HomeMy WebLinkAbout0108 RUDDER ROAD - Health F
8 RUDDER ROAD, HYANNIS
= 247176
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COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 108 Rudder Road
Hyannis Port, MA 02647 y fr7 (,�
Owner's Name: Crai &Sue Burstein //
Owner's Address:
Date of Inspection: November 5, 2006 _ o
Name of Inspector: (Please Print) James M. Ford
Company Name: James M. Ford
Mailing Address: . P.O.Box 49
Osterville,MA 02655-0049
Telephone Number: (508) 862-9400
CERTIFICATION STATEMENT - {—�
I certify that I have personally inspected the sewage disposal system at this address and that the formatioti reported
below is true,accurate and complete as of the time of the inspection. The inspection was perfo& d basedTn my =3
training and experience in the proper function and maintenance of on site sewage disposal systefp31 I am a--DEP G;
approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The sy"ste k
rn
N r"'
✓ Passes
-
Conditionally Passes
Needs Further Evaluation by the Local Approving Auth rity
F it
Inspector's Signature: Date: November 21, 2006
The system inspector shall sub it a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP. The original should be sent.to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time. This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 108 Rudder Road
Hyannis Port, MA
Owner: Craijz&Sue Burstein
Date of Inspection: November 5. 2006
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR
15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass" section need to be replaced or
repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please
explain.
The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
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Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 108 Rudder Road
Hyannis Port, MA
Owner: Craik&Sue Burstein
Date of Inspection: November S. 2006
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 CNM 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety and the environment:
Cesspool or privy is within 50 feet of a surface water
Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface water supply.
The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply.
_ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
The system has a septic tank and SAS.and the SAS is less than 100 feet but 50 feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
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Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 108 Rudder Road
Hyannis Port, MA
Owner: Cram&Sue Burstein
Date of Inspection: November 5, 2006
D. System Failure Criteria applicable to all systems:
You must indicate either"yes"or"no"to each of the following for all inspections:
Yes No
✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS.or
cesspool
✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/z day flow
✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number
of times pumped
✓ Any portion of the SAS,cesspool or privy is below high ground water elevation.
✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
✓ Any portion of a cesspool or privy is within a Zone 1 of a public well.
✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well.
✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. [This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.]
No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of.
Health to determine what will be necessary to correct the failure.
E. Large System:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
gpd•
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
Yes No
the system is within 400 feet of a surface drinking water supply
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped
Zone 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.
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Page 5 of 11
OFFICIAL•INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 108 Rudder Road
Hyannis Port, MA
Owner: Craig&Sue Burstein
Date of Inspection: November 5. 2006
Check if the following have been done: You must indicate"yes"or"no"as to each of the following:
Yes No
✓ _ Pumping information was provided by the owner,occupant,or Board of Health
✓ Were any of the system components pumped out in the previous two weeks?
✓ _ Has the system received normal flows in the previous two week period?
✓ Have large volumes of water been introduced to the system recently or as part of this inspection?
✓ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
✓ _ Was the facility or dwelling inspected for signs of sewage back up?
✓ Was the site inspected for'signs of break out?
✓ _ Were all system components,excluding the SAS, located on site?
✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition
of the baffles or tees,material of construction, dimensions,depth of liquid,depth of sludge and depth of scum?
✓ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has been determined based on:
Yes No
✓ _ Existing information. For example,a plan at the Board of Health.
✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable) [310 CMR 15.302(3)(b)].
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Page 6 of I 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 108 Rudder Road
Hyannis Port, MA
Owner: Craig&Sue Burstein
Date of Inspection: November 5, 2006
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
Number of current residents: 4
Does residence have a garbage grinder(yes or no): n/a
Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required]
Laundry system inspected(yes or no): No
Seasonal use(yes or no): No
Water meter readings,if available(last 2 years usage(gpd)): Unavailable
Sump Pump(yes or no): No
Last date of occupancy: Currently occupied
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sqft,etc.):
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no)
Non-sanitary waste discharged to the Title 5 system(yes or no):
Water meter readings, if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records,
Source of information: Pumped 1 %z years ago-per owner
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped: gallons--How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
Septic tank,distribution box,soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no) (if yes,attach previous inspection records,if any)
Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
Tight Tank Attach a copy of the DEP approval
Other(describe):
Approximate"age of all components,date installed(if known)and source of information:
Installed on 5113103-per as built card
Were sewage odors detected when arriving at the site(yes or no): No
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Page 7 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 108 Rudder Road
Hyannis Port, MA
Owner: Craig&Sue Burstein
Date of Inspection: November 5, 2006
BUILDING SEWER(locate on site plan)
Depth below grade:
Materials of construction: _cast iron _40 PVC other(explain):
Distance from private water supply well or suction line:
Comments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK: ✓ (locate on site plan)
Depth below grade: 20"
Material of construction: concrete _metal _fiberglass ✓ polyethylene
_other(explain)
If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of
certificate)
Dimensions: 1500 gal.
Sludge depth: 211
Distance from top of sludge to bottom of outlet tee or baffle: 30"
Scum thickness: 10"
Distance from top of scum to top of outlet tee or baffle: 6"
Distance from bottom of scum to bottom of outlet tee or baffle: 10"
How were dimensions detennined: Measuring stick
Continents(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.).
Tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs of leakage
Recommend installing risers and pumping the septic tank..
GREASE TRAP: None (locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _fiberglass _polyethylene _other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Continents(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
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Page 8 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 108 Rudder Road
Hyannis Port. MA
Owner: Craig&Sue Burstein
Date of Inspection: November S, 2006
TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: Even
Commnents(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.):
The D-box was level and clean._No solids were present The cover was 12"below grade
PUMP CHAMBER: None (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no)
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
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Page 9 of 11
:F
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 108 Rudder Road
Hvannis Port, MA
Owner: Craig&Sue Burstein
Date of Inspection: November 5, 2006
SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:
✓ leaching chambers,number: 3-500 Qal. drywells (13'x 30'x 29-per as built card
leaching galleries,number:
leaching trenches,number, length:
leaching fields,number,dimensions:
overflow cesspool,number:
Innovative/alternative system Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.):
The drvwells were dry and clean. There did not appear to be any signs of failure.
CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:
Depth-top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or no):
Connnents (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
PRIVY: None (locate on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
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Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 108 Rudder Road
Hyannis Port, MA
Owner: Crain&Sue Burstein
Date of Inspection: November 5. 2006
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.
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Page 11 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 108 Rudder Road
Hyannis Port, MA
Owner: Craijz&Sue Burstein
Date of Inspection: Novetnber 5: 2006
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water 25 +/- feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
✓ Checked with local Board of Health-explain: topographic and water contours maps
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Using Barnstable topographic and water contours maps the maps were showing approximately 25'+1-to ground water at this
site.
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This report has been prepared only for the septic system and components described herein. This septic system has been
inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will
function properly in the future. There have been no warranties or guarantees, either expressed, written or implied,
relating to the septic system, the inspection, this report and/or any components of the septic system which have not
been located and inspected.
11 I
TOWN OF BARNSTABLE
^LOCATION I D a SEWAGE#
VILLAGE P0, ASSESSOR'S MAP&PARCEL IN.
INSTALLERS NAME&PHONE NO. .
SEPTIC TANK CAPACITY /Sn poly
LEACHING FACILITY: (type) 3- S(/0 (L('y"11s (size) I3 x 3 0 x a--
NO.OF BEDROOMS 3
OWNER_ urST iri
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private-Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) J Feet
FURNISHED BY���fAGdr/p, T• FD/G
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3 3a- S7
3 S S�
TOWN OF BARNSTABLE
LOCATION I Q� A-I-We d-- SEWAGE
VILLAGE Il d,—A17S �O�-� ASSESSOR'S MAP & LOT �` a
INSTALLER'S NAME&PHONE N0.
SEPTIC TANK CAPACITY
LEACHING FACELITY: (type)
�-Sov Fad Dn.-weG(-s (size) G 3 A ,710,N .t
NO. OF BEDROOMS 3
BUILDER OR OWNER ��
PERMIT DATE: O 3 COMPLIANCE DATE: '/J
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
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Fee
!!! c THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
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PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01ppfication for Miopo.5al 6pgtem Con5tructiou 3permit
Application for a Permit to Construct( )Repair.(/4Upgrade( )Abandon( ) El Complete System [; tdividual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.G4Z4t& S•V2Qs�yt.e_
Ivg �cicl�eY 626
jAssessor's Map/Parcel ►�15 P0�1' A— 7w 0 (�tJ e�dPl t2c� is FAQ T
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
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Type of Building:
Dwelling No.of Bedrooms .S Lot Sizesq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow 396 gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature ppf��Repairs or Alterations(Answer when applicable) �� CtJ cGre% L l� 9✓
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 t e Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been iss y thi Bo of H alth'—`
Signed a Date 1
Application Approved by-= Date
Application Disapproved for the following reasof.,
Permit No. Date Issued
.:
No. Fee
((( F MASSACHUSETTS Entered in computer:
THE O s
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
01ppYication for Zigb5al *pgtem Construction Permit
Application for a Permit to Construct( )Repair SAgrade( )Abandon( ) ❑Complete System E2111�dividual Components
Location Address or Lot No. Owner's Name,Address and Tel.No.G p A I( f 5uao✓v e-
Assessor'sMap/Paz /U$ QcJcuer `�6
Map/Parcel 16018
Installer's Name,Address,and Tel.No. L Designeerr's Name,Address and Tel.No.
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Type of Building:.
Dwelling No.of Bedrooms _ Lot Size g"),aJU sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow T 511 gallons.
Plan Date f y 3 Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
1
Nature of Repairs or Alterations(Answer when applicable) egy9a l ez4cre T C-d'i�l/hbej+ -
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued-by this�o of,Hgalth.
— ._ _
Signe n l Date
_ Application Approved byrt Date
Application Disapproved or the following reasotts�
L
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (tompliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( )
Abandoned( )by
at has een constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No dated
Installer Designer
The issuance of Vs permit shall not be construed as a guarantee that the systeiiz wtll unction -designed.
Date .5 1 63 r Inspector / `�. r� S _
————— — -- ——————————-————————————————— -
No. � Fee
THE COMMONWEALTH OF,MASSACHUSETTS
s
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Mi!5 poaf *p6tem (Construction Permit
Permission is hereby d!Crtruc/t Repair(Upgrrade( Abandon( ))
System located at o12h ep2 E A �_). /-T V&
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:Consguctijo must b�ompleted within three years of the date of this perm t. n
Date: Approved b
_ PP Y
TOWN OF BARNSTABLElc
LOCATION ;/� 4,,,z>17c AL-. •n SEWAGE 11
VILLAGE_ ff ^,i,-a5 �D•�-�. ASSESSOR'S MAP & LOT a -7'
INSTALLER'S NAME&PHONE NO.2�57-0,i,6 b
i
SEPTIC TANK CAPACITY 4'
LEACHING FACILITY: (type) �Af 4e- Dn.�c��G .g
(sine) l3 .�r3®�►�
NO. OF BEDROOMS
BUILDER OR OWNER �2
i PERMIT DATE 'i' 0 3 COMPLIANCE DATE; '/?-,&
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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„'IAR-20-03 03 : 13 PM R. J. CADILLAC, PLS, RS 508 775 9700 P- 01
RONALD J. CADILLAC, PLS, RS
Professional Land Surveyor
Registered Sanitarian
P.O. Box 258, West Yarmouth, MA 02673
(509) 775-9700 (800) 520-5591
TRANSMITTAL, FORM
To.
Re:
bjold
Date: 31Z 0 J, Certified No:
Enclosed;
Message:
/40 ZY 66--v 9140
dr
JF
6A
ISigned:
4AR-20-03 03 : 14 PM R. J. CADILLAC, PLS, RS 508 775 9700 P. 02
' 3�0
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TOWN OF BARNSTABLE
LOCATION n SEWAGE# G TAP
VILLAGE d� %o R ASSESSOR'S MAP& LOT J��l7b
INSTALLER'S NAME&PHONE NO._ ?o ��-•�a�- S
SEPTIC TANK CAPACITY IrC .9
LEACHING FACILITY: (type) S 3 3_o C e &,�S (siz -d SwZ
NO.OF BEDROOMS
BUILDER OR OWNER B d YC A' T cc O
PERMTTDATE: !' �` �' — L _COMPLIANCE DATE:
Separation Distance Between the:
MwUmum Adjusted Groundwater Table and Bottom or Leaching Facility
Peet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility)
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) _ eel
r _ TOWN OF BARNSTABLE q
N"�O g udf4l k K� SEWAGE # f
VILLAG ASSESSOR'S MAP & LOT-,Z- ,Z
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY d �®
LEACHING FACILITY: (type) "-3 3 0 C o�, Le S (size) /0
NO.OF BEDROOMS 3
BUILDER OR OWNER
PERMTTDATE: 1 2-- < G COMPLIANCE DATE: / — 7— 2
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
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LOCATION SEWAGE #
VILLAGE 4 � t.Ze2i���� ASSESSOR'S MAP&�,LOT //�'9
�5� �NAME&PHONE NO�/`V46 V' 4- (-&d hUr-'HU?W '40l e-e�L�
SEPTIC TANK CAPACITY
� o/s J '
LEACHING FACILITY: (type) (size
NO.OF BEDROOMS
BUILDER OWNER
PERMITDATE: COMPLIANCE DA
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility /� f 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 eachin fac' ) /5/ Feet
Furnishedbya2cyo��}�j- ;1IIS1��Jl�,
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74
No. f Fee$50 00 /
THE COMMONWEALTH OF MASSACHUSETTS.' Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
ZIp prication for Mi5pogar *pztem Con!5truction Permit
Application for a Permit to Construct( )Repair( x)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 1 0 8 Rudder Rd Owner's Name,Address and Tel.No. 7 9 0-8 4 6 5
64 Hyannisport, MA Suzanne & Craig Burnstein
Assessor's Map/Parcel 02672
Installer's Name,Address,and Tel.No. 7 7 5-8 7 7 6 Designer's Name,Address and Tel.No.
Wm E Robinson Sr Septic Srv.
PO Box 1089 , Centerville, MA 0263
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( no
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil sand
Nature of Repairs or Alterations(Answer when applicable) Title 5 Septic repair. I n s t a it
150Og tank, D—box, and 4 high capacity, stonepacked infiltrators.
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Boar,Or of Health.
Signed Date) e
Application Approved by - ate /.—.; 6 `74
Application Disapproved for the following reasons
Permit No. Date Issued
' No. b t9 �P ,�.y Fee T,5 0.0 0�iV 4 r
THE COMMONWEALTH,
OF MASSACHUSETTSyw4;° O' v Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
ZIppYication for Di!5poal *p5tem Construction Permit
Application for a Permit to Construct( )Repair( X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot K0. 108 Rudder Rd Owner's Name,Address and Tel.No. 7 9 0—8 4 6 5
kAssessor's Map/Parcel W Hyannisport, MA Suzanne & Craig Burnstein
•
03672`
Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 - Designer's Name,Address and Tel.No.
Wm E Robinson Sr Septic Srv.
A. PO Box 1089, Centerville, MA 0263
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( no
Other Type of Building No.kf-R son 5j 6 Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil sand
Nature of Repairs or Alterations(Answer when applicable) Title 5 Septic repair. Instal
1500g tank, D-bo)"; and 4 high capacity, stonepacked infiltratorsa
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system,'
'in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi
cate of Compliance has been issued by this Board,of Health. h /
Signed Date M;,./-Q! (.
Application Approved by.,:—° ate Q ,;X 6 ` 7,(
Application Disapproved for the following reasons
Permit No. Date Issued i
----1� f —iz - �`=----_-- ----`----------
THE COMMONWEALTH OF MASSACHUSETTS
Burnstein BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( X )Upgraded( )
Abandoned( )by Wm E Robinson Sr Septic Srv. j
at 108 Rudder Rd, W Hyannisport, MA has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. / -&d'a dated L) -e2 6 94
Installer Wm E Robinson Sr Septic Srv. Designer
The issuance of this permit shall not be construed as a guarantee that the system will function as designed.
Date I _ (z 1 Inspector .-
u
No. o " to tr� Fee$5 0.0 0
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Burnstein lwigozal *p5tem Construction Permit t
Permission is hereby granted to Construct( )Repair( X)Upgrade( )Abandon( )
System located at 108 Rudder Rd, W Hyannisport t
by WM'E Robinson Sr Septic Srv.
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 completed within three years of the date of this permit. ham,
Date: - a T Approved by
NOTICE: This form is to be used for the repair of faiCed
septic systems only
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHQUT DESIGNED PLANS)
I,William E. Robinson, Sr. ,hereby certify that the application for disposal works
construction permit signed by me dated ' �`� �, `a �° ,concerning the
property located at 108 Rudder Road,WHyannisport,MA meets all
of the following criteria:
* There are no wetlands within 300 feet of the proposed septic system.
* There are no private wells within 150 feet of the proposed septic system.
* The obseved groundwater table is 14 feet or greater below the bottom of the leaching facility.
k There is no increase in flow and/or change in use proposed.
x There are no variances requested or needed.
SIGNED:
LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 42
(Attach a sketch plan of the proposed system. Also if the licensed installer proposes a certification
plot plan,this plan should be submitted),
I
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LOCATION JO 1?c,C�r��.s� R� SEWAGE #
VILLAGE G�/ ro ASSESSOR'S MAP.& LOT
INSTALLER'S NAME&PHONE NO. 1?04
SEPTIC TANK CAPACITY /
LEACHING FACILITY: (type) ..3 3 O Co u k s. (size) I o—a S`vZ,
NO.OF BEDROOMS 3 ,
BUILDER OR OWNER R
r
PERMITDATE: l L — 01 L COMPLIANCE DATE: / g
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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 j
,i
3 3 3 v G o I ;,•c
/o -Its- a-'
BORTOLOTTI CONSTRUCTION, INC. v
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
'-
Address Prop
Date of Inspec}� 5� Map / Parce Owner
—
CHECK IF THE FOLLOWING HAVE BEEN DONE: CHECKLIST
PART A
V/ PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH.
NONE OF THE SYSTEM COMPONENTS HAVE BEEN PUMPED FOR AT LEAST TWO WEEKS AND THE SYSTEM HAS BEEN
RECEIVING NORMAL FLOW RATES DURING THAT PERIOD. LARGE COLUMES OF WATER HAVE NOT BEEN INTRODUCED INTO
THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION.
t'�'AS-BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAILABLE WITH N/A.
LATHE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP.
'--'THE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT.
BALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE.
vTHE SEPTIC TANK MANHOLES WERE UNCOVERED,OPENED,AND THE INTERIOR OF THE SEPTIC TANK WAS INSPECTED
FOR CONDITION OF BAFFLES OR TEES,MATERIAL OF CONSTRUCTION,DIMENSIONS,DEPTH OF LIQUID,DEPTH OF SLUDGE,
DEPTH OF SCUM.
-THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR
APPROXIMATED BY NON-INTRUSIVE METHODS.
SHE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER
MAINTENANCE OF SSDS:
PART B — SYSTEM INFORMATION
RESIDENTIAL FLOW CONDITIONS
No of Bedrooms No of Current Residents 1Y4 Garbage Grinder
l �S Laundry Connected to System f Seasonal Use
NON RESIDENTIAL:
Calculated flow
WATER METER READINGS,IF AVAILABLE:
Pumping Records a GALLONSnd Source of Information: /
SYSTEM PUMPED AS PART OF INSPECTION? //(*-) IF YES,VOLUME PUMPED = GALS
Reason for Pumping:
TYPE OF SYSTEM:
Septic tank/distribution box/soil absorption system
Single Cesspool Overflow Cesspool Privy
Shared system (if yes, attach previous inspection records, if any)
Other(explain) c;;L
Appr ximate age of all components. Date installed,if knowource of information.
we
SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE?
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B — SYSTEM INFORMATION (Continued)
SEPTIC TANK:
Depth below grade: Dimensions:
Material of construction: Concrete Metal FRP Other}
Sludge Depth Distance from top of sludge to bottom of outlet tee or baffle
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
Comments:
DISTRIBUTION BOX: DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT
Comments:
PUMP CHAMBER: Pum s in workin order?
Comments:
SOIL ABSORPTION SYSTEM SAS
IF NOT PRESENT,EXPLAIN:
Cv
TYPE: � G
Comments:
s - o��-s �s s add
CESSPOOLS: Number and configuration ,�S
Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer
Dimension of cesspool I Materials of construction 6'
Indication of groundwater inflow(cesspool must be pumped)
Comments:
�OCE-S
�0
PRIVY:
Materials of construction
Dimensions Depth of solids
Comments:
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
ti
PART B — SYSTEM INFORMATION (Continued)
SKETCH OF SEWAGE DISPOSAL SYSTEM:
INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES,LANDMARKS OR BENCHMARKS.
LOCATE ALL WELLS WITHIN 100'
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DEPTH TO GROUNDWATER: DEPTH TO GROUNDWATER
METHOD OF DETERMINATION OR APPROXIMATION:
s
eo v /GQ $ W r Ve Oil e�1, 5. 6.S
�l q'
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C — FAILURE CRITERIA
(Indicate Y—yes N—no ND—not determined.Describe basis of determination.If"not determined",explain why not.)
Backup of Sewage into Facility?
Discharge or ponding of effluent to the surface of the ground or surface waters?
Static liquid level in the districution box above outlet invert?
Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow?
Required pumping 4 times or more in the last year? Number of times pumped
Septic tank is metal?cracked?structurally unsound?substantial infiltration?substantial exfiltration?
tank failure imminent?
Is any portion of the SAS,cesspool or privy, below the high groundwater elevation?
I- Within 50 feet of a surface water?
!---�" Within 100 feet of a surface water supply or tributary to a surface water supply?
Within a Zone I of a public well?
Within 50 feet of a private water supply well?
�y Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools&privies only, not the SAS)?
Less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water
I quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for
I coliform bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen.
I.
PART D.— CERTIFICATION
!INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS
COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508) 771-9399
i
CERTIFICATION STATEMENT
I CERTIFY THAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION
II REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY
!RECOMMENDATION REGARDING UPGRADE,MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE
IN THE PROPER FUNCTION AND MAINTENANCE OF ON-SrrE SEWAGE DISPOSAL SYSTEMS.
CHECK ON .
I HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC
HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED AREAS
STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM.
1 HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN
310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS
FORM.
I
INSPECTOR'S SIGNATURE:
l '
DATE: 9'
I ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(if applicable),APPROVING AUTHORITY
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NOTES Burstein.dwg { 0pa
N CONSTRUCTION NOTES: 1. LOCUS IS A.M. 247, PARCEL 176. ova"o
2. ELEVATIONS SHOWN ARE ASSIGNED.
3. LOCUS IS IN FLOOD ZONE C ON FIRM DATED JULY 2, 1992. TO4'n Ro
a. BE ALERT--EXISTING SYSTEM FAILED IN SIX YEARS (NO. 96-682)--WHY? 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED)
N 5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER.
N CALL R.J CADILLAC OR HEALTH AGENT IF SOIL CONDITIONS DIFFER FROM TEST HOLE. 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. a�
MEDIUM SAND WAS FOUND 3' DOWN IN TEST HOLE. 7. INLET TEE TO PROJECT DOWN 13 OUTLET TEE DOWN 14".
a 8. IF TWO OR MORE LINES, WATER TEST D—BOX FOR EQUAL FLOW
D—BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET.
9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. NOT TO
LOCATIONS OF OLD SEPTIC COMPONENTS BUILD UP COVERS TO WITHIN 1' OF GRADE. MORTAR CHIMNEYS IN PLACE. SCALE
ONE TANK TO EARE APPROXIMATE AND BASED UPON 10. SSTONEOVER TO BEO DOUBLE WASHEDI 3/4 TO 01F1/2A WITH 2" MIN. 1/8 TO 1/2" PEA STONE ON TOP. LOCATION MAP
BENCH MARK--TOP/CENTER OF AS-BUILT CARDS AND IMAGINATION. 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND,
CONC. BOUND= 24.00 ASSIGNED CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC.
12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING TEST HOLE 1
IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 CMR 15.255(3).
13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN DEPTH inches
LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. (inches) ELEV.(18.1
0
14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. A layer 10yr 3/2 8.1
N/F REDUCE GRADE ON NORTH END OF LEACH AREA OR TEST HOE DATE: March 6, 2003 7" sandy loam
PERFORMED BY: Ron Cadillac, Soil Evaluator
20.1 BIRELY ADD EXTRA STONE TO PROVIDE 3' MAXIMUM COVER. WITNESSED BY: 8" B layer 10yr 5/8
O PERC RATE: <2'-00"/inch (C layer) loamy sand
21. 24,3 23.53t SOIL SURVEY(1993): Carver coarse sand 36" 15.1
GEOLOGIC MAP(1986): Barnstable plain deposits
;t { Top Foundation a> C layer 2.5y 6/6
/ Invert 19.2f
�..J 4 4 Use Gas Baffle 4 CULTEC 330'S medium sand
Existing Invert 18.53
24,6 Proposed
• e. 1 8 � ,, 17.5
BENCH MARK--TOP OF SPIKE
22,6 Existing S=3"/ft TOP PEA STONE
SET FLUSH= 23.28 ASIGNED S=6"/ft
/ 17 Invert 19.44 Plastic
/ Ste. 1500 Gal. '
N ('� } �_ 22.5 2S, I Existing — — — — --
L V T i 2 06� I 24 132" no water 7.1
Op. '�Y
14.0 �o� 1 01000±S.F. 1 I Invert 18.70 Invert 17.00 15.00
22,8 I 6 Stone or compact Proposed Proposed I 7 9 Bottom
� x 18, �5.7 I �2 11 — 1 3
F l 4 C�/ 23.0 m Bottom TH1=7.1
�4.2 � 3.5' 24,6 <
25.0
DESIGN DATA `°
1 ,5 F ��� �� o \ z. 3 BEDROOMS: 3
13,0 C� � / • /
�14,20 5,7 - g / / GARBAGE GRINDER:_ No
O / REQUIRED CAPACITY: 330 GPD EACH AREA
16.1 23,2 24.4
/ x �4,4 , SEPTIC TANK: 1500 GAL. USE/REUSE 4 CULTEC RECHARGER 330'S WITH
04 � 22,8 / / BOTTOM LEACHING AREA: 360 SF APPROXIMATELY 4' STONE ON SIDES AND APPROX—
�
IMATELY 2 1/2' STONE ON ENDS TO MAKE A 30' LONG
SIDE LEACHING AREA: 168 SF
} [{30' x W BY 12' WIDE BY 2' DEEP LEACH AREA, AS SHOWN.
1 ,3 ( 33' x 10' x 2' DEEP 2 12'+ 30' X 2' DEEP
��,8` �,-� L,94 2�?�., � � � � / RESERVE AREA USING [ { ) )] PARTIAL REMOVAL
1, �27 1 �/ e�'' 23.6 FOUR RESERVE
TECARE 3USI DESIGN CAPACITY: 390 GPD
15,o T -t!— 20 �'� h�` , =371 GPD [(360 SF + 168 SF) X .74 GPDjSF] REMOVE ANY CLOGGED SOIL AND STONE FROM
�; N co / ryo o� FAILED SYSTEM FROM UNDER AND WITHIN 5' OF NEW
11,7 3 / /, > LEACHING AREA. REPLACE ALL REMOVED CLOGGED
00
x 123 S 70, " 17.4 / 22,3 ��./ MATERIAL WITH GOOD CLEAN SAND FILL FROM A
S,�? op• / fe" GRAVEL PIT. WHEN THIS CLEAN SAND IS RUBBED
ON THE HANDS FINES SHOULD NOT LODGE IN THE
Tr f N/F / PORES OF THE SKIN.
9.13 3
GRANDMONT 5
N/FPROVIDE
GRADE
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AN ORIGINAL RED STAMP AND SIGNATURE. CRAIG & SUZANNE BURSTEIN
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g-- PROPOSED CONTOUR PROFESSIONAL LAND SURVEYOR & 'REGISTERED SANITARIAN
0 UTILITY POLE (IF SHOWN) P.O. BOX 258
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0 TREE (IF SHOWN, NOT ALL SHOWN) HEALTH AGENT APPROVAL DATE
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