HomeMy WebLinkAbout0020 PRINCESS PINE ROAD - Health 20 Princess Pine Road
Hyannis F/R
A = 269 087'
b
• TO OF B TABLE �t. /� i r� `
LOCATION I N ' �+�-� i SEWAGE �Cl V` Y
VILLAGE ASSESSO & L0&a
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY t\; ec " S M
LEACHING FACILITY: (type) 1'14 7:1, t.TluiG (size)
NO.OF BEDROOMS _
BUILDER OR OWNER �1 V' r ►2
PERMITDATE: U� COMPLIANCE DATE: S
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
0
I
TO OF B TABLE .G �/
LOCATIOND i,/V VVM1�_ i SEWAGE 7 � 7
VILLAGE cam, ASSESSO & 1,05469—ZZ?
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY e--:-i
LEACHING FACILITY: (type) 1iti-L' L�li�✓�(size) �X�C� /
NO.OF BEDROOMS _
t BUILDER OR OWNER
B
PERMIT DATE: y I UN COMPLIANCE DATE:
I` Separation.Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility.(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furbished by
a
0
{ C�6, cW/4
k
A.
L� �r
No. 1 FEE
COMMONWEALTH Of MASSACHUSETTS
Board of Health, MA.
APPLICATION FOR DISPOSAL SYST[M CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair�Jpgrade( ) Abandon( ) - ❑Complete System)<Individual Components
Location Owner's Name
Map/Parcel# 2, el IAddress
Lot# Telephone#
Installer's Name S - Designer's Name n h
Address git, Address l)- -0 0
Telephone# Telephone# J46 Z) (-
Type of Building Lot Size T1403 sq.ft.
Dwelling-No.of Bedrooms 1E�C,�2Q J� Garbage,grinder
Other-Type of Building YV GCISL No.of persons Showers ( ),,Cafeteria
Other Fixtures �LC�JQ-�,o(� �'�G�n 1�tee mr in ,
Design Flow (min.required) `,,�C� gpd Calculated design flows ICJ Design flow provided 3 ?i�gpd
Plan: Date f Number of sheets Revision Date`t
Title U T
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS cr,
The undersigned agrees to ins bove described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further a not to the sysik eration until a Certificate of Compliance has been issued by the Board of Health.
Signed Date
DG - .
t
Inspections
J
`.�ii.-.�i✓`tt.:�-1:-2p`4t.+yA3�+++rr-��titlR'"t-r+'P.w.Yti-+„tY.'-t"^-^r.i��+.�rs�,.+�►�-..►�.1'''i'....,f'r-.^'�..
No. �oU �t FEE 5V i
Board of Health, PAS' , MA.
APPLICATION FOP, DISPOSAL SYSTEM[ CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repair
Upgrade( ) Abandon( ) - ❑Complete System 4ndividual Components
Location a?j i��� ,�Q �t< Owner's Name � ��
Map/Parcel# 64 `-) Address ��r
Lot# Telephone#
Installer's Name 5W �S C 1G2 Designer's Name �� nvvz-of)p z, SjC
Address s 19-1W TDA 5 Address"_?v,
Telephone# f Telephone# 59 _a'�
Type of Building Lot Size /� J'�03 s ft.
q
Dwelling-No.of Bedrooms -�cw �� J Garbage grinder�f•
Other-Type of Building No.of persons O� Showers
�(Cafeteria't )
R Other Fixtures . Looa-Vac,\ kt idG � rs t rx,nckC'L.,., ! `,
... I U
2 ell
,Design Flow(min.required) gpd Calculated design flow GJ Design flow provided �5'D, gpd
Plan: Date Number of sheets �-+ Revision Date /
Title o t� l U0 (A �^ C t Ju.S U . CCA�e 'y
Description of Soil(s) CCI46 P v '
r �
Soil Evaluator Form No. r-- Name of Soil Evaluator (X.>;' rl qt)� Date of Evaluation3129
07
DESCRIPTION OF REPAIRS OR ALTERATIONS 5e4 Ab cu.
� J
The undersigned�agrees to ins the. bove described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and_
further a- ee to not to prac the sys a ih o eration until a Certificate of Compliance has been issued by the Board of Health.
--Signed 1,, A Date 1
\ , & LIT
L
Inspections . <
k �
No. W!- FEECOMMONWEALTH Of MASSAC14USETTS 5iP
Board of Health, 0,Y-#J5k`� _ MA.
'CERTIFICATE OF COMPLIANCE
Description of Work: 'Individual Component(s) ❑Complete System
The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded (Abandoned ( )
by: r>,p,�r
at caZ.t'S `�r 1/\l CS.� ��NL:. K.O +rJ �l A"rj,c C
has been installed in acc rd n�je with the r¢viJsion of 310 CMR 15.00 (Title 5) and the approved design plan s/as-builtylan s relating to
application No. � ��y/, dated �/(!(� �7 . Approved Den Flow\ (gpd)
sig
r �
Installer r"\ ,�� N r
Designer: Inspector: Y )(/1 �1X. K4 _ c7`'3'�� KJ_ Date:
The issuance of this permit shall not be construed as a guarantee that the system will function as designed..-
No. I ! y i FEE ai`t✓J� _
COMMONWEALTH OF MASSAC14USETTS
Board of Health,_ 7A `ti� ' MA.
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby granted to; Construct( ) Repair( )Q�Upgrade(4')'Abandon(-. ) an individual sewage disposal system
at C*jj CINK e /
� tl )u-9- UCS1< < as described in the application for-
Disposal System Construction Permit No. W 7'V, dated qllbtll
Provided: Construction shall be completed withi three years of the date ehis e.� it. All loc 1 conditions must be met.
Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date ,i/O Board of Health U �_
Town of Barnstable
oFt"E r°'y Regulatory Services
Thomas F. Geiler,Director
• BA PI ft BLE,
v� MASS. Public Health Division
163.9. �0
'°le° gip Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date:
Designer: � \ Installer: � S
Address: Address: `rj
On S2pk-�(- was issued a permit to install a
(hate (installer)
septic system at c20 �C>C25j ��re based on a design drawn by
(address)
&L>Q>J)M"T\r1_k dated
signer)
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow.
OF t,fgSs9c�
o� CAWvIEN
( staller's Signature) �� E.
SHAY Ny
No. 1181
0
GISTS
(Designer's Signature) (Affix Desi d Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. :`
THANK YOU.
Q:Health/Septic/Designer Certification Form
j S�,P - 20-01 13 : 52 BARNSTABLE HEALTH DEPT 5087906304
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
PERCOLATION TEST AND SOIL EVALUATION EXEMPTION
FORM
a,n—►� Stk-RY -, hereby certify that the engineered plan sio ed by me
concerning the property located at
rneets all of the
l:owing c:ntena�
• This failed system-is connected to a residential dwelling only. There are no
:orvnerci3.! or business uses associated with the dwelling,
• T'.e soil is ciass:t:ed as CLASS 1 and (he percolation rate is less than or equai to
-
n:nu(es per !rich. The applicant may use historical data to conclude (his f3c; Or may
:onduct tests at the site without a health agent present
• There :s no Increase in now and/or change. in use proposed
T here a:-e no variances requested or needed.
. The- bo(torn of the proposed leaching `aciI ty will not be located less than fourteen
14, %ee; a00ve the maximum adjusted groundwater (able elevation. f AdJlust the
TnundIwater table using the Frimptor method when applicable)
Please complete the following:
)I CrOun(+ Surface Elevation (using GIS information)
5, C � E leva(:on �— zd,us(men( for nigh G.W. • =Cis
_)'FT=FRFN(_F. BETWEEN and B
S.G. lED _ DATE;
NOTICE
3asec u-()rt t^c above ir.formacion, a rroair pemt wil! be issued for -)edroorr
ddtuonai bedrooms ue authorized to (he future without en,tneerec
-:e sys(ern plans.
1raih!r,:Oci pa cc.im9
�1 +
Permit Number: Date:
Completed by:
HIGH GROUNDWATER LEVEL COMPUTATION
Site Location: OCO �f+t1GPS5�ic1P "R `I 1 4rlrlt,Z� Lot No.
Owner: Address: (
Contractor: Ff)u, �JC,� Address:- (MDV+6 ,(/ A 2536
Notes:
�y
STEP 1 Measure depth t water table f _s 4
tonearest 1/10 t. .............................................................................. .Date
month/day/year
STEP 2 Using Water-Level Range Zone
and Index Well Map locate
site and determine:
OAppropriate index well.................................................... LM R
OWater-level range zone ..................................................... C
STEP 3 Using monthly report "Current
Water Resources Conditions"
determine current depth to r
water level for index well ...........................
mon h/year
STEP 4 Using Table of Water-level Adjustments
for index well (STEP 2A), current depth
to water level for index well (STEP 3),
and water level zone (STEP 28)
determine water-level adjustment
STEP 5 Estimate depth to high water
by subtracting the water-
level adjustment (STEP 4)
from measured depth to water
level at site (STEP .1) ........r.........................................c.............................................
............. a3�6
I,
Figure 13,--Reproducible computation form.
15
- FAILED INSPECTION
V
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
MAP Z
PARCEL
LOT
TITLE 5
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
SS
Property Address: 20 Prince Pine Road
Hyannis, MA 02601
Owner's Name: Deb Poirier
Owner's Address:
Date of Inspection: February 14, 2004
Name of Inspector:(Please Print) James M. Ford
Company Name: James M. Ford, FEB 2 6 2004
Mailing Address: P.O. Box 49 rOwN OF
Osterville,MA 02655-0049 yE,qLTHgDEpTgglF
Telephone Number: (508)862-9400
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system:
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
✓ ils
Inspector's Signature: Date: February 19, 2004
The system inspector shall su t a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time. This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 20 Prince Pine Road
Hyannis,MA
Owner: Deb Poirier
Date of Inspection: February 14, 2004
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
I have not found any information which indicates that any of the failure criteria described in 310 CMR
15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass"section need to be replaced or
repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please
explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
2
Page 3 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 20 Prince Pine Road
Hyannis, AM
Owner: Deb Poirier
Date of Inspection: February 14, 2004
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system
is failing to protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety and the environment:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
_ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
3
Page 4 of 11
i
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 20 Prince Pine Road
Hyannis, AM
Owner: Deb Poirier
Date of Inspection: February 14, 2004
D. System Failure Criteria applicable to all systems:
You must indicate either"yes"or"no"to each of the following for,all inspections:
Yes No
✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than'/s day flow
✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number .
of times pumped—
✓ Any portion of the SAS,cesspool or privy is below high ground water elevation.
✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
✓ Any portion of a cesspool or privy is within a Zone 1 of a public well.
✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well.
✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.]
No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large System:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
gpd•
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
Yes No
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped
Zone R of a public water supply well
` If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes"in Section D above the large system has failed. The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR
15.304. The system owner should contact the appropriate regional office of the Department.
4
Page 5 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 20 Prince Pine Road
Hyannis,MA
Owner: Deb Poirier
Date of Inspection: February 14, 2004
Check if the following have been done: You must indicate`yes"or`no"as to each of the following:
Yes No
✓ Pumping information was provided by the owner,occupant,or Board of Health
✓ Were any of the system components pumped out in the previous two weeks?
✓ _ Has the system received normal flows in the previous two week period?
✓ Have large volumes of water been introduced to the system recently or as part of this inspection?
✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
✓ Was the facility or dwelling inspected for signs of sewage back up?
✓ Was the site inspected for signs of break out?
✓ Were all system components,excluding the SAS,located on site?
✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition
of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum?
✓ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes No
✓ Existing information. For example,a plan at the Board of Health.
✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)[310 CMR 15.302(3)(b)].
5
Page 6 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 20 Prince Pine Road
Hyannis, MA
Owner: Deb Poirier
Date of Inspection: February 14, 2004
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms(actual): 3 ,
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330
Number of current residents: 3
Does residence have a garbage grinder(yes or no): No
Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required]
Laundry system inspected(yes or no): No
Seasonal use(yes or no): No
Water meter readings,if available(last 2 years usage(gpd)): Unavailable
Sump Pump(yes or no): No
Last date of occupancy: Currently occupied
C OMMERCIALANDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): apd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no)
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information:Pumped in 1999-per owner
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped: _gallons--How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
✓ Septic tank,distribution box,soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no) (if yes,attach previous inspection records,if any)
Innovative/Alternative technology. Attach a copy of the current operation and,maintenance contract(to be
obtained from system owner)
Tight Tank Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Installed 3123195-per as built card
Were sewage odors detected when arriving at the site(yes or no): No
6
Page 7 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 20 Prince Pine Road
Hyannis, MA
Owner: Deb Poirier
Date of Inspection: February 14, 2004
BUILDING SEWER(locate on site plan)
Depth below grade:
Materials of construction: _cast iron _40 PVC _other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK: ✓ locate on site plan)
( P )
Depth below grade: 32"
Material of construction: ✓ concrete _metal _fiberglass _polyethylene
_other(explain)
If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of
certificate)
Dimensions: 1000 gal.
Sludge depth: 2"
Distance from top of sludge to bottom of outlet tee or baffle: 30"
Scum thickness: 6"
Distance from top of scum to top of outlet tee or baffle: 8"
Distance from bottom of scum to bottom of outlet tee or baffle: 10"
How were dimensions determined: Measuring stick
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
Tees were present. The liquid was even with the outlet invert. There did not appear to be any signs of leakage.
GREASE TRAP: None (locate on site plan)
Depth below grade:
Material of construction: _concrete metal _fiberglass _polyethylene _other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
7
Page 8 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 20 Prince Pine Road
Hyannis, MA
Owner: Deb Poirier
Date of Inspection: February 14, 2004
TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: Above
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.):
liquid was above outlet invert.
PUMP CHAMBER None (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no)
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
8
Page 9 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 20 Prince Pine Road
Hyannis, AM
Owner: Deb Poirier
Date of Inspection: February 14, 2004
SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required)
If SAS not located explain why:
Tyler
leaching pits,number: 1-4'x 6'(600 Qal.)
leaching chambers,number:
leaching galleries,number:
leaching trenches,number,length:
leaching fields,number,dimensions:
overflow cesspool,number:
Innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,
etc.):
The leach pit was full. The liquid was above the inlet pipe and up to the top of the pit. The bottom to grade was 7'.
CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:
Depth-top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or no):
Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
PRIVY: None (locate on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
9
Page 10 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 20 Prince Pine Road
Hyannis,AM
Owner: Deb Poirier
Date of Inspection: February 14, 2004
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.
QAC� B,
A
a
a- ay 3°1
O
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: 20 Prince Pine Road
Hyannis,MA
Owner: Deb Poirier
Date of Inspection: February 14, 2004
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked, date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
✓ Checked with local Board of Health-explain:
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
The bottom of the leach pit to grade was 7. Using the Barnstable topographic map and the water contours man. The maps
are showing approximately 25'+1-to groundwater
This report has been prepared and the system inspected and failed as of the date of inspection. This report is
not a warranty or guarantee that the system will function properly in the future. There have been no warranties
or guarantees,either expressed,written or implied relating to the system,the inspection and/or this report.
11
TOWN OF BARNSTABLE
LOCATION ,,2 O 1 is ) 1,,C d S' .S I ic• SEWAGE #
VILLAGE /^f ASSESSOR'S MAP & LOT4?i f—.40 9 7
INSTALLER'S NAME & PHONE NO.
{SEPTIC TANK CAPACITY /G 0--
LEACHING FACILITYAtype) + �/ (size)
It ,.
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATE"A
BUILDER OR OWNER .d �
DATE PERMIT ISSUED: S
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No �/
Ch 3
n�
A
�t
�,r M
,r ;
ASSESSORS MAPNO• --�-
No.... PARCEL FE.B 3 Q.... �.........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
TOWN OF BARNSTABLE
, pphration for Di_aipmial Workii Tontitrurtion Urrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( >j an Individual Sewage Disposal
System at: 4
....20 Princess.Pine--.Rd..Hy..nni......----•---.... ------------------------------•---•-......................••••-•......
- -
Location-Address or Lot No.
Debra Ratliff
......................_.......................................................................... --•-•----•------••--••-•••-----------•.....----------•------------•--........--•--..........-•----
Owner Address
W W.E. Robinson Septic Service .. P.O. Box 1089 Centerville
Installer Address
PQ
d Type of Building Size Lot-----..---_-_-----------Sq. feet
Dwelling— No. of Bedrooms....3----------------------------_-.-.._Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons...._..........._........... Showers ( ) — Cafeteria ( )
p' Other fixtures ..-_-••-------------- •-----•- - -
W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons.
1:4 Septic Tank—Liquid capacity------------gallons Length-----------..... Width................ Diameter_............. Depth................
W Disposal Trench— No. .................... Width.__....._.........._ Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---------............ Diameter----------.......... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by------- ------------------------------------------------------------------ Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water............._..........
Li, Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................
9 •----•••-•---------------------•---•------......••••••••-•-•••••-•-•--------•-......----------..-•--.........................................................
0 Description of Soil....................sand........................................................................................................................................
x
V ........................-•--•---------•--•---------•---------------------------------------------•-•-------...---...----------------...--------------------------------------------------•••-••--•---••
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
VNature of Repairs or Alterations—Answer when applicable..instal_1---a--2nd___stonepackpd__.leachpit
-----------------------------------------------------------------------------------------------••---•--•-•-••-•------------•---------• -•-•••-••--------------------------•--••---••---..............__.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has be�issdh board of health.
�
p�,Signed �---- lo -- -- --------�e
Application.Approved By -----C/ r 17 ---- ---------------------------- v .................................... ... ._` ......��
Dace
Application Disapproved for the following reasons: ....................................:
............__................._.------------------ ------------------- -------- ----...------------............. ........------------.......-------.. .......-- ---
QDace
Permit No. ......!-.S 1. .��-- -------------------- Issued -------------- a.�. �� -------
Dace
t�
No....9 _� 1� �� F>�$...X.I.D 0.........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Digpoti tl World C owitrnrtinn Permit
Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal
System at:
20 Princess Pine Rd HY annis
--....--•-•---..•....-•------------------------------------------ -------..........--•--------- ------------------------------•----- .............................................................
ocation-Address or Lot No.
Debra Ratlif
......................-.......................................................................... -----------••-----------•-••-------•-----•----•---•---......-•---•............----•-............--
O«ner Address
W W.E. Robinson Septic Service P.O. Box 1089 Centerville
a --•-•••••--•....•••••--•-•...•-------------------•-•••-••-•----•------••-••••--••-...--•- -•-----•-----•---------------------------••-••-••--•-----•-•---•-..................................
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms._..3_____________________________________Expansion Attic ( ) Garbage Grinder ( )
aOther—Type
of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
dOther fixtures ..........--------------------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow----------------------_........_............gallons.
Ra Septic Tank—Liquid capacity_-_.___---gallons Length---------------- Width-.--..-_-___.--: Diameter-__-.___.-._..- Depth----------------
W Disposal Trench—No. .................... Width.................... Total Length-------------------- Total leaching area....................sq. ft.
x
Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by----------_- ----------•---•--•-•-•-----•-------••---•---------••-•--•-•- Date.... ..................................W
a Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water-.--____-.----_-_.--.---
fi Test Pit No. 2................minutes per inch Depth of Test Pit_................. Depth to ground water........................
a --------------------------------------------------------------------------------
•-------------------
---------------------------------
•-----------------------
Descriptionof Soil--------------------.sand........................................................................................................................................
x
W
x ---------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------
U Nature of Repairs or Alterations—Answer when applicable.-install-- a.. 2nd---stonepaCked.... e cbpit
----------------------------------------------------------------------•-•-•••-•----••-•-••-•---•••-••-•--•--•---------------....-----•••--•••--------••-••...-----•-•-•---••-•------•-•--•-••-•...•-•-•-
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has been is d by the board of health.
g
Signed i..-7. ............ ..:l/.-- ----- :......
Application.Approved By ...��'�,--- /..�( ,/ ---------------------- ------- -- -- ---`�
.......... ......
n Dace
Application Disapproved for the following reasons: . .... .. .... ............_........ ............................ .. .................... .
r `
Dace
Permit No. ----. .f......... .......... Issued ..............oly-..- .�----- f� .........
Dace
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH `
TOWN OF BARNSTABLE
Cner#ifirate of Cnumplianre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x )
b W E Robinson Septic - .... -..... -
Y - ---
20 Princess Pine Rd Hyannis Insmiler
--------------------- -------------------- ------
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ..._.............. dated _X77'_02-.2.._—I� ' _'..-
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THA�&E
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.
� ..........` ' ��. _.... _ ... ------ Inspector- �� �%' ✓- �-........ �%-%'--- --- ---
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
S�;. �sf TOWN OF BARNSTABLE 30.00
No.......
......• •-•..---• FEE..... .............:.
Dispopal World Tumitrurtion "anti#
W.E. Robinson Se tic Service
Permission is hereby granted............................................ •------•----. ----------------------------------------••--•..........---
to Construct ( ) or Repair ( an Individual Sewage Disposal System
atNo..... 20...Princess...Pine--Rd---Hy._arin-is------------------- --- ------------------------------- --------- ------- ----------------------------
Street _
as shown on the application for Disposal Works Construction Permit �. --- /a�d _� .-''._a�---1�5
--•----- ----------------�/•�� ------------••.--
_ Board of Health
DATE............... -/Q�
------
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
1
1
�tlnlvD ,
SECTION A A; t�
NO PIPES ARE TO BE, SCHEDULE 40°P.V.C. 5
• - 10 min. from TE, ALL E ALL WTtET PIPES FRaM THE
«. o x SYayr,99 Ry ^,
a
.- , ..PT OFILE VIER::OF .ADDITION:TO,-..LEACHING. SYSTEMSOX
DET LE M F R A Si1A11..6E ! ,
Exk roundntlan �house, o tic.tank _ ._. . - d^ ...._Hn0 sep12 *r
CONCRETE CO SET LEVEL FOR AT LEAST FT. VER
a
_
e Septic tank.coV�ra enuat b• , , _ ,- >'. 3 of 1 B -.t 2 Woeh _-: a
TOP nr iTAN1LATTDN EtEV>,coca<Assu+efi 1 / ed Pwston -
tirRhin B in. of fNAel9ed ode - � � z • +:. Enn LA -
9r
3 4 to 1 1 2 Washed Crushed Stonb r-,
Y
Grade over Sgtk Tank � 94.00 Grade over D-9ox-92.00 o�rr SAS- D200 / / .•' 3-S'OUTLET y r'�-•.•c., _ '� $ g y"
KNOCKOUTS
`. PYC(CAPPED)INSPECTION PORT TO 6E ._.:..- S.S: T + OUTLET 12 MET ,
$ 0.02
MIS ALLED AM TO BE V47MN B OF GRADE , - cp?v
„ 3 HOLE H-t0
L
..: . T Load-�'ENv. =69.
.,
EXIST. s=o.ot asT. Box s' ►tmdmw++ corer so
N 10 or Greater Top of SAS-Elev. -39.00 ` ::• -° 2 �IMtefs FAW _...
txdcr. fII+E 1,000 GAL
5- O.ot per foot or greater
a a
to pp 20 18 6
FRON EXIST.FOLOMTION w 'SEPTIC TANK N`: 0 EffeetM Depth 4 SCH 40 T t.TS . : d �E
F�°
r 0 5 Units a 6.25 3W PLAN SECTION CROSS-SECTION #:
cdNCRETE TtRl rouHn�TKst-� N o N s �
d u > al
ao 0.83 .(10 inches)
me aD
B Inaf 3/4-, I/2". r a r t 7. 3 HOLE N-10 DISTRIBUTION BOX .
SYSTEM PROFILE , 0 3 25 + ,
c compacted atone ; • m m Effective,Length NOT TO SCALE
Not to Scale u - wo
• 4' 4. a,' SOIL ABSORPTIONtaos + +or1acn. ew.pT«a. ,�.:n
SYSTEM (SAS)
B in.ot 3/4'-1 t/2' 10' u INFILTATROR .HIGH "CAPACITY (H-10 LOADING)/ GEORGE ❑'BRIEN GENERAL NOTES
compacted .cake Effecthn vaa, OR EQUIVALENT Not;to Scale
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE o m ( ) 1 Contractor is responsible for Digsafe notification
Bottom of Teat Hole 1 Elev.-81.00 NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18' /EFFECTIVE HEIGHT IS 10' and protection of all underground 'utilities and pipes.
-- 2. The septic tank an distribution box shall be set
�Obs. Groundwater - Test Hole 1 Elev.= NONE OBSERVED level on 6" of 3/4 -1 1/2" stone.
3. Backfill 'should be clean sand or'gravel with no
stones over'3" in size.
4. This system is subject to inspection during installation
by Carmen E. Shay - Environmental Services, Inc.
' c 5. The contractor shall install this system in accordance `
PERCOLATION TEST with Title V of the Massachusetts state code, the approved plan
and Local Regulations.
Date of Percolation Test: MARCH 29,"2004 LOT #87 6. If, during installation the contractor encounters any
Test Performed By: CARMEN E. SHAY, R.S., C.S.E. LOT 86 soil conditions or site conditions that are different
Results Witnessed By. WAIVER (per BARNSTABLE B.O.H.) LOT #88 # from those shown on the soil log or in our design
Excavated By. SHAY'ENVIRONMENTAL`SERVICES, INC. installation must halt & immediate notification be
Percolation Rate: Less Than <2 MPI made to Carmen' E. Shay - Environmental `Services, Inc.
3r` �� c 0 7. No vehicle or heavy machinery shall drive over the
\ \ \ N 76d 17' 50" E septic system unless rioted as H-20 septic components.
Test HolePL
8. Install Tuf-•rite gas baffles or equals on all outlet tee ends.
No. 1 \\\ \\ 1,25.00' \` 9. All `Distribution Lines "shall be 4" diameter Schedule 40 NSF PVC pipes.
DEPTH saLs ELEV. Failed �`\ f2' `\��` '�\\`\ 10.. All solid piping, tees & .fittings shall be 4" diameter .
0 92.00 b Leach Pit ��-�`\ _ \\ Schedule 40 NSF'PVC pipes with water tight joints.
Sand O / `\ .-�- 37.25= - \� 11. Municipal 'Water is Connected to ALL OF The Residence and Abutting
Loom r9 \\ ; \\
�y ,.• s;r 1 Properties Within 150 Feet.
j1, THE .PROPERTY LINES ARE APPROXIMATE AND
Loamy' \\ \♦ Septic 70000`gal. ; . � - ..)t� I 5.6 COMPILED FROM THE SURVEY PLAN' GENERATED BY
Sand \` \\ O _1 ,>r I L WHITNEY"'& BASSETT of HYANNIS. MA
10 rR s/a `� `\ :r�" j i ENTITLED - "PLAN OF`LAND,IN BARNSTABLE, MA
6'- M. B. 88.25 \`� \� D-Box i i DATED JUNE 1946,'PLAN 22825`-P sheet 2).
, I I AND IS NOT INTENDED TO_BE A SURVEY,:PLOT PLAN
sMor�,d L 23.5 TEST HOLE #1 l
is r B/B PROJECT BENCH MARK �� �� ELEV.= 92.00 I I. IT SHOULD BE USED FOR NO;PURPOSE OTHER THAN
\ PATIO DECK I ! THE SEPTIC SYSTEM INSTALLATION.
32"- 132 Bt.00 TOP OF FOUNDATION \ i
ELEV. = 100.00 (Assumed) \\ 1 i I LOT #91 EXISTING LEACH PIT TO 'BE PUMPED OUT AND
`\ I
FILLED IN PLACE OR REMOVED TO FACILITATE INSTALLATION OF NEW SAS.
'moo � \ HOUSE �zo � � � ,
t I I NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
LOT #89 \
I FROM THE EXISTING LEACH PIT TO BE DISPOSED
_•+l Is � 1 ` EXISTING I I �
-- _ - I I OF AS PER BOARD OF HEALTH SPECIFICATIONS.
� 3 BEDROOM __. . �_.. . _. �.. __.�:.- _-�-, .___._ .!_,� �- ------ .._ �_ ._•_. __ - - ----- �_..� :_.�_ __.
I
NO WETLANDS ARE PRESENT :WITHIN 200' -OF THE.PROPERTY
O �� t HOUSE ! !
nt t I ASSESSORS MAP 69, PARCEL 087
Perc #1 !
Depth to Perc: 48" to 66" ; LOT #90 T
; ;- -- LEGEND
Perc Rate= Less Than 2 MPI
12,763 Square Feet
Observed ESHWT® - NONE OBS.- 132" Assumed �•'/ t `\••i DENOTES PROPOSED
ADJUSTED H2O Elev. = NONE OBS. 132 Assumed ! I ! ! 104X 1
/ ! I ! i SPOT GRADE ,
Q � t i i DENOTES EXISTING'
130.00i I ! i !� X 104.46 SPOT GRADE
1 ! !
! S 176d 17', 50" TP / PL
a, ! PROPERTY LINE
9 I
-�96P PROPOSED CONTOUR
--------------------------- ------ `---------------------
-- •------ -497 EXISTING CONTOUR '
PR I1V CE AS,�' PINE .R O-A D DEEP TEST DOLE &
2-18' DIAM- AOCESS MANHOLES
PERCOLATION TEST LOCATION
B' (50 FOOT RIGHT OF WAY) 6 'FOOT STOCKADE FENCE
ou
PLOT P LAf�
THE ACCESS COVERS FOR THE SEPTIC TANK
.+ c �; DISTRIBUTION BOX AND LEACHING COMPONENT
'^ SET.DEEPER THAN B 1NCHES BELOW FINISHED
OF PROPOSED SEPTIC SYSTEM UPGRADE
t••a-_.• r ._.:J_ . t 'r�r �-^t S GRADE SHALL BE RAISED TO VATHIN B' OF
STEEL REINFORCED' PRECAST CONCRETE FINISHED GRADE
PREPAREDY FOR
- R ,
PLAN VIEW
INSTALL TUF-T1TE GAS BAtFiEs OR EQUALS MS. D E W R A A: R AT C Ll F F
3-24'REMOVABLE COVERS
AT
> 4'
_r;
9
- 20 PRINCESS PINE ROAD
s r
parT m-T- r m�. ��t toLt H YA N N I S A
t L3' IFT i i
- -��--- aunEr =
M
W -r L_ s -r Design Calculations
r• 6' 9 GSM G;
E - R S� <.
g _ 4 o ink,. �a'c u PREPARED BY.
�� ....... depth, - Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gal./Day Min. per Title V) _ CA Ely
:a Garbage Grinder. No
Leaching Capacity Proposed. 330 Gol./Day Minimum (Min. Per Title V V 1Rl li ► Lie .Ll tl l
tic Tank": -'-3 �( 3 Gal "'
. Septic 30 /Day 660 USE EXIST. 1,000 GAL Septic Tank. p 20 40 50 S1 ENVIRONMENTAL SERVICES, INC.
4' -tD' SOIL'ABSORPTION-AREA: Using percolation 'rate of <2 min./inch
CROSS SECTION END SECTION Bottom Area. 0.74_gal/sq. ft. x 370 sq, ft. . 273.8 gallons
g P.O",:; BOX : 627,
Sidewall Area. 0.74 gal./sq. ft. :� 78 sq. ft. 58 gallons
IST/"
- - _ AhfTAl kkk EAST -FALMOUTH, MA 02536
Providing. 331.80 gallons
TYPICAL 1000 GALLON SEPTIC TANK
,. TEL FAX :-.508-548 '079s
SCALE: 1 =20 1.
Use. 5 INFILTRATORIG CAPACITY H
NOT TO SCALE
O HIGH 10 UNITS, HAVING A 0.>`33 (10 INCHES) EFFECTIVE DEPTH, - ,
TO BE USED WITH -4,t7 OF WASHED STONE ON THE SIDES,,`AND 3.5 OF WASHED STONE
SCALE. 1 20 DRAWN BY.. CES GATE. MARCH 31, 2004
ON THE.ENDS. N `STONE UNDER.
PROJECT SD548 FILENAME. SD548PP.DWG SHEET 1 OF 1
,
,
,
, r ,