HomeMy WebLinkAbout0692 SCUDDER AVENUE - Health 692 SCUDDER AVENUE
Hyannis
A= 287-004
i
�� J
TOWN OF BARNSTABLE `
LOCATION SGJi>10ER AV E SEWAGE# 26(ci qj?,
VILLAGE HYi4 4tj1sP0A; ASSESSOR'S MAP&PARCEL all
INSTALLER'S NAME&PHONE NO. JrAExZ� ac)P_d0,
SEPTIC TANK CAPACITY 4500 G Lo c,
LEACHING FACILITY:(type)(2)Sbo GALa14 (size) 1,7,k X Aj �i3a�ci�
NO.OF BEDROOMS ��Fp cGA 0&E
'tA'D OG 6eY. lard PL A1L i*
OWNER :TAICE 'DJEUM Y
PERMIT DATE: COMPLIANCE DATE: I-XI-'XO 3O
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 A
300 feet of leaching � 4 facility) Feet
FURNISHED BY .®i����
S �
o N p
W t
Ln_ td ;7-
No. Fee V
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplitation for Mispo8al 6pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade( Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. 4�Qa J t4J DQ Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel a 1
Installer's Name Address,and Tel.No. JOR-471-198"11 Designer's Name,Address,and Tel.No. 5Og -1,73-e)377
cr�oQw,o 1rz �v� ,SC- �C sn1G
1. 3 C1�w4 r_1C.t 4(_ S'T H-wi F,
Type of Building:
Dwelling No.of Bedrooms Lot Size `�gyp$��--sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) ;'`j gpd Design flow provided gpd
Plan Date (I-to a aD I CI Number of sheets ( Revision Date
Title 6RX J r to oo Ey_ Ayi= i4YA yAj 1$Pd 9-7C
Size of Septic Tank I GE.L WS Type of S.A.S. .4+5 ; ) 500 694- f.ww6X_� G_A4K igvsz"
Description of Soil L0 �b . L-2`i 4S,_ I>LAJ
Nature of Repairs or Alterations(Answer when applicable)
Ild- D A 4- c7 � '
c QC-S_ jQQ& H-Jo 96&&AQd Uj 1 _4R5M>Nr DEC;
Date last inspected: G36-W
Agreement: q +-g
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Healt
Signed Date I;L'
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued �'-�
( ✓ .� Fee
4' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: JZ
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftplication for Disposal *pstrm Construction Vermit
Application for a P it to Construct( ) Repair( ) Upgrade(uj Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. (��, �QVQ�� /��� Owner's Name,Address,and Tel.No.
k
t ZACoB Dom-ty"
Assessor's Map/Parcel g
Installer's Name Address,and Tel. o. 5Vjg_t4-I l_gg,-11 Designer's Name,Address,and Tel.No. 60� _1-73-03-77
CAp6w,o r OVA Cep 3,G. E?1 czd&JQ_� mxt.
IS1. c
Type of Building:
Dwelling No.of Bedrooms Lot Size '{sq.ft. Garbage Grinder( )
Y
Other Type of Building R ��f-�T,��_ No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) ( gpd Design flow provided c�c� gpd
t �,
Plan Date I X-1 o _ n t 4 Number of sheets Revision Date
Title��a1 s t?E�2 AVr= 14YAw,& s�y�
Size of Septic Tank 1 5pp C-Z,�QS Type of S.A.S.
Description of Soil 6,tfiM11a) 1 S A i
Nature of Repairs or Alterations(Answer when applicable) _I ,C - .
Date last inspected: sang
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
k, accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Complies ce has been issued by this Board of Health.
Signed Date
Application Approved by �~ Date ' -i 6,-
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
---------------------------------------------------------------------------------------------------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
b F4,lrrr S/F� BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(x)
Abandoned( )by CAVe,
at (tQ a 15C+Ljj)0Vc has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. _ -U iated —
installer Q4&4)MC- �N ba �►-y A Designer
#bedrooms Approved design flow gpd i
The issuance of t is peT)o
it shall not be construed as a guarantee that the system will c' n A designed
Date Inspector W
----------------?--------------------------------------------------------------------------------------------/---------------
No. ROB ! J f - Fee /
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstetn Construction 3permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade(k) Abandon( )
System located at
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit. �~
Date Approved by
Town of Barnstable
Regulatory Services
Richard V. Scali,Interim Director
BAMESMABM
gbMAM
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer&Designer Certification Form c�
Date: �� 2� 2� Sewage Permit# 94N CJ- 4 7 a Assessor's Map\Parcel
Designer: Eo,- meecm3, ':Cm. Installer: p 9-30
Address: ZSSy Cran�oerry �iSi uJa y Address: 1103 w Mks
ea5k UUaresnavA , H!- d 253 8 S. `(arv,nv✓kh , Yl ft 6 Z l06 y
bzrk �: OL,u Ca "C
On ��"`��'�®L� �o � was issued a permit to install a
(date) (installer)
septic system at (092- S 60d zr AVWUe- based on a design drawn by
(address)
—SC CriSi<i eci0 OC. _ dated DeC. 10 , 2.019
`/ (designer)
`� 1 certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Strip out (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-built by designer to follow. Strip out(if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed i iance with the terms
of the IAA approval letters (if applicable) sH of M4
� cy
O G
.� JaHN L F�
CHURCHILLJR. N
Installer's nat e) CML
.4
A
(D ner's SignaturVARNSTABLE
(Affix De t p Here)
PL SE RETURN TO PUBLIC HEALTH DLASIQN. 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:1SepticlDesigner Certification Form Rev 8-14-13.doc
Commonwealth of Massachusetts ag�-0014D�2 i:37 bIa�"
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i
Property Address
Owner Owner's Name
Wbrmation is �41 ✓ !` c% � /Z- �_ £3
required for every _
Me- City/rown 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.
h'e1Orin'"When A. Inspector inforirnation
tag out forms
an the oomputer. Ow 2 4L. cSTan�6
use only the tab
key to move your Name of Inspector
cursor-do not C $ Jig✓�
key. y �
use the return Company Name
ar Company Address
City/Town, State Zip Code
6eB- sz3- � v� 9�
Telephone Number License Number
B. Certification
I certify that:I am a DEP approved system Inspector in full compliance with Section 15.340 of Title 5
(310 CMR 15.000);1 have.personally Inspected the sewage disposal system at the property address
listed above;the information reported below is true, accurate and complete as of the time of my
inspection;and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined
that the system:
1. Passes
2. ❑ Conditionally Passes
3. 0 Needs Further Evaluation by the Local Approving Authority
4. ❑ Fails
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection.If the system has a design flow of
10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate
regional office of the DEP..The original form.should be sent to the system owner and copies sent to
the buyer,if applicable,and the approving authority.
Please note:This report only describes conditions at the time of inspection and under the
conditions of use at that time.This inspection.does not address how the system•,will perform
in the future under the same or different conditions of use.
6nap doc•rev.7/2W2018 Tice 5 MW I on Form:Subsurface 1 S
nspeeb Sewage Dispose yetem•Page 1 of 18
J
if
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-riot for Vduntary Assessments
�1 Z (5C C/O1>E/z
Property address
owrw Owner's Name
regt*W fo is
req�red for every /
Me- Cityrrown State Zip Code Date of inspection
C. Inspection Summary
Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6.
1) System Passes:
I have not found any information which indicates that any of the failure criteria described
/ in 310 CHAR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are
indicated below.
Comments: J J
avLlc,
v` LdG�cd��
7, lVef�s
2) System Conditionally Passes:
❑ O e or more system components as described in the"Conditional Pass"section need to be
reps or repaired.The system,upon completion of the replacement or repair,as approved by
the Bo of health,will pass.
Check the box for s", "no"or"not determined"(Y,N,ND)for the following statements. If"not
determined,"please a ain.
The septic tank is metal an ver 20 years old*or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial in tion or exfdtration or tank failure is Imminent.System will pass
inspection if the existing tank is rep[ with a complying septic tank as approved by the Board of
Health.
"A metal septic tank will pass inspection if it is ucturally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 ars old is available.
❑ Y ❑ N ❑ ND(Explain below):
ftap doc•rev.7/26W 8 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 2 of 18
NUN
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System-fnrrn—Not-for-Voluntary Assessments — - -
G
Property Address
Other Owner's Name
kftmation is
mgdv d for every
PW. Cityfrown State Zip Code Date of Inspection
C. Inspection Summary (coat.)
oi,��2) System Conditionally Passes(cont):
Pbw4.3 Chamber pumpsialarms not operational. System will pass with Board of Health approval if
pump farms are repaired.
❑ Observation of s age backup or break out or high static water level in the distribution box due
to broken or obstru d pipe(s)or due to a broken,settled or uneven distribution box.System will
pass inspection if( pprovai of Board of Healthy
❑ broken pipe(s)are laced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or placed ❑ Y ❑ N ❑ ND(Explain below).
❑ The system required pumping more than 4 times a year due o broken or obstructed pipe(s).The
system will pass inspection if(with approval of the Board of Ith):
❑ broken pipe(s)are replaced ❑ Y ❑ N ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ (Explain below):
ff1 3) Furfl Evaluation is Required by the Board of Health:
❑ Conditions exrs his a uire further evaluation by the Board of Health in order to determine if
the system is failing to protec Ith,safety or the environment.
a. System will pass unless Board of Health determines r rd ce with 310 CMR
1S.303(1)(b)that the system is not functioning in a manner which will pro tic h �th,
safety and the environment:
61rdip doc•rev.7/AM18 Title 6 Olfidel Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
i
Commonwealth of Massachusetts
Title 5 Official Inspection Fora
Subsurface Sewage 1 sposal System Fob Not for Voluntary Assessments- - -
6 92 Sc vrJOEQ �✓>✓
Property Address
Owner Owner's Name
1140 mation is Z7 ,�n/Nt S / -:5
` Z 8
mWred for every
pa- City/Town State Zip Code Date of Inspection
C. Inspection Summary (cunt.)
N�A
❑- Cesspool or privy is within 50 feet of a surface water
❑ esspool or privy is within 50 feet of a bordering vegetated wettand or a salt marsh
b. System fail unless the Board of Health(and Public Water Supplier, if any)
determines th the system Is functioning In a manner that protects the public health,
safety and envi ent:
❑ The system has a eptic tank and soil absorption.system(SAS)and the SAS is within
100 feet of a surface wa supply or tributary to a surface water supply.
❑ The system has a sop ' tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic to and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank a. SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply w
Method used to determine distance:
"*This system passes if the well water analysis, p rmed at a DEP certified laboratory,for fecal
coliform bacteria indicates absent and the presence f ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure crt a are triggered.A copy of analysis must
be attached to this form.
c. Other.
4) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
❑ �{, Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
EDischarge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or dogged SAS or cesspool
•rev.71262018 Title 6 offidal Irspedion Form:Subsurface Sewage Disposal System•Page 4 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal system Form.-Not for Voluntary Assessments
Property Address
�lGi1�6LT
Owner Owner's Name
irldotmation is t/y���s ljiL, OZ4 a T /Z-S /B
repired for every . .
EIVf Town State Zip Code Date of Inspection
C. Inspection Summary (cone.)
4) System Failure Criteria Applicable to All Systems: (cont.)
Yes No
❑ W,j/ Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ la Liquid depth in cesspool is less than 6"below invert or available volume is less
than /:day flow
❑ rM 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.
❑ � A Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ All Any portion of a cesspool or privy is within.a.Zone 1 of a:public water supply
well.
M N/9 Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ( d/A 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 N the well water analysis,performed at a DEP certified
laboratory,for fecal coNform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.)
The system is a cesspool serving a facility with a design flow of 2000 gpd-
10,000 gpd.
❑ The system fpfls.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.
W`a- 5) LaW Systems: To be considered a large system the system must serve a facility with a
designikmuolf 10,000 gpd to 15,000 gpd.
For large systems-,youmust indicate either"yes"or"no"to each of the following, in addition to the
questions in Section CA.
Yes. No
❑ ❑ the system is within 400 feet of a surface water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drin water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead on
Area—IWPA)or a mapped Zone II of a public water supply well
Sft4kdoc-rev.72612018 Title 5 016dal Inspection Fortrc Subsurfie Semp Disposal System-Page 5 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System form-Not for Voluntary Assessments _ -
1092
Property Address
owner Owner's Name
incarnation is �/,�q/a✓is UZGo/ /Z
"Ired for every ---
pe", cityfrown State Zip Code Date of Inspection
C. Inspection Summary (cunt.)
If you have answered"yes"to any question in Section C.5 the system is considered a significant
threat,or answered"yes"to any question in Section C.4 above the large system has failed.The
owner or operator of any large system considered a significant threat under Section C.5 or failed
under Section C.4 shall upgrade the system in accordance with 310 CMR 15.304.The system owner
should contact the appropriate regional office of the Department.
6, You must indicate"yes"or"no"for each of the following for all Inspections:
Yes No
❑ ( Pumping information was provided by the owner,occupant,or Board of Health
❑ � Were any of the system components pumped out in the previous two weeks?
❑ Has the system received normal flows in the previous two week period?
❑ Have large volumes of water been introduced to the system recently or as part of
this inspection?
❑ Were as built plans of the system obtained and examined?(if they were not
available note as N/A)
(� ❑ Was the facility.or dwelling inspected for signs of sewage back up?
❑ Was the site inspected for signs of break out?
r4 I f%I
Were all system components,e�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 stunt?
❑ 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 Sol!Absorption,System( S on the site has
been determined based on:�pe� Rio--a✓ 0�")/PT �G��
❑ Existing information. For example,a plan at the Board of Health.
i¢ ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
f' approximation of distance is unacceptable}[310 CMR 15.302(5)j
GkGpAoc-nev.7rXM18 Tide 5 Offidal Inspection Form Subsurface Sewage Disposal System•Page 6 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal Systnn Form-Not for Voluntary Assessments .
6 9Z
Property Address //��
<yi/—/ C T
Owner Owner's Name n Is
regt*W for every �✓�✓! S / U� /Z- cS"— l S
Cityfrown State Zip Code Date of Inspection
D. System InforMation
1. Residential Flow Conditions:
Number of bedrooms desi n): Number of bedrooms(actual):
a
Lvdge
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): S"SD
Description: /
r
Number of current residents:
Z
Does residence have a garbage grinder? ❑ Yes No
Does residence have a water treatment unit? ❑ Yes 1% No
If yes,discharges to:
Is laundry on a separate sewage system?(include laundry system inspection ❑ Yes ] No
information in this report.)
Laundry system inspected? ❑ Yes No A114
Seasonal use? L Yes ❑ No
Water meter readings, if available(last 2 years usage(gpd)):
Detail:
4,S0W) 4- 74,ovv -i-- 24 ZSO = q3-750 /dam a 93 d
z�l6 zo I
7
Sump pump? ❑ Yes T9 No
Last date of occupancy: p1/o✓Ze)1.41Date
kftap doc-rev.7/26=18 Title 5 Official Inspection Form Subsurface.Sewage Disposal System•Page 7 of 18
Commonwealth of Massachusetts
Title 5 Official inspection Form
Subsurface Sewage Disposal System form_-Not for Voluntary Assessments _
Property Address
oar Owner's Name
taquirred�ieven► !} ✓/�//S �Z' s� !8
Me. City%Town State Zip Code Date of Inspection
D. System Information (cont.)
N/4, 2. Commerciallindustrial Flow Conditions:
Type o stablishment:
Design flow( sed on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow ats/persons/sq.ft.,etc.): -
Grease trap present? ❑ Yes ❑ No
Water treatment unit present? ❑ Yes ❑ No
If yes,discharges to:
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 syste ❑ Yes ❑ No
Water meter readings,if available:
Last date of occupancy/use: Da
Other(describe below):
3. Pumping Records:
Source of information:
Was system pumped as part of the inspection? ❑ Yes No
If yes,volume pumped: gallons
How was quantity pumped determined? ,/ NSA
Reason for pumping f!(/�t B�Sci fUvv �%1/0
WOSPAW•rev.71262018 Title 6 Official Inspection Force Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of.Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System form-Not for Voluntary Assessments
9Z �a F2 a e-z �t�
Property Address
Cz•e-r3C�T
owner Owner's Name
Kwmadon is / .��/�/� QZGq
required for every City/Town.PW- State. Zrp.Code. Date of Inspection
D. System Information (cone.)
4. Type of System:
ASeptic tank, d' ,soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system(yes or no)(if 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 I/A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components,date installed(if known)and source of information:
L/o(/�tNDa/iy
Were sewage odors detected when arriving at the site? ❑ Yes, No
5. Building Sewer(locate on site plan): /
Z
Depth below grade: feet
Material of construction:
cast iron ❑40 PVC ❑other(explain):
`lam
Distance from private water supply well or suction line: feet
Comments n condition join entin vid nc� �e of leaka�, etc.):
�fjll y-�
dkapdoc•rev.7/26/2018 Title 5 Of6dal Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
Commonwealth of Massachusetts
Tale 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments _
Property Address
Oamer Owner's Neme
information is y���S i OZ"�6,
W#dred for every
Me- City/Town state Zip Code Date of Inspection
D. System information (cont.)
6. Septic Tank(locate on site plan):
Z /
Depth below grade: feet
Material of construction:
concrete ❑metal ❑fiberglass ❑ polyethylene ❑ other(explain)
N tank is metal,list age: years _-//
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) El Yes ❑ N04
Dimensions: 5 K 8' �x S� /�U�,.���' �as�
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
Mow were "nsions,�d/etermined? L
G7L'{'CCQSSZ X /)" /vz e<, your vv
Comments onpumping recommla' dinletl�d o tee or baffle condition 6 ra1 integrity
Z*Cluld levels relat to outlet invert, idence of leakage,etc.):
A�
G
Gbvwdoc•rev.7126f2018 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18
Commonwealth of Massachusetts
JEW Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
Property Address
�q/L/3E=RT'
Owner Owner's Name
IMorrnation is t
l //r///S f
a2G U/ /Z-✓-/8
required for every
P"e- City/Town State Zip Code Date of Inspection
D. System Information (cont.)
1,111-7. Grea Trap(locate on.site plan):
Depth beto grade: feet
Material of con ruction:
❑concrete metal ❑fiberglass ❑ polyethylene ❑other(explain):
Dimensions:
Scum thickness
Distance from top of scum\evidence
ee or baffle
Distance from bottom of s o t tee or baffle
Date of last pumping: Date
Comments(on pumping r ,inlet and o let tee or baffle condition, structural integrity,
liquid levels as related to oence of leaks etc.):
AA 8. Tig r Holding Tank(tank must be pumped at time of inspection)(locate on.site plan):
Depth below g e:
Material of constructio .
❑concrete ❑ metal El fiberglass ❑ polyethylene ❑other(explain):
Dimensions:
Capacity: ga s
Design Flow: gallons per
M3 ap doc•rev,7262018 Tide 5 Official Inspection F—_Suhsurfaoa Sewage Disposal system•page 1 I of 19
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface gage Disposal System Form-Not for-Voluntary Assessments
Property Address
�lL�Gs2T
oar Owner's Name
kdormation is `j�/,�
re every
for eve tea//
per, cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
Mk 8. Tight or ding Tank(cont.)
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping. Date
Comments(condition of alarm and fi t switches,etc.):
Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
/VI 9. Dis 'bution Sox(if present must be opened)(locate on site plan):
Depth of ii 'd level above outlet invert
Comments(note' box is level and distribution to outlets equal;any evidence of solids carryover, any
evidence of leakage or out of box,etc.):
t Wdi'doc•rev.7/2ril2 I S Titre 5 o(ficW Inspection Fome Subsurface Sewage Disposal System•Page 12 of 18
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Vokmtary Assessments
Property Address L Qc�2 T
Omer Owner's Name
Information is , �,✓/1//5 o2�a
required for every
POW City/Town State Zip coiG Date of inspection
D. System information (cont.)
MIA 10. Pu hamber(locate on site plan):
Pumps in working er [] Yes ❑ No;
Alarms in working order: ❑ Yes ❑ No`
Comments(note condition of pump c bar, condition of pumps and appurtenances, etc.):
*If pumps or alarms are not in working order, system is a conditional pass.
11. Sol!Absorption System(SAS)(locate on site plan, excavation not required):
"AS-ag located, e
,.12� / �"° f� /�/� �c� Y�y�✓an�old-n�s-��/e f�-►-�
y .
Type:
leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number,length:
❑ Teaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/altemative system
Type/name of technology:
doc•rev.726/2D18 Title 5 official Inspection Forth:Subsurface Sewage Disposal System•Page 13 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
lv 9Z �rJ�o ER ��
Property Address
Ovater Owner's Name
Iniiumetion is
wired for every
P"e. City/Town State Zip code Date of Inspection
D. System information (cons.)
11. Soil Absorption System (SA (cont.)
Commen (not n ition of s 1,,e;ignshy_draulic fall ur to of pond in da p soi! �ndifion of
nietatt0 etc. �-- ��"e �h
z4vcrMa, )
/�Goz fi L � is /dyf �� / �/z � �t /.E9 a'�-
7�1 til VQ✓r
oM rY7 iO4/1 1 'e/ 3 �� �'4, teej- y� Ol�v�� ,�eyL�s
hl ✓�C? 7�� i� v�/ d d cSovYc� a�'l�c�sYr2�
2. Cessp Is(cesspool must be pumped as part of inspection)(locate on site plan):
Number and figuration
Depth—top of liquid inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
Comments(note condition of soil, signs of hydraulic failure, le I of ponding,condition of vegetation,
etc.):
V%mp.dDc-rev.rrAM18 Title 5 official Inspection Fomc Subsurf=8 Sewage Disposal Sydem•Page 14 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface&wage Disposal System Form-Not for Voluntary Assessments
��2 �Gv/�4cslZ 7�
Property Address
Owner Owner's Name
irdbmultion is *,fN4/rf lJZl07 j2•S GS
Nquired for every
POP. City/Town state. Zip Code Date of inspection-
D. System Informattoh-(coat;)
A4 13. Privy Cate on site plan):
Materials of cons tion:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydr is failure, level of ponding, condition of vegetation,
etc.):
tip doc-rev.MAW Title 5 Official Insped ion fomt Subsudaoe Sewage Disposal System•Page 15 of 1S
Commonwealth of Massachusetts
Title 5`Official Inspection Form
Subsurface Sewage Disposal System form_ Notfor Voluntary Assessments-- _
Property Address
Owner Owner's Name
deformation is
required for every '�PW_ cityrrovyn State Zip Code Date of insp 'action
D. System Information (cone.)
14. Sketch Of Sewage Disposal System:
Provide a view of the sewage disposal system, including ties to at least two permanent reference
landmarks or benchmarks.Locate all welts within 100 feet. Locate where public water supply enters
the building.Check one of the boxes below: y
hand-sketch in the area below /141 �Ae_6
drawing attached separately
z.-)- A
3 P
Twn fit✓v�l es•e VIA �-
jFes- I -7• 4. 22.0'
1 P._34�.5'�-3 �.b'C-3 3d•5' P-3 3S•b'
li
I �
i
I �
dktSp doc•rev.1FAM o18 Me 5 OfficW Inspection Fo w Subsurface Sewage Disposal System•Page 16 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System_Form_-Not for Voluntary Assessments
Property Address
Owner Owners Narne
4rf6nnation is W411 S Z/ZG
fequired for every
pe, City(Town State Zip Code Date of Inspection
D. System information (cont.)
15. Site Exam: /
�[ Check Slope Z to
Surface water 'J/4-
[ Check cellar d P y
Shallow wells ° ��✓ Y�� Sp�¢.���11��r/s�, �L 2
Estimated depth to high ground water:
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)
A�//cc;ssed USGS da base-explain:
v�i¢�� Y'9-Tlr lj/S
You must describe how you established the high ground water elevation:
F�N
-gam 0 4
3 t' rr. ►c'9
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
Adoc-rev.7/26f2018 Title 6 0115 l tnsPOdw Form:Subsurface Sewage Disposal System•Page 17 of 18
, \ Commonweatth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System_Forw--Not for-Voluntary Assessments
�9 2 c5cy p Oct �i�
Property Address
fAwner on is Owner's Name
itniormati
rehired for every
pqp, City/Nown State Zip Code Date of Inspection
E. Report Completeness Checklist
Complete.all applicable sections of this form inclusive of:
A. Inspector Information:Complete all fields in this section.
B.Certification:Signed &Dated and 1, 2, 3, or 4 checked
C. Inspection Summary:
1.,2,3, or 5 completed as appropriate
4(Failure Criteria)and 6(Checklist)completed
( D.System Information:
For 8:Tight/Holding Tank—Pumping contract attached
For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached
For 15: Explanation of estimated depth to high groundwater included
GknPdoc•rev.?mwm18 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 18 of 18
TOP OF FOUNDATION = 41 .8't FINISH GRADE OVER D-BOX= 40.8'± A=SYSTEM "A" A=41.0' - 42.5' PROP.VENT WITH CHARCOAL FILTER TO ABOVE GRADE GENERAL NOTES
PROVIDE EXTENSION RISER B=SYSTEM "B" FINISH GRADE OVER CHAMBERS B=39.0' - 39.5'
WITH COVER OVER INLET& r REMOVABLE WATER-TIGHT COVER OVER ! SLOPE @ 2% MIN. OVER SYSTEM 3l4"TO 1-1/2" DOUBLE WASHED 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
FINISH GRADE OVER TANK EL.= RISER TO WITHIN 6"OF FINISHED GRADE STONE TO CROWN OF PIPE
FINISHED GRADE OUTLET TO WITHIN 6"OF F.G. 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
FOUNDATION = 41.3'± 40'9 ± MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2" OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES.
5 DIA. OUTLET(S) ,
20"MIN.ACCESS r - - TOP OF SAS =A=38,00' STONE OR GEOTEXTILE FILTER FABRIC 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
COVER (3 TYP.) 9�� MIN' 1 - � B=36.00' PLACE H-20 RISER ON DESIGN ENGINEER.
36 MAX. � � -
PROP. SCH. 40 9"MIN. A=37.O0' A-4.5 MAX. 3. 4 SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
MAX A B=35.00 t SYSTEM UNLESS OTHERWISE NOTED.
TH
PVC SEWER I 1 1 PVC SEWER 40 { } �'-2Q;+ ' 8=3.5' MAX. BREAKOUT EL-A=37.50; ALL CHAMBERS INLET P ESITO
�1 r-_� (B) L=47± SEE NOTE 22 B=35.50 \ WITHIN 6"OF F.G.-f 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
�i" s�oPE�,i 6" 3" 2" DROP MIN. V � �
3" DROP MAX. 3 9 = - L=2'± ELEVATION=37.50' FOR SAS "A"& ELEVATION=35.50' FOR SAS"B" FOR A DISTANCE OF 15'
"'�".s`oaE�' PROVIDE WATERTIGHT
13 4" PVC IN FROM JOINTS (TYP.) AROUND THE PERIMETER OF THE SAS, UNLESS A 40 MIL GEOMEMBRANE LINER IS PLACED AT
LEAST 5' FROM S.A.S. & THE TOP OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
14" 38 25' SEPTIC TANK 4" PVC OUT TO Q 0 0 0 0 0 0 0 0 0
0
LEACHING FACILITY _ 5. SLOPE ALL SOLID PIPE AT 1.0/o MINIMUM.
12" " oa �---� a o 0 0 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
qg�� OUTLET TEE 38,17 ' � o
38.50' MIN. 38.00 E 2 00 ) oQ, 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
GAS BAFFLE 6" CRUSHED STONE I 00 0 o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
OVER MECHANICALLY o0 0 0 00 o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
13.8' OFFSET TO FND COMPACTED BASE AND DESIGN ENGINEER.
I TEES TO BE CENTERED 5 2.0' ! 8.5' (TYP)- 2.0
6"CRUSHED STONE 1 DIRECTLY UNDER RISERS OUTLET DISTRIBUTION BOX 4 4.0' 4 83' 4 0 I I 8. ELEVATIONS ARE BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK#1 ELEVATION OF
� OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE 21.0' (TYP.)
40.00' ESTABLISHED ON THE TOP CORNER OF A CONCRETE WALL AS SHOWN ON PLAN.
COMPACTED BASE BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV= < 27.00' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
PROPOSED 1 ,500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. A=35.00 12.83' THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
B=33.00' 2-500 GALLON CHAMBERS 5' MIN. 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
LENGTH 10'-8" WIDTH 5'-10" DEPTH 6'-2" (Dimensions per Wiggin CROSS SECTION VIEW (TYP OF 2) CHAMBER END VIEVv TO THE DESIGN ENGINEER.
-CON 10 VERIFY EXIS-1INc7 Precast Corp., Pocasset,MA) TYPICAL CHAMBER PROFILE
ELEVATION PRIOR TO ANY WORK & �- i U 6 r I✓ I i V I kN Ix �RO�I�� D i b.i,. I H(.� � �t...) C, �X DETAIL H_2 Q � � !���"�'� ETA�LS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE STRUCTURES SHALL BE MADE
NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE I NOT TO SCALE WATERTIGHT.
■ ., • TEST PIT DATA 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
- �s •'� rf REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
t�! a PERC NO. TPT-19-218 APPROPRIATE AUTHORITY.
1D(f INSPECTOR: David W. Stanton, RS 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED
' EVALUATOR: Michael Pimentel, EIT, CSE UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR
C.S.E. APPROVAL DATE: Oct. 27, 1999 TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
11 .a
�� •-= --+ DATE: December 5, 2019 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES-
PROPOSED H-101,500 a �cEA�
GALLON SEPTIC TANK . '' • TEST PIT# 1 14, WHERE REQUIRED; CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
`��' ! ti_ t/ c• ELEV TOP= 39.00' MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
EXISTING 1,000 GALLON SEPTIC TANK '�,� - �. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
w c -. ELEV WATER = < 27.00 FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
BE PUMPED, BOTTOM RUPTURED & � . . � � � � - , .,, , . .
FILLED vd/CLEAN SAND &ABANDONED-, PERC RATE _ < 2 min./inch
PROPOSED 4" PVC VENT PIPE; I '- ; 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
PROPOSED " SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
m EXISTING LEACHING PIT TO EXACT LOCATION PER OWNER �'' �✓ �_ 5 {� �("
DISTRIBUTION BOOVED& X { - ` (� + DEPTH OF PERC= 48 -66'
REPLACEMD�w CLEAN SAND MAP 287 ' MAP 287 � � � 'r �' � �+ 40
t '' A0 ev 16. PROPOSED PROJECT IS LOCATED WITHIN:
N � TP 1 LIGHT '}
_ TEXTURAL CLASS: 1
at LOT 3 POST LOT 8 i I �( AV
z PROPOSED 4" PVC VENT PIPE; TP 2 39x0' � ' � I ASSESSOR'S MAP 287 PARCEL 4
/
Q ; 'y V1 ""'"L E3N: OWNER OF RECORD:EXACT LOCATION PER OWNER 39x0' P �31 S%l nse t CO D JACOB T. DEWEY _
a 38 - 161-78' _IO�. �,
° " --= - �`�""='�i1i�' 105.96' S00 26' 00 E
7 S89° 06'40"W 0' 39.00
° , - --'' LOC U S ADDRESS: P.O. BOX 614
S8 34 45 W , oo '�. S88 45' 00'W 3.00 r.-
t, \ !- a. „ -- Fill i HYANNI PORT
o Benchmark#1 ! � * S . MA 02647
F Na o A I` 15.0' I S � 2! t1 C� y, ,. �,-.
Top of Conc. Wall ■. / + c • p 18" 37.50 FEMA FLOOD ZONE X
o /- A Loam Sand
Elevation =40.00 .,.. • _,�-.._- . ; � * 'K c� Y
-- �:
O ? / Approx. M.S.L. •+^ '` Y ~� _ *�r- * art 22" 10Yr 3/1 37.1 T COMMUNITY PANEL# 25001 C0568J
- GARAGE o ( !; ' x * * *\�' Loamy Sand 17. DEED REFERENCE: L.C. CERTIFICATE#218813
PROPOSED (2) 500 GALLON O Q N + �� * r`
H-20 LEACHING CHAMBERS B 10Yr 5/6 18. PLAN REFERENCES: 1. L.C. PLAN#20371B
'��' ( ► , #* x * 48,
(SYSTEM .,A..) t� t
35,00 2- L-C. PLAN#11256A
1 STONE (n Perc I 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
S22° 39'20"E� i B ^� M 66"
8.46' 3 LIGHT t. o C - 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
TOF=41.8± 0
I FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
� S14° 22' 00"E� �- POST ,_. ��PROPOSED (2) 500 GALLON � �
• Cn 7.64' INV -�9.0' �r Medium Sand FOR USES OF THIS PLAN OTHER THAN ITS INTENDED ENDED PURPOSE.
H-20 LEACHING CHAMBERS m C 2.5Y 6/6
o S140 15' 30"E 692 c (SYSTEM "B") -- - - -- - 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A
7.43' I EXISTING � / � -EXIST. o � REMOVADEPTH BLE THE BOTTOM
SHALL BE PLACED WITHIN 3"OF
TO ALLOW W FOR
INSPECTIONS.
GRADE. A ,
5 / ARAGE
°, S06° 09' 10"E 41 -BEDROOM i DWELLING , MAP 287 q m O O
m8.21 I fps\�' / LOT 7 z LOCUS PLAN 22. IN ACCORDANCE WITH 310 CMR 15.401 -15.405, THE FOLLOWING LOCAL UPGRADE
0 •Z SO4° 31'40"E_/' AO ..-•-- / \ \� / • � m j APPROVALS ARE REQUESTED FROM 310 CMR 15.221(7)&15.211:
/ ' SCALE: 1"= 1000'
-t C 8-49' ' 39-"' �' a (1.) A 1.50' WAIVER (3.00' -4.50') FOR THE MAXIMUM COVER OVER SAS"A".
m o _.-- co 144" 27.00' (2.) A 0.50' WAIVER (3.00' -3.50') FOR THE MAXIMUM COVER OVER SAS "B".
m MAP 287 , -38 ( °' „ „
-o ►� N __ No Mottling, Standing or Weeping Observed (3.) A 9.00' WAIVER 20.00 - 11.00 FOR THE SETBACK FROM THE DWELLING TO SAS A .
Benchmark#2 in o ( ?
o cv LOT 4 / V- o `_ (4.) A 4.90'WAIVER (20.00' - 15.10') FOR THE SETBACK FROM THE DWELLING TO SAS "B".
Bulkhead Corner ° c� -37 / /� 5. A 3.00' WAIVER 1
12,058± S.F. coin I to o I Ir-i i L,�/A I A ( ) ( 0.00' -7.00) FOR THE SETBACK FROM THE GARAGE TO SEPTIC TANK.
Elevation=41.73' o /
,/ DESIGN DATA _
Approx. M.S.L. Z 76.32' 36f �y \ \ PERC NO. TPT-19-218
S88° 37'00"E INSPECTOR: David W. Stanton, RS LEGEND
N ^ 110.77 NUMBER OF BEDROOMS 5 EVALUATOR: Michael Pimentei, EIT, CSE 50xO' EXISTING SPOT GRADE
'n `'? S00° 26'00'E
MAP 287 0 ¢ 1501' DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 27, 1999 50 -- - EXISTING CONTOUR
N r .132 22' TOTAL DESIGN FLOW 550 GAUDAY DATE: December 5, 2019 50 PROPOSED CONTOUR
LOT 5 z N88°37'00"W _ TEST PIT#: 2
t DESIGN FLOW x 200 % = 1,100 GAUDAY 50 PROPOSED SPOT GRADE
ELEV TOP= 39.00'
MAP 287 USE PROPOSED 1,500 GALLON SEPTIC TANK
ELEV WATER = < 27.00' EXISTING GAS LINE
LOT 6
PERC RATE = EXISTING UNDERGROUND UTILITIES
INSTALL 4 - 500 GALLON LEACHING CHAMBERS w --------- EXISTING WATER LINE
(2 CHAMBERS FOR SAS "A" & 2 CHAMBERS FOR SAS "B") DEPTH OF PERC =
SIDEWALL CAPACITY TEXTURAL CLASS: 1 TEST PIT LOCATION
(LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) x 2 SAS's=GAUDAY _ O O O PROPOSED 1,500 GALLON H-10 SEPTIC TANK
(21.0'+ 12.83') (2 ) ( 2' ) ( 0.74 GPD/S.F.) x 2 SAS's = 200.3 GAUDAY 0" 39.00'
Fill --------- PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE
BOTTOM CAPACITY 18" - 37-50' ❑ PROPOSED H-10 DISTRIBUTION BOX
(LENGTH x WIDTH) (0.74 GPD/S.F.)x 2 SAS's= GAUDAY A Loamy Sand
�O
(21.0' x 12-83') (0.74 GPD/S.F.) x 2 SAS's = 398.8 GAUDAY 22" 10Yr 3/1 37.17' PROPOSED 500 GALLON H-20 LEACHING CHAMBER
SWING-TIES SCALE: 1=20" -
B Loamy Sand
--- -- ----- -_ - 10Yr 5/6
NOTES: DESCRIPTION GC-1 GC-2 GC-3 HC-1 TOTALS: REV. DATE BY APP'D, DESCRIPTION
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP TANK INLET COVER (1) 13.7' 15.5' -- --
3) C-2 7 s TOTAL NUMBER OF CHAMBERS 4 Perc 35.00 PROPOSED SEPTIC SYSTEM UPGRADE
EDGE OF EACH SEPTIC SYSTEM COMPONENT. (4 SAS 2) ( 12 S "&, TOTAL LEACHING AREA 809.6 SQ.FT. 66 33.50' j PREPARED FOR:
TANK OUTLET COVER (2) 20.1 10.6 -- -- I--- 21.0' GC- 8 8) TOTAL LEACHING CAPACITY 599.1 GAL./DAY
2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION le
CORNER OF STONE (3) 25.3' 18.7' -- -- O 7 0' i 1 CAPEWIDE ENTERPRISES
OF THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY O --. ___- C Medium Sand +
WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER 0o 1). 2.5Y 6/6
CORNER OF STONE (4} 40.4' 39.T -- -- ls0' N
AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH GARAGE LOCATED AT,
i
TEST PIT DATA. CORNER OF STONE (5) 35.2' 41.4' -- -- (5 (6 � a, 1p.Or 692 SCUDDER AVENUE 1
3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED CORNER OF STONE (6) 15.8' 22.1' -- -- )
HYANNISPORT, MA 02601 j
ZONE 11 OR ESTUARINE WATERSHED- 10)�� 9)
4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A
CORNER OF STONE (7) -- -- 13.5 36.2' ! 144" 27.00' SCALE: 1 INCH = 20 FT, DATE: DECEMBER 10, 2019 j
24.6' 37.5'
CORNER OF STONE (8) 0 10 20 40 80 FEET
COURTESY FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING -- - #692 No Mottling, Standing or Weeping Observed .114OF
TIE MEASUREMENTS IN THE FIELD PRIOR TO INSTALLING THE -- - C-1 PREPARED BY:
CORNER OF STONE (9) - 25.8' 18.1' EXISTING o ,WFIN L G
SYSTEM. CONTRACTOR SHALL NOTIFY ENGINEER IF MEASUREMENTS JC ENGINEERING INC.
APPEAR TO BE INCORRECT. CORNER OF STONE (10) -- - 15.6' 15.3' 5-BEDROOM ` CENOkCHIILI.
ML �
.a
DWELLING 2854 CRANBERRY HIGHWAY
c� f
5.) CONTRACTOR TO PROVIDE H-20 CONCRETE RISER WITH C.I. a,
MA 02538
,EAST WAREHAM FRAME & COVER TO GRADE OVER ANY CHAMBER UNDER ASPHALT. SITE PLAN 5os. HAM, 77
SCALE: 1"=20' --
--- CAL ---------- + __ Drawn By: ATB Designed By:MCP Checked By JLC JOB No 4947