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Home My WebLink About0037 RUDDER ROAD - Health 37 Rudder Road Hyannis A=247 - 191- I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is Hy annis MA 02601 March 15, 2016 required for every page. Cityrrown 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. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not David D. Coughanowr, IRS use the return Name of Inspector key. Eco-Tech Rapid Response r� Company Name 155 George Ryder Road South Company Address Chatham MA 02633 Cityrrown State Zip Code 508 364-0894 1328 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 ElFails -�N OF Mgss . ❑ Needs F r E&,kuatl q �� he Local Approving Authority CO HA OWR - 9 March 15, 2016 Inspector's Sig re c/STER Date SN The system insp gNIT RO' bmit 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. ****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-twjNdd3f g ffvw.m•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is required for every.. Hyannis' ,. MA 02601 March 15, 2016 . page. City/Town..- + 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: Inspector's Notes==> The septic system described herein is deemed to pass this Real Estate Transfer Inspection if it does not meet any of the failure criteria enumerated in Section D on pages 4- 5, or specified by local regulations. The scope of this inspection is limited to health and environmental compliance and the septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. 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•3113 ,� vPT h +n �� ,i Title 5 Official Inspection Form: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 wM 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is required for every Hyannis MA 02601 March 15, 2016 page. Citylrown 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 N 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 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address _ Judith Carpenter Owner Owner's Name information is required for every 'Hyannis MA_ 02601 March 15, 2016 page. _ City/Town 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 aseptic 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 El ® clogged SAS or cesspool El; - ® Discharge or ponding of,effluent to the surface of the ground or surface waters due to an overloaded or clogged- 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 '/2 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 °M 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is required for every Hyannis MA 02601 March 15 2016 page. City/Town 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 the system is.located in a nitrogen sensitive area (Interim Wellhead Protection ❑ El Area— IWPA) or a mapped Zone ll 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is Hyannis ` `` MA 02601 March 15, 2016 required for every y page. City/Town _ 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): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example:110'gpd x#of bedrooms): 330 gpd t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is required for every Hyannis MA 02601 March 15, 2016 page. Citylrown 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?. .: y = : „ . . y El Yes ® No Water meter readings, if available last 2 ears usage(gpd)): 174 gpd 9 ( Y 9 Detail: 2014: 62,836 gallons 2015: 64,332 gallons Sump pump?- ❑ Yes ® No Last date of occupancy: November, 2015 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? El Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: l5ins-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 37 Rudder Road -Assessor's Map 247 Parcel"191 - <. Property Address " p Y Judith Carpenter. Owner Owner's Name information is H annist' MA 02601 . March 15, 2016 - required for every y page. _ City/Town State Zip Code Date of Inspection D. System Information (cont.) LaJldate of occupancy/use: ; Date Other(describe below): i y General Information Pumping Records: ° Source of information: Owner Was system pumped ag,part of the inspection•? - - z..: ❑ Yes ® 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 El 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 operato'r'under contract ❑ Tight tank.Attach a copy of the DEP approval.• t ❑ 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 37 Rudder Road -Assessor's Map 247 Parcel.191 Property Address Judith Carpenter Owner Owner's Name information is Hyannis MA 02601 March 15; 2016 required for every y - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) - Approximate age of all components, date installed (if known) and source of information: Age: 7+ years. Certificate of Compliance for a new system was issued 4/16/2008 (Permit#2008-126 at Health Department). Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting,-evidence of-leakage, etc.): Sewer line appears structurally sound with no evidence of leakage or backup into dwelling. Septic Tank(locate on site plan): Depth below grade: 2 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: 10.5 x 5 x 6-1500 gallon Sludge depth: 4 in t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form- Not for Voluntary Assessments .37 Rudder Road -Assessor's Map 247,Parcel 191 Property Address _. Judith Carpenter. Owner Owner's Name information is H anhis" MA 02601 _ March 15, 2016, required for every�` y - page. Cityrrownv 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 30 in Scum thickness 2 in Distance from top of scum to top of outlet tee or baffle 9 in Distance from bottom of scum to bottom of outlet tee or baffle 13 in How were dimensions determined? Design Plan Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping not required at this time. Maintenance pumping is recommended every 2-4 years with year round occupation. Tank and tees appear structurally sound and functioning as intended. No evidence of leakage in or out was observed. • A .. a - • - . r _ Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): • 9 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is Hyannis MA 02601 March 15, 2016 required for every _ -- page. City/Town 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: ❑ 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.): 9 - *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No i t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 37 Rudder Road Assessor's Map 247 Parcel 191 'GSM sv - ssessor arce r.. . Property Address Judith Carpenter Owner Owner's Name information is required for every` Hyannis - !` V MA 02601 _. March 15, 2016 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 at outlet invert 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.): No adverse conditions observed. 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: A t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 I Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments M , 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is ,• required for every Hyannis MA 02601 March 15, 2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 1 ❑ leaching trenches number, length: ❑ Teaching 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 evidence of surface ponding, breakout, lush vegetation, or other evidence of hydraulic failure was observed. A hole was dug into leaching gallery stone and no effluent contact staining was observed in the stone or overlying soils. No standing effluent was observed to a depth of 1 feet below the top of the stone layer. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): _ Number and configuration Depth—top of iliquid 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 W Title 5 Official "Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c,M 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is required for every Hyannis , MA 02601 March 15, 2016 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.): . y t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M ,•'y 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address -Judith Carpenter Owner Owner's Name information is required for every Hyannis MA 02601 March 15, 2016 . .. , .. page. CityrFown 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 L OC A Tg0NS LEACHING GALLERY —OF SEPTIC COMPONENTS —DISTANCES IN DECIMAL FEET A B 1 27 31 oil 2 33 25 3 61.5 - 23 } o 1 2 L DISTRIBUTION BOX 1500 GALLON SEPTIC TANK A B THIS SKETCH IS BEST VIEWED IN EX#S TQ#y� COLOR FORMAT D WELL o�( 0 3; F-1 NOT or TO z o SCALEULJ � Q w S � RUDDER ROAD 508 364-0894 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 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address 'Judith Carpenter Owner Owner's Name information is required for every Hyannis MA 02601 March 15, 2016, page. City/Town 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: 2 fe eett Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record h If checked, date of design plan reviewed: Date 008 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: Approved design plan on file with the'Board of Health shows bottom of system is over 5 feet above the high groundwater elevation. I 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 37 Rudder Road -Assessor's Map 247 Parcel 191 Property Address Judith Carpenter Owner Owner's Name information is required for every Hyannis MA 02601 March 15, 2016 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 GEOHYDROLOGICAL PROFILE - NOT TO SCALE z n Q s i5 a 2 . 0 H W Q O F_ BOTTOM OF LEACHING PER DESIGN PLAN LEACHING IS + ABOVE HIGH GROUNDWATER NO GROUNDWATER MOTTLING NOTED ON DESIGN PLAN t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 0000 TOWN OF BARNSTABLE ,LOCATION IZO( SEWAGE# d�✓ 1 VILLAGE -ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. J ti ' �?°" s' 4 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 3 G l`b (size) NO.OF BEDROOMS OWNER G PERMIT DATE `� �`�� COMPLIANCE DATE: 0 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 C V �t � No. . Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i. � LIC Yes HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2 pplicatton for ]Di!5poga1 ,patent Cow6truction Permit Application for a Permit to Construct( ) Repair 4) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location.Addresp or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel &y� tq �� ,� L6-^,k Ckx-,,Au v N Installer's Name,Address,and Tel.No D igner's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder OP Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable)�j7oS a,�_L o— rlEto 1 ►A' e_ J s Z,. SUSS +0 P limns o F �� -�-e clZ,, TiE - 01-1,5� 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. Signe L t� Q Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. ' Date Issued -.,-."ram.,.� .+...,..,.«+i--........*.;..-,.r �..n.. � `+,Mv-�'� `r_� .,-.�a`�al'°"v'.M..'..`�i..�- .-%ti•}e.,...�;:w+•'4- .yr .r--r=-,e-+.. ,....:. p � -.-�-«"'��. _-x Fee _ II THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: til P LIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes f ZippYication for Migogal *pgtem Construction Permit • Application for a Permit to Construct( ) RepairV) Upgrade( ) Abandon( ❑Complete System ❑Individual Components Locatio•Address or L Owner's Name,Address,and Tel.No� �' d p 1161 o No. Assessor's Map/Parce.1 ow) 1 19 0'}S VPA,) L&,�Nk, Cen4x V� A y � Installer's Name Address,and Tel.No..., Designer's Name,Address and Tel.No. 50K r3 -b gq y r, 6 iZ0bIR Scrn fir Sve4,G ECo-'T^e-0)• n -Go '109 O-� t llL 143'TrkQ v\C4 f. f0e. Type"of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. De,r scription of Soil r Nature of Repairs or Alterations(Answer when applicable) lnS� � ��t J�► Y - 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. ? Sign d t�Wc" f Q (� � Date J +��J VQ i,✓ Application Approved by / �7 c."j fi Date i Application Disapproved by: �' Date for the following reasons Permit No: ' ( Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS 96 Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (X ) Upgraded ( ) Abandoned( )by)JOM G t(D16 t1apy-N 4�;r(' S`e&( at ( LYa E r Zoa 8, �1�r-�t S hasibe nn gions�ructedh. c rdance with the provisions of Title 5 and the for Disposal System Construction Permit No. [/ /1 dated 1 v � Installer n Designer , #bedrooms Approved design flow � gpd The issuance of this permit shall not Jbe construed as a guarantee that the system will function as designed. Date ,/) ( InspeEtr -A ,� !� / No. Fee r 00.— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS ,_Cou"' Digool *pgtem Construction Permit Permission is hereby granted to Construct ( ) Repair ) Upgrade ( ) Abandon ( ) System located at � .l�c� e,c- r VC.cl . t-C�l Q•`<1 \`� . and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be co pleted within three years of the date of this Date /G�Y� / Approved by I .. i Town'of Barnstable oFmEt �. Regulatory Services _ Thomas F. Geiler,Director. + BARNSFABLE. .� 9 ice. Public Realth.Division i639 ♦0 °rFora►o�A Thomas McKean,Director. 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: `� Sewage Permit# d �� Assessor's Map\Parce1gL1 (cl l Designer: Installer: W(Y r�SOY� Address: 43 _6 Address: rFO 60—A Og� On Z' M Shwas issued a permit to install a (date). (installer) septic system at 3'� -0Cx ��5 based on a design drawn by (address) �'1^ �li l dated -J o2 i /03- . (designer) T 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 systein)'but ur`accordance'with State &"Local Regulations.-'Plan evasion or J certified as-built by designer to follow. OF MqS M ® DAVID (Installer's Signature) p �, COUGHANOWR ` N0. 1093 (Designer's:Signature) (Affix Designer re) 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 BARNT Tf"LE.PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3726-04.doc i Town of Barnstable P# / /5 Department of Regulatory Services HABNOUBM ! Public Health Division Date mlgk'G/ l41 wDy tb�g ♦� 200 Main Street,Hyannis MA 02601 Date Scheduled Time Fee Pd. / Soil Suitability Assessment for Sewage Disposal Performed By: A l_(/(�HITN R LS 461 Witnessed By: JDAv i LOCATION& GENERAL INFORMATI,QN Location Address �1 %)4e it p Name Owner's r� `10►'e+► Address -2.)7 ' Assessor's Ma 24'7 ( V q I ' P/Parcel / Engineer's Name D w <fB dOG112 6 NEW CONSTRUCTION REPAIR ✓/ Telephone.# Land Use IZ S►A e (4) Gj W vjSlopes 4b PO 0 Surface Stones m o m e Distances from: Open Water Body ft Possible Wet Area D 0 + ft Drinking Water Well top t _ft Drainage Way 0 t ft Property Line 10 ft Other ft ' SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) R�AD GROUNDWATER ADJUSTMENT / I EXISTING GROUNDWATER LEVEL BASED ON TOWN OF BARNSTABLE GIS DEPARTMENT RECORDS. �. INDICATED GW 15.00/ f / INDEX WELL M1W-29 ' / ZONE. C READING DATE FEBRUARY. 2am8 TP i ® READING 8.6 I / ADJUSTMENT 3.9 j / f ADJUSTED GW 18.9 ® / I Parent material y O*'V(1 S 6 Depth t4 Bedrock n 0 vie (geologic) Depth to Groundwater. Standing Water in Hole: Weeping from Pit FAce d Estimated Seasonal High Groundwater S e P el b0V e DETERARNATION FOR SEASONAL HIGH WATER TABLE Method Used: See 4t.9 V ('_ Depth Observed standing in obs.hole: in. Depth to soil mottles: Jn, Depth to weeping from side of obs.hole: in, Groundwater AdJushrient €t. Index Well#) Reading Date: Index Well level Adj,factor Act{.Groundwater Level PERCOLATION TEST Datea 2, o__ ' IM0 Observation ff Hole# 71me at 4" Vl hh � I„►� Depth of Perc � Time at 6" l Start Pre-soak Time @ �i^D Time(9"-6") �� • End Pre-soak L:' I ; P' Rate MinJlnch �—� 1 { Site Suitability Assessment: Site Passed ✓ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on'Back`---------- U ***If, percolation test is to be conducted within 100' of wetland,you must first notify the. c Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICIPERCFORM.DOC • SOIL TEST LOG e DATE OF TEST: MARCH 21, 2008 4 APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR, n461- WITNESSED BY: DAVID STANTON. HEALTH DEPT. PERC NUMBER: - 12152 -TEST PIT I NO ED PAARENOTUMAATERIA EPROGLACNCOUNTEA L OUTWASH PERC AT 64 to - 2 MIN/INCH IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON - TEXTURE (MUNSELL) MOTTLING 42.49 0-12 Ap LOAMY SAND 10 YR 3/3 NONE FRIABLE 39.16 12-40 B w LOAMY SAND 10 YR 4/4 NONE LOOSE 31.49 40-132 C MEDUIM SAND 10 YR 6/4 NONE LOOSE a . NO GRNCOUNTERED NDWATE TEST PIT 2 T_ PAARENOTUMAATERI R EL: PROGLAC AL OUTWASH 2 MIN/INCH IN C SOILS 1 ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 42.40 (INCHES) HORIZON TEXTURE (MUNSELLI MOTTLING � i 0-10 _ Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE 39.23 10-3B' B. LOAMY SAND _ 10 YR 4/4 NONE LOOSE 1 3B-132 C MEDUIM SAND 10 YR 6/4 NONE LOOSE i 31.40 _ 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) f DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency.,% Flood Insurance Rate Maps Above 500 year flood boundary No_ Yes - Within 500 year boundary No j� Yes Within l00 year flood boundary No-Z Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? e5 If not,what is the depth of naturally occurring pervious material? T Certification I certify that on v s (date)I have passed the soil evaluator examination approved by the '. Department of Environmental Protection and that the above analysis was performed by me consistent with . OF the required training, R'expertise and experience described in 10 CM 15.017. ZH Mgss9 � J41�,L t� � I Date �l'C; Z , �� DAVIDSignature " D. COUGHANOWH �O /CENS�O 0�' Q:GSE7r1CIPERCFORM.DOC /� F V A L V P� COCA TION SEWAGE PERVIT p0• PILLAGE INSTALLER'S NARSE ADDRESS GUILDER OR OWNER DATE PERMIT ISSUED DATE CO-MPL1ANCE ISSUED /0"/Z-gL see a �' No................�------ oL :` s..............•00 ....... 82- THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .....Town............OF............Barns.table . ................ ............................................ Appliration for Uhipvii al Workii Tnnitrnrtiun Prrnti# Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: ...02b72. •................................................................................................. Location-Address or Lot No. JonC.. ... atQr................................................................... 32....._...... Owner Address aA__&..B Cesspool__Service.----•-----....•....•.......................... 12.8..Bishops_.T.eriz ae,..I yanaia,..-MA.....02b01..... Installer Address QType of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms...............3.......................... Attic ( ) Garbage Grinder ( ) PL4 Other—Type of Building ............................ No. of persons.............3------------- Showers ( ) — Cafeteria ( ) d �x. Other fixtures --------------------•---------•---------•----•-•-......---•---•----•-•---......------------------------•--...-•-•----------•-•-•-••--•-•-•-----•------ W Design Flow............................................gallons per person per day. Total daily flow............................................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---------------z.... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (i ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -----------------------------------------------•••--------------------.......-•--------------•-.............................................................. 0 Description of Soil..............Sand--.............................................................................................................x V ----------------------------------- •--•------------------------------------------------ --------------------- •-----------------------------------------------------------------------W UNature of Repairs or Alteratio s—Answe when applicable------instaRation of a 1,000--gallon,,_--pre-rapt stone packed leach pit overflow . -- -- - ------------------------------ --•-------------------------------------------------------------------------------=----------------------------------•----•-----• Agreement: } The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI`ILZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has en 'ssu` . ed by-the board 1 Signed ..--- •--•------..... ��:�-° 10,12�82 Application Approved By . r'�.... ............................. ....................Date 82. -- -- Date Application Disapproved for the following reasons--------------------------------------------------------•--------------•-------................................. --------------•----------•-.... .---•--••••••--•--------•-------••-•-•-•-...-------------••-•--•-----------•-•--........-------------- •-----•----••--------••-•-------------••--. ............. 82- 10/12/8Z PermitNO......................................................... IssuecL........................................................ Date Q - .00 No---= •�: 9-•-- F $ `t.....�'.................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -...-.......OF.............earns table •................... .. .... . ................................------.......---- Applirtt#iun for Diupuuttl Vorkii Cnunitrttrtion "pan fit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: ...026?2 ---------------------------------------------------------------------•-•--•------............----- Location-Address or Lot No. Jon Carp_Q)Iter...... .................... ......... z5...#'exln_. +..�ent�x�ri.11e+.. "A.•..ULU.---•-------- Owner Address w A & B W Cesspool Service . - •--- .....026Q1.... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................3.........................Expansion Attic ( ) Garbage Grinder (. ) Other—T e of Building No. of persons.............3............ Showers — Cafeteria Other fixtures -•------------------------------ . W Design Flow............................................gallons per person per day. Total daily flow............................................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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ gZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ W 0 Description of Soil.................an.......••---- W ---------•----------•---------------•-•----=-- •---- ------------•--•----•-•-------------------•-------•--------- --•-----•••-•--- ....... --- - --- ---- - x inste2ation of a 1,000 lion re-cast V Nature of ��e Ir or Alterdo A wer when applicable._-_______-_•................................................. '__......................... stone pac, .each pi t �overtLow) . ------------------•---------._...---•--•---•----------------------------•-----------..........-------------------------------••----------------------•--------------------------------------------•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has een issued by-the board f 1 h. / / Signed�x��.___. _/_ _. - ---............................. ..f/12/8.. Application Approved B .. -- . ---=................ - --- 82 Date Application Disapproved for the following reasons------------------•-----••-----------------------•---------------------------------------------------------•--•-- ---------------------------------------------------------------------------------------------------------._...--------------------------------------•-------------------------------•-•-•------------.--- 82- 10/12/88 Permit No.... Issued --•a�-•---- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T own Barnstable ..........O F..................................................................................... �rr�ifirtt#r of f�uttt�littttr�e THIS I TO CERTIFY, That.the Inodividual Sewage Disposal System constructed_( ) or Repaired A �C Cesspool Service, 12u: Bishops Terrace, Hyann3 ? A 0260j bY•--•---•................ ...........---•-------•-----------.........••-•------------ 3a Rifler Rd., W. llyannIs port. 111 09"r- Jon Carpenter at -------------------------------------•-------••-..............-••-------------- has been installed in accordance with the provisions of TI`" r' 5 of The State SanitaryCody as/described in the. application for Disposal Works Construction Permit No.... 5.Y-2............... d-ated ...10/12 tS2 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® A A�G 'RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 10/12/82 ._-_...__•. Inspecto _._.DATE....._..... ---•-12 -- - THE COMMONWEALTH OF M SSACHUSETTS BOARD OF HEALTH owr..........OF----------------•...Barnstable 00 2-.r3 `.......... ........................................................ No.....:.................. FEE..........5:.......... Rupuuttl Workii Tuttutr tiun rrttti A-& B C�spo Service Permission is hereby granted . ------------------•----•............................--- to Construct , or Repair ( x an Individual Sewage Dis o al System at No............. b udder Rd.► W. Hyannisportc...1"A C2672 Jon Cappenter --•---...... . Street / A as shown on the application for Disposal Works Construction Permit No�2-_----------- Dated-----------10/12�-'2 'z 10/12/82 0-Board of Health DATE.............•----------------•----•------•-•----...--------------------....-•-- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - µr ONTOURS 0<o , ow i EXISTING - - - - - - - 50 RO�o MINIMAL GRADING PROPOSED N . DISTANCES SNO T TO CALE RUDDER ROAD J TO SYSTEM COMPONENTS i Rol, �1�Py i 00 ALL DISTANCES ARE IN DECIMAL D LOCUS a �Z w + FEET NOT IN FEET AND INCHES. _ GAS EOGE OF P �� o<J m. / GATE QWATER '1 VEMENT O W< m m A 8 i _ 42I GATE _ _ WEST HYANNISPORT. MA m�c� � � 1 24.4 31.3 � l � �` -�0000 �£ FOCUS MAP 2 32.8 23.1 !! Lu u� �'' 3 59.5 20.2 i / �� Z7 �____3 NOT TO SCALE mm< Q 4 P0.3 42.5 ti I'ti m=z z� 5 80.4 47.6 l /J J ow�� N e ,�3 LOT 28 Wl L EGEND J a�oL "' w wo 3 m l 0— AREA = 10023 sf+— (D° � � °� � m / zm a=° z w OD 2 A ~ / / 3 / 1500 GALLON Z< u°i< = W w z N 1 / / SEPTIC TANK am z > O 7= 1 /U J / / / �j s I/V EXISTING T- (f) z° x m Q J z Z N o= / Q� T i o m m r` W Q w ►- 5 4 I / e -D� �' / CESSPOOL O �n �/ M W= o ~~ v W l rOP �IN UTILITY POLE ai "' J � ° az" >W W 3u v ^ wZ < OUO w EL , OFF G ° �J ti 43 �/ I TEST PIT ® D-BOX O w < p 1s-o Zm f �, �� > z O< / 0-oc> m DECIDUOUS TREE CONIFEROUS W b- U X / � b /M TREE o00 e O Zo 0 0 m ]Ln. / m db0 12-M �i2-P I- �- W Qj 7 r1 / TP-1 / -NUMBER REFERS TO DIAMETER IN WZI w UO I m m 25 f L X 12 f L X G r L l " / INCHES. LETTER DENOTES TYPE. rLu Lu U dW Li LEf1 CHING G�1 LLERY l O-OAK M-MAPLE P-PINE C-CEDAR UW z UlW \A / LL x Z° F�26'cnd ISemZ IH OF MgZOZ z °° TP-2 / �o`� DAVID yGN �o�' DAVID D. `� g I z 3 <? BENCH MARK — m StiF / COUGHANOWR N COUG ANOWR N O 1 _ / No. 1093 P m m � PAINT SPOT ON WO zo + c, co `� BULKHEAD CORNER x --� / �`�cISTE �`a �oA��CENSE° pQ �� w m r m m ELEVATION = 43.00 100000 / sq ,R1Pa AL P� J x 0 m w BARNSTABLE GIS DATUM I_(_J W z V FLAN r,®o T e SEWAGE DISPOSAL SYSTEM PLAN w w cn z ( -TO SERVE EXISTING DWELLING H J L m _1 < " ch r EST. JOHN & JUDITH CARPENTER 3 <Q W —� ~ -SCALE. t i n = 20 f L OWNERS OF RECORD 0 O w° Z GARBAGE GRINDER ° -' U 20 0 20 40 �° 37 RUDDER ROAD 0 Z ❑ w IS NOT ALLOWED O I � F 1995 �' v WITH THIS DESIGN. PROPERTY ADDRESSNS. MA o + LLL J i a 10 20 ®'�ONV��`� Z co Lo ( ASSESSORS MAP 247 PARCEL 191 O 43 TRIANGLE CIRCLE z SANDWICH MA 02563 PLAN BOOK 232 PAGE 125 0 0 I 508 364-8894 DATE_ MARCH 21, 2008 -1 - �0. ~ N. �' b JOB #E T E—2 6 7 5 PAGE I OF 2 1 VERSION: Q m X m THIS PLAN IS BASED ON AN INSTRUMENT SURVEY AND IS INTENDED LL W SOLELY FOR INSTALLATION OF THE PROPOSED SEPTIC SYSTEM " DEPICTED HEREON. FOR ANY OTHER CHANGES TO PROPERTY INCLUDING 3 PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS. OWNER 1 SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. - S SOIL.._ TEST LOGDESIGN DULATIONS :I- DATE OF TEST: MARCH 21, 2008 DESIGN FLOW: 3 BEDROOMS X 110 GPD = 330 GPD APPROVED SOIL EVALUATOR: DAVID D. COUGHANOWR. #461 SEPTIC TANK: 330 GPD X 2 DAYS = 660 GALLONS WITNESSED BY: DAVID STANTON. HEALTH DEPT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) PERC NUMBER: 12152 DISTRIBUTION BOX: USE 3 OUTLET D-BOX. TEST PIT 1 NO GROUNDWATER ENCOUNTERED SOIL ABSORBTION SYSTEM: A 25 Ft, x 12 Ft, x 2 Ft- LEACHING GALLERY CAN LEACH PARENT MATERIAL: PROGLACIAL OUTWASH PERC AT 64 in - 2 MIN/INCH IN C SOILS A6ot = ( 25 x 12 ) = 300 sf Asdw = ( 25 + 25 + 12 + 12 ) x 2 = 148 sf ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER Atott = 448 sf (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING Vt 0.74 x 448 = 331.5 GPD 42.49 0-1Z AR LOAMY SAND 10 YR 3/3 NONE FRIABLE USE A 26 ft x 12 Ft. x 2 ft. GALLERY. Vt = 331.5 GPD > 330 GPD REOUIRED 39.16 12-40 B LOAMY SAND 10 YR 4/4 NONE LOOSE 40-132 C MEDUIM SAND 10 YR 6/4 NONE LOOSE 31.49 NO TEST PIT 2 PAARENTUNDWATE MAATERIA EPROGLAC ALD OUTWASH 2 MIN/INCH IN C SOILS NOT TO LEA CHI NG GA L L ER Y 1500 GALLON SEPTIC TANK ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER _ SCALE DIMENSIONS AND DETAIL NOT TO (INCHES) HORIZON TEXTURE (MUNSELU MOTTLING CONSTRUCTION DETAIL USE SHOREY ST-1500-H-10 SCALE 42.40 0-10 Ap LOAMY SAND 10 YR 3/2 NONE FRIABLE USE CUL TEC RECHARGER 330 CHAMBERS 1H-10 LOADING) 10-38 B LOAMY SAND 10 YR 4/4 NONE LOOSE 1 In 39.23 - CC) TAPER 38-132 C MEDUIM SAND 10 YR 6/4 1 NONE LOOSE 31.40 � 4j END CENTER END UNIT UNIT UNIT N 0 0 5 FL- GROUNDWATER ADJUSTMENT 0 81n EXISTING GROUNDWATER LEVEL v BASED ON TOWN OF BARNSTABLE GIS DEPARTMENT RECORDS. 2.5 f t 20 FL INDICATED GW 15.00 25.0 ft. 10 INDEX WELL M1W-29 ZONE C READING DATE FEBRUARY. 2008 "READING 8.6 CROSS SECTION VIEW -,ADJUSTMENT 3.9 INLET CENTER OUTLET ..'ADJUSTED G W 18.9 END COVER END 2 in 4 in 2 in PEliSTONE ;.Gs. n r M 24 to IN DROP LINE 26 1n EFFECTIVE 1-1/2 �1GR TO FROM l0�n 14 TO DEPTH BUILDING to % D-BOX 48 in 1 46 1n 52 in 46 1n LIQUID GAS LEVEL BAFFLE NOTES 1441n INSTALLER MAY SUBSTITUTE AN APPROVED GEOTEXTILE 1) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. FABRIC IN PLACE OF THE PEASTONE LAYER SPECIFIED CROSS SECTION VIEW 2) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). SEWAGE DISPOSAL SYSTEM PLAN 41 INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES BEFORE EXCAVATING FOR SYSTEM. -TO SERVE EXISTING DWELLING 51 EXISTING CESSPOOLS TO BE PUMPED, COLLAPSED, AND FILLED OR REMOVED. JOHN & JUDITH CARPENTER 61 ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON, FINES AND DUST IN PLACE. 37 RUDDER ROAD HYANNIS, MA Z) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK. ECO-TECH ENVIRONMENTAL B) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH 43 TRIANGLE CIRCLE SANDWICH MA 02563 SIX INCHES OF CRUSHED STONE HAS BEEN .PLACED TO MINIMIZE UNEVEN SETTLING. ETE-2875 MARCH 21, 2008 2/2