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0076 SAINT CATHERINE AVE - Health
Saint.Cath'erine Ave ( a.k.a..tj�Saint Catherine) 9` Hyannis j A = 291 - 092 'el ` 76 a i; / TON"OFF BARNSTABLE LOCATION 7 574 (RGj IOJ!� ,,&U S SEWAGE# (S/ ll/ VILLAGE ASSESSOR'S ASSESSOR'S MAP.&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 9 � LEACHING FACILITY.(type) 5�D6 6,0& 04 size) NO.OF BEDROOMS OWNER 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) Feet FURNISHED BY Z�s 00 CP I - t Town of Barnstable Barn Regulatory Services Department ANWICdO • snaxsrr►atE I.F Public Health Division 639• 1� a 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FINAL ORDER Richard Scali,Director ' FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7008 3230 0002.5178 2514 April 22, 2014 Jose & Judite Lima 91 Saint Catherine Ave. Hyannis, Ma 02601 The two septic systems located at 76 Saint Catherine Ave,MA was last inspected on 10/19/2013 by Michael Kellett, a certified septic inspector for the State of • Massachusetts. The inspection of the two septic systems showed that the systems "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following • Systems 1 & 2: Single cesspools automatically fail in the Town of Barnstable. You are ordered to repair or replace the septic systems within sixty (60) days from the date you receive this notification. Any person who shall fail to comply shall be fined not less than $10.00 or more than $500.00 for each day's failure to comply with an order shall constitute a separate violation. You may request a hearing before the Board of Health, a written petition requesting a hearing on the matter,within seven (7) days after the day this order was served. PER ORDER OFTHE BOARD OF HEALTH j Thomas McKean,R.S. CHO Agent of the Board of Health d QASEPTICTinal Order\76 Saint Catherine Ave Hy 2014 �_, OfSHE Town of Barnstable Barn Regulatory Services Department ASAMMINCft s Public Health Division � D b�a,0 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 SECOND NOTICE Richard Scali,Acting Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 2521 November 7, 2013 Jose &Judite Lima 91 Saint Catherine Ave Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE. TITLE 5 • The two septic systems located at 76 Saint Catherine Ave (a.k.a. 91 Saint Catherine Ave)Hyannis,MA were last inspected on 10/19/2013 by Michael Kellett, a certified septic inspector for the State of Massachusetts. The inspections of the septic systems showed that the systems both"Fail"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System I: is in hydraulic failure • System II: a single cesspool automatically fails in the Town of Barnstable. You are ordered to repair/replace the septic systems within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic systems within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH v Thomas McKean,R.S. CHO a-1 Agent of the Board of Health r � . -40 Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\76 Saint Catherine Ave Hy Nov 2013.doc Parcel Detail http://issgl2/intranet/propdata/ParcelDetaii.aspx?ID=22647 't t Logged In As: Parcel Detail Tuesday, March 4 2014 Parcel Lookup Parcel Info Parcel rn91 Developer I LOT 9 ID IL Lot° Location 76 SAINT CATHERINE AVE ri l 10 Frontage Sec�� Sect� - Road, I Frontage l Village JHYANNIS f Fire HYANNIS District Town sewer exists at this _ Road 405 -- --- address lNo � Index' Interactive . pYhtk '® Owner Info Owner ILIMA,JOSE&JUDITE — — - Co- �� Owner Streetl 91 ST CATHERINE AVE Street2 City HYANNIS �� State MA Zip[02601 Country Land Info ..... _ _ .._.... ..... . ....... ..... . Acres�0.38 _ Use ISing�� gle Fam MDL-01 Zoning,R��� Nghbd� _J Topography Level Road Paved Utilities ISeptic,Gas,Public Water Location Construction Info Building 1 of 1 Year 9 5� ) Roof F&able/Hip���LL� Ext Wood Shingle ^-V) Built Struct Wall Living;2110 Roof,Asph/F GIs/Cmp ( AC`None +.` s r Area Cover' Type' In t -- Bed Style Cape Cod iDrywal1 I 15 Bedrooms Wall - Rooms ie r mw Bath Model Residential Floor lCarpet � - Rooms 12.Full � - � •� _ Grade Average , Heat!Hot Waterf Total 110 Rooms ( ?` 1 Type Rooms' + 4 ��— Heat Found Stories 11 1/2 Stories Fuel'Oil ation IPoured Conc. Gross http://issgl2/intranet/propdata/ParcelDetal.aspx?ID=22647 3/4/2014 4 t Town of Barnstable Barnstable °# Regulatory Services Department MAEfteft ' A&S Public Heath Division A Q D a 1651�� ub l2007 �Fp 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 SE TICE Richard Scali,Acting Director FAX: 508-790-6304 NO Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 2521 November 7, 2013 Jose&Judite Lima 91 Saint Catherine Ave Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE. TITLE 5 The two septic systems located at 76 Saint Catherine Ave (a.k.a. 91 Saint Catherine Ave) Hyannis,MA were last inspected on 10/19/2013 by Michael Kellett, a certified septic inspector for the State of Massachusetts. The inspections of the septic systems showed that the systems both"Fail"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System I: is in hydraulic failure • System II: a single cesspool automatically fails in the Town of Barnstable. You are ordered to repair/replace the septic systems within sixty(60) days from the date you receive this notification. Failure to repair/replace the septic systems within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH e Thomas McKean,R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\76 Saint Catherine Ave Hy Nov 2013.doc �f t� -Town of Barnstable Barnstable Tay Regulatory Services Department AtftedtaCft KAS& Public Health Division I %63q ♦� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Acting Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 0992 November 7, 2013 _z4s Jose & Judite Lima 76 Saint Catherine Ave Hyannis, MA 02601 • ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE. TITLE 5 The two septic systems located at 76 Saint Catherine Ave (a.k.a. 91 Saint Catherine Ave) Hyannis, MA were last inspected on 10/19/2013 by Michael Kellett, a certified septic inspector for the State of Massachusetts. The inspections of the septic systems showed that the systems both"Fail' under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System I: is in hydraulic failure • System 11: a single cesspool automatically fails in the To�[i of Barnstable. d You are ordered to repair/replace the septic systems within sixty (60) days from the date you receive this notification. Failure to.repair/replace the septic systems within the deadline period will result in future enforcement action. PER ORDER-OF THE BOARD OF HEALTH • IcKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\76 Saint Catherine Ave Hy Nov 2013.doc �• outbind://1-OOOOOOOOD29B6432901CDB49B30FFF776DBODF8507008249EAC50E1D794ABA69DC2DID147BDCOOOO... Flynn, Judith From: Schlegel, Frank Sent: Tuesday, August 13, 2013 10:43 AM To: Barrows, Debi Cc: HeathDeptMailbox; 'MacNeely, Martin' Subject: Address change for Map 104 Parcel 005.002, Formerly#875 Race Lane, Marstons Mills He Debi, The owner came in and indicated his new house is facing and taking access off Wheeler Road and he believed he needed an address change for the property identified above. Based on his submitted site plan, I have changed the address to#11 Wheeler Road, Marstons Mills for this property. Please update any hard copy files you may have on this property to reflect this address change. Frank Schlegel E911 Data Liaison Engineering Records Manager (508) 790-6400 x-4942 - 8/13/2013 No. '' Fee l THE COMMONWEALTH OF MASSACHUSETTS. Entered in computer:__-ef!5' Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2ppYication for Disposal *pstrm Construction j3ermit Application for a Permit to Construct(Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel — m= ��e_ .m Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type o uilding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building HouSe— No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ® gpd Design flow provided ::W gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 1a � Type of S.A.S._�� �y �'L!*7"-t Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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`p?ace the system in operation until a Certificate of Compliance has been issued by this Board Pealth. Si ed Date el'Ile Application Approved by Date — C Application Disapproved by Date for the following reasons Permit No. /p / _ ' I/ Date Issued -------------------------------------- f Ir No. �` I I I I - '_ ,....,_ Fee THE.COMMONWEA6T"F MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION--TOWN OF BARNSTABLE, MASSACHUSETTS application for Disposal *pstrm Construction 3permit Application for a Permit to Construct(t/Repair( ) Upgrade( ) Abandon( ) 19/complete System ❑Individual Components Location Address or Lot No. —J'6 _5�4,C`14,4144,(4,5Z_S Owner's Name,Address,and Tel.No. Assessor's Map/ParcelAl- Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type o uilding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building HoySPi No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.requiredr) 0 gpd Design flow provided �2�J gpd r. Plan Date Number of sheets Revision Date Title Size of Septic Tank �� Type of S.A.S. S 6Py 6� *Y,,,4 e.�{ Description of Soil f F Nature of Repairs or Alterations(Answer when applicable) Date last inspected: r 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,Rot to p al ce the system in operation until a Certificate of Compliance has been issued by this Board Health. C/ G � Si red'_ Date Application Approved by Date Application Disapproved by �` Date for the following reasons / Permit No. / y _ Date Issued - - - - ----.---------------- ------ - - _-.---- ---------------.---------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS P Certificate of Compliance THIS IS TO CERTIF ,tat the On-site Sewage Disposal system Constructed( ) Repaired(!/Upgraded( ) Abandoned( )by �O'f1 h4 n ry' at (f/ S/ ( 94 yt.--�, has been constructed in accordance with the provisions of Title 5 and for Disposal System Construction Permit No. )UI 1 "1 I dated Y — l b 6(�J ' y Installer Designer S (�✓� #bedrooms Approved deslan flow 5 D gpd The issuance of this pe t al not a co &trued as a guarantee that the system w' nct on as designed. /� d p Date Inspector ----------------------------------------------- --- - - ------------------ ---------Fee------------------- No. G - 1 /0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ' Misposat *pstrm strnction 3pPrmit Permission is hereby granted to Construct,(r) Repair( Upgrade( ) Abandon( ) System located at ��, �� ��I✓�/c1�.S re tag and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. i Provided:Construction must be completed•within three years of the date of this permit. Date �I ' I b / Approved by k, .\y Town of Barnstable SINE r Regulatory Services ti c� Thomas F. Geiler,Director BABNSTABLE. ' Public Health Division Thomas McKean,Director FD MA'S 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 a0/// /// Fax: 508-790-6304 Date: -16' w Sewage Permit- Assessor's Map/Parcel 275,1- 0 92 Installer & Designer Certification Form Designer: - Sd 5�- Installer: 0�'h �b ✓ Address: Tdf",XQ �'ZZ9 Address: �,cn -� �ict1 ,0 6 3 �vt.ltGy � A On n 2.v was issued a permit to install a (date) (' staller) / septic system at7(vr�17-�dEJ2cn1 t/ty� based on a design drawn by (address) S►L dated 4�-P(2-+L i 1 Zv t . (designer) 4— I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-b ilt by designer to follow. Stripout (if required) was inspected and the soils were found isfactory. DAVI D. stal Signature) U FLAHERTY,3R. No. 1211 X (Desiger's Sign (Afix Desk ;n imp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. q:\office forms\designercertification form.doc I Town of Barnstable P# Department of Regulatory Services IInIW9rA9r� ! Public Health Division Da te ate 200 Main Street,H anuis MA 02G01 ArFt7 MAC A Date aclieduled— Tune Fee I'cl f S�o ° ��� �z ssess�zent for Se Dis ®s e � Performed By: Witnessed By: LOCATION& G]CNERAL MOII`MA TION Location Address �/ S� A� G e- Owner's Name L/ 0 If l��J �LIIiLC/7 - -( Address Assessor's Map/Parcel: .791,j9091, Engineer's Name NEW CONSTRUCTION REPAIR Teleplibne# C�(,� Sl/�� 672?-X Land Use / v141 Slopes M Surface Stone Distances from: Open Water Body--� ; K/ P y ft Possible Wet Area��__ft Drinking Wafer Well {t Drainage Way / g Y---�ft Property Line fit Other 149 �� (�l.Qe►'yft SI UCH:(Street name,dimensions of lot,exact locations of test boles&Pere-tests,locate wetlands to proximity to holes) oc- _ �l t CD Parent material(geologic) Depth t0 13edroek t "gol Depth to Groundwater. Standing Waterin Hole: A1 ` Weeping flout Pit Ppee T_T Estimated Seasonal High Oroundwnter5. DIE,TERIVIINAI7[ON FOR SEASONAL,YUGH WATER TABI.E V l" - MethV Used: - `- NDcp7,11bObscrv.d s "ng inobshole: lu Depth to soil mottles:weeping from de of obs_hole: In Groundwater Adjustmen► \ fr. Index We Reading Date: index Well level M•� Adj,factor�� _ At f.(JI'uuadwater)xvel > -z— PE RCOL,ATI0N TEST 11-?-4-riwe 114 4A, Observation )� #i Hole Time it' 9" Depth of Pe rc Time at G" Start Pre-soak Time @ �! �/ Z4 End Pre-soak G 2 ,Gt Rile Min./I¢ch Site Suitability Assesentcnt: Site Passed Site Palled: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back-----V- S ***1f percolation test is to be condlicted within 100' of wetland,you must first notify tite Barnstable Conservation D.h4sion at least one (1) Week prior to beginning. Q:�sErrlc�PERr_roltM.noc DEI1P-OIBSER'VATI!0N HOLE LOG Hole# ,CS Depth from Soil Horizon Soil Texture .Soil Color Soil. Surface(ht.) Other ' (USDA) (Munsell) Moullag (Structure,Stones;Boulders. Consistency, WOO �E 7S2 s lvYs DEEP OBSERVATION HOLE LOG Hole# � Depth fro m P Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. . onsisten % ra el fv f{4/s y 2 _ C `6tY2 S! /ol Maur ]DEEP OBSERVATION HOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(iu_) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Co i to cy,95 t3rayan DEEP OBSERVATION HOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color moll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders, Cons ten 6n,avell Flood insurance Rath Map: Above 500 year flood boundary No— Yes Witldn 500 year boundary No i Yes Within 100 year flood boundary No Y_ 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? ' If not,what is the depth of naturally occurring pe vious material? Certification I certify that on Ya (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, a ise d e pe i described in�10 CNM 15.017. Signature Date Q:LS.PPTIC\PIIRCPORM.D OC PL 6 o ys /s g a/owl is AIX Commonwealth of Massachusetts lugTide 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a-.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 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 the tab 1. Inspector. key too m move your cursor-do not Michael Kellett use the return Name of Inspector key. Aardvark Environmental Inspections Q Company Name PO Box 896 Company Address East Dennis MA 02641 Cityfrown State Zip Code 508-385-7608 S13742 Telephone Number License Number I B. Certification I certify that I have personally inspected the sewage disposal system at this addreff@t d that the, information reported below is true,accurate and complete as of the time of the insn.The Mpectg was performed based on my training and experience in the proper function and mance o sites sewage disposal systems. I am a DEP approved system inspector pursuant to` tion 15.9 of z Title 5(310 CMR 15.000).The system: -� o ❑ Passes ❑ Conditionally Passes ® Fails zM ❑ Needs Further Evaluation by the Local Approving Authority w . N �Gcs✓T _ 100/13 Inspecdo s Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system 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. so t5ins-11/10 Tole 50Nicial Inspection :S rface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityrrown 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: Mail is delivered to this adress as 91 St Catherine ave but the assessor's office has it as76 St. Catherine ave 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): t51ns•11/10 Title 5 Official inspection Form:Subsurface Sewage Deposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °t 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. City/Town state Zip Code Date of Inspection B. Certification (cost.) B) System Conditionally Passes (cunt.): ❑ 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,settied or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑' ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR. 15.303(1)(b)that the system is not functioning in a mannerwhich 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•11l10 TMe 50ffclai inspaMon Foam Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St.Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityrrown State Zip Code Date of Inspection B. Certification (cunt.) 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow t5ins•11/10 Trite 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 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is Hyannis MA 02601 10/19/13 required for every y page. Cityrrown 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 coliforrn 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.t 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 Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins!11/10 Title 5Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every y H annis MA 02601 10/19/13 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 NIA) ® ❑ 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 Sorel 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)P10 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 5 Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15203(for example: 110 gpd x#of bedrooms): 550 t5ins•11/10 Me 5Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityrrown State Zip Code Date of Inspection Di System Information Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings,if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date CommerciaUlndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Ganons per day(gpd) Basis of design flow(seats/persons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings,if available: t5ins-11/10 Title 5 MOW Inspection form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y�< 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank,distribution box,soil absorption system ® Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no) Cif yes,attach previous inspection records,if any) ❑ Innovative/Altemative 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 VA system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Forth-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. City�Town State Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components,date installed(if known)and source of information: 30+years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.2 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.): Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑metal ❑fiberglass ❑polyethylene ❑ other(explain) If tank is metal,list age: years i Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. City/Town 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 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 How were dimensions determined? Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Tine 5 Official Inspection Fort Subsurface Sewage Disposal system Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) 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.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official inspection Forth:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form UIV Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityrrown state Zip Code Date of Inspection D. System Information (cunt.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above 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.): 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.): Soil Absorption System(SAS) (locate on site plan,excavation not required): If SAS not located,explain why: r t5ins•11110 Title 5 Official inspection Forth:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Forth-Not for Voluntary Assessments �< 91 St. Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number,length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil, condition of vegetation,etc.): Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration 2 in line Depth—top of liquid to inlet invert 1" Depth of solids layer Depth of scum layer 2" I Dimensions of cesspool 5,)6, Materials of.construction drywell block Indication of groundwater inflow ❑ Yes ® No t5ins•11/10 Me 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 's Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown state Zip Code Date of Inspection D. System Information,(cunt.) Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): The cesspool was full to above the inlet pipe.The grass above was thicker and greener. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): t5ins•11/10 Title 5 official Inspection Form:Subsurrace Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System:Provide a view of the sewage disposal system,including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building.Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately n rear 0 25 21 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title .5 Official Inspection Form Subsurtace Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76.St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. City/Town state Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 20.0 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked,date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators,installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: USGS maps show an elevation of over 20.0 feet. Before filing this Inspection Report,Please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A,B, C,D,or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-11110 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ��y� ���v� ��� � � w�,�� ��� �v�s � ,m REAL ESTATE { 487 Station Avenue 7 South Yarmouth, MA 02664 Business (508) 568-8202 Cell (508) 360-5472 Fax (508) 398-0684 MA1ZA ELOY MEloyOTodayReal Estate.com REALTOR® TodayRealEstate.com P OiL Commonwealth of Massachusetts � Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St.Catherine Ave) `, VVL Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown 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 A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your I cursor-do not Michael Kellett kY e the return Name of Inspector Aardvark Environmental Inspections F� Company Name PO Sox 896 Company Address few East Dennis MA 02641 City/rown State Zip Code 508-385-7608 SI 3742 Telephone Number License Number B. CertificationCM I certify that I have personally inspected the sewage disposal system at this address. that the information reported below is true,accurate and complete as of the time of the inspection.The it spectir was performed based on my training and experience in the proper function and maintenance of ari site ca sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: _= , ElPasses ElConditionally Passes ® N r Fails I x_ M ❑ Needs Further Evaluation by the Local Approving Authority i Luc J� 1021/13 Inspe or's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system 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•11/10 Trite 50frciartnspeirion Form: sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityfrown State Zip Code Date of Inspection B. Certification (cunt.) 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: Mail is delivered to this adress as 91 St Catherine ave but the assessor's office has it as76 St. Catherine ave 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 extiiltration 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•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Luna Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. C-41 town state Zip Code Date of Inspection B. Certification (cunt.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5irts•11/10 Tdte 5Official inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityfrown state Zip Code Date of Inspection B. Certification (cunt.) 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well*". Method used to determine distance: **This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow t5ins•11/10 Title 50ficial Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. City/Town state Zip Code Date of Inspection B. Certification (cunt.) 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 east 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 El ❑ the system is within 200 feet of a tributary to a surface drinking water supply El El the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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 Departm..ent. t5ins•11/10 Me 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St. Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 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): 5 Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 t5ins•11/10 Tdte 50tficiaPlnspedion Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityrrown state Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings,if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings,if available: t5ins•11/10 Title 5 Official'inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. C'Ityrrown state Zip Code Date of Inspection D. System Information (cunt.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank,distribution box, soil absorption system ❑ Single cesspool ® Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(f yes,attach previous inspection records,if any) ❑ Innovative/Altemative 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 VA system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Tide 5Offcial Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) 19--1 Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown state Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components,date installed (if known)and source of information: 30+years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.0 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.): Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑metal ❑fiberglass ❑polyethylene ❑other(explain) If tank is metal,list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page_ City/Town state Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) 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 How were dimensions determined? Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 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 91 St.Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown State Zip Code Date of Inspection D. System Information (cunt.) 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.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown state Zip Code Date of Inspection D. System Information (cont.) Distribution Box(I present must be opened)(locate on site plan): Depth of liquid level above 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.): Pump Chamber(locate on site plan): Pump in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber,condition of pump and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan,excavation not required): If SAS not located,explain why: t5ins•11/10 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown - State Zip Code Date of Inspection D. System Information (cunt.) Type: ❑ leaching pits number: ❑ leaching chambers number. ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ® overflow cesspool number: 1 ❑ innovative/attemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): This system has a 5Y5 drywell block pit as an overflow pool.The pit was full. Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 2 in line Depth—top of liquid to inlet invert 5"above Depth of solids layer 5" 1„ Depth of scum layer Dimensions of cesspool 5'x5' Materials of construction drywell block Indication of groundwater inflow ❑ Yes ® No t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is Hyannis MA 02601 10/19/13 required for every y page. Cityfrown state Zip Code Date of Inspection D. System Information (cunt.) Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): The cesspool was full to above the inlet pipe.The grass above was thicker and greener. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): t5ins-11/10 Title 5 Official inspection Farm:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Citylrown state Zip Code Date of Inspection D. System Information (cunt.) 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 rear 29 15 58 52 t5ins-11/10 Title 5 C f trial Inspection Fonn: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 yy. 91 St Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is Hyannis MA 02601 10/19/13 required for every y 'i page. Cityrrown state Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 20.0 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked,date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators,installers-(attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: USGS maps show an elevation of over 20.0 feet. Before filing this Inspection Report,please see Report Completeness Checklist-on next page. t51ns-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 I r Commonwealth of Massachusetts MM Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St.Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is Hyannis MA 02601 10/19/13 required for every y page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C,D,or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-11/10 Me 5 Oficial inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 61 Y.. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i �3 91 St Catherine Ave(a.k.a.76 St Catherine Ave.) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. Cityfrown State Zip Code Date of Inspection i D. System Information (cunt.) Sketch Of Sewage Disposal System:Provide a view of the sewage disposal system,including ties to I 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: i ® hand-sketch in the area below ❑ drawing attached separately i i i rear 29 I i 15 I 58 52 I i I i i I I i i t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 �f I 41 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 91 St. Catherine Ave(a.k.a.76 St Catherine Ave) Property Address Jose Lima Owner Owner's Name information is required for every Hyannis MA 02601 10/19/13 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Deposal 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 o rear 0 25 0 21 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 w a 28 LOCUS DATA CURRENT OWNER JUDITE LIMA N c^ I y • .o � sue;, ���5 ,. PLAN. REFERENCE LCP 14034—H p`� PUMP, CRUSH AND n LOT r 10 9 I / ABANDON EXISTING ?� � ,fit DEED REFERENCE CTF 75653 / N CESSPOOL IN 70 ACCORDANCE WITH 2 LOCUS i TITLE 5 PROPOSED S.A.S. c^ ZONING DISTRICT RB 36'30";`E 13.0' x 41.5. I ST81' \ j 110 (3) 500 GALLON CONC. . FLOOD ZONE �C \ t' \\ STONE CHAMBFALL RS AIROUNTH 'DOF I I ' L O T 9 ,1 150" \ \ LOCUS MAP ASSESSORS MAP 29 �' .00, NOT TO SCALE: PARCEL 092 16,400f S.F. \ ` I 14-0106 OVERLAY DISTRICT N,OT A ZONE it 1 \ LOT AREA 16,500f S.F. II 1 �` ` I DRIVEWAY / \ GARDEN I ' AREA s S[TE & SEWAGE REPAIR PLANS ► I ICI ��,� `�� I SHED o o GARAGE I \ �� y` 18. #76 W I l� I p w�REs 1 } � ` 4' , ,5T Cal THERINE % VE �'I I '\ W `\ OVERHEA� ' REPLUMB I 0 EXISTING ° 4' SHED o r ` I �W� OUTLETS TO 3 N I ' V \ :\ ONE OUTLET DECK '4' D. .H. #2 r 39 H YANN I,S, MASS o , CONCRETE ; DATE: APRIL 11 , 2014 #76 14.6' 4' d BOUND FOUND U Lllf L u EXISTING \ 4' & HELD POSE �\ Z� o �RyEAD Wj TOFDWEL I 6 0. D. H. #1 OWNER/APPLICANT: I -�W I M �S ?INV=40.1 ° - JUDITE LIMA I �' ! Go 91 ST. C THERINE AVE. i i Z 130' ° M ' WYANNIS, MA 02601 I o I Z S 81'36 ~ SHEET 1 OF 2 '30 E ► / I Q BENCHMARK CORNER OF PREPARED BY: 0SAOF MASS,I CONCRETE BULKHEAD � � 145.o0' E A S SURVEY, INC. ��� ED BARD �� LSO T 7 - P:'0. B O X 1729 STC1 28I N • 9800 >� 0 20,� 30 1 40 PUMP, CRUSH AND PROPOSED 1,500 CONCRETE SANDWICH MA 02563 ^ �o�ST��/ �` REMOVE EXISTING GALLON SEPTIC ANDBOUNHDELD FOUND s� CESSPOOL(S) IN TANK PH. (508) 888-361-9 {V %"iaL LnNo .. ACCORDANCE WITH -3600 GRAPHIC SCALE' CELL508S TITLE 5 _ ( ) 527 z 1 INCH"= 20 FEET F EAS.SURVEY©YAHOO.COM . • a , rence#,��� - oef SYSTEM DESIGN TOP OF FOUNDATION ! ' � RAISE COVERS TO WITHIN 6" OF FINISH GRADE ' CENTER CHAMBER RISER DESIGN FLOW ELEV. 43.63 'l FINISH GRADE RAISE TO WITHIN 6" 5 BEDROOMS AT 110 GPB D 5.50 GPD f €LEV.*41.5 FINISH GRADE OF FINISH GRADE / ELEV. 40.2 ELEV. 39.8 //(�� \ \�// ;7.8 \ UND ELEVATION 40.0 REQUIRED SEPTIC TANK TOP _ ///ate /.�� a �� // /��/// N � /c1i 1 MIN.-3' MAX. COVER26' (�5=0. 4�� 18'®S= 0.08 2.5'®S= 0.12 TOP ELEV 3 "� 550 x2 _ __1 100 GAL. SCH 40 - 4 PVC 4" PVC SCH 40 15'®S= 0.02 O O O. o o 0000 0 SEPTIC TANK PROVIDED = _1.500_GAL. INV.= 2 MI -3 MAX O O O INV.= 40.13 It 39.09. . 10"TEE 14"TEE INV.= O 00 00 o c 00000 SIZE OF LEACHING FACILITY REQUIRED INSTALL :38:89% 6" �0000 0 0 00000 N 5'-7" GAS BAFFLE 3 OUTLET DESIGN PERC RATE ___<_? __MIN./INCH 4'-6 1/" 2 4'-1" LIQUID LEVEL H-10 DB3 THREE 5'-O"x8'-6"x2'-10" CHAMBERS LONG TERM APPI. RATE_0.74_GPD/S.F. INV.=37.47 S.A.S. (13.0' x 41.5') p cr SIZE OF LEACHING SYSTEM PROVIDED: LINV.=37.30 , a 35.00 DATUM: o 0 0, , BOT 34.55 INV.=37.00 � q 550 _ 0.74 SF/GPD = _7_44 S.F. MIN. REQ. VERTICAL DATUM: 6" BASE OF CRUSHED STONE OR 27.80 USING H-20 CONCRETE LEACHING CHAMBERS M / BARNSTABLE GIS MECHANICALLY COMPACTED FILL WITH 4' OF STONE ALL AROUND BENCH MARKK U USED: 1,500 GALLON PRECAST CORNER OF BULKHEAD CONCRETE SEPTIC TANK BOTTOM (13.0 x 41.5,) _ _539 S.F. ELEVATION 44.0 O O7000ia 7- ccc O O O O O SIDE WALL (13.0' + 41.5') 2x2 = 218 ,.EJOB # 14-0106 CONSTRUCTION NOTES: 0 00 00 00 757 S.F. 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND 0000o 0000 757 S.F.x 0.74 G/SF = 560 GPD SITE & SEWAGE ELEVATIONS WORK ON THE AND SITE CONDITIONS PRIOR TO COMMENCING iE. ---4.0' 5.0' 560 GPD PROV > 550 GPD REQ. = 10 GPD RES. 2• NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE NO (GARBAGE DISPOSAL / GRINDER ALLOWED) REPAIR PLAN WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 13.0 P#14318 #76 IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. SIDE VIEW 3. ENGINEER TO VERIFY REMOVAL OF UNSUITABLE SOILS PRIOR , D.T.H. #1 0 D.T.H. #2 S T. CA THERINE VE 4. TO INSTALLATION OF NEW SEPTIC SYSTEM. DATE: 4/7/14- DATE: 4/7/14- NO PARKING OVER SEPTIC TANK IS ALLOWED. GROUND ELEV. 40.0 GROUND ELEV. 39.8 IN GENERAL NOTES: I CERTIFY THAT I AM CURRENTLY APPROVED BY THE NO GROUNDWATER NO GROUNDWATER 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT H YA N N I S MASS TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL A A EVALUATION ABE ACCUR TE 9 IN ACCORDANCE WITH 310 LOAMY SAND LOAMY SAND FOR SUBSURFACE DISPOSAL OF SEWERAGE. CMR 15.10R UGH 107. 10YR 4/3 10YR 4/3 DATE: APRIL 11 , 2014 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE 6„ 6„ ACCESSIBLE WITHIN 3" OF FINISH GRADE, WITH ANY REMAINING __ __`____ ______ _ 8 B ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE, EDWARD A. STONE, CERTIFIED SOIL EVALUATOR LOAMY SAND LOAMY SAND 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE t 7.5YR 5/6 7.5YR 5/6 OWNER/APPLICANT: CAPABLE OF WITHSTANDING, H-10 LOADING UNLESS „ OTHERWISE SPECIFIED. EL. = 38.2 22" EL. = 37.8 24 JU D I TE LIMA 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION 4jµ�F�gs19, DTH #2 INDICATES DEEP OF ALL UTILITIES PRIOR TO ANY EXCAVATION. o�' Y TEST HOLE 91 S T. C A TH E R I N E AVE. 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE 0 VID C-1 C 1 H YA N N I S, M A 02601 R JR. cn COARSE SAND COARSE SAND 48" OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. �, Q 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER 1 J INDICATES 1OYR 5/6 10YR 5/6 FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. 9 0� P-2 48" PERC TEST 10% GRAVEL 84„ 10% GRAVEL 86" 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF R SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE s CASTER NO MOTTLING C-2 C-2 SHEET 2 OF 2 THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND gN1TA P NO WEEPING MEDIUM SAND MEDIUM SAND LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. 2.5Y 7/4 2.5Y 7/4 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN I( �� 144" INDICATES ADJ. GROUNDWATER PREPARED BY: 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT NO G.WATER NO G.WATER ELEVATION OF THE OUTLET PIPE. NO OBS. GROUNDWATER EL. = 28.0 144„ EL, = 27.8 144" E A S SURVEY, INC. 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS } NO OBSERVED GROUNDWATER B.O.H. P. O. B 0 X 1729 BAFFLE, 4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC DONNA MIORANDI 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND DEPTH TO BOTTOM OF HOLE 144" SOIL EVALUATOR SANDWICH , MA 02563 SHALL BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE ED. STONE FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL VARIANCES REQUESTED BACKHOE OPERATOR. PH. (508) 888-3619 BE LEVEL RODNEY FISHER CELL (508) 527-3600 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION NONE SOIL TYPE: 1 TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW PERC RATE: <2 MIN. PER INCH EAS.SURVEY©YAHOO.COM AND APPROVAL. i LOADING RATE: 574 GAL/SF/MIN 13. MAGNETIC TAPE ON ALL COMPONENTS.