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HomeMy WebLinkAbout0093 REDWOOD LANE - Health 93 Redwood'Lane Hyannis j A =288 - 106 I UPS 177#3 y l� A)e Q'- ti o � � 6 C�lJl i s a . - 30 i b t r c Commonwealth of Massachusetts 299, �n Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 93 Redwood Lane u� Property Address Harryson Lima Owner Owner's Name information is Hy annis MA 02601 06/01/2020 required for every ' page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information S/ /45�-S on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key. 52 Rivers End Road Co Company Address Teaticket Ma. 02536 City/Town State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 06/02/2020 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 J,. Commonwealth of Massachusetts Title 5 Official Inspection Form 11 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is Hyannis MA 02601 06/01/2020 required for every y page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 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: This 3 bedroom home has an H-10 1000 gallon septic tank with an H-10 D-Box feeding a leaching filed. At the time of the inspection no visible failure criteria was found. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts �v Title 5 Official Inspection Form r_ I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts �v a Title 5 Official Inspection Form �Ia Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *' This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth,& Massachusetts I? Title 5 Official Inspection Form ii; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 - page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts �- Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments I u� 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of.the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts �v Title 5 Official Inspection Form iI; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): N/A Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): N/A Description: Number of current residents: 5 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): town water Detail: In 2019-7000 cubic feet was used and in 2018-3000 cf was used Sump pump? ❑ Yes ® No Last date of occupancy: occupiedDate t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts �v Title 5 Official Inspection Form �1. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ' il� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is Hyannis MA 02601 06/01/2020 required for every y page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: New leaching installed 6/9/2011 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): " Depth below grade: 21feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: town water feet Comments (on condition of joints, venting, evidence of leakage, etc.): Water was flushed and it came freely. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts �v Title 5 Official Inspection Form I? ti; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 93 Redwood Lane u Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 12"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: H-10 1000 gallon tank 4" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): recommend the new owner put the septic tank on a maint. plan with a local septic pumping co. based on the future use of the home. At the time of inspection the liquid level was at working level and the tee's were in place. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form '•_ iI Subsurface Sewage Disposal System Form - Not for Voluntary Assessments � 93 Redwood Lane u— Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. City/town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): At the time of the inspection the liquid level was at working level and there were no visible signs of leakage or solids carryover. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 c Commonwealth of Massachusetts e Title 5 Official Inspection Form r �= _ � Subsurface Sewage Disposal System Form Not for Voluntary Assessments 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis annis MA 02601 06/01/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: One-32 X 8.5 ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection no visible failure criteria was found. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form <iI Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u— 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: hand-sketch in the area below ❑ drawing attached separately i i *As-Built from the installer attached on next page** I I N. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 6/2/2020 Assessing As-Built Cards I TOWN OF BARNSTABLE /' 41;4 t LOCATION �3 �s_<=....t/>>' �'Y- � SEWAGE ii gO/I-I 75 vILLAGE ASSESSOR'S MAP&LOT ZEE Id 6 I INSTALLER'S NAME&PHONE NO_rdsg-w24)-q7J2 i SEPTIC TANK CAPACITY LEACHING FACILrrY:(type).5-9~5 cAl du/tk `/(size).J12 X 6.5`0, NO.OF BEDROOMS �Z BUILDER OR OWNER lI%I'S PERMITDATE:G'?-1I 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 j on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachinn facility) Feet Furrtishedby �c¢e.�L/ _41� 4 I U- I i i I i r s�`sgr�wr hftps://townofbarnstable.us/Departments/Assessing/Property_Values/HMdisplay.asp?mappar=288106&seq=2 1/2 Commonwealth of Massachusetts Title 5 Official Inspection Form �1� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u— 93 Redwood Lane Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 12 plus feet feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: I augered a hole at a lower elevation and shot it with a transit to show 4 feet of seperation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 f Commonwealth of Massachusetts �- Title 5 Official Inspection Form iI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ............. 93 Redwood Lane u— Property Address Harryson Lima Owner Owner's Name information is required for every Hyannis MA 02601 06/01/2020 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 93 Redwood Lane Property Address Sellers Owner Owner's Name/ information is H annis V Ma 8/10/16 required for every Y ty page. Cityrrown State Zip Code Date of Inspection W Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information 034 on the computer, �� use only the tab 1. Inspector: key to move your cursor-do not Chad Hathaway use the return Name of Inspector key. 00-7-1 H.P.S. � Company Name P.O.Box 151 Company Address Forestdale Ma 02644 Cityrrown State Zip Code 774-274-2581 12866 Telephone Number License Number B. Certification - 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 ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 8/10/16 Inspector's Sign Date he T syste inspector shall submit copy of is inspection report to the Approving Authority(Board of Health or DEP)within 30 days com in this inspection. If the system is a shared system or has a design flow of 10,000 gpd or ater, 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. ""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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,M 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 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: Tank in good condition tees in place no visable cracks or leaks. tank was pumped at time of inspection. Dbox clear of carry overs no visable cracks. leaching was dry at time of inspection 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® 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 %day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G M $ 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ❑ 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 Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. 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 ❑ El Area system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M5.193 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection C. Checklist 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: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts 4 Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityfrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: none info Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1000 gal gallons How was quantity pumped determined? tank size Reason for pumping: Maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: tank unknown Dbox and leaching 2011 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.5' feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line. 20+feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 1' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 6" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of V Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 93 Redwood Lane M Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 6" Distance from top of scum to top of outlet tee or baffle 2" Distance from bottom of scum to bottom of outlet tee or baffle 20" How were dimensions determined? tape and sludge judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): pump every 2-3 years as maint. to protect leaching Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 93 Redwood Lane Property Address Sellers Owner Owners Name information is Hyannis Ma 8/10/16 required for every y page. Cityffown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): , Depth below grade: Material of construction: El concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): structually sound Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Dry at time of inspection no staining to indicate past failure inspected through 4"port at fround level t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 24)quick 4 panals ❑ 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.): no signs of hydraulic failure Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every Y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page, City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately , a 33/ 0 3(o" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 10+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: town GIS maps You must describe how you established the high ground water elevation: town gis map indicate lot to be at el. 20'abutters low area is el. 10 and stewerts creek is el. 1 ground water is more then 10' deep bottom of leaching is 4' below surface Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 93 Redwood Lane Property Address Sellers Owner Owner's Name information is Hyannis Ma 8/10/16 required for every y page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 m � / TOWN OF BARNSTABLE LOCATION /�,�'G1c �®� Lds�t� "` 'SEWAGE # go//-/73 VILLAGE ,r•T41000/.,S . or7— ASSESSOR'S MAP & LOT 283,-/d6 i r INSTALLER'S NAME&PHONE 10 w&A,--ea"dS SEPTIC TANK CAPACITY LEACHING FACILITY: (type) '/ VW5 ®e S J!(size) X NO. OF BEDROOMS BUILDER OR OWNER J15// °r^S PERMITDATE: l'2-W COMPLIANCE DATE: l 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 leachin fa�c1t Feet Furnished by : .a a co a �t • b ZOONo. � ' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitation for Mispo8al 6pstem Confitridion �Prtrilt Application for a Permit to Constr<ct(� Repair(/_)-'6_pg;rade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No. 1?9 Raefalelaof 4Nee Owner's Name,Address,and Tel.No. Hy���is Porn' .Sr/lr�as Assessor's Map/Parcel 88- 106 Installer's Name Address,and Tel.No.,S'08- 280'9'�3 Z Designer's Name,Address,and Tel.No.S"08-3G 1 2 922 ✓a s e, Type of Building: Dwelling No.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) t5k 5 0 gpd Design flow provided 336 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) TR,4r1011 3 / OW S 01C, B 2!� �1�rroTors Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. gn Date Application Approved by Date '7 Application Disapproved by Date for the following reasons rr� Permit No. OR©� � Date Issued 1 s No. ©fl I —l s 3 .,8 _ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN'OF BARNSTABLE, MASSACHUSETTS Yes appliLation for Misposal *pstrm CoTY f U 4on'Permit Application for a Permit to Constpuel. Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ?_? f / 0(64"Uv e�' Owner's Name,Address and Tel.No. Assessor's Map/Parcel 2 Z/- /06, Installer's Name Address,and Tel.No. - 6G ) 2 r Designer's Name Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 2 19,,;Lot S• sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) C-5��r gpd Design flow provided 3�t0 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs orAlterations(�swer hen applicable) .10 r�// � f 'Ucy S O� 3 zN/�/�jda�f�I^S i Date fisi inspected: 'i' Agreement: ` The undersigned agrees to,ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with!the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ign—ed, Date Application Approved by Date . 7 . Applic Yiori'Disapproved by Date for the following reasons Permit No. Date Issued 7 r' f THE COMMONWEALTH OF MASSACHUSETTS i BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO C/RTIFY,that the On-site Sewage Disposal system Constructed Repaired O Upgraded( ) Abandoned( _)by �/GS at �,s I�(s�f G fClU �6�1Gj/y HV4,eldv1S 120raTs-been constructed in accordance I with the provisions of/Title ��5 and the for Disposal System Construction Permit No.'()') /?3 dated 69 /7M Installer /dj C�✓Li (/e �j!4�"�/�S Designer #bedrooms Approved design- ow 33 gpd The issuance of this permit shal n t b o strued as a guarantee that the system'will functio a I srgne. � y d Date Inspector, r---R-�"" - --------- -------- - ------------- . No. G Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS disposal bpstem Construction Permit Permission is hereby granted to Construct(4) Repair( G)B, Upgr e( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction -m stt 7be bmpleted within three years of the date of thisCb . Date ll% � ! 1 Approved Town of Barnstable '"E' i.� Regulatory Services Thomas F. Geiler,Director' • snxxsrnete. 9MAS& g Public health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: -508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Sewage Permit# �0�1 ! 7�Assessor's iVlap\Parcel LSO �6 A4Designer: "'NW r�'�` ' Installer: Address: X I Address: 55"3 7 On was issued a permit to install a (date) f installer) septic system at !�3 &_4�eAM e based on a design drawn by (address) dated (designer) , 1 certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral re!ocation of the distribution box ancUor 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 anv 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. MAss9 DAR R —� (Ins aller's Signature) " No: 1140 J/t/t SANITAR�I`� esigner's Signature) ( �ffi c Designer's Stamp Here) PLEASE RETURN TO BARIN ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COiNIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Heal th/Septic%Desiganer Certification Form 3-26-4doc R r � Town of Bk7nstable r# �)2G Department of Regtilatory Services • '� Public Health Division Date ar„sa s63¢ `�$ 200 Main Street Hyannis MA 02601 Date Scheduled ! Time Fee Pd. i . i Soil Suitability Assessmient for S rage Disposal rre to 1'r���� Witnessed By: J Performed By:.�,,,, ly � . i LOCATION &�yG�fENERAL INI+'ORIIRATION S LocationAddress'.93 IZEoWOOD Ln ry Owner's Name SE(,L � N I C PO Address �o goX 49 J ��r•!Il is po-R� Assessor's Map/P4rcel: 2 l�h I" Engineer's Names i A r f,e, NEW CONS1RUt�`EON REPAIR � � Telephone# Land Use 4 ` ` '/"► Slopes(9'0) `5 047 Surface Stones >2vU Distances from: Open Water Body ft Possible Wet Area � �Gi�ft Drinking Water Well ��� t�> ft .—a Drainage Way / i ft Property Line ` _ft Other ft SKETCH:(Street name,dimensioos'of lot,exact locations of test holes&perc tests,locate wetlands in proxitnity to holes) 6*81 O 1 m 0co 2i _ ~ � ' O z1 \ N Parent material(geologic) �'L O 1 "'�3 j Depth to Bedrock Depth to Groundwatdr. Standing Water in Hole: 1 a Weeping from Pit FACe i rid Estimated Seasonal Nigh Groundwater — DtTERNIINATION FOR SEASONAL HIGH WATER T"LE Method Used: I In, Depth dbp xved standing in obs.hole: in. Depth to Sol]1nottles: it Depth[oiweeping from side A of obs.hole: in, Groundwater Adjustment .fletor.�.._.-� Ad).Groundwater Level Index Well# Reading Date Index Well levdl dl PERCOL,ATIiON TEST . Datp.�.---- Observation I Time at V N - -- Hole# i Time at V Depth of Pere J Time'.(9'-V) Start Pre_-soak Time.@ End Pre-soak Rate MinJInch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original:.Public k,e$lth Division Observation Hole Data To Be Completed on Basic— ***If percolafiWn test is to be conducted within 100' of wetland,you must first notify the Barnstable C4 iservation Division at least one (1) wedk prior to beginning. r ,a s DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel) lid DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel DEEP OBSERVATION HOLE LOG Hole# = Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consistency. ra I Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughoutthe.' area proposed for the soil absorption system? If not,what is the depth of naturally occurring per ious material? 'Certification I certify that on �l (date)I have passed the soil evaluator examination approved by the LL Department of Environ ental Protection and that the above analysis was performed by me consistent with the required ti 'Wingpxpertise and experience described in 3.10 CMR 15.017. Signature L Date 6 1 PTI ERCFORM.DOC Q:1SE CAP _ , WCAN SEWAGE PERMIT . Id9. IN l M R'S NAME, AD0RESS I UILDE R ON WNER DATE PERMIT ISSUED DAT E . C0MPIIANCE ISSUED 1 No.13.-131..... Fimim ..5 ............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .............OF............ .........Y ... . , ..... Apli irFation for Dispvii al Works Tanoirurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at L ation e Lot .... . . .... ............. ..-- ........ .: .. Owner Address a ......"....... •... ... .................................. .............•-•------------------•----------..........--•-•-----•-..................-^.......... Installer Address, UType of Building Size Lot-----�t 9.5s----Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ((�)E� Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.....................------. Showers (24 — Cafeteria ( ) Q' Other fixtures ........................•...-. . - d ------ W Design Flow................�.�................gallons per person per day. Total daily flow----.---.- ..1.1�.._...............gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----------_-------- Diameter..----------.----.-- Depth below inlet.....--............. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by---------------------_-................................................. Date........................................ 1-..7 ,-4 Test Pit No. 1................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 j --•------------------------------------------ .--------- •------•----------.----- O Description of Soil---------- y1 -------------------------------------- ----------------- .- ------ ---- -- ............................................. -••-•--•-•-------- '-1 .... .. ............. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ----------------------------------•-••-••-----------•--•-----•-•••••--•-•--••----•-•........•----•-••-------•••.......--••-•-•--•-•----•••••--•----•----••------••••--•--•--•--•••---•-•---•-------•--- Agreement: The undersigned agrees to install the aforedescribed -Individual Sewage Disposal System in accordance with the provisions of TIT?E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i d by the o d of health. r rowing ed... -- •• . ....--� ----------------------------------- . S �� f Date Application 'Approved By.............. Date Application Disapproved for the oreasons-............................................................................................D•-.e..........4 .......................................-...............................................................................-...............................-................................................. 4 Date PermitNo......................................................... Issued........................................................ Date F N&O....!� ..... Fps...... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .... ........OF........... ------------_---------------....... Appliration for Dwvoiial Workii Tomitrurtion "amit V Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: L)664 .................. . ....................... ......................................... ............... Lanon. ................... . ). ................. ........................... ......U. A. ner Address _V45- .................................. ................................................................................................. ..................... ..... ...... .... .. ..... Installer Address Type of Building Size Lot...: --.,Sq. feet Dwelling—No. of Bedrooms..................7---I...... ..........Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons_.._________________.______- Showers Cafeteria Other fixtures .................................................................................................... --- - --------- --------------------- Design Flow.................6.�.O........._..__..gallons per person per day. Total daily flow....... a...................gallons. 9 Septic Tank—Liquid:capacity............gallons Length................ Width..............._ Diameter________--___ - Depth____.__.._..._.. Disposal Trench I No....-............... Width-............_...... Total Length..____........_..... Total leaching area---- sq. ft. :--------------- Seepage Pit No---_--------------_ Diameter.........._..__..... Depth below inlet.................._. Total leaching area.................sq. ft. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by........................... .............................................. Date........................................ 4 Test Pit No. 1................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........................ P------------------------------------------------------------------------------- Description of S - --------- 5? ................................................................................ 0 oil.............. ......... --- ................................................... ................................................................................. U 50*el_�Q--------------------------------------------m------------------------------------ -------­--------------------- ................C U Nature of Repairs or Alterations—Answer when applicable......... ................................................ ................................... ...................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T IT!L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i§4d b� p the of health. • .. ... .. ed/..�. en.. . .................................... ......................... Date ApplicationApproved By...................... ........................................................ ........................................ " .lo, Date Application Disapproved for th f.6, owing reasons:................................................................................................................ ........................................................................................................ ............................................................................................ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS _..0 BOARD AW HEAL ........ .............OF....... .... . .... ... .. .............................. or Repaired THIS IS ., IFY, T the Inokvidual Sewage Disposal System constructed ................. --- by................... 14. .... ------_---- ---- .... ... 7;---------- Ins:,ajll ................ .... . . . ........ 0,-0. at----_----------- .....41_7_4 ------------ has been instilled in accordance with the provisions of TJIE 5 of The State Sanitary. Co A as scribed in the application for Disposal Works Construction Permit No.. _ dated__ ....T:n.�1/------- ----...... d, ..................... ;T THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED S A GUARANTEE THAT THE SYSTEM Wig ONCTION SATISFACTORY. DATEJ�llrl�rll........................................................ Inspector..... I.... ........ ............................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD Oir�EALTI� V_ V-1 .. .....OF...... ..... . .. .................. ............ .................... . No.... ....:. : ... FEE........................ Apr ........ ... ............................................................... Permission is hereby granted------------. . .- ...'j. ___- to Construct (� ep an di idualSeA,age Disposal System at No..................... ... 471�.. ..... ... ........ -- -------A-•0K......................................................................... ------- ............... shown on the application for Disposal Works Construction Permit No..................... Street as s A5 Dat `................... - --------------...................... ..... ... . ................................................. ard Health DATE............... ........................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS LoI :ELp qA t O � D.�I. I / o ! DEL WL�D eFSFNp 44.73 too,o & ZC: QE { �cP� rs .I too' wiD ' 24t 0 1'l. 20 'Fp0 ,-r s, (3: 1 is 14t — qq fiSSuMED �Qo?Er-T)OJ 0 .,.Irk `4� a — �r�DER: AL; ��11Tesr, r'N qQ Go �1':r too GAL _ f' O -` N `K,o•i-EAC �toq p� rr 94. Qq �l `H OF. ' �Mu r� ��sTea�o� LEGEND CERTIFIED PLOT PLAN EX BSTIN® SPOT ELEVATION OxO; EXISTING 'CONTOUR,-- 0 "_�' P,'..+0 N wT 1 �2�(�w ooD LA F 1 FINISHED :SPOT ELEVATION ' I ' w G—I�r��1►J I��0 —f F'B.NISHED, CONTOUR IN APPROVEQ' BOARD OFF HEALTH SA ( LR DATE " AGENT u> y SCALE: DATE o'L'25 83 d DREA'GE ENGINEERING Cf� �N 0 � ,N�►r (3.a�s�DE _ .� � - 1 CERTIFY THAT THE PROPOSER EGISTERE RE.GISTE-R:FA F` O 'xW(�,'BIA:' `BUILDING SHOWN ON THIS PLAN- G1VIl 'LAND: y CONFORMS TO THE ZONING LAW /� R RVE �ax4 :RY� CONFORMS OARNSTA LE ASS. EY E �Q Z'i .n;}r ro� YV T ' HYANN I S.,, MA$S:4 -,`'' OF -'�C_. DATE . IEQ. LAND SURVEYOR gM,EET..,..... Gov rn CA rn ;�o ,,• ii Z � � o : , Am' o ,, off 0 3• � 3t h �aAW a D � � i0 y �, cy � p • 0 o T. .. � 2 � 2Z ON T1 � E � Ir r-vji 9DcA {? 6� w0 0 OZ �h isc 40 . iJ r yY � `!:Mowl Ll N :i 7 y -I . tPN 10 ol : Z rr pp � • •• Z. G► �` � • 0` ,(\ \ � Z� A y ' °.� ri 2 A� n A P °camv all do Ai O Sri O • • AL tj . . . . o' . O � . � � � •. . • � •� • . . amp •yam r M14 N " o o . °Rowot , . s IA Z4 ID 0 IA Z� � � � � �� o � 04 1 HYANNISRORT y � c I LEGEND moo N � OQ PROPOSE9 C-C' 0 R y a I ® PROPOSED SPOT GRADE O —— gg —— EXISTING CONTOUR o 0 + 96.52 EXISTING SPOT GRADE v a 4P W— EXISTING WATER SERVICE REDW ^� O pF TEST PIT SITE SMITH ST P G� ARMRSTpN AVE Q r,. O US MAP LOCUS N.T.S. now 44 GENERAL NOTES: 3 23 20 �ft � r �• 22 21 ,L k'- 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 23 3� ( A — 6 k1 I BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE.STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR I 441 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE _ \\ I / // 19 DESIGN ENGINEER. ' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING f� FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF DO THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF \ D S�/ HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. p \\ I�/�// NC / 7. WATER SUPPLY PROVIDED BY TOWN WATER'SERVICE. \ Op O``//\ �� // M 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED i �/ / TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. LOT 18 ` F 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 24 FNON l THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING AREA = 8685 sf +— I CONSTRUCTION. EXIST. LEACH PIT _ �' I 10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. see note 1 0 //^ `\ "= / i l� EXIST. 1 ,000G 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION // �\ N /� �� — 19 SEPTIC TANK 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY \ -20 13. NO PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING 12 ft I / — 14. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPEC. OTHERWISE) / I I 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW I I I BENCH MARK FOR THE USE OF A GARBAGE GRINDER I I 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING I TH— / TOP OF CONCRETE 17. PROPERTY IS NOT IN ZONE II OR NITROGEN SENSITIVE AREA. BULKHEAD CORNER * I ELEVATION 20.80 N G 2 rt BARNSTABLE 'GIS DATUM 22 of OF '- D E D s 1 Int w Pb PROPOSED SEPTIC SYSTEM UPGRADE PLAN 1 0. 1140 93 REDWOOD LANE, HYANNISPORT, MA SANITAR\p� Prepared for: Sellers Engineering by:5 MAP; 288 DARRENM.MEYER,R.S. Surveying by: SCALE DRAWN EcoTech Env. 1"=20' DMM Po BOX 981 LOT 106 EAST SANDWICH,MA02537 (508) 367-8097 DATE: CHECKED SHEET NO. 508-362-2922 05/29/1 1 DM M 1 of 2 I NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:18.58 FORA DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D=80X PROPOSED S.A.S. � T.O.F. EL.=24.76 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER --- ���°�F 'ygS,r OUTLET AND SET'TO 6 OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G. • F.G. EL.=22.Ot F.G. EL.=21.0t F.G. EL: 21.50t F.G. EL: 21.0 (MAX.) D E yG � ,o ,�1 ✓+ .�-^ No. 1140 L = 13't 9" MIN COVER/ ! L — 10' L = 10'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) 0 S=1% (MIN.) 36' MAX COVER ® S=1% (MIN.) 0 S=1% (MIN.) a"scttao PVCra 4'SCH40 PVC 4'SCH40 PVC SANJTAR�a� 1a" 6 =19.70 14' 11.2" TO INV. 48'LIOUID �INV.=19.45 INVERT LEVEL INV.=18.40 GAS BAFFLE PROPOSED 3 ROWS OF 8 UNITS AT 4'/UNIT = 32'/ROW D-80� INV.=18.25 INV.=18.57 DB- SOIL ABSORPTION' SYSTEM PROFILE 3 EXISTING 1,000 GALLON SEPTIC TANK RESTORE VEGETATIVE COVER EXISTING SEWER OUTLET LL WITH CLEAN PERC SAND 47" TO TO TO TOP OF CHAMBERS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS-PRIOR TO CONSTRUCTION BREAKOUT=TOP ELEV.=18.58 2) D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.= 18.25 GRADE ON A MECHANICALL COMPACTED SIX BOTTOM ELEV.= 17.58 INCH CRUSHED STONE BASE, AS SPECIFIED IN EXISTING SUITABLE 310 CMR 15.221(2) 2.83' MATERIAL 3) REPLACE EXISTING 1,000 GALLON SEPTIC 5' MIN. ABOVE BOTTOM OF I� 48" — TANK WITH 1500 GALLON SEPTIC TANK T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 3 x 2.83' = 8.49' IF FAILED, DAMAGED, OR UNDERSIZED. (6.46' PROVIDED) USE 3 ROWS OF 8—INFILTRATOR QUICK 4 PROFILE 4) INSTALL INLET & OUTLET TEES W/ ADJ. GROUNDWATER EL.=75.10 _ STANDARD UNITS—NO STONE GAS BAFFLE AS REQUIRED ' SEPTIC SYSTEM PROFILE TYPICAL SECTION N.T.S. N.T.& 8,r 12" DESIGN CRITERIA SOIL LOG P#: 13278 I NUMBER OF BEDROOMS: 2 BEDROOM DWELLING/3 BEDROOM DESIGN DATE: MAY 18, 2011 I�34" � SOIL TEXTURAL CLASS: CLASS I SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE. SECTION END CAP WITNESS: DON DESMARAIS, BARNSTABLE BOH DESIGN PERCOLATION RATE: <2 MIN/IN INFILTRATOR QUICK 4 STANDARD UNIT DAILY FLOW: 330 G.P.D. Elev. TP—1 Depth , Elev. TP-2 Depth DESIGN FLOW: 330 G.P.D. 21.70 0" 21.80 0" A LOAMY SAND A LOAMY SAND MODEL QUICK 4 STD GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 21.20 1DYR 3/2 6' 21.30 10YR 3 2 6" LENGTH 48" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT PROPOSED SEPTIC TANK: USE EXISTING 1,000 GALLON CAPACITY B B EFFECTIVE LENGTH 48" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY SANDY LOAM SANDY LOAM DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. LEACHING AREA REQUIRED: (330) = 445.94 S.F. 10YR 6/8 IOYR 6/8 SIDE WALL HEIGHT 8" .74 OVERALL HEIGHT 12" DISTRIBUTION BOX: 3 OUTLETS (MINIMUM) 19.t2 C1 31" 19.30 C1 30" OVERALL WIDTH 34" PRIMARY S.A.S. , USE 3 ROWS OF 8 — INFILTRATOR QUICK 4 STANDARD UNITS NO STONE MEDIUM SAND MEDIUM SAND CAPACITY t(43.5 GAL) E BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.73 SF/LF OF CHAMBER) PERC O EL. 17.52 2.5Y 7/4 2.5Y 7/4 (BIODIFFUSERS) 24 UNITS x 4.0 LF x 4.73 SF/LF = 454.08 SF I PROPOSED SEPTIC SYSTEM SITE PLAN • DESIGN FLOW PROVIDED: 0.74(454.08 GPD/SF) = 336.02 GPD > 330 GPD req'd 10.03 140" 10.80 132" 93 REDWOOD LANE, HYAN N I S PO RT, MA PERC RATE <2 MIN/IN. ("C" HORIZON) Prepared for: Sellers NO GROUNDWATER OBSERVED Engineering by: Surveying by: SCALE DRAWN JOB. N0. DARRENM.MEYER,R.S. EcoTech Env. NTS D.M.M. • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 pOBOX98f to conduct soil evaluations and that the above analysis has been' performed by me consistent with the EAST SANDWICH,MA 02537 (508) 367-8097 DATE CHECKED SHEET NO. requirements of 310 CMR 15.017. I further certify that I have passed the Soil Eval. Exam in October, 1999. 508-3621922 / / 1 05 29 1 D.M.M. 2 Of 2 I, L ' r V � gZ �� t