HomeMy WebLinkAbout0010 PRAM ROAD - Health i10 Pram Rd. Hyannis
A= (Guy's Refrigeration Co.)
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COMMONWEALTH OF MASSACHUS ETTS
ExECUT1VE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
C)
pG lJ .
TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 10 Pram Road
Hyannis
Owner's Name: Guv McKenzie
Owner's Address:_ ,prr,,
• e¢hh r y
Date of Inspection:
Name of inspector:(please print) Sean Jones
Company Name: William E. Robinson Septic Service
Mailing Address: P O io 1 089
Centerville MA
Telephone Number._(5p$j 775 877E
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the info ation rgprtedc
below is true,accurate and complete as of the time of the inspection.The inspection was performed eased on training `--
and experience in the proper function and maintenance of on site sewage disposal systems.IS?m a D
approved system inspector pursuant7toseion 15340 or Title 5(310 CMR 15.000).
The systems -
Passes
N
Conditionally PassesTIP
Needs Further.Fl luation by the Local Approving Autho
C31 � [_
Fails
Inspector's Signature:
Date: r
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heanh yr
DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving
authority.
Notes and Comments
y5 •„e e,4
„ry ;
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.... ` , s :4€� n,£-e:d� .�G lE E/4°4n t �:L C.� ivlc�E�'h s • ci This report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 61 15l2000 page 1
Page 2 of 1 I
OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 10 Pram Road
Hyannis
Owner: Guy McKenzie
Date of Inspection;
Inspection Summary: Check A,B,C,D or E!ALWAYS complete all of Section D
A. System Passes:
i have not found aiy information which indicates that any of the failure criteria described in 310 CMR
15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes: All
One or more system components as described in the"Conditional Pass"section need to be replaced or
repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please
explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board of Health.
•A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or briak out or Pugh static water level in the distribution box due to-broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 tunes a year due to broken or obmvcted pipe(s).The system will
pass inspection if(with approval of the Board of Hearth):
broken pipes)are replaced
obsuuctkm is removed
ND explain:
Page 39f 11
OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 10 Pram Road
Hyannis
Owner. c,,y M�KPnz
Date of Inspection::_ 3c ?
r
C. Further Evaluation is Required by the Board of Health: .
Conditions exist which require further evaluation b
is failing to protect public health,safety or the environment.the Board of Health in order to determine if the system
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety_and the environment:
_ Cesspool or privy is within750 feet of a surface water
_ Cesspool or.privy is within 50 feet of a bordering vegetated wetland or a salt marsh
Z. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the
System is functioning in a manner that protects the-public health,safety and environment:
r _ 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 i 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 front a
private water supply well** Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered.A copy of the analysis must be attached to this form.
I Other:
3
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM_ INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 10 Pram Road
Hyannis
Owner: Guy McKenzie
Date of Inspection: `4/,,?
D. System Failure Criteria applicable to all systems:
You must indicate`.des .or no"to each of the following for all inspections:
Yes No
1`
— _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
Discharge or ponding of eMuent to the surface of the ground or surface waters due to an overloaded or
Clogged SAS or cesspool
Static liquid level in the distribution box above.outlet invert due to an overloaded or
clogged SAS or
/Cesspool
P
Li uid depth in cesspool "— q p is less than 6 below invert or available volume is le �— less than /�day flow
d Re uire
q pumping more than 4 times to 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 I00,feet of a surface water supply or tributary to a surface
water supply.
Any portion of a cesspool or privy is within a Zone 1 of a-public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis.(This system passes if the well water analysis,
performed at a DEP certified laboratory.,for coliform bacteria and Volatile organic compounds
indicates that the well is free.from pollution from that facility and t(te 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 forma
(Yes/No)The system fails.I have determined that one or more o(the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems: A/
To be considered a large system the system must serve a4acRity
gpd, tivilh a design flow of 10,000 gpd to 15,000
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
— the system is within 400 feet of a surface drinking water supply
— the system is within 200 feet of a tributary to a surface drinking water supply
— the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone 11 of a public water supply wel
l
If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered .
Ss to Section D above
the large system has fined.The trsacr or operator of arty large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 3I0 CMR
15.304.The system ov.-ner should contact the appropriate regional office of the Department.
4
Page 5 of 11
Z
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 10 Pram Road
Hyannis
Owner:_ Guy McKenzie
Date of Inspection: / ;f 7
Check if the following have been done.You must indicate"yes"or"no"as to each of the following:
Ye�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?
`' IL Were the septic tan):manholes uncovered,opened,and the interior of the tank inspected for the condition
of the antes or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum?
_I_ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes, no
_ Existing information.For example,a plan at the Board of Health.
Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)[310 CMR 15.302(3)(b)j
5
Page 6 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 1 0 Pram Road
_Hyannis
Owner: Guy McKenzie
Date or Inspection:
FLOW CONDITIONS
RESIDENTIAL ,
Number of be sysh'`� c:�,•<-ae��'
(design): Number of bedrooms(actual):
DESIGN flow based on 310 CMR 15.203(for example: l 10 gpd x#of bedrooms):
Number of current residents: -
Does residence have a garbage grinder(yes or no): /vo
Is laundry on a separate sewage system(yes or no):^=% [if yes separate inspection required]
Laundry system inspected(yes or no): rv/1�
Seasonal use:(yes or no): ,vim
Water meter readings,if available(last 2 years usage(gpd)):
Sump pump(yes or no): ::
Last date of occupancy: cl�rre.+a'
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): Qpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):Non-sanitary waste discharged to the Title 5 syste_m(yes or no):
Water meter readings,if available:
Last date of.occupancy/use:.
OTHER(describe):
Pumping Records GENERAL INFORMATION
Source of information: tag -ham
Was system pumped as part of the inspection(yes or no):_4ej
If yes,volume pumped:i_gallons—How was quantity pumped determined? S.zcr_ oP
Reason for pumping: c. -e4,-Rr
TYKE OF SYSTEM
oV.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/Alternativc technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
—Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Were sewage odors detected when arriving at the site(yes or no): /VD
6
Ott 7 "1 11
OFFICIAL INSPECTION F0101 —NOT FOR VOLUNTARY ASSLSSNIM'S
SUBSURFACE SEWAGE DISPOSAL SY51'EA1 INSPECTION F0101
PART C
SYS'I'm INFOW1IATION(continued)
Propefly.Addr-cm. 10 Pram Road
Hyannis
Owncr: Guy McKenzie
Dale o(Inspeetlon: =j �J
1JUILWNG SEWER(locate oil site plan)
Dcpds below grade: 1`v
Malerials of construction:_cast iron —/40 PVC_uglier(explain):
Distance (run)private water supply%cell or suction line:_
Cununersts(on condition of jvutts,venting,evidence of leakage,etc.):
�< �s ivLs d Cc Gc
SEPTIC TANK: V (lot ale on site plan)
Dcpth below grade:
Material of construction: v concrete Illegal fiberglass pulyetltylene
If tank is metal list age: is age confrrmed-by a Certificat
certificate) e of Cvnryrliance (yes or nu):—(attach a copy of
Dimensions:
Sludge depth:
Distance from lull of sludge to buuum of ou11cl Ice or lsaflle:
Sewn thickness: ('P`1
Distance from top of scour to lop of outlet Ice or bank: e.v�
Distance Gom bottom of scum to bottom of outlet Icc or ba111c: - / , P �
1 low were dimensions determined: !r (
Cumnunts(un pumping recornmenJ,tiuns,inlet and outlet Ice or banic conditi a
on,sllucgur { integrity,IiyuiJ lc�cls
as related to outlet usverl,evidence of leakage,etc.):
fi•-f' ✓l .� t,:... '71s i.'tc¢�3�< [�.l t't•,�,�- .r a 1�5
Cjo—, s� r.sasr�z',
GIIEASETRAI' �(locate un site plan)
Depth below grade:
Malcrial of construction:____cuucrcle u►clal libcrgWs,pulycilt)•lcnc _other
(caplain): — —'
Dinscusions:
Scorn lhickncss:
Distance front Ipi of scum to loll of outlet Icc or ba111c:_
Distance Gom button,of3cunt to bunum of outlet Ice or bank:
Date of last pumping:
Conurtenls(oil pumping Iccununendatlulls,inlet and outlet Ice ur baflle cundiliu:I, situctural inte61ity, liquid levels
as related to oullcl invc1l,ct-idcncc of leakage,cic.):
r
)'age 8 of 11
OFFICIAL INSPECTION DORM -NOT I-OI( VOLUNTARY ASSLN N t S
SUBSUIU-'ACE SLWAGE DISPOSAL Sl'STL:A1 INSI't?C'TION 1 01(1
t'A1(1' C
SYSTEM tNFORAIATION(cunimucd)
ProperIy Address: 10 Pram Road
.Hyann—is—
Owner: Guy McKenzie
DAIC of lospectloo;
TIG11T or lIOLDING TANK: Al 'A !
(ta►sk must be !urnr rcd at time of iuspection)(lucatc vn
Depth below grade; sue),Ian)
htatetial of construction:__concrete__rrsetal
`fiber lass
6 J)UlyctJrylcmc oQrc
Dimensions: r(cx'rlain :
1 )
Capaciq;
Design glow: allurrs
Alarmm ►c gallons'day
p sent(yes or no)._
Atom level: Alan"i,,svurl,ing urdcr()•cs or nu):
Date of last pur porn g:
CununcnIs(condition of alarm and (1 val Swi klus,cic.):
DISTRIBUTION UOX:Z('f lllcscl""suss be opened loca)( Ie on site plan)
Depth or liquid level above oullct invert: £ ►+
Cokage nts(Hole if box is level and distril,u,ion sv outlets cyuat,any evidence of;vlids carryover,an cvid
Ica►,asc into or out of buz,cic.);
!•�•d� tra=s Y cntc Of
�ws �•t ���,b., cam
jA
runtP CHAMBEI(: A/
(locate o,,site ilia,,)
)'umps in working order(yes or no).:_
Alarms in srorking order(yes or no
Comments
(note Condition of pump cha,,ibcr,cu,,ditiun of puri,lrs and appu►icnanccs,cic.):
Page 9 of I I
r« .
OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 10 Pram Road
Hyannis
Owner: Guy McKenzie
Date of Inspection: 34>?
SOIL ABSORPTION SYSTEM loca 1
(SAS): ( to on site plan,excavation
p not're wired
9 )
If SAS not located explain why:
Type
caching pits,number:_
leaching chambers,number. (9
leaching galleries,number:
leaching trenches,number,length:
leaching fields,number,dimensions:
overflow cesspool,number.
innovative/altemative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,
etc.):
SE��I 1�-t� — !vp C•aPAO f
r u'rMG'l+
CESSPOOLS:N 11 (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:
Depth—top of liquid to inlet invert:
Depth of solids layer.
Depth of scum.layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or no):
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
PRIVY: (locate on site plan)
Materials of construction:
Dimensions:
Depth of solids.
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
9
Page l0 of l l
OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 10 Pram Road
Hyannis
Owner: Guy_ McKe az i P
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building.
E1
1 '
# G
-1 � �
i3•-3 v'
10
Page 11 of 11
OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 10 Pram Road
Hyannis
Owner. Guy McKenzie
Date.of Inspection: 3L`7
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water Jr feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design
ys estgn plans on record-if checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation: ry
11
TOWN OF BARNSTABLE
LOCATION A �� � "'" SEWAGE# d
VILLAGE (j ASSESSOR'S MAP&PARCEL
INSTALLERS NAME&PHONE NO. 1l ^' s °� 7 J d7
SEPTIC TANK CAPACITY I
LEACHING FACILITY:(type) (size) `D
NO.OF BEDROOMS 3
OWNER c
PERMIT DATE: COMPLIANCE DATE: (�S `"��~G
Separation Distance Between the:
i 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
s b
Q
f
t
( c
C
4
No.� ) y 75 Fei 1 00 00
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pprication for Mis;posal *p!Orm Construction Permit
Application for a Permit to Construct( ) Repair X) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address,and Tel.No. 7 71 —0 0 4 4
10 Pram Road, Hyannis Guy McKenzie
Assessor's Map/Parcel 2 68/4 5 10 Pram Road, 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
43 Triangle Cir, Sandwich
'lope of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Po)
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
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) We will install a new Title 5
leach system to plans of Eco-Tech, #ETE-2720
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 o He h.
Signed /6z Date 17
Application Approved by Date
Application Disapproved by: Date
for the following reasons
Permit No. '��j Date Issued
�r��.;,r-:,,"i�h�y�..*(�.m-r'•.,t:.�--.�y�; .r`ti-1':.rr�i°"'rn n ..r^ ,_,y+.`r.�. —v"�?t".......;�:'.i•T�>+tK..,*Y-'"�;A_,.. w... r� .�f�.,r��ln �-°"�..Tr��...i''+....tn'- . ' ., . �' .i.
�C`C -_eAj A y r
THE..COMMONWEALTH`OF MASSACHUSETTS Entered in computer:
/ PUBLIC HEALTH DIVISION -;TOWN OF `BARNSTABLE, MASSACHUSETTS Yes
01ppYitation for �Diq' oar 6p6tem Con.5truction permit
Application for a Permit to Construct O RepairX ) Upgrade O Abandon O ❑ Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address,and Tel.No. 7 71 —0 0 4 4
1,0. Pram Road, Hyannis Guy McKenzie
a Assessor's Map/Parcel 2 6 8/4 5 10 Pram Road, Hyannis
Installers 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 9 A v; 1 1c:, i43 Triangle Cir, Sandwich
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder {0)
Other Type of Building No.of Persons Showers( ) Cafeteria
Other Fixtures
Design Flow(min.required) 111✓7P?e '° gpd Design flow provided gpd
� .
Plan Date Number of sheets Revision Date'
Title
Size-,of Septic Tank Type of S.A.S. M
Description of Soil a
A
Nature of Repairs or Alterations(Answer when applicable) We will install a new Title 5
leach system to p.l-a of Eco-Tech, #ETE-2720
e
Date last inspected:
3
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 o_f Heakth.
Signed ,, Z D Date J—f
Application Approved by Date
Application Disapproved by: Date
fon'the following reasons
Permit No. ' ��� --Date Issued
——————————————————- -----------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE;MASSACHUSETTS
McKenzie Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (X ) Upgraded ( )
Abandoned( )by Wm"E Robinson Sr Septic
at 10 Pram Road, Hyannis has been constructed in accordance Q ,/
with the provisions of Title 5 and the for Disposal System Construction Permit No. .?w-7',?j 57� dated (J y' 1
Installer en Designer
#bedrooms Approved design flow Z gpL,
The issuance T f this permit shall not be o slrue a a gu rantee that the system wi tion as design
Date Inspector
l
————————————————————————————————— ———-
-'j $100.00
No. T +� Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
McKenzie
1wi,5p9al *patent Construction Permit
Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon ( )
System located at 10 Pram Road, 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: C nstruc ion must be completed within three years of the date of this, ' it �a
.
Date N Approved by
t
I_ r
Town of Barnstable P# 1/ 1 Ps
Department of Regulatory Services
Public Health Division Date Y
sue.
200 Main Street,Hyannis MA 02601
Date Scheduled k_0Time I I' Fee Pd. 0 O
'Soil-Suitability Assessment for Sewage Disposal
Performed By:_WV t_l.CD Qe i4 A-l\)y tJZ Witnessed By:
{ t
LOCATION& GENERAL INFORMATION
Location Address to Qt-q (��)m d `'t 1 Owner's Name
9 / Gam'( A1C 1<eVL/4v_
Address
i Assessor's Map/Parcel: l�fo�l 49 Engineer's Name 4 Yaoitk, off 02601
avid Covghilnt�.sO
NEW CONSTRUCTION' REPAIR Telephone# S®Ar S64 0%g4
r �00 �1f f
Land Use (G:p�nT l -- Slopes Di Surface Stones wo y e
Distances from: Open Water Body 0'� tt Possible Wet Area ^DV '+ ft Drinking Water Well Do I. ft
- -_ Drainage Way ®� A Property Line / �' ft Other ft
I
_ SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate we in proximity to holes)
g90% u� 'p0
`01
\-
10,
2
N�
0- N�
or Iv
GROUNDWATER
ER ADJUSTMENT
/ EXISTING GROUNDWATER LEVEL
TP-2 iE BASED ON TOWN OF BARNSTABLE
Q �m GIS DEPARTMENT RECORDS.
TP-1 I INDICATED GW 16.00
INDEX WELL M1W-29
ZONE C
READING DATE JULY. 2007
/ READING 8.2
\/ ADJUSTMENT 3.3
ADJUSTED GW 19.3
Parent material(geologic)! ` I QG 1 Q j O(J f nrQ�j Depth to Bedrock
Depth to Groundwater. Standing Water in Hole: "N Weeping from Pit FnCc A®h 1
Estimated Seasonal High Groundwater <'Fe q b0gV,(
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: C P P (4 D D it f `
Depth Observed standing in obs.hole: in. Depth to soil mottles:
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. 0 -
Index Well# Reading Date: Index Well levels Adj.factor-,, Adj.Groundwater level,,,e
Observation PERCOLATION TEST Dmte`blik 'ate 1t PrM
Hole# I Tlme at 9" h I I
Depth of Perc (v 7 h Time at 6"
Start Pre-soak Time® l 1"r I 71me(9"-6")
End Pre-soak
Rate MinAnch
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
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 Conseirvation Division at least one(1) week prior to beginning.
Q:SEPTICIPERCFORM.DOC
SOIL TEST L O G DATE TEST: AUGUST 200'� _ i
SOIL EVV ALUATOR: DAVID D. COUGHANOWR. R.S. j
WITNESSED BY: DONNA MIORANDI. HEALTH DEPT.
PERC NUMBER: 11695
T E S T PIT 1 NO GROUNDWATER ENCOUNTERED
PARENT MATERIAL: PROGLACIAL OUTWASH
PERC AT 62 in - 2 MIN/INCH IN C SOILS '
ELEVATION `DEPTH --,-SOIL USDA-SOIL SOIL COLOR SOIL OTHER
1 42.00 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING _
0-9 FILL ---
9-11 O LOAMY SAND 10 YR 2/2 NONE FRIABLE
11-13 - 'E - - - `LOAMY SAND 10 YR 4/1 NONE FRIABLE
13-18 A _. ._. .LOAMY. SAND-.- 10 YR 4/4 NONE FRIABLE
3900 16-36 B ' LOAMY-SAND T "` 10 YR 4/6 NONE LOOSE
31.33 26-126 C MEDUIM SAND 10 YR 6/3 NONE LOOSE
i
TEST P T T NO GROUNDWATER ENCOUNTERED
I 1 PARENT MATERIAL: PROGLACIAL .OUTWASH- -
' 2 MIN/INCH IN C SOILS
j ELEVATION
DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER
42.15 (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING
0-9 FILL
9-11 0 LOAMY SAND 10 YR 2/2 NONE FRIABLE
'11-13 E F LOAMY SAND 10 YR 4/1 NONE FRIABLE
13-16 —A- LOAMY SAND 10 YR 4/4 NONE FRIABLE
L36.15 -16-36 B LOAMY SAND 10 YR 4/6 NONE LOOSE
31.48 '26-126 C MEDUIM SAND 10 YR 6/3 NONE LOOSE
I
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.
I
a
Q
Flood Insurance Rate May:
o
Above 500 year flood boundary No_ Yes;t%
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? �S
If not,what is the depth of naturally occurring pervious material?
Certification .
I certify that on '�)Oy MJS (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 training,expertise and:experience described in 310 CMR 15.017. �H OF u4 syk
Signature k4 Date t �o� DAVID yes
o D.
" COUGHANOWR
E Q
Q:\SEPTlCVERCFORM.DOC `�O E N S
/���c EVALUP�O
To kAble
of - a-p _ semen
* .. a -. - ThAIDaS:�`.-�sel�eFj,DlrerL`toF --
ra�ss. He�l#h p si®n
.1659. -
•�eii]] Th€lllt S 6 hector
200 Main-Sheet;HyauuK MA OMI
Office: 508-862-4644 Pax: 508-790-6304
hmbdler&AgiMer Certification Form
Date J C3 Sewage-Pen" 6.1. 3 Assessor's MaplPareel 2 6 8/4 5
ti
Eco=Tech Wm E" Robinson Sr Septic
. Desigc>Eer: Installer: P
_ .. :Address:
43 Triangle Cir Addrm. PO Box 1089 -
Sandwich -Centerville
on _ . '�Gl"G� Wm. E- Robinson Sr Septic vas s•suedapemai##o.insta3la
(date) ' (insta Her)
septic system�t--:1"_0 Pram :Ra, Hyanni-s:: based on a design drawn
(address) .
Eco-Tech dated 08/10/07.
-
!�' i certify that the septic-system referenced above was insta led substantially according to
.- : :,-:-the design; which may_:.include.mrnor_agproved.c�es_such.as lateral-relocation of the.:
dittributiom box andfor septic tail.
J certify that the septic system ref+ -above vial-installed"with major changes (i.e.
greater than-"i0' lateral relocation of the SAS or any vertical relocation of any component.
_. .""of thu-septie systemybut In-s da ce with Stye&Local Regulations. -Plan-revision or
certified-as-built.by designer to follow.
r
�
rr�MASS��Az
y L _ ti-�. � rl 1 S►
a
0 S
(hBtaUet's Signature) 4� ill •
11,3.
esig e i j (_Designer's Stomp Here)
PLEASE.-.-RETURN:.TO_ .-BARNSTABLE. -PUBLIC MEALTH .DIVISION.. CERTIFICATE OF
COMPLIANCE WILL-NOT BE---ISSUED UNTEL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVMQN.-THANK YOU.
Q:HealtWSegtic/Designer Cerii#ication Farm 3=26-04.doc
s �
C0=%10X%1TALTH OF MASSACHL;SETTS
_ EXEC7MT OFFICE OF DN VIRCINA NTAL AFF.AJR.;-
_ •DEPARTMENT OF ENVIRONMENTAL PROTECTION
= O\'E t<L-M STR_r'-.BOSTON MA 0210F 16I'1 292551k-
FAWO
ECEIVE
TRL'DI' COL
Seer@:&-�
ARGEO PALL CELLUM N 17 ZOO1 Da�;�g gyp:-vc
. Governor Com.-aus:one-
SUBSURFACE SEWAGE DISPOSAL SYSTEM nwECTIONOF BARIVSTABLE
PART'A ALTH DEPT.
CERTIFICATION
Property Address.1 0 Pram R d. . Nannot Oarrlar M r K P n 7.i P
Hyannis Address of Owrtar
Date of Mspection: -.0 0--
Name of fespeetor:(Please Prin0Wm. E. Robinson Sr.
f arrr•DEP app►oved s impactor to Saedan 75.340 of T(Ne 51310 CUR 15.000)
C npwwNarne: Wm• E. Robinson tic Service
Marring Address: PO Box 10bg, C ent ery i l a MA
T.fepfwne Nuelber: �7-K�-R 7-7�'
CERTIFICATION STATEMENT
1 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 funcuon and
maintenance of on-site disposal systems. The system:
_ Passes
Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's SignetLre: 1 Date:
The System Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty (30)days of
completing this inspection. If the system is a shared system or has a design flow of 10.000 gpd or greater.the inspector and the system owner
shall submit the report to the appropriate regional office of the 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
Pair I or I I
w
o-BKR.rdd Pam-
r
SUBSURFACE SEWAGE DISPOSAL SYSTEIM NSPECTUM FORM
PART A
CE .FWATUM tcorrtiraad)
NopertyAddress: 10 Pram Rd. , Hyannis.
.Iwner: MC n z i e
Date of on: rQ o G
NSPECnON SUMMARY: Check/A,J8, C, Or D:
SYSTEM PASSES:
1 have not found any informs an which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure
criteria not evaluated are indicated below.
CO mENTS:
B. SY TE1M CONDITIONALLY PASSES:
ne or more system components as described in the'Conditional Pass'section need to be replaced or repaired. The system.upon
ompletion of the replacement or repair,as approved by the Board of Health,will pass.
Indicate ye .no, or not determined(Y.N.or ND). Describe basis of determination in all instances. If'not determined'.explain why not.
The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance lattached)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 cocked.structurally unsound.shows substantial infiltration or exfiltration. or tank
failure is imminent. The system will pass inspection ff the existing septic tank is replaced with a complying septic tank as
approved by the Board of Health.
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
The system►eouired pumping more than four times a year due to broken or obstructed pipets). The system will pass
inspection if Iwith approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
_�V1S?C 5;2/5C Page 2of11
„
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
n CERTIFICATION Icontinued) -
Property Address: 10 Pram Rd. , Hyannis
Owner: McKenzie
Date of Inspeetion:
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.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM
IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT 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 mash.
2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH RAND 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 eoliform 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 lapproximation not valid).
3 OTHER
PaRc3or11
' v
SUBSURFACE SEWAGE DISPOSAL SYSTEM!INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 10 Pram Rd. , Hyannis
owner: McKenzie
Date of Inspe rbon: �,. �e, a--
D. SYSTEM FAILS:
You ust 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 fauure
Yes o
Backup of sewage into facility or system component due to an overloaded or-clogged SAS or cesspool.
Discharge or pondmg of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or
cesspool
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool
Liquid depth in cesspool is less than 6" below invert or available volume is less than 112 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone I of a public well.
Any portion of a cesspool or privy is within 50 feet of a private water supply well.
Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no
acceptable water quality analysis. 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 YSTEM FAILS:
You must in icate either "Yes or "No' to each of the following:
T following criteria apply to large systems in addition to the criteria above:
T e 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
h alth and safety and the environment because one or more of the following conditions exist:
Yes o
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)
The owner r operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional
office of I Department for further information.
PaRt 4 of I I
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 10 Pram Rd. , Hyannis
owner: McKenzie
Date of hapection:
Check if the following have been done:You must indicate either 'Yes' or -No- as to each of the following:
Yes No
Pumping information was provided by the owner,occupant, or Board of Health.
_ None of the system components have been pumped for at least two weeks an&the system has been receiving nvrrnal flow
rates during that period. Large volumes of water have not been introduced into the system recently or as part of this
inspection.
_ As built plans have been obtained and examined. Note if they are not available with N,A.
_ The facility or dwelling was inspected for signs of sewage back-up.
_ The system does not receive non-sanitary or industrial waste flow.
7/ _ The site was inspected for signs of breakout.
All system components,excluding the Soil Absorption System, have been located on the site.
,6/ _ 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:
_ Existing information. For example, Plan at B.O.N.
_ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)
115.302(3)lb))
_ The facility owner land occupants,if different from owner) were provided with information on the Aropermaintana-ce f
Subsurface Disposal Systems.
II
r
SUBSURFACE SEWAGE DISPOSAL SYST13A INSPECTION FORM.
PART C
SYSTEM INFORMATION
rropertyAddress: 10 Pram Rd. , HyannJ6
Owner: McKenzie
Date of Inspection:
FLOW CONDITIONS
RESIDENTIAL:
Design flow: LI64' g.p.d.lbedroom.
Number of bedrooms(design): 21 Number of bedrooms factual):
Total DESIGN flow 4/S O
Number of current residents:�
Garbage grinder lyes or no):,U
Laundry Iseparate system) (yes or no):&V; If yes,separate inspection required
Laundry system inspected (yes or no!
Seasonal use (yes or no):!�d
Water meter readings. if available (last two year's usage(gpd): 1 9 9 9-2 9 8 0 24, 825 gal.
Sump Pump(yes or no!:A- 0 1 998-1 999 1 6,725 -gal.
Last date of occupancy:
CO MERCIAUINDUSTRIAL:
Type f establishment:
Design flow: dpd 1 Based on 15.203)
Basis o design flow
Grease rap present: lyes or no)_
Industri I Waste Flolding Tank present: (yes or no)
Non•sa tary waste discharged to the Title 5 system. (yes or no)_
Water eter readings,if available:
Last d to of occupancy.-
0 : (Describe!
Last to of occupancy
GENERAL INFORMATION.
PUMPING RECORDS and source of information:
ALI'-1-1114
System pumped as part of inspection: (yes or no),&
If yes. volume pumped: gallons
Reason for pumping
TYPE O SYSTEM
Septic tank%distribution boxrsoil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system Ives or no) (if yes, attach previous inspection records,if any)
PA Technology etc. Attach copy of up to date operation and maintenance contract
Tight Tank Copy of DEP Approval
Other
APPROXIMATE AGE of all-components. date installed lif known) and source of information: _1/t% t• ►—a j
33 3 W-
Sewage odors detected when arriving at the site: (yes or no)�rilJ
. SUBSURFACE SEWAGE DISPOSAL SYSTEM NSPECTION FORM
PART C
SYSTEM NFORMATION Ica+dnsud)
Address: 10 Pram Rd. , H Hyannis�Y ya is
owner: McKenzie
Drte of Inspection:
7�.-lit-o---'
BU G SEWER:
Mocat on site plan)
Depth slow grade:_
Materi I of construction:_cast iron v 40 PVC_other(explain)
Diste ce from private water supply well or suction line
Die ter
Com nts: tcondition of joints, venting, evidence of leakage.-etc.)
SEPTIC TANK:_
(locate on site plan)
Depth below grade: .
J�
Material of construction: -concrete_metal_Fiberglass _Polyethylene_othertexplain)
If tank is metal,list age_ Is age confirmed by Certificate of Compliance_ (YaS/NO)
1 '
Dimensions: '/' 'e (,, 10
Sludge depth: V r
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness: 0 57— ,
Distance from top of scum to top of outlet tee or baffle: U i
Distance from bottom of scum to bottom of outlet tee or baffler
Mow dimensions were determined:
.:omments:
Irecommendation for pumping, condition of inlet and outlet tees or baffles.dep,�of I' uid level in relation to outlet invert, structural integrity,
evidence of leakage. etc.) u� l< R x� ` T; ys
GREA E TRAP:
(locate n site plan;
Depth be. w grade:_
Material o construction:_concrete_metal_Fiberglass _Polyethylene_othertexplain)
Dimension
Scum thic ness:
Distance fr m top of scum to top of outlet tee or baffle:
Distance tr m bottom of scum to bottom of outlet tee or baffle:
Date of las pumping:
Comment
imcomme dation for pumping. condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity,
evidence f leakage. etc.)
Page 7of11
a
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION Ieeero wao
hopertyAddress: 10 Pram Rd. , Hyannis
'Owner: McKenzie
Date of Inspection:
TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or at time of, inspection)
(locate n site plan)
Depth b low grade:_
Material f construction:_concrete_metal_Fiberglass_Polyethylene otherle:plain)
Dimena. ns:
Capacit gallons
Design ow gallons day
Alarm p esent
Alarm 1 vel: Alarm in working order: Yes_ No_
Date of previous pumping:
Comm nts:
Icond ion of inlet tee, condition of alarm and float switches,etc.)
DISTRIBUTION BOX: l/
(locate on site plan:
Depth of liquid level above outlet invert: 0
Comments:
Incite if level and distribution is equal. evi eee of solids carryover, evidence of leakage into or out of box. etc.) _
PUM)osite
MBER:_
(locat plan!Pumporking order: (Yes or No)
Alarmorking order (Yes or No!ComInote ron of pump chamber. condition of pumps and appurtenances. etc.)
=e'.'_5
` Page 8 of l
SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPEC I ON FORM
PART C
SYSTEM INFORMATION(ewbril ild)
top"Address: 10 Pram Rd. , Hyannis
Owner: McKenzie
Dote of Inapeeoon:��,_/�►o t.�- /
SOIL ABSORPTION SYSTEM(SAS):v
(locate on site plan, if possible;excavation not required,location may be approximated by non-intrusive methods'
If not located, explain:
Type:
leaching pits, number:_
leaching chambers,number:_
leaching galleries,number:_
leaching trenches, number. length:
leaching fields, number, dimensions:
overflow cesspool,number:_
Alternative system:
Name of Technology:
Comments:
(note condition of soil, signs of hydraulic failure, level of onding, damp soil, condition of vegetation, etc.l
Ae
CESSPOOLS:_
(locate on site plan;
Number and configuration. `
Depth-top of liquid to inlet invert:
Depth of solids layer:
)epth of scum layer:
Dimensions of cesspool.
Materials of construction.
Indication of groundwater.
inflow (cesspool must be pumped as pan of inspection;
tsoil.
ts
dition of soil, signs of hydraulic failure. level'of'ponding, condition of vegetation, etc.)
site planiof constructionsolids: Dimensions:
s:ition of soil, signs of hydraulic failure, level of pondrng, condition of vegetation, etc.)
PAR(9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM
PART C
SYSTEM MIFORMATION feonertwdl
Nap"Address: 10 Pram Rd. , Hyannis
J--: McKenzie
Date of Inspection:
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) O
J�
9
0
P. pp
0
7
PIK te e/
PdRi.10 of 11
SUBSURFACE SEWAGE MPOSAL SYSTEM NSPECTM FORM
PART C
SYSTEM NFOORATION 11CM irNOM
jopm Address: 10 Pram Rd. , Hyannis
own.riMcKenzie
Date at kospaetion: 9 1/-6 G—
NRCS Report name
Soil Type_
Typical depth to groundwater
USGS Date website visaed
Observation Wells checked
Groundwater depth: Shallow Moderate DAP
SITE EXAM Slope
Surface water _
Check Cellar "
Shallow wells
)
Estimated Depth to Groundwater 26 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
Used USGS Data
Describe how you established the High Groundwater Elevation. (Must be completed)
7rC> 97 -3 �
e
_e . Ise" 9,'2/7E Patc11of11
TOWN OF BARNSTABLEs L�E
a <
LOCATION 16 SEWAGE � �313 -
VILLAGE ASSESSOR'S MAP & LOT �i
INSTALLER'S NAME&PHONE NO. K�c:h!ws
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) .. 1; �' (size)
NO.OF BEDROOMS d�
13UII..DER OR OWNER` C a r Itd
PERMIT DATE: 7 7�-�-c;.�Cl.. 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;-,F r.
within 300 feet of leaching facility) Feet
Furnished by s
'x �rE
. y3-
into"e
s j
w d a
.r�
No. Fee $5 0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYication for Mi!6pool *proem Cottgtruction Permit
Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
1 0 Pa�l Rtd. , Hyannis Estate of Damon Sable
Assessor's ap arce�
�j �l
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm.E. Robinson Septic Service
P O Box 1089, Centerville
Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil Sand
Nature of Repairs or Alterations(Answer when applicable) m it l e—5 S 8ptiG—Sy S t effi GGRS i S ting
of a tank, D-box and 2 1Pac-h rhamhPrc with stone all around
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 Certifi-
cate of Compliance has been iss d by ' B�d gf Heal Q
Signed b T( �ice-' Date
/ `7—C3--t°S
Application Approved by Date
Application Disapproved for the following reasons
t Permit No. Date Issued �'
No. "V 0116 0 Fee 5[)
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
ZIpplication for Mie;pozal *p!gtem Con!5truction Permit
Application for a Permit to Construct( )Repair(X.)Upgrade( )Abandon( ) El Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.
10 Pram Rd. , Hyannis Estate of Damon Sable
Assessor's Ma 2-
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
Wm.E. Robinson Septic Service
0 Box 1089, Centerville
Type of Building:
Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
` y Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil Sand
Nature of Repairs or Alterations(Answer when applicable) Title-5 septic system nonci et i nq
of a tank, D-box and 2 leach chambers with stone all around.
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 Environm ntal Code and not to place the system in operation until a Certifi-
cate of Compliance has been iss ed b and of Hea
Signed < < Date "k 7�C'!-�
,.w Application Approved by Date
Application Disapproved for the following reasons
Permit No. ^"AJ Date Issued
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Est. sable Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired (X )Upgraded( )
Abandoned( )by Wm. E. Robinson Septic Service
at 10 Pram Rd. , Hyannis as been consmjted�Pccordance
with the provisions of Title 5 and the for Disposal System Construction Pe �� dated % 61.3
m. E. Sr,b � " "
InstallerW E Robinson � � Designer .-
The issuance of this permit hal�not r e p�ons�ttrue�d as a guazanteeliat the system wPl�lsfuln�ctiorn/s as des*fined. It/�41�
Date �-,ti. l Inspector
v '
Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Est. Sable &!6pagal &p.0tem Construction Permit
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 10 Pram Rd - TI-g a n n i s
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes 's r dZty.,to
comply with Title 5 and the following local provisions or special conditions.
Provided:Cos ction must be completed within three years of the date of th 'MO.
Date:Date: /'r Approved by
i
1161"
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only. -
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS)
1, W i l l iain E. Rob ins on,s y certify that the application for disposal works
construction permit signed by me dated concerning the
property located at 10 Pram Rd Hyann; s meets all of the
Mowing criteria:
The system is connected to a residential dwelling only. There are no commercial or business
uses ass iated with the dwelling.
The soi is classified as CLASS l and the percolation rate is less than or equal to S minutes per inch.
There•re no wetlands within 100 feet of the proposed septic system
Ther are no private wells within 150 feet of the proposed septic system
The a is no increase in flow and/or change in use proposed
• re are no variances requested or needed.
• e bottom of the proposed leaching facility will no_be located less than five feet above the
.mum adjusted groundwater table elevation: [Adjust the groundwater table using the Frimptor
method when applicable)
• if the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed
leaching facility will not be located less than fourteen 114)feet above the maximum adjusted
groundwater table elevation,
Please complete the following:
A) Top of Ground Surface Elevation(using G1S information) t �
B). G.W.Elevation _ +the MAJK- High.G.W. Adjustment.
DIFFERENCE.BETWEEN A and B
SIGNED :z ' G DATE:
[Sketch proposed plan of system on backs,
y:health folder:cen
a-
c
E TOWN OF BARNSTABL
LOCATION EWAGE 00&S`-533
VILLAGE ASSESSOR'S MAP & LOT 'D R
INSTALLER'S NAME&PHONE NO. ;�-6
SEPTIC TANK CAPACITY /..S O`0 '
(size)
LEACHING FACII.TTY: (type) S C,
b
NO.OF BEDROOMS
BUILDER OR OWNER / ,3
t
PERMTTDATE: 9�`�—¢�'''U 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
i Edge'of Wetland and Leaching Facility(If any wetlands exist
within 300 feet.of leaching facility) Feet
Furrushed b
:..y
f-
,
i r
r.
•
t-;-
g .L -
s ,
J
TOWN OF BARNSTABLE
LOCATION > gCo P2,4419 IN SEWAGE # 76 7
ASSESSOR'S MAP& LOT S
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPAC DO
LEACHING FACILTI'Y: (type) f,o5lbiL/4600 (size)
NO.OF BEDROOMS 3
BUILDER OR OWNER b
PERMITDATE:q_)6'9,157 COMPLIANCE DATE: -
Separation Distance Between the:
_Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well 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
•
O
l�
i,
rt `
t
OQ
No.
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppYication for �Dig;pont *pztem Conotruction 3permit
Application is hereby made for a Permit to Construct( )or Repair( 4an On-site Sewage Disposal System at:
Location Address or Lot No �� ��� Owner's Name,Address and Tel.No.
/o P��m /LcO C�,gMM S',4 b(R-.
Gc%,)f /fie r /061 1" Sys" /D &,n 7-)5-J 5/(o
Installer's Name,AddAssDaTe3s1]I NCO Designer's Name,Address and Tel.No.
350 Main Streef /j/4
W. Yarmouth,
Type of Building:
Dwelling No.of Bedrooms - Garbage Grinder( )
Other Type of Building I-e-5. No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow 33o gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 3n3 fH I I t— / 0 a C�rg /, J`e e¢"C
4o , rJ, day_ �o q - Ln f f.44i rl 1,, lam ' zz/I ✓ 2,.-z P
vn 6ee l'' J
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 Certifi-
cate of Compliance has been issued by this Board of H th. q
Signed 0 Date 7'a�v -
Application Approved by
Application Disapproved for the following reason
l Ii
Permit No. Date Issued
i... ..,,. a<; . ..... ., .. ,._,.a . %t • ...row...-� - .. .. .. ,��p � ... .. r _ .
No. w� V „•Fee 3
y
t THE COMMONWEALTH OF MASSAC USETTS $.
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
Rppfication for Miq,00l *raem Con5tructiou 3permit
Application is hereby made for a Permit to Construct(,Z )or Repair( ✓fan On-site Sewage Disposal System at:
Location Address or Lot No Owner's Name,Address and Tel.No.
/0 ?,1A7m /1� � a�i
Oe z,f 4,717is !�o r T par Q 75-
/- /o k,4,-n 4?a0,
Installer's Name,AddreA&d B1.CIAN`O Designer's Name,Address and Tel.No.
350 Main Street
W. Yarmouth; MA 026 3' ,
Type of Building:.
Dwelling No.of Bedrooms `, r'4, '�Garlia ge Grinders(.,
Other Type of Building P e S No.of Persons ' '` —Showers( ) Cafeteria( )
Other Fixtures _ -
Design Flow 33o 4 gallons,per day.`Calculated daily flow gallons. .
Plan Date NNumber,of sheets Revision Date
Title ' �
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 2 n.5 f A 11 1- 1,o o 94 P e e f"C f/*,Vk
+13 1 t). dox 4 0 14 - =r)PjfIA4orJ 6,149 ` al-ou ce
01#1 der /
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 Certifi-
cate of Compliance has been issued by this Board of H th.
Signed 'Date
G f � Gi-a
Application Approved by ® + ` 7 ,r
Application Disapproved for the following reason
,
Permit No. 9Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Certificate of Compliance -
THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or re afire replaced(t )on
by fti7-ry for JA,erdA1 6 ,.
as /0 asbpell constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. dated
Use of this system is conditioned on compliance with the provisions set forth be ow:
No. ` Fee ?p
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Iigpool *pftem Construction Vermit
Permission is hereby granted to L ANt o
to construct( )repair( t.�Iakn On-site Sewage System located at /D /9/}7 A
} and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions. / !,
All cons c on u �e c�=pleted within two years of the date below. ? , d Q
r/7C� /'/ V� ��
Date: ` Approved by �' P) 'j Y
r.
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONS RUCTION 1'EItMIT (WI'I'110U'F DESIGNED PLANS)
CAA Vq-v r- , hereby certify that the application for disposal works
construction permit signed by me dated ' -c)- G - °Ly , concerning the
property located at 10 P AVVk cjJ� pyi— meets all of the
following criteria:
• There are no wetlands within 300 feet of the proposed septic system
• There are nb private wells within 150 feet of the proposed septic system
• The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
Q
SIGNED: L DATE: 1 -a G
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
[Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan,
this plan should be submitted].
Q,
-
350 Main St. • W. Yarmouth, MA 02673 • 775-6264
Division of Canco Energy Corporation Septic Services • Pumping • Installation
# r'� PPAMLF
2� ,
2ea2
IJ'
0t
0
10, -
to ,
Date: 9 7 O�....
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAMEOFBUSINESS: � V ,5 ��' J�►��'�'i-l��°tp CO
BUSINESS LOCATION: /0 Pr."', fzd rr O5 ®a&®►
MAILINGADDRESS: /� ®- Box /17 - W . 4!jC-"Nrs,OcrT Oa&7a Mail To:
Board of Health
TELEPHONE NUMBER: _<b 77/ - 00V`f�-0 Town of Barnstable
,CONTACT PERSON: G U 4i'/ Mw-Kejq zm_ ►z P.O. Box 534
EMERGENCY CONTACT TELEPHONE NUMBER:_(5D §D 77/ - 579-P- 3 Hyannis, MA 02601
TYPEOFBUSINESS: If L'A-C + ReZi P5.C/`a�'�i✓
Does your firm store y of the toxic or hazardous materials listed below, either for sale or for you own
use? YES NO
This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed
envelope for your convenience.
If you answered YES above, please indicate if the materials are stored at a site other than your mailing
address:
ADDRESS: to VWN OA(00I
TELEPHONE: CS02) 771 - ® O'f`t
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health has determined that the following products exhibit toxic or hazardous character-
istics and must be registered regardless of volume. Please estimate the quantity beside the product that
you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS.
Quantity Quantity
Antifreeze(for gasoline or coolant systems) Drain cleaners
NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salt (Halite)
Hydraulic fluid (including brake fluid) f�®Z Refrigerants
Motor oils Pesticides
NEW USED (insecticides, herbicides, rodenticides)
Gasoline, Jet Fuel Photochemicals (Fixers)
Diesel fuel, kerosene, #2 heating oil NEW USED
Other petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil NEW USED
Degreasers for engines and metal Printing ink
Degreasers for driveways & garages Wood preservatives (creosote)
Battery acid (electrolyte) Swimming pool chlorine
Rustproofers Lye or caustic soda
Car wash detergents Jewelry cleaners
Car waxes and polishes Leather dyes
Asphalt & roofing tar Fertilizers
Paints, varnishes, stains, dyes PCB's
Lacquer thinners Other chlorinated hydrocarbons,
NEW USED (inc. carbon tetrachloride)
Paint & varnish removers, deglossers Any other products with "poison" labels
Paint brush cleaners
(including chloroform, formaldehyde,
Floor& furniture strippers hydrochloric acid, other acids)
Metal polishes
Laundry soil & stain removers Other products not listed which you feel
(including bleach) may be toxic or hazardous (please list):
Spot removers & cleaning fluids
(dry cleaners)
Other cleaning solvents
+l
Bug and tar removers
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
f
ALL PIPE SPECIFIED ARE
E L_O W PROFILE EXPRESSED INV DATIONS ECIMAL FEET NOT FEET ANDT INCHES.TIONS
TOP OF FOUNDATION RAISE COVERS TO WITHIN SIX INCHES OF FINAL GRADE
EL = 43.46+- ONE INSPECTION RISER FOR LEACHING GALLERY TO
WITHIN 3 INCHES OF FINAL GRADE AS INSPECTION PORT.
42.25
D-BOX 3 Ft ALL PIPE TO BE
SCHEDULE 40 PVC
3" DROP MAX AND TO PITCH AT
FLOW LINE TEE 39.75 1/8 in/ft MIN.
10" - 14'
48" GAS�� PRECAST
BAFFLE DRYWELL
6 in BOTTOM OF
39.TING STONELEACHING GALLERY
LEACHING
EXISTING EXISTING BASE 39.13
EXISTING 39.30 GALLERY
EXISTING 1000 GALLON 39.00 (END VIEW) 37.00 5.00 Ft +
SEPTIC TANK SEE DETAIL ON REVERSEF EXISTING 1 Ft al 11.5 t 9.8 Ft
bl 6.3 Ft
ADJUSTED SEASONAL y 19.3
t3 nr-n�-gym
oo co� m-I o 3 0~ HIGH GROUNDWATER
= Z � zny �m-Ipm-�i Z
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ZO7�O:KM Z V z
SOIL TEST LOG DATE V TEST: AUGUST 2007 A SELLING IS SERVED BY TWO SEPARATE SYSTEMS.
SOIL EVALUATOR: DAVID D. OUGHANOWR. R.S. DESIGN C J \rL G U L A T I 0 N S SYSTEM
BEDROOMS PIS ROPOSED TO SYSTEM TO STHE FLOW
WITNESSED BY. DONNA h)IORANDI. HEALTH DEPT. SOUTHEAST IS TO BE DESIGNED FOR 1 BERDOOM AND
PERC NUMBER: H695 DESIGN.. FLOW: 1 BEDROOMS X 110 GPD = 110 GPO SIZED FOR A MINIMUM OF 3 BEDROOMS PER TITLE 5.
TEST PIT 1 NO GROUNDWATER ENCOUNTERED SEPTIC TANK: HO GPD X 2 DAYS = 220 GALLONS
PARENT MATERIAL: PROGLACIAL OUTWASH USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL
PERC AT 62 In - 2 MIN/INCH IN C SOILS CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED)
ELEVATION DISTRIBUTION BOX: USE 3 OUTLET D-BOX.
DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER(INCHES) HORIZON TEXTURE (MUNSELU MOTTLING SOIL ABSORBTION SYSTEM: A 13.5 F' x 9.B3 F t x 2 f t LEACHING GALLERY CAN LEACH
42.00 A6ot = ( 9.83 x 13.5 ) = 132.71 sf
0-9 FILL Asdw = ( 9.83 + 9.63 + 13.5 + 13.5 ) x 2 = 9 3.3 2 sF
9-11 O LOAMY SAND 10 YR 2/2 NONE FRIABLE Atot = 226.03 sF
Vt 0.74 x 446 = 167.26 GPD
11-13 E LOAMY SAND 10 YR 4/1 NONE FRIABLE USE TWO 9.63 Ft x 13.5 Ft x 2 Ft. GALLERIES. Vt = 334.52 GPD > 110 GPD REQUIRED
13-1B A LOAMY SAND 10 YR 4/4 NONE FRIABLE
39.00 18-36 B LOAMY SAND 10 YR 4/6 NONE LOOSE
26-128 C MEDUIM SAND 10 YR 6/3 NONE LOOSE 1000 GALLON SEPTIC TANK
31.33 LEA CHII�LG GALLERY DIMENSIONS AND DETAIL NOT TO
USE SHOREY PRECAST 500 GALLON NOT TO USE EXISTING H-10 UNIT SCALE
NO
GROTUNDDWATER ENCOUNTERED OUTWASH LEACHING DRYWELL lH-10 LOADING) SCALE
TEST PIT
2 MIN/INCH IN C SOILS CONSTRUCTION DETAIL ATP IME OF INSTALLLC TANK IS TOB PUMPED D ATIONAND IS TO
BE EXAMINED FOR STRUCTURAL
ELEVATION
DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER DRYWELL UNIT INTEGRITY. INSTALL NEW PVC OUTLET
U
42.15 13.5 Ft
(INCHES) HORIZON TEXTURE (MUNSEL MOTTLING STONE TEE EOUIPPED WITH A GAS BAFFLE.
0-9 FILL Ln j 1 In
9-11 O LOAMY SAND 10 YR 2/2 NONE FRIABLE N TAPER
�
11-13 E LOAMY SAND 10 YR 4/1 NONE FRIABLE 4 0 Q
13-18 A LOAMY SAND 10 YR 4/4 NONE FRIABLE m
of o ao
38.15 18-36 B LOAMY SAND 10 YR 4/6 NONE LOOSE 0
N�
26-126 C MEDUIM SAND 10 YR 6/3 NONE LOOSE
31.48 2.5 Ft B.5 f t .5 f t / Ln
13.5 F t 1�
�1
GROUNDWATER ADJUSTMENT BIn Q
EXISTING GROUNDWATER LEVEL 500 GALLON DRYWELL
BASED ON TOWN OF B A R N S T A B L E DIMENSIONS AND DETAIL INLET OUTLET
GIS DEPARTMENT RECORDS. COVER COVER
USE H-10 UNIT
INDICATED GW 16.00 INSTALL ONE INSPECTION 3 IN DROP
INDEX WELL MIW-29 RISER TO WITHIN THREE -> Il -FLOW LINE
INCHES OF FINAL GRADE FROM -�
ZONE C AND INDICATE LOCATION BUILDING 10 in = 14 TO
READING DATE JULY. 2007 ON AS-BUILT PLAN in D-BOX
in
READING 8.2 48LrourD GAS
ADJUSTMENT 3.3 LEVEL BAFFLE
ADJUSTED GW 19.3
00 33
1�Ir,
omoo0 �0NOTES 0[: CROSS SECTION VIEW
1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK.
2) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED 1021n
FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE.
3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS CROSS SECTION VIEW
OF MASSACHUSETTS TITLE 5 SEPTT.C: .CODE (310 CMR 15).
4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES' 2 1n PEASTONE 2 in PEASTONE SEWAGE DISPOSAL SYSTEM PLAN
BEFORE EXCAVATING FOR SYSTEM. ,
5) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES' AND'i- DUST•-IN PLACE. 24i, C -TO SERVE EXISTING DWELLING
+ 28w
EFFECTIVE 4 u, TO 26) ECO-TECH ENVIRONMENTAL RECOMMENDS THE- INSTALLA•TI'ON OF .LOW FLOW' FIXTURES In DEPTH 1-1121 GAVEL
1n GUY McKENZIE, JR
AND APPLIANCES. AND BIANNUAL PUMPING..OF THE SEPTIC TANK`.' ; , • ;
10 PRAM ROAD HYANNIS. MA
7) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT • � 30 In 56 in 30 in
PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. `,
11 EEO-TECH ENVIRONMENTAL
81 SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE •,O AN APPROVED A 'LEVEL INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE
STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED 'A'ND ,ON TO WHICH FABRIC IN PLACE OF THE 2 in. PEASTONE LAYER SPECIFIED. 43 TRIANGLE CIRCLE SANDWICH MA 02563
SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING.
ETE-2720 AUGUST 10. 2007 1 1212