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HomeMy WebLinkAbout0092 SUNNY-WOOD DRIVE - Health Sunnywood� Drive r i Hyannis 4 • 113 1 a,z TROY WILLIAMS 4 RUOVEp SEPTIC INSPECTIONS ( = 4AY Certified try MA Department of Environmental Protection rolyNoF (508) 385-1300 19 Hummel Drive South Dennis, MA 02660 � 6 VIA COPY COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292-5500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A Q �^ CERTIFICATION 1 n Property Address: / `� y Name of Owner O H a I d Address of Owner: 9 Date of Inspection: S/� /D O Ge r. c✓ 1 c M o t ?2 Name of Inspector:(Please Print) Trey Nfilliamn 1 am a DEP approved system inspector pursuant to Section I S.340 of rife 5(310 CMR 15.000) Company Name: Troy Williams Ss c Insnactlons Maing Address: 19 Hummel'Drive, So. Dennis, MA 02660 Telephone Number: (508) 385-1300 CERIIRCATION STATEMENT I certify that 1 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 Inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspectors Signature: Is o+, �/� Data: s�.2 164) The System Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(301 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 Department of Environmental Protection. The original should be sem to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS Although system meets the minimum requirements set forth by the Massachusetts Department of Environmental Protection,certification is not to be construed as a guarantee of future working condition of system,piping or components. This inspection represents the conditions of the system on the Date of Inspection noted above. rPvi sari 0 /oo _ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (coat wed) Property Address'owner: 92 Sunnyw ood Road, Centerville,MA Date of.kispection: Ronald Hidenfelter May 2,2000 INSPECTION SUMMARY: Check A, Q, C, or D: A. SYSTEM PASSES: I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: All'? 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. Indicate yes,no,or not determined(Y,N.or ND►. Describe basis of determination in all instances. If'not determined', explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank, whether or not metal,is cracked,structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by'the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipets) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipets)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 revised 9/2/98 Page 2 of II SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Prop"Address: 92 Sunnywood Road, Centerville, MA owner: Ronald Hidenfelter Date of lrnpection: May 2,2000 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: A/(,) Conditions exist which require further evaluation by the Board of Health in order to determine.if the system is failing to protect the public health, safety and the environment. 11 SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES W ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING W A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS Is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER I revised 9/2/98 , Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(confirmed) 92 Sunnywood Road, Centerville,MA Property Address: Ronald Hidenfelter Owner: May 2, 2000 Date of Inspection: D. SYSTEM FAILS: A//19 You must indicate either'Yes" or "No" to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is.identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due-to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth.in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: A/111 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: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 11 of a public water supply well) The owner-or operator of any such system shag upgrade the system in accordance with 310 CMR 15.304(1). Please consult the local regional office of the Department for further information. revised 9/2/98 . Page 4 of I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST 92 Sunnywood Road;Centerville,MA Property Address: Ronald Hidenfelter Owner: May 2, 2000 Date of kupection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. ' Y _k/4 None of the system components have been pumped•forat least two weeks and-the system has been-rocei rates during that period. Large volumes of water have not been introduced into the system,recen inspection. tly or as p rt of this l flow f / �L _ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up., _ The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs•of•breakout. All system components,excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered,opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions,depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: _ Existing information. For example, Plan at B.O.H. _ Determined in the field(if any of the failure criteria related to Part C is at issue,a / 115.302(3)(b)) approximation of distance Is unacceptable( - _ The facility owner(and occupants,if different from owner)were.provided with information on tha. p proper maintenaAcecf Subsurface Disposal Systems. revised 9/2/98 • Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 901 —So- yt�upcl 2a• Owner: Date of Inspection: RESIDENTIAL; FLOW CONDITIONS Design flow: //0 g,p,d./bedroom. Number of bedrooms(design): Number of bedrooms(actual):_j Total DESIGN flow Number of current residents: 0 t Garbage grinder(yes or no):No Laundry(separate system) (yes or no):MD; If yes, separate inspection required Laundry system inspected (yes or no) Seasonal use(yes or no): -1�6 S . Water meter readings,if available.(last two year's usage(gpd): 99 Sump Pump(yes or no): 0 Last date of occupancy: •­kc ,,1 v t� 4t *,4;j 4i p,, COMMERCIAL/INDUSTRIAL: NIA Type of establishment: Design flow:_ apd (Based on 15.203) Basis of design flow 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: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Syste r+tpump ed as p`K of inspection:(yes or no),d[v If yes,volume pumped: gallons Reason for pumping: TYPt;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) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of I components,date installed(if known)and source of information: Sewsge odors detected when arriving at the site: (yes or no) A/O . F revised 9/2/98 Page 6or11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Adaess. 92 Sunnywood Road,Centerville, MA Data of Inspection:Ronald Hidenfelter May 2,2000 BUILDING SEWER: (Locate on site plan) Depth below grade:l�f Material of construction:_cast iron Z40 PVC_other(explain) Distance from private water supply well or suction line Al Diameter 1/1, Comments:(condition of'oints, venting, evidence of leakage,etc.) wart v..d� [,1to.✓ s�o41Lc SEPTIC TANK: (locate on site plan) Depth below grade: 1' Material of construction:Zoncrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age )s.age confirmed by Certificate of Compliance_(Yes/No) Dimensions:_ six 9 'X 6 /ood s 4//a h, Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness-7rl'.,f'a.Y�.. Distance from top of scum to top of outlet tee or baffle: 6 Distance from bottom of scum to bottom of outlet tee or baffle:' /V" How dimensions were determined: A-V 6 e Comments: (recommendation for pumping condition of inlet and outlet tees or baffles,depth of liquid level In relation to outlet invert,structuralintegrfty, evi once of leakage,etc.) Yt/C— /� 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: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural Integrity, evidence of leakage,etc.) r • revised 9/2/98 Pagt7ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Owner: Address: 92 Sunnywood Road, Centerville,MA Date of Inspection: Ronald Hidenfelter May 2,2000 TIGHT OR HOLDING TANK: N/(Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_Fiberglass_Polyethylene_other(ezplain) Dimensions: _--_...._.. ..._...._. Capacity: gallons Design flow: gallons/day Alarm present Alarm level: Alarm in working order:Yes No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: (notW level and distribution is equal,evidence of solids carryover, evidence of leakage into or out of box;etc.) Qd PUMP CHAMBER:_[/,g (locate on site plan) Pumps in working order:(Yes or No) Alarms in working order(Yes of No) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.). � r revised 9/2/98 Page sofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Address: 92 Sunnywood Road, Centerville,MA Date of Inspection:Ronald Hidenfelter May 2, 2000 SOIL ABSORPTION SYSTEM(SAS):z (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: Type: r leaching pits,number:_ G X6 r L Gam c �,} w% �2 leaching chambers,number:_ leaching galleries,number:_ leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number:_ Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydr lic failure,level of ponding, damp soil,condition of vegetation, etc.) J Z CESSPOO : M '9 (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(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation,etc.) 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.) revised 9/2/98 Page9of It ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: 92 Sunnywood Road,Centerville,MA. Dace of Inspection: Ronald Hidenfelter May 2,2000 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks 1 locate all wells within 100'(Locate where public water supply comes into house) WI-4— /'>&« - 13e`c-k . f�F C— revised 9/2/98 Page 10ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(contirr,80 Property Address: Owner: 92 Sunnywood Road, Centerville,MA Date of Inspection: Ronald Hidenfelter May 2,2000 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater to Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site►Abutting property,observation hole, basement sump etc.) Determined from local gonditions Checked with local Board of health Checked FEMA Maps Checked pumping records /Checked local excavators,installers V Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) �t�.,/� c►.�j.�,,,uA 7 . S b c.�J c./ �.cc��•�n : h S h+�n 4 0 . revised 9/2/98 Pace it or it LOCATION / � SEWAGE PERMIT NO. - V1, L A G E I N S T A LLER'S NAME j ADDRESS k- R U I L D E R OR OWNER " DATE PERMIT ISSUED 3 _95 DATE COMPLIANCE ISSUED "� I r � W a i F � y r ' No.� )�S Fxs..... .64. .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH . ...........TOWN....................OF.....BARNST11A.BLE..................................................... Appliration for UiupugFal Warks Tunutra rtinn thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ......................_........................................................................ .............................Lat...#.32................................................. 14 Locatio -Address or Lot N Capricorn Realty Trust Sunny Wood ..- .................................. r Own Address a ------------- ---•- ..................................... ......Hyannis..................-.................................................... Installer Address U Type of Building m Size Lot.___..._15 M.-,_Sq. feet Dwelling—No. of Bedrooms..............3.................._.___.__.Expansion Attic ( ) Garbage Grinder (nc) 44 Other—Type of Building _______________________---- No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .................................. W Design Flow...........5.5...........................gallons per person per day. Total daily flow..........33.0.........................gallons. WSeptic Tank—Liquid capacitylD.O.O.gallons Lengtli _'.^>6"__;:Width..4_�.-10tDiameter................ Deptl .t.,,¢+!._.. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........1......... Diameter.._.. ... Depth below-inlet.5.,17.1..... Total leaching area.157........sq. ft. Z Other Distribution box (xy) Dosing tank ( ) Percolation Test Results Performed by..Cape.•Cod Survey Consultants Date._l2f§/84 aTest Pit No..I......2--------minutes per inch Depth of Test Pit-_12............. Depth to ground water. � �of q L14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground Ovate . ...B H�N c O 9 � TEP ---•------------------------------•-----------------------•---••--•------------•------...--••................................... g-------att"-- 0 Description of Soil...0-611 Wood Loam- 6"-2411 Brn Sandy Subsoils...................................... __-_-W�QN ^� ------------------------ "-84", Sand.•and Graveli--84"_-144"_Stratified..Sand........ ......... ......... ............................. No__�QZIk 0 y ••---•-•-•-•--------------------------------•-----•---......--............._...-•-•--•-••-•------------------------._..__.....-•----.........---•---------------•...-------••--- 9� G1ST�aG� U Nature of Repairs or Alterations—Answer when applicable............................................................................ sCON,4l Agreement: The undersigned agrees to install the ' Individual Sewage Disposal System in accordance with the provisions of iITI.. 5 of the State anit'a de—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of lth. Si ned--__-_r_l-7- ------z- .. ......... Date Application Approved By........ - - ..... -•--•------•---••------••.= - � Dafe Application Disapproved for the following reasons----------------------------------•-----...--------------------•-------------------------------------------...-- •..................•....--•------------------------------•-•-•....-----•-•--------------•--•----------....--•-•••---•--••---------------......---------------••---•---•---•-----------•••--••------------ f� Date • Permit No......................................................... Issued....................................................... Date ! FRB.... ..... .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF !-HEALTH ..........T010 ..................OF.....BARNSTAI3LE...----................------...--•-•-... .DPP iration for Disposal Works Tnnslrur#iun 11crutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...... _ __ ...... ......... ... ... Location•rlddress �t or2-•--............................................. 3-Lot No- cal5ri,arn.Re tv 'cruet--•----------•--------- Sulm ldnnd._.Lane._.. �5 "a - Address ppqq iI E£Ekti$9 •••-e"s's".. ------- --•••--••............. UType ofAng Address ►-1 Dwelling—No. of Bedrooms________________ m Size Lot___._.___15tDQ0..___Sq. feet 3__________________________Expansion Attic ( ) Garbage Grinder (n9 a Other—Type of Building ___________________ _ ____ No. of persons._._____.._____.__________.. Showers ( ) — Cafeteria ( ) d Other fixtures . ------••---•---•------••----------•-------------------•---•----------------------•----•---••••-••-•-•--..__...._-• W Design Flow............. ___gallons per person per day. Total daily flow_._.__._.__. S�' Y 330••••••••--••-•-••- gallons. a•; Ma W Septic Tank—Liquid capacity. _. allons Length _ �� ��Tidth__.t3!.�1.Q�' x Disposal Trench—No. ------•••-- $ ,ameter Depths_!_...¢!!... idth---------------•_••• Total Length............._..---- Total leaching area....................sq. ft. Seepage Pit No._.__..__..rr. ______ Diameter------- _ ., Depth below inlet____ , � Other Distribution boaC $© 5.b?•------ Total leaching area... �___.__.sq. ft. ( � Dosing tank ( ) a. Percolation Test Results X' Performed by.._.ape_-�••SUrVey..C'J 1St31.t�1tits____. Date_.. 216184 Test Pit No. I........ _____minutes per inch Depth of Test Pit.... !_..___.__ Depth to ground water.. A.. • ,es OP- Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground watero�_..&TAktEN q�yN p ---------•- �'—•--•-- '-'-- _ ....... rn�E� 6 ; Vb iioarn; E � 13 �a AYescription of Soil...... ""Subsoil,-----•---•-----•------- ................wI�SON 44"-84"-, Sty aru3 G v i;" 8 "u"r�: u �^J�.3"t��'1�1L E' SAI�IC1........................................................... •----- 'p No.30216 Q x -•----•----•---•------ - C� Nature of Repairs or Alterations—Answer when applicable__________________________________________________________________________----------------------------- NA F ------••-- -••--•••--••••--•••-•••••--••---•-•----••-•••--••---•-_.._. ----------------------------------------------------------------------- greement: •G�cJ�e. The undersigned agrees to install the aforedescri ndividual Sewage Disposal System in accordance with -the provisions of"Ii'Ll E 5 of the State Sa ' ar - The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by he b/oard,of h je�h. Sign d .../ 1�1� �/ d Application Approved By............ Da : _ g5 a._.� _ Application Disapproved for the ollowing reasons:............................................. Dace -----------------------------------------------•- Date Permit No. - Issued._.._. Date s ; THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF .................................... Trrtifiratr of fjuntplittnrr THIS IS TO CERTIFY, That the Individuall Sewage Disposal System constructed ( Vor Repaired ( )w .._._. --•-•-•--•-----••-•.............•--•..._.._._.__..__..._....---•-----•-••--••--•---•--._.......---••-•--.._..._. Installer at---- "' ------:`. + is._ has been p t,ed 1n accordance wit tIZe provisions of I^ r' application for Disposai Works Construction Permit No.____ 5 of The State Sanitary Code a de cribed in the _�����•- -- ' ' 6 _:_.IJ!a-----•----_ dated....._'_ -"7 - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS RUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..................... •` ?._--. ,5 ........................... Inspector...............--- THE COMMONWEALVH OF MASSACHUSETTS V BOARD OF HEALTH .....................................OF............... FEE__._..... Permission is hereby granted_____________________________' ' = --•--••--•--------•-•---•----•--•--••••-••-••._..._..-••-------•• to Construct ( )&,or Repair ( ) an Individual Sev�a.g Disposal Syst at No........... 1 y� .._•_ Se•--•• --•--•_._.--•-•--•____ .......................................... Strtreet as shown on-the application for Disposal Works Construction Permit No__________ 2 DATE______________________ of Health FORM 1255 HOBBS& WARREN. INC., PUBLISHERS REViSIONS) PERC TEST APPLICATION NO. '5"l �ii) UATL 19 -RC. TEST DATA : DATE TE Of- TES TI NG 9.43 4 SEPT/ C TANK DE TAIL loo GAL. DIET. BOX DETAIL : LEACHING FACILITY DETAIL TEST PIT DA TA d-C, _y TEST HY: TE Of- •TESTIN TO CONFORM TO TITLE 5 REOUIREMEA'," D 14 (y TANK TO CONFORM TO TITLE 5 REOUIREMENrS. rEST8Y. A0. OF OUTLErS,T P WITNESSED 6Y- W/TpvEss'E'o Hy: r J REMOVEAHLE COVER 47s, VV4)CJD 'LQ6r_4_ 70, MANHOLE BROUGHT To FINISH GRADE. MIN. _P"PEASTOME, _-LOAM 8,15-L 12 CLEAR 3"C4E4R k L OUTLET PIPES ,,a SIC,6 /'o 6 M/ _3"MIN. 6 M IN .45 REOUIRED DEPTH OF 7-EST. 1-t-L '�\ ---A-- INLE r ! f !"'j i RA TE /O"M//V. DIST. Box ___�5AAII AC7 INLET rEE —.OUTLET TEE -9 \ / 11 ' 4"Cd. 4--oo. GAL. INLET AND OUTLET 4'_0" MIN/MUM 0 U TL Er TEE DEPTH- A4 TT LI t r 6 NEPTIC TAIW L PRECAST OR&LLACff r_-0?0;v#rj L IOUID DEPTH 14 4 T L I OUID DEPTH OF 4 TEES 7-0 BE CAST CONCRE71. 16 5EEPAC %; PAGE PIT 01 IRON, SCHEO. 4 ♦ CONSTRUCTION 24 16 ! I DE. TH OF TES T- V.C' OR CAS7-IN /0 29" 7 34 7C) 4p 3.6 PLACE CONCRETE BOTTOM ON LEVEL STABLE BASE Mlff RA FE CONCRETE CONS rRUC T/O/v' (W4rER7'1GHT) _T INL E 7 TEE PRO VIDEL) WHERE SZOPE FOUNDA TION ;U OF INL E r PIPE ExCEED S 0.o8 OR )K TANK' rO 8E48LF TO WITHST4A'� IN A PUMPED sysrEm. 20 AVIV 80 7'TOAf OF TANK ON LEVEL STABLE 84SE H-iO LOAOING UNLESSUNOER $14 1�Y'woiswo s-roNE- PA PAVEMENT T OR IN DRIVE.H 20 t 0 A D I N(.^, UNDER PA VE44F N T OR DRIVE: 77T7 7 Y 4 IN VER T EL E IVIA I TIONS: 1.NO TES : P L A /Iry VIE .w, THIS PLAN IS FOR rHE DESIGN AND CONSTRUCTION OF THE SE-WAGF 5'CA DISPOSAL FACIL17-YONLY 6-1?1 2 4 L L CONS T R UC TI ON METHODS AND MA rER 1A L 5 SHALL CONFORM TO /N VA T SFP T/C TANK //A/) 99 MASS- D.F.O.F. TITLE 5 AVL) THE-&, _1C TANK/(,VT,) 9R _g�74 W,S-r _- 6 4 OARD OF IN V A TSEP 7 HEALTH REGULATIONS. .3, 7_,!�.i u.W t-w_,'A 7-,5-R -9 V,,4 A,8�6- 7-,4,1 ru INV AT DIS 7- 80Xt"//V!' 3 INV AT & AT LEACHING FACILITY 8E-J7 4C BOSTON. MASS, WORCESTER, MASS. AT 80TT01V OF'PIT- 96 Z1. HALIFAX, MASS, NORWELL, MASS. BEDFORD, MASS LEXINGTON, MASS. HYANNIS, MASS MANSFIELD, MASS. CRANSTON. R.i DERRY, N.H, B C S DESIGN DATA : DESIGN FLOW- -mom- E3 !Eqa C"w: 'v 2 57 , 20 I REQUIRE,05iPTIC FANK: 50. 0 O 'l GAL ( ')D SURVEY C; SEPTIC TANK PROVIDED -1-00-0- GAL. APE ff _'ONSUI _TAt"T8 PEOUIRED SIZE LEACHING FACILITY: 3261 Main Street Route 6A j Barnstable Viliage, Massachusetts 02630 ------- Number (617) 362-8133 ILI\ DIVISION OF 7 1BOSTON SURVEY CONSULTANTS INC SURVEYING P1 ANNN' 4 SIZE OF LEACHING FACILITY PROVIDE[)— ENGINEERING • -TYPE OF SYSTEM: TITLE: _5 ---------- T K SEWAGE DISPOSAL SYSTEM 70 DESIGN Lo r 7-',Z L OCUS P1 AN: A3, 1-77, -qpor7w S5 ? -Z o"vv 4'19AIAII�,..Jl FOR: o SCALE: AS SHOWN METERS 7�1 "09 ^"Cc FEET 0 /ell Z' 4�7 7- DATE: Q COMR/DESIGN� 'J CHECK: - 4)R -5- DA TUM.- U56 DRAWN J 01A C' /V. cv V. 0, FIELD: R FILE NO: /79 6,IV 0/-rg --IV -r ,c-o ti c--7,^/ 77-A145- DWG. NO: 7B.3 JOB NO.c)3 z/ 1 31 f 'A?17_�E_ I-F2 'Al SHEET: 5 ,�7) 7' OF.