench—No.--------Ph..... Width._.rr ----------- Total Length.................... Total leaching area......., __._ sq. ft.
Seepage Pit No--------i........... Diameter.._. l�fb�----- Depth below inlet......&......... Total leaching area._ -�_�._._s q.
ft.
Z Other Distribution box ( Dosing tank ) L �
`� Percolation Test Results Performed b - - r :f ._._._.�.b/Ili p Date__..___ ..
y--••••---..--- --�-ll22--- .. .
,aa Test Pit No. 1... ._° ____minutes per inch Depth of Test Pit------ f� Depth to ground water.__._14A/
w Test Pit No. 2.... .a..minutes per inch Depth of Test Pit..---.. __- Depth to ground water----!v�.-_____
x ----------- .e ---------------------
Description of Soil XC'E. LE/I�/--- . ------..'4---�------- �� � - ---------------------
U ----•-•--•-•......-----�� ---• �Jtea e� �= ------------•-•---•----...-•--•---------•-••-----•-------•-•----•---•-•-------•-•------•-------•--•-----------•---•-
W •-•-•-----------------------------------------------•-./.-•--------•---------------------•-----•-----...------------•------••---------•----•-•---•••-••.....•---•••---••---•-•----••-•-•----•--•----•--
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 I-;I
p of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been iss y the boa I of,*th
Jigned -- -••---••........................
Da
Application Approved By---•-. -� .. ......•. .--- ---- --- - .
Date
Application Disapproved for the following reasons----------------------------------------- -------------•--------------------------------------------..._.._...._
-------•------•---.•......-•---------•---•---•----••-----------------------------------------•---------•--------•-•-------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued.......................................................
Date
No.. /....... ... Fay—L . ............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
._..OF......... ! I... .........................
Appliration for Uiipoia1 Workfi Tontrnrtion Vamit .
Application is hereby made for a Permit to Construct (7e or Repair ( ) an Individual Sewage Disposal
System at
. " � .
................----....- .. ----............--.--... ....A/z.07-.. .........-----•------ '... .............................................................
Locati n—Addre "'7 ��1� L?�/�
.. {� /..................................................... -----.......... - --
ess
Installer Address
Type of Building �3 Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ). Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtu es
W Design Flow.......................:.. ..... gallons per per son p er,day. Total daily flow__._....__._._ ..3.................._..gallons.
WSeptic Tank—Liquid capacity....i gallons Length...... .......Width.__ Diameter................ llepth..._` ._..___.
x Disposal Trench—.'�T,p. ................. Width l-d- ............Total Length............ Total leaching area----------
._sq. ft.
Seepage Pit No----------------__.. Diameter................... Depth below inlet....... Total leaching area....._..___:.._...sq. ft.
Z Other Distribution box ( Dosin tank ! f
`- Percolation Test Results Performed b g )a�A.5------_5:4t✓;!e___.pll Date.._..... ��o
Test Pit No. I..... :° _._minutes per inch Depth of Test Pit...... >.._.__¢f_ Depth to ground water________________
Test Pit No. 2.... :..minutes per inch Depth of Test Pit....... ..... Depth to ground water____-----
---------E----/r•-- - --------------- ------- ..------..............
.. ---------------------••--------.-----
-D Description of Soil.----•- fi
x -- ----------- ct ` �.'tav-e-46
U
W :. •--•..........................•-•-•------....-----•----------------- --•---•-------•---•---•------------•----•------•--••-•-•-•-----._.........-•---
x
U Nature 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 ii 1 is
p 5 of the State Sanitary'"Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issues •y the boa of/1 fea ` / r /
o
igned ----- ---------•--•... Da................
' r
Application Approved By........- .... .'" ate {' .
.ace ---
Application Disapproved for the following reasons:........................................ ----••...------------•-••--•-----•--•--•-•-••---•--•--•••-•••-•-
..-•---•-----••---•-••-------•---•-•------•-----------••-•••••......--•-------•-----------------------------••-••---•••---••-•--•----•-----•---•------------------------------------------------------
Date
PermitNo......................................................... Issued.....................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
xnh BOARD OF HEALTH
................ ...............OF...........eele4''. +�,,...`...............................
Cwrr#ifiratr of Tomplianrr
THIS IS TO CERTIFY, That That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by...........Ji 1941.1Lt........................
I tall
at.......... f ...... -- (l'`f_Arl) ----
has been installed in accordance with the provisions of T j of The.S{ate Sanitary Code as desc 'bed in the
application for Disposal Works Construction Permit N _ ...... ..................... dated___. ."' ��"
THE ISSUANCE OF THIS CERTIFICATE SHAL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION /SATISFACTORY.
DATE.......................1J/l```-�/-••-••------------.........--•--•-•---- Inspector........&�-------------•----•------•----•-------•----------•--•----..._.
THE COMMONWEALTH OF MASSACHUSETTS
S
BOARD OF HEALTH
........+a !..'."...... ..OF...-•----- !! /.!. e -............................ /�FEE I l.............
�io�roo�l� �or """yyyyyyJ
i#
..
Permi`sioh is�hereby granted---------•- --. .._... : . 47f 1/
to Construct ( or Re ,air ( ) an Individual Sewage D'sp s System
Street
as shown on the application for ibis osal Works Construction Perm
.. •-•....•-----
f Board of eal J
DATE......./ ........•...•-•---•--•-••-•--•-•---•------•-•-••-•-----------
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
1
, � --�
AREA PLAN FINISH GRADE=-�/•a0 TYPICAL SYSTEM PROFILE
FDN TOP % -- NOT TO SCALE
4G , ✓/,0Q ' _.._.__._. .. - FINISH
SCALE : I "-- FINISH GRADE OVER TANK--
„- �" � `� GRADE OVER PIT= �`��• �e_ '
i
44W`_,
PVC OR 97, 67 0 o a ° vi
NO COAJ5E-A�' A7 10N /A1`S 0,e V4e � �C. 1 . TEES 47.33' �
7-OWN llil. ? f ' 9 T TEE' J57 1 �" B S M T
.;::, F L R `=%4. ,:�_ `-- GAL. 4" ° ° ° • • ° o o �
REINFORCED DIST. BOX `q7g� ti
CONCRETE -8 TO BE INSTALLED ON ° ' ' ' ' • • ' ° ° o
"_... ----
A LEVEL STABLE BASE
f` •' e e o . • • • o o • p 0
Z SEPTIC TANK
7 • / • e • • e •
TO BE INSTALLED ON A • o • ° • ° °
�• Q LEVEL STABLE BASE o • • e o 0 0 ° ° t
�. - 2"-I/8'l 1/2 "WASHED PEASTONE ALL � ' ' ' • • ' ' ' o ' !
/� e . . . e • . 0
Lt1, �,Q' I � � � � BRICK 8� .MORTAR COURSES AS AROUND FREE OF IRONS, FINES
l REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE
24 "C.I . MANHOLE COVER 81 I 3/4 " TO 1 -112 "WASH ED CRUSHED LEACHING PIT
FRAME - SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL
/ 74, 73 � _ c� IRONS, FINES AND DUST IN (
.� i
/ads 4ec. s C/�sr 2.5 N'n FOR FIN. GRADE \\ PLACE
' Tp.VK—SEW PWWli- \ i SEE SYSTEM PROFILE \ SOIL L AND PERCOLATION
t^ I -� _ D
T N � =
3$. o 14 DATA
p aox,s�/a'raf ►c' c, it LQ .3' PERC. RATE ' I< MIN /IN.
-
o r Cc��+>�t2�"IE' ' e' p L 4 °` FOR INV. ELEV SEE
LE9C�/,�l�. van; /PE4D, 5 INLET _ b - SYSTEM PROFILE ° •, TAKEN BY . C. D. SPOHR
S� Dew//.scar �' _ LINE ° 6 °" ° /Lll�. Pf1�/ �cJ/�'
M� /9kl6p e R°P. LL�i`� f„� � � � ' - ,' ° _ ° OPENINGS Wi 4-1i8 � ` WITNESSES BY. a � r• � e
�fsE>rnreP, 1-0 : b` b OUTER DIA. & 1 -3/4 0 0 /e ,' DATE .
,
7' INSIDE DIA . ° TEST PIT -GND ELEV. ��, 7.�
't p -; : 6 a ° TOTAL ° o ;
i /q ; , ' �` I ► :' . o 0 o AREA o U V�G. LDFa:v!
-IC — A/ro 0' /6 Q '�f�/......r. Q `b ° ° ° t- _ — l — s.-
r- 2 ! ° 2 f3 J o 0 0 b - _ SUES v O! ltfff� ,BUST" ' , �7ia►o�:
L C�T�`,1,� N � •: o 0 0 0 0 0 0 ° - , L4„ Off' vvA T�k
0 Oct
.off ,b. 000 ° o a o 0 0 .:�f31E/ia'
r 6 6 DIA L.9yrk�S
EFFECTIVE DIA.
BOT. PERC. HOLE
10 DOWN
LEACHING PIT - SECTION (/ kEQ0,) II
NO SCALE DESIGN DATA :
NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM
L-L.EY�-3 TIONS 83 9-57E7.3 Ohl P,9 vA4Z-AlT E-Dcr4r N 0. O F BEDROOMS
CEtiiT�,�2t✓�tlE' OF` LoT � A.S57OA- rD EL. sb.o I ;
L {{ c ti_ DISPOSAL
f L./�1 � f � � LEACHING PIT NOTES: EST. TOTAL DAILY EFFLUENT GALS.
34AYv(_5_7_/4 3Lk" REG/STi2Y' or I . CONC. TO BE 4000 P.S.1 a 28 DAYS . SEPTIC TANK IL-)C " GAL.
I)FEL�t_ P4,"AJ 300/< :27/ 2 . RE1NF W 6 x 6 **6 GA. W. W. M.
PA GIG' "p3 3. 2 'AND 4 ' SECTIONS ARE AVAILABLE FOR GENERAL NOTES �
GREATER DEPTH REQUIREMENTS
I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN
NOTE . :' ' t ACCORDANCE WITH TITLE 5OF THE STATE SANITARY CODE
EXCAVATE TO ELEV. ' / OR SOWER AS DATED JULY 1,1977 a ANY LOCAL RULES APPLICABLE.
REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPR'D. IN
MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL WRITING BY MR. CHARLES D. SPOHR.
WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY
COMPACTED IN PLACE. 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING,
SIDE AREA = L-L`i S. F.0 S. F./GAL '` 95" GALS NOTIFY THE ENGINEER AND BOHKv OF HEALTH FOR I NSPECT IO%.
4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED.
BOTTOM AREA= LZ S. F.@ S. F./GAL GALS
TOTAL AREA = S. F. TOTAL '" '— GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN
APPROVAL BY CHARLES D. SPOHR,
LEGEND 6. FOUNDATION INSPECTION READ. WHEN EXCAVATED.
F ' AREA. PLAN:
+ 50.0' EXIST. GROUND ELEV.
v� (� � :D 4 L U I L G E R S
, �zrl L+ F7•�'(�xt PLor �%Lf�1'j 50.0' FINISH GROUND ELEV.2'UNDERLINED"
'. _../a /G ` FL Y/V IV �1t1 L Dom' `' O/c 1-y AI D /AI Al Y oQ1V fV 1.S s4 .,Q, FG ' R E V D A T E D E S C R I P T 1 0 N
,F 0)< 37, C AJIr r� yILL� ? 47 50 PIPE INVERT. ELEV.
�.�, a ' .�!' C BLliLD S 5_CA)j.E'
a A10Y, 29, 1980 24Y C191-`E U-4,4A/,05 0 TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM
suPveYlNG CO, FOR
o O SEPTIC TANK
CLAkK FL YI N BU I LL;ERS
Cl DISTRIBUTION BOX LOT I C�� V t,I1iA`��
vt MAS `�
4 C. 1 . PIPE
-H I I I Itt -- 4"BIT, FIBER PIPE - TIGHT JOINTS � harles D. HYANN I S, MASS. i
SPOHR w
I / � - -- - PROPERTY LINE FNP 46811�, s`�i DFSIGNED. C D SPOHR DATE.19 DEC ' DRAWI N c N0.
STEP.
MIN CODE DISTANCE fSs'0 - DRAWN: SCALE:AS SHOWN
.
MAP SEC PC-L LOT HOUSE I I � I
CHECKED: C,. D. S .
T .
ASSESSORS MAP : `�27c... TEST HOLE LOGS NOTES:
PARCEL: /'711
Ale
SO i L EVALUATOR : i '� 'rf� C
L' FLOOD ZONE: A107 ,�j?��C,IC �� 1) The installation shall comply with Title V and Town of Barnstable Board of
W I TNESS :-D PC5tA411 �
_ r Health Regulations.
REFERENCE: L��I - ,� 4D a ' l DATE: 011 Z
- -- - -- � Y 2) The installer shall verify the location of utilities sewer inverts and septic
PERCOLATION RA
1 components prior to installation and setting base elevations.
3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8"per foot. The first
TH- 1 TH-2 two feet out of the d-box to the leaching shall be level.
4) This plan is not to be utilized for property line determination nor any other
A �' Sly A hi4u� purpose other than the proposed system installation.
10443 Z` ►► �'L3 Z
8 5) All septic components must meet Title V specifications.
Z� �4-4tJ -3t� 6) Parking shall not be constructed over H10 septic components.
1� (, [,`Z,. ►� C 2�/g 7) The property is bounded by property corners and property lines.
LOCATION MAP ' 8) The property owner shall review design considerations to
� g approve of total
design flow and number of bedrooms to be considered for design. Receipt
I�ftl 10 of payment for the plan and installation based on the plan shall be deemed
approval of the design flow by the owner.
1 1 I 9 The existing leaching or cesspools
) g g p shall be pumped and filled with material
�� per Title V abandonment procedures. Those within the proposed SAS shall
u D be removed along with contaminated soil and replaced with clean sand per
-�� I p D Title V specs.
46 �t / � � - ^ --_--- � - "" " - 10)System components to be 10 feet from water line. Sewer lines crossing the
water line shall be sleeved with 4 inch SCH 40 PVC with ends routed if
g
applicable. The proposed SAS is being installed below the water service
SEPTIC SYSTEM DESIGN line. The line is to be sleeved as aforementioned and maintained in place.
11) If a garbage grinder exists it is to be removed and is the responsibility of the
FLOW ESTIMATE owner to ensure such.
—� 12)The installer is to take caution in excavation around the gas line if such
Z BEDROOMS AT GAL/DAY/BEDROOM - 33O GAL/DAY exists.
I 1 H o 0 13 13)The installer shall verify the location, quantity and elevation of the sewer
I SEPTIC TANK lines exiting the dwelling prior to the installation.
GAL/DAY x 2 DAYS - �OD GAL
rq
USE IDS GALLON SEPTIC TANK
5' W 1 ��►�2�j+� 1�IrJ �i w�
j � ac'u �� • ' SOIL ABSORPTION SYSTEM
. i rn UrJ�-
EXISTING ' -��, ►r ,,'{gib -( ,_ .—�__ ,- _,�; 4,6
DWELLING \ -� - -
S 1 DE AREA: �X z 4 �Z b�1 ��9, ��. ��' 'ST-
TOP OF FNDN
BOTTOM AREA: ' 7(
� \ 3=I -
� EL = 65.5@► - I
o zoo?I 7J�Z
I
�m SEPTIC; SYSTEM SECT I ON
I I _
B�rN4 covrreGs
I < I 1~�(I`-'Til
I m
p i
2� w' Siau
D_ OX U L
GAL (�
m SEPPTIC TANK
�
_U�U_
.°
LL
o � w
, ElrsTl 3 a � V)EL= °Bd> tb
z f I
o
,
�l
-- -- -- -- ------ A = B1.02 FLe- 43.9B ft 0 S I TE AND SEWAGE PLAN
mm
MENT rOCATION : V��
EDGE OF PAVE
A y Y4 PREPARED FOR :
FITCHERS _
1 BENCH C y+ l�..i I , ►M
PK NgIL MARK
IN DRIVE SCALE
ELEVATION = 64 �� DAV I D B . MASONS DATE:
eARNSTgBLE sIs DATUM DBC ENV I RONMEN
W IiAL DESIGNS
EAST SANDWICH . MA
W DATE HEALTH AGENT ( SOH ) 833- 2 177
Z