Loading...
HomeMy WebLinkAbout0030 SUNNY-WOOD DRIVE - Health op 30 Sunny-wood ;Drive Hyannis P 273 217 p �i I i c COMMONWEALTH OF MASSACHUSETTS z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONM � � ON SEP 15 2004 -TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFTCIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: AP O`vner's Name: 'ARCEL Owner's Address: ��P �r 2$ Date of Inspection:' JY—o17-0I Name of Inspector: (please printp61gias A.Brpwri Company Name: Q0ji►glas O an,yyn Septic inspections Mailing Address: RO Box 14R 6entewilleTelephone Number: ' . A 02632 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 mainienancq of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Sec 'on 15.340 of Title 5(310 CMR 15.000). The system: Passes " . Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: -27-0 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 io the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that . time.This.inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I 4t7312 l lcty Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owner's Name: r A4/ Owner's Address:. $a,c�e Date of Inspection:.6-;yrp f Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A.71have asses: not found any information which indicates that any of the failure criteria described in 310 CUR 15.303 or in 310 CMR 15.304 exist Any failure criteria not evaluated are indicated below. Comments: // ol �� ,�i1!is ,G.rur Yfir�! �iir�.d/'bY51r/� B. System Conditionally Passes: one or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair;as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static Rater 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 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 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 60l7 NY✓ �_ Owner's Name: Owner's Address:_ Sty. 10 Date of Inspection: -�z 7 tP 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 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ the system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: • n_._.. / 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: r ,P Owner's Name: Owner's Address: 6?4-" Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No / $ackup 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 c�ged SAS or cesspool V Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or �spool . uid depth in cesspool is less.than 6"below invert or available volume is less than%z day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number o 'mes pumped _ 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 meter supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. _ ortion of a cesspool or privy is within 50 feet of a private water supply well. _ 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.] (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 necessaryto 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- You must indicate either`yes"or"no"to each of the following: (The following criteria'apply to large systems in addition to the criteria above) yes no _ the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply' the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes".in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR i Page 5 of 11 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: ��► y Owner: Date of Inspection:_ 0-,2 7 of- 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 i Were any of the system components pumped out in the previous two weeks? as the system received normal flows in the previous two week period? ave large volumes of water been introduced to the system recently or as part of this inspection? _ ere 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? Y s the site inspected for signs of break out? _ �:_ re all system components�te SAS,located on site? _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions,depth of liquid,depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes o Existing information.For example, a plan at the Board of Health. N _ 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)] 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Jp Owner's Name: Owner's Address: Date of Inspection: y i RESIDENTIAL FLOW CONDITIONS Number of bedrooms(design): Number of bedrooms(actual):3 DESIGN flow based on 310 CUR 15.203(for example: 110 gpd x#of bedrooms):_.A::? Number of current residents:_ Does residence have a garbage grinder(yes or no): I Is laundry on a separate sewage system(yes or no):,,-1W[if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no):," 2c o l /,f 900 Water meter readings,if available(last 2 years usage(gpd)):-4 003 29"Oob Sump Pump(yes or no):AV Last date of occupancy: c COAT MRCIAL/INDUSTRIAL: Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sgtetc.): 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): Pumping Records. GENERAL INFORMATION Source of information: Was system pumped as part of the inspection(yes or no): If yes,volume pumped:_gallons__How was quantity pumped determined? Reason for ping: TYP SYSTEM _Septic tank;distribution box, soil absorption system _Single cesspool Overflow cesspool —Privy Shared system(yes or no)(if Yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from.system owner) —Tight tank —Attach a copy of the DEP approval _Other(describe): Approximate age of all components,.date installed(if known)and source of information: �)(S�t� ir✓s ��/,yr/� FJd Off, Were sewage odors detected when arriving at the site(yes Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:.�C7 Owner's Name: Owner's Address: p Date of Inspection: BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_(locate on site plan) Depth below grade: Material of construction:_cam oncrete_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:_ZaV Sludge depth: /Bz1' N 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 tlet tee gr baffle: How were dimensions determined: cvG2� P Comments(on pumping recommendations,inlet find outlet tee or baffle condition,structural integrity,liquid levels as related to outlet• vert,evidence of leakage,etc.): GREASE TRAP:_(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: Owner's Name: ok e Owner's Address: Date of Inspection:0-2 Z-op 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. gaLtons Design Flow: gallons/day 'Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.).- DISTRIBUTION BOX: (if present must be opened)(locate on site plan). Depth of liquid level above outlet invert: knd dvllels Comments(note if box is level and distriboutlets equal,any evidence of solids over'�'evidence of leak ge into or o_ of box,etc.):_ - �' P CHAMBER:__(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 i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SY INFORMATION(continued) 3� Property Address: a Owner's Name: Owner's Address: !lant,e Date of Inspection: ¢�- SOIL ABSORPTION SYSTEM(SAS):_(locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: 9yefflow 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.):. <c Gr-e CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): iComments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of constriction: 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: Owner's Name:_ j c,w Owner's Address:_5c..-c-r_ Date of inspection: 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. o � Page 11 of 11 OFFICIAL INSPECTION FORM—'NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYS + INFORMATION(continued) Property.Address: N Owner's Name: Owner's Address: Date of Inspection: -Q7_j!5pyf SITE EXAM Slope:. 4-el-e l Surface water:.i(, rV r Check cellar: z2r Shallow wells Arcrtv iP Estimated depth to ground water 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) Accessed USGS database-explain: You midst describe how you established the high ground water elevation: COMMONWEALTH OF MASSACHUSETTS RECEIVED n EXECUTIVE OFFICE OF ENVIRONMENTAL AF R§UL 3 12002 DEPARTMENT OF ENVIRONMENTAL PROT q'SWb�BARNSTABLE HEALTH DEPT.. 5� FAILED INSPECTION RECEIVED TITLE 5 JUL 2 .5 2002 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSES 11 BARNSTABLE SUBSURFACE SEWAGE DISPOSAL SYSTEM FO HEALTH DEPT. PART A c�j>Y CERTIFICATION Property Address: 30 Sunny Wood Drive C-cmE'Ile MAP Owner's Name: Neil Suchy `-A.%f 1%4 N t 5 PARCEL O � Owner's Address: Same LOT Date of Inspection: 7/8/02 Name of Inspector: Timothy Lovell Company Name:Accurate Inspections Mailing Address: 550 Willow Street W.Yarmouth,MA. Telephone Number:508-771-3700 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 mainten$nce 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 -- f Conditionally Passes Needs Further Evaluation by the Local Approving Authority X Fails Inspector's Signature: Date: 7/6/dA. 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 System Fails reason is the leaching pit is not on the property also water level in tank is over invert out and Distribution box is overflowing ****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 2ofll OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:30 Sunny Wood Drive Centerville Owner: Neil Suchy Date of Inspection:7/8/02 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: & System Conditionally Passes: N/A One or more system components as described in the"Conditional Pass"section need to be replaced or red.repai 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: I • Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL•SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:30 Sunny Wood Drive Centerville Owner: Neil Suchy Date of Inspection:7/8/02 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 col form 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:30 Sunny Wood Drive Centerville Owner: Neil Suchy Date of Inspection:7/8/02 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 _n/a _Liquid depth in cesspool is less than 6"below invert or available volume is less than''/z 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.] _Yes (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 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. i Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:30 Sunny Wood Drive Centerville Owner:Neil Suchy Date of Inspection:7/8/02 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? _x_ _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. _ _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)] Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:30 Sunny Wood Drive Centerville Owner:Neil Suchy Date of Inspection:7/8/02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_3_Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):_330 Number of current residents:_3 Does residence have a garbage grinder(yes or no):_no_ Is laundry on a separate sewage system(yes or no):_no_ [if yes separate inspection required] Laundry system inspected(yes or no):_n/a_ Seasonal use: (yes or no):_no_ Water meter readings,if available(last 2 years usage(gpd)):yr2000(48000Gallons)Yr 2001(43000Gallons) Sump pump(yes or no):_no_ Last date of occupancy:_Current COMMERCIAL/INDUSTRIAL n/a 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: Owner 2°d week June 2002 Was system pumped as part of the inspection(yes or no):_no_ If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _x_Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: 1/15/89 Were sewage odors detected when arriving at the site(yes or no):_no_ Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:30 Sunny Wood Drive Centerville Owner.Neil Suchy Date of Inspection:7/8/02 BUILDING SEWER(locate on site plan) Depth below grade: 3' Materials of construction:_cast iron _x_40 PVC other(explain): Distance from private water supply well or suction line: 70, Comments(on condition of joints,venting,evidence of leakage,etc.): Pining lookd to be in good condition venting ok no evidence of leakage SEPTIC TANK: X_(locate on site plan) Depth below grade:_1' Material of construction:_x_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: 1600 Gallon Tank Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness:_none Distance from top of scum to top of outlet tee or baffle:__01, Distance from bottom of scum to bottom of outlet tee or baffle:0" How were dimensions determined: in the field tape measurements_ Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Septic tank liquid level was over Invert out no evidence of tank leaking tee's were in place Angurally ok rg ound was saturated while digging covers GREASE TRAP:_n/a (locate on site plan) Depth below grade:_ Material of construction:_concrete — te_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 8of11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:30 Sunny Wood Drive Centerville Owner:Neil Suchy Date of Inspection:7/8/02 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:_z (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.): Distribution box was over flowing the ground was saturated while digging 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.): a Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:30 Sunny Wood Drive Centerville Owner:Neil Suchy Date of Inspection:7/8/02 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type x Leaching pits,number:—I— Leaching chambers, number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): CESSPOOLS:—n/a (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): � I 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:30 Sunny Wood Drive Centerville Owner: Neil Suchy Date of Inspection:7/8/02 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. I Back of Home 23' Deck 4 50' 18, 61' i Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:30 Sunny Wood Drive Centerville Owner:Neil Suchy Date of Inspection:7/8/02 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_14+_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) Accessed USGS database-explain: You must describe how you established the high groundwater elevation: Will be determined at time of test hole for repair TOWN OF BARNSTABLE EL ✓ LOCA i1ON d 50evrl�--(ti Y Ui2 t�r�_'�`t SEWAGE.# VII.LAGE t�'—E c��S OR'S MAP & LOT'a 7�J'a/� t ,INSTALLER'S NAME&PHONE NO. i � (_� ✓`� SEPTIC TANK CAPACITY ' �i�f—F G-Y�.cui2.S LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER.OR OWNER ~ PERMIT DATE: / U COMPLIANCE DATE: - U 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 r � R 3 LE= I�I N . _ f No. 3:29 - FEE 56 Board of Health, _C�t��]�a� , MA. APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) - ❑Complete System eAlndividual Components Location �yyn Owner's Name a &m, h Map/Parcel# Address Lot# Telephone# Installer's Name O � Designer's Name Address Address d1 M Telephone# Telephone# IR Type of Building Lot Size sq.ft. Dwelling-No.of Bedrooms Garbage grinder Q J/,4 Other-Type of Building dC1Q No.of persons c9--Showers (r,Cafeteria (rY Other Fixtures Design Flow (min.required) L336 gpd Calculated design flow Design flow provided S2M.6 gpd eq Plan: Date 626SN oo— Number of sheets Revision Date Title ` O Description of Soil(s) Ala c+ Soil Evaluator Form No. ` Name of Soil Evaluator CAQAAXA Saifte Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS f' The unde gned agrees to ins a above described Individual Sewage Di posal SysteWYLATION �'annce with the provisions of TITLE 5 and further a t n to place tem' tion until a Certificat f ,om lian e � 1` 1�RVISE Signed Date SYSTEM D CERTIFY IN WRITING 6G �� WAS INSTALLED IN STRICT ACCORC;;:;�E TJ pLA V"7/3! 0 2 Inspections 3�q A^ ` c��w ' �?��� FEE J" . ► 'y;�� 0NWEA T19"`OAF MASSACHUSE TS Board of Health, ;C n<f`,,C�-Cmu) MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( Repair Upgrade( Abandon( ❑Complete System ekIndividual Components Location '2,0 � OCR yh,t ; Owner's Name Map/Parcel# a 1� Address t Lot# Telephone# ' Installer's Name �CN\� Designer's Name Address _ Address ``�� QA S lM S o � <A 70- I M cokAA M4 Telepho`iie# ;J'' 68- ���- C Telephone# ^V Type of Building CNP C\ Lot Size sq.ft. -.Dwelling-No.of Bedrooms s -1(f w-e_Q Garbage grinder a r � Other-Type of Bi i•Yding N bCle 11 No.of persons o� t/Showers ( ,Cafeteria ( yam Other•Fixtures L—c,,)c, N:,�n , F\��1'l"1,of1 E y Design Flow (min. required) gpd Calculated design flow� Design flow provided gpd�- '-, Plan: Date �hs^ D Number of sheets Revision Date � ^' Title U vnU CAA C_ CCc1k e Description of Soils) `r 1 Soil Evaluator Form No. 2 Name•of Soil Evaluator ��42cM€'J S+IPY Date of Evaluation - O� DESCRIPTION OF REPAIRS OR ALTERATIONS The under ' ed agrees to ins the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agry ton 't to place s�stem in lion until a Certificat f Otianpe has been issued by the Board of Health. Signed / Date M4 /P� Inspections —7/7 1/U ? >±-�-a::_.-.., _ -�•.s__:,...n-:.... p.,.-r...sl.�r�.�c.-.ems. a,::�-.ai-.+�-=��.�-r--.:��.-s=r...�s.�._•.ws,.a^•d�.a.ra�:_:=?._-.�...�-4--..�:���%as�a+.x.-`_ No. Poo 9 FEE COMMONWEALTH OF M[J ASSACHUSETTS Board of Health MA. /J CERTIFICATE OF COMPLIANCE Description of Work: S4Individual Component(s) ❑Complete System The un.ersign d hereby ,C tify that the Sewage Disposal System; Constructed ( ),Repaired'( ),Upgraded�Q Abandoned ( ) by: � ��, ''mm /I at ( UU hk L_ . a j has been installed in accordance wit the pro}isions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. J09 2 p­32 ,df a ed 7!3 t 0 '2- . Approved Design Flow (gpd) Installer t /�- (9 Designer: Inspector: W Date: /, v� The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. C�SIcI FEE—�— COMMONWBUTH OF MASS CHUSETT�`y"STAc� Board of Health, • \ ^' DISPOSAL SYSTEM CONSTRUCTION PERMIT �ff.(FO'�NS I,N. Permission is hSU anted to; Construct( ) R'e/pair(�i Upgrade( ) Abandon( ) an indiNridual sewage disposal system at �&-A h AL t W� ��✓ as described in the application for Disposal System Construction Permit No. U -3.�c1, dated )Z . , Provided: Construction shall be completed within three years of the date of this permi . Al�l local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date Board of Health �'^ i CABA1d1E1 v E. SHAY (508)-548-0796 ENVIRONMENTAL SERVICES, INC. P.O. Box 627, East Falmouth,MA 02536 August 2, 2002 RE: Certification of Title V Septic System Installation: Residential Property—30 Sunnywood Drive, Hyannis, MA Dear Sir or Madam: On July 10, 2002, Roger Roberts, Inc. was issued a permit to install a Title V Septic System at 30 Sunnywood Drive, Hyannis, MA, based on a design drawn by Shay Environmental Services, Inc, dated, July 25, 2002. 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. Sincerely, CARMEN E. SHA Y ENVIRONMENTAL SERVICES,INC. OF 41,j L c'R �o CARMEN 1p E. - SHAY Cn Car ri E. Shay, R.S., C1 No. 1181 o President Sq" 'tPwR\Pa FORM ,11 SOIL EVALUATOR FORN Page 1 of w No,: Date: 7/25/02 COMMONWEALTH OF MASSACHUSETTS ' Barnstable , Massachusetts Performed By: Carmen E. Shay Date: 7/25/02 Witnessed By: Waiver Location Address or#30 Sunny Wood Drive Owners Name: Ms. Geraldine White Hyannis,MA Address and #6145 Sequoia Drive,Port Orange ,FL Lot# (Map—273,Parcel 217) Telephone Number: New Construction: X Repair OFFICE REVIEW: Published Soil Survey Available: No ❑ Yes ❑ Year Published: Publication Scale: Soil Map Unit: Drainage Class: Soil Limitations: Surficial Geologic Report Available: No❑ Yes❑ Year Published: Publication Scale: Geologic Material: (Map Unit): Landform: Glacial Outwash Flood Insurance Rate Map: Above 500 Year Flood Boundary: No ❑ Yes a Within 500 Year Flood Boundary: No ❑ Yes ❑ Within 100 Year Flood Boundary: No FX7 Yes ❑ Wetland Area: None National Wetland Inventory Map (map Unit): Wetlands Conservancy Program Map (map unit): Current Water Resource Conditions (USGS): Month , Range: Above Normal ❑ Normal ❑ Below Normal ❑ Other References Reviewed: USGS Topographic Map DEP APPROVED FORM 12/7/95 FORM 11 — SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No.: #30 Sunny Wood Drive, Hyannis, MA On -Site Review Deep Hole Number: #1 Date: 7/25/02 Time: 10:00 AM Weather: Sunny, Cool Location (identify on site plan): Refer to Sketch Landform: Outwash Plane Position on Landscape (sketch on back): Refer to Sketch Distances From: Open Water Pody N/A feet Drainage Way N/A feet Possible Wet Area N/A feet Property Line 25' feet Drinking Water Well N/A feet Other DEEP OBSERVATION HOLE LOG Depth From Soil Soil Soil Soil Other Surface Horizon Texture Color Mottling Structure, Stones, (inches) (USDA) (Munsel) Boulders, Consistency, % Gravel 0" — 8" AB Loamy 10 YR 3/2 None <5% Gravel, Friable Sand Friable 8" — 36" Bw Loamy 10 Y/R None <5% Gravel, Friable Sand 5/6 Friable 36" — 168" C' Medium 2.5 Y 7/4 None Medium Sand, 10% Sand gravel, Loose Parent Material (Geologic): Glacial Outwash Depth to Bedrock:None encountered Depth to Groundwater: Standing Water in the Hole: None Weeping From Face: None Estimated Seasonal High Water Table 168" Assumed -No groundwater Observed DEP APPROVED FORM 12/7/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No.: #30 Sunny Wood Drive, Hyannis, MA Determination of Seasonal High Water Table Method Used: ❑ Depth observed standing in Observation Hole: N/A inches ❑ Depth weeping from side of Observation Hole: 168 inches (assumed) ❑ Depth to Soil Mottles: None inches ❑ Groundwater Adjustment: None feet Index Well Number: Reading Date: Index Well Level.: Adjustment Factor: Adjusted Groundwater Level: N/A DEPTH OF NATURALLY OCCURING 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: Yes CERTIFICATION: I Certify That on September 17, 2000, (date), I have passed the soil evaluators examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature: r6L Date: S FORM 12 - PERCOLATION TEST Location Address or Lot No.: #30 Sunny Wood Drive COMMONWEALTH OF MASSACHUSETTS Hyannis , Massachusetts Percolation Test Date: 7/25/02 Time: 10:30 AM Observation Hole #: #1 Depth of Perc 38" — 54" Start Pre-soak 10:28 AM End Pre-soak 10:38 AM Time at 12" Would Not Hold 24 Gallon Presoak Time at 9 Time at 6" Time (9-6") Rate Min./inch < 2MP1 * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Performed By: Carmen E. Shay Witnessed By Waiver Comments: .3.. Would Not Hold 24 Gallon Presoak - <2 MPI Site Passed X Site Failed DEP APPROVED FORM 12/7/95 Sep-20-01 131.52 BARNSTABLE HEALTH DEPT 5087906304 P .02 S/ZSlol NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM hereby certify that the engineered plan signed by me dated. d , concerning theproperty located at meets all of the following criteria: This Failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is ciasslEied as.CLASS I and the percolation rate is less than or equal to 5 rrunutes per inch. The applicant may use historical data to conclude this fact or may conduct pre!iminary tests ac the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching ;acility will not be located less than fourteen en feet above the maximum adjusted goundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable]' Please complete the following: ,a.) Top of Ground .Surface Elevation (using GIS information) • C� B) G.W. Elevauon 0 + adjustment for high 0.W.(�_ _ 01+ DIFFERENCE BETWEEN A and B SiG WK VID DATE: cZ NOTICE l IBased upon the above information, a reoair permit wil! be issued for .bedrooms maximum. No additional bedrooms ue authorized in the future without engineered lsepnc System plans. 1 01 q:hrllh loldcr.puccxmp Permit Number: Date: Qp� Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: Lot No. Owner: t \tVrre++�� (����Address: Contractor: 5 " t:C,' • Address: taa-+ 0AS34 i Notes: STEP 1 Measure depth to water table tonearest 1/10 h. .............................................................................. Date S-C) rnonth day/yeu STEP 2 Using Water-Level Range Zone and Index Well Map locate ! site and determine: I (�A Appropriate index well.................................................... t © Water level range zone..................................................... i i STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to ��,.� j water level for index well ........................... S•3 imon 01/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 28) determine water-level adjustment .......................................................................................... I � STEP 5 Estimate depth to high water by subtracting the water• level adjustment (STEP 4) from measured depth to water 2 levelat site (STEP 1) ............................................................................................................. 2� I j Cape Cod Commission: USGS Well Data - July 2002 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 Belf tt at the Commission offices (508-362- 3828). July 2002 USGS Site Water Record Record Departure from Number-,'*** Location Well No. Level* High* Low* Average** (links to (JSGS Monthly Overall national water-level database) Barnstable 230 25.3 20.5 26.6 -1.8 -1.7 413956070164301 Barnstable 24W 26.6 20.5 28.6 -2.4 -2.1 414154070165001 Brewster BMW 21 12.9 6.9 13.3 -3.0 -2.7 414518070020301 Chatham CGW138 25.3*** 20.9 26.6 -1.5 -1.3 414100070011101 Mashpee MIW 29 9.3 5.6 10.0 -0.9 -0.8 413525070291904 Sandwich D 47.9 45.9 48.2 -0.6 -0.6 414418070241601 Sandwich Zpw 54.1 45.8 55.1 -4.3 -4.0 414 124 070265901 Truro TSW 89 12.4 10.2 13.0 -0.2 -0.4 420206070045901 Wellfleet W 7W 11.9*** 7.3 12.8 -1.7 -1.5 415353069585401 http://www.capecodcommission.org/wells.htm 7/30/2002 No.... ��.- Fss... ...... ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .VU.......OF .�H1�.I F k............................... Appliratinn for Disposal Works Tonstrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ,( (fin Individual Sewage Disposal System at: ...... rp......D'�.Z_v 6 ........ ..............6-0_........_......_.:- ------•-•----•----•-•--_._--------•--- Location-Address or Lot No. ..... :!r'L� ±,.J►Z,.�y.> .-----.kw__...�1AM..---------------------- ....................... . .................................................--..... Owner �S Address a G'ItP L �a4w 1L�.-C r 1 X►-ft.cn! Installer Address Type of Building Size Lot............................Sq. feet a Dwelling—No. of Bedrooms......3.................................Expansion Attic ( ) Garbage Grinder ( ) WOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ..............•---------------------................--.--•--•......---.....•--•-----•-----•-•-•••-.....--------------..............----............... Design Flow..... ...........................gallons per person per day. Total daily flow.....'.Q.........................gallons. Septic Tank—Liquid'capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No........I............ Diameter.....LO-........ Depth below inlet.....(vi......... Total leaching area.........:.......sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '•-' Percolation Test Results 'Performed b ........................................... Date........................................ 1.4 .,� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •--------------------•--------------•----------------------.......-----..........-----•-•---•-•-•---......................................................... 0 Description of Soil.........................•-------------...._....----•-•-•--......-•---...--••----------------•------....----•---------...---••-•-•-•--••------------............-•_•-•-- W W -----------------------•................._.. x •---••--•--------•••--•---------•--••••--------•----------•-----------------------•••------------•...--••----••--------••------••--•--•-----......•------•--.....-•-----•-......._......---------...---- U Nature of Repairs or Alterations—Answer when applicable-.---_ -1PST.....' � 1 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i 1 4 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board f health. Signed-.-•- ...... ........................ ...4:7'ao`' Date Application Approved By................... .... ............................--••-- -•----1 �._ .... Date Application Disapproved for the following reasons:------•--------•........................•---•-•----••---------------------•--------------•------•-•------....._. ............................................................................................................................................................................................. ..... Date Permit No.........11. .:._:7_7 k.....................- Issued.....................---------..................._...--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. .........OF....... Appliration for Disposal Works Tonstrurthin Vanfit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ..... .. ..Location ............ ............... ............ Location-Address._.. Address or Lot No.................. ..... o......................................... ................................................................. .........................w�............ ............................................................. Owner Address .................................­------- ............................................... .................................................................................................. Installer Address U Type of Building Size Lot............................Sq. feet 0.4 Dwelling—No. of Bedrooms..........).................................Expansion Attic ( ) Garbage Grinder a4 Other—Type of Building ............................ No. of persons......._.................... Showers Cafeteria Otherfixtures ........................................................................................................ ----------------- Design Flow.._...` .............................gallons per person per day. Total daily flow........ -----------...............gallons. Septic Tank—Liquid'capacity............gallons Length................ Width........._...... Diameter....._...._._... Depth.............._. Disposal Trench—"No. .................... Width....._.............. Total Length....._.............. Total leaching area....................sq. f t. Seepage Pit No._._....'........._.. Diameter._... .............. Depth below inlet....... ............. Total leaching area..................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit............_...._._ Depth to ground water.....................-_. 44 Test Pit No. 2................minutes per inch Depth of Test Pit..._._.............. Depth to ground water___._...._...._._....... 0 9 ............................................................................................................................................................. Description of Soil............................................................I........................................................................................................... �d U ...................................................................................................................................................................................... ...... ..........................................:............................................................................................................................................................. U Nature of Repairs or Alterations—Answer when applicable...... ........... ....................................... ..................................... .......................... ..................... ...... ........................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.._..... ............................................................................ ................. ........... <� Date Application Approved By___...... ___.. .................................. ............................. ........ Date Application Disapproved for the following reasons:........................................................................................................I....... ........................................................................................................................................................................................................ Date Permit No.... '..:._._ ....... ......................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................................OF..................... ........................w....................................... Tertifiratr of Tautplitturr THIS IS TO CERTIFY, That the Individual'Sewage Disposal System constructed or Repaired by.................. ....... ................................................................................................................................................ Installer at... ........ ............................................... ............. .. . ... ................................... .....A... .............................................................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......... .......... ................. dated_............_._.-_...._-_........._._.-_....... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... ................OF.....!. ....................................... No. .............. Disposal Marks Tonotnulivit Vernfit Permission is hereby granted............... ......... ................................................................................................ to Construct or Repair )-.an Individual Sewage Disposal' System atNo............... ............................ ......I................ ....................................................................................................... Street as shown on the application for Disposal Works Construction Permit No._.__.-:.__-::__-_- Dated.......................................... ......................................................................................................... Board of Flealth DATE.. :.............I......�� I ............................................... L TOWN OF BARNSTABLE LOCATION O..W EWAGE #5P9 VILLAGE �����vZv��� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.� SEPTIC TANK CAPACITY n LEACHING FACILITYAtype) (size) c NO. OF BEDROOMS '3> PRIVATE WELL OR IC WA R ' BUILDER OR OWNER S DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ✓ d L "LOCATION SEWAGE PERMIT N %,. VILLAGE 1t1� I N S T A LLER'S NAME i ADDRESS _ �CK S U I L D E R OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE * ISSUED g a i (k ND { 4-p 1 ND �D Fxs. d / THE COMIVIONWEALTH.OF MASSACHUSETTS ' BOAR® OF HEALTH TaWN.........................0 F.......BARNSTMI E - ------------------------------------•••••.......................... ApplirFation for Dinpuuttl Works Tonstrurtiun rrntit Application is hereby made for a 'Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: Lot 28 ................_........_..................................................................... .................-.............. ocatio Ad ress or Lot No. �. ��••�•- . Caprico Real�£Xrus Sunny. Wood e -•-..--• ...... ..•-•t.... ----------•--•••-----• ..... ......... •--••........................................ O Address WHyannis---•................................................................ Installer Address 15,095 Type of Building Size Lot.............:..............Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (10) 04 Other—Type of Building ............................"No. of persons............................ Showers ( ' ) — Cafeteria ( ) Q, Other fiXtures •-•-•---•-•-•--•-----•-•-•-••-•. -------------------------- --.......... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacitya.OM.gallons Length._8..'=16.".. Width..V:nlo.:'Diameter................ Depth.5':4.'.'.-- x Disposal Trench—No. .................... Width.................... Total Length........:_...........Total leaching area....................sq. ft. 3 Seepage Pit No..........1......... Diameter........16..'...... Depth below inlet.....5_67.'.... Total leaching area....25.7.......sq. ft. Z Other Distribution box ( X) Dosing tank ( ) aPercolation Test Results Performed by..., ..................... Date....19V 8� I t-TwV Test Pit No. l.....2........minutes,per inch Depth of Test Pit.......).2_........ Depth to ground wate r ............. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wat ----•--••................................• . .........................-- ............_............. .a.... ALLYN N YN Description of Soil..._.0-24", loam and.subsoil;..-24"-84"l.•Bony•meditun•• " �viLsoN ti v .......sand.....-84"-144" mediwn Sand-•--••-•-•---- ••-•-•.. ......... '0���`�. W ••••-•----•.................••----......-•-........-•-••-...--------•-•-•---................•-••••••-••-•-•......................---........•-•--......-•-•---•-••............... -�'rP/UI..... �I► U Nature of Repairs or Alterations—Answer when applicable......................................................................... -•------------------•--•----•-............-•----•--•----••-•-----------------....---...........---- •---••-•-------•----------------------••-•--•--•-•••-•-•-•-....-•••• ............ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL% 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee ssue y e board of health. Si . ........ ••••......... .•..... .............................P.re_s_.. Date ApplicationApproved By.......... ... ............................... ........................................ Date Application Disapproved for the following reasons-------------------------•-------••-----•-•----•--------•....................................................... ------•------••-•-•----•-••...-••-•••-------•-----....--•••••--••---•--•------•--•..............•--•--•--'--•--••--------------•-------•-•---•---•-•---•--•-----••-•----••••.-•---... -•-•-•.. Date ...._. PermitNo......................................................... Issued_....................................................._ Date w 1�0..1 •�!..0 � :. l 4. 5 FzB...............�d............._ s'THE COMMONWEALTH"OF MASSACHUSETTS = ' nrS.l� • BOARD OF H E,•ALTH. -. T0�.............................O F.......Bi3t 1 S S,hi3LE......._.................. :..`.:............. ApplirFatioaa for BWposFal-:lurks Tomitrurtiou firmit Application is hereby made for a Permit to Construct (X ) or Repair (,,#! an Individual Sewage Disposal System at: Lot 28 ......... - •- -.................................. ._....... .............. • ............. Location Address or Lot No. / . Capric orn Realty '� t S�.auiy_tiood Lame ............�nstaller ....... ......a._................. ......... .... .........._..--------•-----------------.-----•-•-------•----- O Address ............... .. ............. ....Haarn ................. ....... ...................................... Address _ U Type of Building Size.Lot.... Sq. feet Dwelling—No. of Bedrooms.......... ................................Expansion Attic ( ) Garbage Grinder (no) Other—Type of Building ._..... No. of persons............................ Showers G.I YP g ------•-------------- P �` � ) — Cafeteria r( ) Q' Other fi res ......................... -•-- . WW Design Flow..•........•... .........................gallons per person per day. Total daily flow------- WSeptic Tank—Liquid'capacity.iQQL?.gallons Length__-W-6°°.. Width-_- Diameter................ Depth.-S-e-dry'-' x Disposal Trench—No...............:..... Width.................... Total Length.................... Total leaching area....................sq. ft. > Seepage Pit No.................... Diameter........1Q s..._. Depth below inlet.....5_iz7°__. Total leaching area....2S7_......sq. ft. z Other Distribution box ( Dosing,tank ( ) Percolation Test Results Performed by.....r1i?1Ccdete..Ehoireanim..................... Date....1 Q 1 /"14 Test-Pit,`•No. I......2.......minutes per inch Depth of Test Pit.......12........ Depth to ground water ��,�1f.Af 4 Test Pit No. 2................minutes per inch Depth of Test'Pit.................... Depth to ground wat a�?t -STEpHEN �'f O . Q--2 '+ ..........................................................................................•---•--•-•-••--• � ---•ALCV/d...+ Description of,Soil------ •- --�:__1-Qanl_ d-_�3�.�Y2U1... --.- ._.:.__ Qt�V._311E ?,L ......-•----------•-------- U1•... --------------•----•----•-•----.....-------•-•-------•-••-••--•••----------.---•-- Na 6 . U -Nature of Repairs ar.Alterations—Answer when applicable......................................................................... ... .•-••- • ••• -••----••-•----•-•••••--••-•-••--•••-•--- Agreement: cv w 4 The undersigned agrees to .install the.aforedescribed Individual Sewage Disposal System in accordance with 8'o the provisions of TITLZ",*5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a.Certificate of Compliance has been.issued .e board of health. Signed. .. ................................. �.LS_t_.. ... 1=29-834....... g = �`:.. J Date Application`Approved By...............................f.................................:.................................. ._. --••----•----- ........ ----------Date :.,Application Disapproved for the following reasons:....... .:-`- t ......................................................... ........................--•-•••...•.........•-•-------------------•------••-----••-•---•-•••----•----•-••••---•......•--•--•-•-•-----.-- 11 3 Date PermitNo......................................................... Issued........................................................ Date b THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH i ...... T'own....................OF....Barnstable - ...........................................................•••--- (9rrtif irate of TumpliFana ; THIS IS TO CERTIFY, Th he'Individua �e.,Aaisposal System constructed (X ) or Repaired (T-p .-----•-be ... -------------------------------------------------------------------------------- - - --•-;` at_:Lot..#- 28.#.._Sunny-..Wood_Lane... �yann s........................................................................................ - Has been installed in accordance with the provisions of TITLE 5 of The State Sanitary C de as described in the application for Disposal Works Construction Permit No.........r1._.�:./I/_�l.?_.... dated_..r.I 'Z,.Q_1__,2. .............•... THE ISSUANCE 00THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A G.ARANTEE THAT THE SYSTEM�WI L FUNCTION SATISFACTORY. ; '.. DATE....... �:�s................................................ Inspector..... . THE COMMONWEALTH OF MASSACHUSFTTS %r BOARD OF HEALTH �- Town Barnstable ...........................................OF..................................................................................... Eo y � iruuaal rku a�utr ion Permissionis hereby granted............. .....................................- -• . ••----_---- ..................:...................................... to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at No.... ot 1.28i... unnY.... ood_-Lane.,...Hyannis-•-------------------•-••--------------------.....-------------•-••----•••--•••-...... Street as shown on the application for Disposal Works Construction Permit No..................... Dated_'.....____.............................. sj Board of Health DATE...............{�02 -5.................. ......... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS f. , .M T t� 2000' �{ SEC ION..A A OLL CUTLET S PIPE IRON 7rt 10 min from d JV:r w . ' PROFILE:VIE _OF ADDITION TO.LEACHING SYSTEM . txs P ARE T 4 SCHEDULE OtJLE 40 P.V.C. TRbU1pN eac SHALL BE {h I house to septic tank NOTE: ALL PIPES E p BE G E .. p. ,� : .. ,. .: ,... T ..F .AT t.. ,.-.. r .-` 12 '. -.CONCRETEC01rER Foundation _ SE LEVEL OR LEAS 2 FT. Existing - : . nk towns 1 a a 2 Washed n '. Septic 10 mut+be _3 -of ✓ / shed Peasto _ .< A n. lino wt m 6 t shed rods - ;• , ,, , Of 0 a t 1 ..3 t4 2 .. wOS140 Stone , s 4 - , / d Crushed S an j( a _ _. / , '`3 5 OUTLET - 7 csdr over D-Bo■ 96a2 rer A .. �.. _ ,.. Grade ew 3ept,c Tanta tI .50 G —t`+•ode o SAS 96 00 ,; ,r. _,. , . KNOGtWTS c a 12 11LE7 ,. .. _ ouTr E .c 4 _ e p 3 H 20 tWLE 6> ..: - _ r ITE ' 3 a otST. BOX T - , :. .•. ,, • t- To ,...EXIST.. 0.01 or SAS E ev 93 50 EXIST PIPE N 1,000 GAL. . { 1S3 -40 £ b S O bib per oat 4 SCH. T 4 f EXIST.r RATION , 't? T NK N 50 Eftedne Depth, 1.75 . aoN c Is auN ,� � `SEPTIC A „ - , V ; _ r o� H 10 � ur,ttz e � � ao. � n n � DEAN SECTION GROSS SECTION n 1 STCINE RJDER'>HAMB6RS _. ftJll r _3 CONCRETE • tl .r > o+ 1 (wLK OVr DASEmEN1) y o ..:rn- $ - -3b' - �, r a .r 1 u 3 'HOLE H 10 DISTRIBUTION BOX PROFILE s a 3/ /2 , v � � s6 � SYSTEM > can Led atone - < _ c > _ v e it Effective Lrngtn NOT TO SCALE - c t Not to SCole _ m > LCICUS MAP � 4 4' - 2.5 6 in.of 3/4'-t"1/2' t0 • Z SOIL ABSORPTION SYSTEM (SAS) compacted stone Effectty."Vidth p _ m CULTEC MODEL 125 (H-Ct) CtlADING>/ SHOREY PRECASTE J@4llstsD_s!_I4a� tf�s.]_EIR�_62_2-_-__--, (OR EOUiVALENT)Not to Scale GENERAL NOTES . NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18"./EFFECTIVE HEIGHT IS 12" 1 Contractor is re onsi le for Di safe'notification. sp b g t and protection of all underground utilities and pipes. 2. The septic tank and distri ution box shall be set level on 6 of 3/4 -1 1/2 stone. 2-18" DIAM.'ACCESS MANHOLES 3. 3ockfill should be clean sand or grovel with no stones over 3" in size. 8 4. This system is subject to inspection during installation .L• s• .:�'r Cormen E. Shay Environmental Services, Inc ,:-,.. `.:._ �• _....�. �.._.._-...:;,, by E ." S . `( 5. The contractor shall install this system in accordance • c PROJECT BENCH MARK op with Title V of the Massachusettsate o e the approved tan - state code, e apPo P TOP OF FOUNDATION and Local Regulations, -• a THE ACCESS COVERS FOR 1W SEPTIC TAW, = ' " i T / \ ELEV. t00.fl0 (Assumed) i N 77d 02 40 jrW 6. If, 'during installation the Contractor encounters an . ..WEE + —' OtSTR1BUTION80X.AND LEACtRNG COMPONENT R = 2'00 1 9 Y / t f OU ET, 'SET DEEPER THAN`6 INCHES BELOw FINISHED ry r soil'conditionS or site 'conditions that ore different •. ,. +.,. i GRADE.SHALL BE RAISED TO"V414N 6 OF - " L 2!. 1 4 I t from those 'shown on the soil log or in our design n ^� FmSHED GRADE. 0 1 38.88 I _.g I installation must halt & immediate notification be INSTALL TUF-TITS GAS BAFFLES OR EQUALS �F , mode to Cormen E. Shay - Environmental Services inc. 7. No vehicle or heavy machinery shall drive over the STEEL REINFORCED PRECAST CONCRETE i / I septic system unless noted as H-20 septic components. PLAN �/�EW �' i j 44 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. " 3-2a REuovAai.e COVERS .- / t O „ e 40 NSF. PVC pipes. LOT #28 r 9. All Distribution Lines shall be 4" diameter Schedule/ 1 � 10. All solid piping, tees' & fittings shall be 4 diameter 15,037 Square Feet +/- / Schedule 40;NSF PVC pipes with water tight joints. '_min:deoronce ,�. T SWIMMING t to 11. Municipal Water is Connected to. The Residence and Abutting OOL INLET s' ntn- i!2"ymin: inlet to outlet 's.,,,, W / Properties Within 150'Feet. --T T OUTLET Lrquk! level nl , 5• '-7- ' s t--- l 5. -2. :• E" a-0' min. f l THE PROPERTY LINES ARE APPROXIMATE AND o a..ede. :• Liquid depth r COMPILED FROM THE SURVEY PLAN GENERATED BY is r ROBERT RAYMOND. SURVEYORS. OF BARNSTABLE, MA ENTITLED " PLAN OF LAND IN BARNSTABLE, MA" w., �. .,•., ,.. ,..,.:• . ...,.. .,.. .. .•. f � ' 1 DATED JULY 17, 1982, LC 32$4$ SHEET 1 OF 2 _••.;:. .. . �.,, f SHE[ g•_0" a' -10- / AND IS .NOT.. INTENDED`TO BE 'A SURVEY PLOT PLAN EXISTING EXIST. 1000 goi. l IT, SHOULD BE USED FOR NO PURPOSE OTHER THAN CROSS SECTION END—SECTION Septic Tank , I 3 BEDROOM THE SEPTIC SYSTEM INSTALLATION. +_ HOUSE 1 rl USE EXISTINGl 1000 GALLON H- 10 SEPTIC TANK ; #30 \�Foil4d I i Leath Pit NOT TO SCALE 1 r LEGEND _ ..Mnnici`pal +ter-L-ine / + ., DECK j r PERCOLATION TEST � ! DENOTES PROPOSED A t I( 1Q4X9 I , SPOT GRADE fPercolationT LY2 2 2 Date oTest: JU 5, 00 1 EXISTING 1 O Test Performed By. CARMEN E. SHAY, R.S., C.S.E. y^ I 1 X 104,46 DENOTES EXISTING Results Witnessed By. WAIVER ( per Barnstable B.O.H.) a WAY I GARAGE-SLAB y SPOT GRADE Excavator Roberts.Septic Services DRIVE i r w Percolation Rate: Less Than 2 MPI { i PL PROPERTY :LINE PROPOSED CONTOUR 98- o ---- --- r " Test Hale _' _ yj -- -- -- —97 EXISTING CONTOUR No. r jco ,• • - • . • ' DEPTH SOILS ELEv t"; <^ � �" ': •� "i„zr�:++ •4•!� tt„'+,<• = DEEP TEST HOLE & 0 96:12 PERCOLATION TEST LOCATION o fie" f z, Loamy Sand n7 to fft 3/2 . , .�s, Z __�-_---______ TEST 'HOLE #1 Co 96-_-_ -"�" M` ELEV.= 96.12 - 6 FOOT STOCKADE FENCE A, 95.85 O Z 23.26 Loamy ,e 177 Sand 10 Y 5/6 ,U GC - }�, 100.00' 8`- 36- B. 93.12 O 1 I Coarse i!� $ : 77d 02' 40» E Sand C P LOT PLAN 2.S Y 7/4 � 34"-168" C. 82.12 OF PROPOSED SEPTIC SYSTEM UPGRADE LOT #29 PREPARED FOR Perc #1 Depth to Perc: 38" to 56" MS . G E RA L D I N E WHITE Perc Rate Less Tho 2 MPI Groundwater Not Observed AT No Observed 0 Elev. # 30 SUNNY WOOD DRIVE ADJUSTED H2O Elev. None _ HYANNIS , MA ( Design Calculations 0 20 40 50 I �zN OF REPARED BY: Number of Bedrooms: 3 Equivalent to 330 Gol./Doy (330 Gal./Day Min. per Title V) Garbage Grinder: No CAR EN /�/� j Y 9 Capacity P / Y m (Min. Per Title V� -+ )? it Li� - .L . SHA l Leaching Ca acit Proposed: 330 Got. Da Minimum E Septic Tank 3 x"330 Gol:/Doy = 660 USE '1,500 GAL. Septic Tonk. SCALE: 1 =20 ; SOIL ABSORPTION AREA: Using 'percolation rate of E2 min./inch 1181 ENVIRONMENTAL SERVICES, INC.` �L Bottom Area- 0.74 got/sq. ft. x 360 sq. ft: _ 266.4gallons Sidewall Area: 0.74 got./sq. ft. >x 92 sq. ft. - 68.08 gallons F� ��a P.O. BOX 627 Providing: = 334.48 gollons EXISTING LEACH PIT TO BE PUMPED & FILLED IN PLACE. rSTE EAST FAL.MOUTH, MA 02536 SANiTARtP TEL /FAX 508--548-0796 ` Use: ,(5) CULTEC-MODEL 135 ;UNITS..HAVING A 1' EFFECTIVE DEPTH,.. ' : f P CONTAINING �� f NOTE. ANY STRIPPED OUT .SOIL. CONT N NG LEACHATE` _ ,, TO BE USED WITH 4,0 OF WASHED STONE ON THE SIDES, AND 3 OF WASHED STONE GALE 1 —2 -DRAWN, BY E AT Y-' FROM THE 'EXISTING LEACH PIT TO BE DISPOSED S Q D .. C S DATE: JUL 25, 2QQ2 ON THE ENDS. NO STONE UNDER. A F TSPECIFICATIONS,OF As: PER �o RD o HEALTH PROJECT SD337 FILENAME:=SD337PP,DWG SHEET 1 "OF 1 1 , , No f✓ 3737 REVISIONS: TEST PIT DA TA DATE w� TES os T : y � PERC. TEST DATA : SEPTIC TANK DETAIL : sizE- _�co _ GAL. DIST. BOX DETAIL : LEACHING FACILITY DETAIL N DATE TEST IDi:1E j ff Al y TANK TO CONFORM TO TITLE 5 REQUIREMENTS. TO CONFORM TO TITLE 5 REOU/REMENTS T P1' WITNESSED BYE fT 1.7.t/c�>F�=D 15;',� DATE OF TEST/NG� � - / ,L..�-�'_. rEST BY, ___ NO. OF OUTLETS f 3 ___ W/TNESSED BY: _L.Z,0L-��l f /�L.�/�L�_ �r�r . r� .:�ii� . iT yn�a�71s�/��/� -- -— �_`��? ���G���'�����R�S`�y REMOVEABLE COVER MANH� B Oe GHr T �, ; • r. ..• .. •�.... . . ..: •: • FINISH GRADE. Z„ or —--- T S✓ 50/ . .. .• .✓ PEAS ONE\ /LL34M9FILL /2� MIN. 3 CL EAR 3 T— �. OUTLET PIPES - - 6"M/N. A"MIN. 6'M/N _" I� AS REOUIRED\ I•'• DEPTH OF TEST: __ ___,� di RATE: 2�'I/N / C f/ {',4 S S y - --- ----- /O'M/N D/ST. --- - INLET TEE - - - OUTLET TEE _II -- , BOX 4"C./. /_ r' r - GAL. r I 5 N� INLET AND OUTLET 4 O" MINIMUM OUTLET TEE DEPTH EPT/C TAN PR i 14 TEES TO BE CAST L/QUID DEPTH /4"AT L lOUID DEPTH OF 4' 2 6 / S K I ECAST OR BLOCK 'MIN' - -- l9„ 5' /" CONCRETE i. ' SEEPAGE P/T DEPTH OF TEST ' 29 " " s' ,. .. o coNSTRucriav PLACE CONCRETE �►///y. / E4 3 CONCRETE n 34 " B' BOTTOM,ON LEVEL STABLE2ASE RATE - -_ _- -- CONSTRUCT/ON '- I NLET TEE PROVIDED WHERE SLOPE 11,79 E °' ET PIPE EXCEEDS O.OB /, OR �I TANK TO BE A BL E TO W/THS TAND � — •' -- S N BOTTOM OF TANK ON LEVEL STABLE BASE T A N LOADING UNLESS UNDER IN A PUMPED SYSTEM. 20 M/N, W � _I PAVEMENT OR IN DRIVE. H-20 ---"I I 'WASHED STONE LOAD/NG UNDER PAVEMENT OR I I i DRIVE. IF I I NOTES : PLAN VIEW : INVERT ELEVATIONS: I. THIS PLAN /S FOR THE DESIGN AND CONSTRUCTION OF THE SEWAGE , ...�• DISPOSAL FACILITY ONLY. SCALE : / _ y, __ INV AT BUILDING 2 ALL CONSTRUCTION METHODS AND MATERIALS SHALL CONFORM TO P srLLYP4 /NV. AT SEPT/C TANK(/N) 6q, �'�j _ � MASS. D.E.Q.E. TITLE- 5 AND THE .� �i�ysr.4�?�: - BOARD OF y /NV. AT,SEPTIC TANVOUT) �41_� Wl�.sar� HEALTH REGULATIONS. -- �.�..'- No-3021ii _ T�'�-y+/1/ [<J�T,tR /.0 r•)[/r9f�.,�IG�L�" T+C: !Nl,� [.d T, +� INV. AT D/ST. BOX(IN) _4 e 44 INV. AT D/ST. BOX(OUT) G9, -7 4'4 AT LEACHING FACILITY 7 --- BOSTON, MASS. WORCESTER, MASS. AT BOTTOM oFPir: ��,so MASS. • HALIFAX, MASS. NORWELL, BEDFORD, MASS. LEXINGTON, MASS. } HYANNIS, MASS. MANSFIELD, MASS. CRANSTON, R.I. DERRY, N.H. B C S DESIGN DA TA 4 3 a ; Y I ' � DESIGN FLOW t =. �:•:.1�rr2:._X tlU �4�ta��d.nm-r_3�.Q-�F'C. - --- O r 1 00 REQU/RED SEPTIC TANK GA '2 SEPTIC TA GAL.TANK PROVIDED = - CAPE COD SURVEY > `" �� -- CONSULTANTS REQUIRED SIZE LEACHING FACILITY Y 3261 Main Street Route 6A i T `� 1 4opc,����J - -- Barnstable Village. Massachusetts 02630 (617) 362-8133 t Q +Z. ! �. 0 O -- - - DIVISION OF BOSTON SURVEY CONSULTANTS INC. 1 ti SIZE OF LEACHING FACILITY PROV/DED ENGINEERING SURVEYING PLANNING TYPE OF SYSTEM TITLE: T. jl- I- _ `_ �� r__ X SEWAGE DISPOSAL SYSTEM DESIGN LA r � /2 - s 7 - 20 w /Sz. oo ' � - -- - --- - - ---- -=- --- --- SUiv,wY wovb G��✓c:.. LOCUS PLAN: 34RA1 s 7'4SL FOR: SHA1[ ow C L"f'O rt'E"r4 T y L/'Vc S S'Ho 1vf1/ .yE'h'O�t! `c/ERE J '3C SCALE: AS SHOWN co"c F?/l E© F h�v..'7 C, C. �. 3 2 Sr 9 8 .9/Vfi METERS is 3 Q G11Gu ,$ .ODES NO l �Ef/�'GCSE/VT i4/V �i T4�•QC �0� !7 5 t 4 7- FEET 0 O SG'r4 vE y G7N 7".�/E Cif?�7G%NQ 5 E T.CgAC'/YS � `'= ',Vr,we0 � DATE: % v 4, 196,1 1`145',01t/ T COMP./DESIGN: CHECK: DA TUM' 13m USEL? - //,�9 C.' DRAWN: J, #C" G. 7S_ &<!9 mil! C,-f-YIJ, FIELD: 57Wee E, SE`7 /v ­9 i,^ ' ,�h�E'rU z.4/? FILE NO: C':��'VG',.,►?O�S/�%: <<`V 7 f=%:.s✓t> G�rir' Ts4/t1 DWG. NO: ? JOB NO: 4r ? ,5, SIZ ,�i�t%L 1,41ve 6-3-`^ SHEET: I OF: _1'W /3 2,