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0086 STRAIGHTWAY - Health
86 S�-raightway _ Hyzan A =r�268 112 e P r N ° f a { a 6 o I I o �I i o i 0 14 ' TOWN OFF BARNSTABLE LOCATION P(5.- SEWAGE VILLAGE ASSESSOR'S MAP&PARCEL .D 6-4P-"//CX INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY �jC`/�'l>''6: t��� ` � �• LEACHING FACILITY: (type) i:::� (size) ,3< 51 11 'X. NO. OF BEDROOMS 3 A'J�7��OL.P OWNER PERMIT DATE: 45 `OP--� COMPLIANCE DATE: Separation Distance Between the: n/® Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility /.I 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 g 3 b � e No. Fee _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpfiration for Misposal *pstrm (Construction Vermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. d�l�j /��� Owngr's Name,Address,and Tel.No. Assessor's Map/Parcel-2 14 1n A Al �— Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. te o> �� %� 460> 11-0,14J'aAl Ole✓' Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building e5;r C?_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided �� gpd Plan Date ` �"� $� Number of sheets 10* Revision Date Title Size of Septic Tankj�l�?���' /3`c o Type of S.A.S. COJ� 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 place the system in operation until a Certificate of Compliance has been issued by this Board of 6-- n✓� Si Date d� Application Approved by Date 1/ Application Disapproved Date for the following reasons Permit No. Date Date Issued l --- --- ------------- - 6 a j No. y / Fee ®� •�J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es `:PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftplicatlon for Misposal;*p trm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. ,6—J, ZWW'k ff/� Ownenr's Name,Address,and Tel.No. Assessor's Map/Parcel-2 ��'� �' + G��I S `/ +""v O14�1 Installer's Name,Address,and Tel.No. ` Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. >..Garbage Grinder( ) Other Type of Building 45;ret-C. No tvb Persons Sho ers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) .��� gpd Design flow provided .��� gpd Plan Date d'""'o' St Number of sheets 1000 Revision Date Title Size of Septic Tank /J'��/r�' / i-c o h ype of S.A.S. i Description of Soil ) t I r 3 } 1 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 place the system in operation until a Certificate of Compliance has been issued by this Board of n� l Sigae Date d Application Approved by/ r` Date � Application Disapprove�� Date for the following reasons Permit No. �l�! �7 J Date Issued g / _ ------------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(� Upgraded( ) Abandoned( )by��".�7 at Cf �/r�/ ��lil/ y � has been constructed in accordance 7 with the provisions of Title 5 and the for Disposal System Construction Permit No?O/'`J• dated InstallerQv�J,--/. Z Designer #bedrooms Approved desi owA gpd The-issuance of this permi shall not be construed as a guarantee that the system will ncti( as desi d. c Date � In 1 r spector vv: -----No.--=--- (� ------- -------------------------------------------- --- -----------------------------Fee-----------u------ 7 �� . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction permit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at :::P .14 V ,xl y 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:Cons uction must be completed within three years of the date of this permit. Date �/� 7i0/5 Approved by i TOWN OF BARNSTABLE LOCATION ������iir SEWAGE # ���� VILLAGE -4 s, wv\,-4-L ASSESS R//'S MAP& LOT At N(2 INSTALLER'S NAME&PHONE NO. b SEPTIC TANK CAPACITY ®y S LEACHING FACILITY: (type) (size) NO.OF BEDROOMS 9 BUILDER OR OWNER PERMIT DATE:: y a COMPLIANCE DATE: 3 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 T � (w q s ! a LOT NO. : ADDRESS :_ 24 3inR414 ujk� Hyams •OWNERS NAME: SEWAGE PERMIT NO. : NEW: REPAIR: cK3�cd�•. DATE ll S s/ DATE INSTALLED: INSTALLERS NAME: OF: Sf, -r WATER TABLE: /'-,/ ' FINAL INSPECTION BY: ` DRAWING OF INSTALLATION ON REVERSE SIDE: d �.6 � a a� a F� a No` �3' ',73 FEE COMMONWEALTH. OF MASSACHUSETTS Board of Health, 5��0\e— ' MA. APPLICATION FOP, DISPOSAL SYSILM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair)< Upgrade( ) Abandon( ) -)4Complete System ❑Individual Components Location \ Owner's Name Map/Parcel# 'I) Address Lot# � Telephone# �4[S - — Installer's Name Designer's Name \ n� Address e-^ K_e ��� � ��.� Address O, Telephone# Telephone# _ >b g 6:�5 Type of Building Si yyGT{S\`t1C'�'\ Lot Size [(TO sq.ft. Is Dwelling-No.of Bedrooms s Tp J ) Garbage grinder Other-Type of Building (911tt No.of persons _��__Showers V,Cafeteria (� Other Fixtures Design Flow (min.required) gpd Ca culated design flow Design ow provided 43 gpd Plan: Date a2J1 h Number of sheets Revision Date ,c 1� Title - Description of Soil(s) Soil Evaluator Form No. 0, Name of Soil Evaluator if7 Date of Evaluation L161 O DESCRIPTION OF REPAIRS OR ALTERATIONS � � R� C� i p: CC OAIV WAS/CE�I�Y 4N� ^� The undersigned agrees to install the above described Individual Sewage Disposal System in accor onsWjT-ITLE 5 and further a- s ton t to place the;�te m o ation until a Certificate of om fiance has been issued by the Board o FIealth: � t ,f Signed Date lr Inspections 4. .��.�.»...r,.� .. rv^wX-•---,+'^.-4r.,,aS"•. •,.r-->-..,•v1. ....1-^'. *'�yl:, r �: �..�'S q'� JW�F .`.-�1y2;. ,;hg'�'"7� :,,,�f'4�-51.".J`Y''�....: a+T a . �.._.+. �;,/`•.vrY�.-•^.' 'No.- Up- ' ,.. °." FEE f r Board of Health ° y APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) - Complete System ❑Individual Components ' Location $� 17't �� . Owner's Name ' Map/Parcel# �,� Address g(p ��► ^, Lot# ._ L Telephone# Installer's Name Designer's Natne Address � ..� ► ,. Q l o Address�bx Telephone# sce � kg —�J�O �•�`�'� lTelcphone-IP_ _5\ _Q-i% 53� Type of Building J\C Kai�"�Cj� Lot Size rQ ��y s "sq.ft. ` .Dwelling-No.of Bedroomscte2. 3� Garbage grinder Other-Type of Building No.of persons 5 Showers �,Cafeteria (V)' Other Fixtures Lcl\lyl , k,Ar� S1Y,k nc\V1'1 Design Flow (min.required) gpd Calculated design flow Design flow provided 43'-44- gpd Plan: Date 41 a21 -'r'C' Number ofsheets �+i Revision Date Title ` P t C� ��� JSAs' `i M JDrlra�'Ie1► Description of Soil(S) c —Im Soil Evaluator Form No. `� Name of Soil Evaluator C,t YY'►R t Shag Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS '`'., t'C3 CZ QC�Q� � s^ _`�,�_ .bMS'1n.r� The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further afire/es to not to place the/system in opera.tion until a Certificate ofCompliance has been issued by the Board of Health. Signed I d�9� / t/� t/� Date AWrov by "y iy©3 Inspections + • fa-�.... ..'... .T..�-^N.n..'.'--v.:.vn."- =.T...: Tom..- .. y .. -..r a,£r.i...—.,.�1".� `—S.�£..+.+•.�.. -i°."t �� - A . '..K......tee..=.._.�.-`. No.200 1`73 C®MMONWWJ14 OF MASSAC14USETTS FEE - Board of Health, �l l 51�----' MA. CERTIFICATE Of COMPLIANCE Description of Work: ❑Individual Component(s) O�Complete System The undersigned hereby certify t�at,(t;heSewage Disposal System; Constructed ( ),Repaired �,Upgraded ( ),Abandoned ( ) by: J � t t �pp �(/` t r at has been installed in accordance with the p ovisi r°ns of 310 CMR 5.00 (Title 5,l and the approved design plans/as-built plans relating to application No. 2W' —113 /dated y Z q o 3 . Approved Design Flow (gpd) Installer 1.-)a t-Fw�� lL�/ J pA� Rr , Designer: Inspector: r1"' t^^^° •AWN";)\�][7 ";) 16 •Date: q I Ct The issuance of this permit shall not be construed as a guarantee that the system will function as designed. ` No. 6 3_ '7 3 FEE Board of Health, E L( cif. Ole— ,MA. y. �f DISPOSAL SYSTEM[ CONSTRUCTION PERMIT 3 Permission is hereby granted to; Construct( �1 Con struct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at r) f!) c, 1� ./ 14 ;�*�: .df 11 Z,,1 �} 6 LZ as described in the application for Disposal System Construction Permit No. 2W0,f7 , dated 3. f Provided: Construction shall be complete/d� 'th i n three years of the date of this car c c ditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date 1 1�Q 3 Board of Health • r TOWN OF BARNSTABLE .( ��� SEWAGE # LOCATION Sc LOT Lc L�2 ASSES R'S MAP CoL VILLAGE I INSTALLER'S NAME&PHONE NO. ' j SEPTIC TANK CAPACITY (size) LEACHING FACILITY: (type) j NO.OF BEDROOMS BUILDER OR OWNER 3� a 3 PERMIT DATE: y a 0- COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility private Water Supply Well and Leaching Facility (If any wells.exist Feet on site or within 200 feet of leaching Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leachingfacility) Furnished by i r o o 0 Ia 6a< �. CARMEN E. SHAY (508)-548-0796 ENVIRONMENTAL SERVICES, INC. P.O.Box 627,East Falmouth,MA 02536 April 29, 2003 RE: Certification of Title V Septic System Installation: Residential Property—86 Straightway, Hyannisport,MA Dear Sir or Madam: On April 16, 2003, Roger Roberts, Inc. was issued a permit to install a Title V Septic System at 86 Straightway, Hyannisport, MA, based on a design drawn by Shay Environmental Services, dated, April 15, 2003. XX I Certify That The Septic System Referenced Was Installed Substantially According to the Plan I Certify That the Referenced Above Septic System Was Installed With Changes but in Accordance With State and Local Regulations, Revisions or As-Built Plans/Sketch will Follow. The Septic System Was Not Installed Per State and Local Regulations and Corrective Action is Required. If you have any questions, please do not hesitate to call the undersigned at (508)-548-0796. in er 1 S c e y, CARMENE. SHAY ENVIRONMENTAL SERVICES,INC. J, moo`' RMEN AX c��\ E. Carmen E. Shay, R.S., C. F ° Gf STC + President Sep - 20-01 13 : 52 BARNSTABLE HEALTH DEPT 5087905304 N • UC NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM CAe*%4EN1 , hereby certify that the engineered pian signed by me ciatee3 concerning the property located at If+..�c\ meets all of the lcl:owing cr;tena • This failed system is connected to a residential dwelling only. There are no _ornmerzIa.1 or business uses associated with the dwelling. • "rhe soil is ciass:;:ed as.CLASS I and the percolation rate is less than or equai to 5 m.njt's per !rich. The applicant may use historical data to conclude this fac: or may :orduct pre!tm�..ar% tests at the site without a health agent present. • Therc :s no incr,,al,e in flow and/or change in use proposed i hire are no vanances requested or needed. • The bottom of the proposed leaching facility will not be located less than Fourteen :14} iee, aoove the maximum adjusted groundwater table elevation. (Ad)ust 'he nund,yater table using the Frimptor method when applicable) Please complete the following: op �! Ground Surface Elevation (using GIS information) _ 0 t B; C; W' E;cvat:0r. S _ + ad;ustment for high G.W. 1� '._... - __. 0.4 ;� FTC RE�t.F BETWEEN r\ an B `S ,U S.OVED DATE: �.4 O .......... -"-- NOTICE 2,asec j-ori tr-e above information, a ceoair permit wil! be issued for 5edr^orris -ra.irnum. `n bedrooms ue authorized to the future without engtnc.erec ?aem plans. � gain!each p<1cc.%m9 Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: (4 Lot No. �S Owner: Ad Press: Contractor: Address: 6X Notes: STEP 1 Measure depth to water table tonearest 1/10 ft. .............................................................................. .Date !i 0 mo h/d /year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: M OAppropriate index well.................................................... �B Water-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to d3 water level for index well ................... month/year STEP 4 Using Table of Water level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 26) determine water level adjustment .......................................................................................... '14 STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to.water •� levelat site (STEP 1) ............................................................................................................. f; Figure 13.—Reproducible computation form. 15 Cape Cod Commission: USGS Well Data - March 2003 Page 1 of 2 United States Geological Survey Observation Wells As a service to Cape officials, engineers and other interested parties, the Cape Cod Commission publishes monthly groundwater data gathered by its Water Resources Office. The water level measurements shown below are taken monthly from United States Geological Survey (USGS) observation wells and compiled during the last week of each month. They are published as soon as possible thereafter. Listed below are nine out of the 61 wells measured across Cape Cod by the Commission's Water Resources Office. These nine are employed as index wells to be used with Technical Bulletin 92-001 to predict high groundwater levels. For your convenience, we've also provided links to USGS national and state data. See the last column in the table and the footnotes below. For further information, please contact Hydrologist Gabrielle_Belfit at the Commission offices (508-362- 3828). - .n.: sssn:::..•, - ,.;N.w... ;=M;e,T;gwmrxaoaia. ;w,amac,w.eca.rx..:sus.w .cw.wa.,a:n;r March 2003 (.IS(. s Site Water Record Record Departure from Number's*** Location Well No. Level* High* Low* Average** (links to iJS(,S Monthly Overall national Nvater-level database) Barnstable A�� �'2.3 20.5 26.6 0.8 1.4 413950070164301 Barnstable AW ?4.8 20.5 28.6 -0.5 -0.2 41415407016.5001 Brewster BMW 21 1 1.6 6.9 13.6 -1.4 -1.4 414518070020301 Chatham CGW 138 22.6 20.9 26.6 1.0 1.4 41410007,0011101 101 Mashpee M1 W 29 '.l 5.6 10.0 0.9 1.4 41352507029.1904 Sandwich SDW �16.8 45.9 48.2 0.3 0.5 4144180701-41601 Sandwich SDW >2.1 45.8 55.1 -2.1 -2.0 414124070265901 Truro TSW 89 1 l.3 10.2 13:0 0.4 0.8 420206070045901 Wellfleet WNW 17 9.7 7.3 12.8 0.4 0.7 415353069585401 http://w�\�v.capecodcommission.org/wells.htm 4/3/2003 Town of Barnstable �P tHE l Regulatory Services Richard'V. Scali, Interim Director RARNSM'q EM Public Health Division te1g Thomas McKean,Director 200 Main Street,Hyannis,IVIA 02601 Officc, 508-962-4644 Fax: 509-790-6304 Installer&Designer Certification form Date: ,s'' Sewage Permit# MapTarcel j Designer: l 'v (�v4 Installer; 1 Address: "1(14 Address: R *q1&A U On �'� L was issued a permit to install a (date) (installer) septic system based on a design drawn by (address ,,3 , Wad dated 12>4p (designer) 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. Strip out (if required) was inspected and the soils were found satisfactory. 1 certify that the septic system referenced above was installed vvith 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 but(if required) was inspected and the soils were found satisfactory. _ I certify that the system referenced above was constructed ' lice with the terms of the AA approval letters (if applicable) OF 41, DAVID � ( sta er's Signature) MASON No, 1066 'a', re r , s'' r' ature) (Affix Desi `�� p Here) PLEASE RETURN TO BA ZINSTABLE PUBLIC HEALTH DMSION. CERTIFICATE OF CO'KPLIANCE WILL NOT BE ISSUED UNTM BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARrNSTABLE PUBLIC HEALTH D•CVISION. TI ANK YOU, . Q\Saptic\Desigmer Certification Form Rev 9-14-ildoc Town of Barnstable P# 7 '. Department of RegWatory Services M, M Public Health Division Date 200 Main Street,Hyannis MA 02601 rfU AAltt A Date Scheduled_ Time Fee Pd. I vd �l Soil Suitability Assessment,for Se e 21�v. 'spos .i Performed By: Witnessed By:_LZ V / OCATION & GENERAL INFORMATION J Location Address . � %�j� Owner's Name ' Address Asscssor'sMap/Parcel: : �C1r��fe Engineer's Nam . NEW CONSTRUCTION REPAIR Telephone# Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SIMTCII:(Street name,dimensions lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) r Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole:_ Weeping frotn Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL IGH WATER TABLE Method Used: Depth-Observed standing in obs.hole: In. Depth to soil mottles: in.` 4 Depth to weeping from side of obs,hole: In. Groundwater Adjustment ft. Index Well# Reading Date: Index Well lever Adj,factor m Adj.Groundwater Level PERCOLATION TEST Date �� Tone Observation Hole# Time at h" 11 I( Depth of Perc Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch `�• !I v Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. �Q Barnstable Conservation Division at least one(1) week prior to beginning. ^ �C Q:\SEPTIC\PERCFORM.DOC J DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. onsistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsisten % rav DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Cnite c O DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stories,Boulders. Cons' ten Flood Insurance Rate Mau: Above 500 year flood boundary No Yes V__ Within 500 year boundary No=f Yes Within 100 year flood boundary No. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring per ' s al exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth ofly occurring per ' us material? Certification I certify that on4/nalurro (date)I have passed the soil evaluator examination approved by the Department of Entection and that the above analysis was perfor=4 by me consistent with . the requi training,expertise ex nce d cribed in CMR 15.017. Signature Date Q:WEMC\PERCFORM.DOC • i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS r d DEPARTMENT OF ENVIRONMENTAL PROTECTION R e r W TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FOR PART A RECEIVED CERTIFICATION Property Address: 86 Straight Way Hyannis MAY 2 4 2002 Owner's Name: Tony and Kathy Maynard TOWN OF BARNSTABLE Owner's Address: Same HEALTH DEPT. Date of Inspection: 5/14/02 Name of Inspector: Timothy Lovell 7 3 Company Name:Accurate Inspections MAP Mailing Address: 550 Willow Street W. Yarmouth,MA. PARCEL • � .2 Telephone Number: 508-771-3700 LOT _ 4- CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails o� Inspector's Signature: Date: 5114/02 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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14102 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _X_I have not found any information which indicates that any of the failure criteria described in 310 CNIR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: 9 _N/A One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. _N/A 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 infiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: N/A Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): Broken pipe(s)are replaced Obstruction is removed Distribution box is leveled or replaced ND explain: N/A The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): Broken pipe(s)are replaced Obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5114/02 C. Further Evaluation is Required by the Board of Health: . _N/A 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: _N/A_Cesspool or privy is within 50 feet of surface water _N/A_Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _n/a_ 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. _n/a_ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _n/a_ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. n/a_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14/02 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _x_Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _x_Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _x_Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _x_Liquid depth in cesspool is less than 6"below invert or available volume is less than'/2 day flow _x_Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _x_Any portion of the SAS,cesspool or privy is below high ground water elevation. _x_Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _x Any portion of a cesspool or privy is within a Zone 1 of a public well. _x Any portion of a cesspool or privy is within 50 feet of a private water supply well. _x Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] _No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: N/A To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No The system is within 400 feet of a surface drinking water supply The system is within 200 feet of a tributary to a surface drinking water supply _The system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone R 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. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14/02 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _x _Pumping information was provided by the owner,occupant,or Board of Health _x Were any of the system components pumped out in the previous two weeks? _x_ _Has the system received normal flows in the previous two-week period? _x Have large volumes of water been introduced to the system recently or as part of this inspection? N/A_ _Were as built plans of the system obtained and examined?(If they were not available note as N/A) _x— _Was the facility or dwelling inspected for signs of sewage back up? _x _Was the site inspected for signs of break out? _x_ _Were all system components,excluding the SAS, located on site? _x_ _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? _ _x Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _x_Existing information.For example,a plan at the Board of Health. _x_ _Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] I Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14/02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_2_Number of bedrooms(actual):_2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):_220 Number of current residents:_2 Does residence have a garbage grinder(yes or no):_n_ Is laundry on a separate sewage system(yes or no):_n_ [if yes separate inspection required] Laundry system inspected(yes or no): N/A_ Seasonal use: (yes or no):_n Water meter readings,if available(last 2 years usage(gpd)):_2002(34000 Gallons)2001(31900 Gallons) Sump pump(yes or no):_n_ Last date of occupancy:_Current COMMERCIAL/INDUSTRIAL NIA Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:_Barnstable Sewer Facility Was system pumped as part of the inspection(yes or no): Yes_ If yes,volume pumped:_800 gallons--How was quantity pumped determined?Gauged by pump truck Reason for pumping:Block 6x8 cesspool TYPE OF SYSTEM Septic tank,distribution box, soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval Other(describe):Block 6x8 cesspool with a 28x2 leaching trench Approximate age of all components,date installed(if known)and source of information: Approx Mid 70's Were sewage odors detected when arriving at the site(yes or no):_nc_ Page 7 of II OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14/02 BUILDING SEWER(locate on site plan) Depth below grade: 2' Materials of construction:_x_cast iron —40 PVC—other(explain): Distance from private water supply well or suction line:_50+ Comments(on condition of joints,venting,evidence of leakage,etc.): At time of inspection piping had no evidence of leakage pipe looked to be in good workingorder rder SEPTIC TANK:_N/A_(locate on site plan) Depth below grade: Material of construction:_concrete—metal_fiberglass—polyethylene—other (explain) If tank is metal list age:—Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: 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: 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:_N/A (locate on site plan) Depth below grade:— Material of construction: — — concrete—metal fiberglass___polyethylene—other (Explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14/02 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:_N/A (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:_N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14/02 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Located leach trench by probing with bar also dui down to look at perforated pipe look fine no sign of hydraulic failure at time of inspection Type Leaching pits,number:_ Leaching chambers,number: Leaching galleries,number: _1 Leaching trenches,number,length: 24x2x2 Leaching fields,number,dimensions: Overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): No sign i of hydraulic failure at time of inspection no pondingor r dampness observed vegetation normal CESSPOOLS:_x (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: I Depth—top of liquid to inlet invert:_8" Depth of solids layer: I' Depth of scum layer: 3" Dimensions of cesspool: 6x8 Materials of construction: Block Indication of groundwater inflow(yes or no):_no Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): This cesspool is being used as septic tank with a leach trench off of it had cesspool pumped no evidence of rg ound water no pondingor r damp soil vegetation normal PRIVY:_N/A (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.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14/02 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. Back of home 3 3 g' • Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:86 Straight Way Hyannis Owner: Tony And Kathy Maynard Date of Inspection: 5/14/02 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_25'_feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) _X_Accessed USGS database-explain: You must describe how you established the high ground water elevation: Information Provided by Cape Cod Commission Well information Well#AIW230 well elevation including adjustment is Elevation 23.6 leaching pit is 8' deep bottom of pit approx. 14.6 with a approx. 9ft separation �I LOT NO. : ADDRESS:_ 014NERS NAME:- A A-XAj c( SEWAGE PERMIT NO. : NEW: REPAIR: 1 I L3 Acefto•, DATE -HtMD:_�- �/Z DATE INSTALLED: INSTALLERS NAME : OF: WATER TABLE: !y/ ' FINAL INSPECTION BY: DRAWING OF INSTALLATION ON REVERSE SIDE: kfA L 77 f -Lj L 24 lnh*�'toll) r"in, from U 001 Odor 'VENT 0 Le"t- -e SCkE LE 0, f 0. ALL PIPES E TO k DU 4 PIPE so we PVC,*/Chorc Faie, Ex ing�J oun otion, I itouse to,Septic tdnk ist TRENt Et QRQtS-�` SECTION �i :� OTAL) SWit lank H ID 70 0.00 S 664r* hiiit be .10 umed) F'IELEV, L"A vithin aftV, sny6er '601 Oft ow 3 tic Tank' O&SO area W, r I/T 0 0 HoLE "�!o X 0 ftood 061"go W 0,10 or ovat4w S. 'sn O-of --1/2- Wcah"SWn* PI GAI E P Z cl T ok ATER 4' 1*�-94,72 y -10 �,SE C TAW,, E hrwi� be 644�� at'ago*w/vw top. 6 iro.of 3/4'-1,1/2* SYSTEM PRM�L -87�00 am TIREJ` E "' "I I:,;", e I I I I r , , I �NOT TO SCALE led it NCH S Not to Scale C 2000, +/ C j 6 in-of 3/4--1 1/2- compactod Van* COMPONENTS MUST TO VATHiN 6",,BELOW GRADE RISER; QENERAL ,�NQTE 1. Contractor jS,reSponsibe,_,for Digso'feinotification and prot ion, of oil round u ilities and pipes. ec underg 2,, The septic tank o6j distri ution box�tsholl,be t se level on V,of 3/4 -1 2", stone. 3. Bockfill should be clean sond or.qrovel with no TYPICAL 1500 ' GALLON SEPTIC TANK over stones .3" in size. NOT TO SCALE 4. 'This system is subject to"irispection durin4 installation by �Corirnen E.�$hoy -, Environmental �Services, Inc. roctor, sholl' install t 3-24"DIAM. ACCESS MA�OIOLES The t' his system in. occordonce woo with Title V of,the, Mossochusetts�.stdte,code, the approved pion to' -V andL col Regulations.. 0 Ifj, during 'installation the conteoctor encounters any soil Conditions or site,conditions that re different 0 :from those ShOW6'Lon the,soil',16g"�or 'in our design b A :' instollotion'�Must halt &''immediate notification'.L e All mode to"Co�rnen;E- S OUT ET .. .... hay Environrnental Services, Inc., INLET -THE,ACCESS C014RS FOR THE SEPTIC TANK. ve eov'y machi 11 dri over the ME! inery sho ve DISTRMUTION BOXAND LEACHING COMPONENT. 1: 7. No"' hic e or h ble, S less', SHAL eptic system v n as H�,20 septic components. L BE.RAISED TO VATHtN,6* OF 'Z:-7, �,8, install f� t boffl s FINISHED GRADE. u -Ti e e or equals cir),bit outlet tee ends. ., -40 N F PVC pipes. TEEL REINFORCED�PRECAST CONCRETE INSTALL TUF-TITE GAS BAFFLES OR EOUL 9, All Distribulion"Li 1 1,4-4" dionneter,'Stbedule S, nes.shol ENDS, ON ALL OUTLET TEE sot di gs :t PLAW,-VIEW- 75-00 16.:All I piping tees hall be 4 tometer che 3-24'NNOVABLE COMERS S dule 40 NSF�PVC pipes.�with waterli4ht joints."". T s"Connected to' he Residen e ond A' butt* 11.� Municipol-Woter, C Ing 'h 206;f pert Or,_#45 Pro ies Withi 2"alln. Wei to*UtWt OUTLET 10,120.Squatv Feet,+I� L THE��P 0 -A PROM 'TE PlEf:tTY LINES:ARE MA AND COMPILED FROM THE.SURVEY,PLAN ,GENERATED BY RVEYOR OF HYANNIS_MA� 'H.' �GREENEi'SO u4mid depth DAIAD �fy ENTITLED Subdivision "Plon 'of Land";in, Hyonnis� MA", DATED NciVo beir 196 5 M AND :1 :NOT, INTENDEV�10 BE A, SU VEY:,PLOT PLAN' -SHOULD.�'BE,USED'F6R 'PURPOSE OTHER-THAN THE SEPTIC SYSTEM INS {LSECTION ROSS: SECT 0 TS71ING TALLATION. 1 'BEOOM Nous �NO i WETLANDS�VTHIN��200 THE�'PROPtR*Y 'D # LOT 44 N LEG CK L U -�s \,TEST 'DENOTES PROPOSED' HOLE #1 04XI� �PERCOLLTION EST Not (154 F1 ELEV.-_ 99.,00 SPOT RADE Dote of Percolation Test:' APRIL 18''2003 Test Performed By. CARMEN E. SHAY, R.S., C.S.E. DENOTES, EXISTING X 104:46 Results Witnessed 8 WAIVER(�Per Barnstable B.O.H.) OZ SPOT GRADE EXCAVATOR, , Shay Envircitirrientol Services, Inc. 4* PL Perool 'Than 2 MPI '0 30", Below' Lond Surfo PROPERTY otion Rote Less ce LINE D-BOX 7est Hole 496P PROPOSED ,CONTOUR, ,,, No ;j of Cesspo ox.) ---- - ------- DEPTH S ELEV (Appr —97 EXISTING CONTOUR 105.00.00 0 VENT PIPE—/, DEEP EST, HOLE 'Ilk io�YR SA, PERCOLATION TEST IN�o ';. 8.25 A, to Loath t Sond 6 FOOT STOCKADE' FENCE to i* 8, 96-50 Mtdium Sond,1 2.5 Y 7/4 30- C 44' LOT #46 PLO T": , AN . Per�c #1 OF P U P(�R SE0 ,, 'SEPTIC ,� SYSTEM. AD'E Depth' to Per6, 30" to 48" Perc,Rote= Less Tho 2 MPI FOR, REPAREDL Grou er o indwt .N 't Observed Observed ESHWT No KATHLEEN MAYNARD LOT 09 ! ADJOSTED 1120' bev.'� Nohe AT AY O' AD ,- �48'6,' STRAIGHT fASWAWT"BOX SH^U K OUTLET*F�S FkM TIC ' ANNIS, �HY AU De�ian CI5ic' Utotion' COkMTE COWR SET I.EVEL-f*R AT LEAST,2 IF 2 0 to �3SO �6 Nuhnbqtr�:oi`�Bedrooms.'�3: Equivalent.. 0. y 0 �,40 50 1 Gorboge'.0rinder No 3- 51 CUTLET, INOCK pt CA SHA ity hquiir6d. 3301,Gol,/Doy Minimum !per Title 1e&hing Copoe 216 -tank-"' �V 330 001,/Doy� ,500'GAL_ Septic t CUsin ENVIRONMEN OIL :ABSOR TION, AREA. Se Tank" 660'", USE'�t' 2-min./inch I ercolo ioh�rfate�oj < 2rAL-:,SERV10ES,- INC. S L '=:20' Proposed Leaching ench� Dimensions. Wjde',�by 56 Long,��,by, 2 i'Depth,: 4 -62, 4',- SCH. 4 7- 7 0 �,c ACH 'TRIENCI-1:10 OUT, Wr:''it, X 224�S4.'4 C 165.76,go(lons 0 0 om . !",�,' AraEXISTING CESSPOOL.-&:�IE 74� goL/sq. -2*6 sq.. ft 177.46�qollons P CTION k 'PUMPE6 U 2536 'Side,walf'.Area.- LAN SE S-L SETIQN INSTALL,NE SEPTIC AND ;'EAST FALMO, Providing: ��'': .1, REMOVED�40 343.36 'gollons 508:44548, 0796_:�, or row 0 E-, �ANY'S ING ItACHA-TE -4-W 011 DATE!, APRI ��2003, 1 TR 561 by L 3 Hb0 ` 6 10 TRt 011OWBOX SC T RIPPED�,'OUf :S61L tbiNtAINi US6: ENCH 2 FR JH EXIS D JO 04, E' TR.tktk�CESSPOOL',TO,BE ,-AS ER HtALT BOARD H :SPECIFICATIONS:�'- FILE AM G' N 5L)41 PP L)W F ' ROIF*rT#SD41 6: Not DISPOSE P tap o� frs��� "• rM r7. covers 4,r Gast' i ran or ;',`:'• � `---_.._._•. �� 2�, /a ye r of , sch. 4o pvG ;'. min. pipe w1rnirl. •' ,, Washed/ pitcf7 V4•"per foat 4 sch. i� o Vc pipe. '• rnih. pjtc I/8"/der ft �� _.._ � /ow line O� D ;; Y25 _ •.• •: o • _I I i - rC G� �W�dtih) _� �� � a.� •f• ne base inv e% I t�Ttz Variobie, inv. a Se tic tanit Q SP.S�j�F,CE inv e9 al i 1 75.00 9a • c'o :,crushed, ,sfone, ba a .•. _ ��i x q _ ground water fable elev. - /�/.19•. --- ��', LO� #45 ; Op Eaotfom test hole e/ev. - ¢' VI i 10,120 Sq uare Feet +/- i , , EJ�/9 G S�""` `Y''J�' ]'E f`� Ply 0�/L. — - ,�•- �' hc7T� fo 5ca Ci \ ! o .--- 1 EXISTING I cMa 3 BEDROOM t r HOUSE z 7- ,�-� C� G.. 1_... � G I c 1 C7I'lAzar3GF, O/;3Po:5At'._. W "!T : -iC`�D7� �1 U � -7'E=ST" MATE- . � g6_-- DECK J }=� ',Ji'V1./,/ NaturcFwas Li \t TEST HOLE #1 ,' (� G! /-•/jf31�.�L�f�`/' a: � , �3/E'•�� f l CQLAT/OA.1 R/� = `� �' �M /A/C - / r O !0 EL EV.= 99.00s/;'/� Ga/q L-.J a A�- /�E,�1�p�,f��f1. O L_ , ►� 02 lQ E .� E/�TJtr TFJN/� C , F �lC/TY. GA HOLE �- E _ ' *, ,, �- . .• ; , _ /7C &fl,7'lC TF-?Nl� J2E Ci,A • 4 T vA e� s ' ,; _ _'� L � 'Foiled o-Box Ja SIA WA Lt . /2� ?J X�7 ("7f�L r �--- cesspool 1 __ I 0 TT0�7 z� - -> � ? ' . sip ' _ - Jo5.0o' r�oTqL LEAcHIN� ^.SPA VENT PIPE / I� RESERVE L- EACHItIG CAS' JTY g$ ' GAL. ' ivoT PLL WORkMANSH/P AND /YI19TC- P_h9LS _ S H A L L. C ONFO R M T�� P T T 5 _ AND THE ToWAJ OFit - 12 U L E S t9 NO R E G UL P T/OR./S FoR - - -~- SUBSURFACE O/Spo�AL. OF / SANI TAi2Y SEW19GE•. 5"') COMPG/A/VCE LV/TH SON/NG i2EGULAT/O/l./S OT --- XG_ Y_. - C' /kl_V_ _W SP4j9 L L BE O&TEi2M o',&JE 0 BY B Ul LD/NG -- _ �L ' b� P/,�.(�i ,� /NSPE CTof2 / CoM/-1/SS /UN�l2. _ L �,/,*>Z/ —CL �� :3� EXJST/JVG �9NO FItiAL Gf�A0ES SHFILL -'--.r'--1--j � �2 EFM ff�l til �S s E NT; i9 L L.Y ?�%-�E : SAME. ._.K O f9 T� fPP�e o VE O _..--- 'n'-f� .�ocx}�o�c..� c��' q,�,,r, (>7"rL,/ t�� B c� o,� ,� ,9 LT y . YS 7M G,dlac .��o�)T.S7G?l � 4Orr nJa7-/C /7 '-' - P L � /V 0)= P) 0 P 0 5 � D C- O AJ S 7-le_ UC.T 10 AJ �A s � oCfy7-/0� J to � 15 I MIA v mt °3 Snyder CL' _ /�./C: E ?� �b�� � !'r /` L?7 c v oh Jc-- T�' /� �•- Ic J L P A � r I C� j tj 0. w ok d SITE s S° !��\AOF�i,Jtc . t ° LEGEND j� � � '•� 9� Q� l • -f p e�cistln spot `l�:u = c�.o _--- - __--" �-•� � oh y exisfin.7 contour - —_ _. - -_ - L �-T ! -- -_. ---- N _O�a �'' Lu --- tyP. prop. ¢1►7• SPn f- a/ev'. o.o / ~7-•� f� 66.1 5 prop. •f i r1. c o n•%o u:- = ._ o . o (_� v -esf- hole loca-/ior� w Z_Q c A 7'/0/�„ _..._- ul SCALE: ', .mar+: .drrarmvmoec•:ewns wmxae..•n.+wxucea•x..e.r.rvcscn.uxaa:srui.oar::•_•••:•.,drsyatiditv�::w^..•mamr:rr:sm,.•vuax:srs.a.e.:?.i.;rc:•... ••..•--va•xoa+a• :xrrsu:•ror..aauswa+ r .+• _::. i