HomeMy WebLinkAbout0053 SUOMI ROAD - Health 53 SUOMI RD., HYANNIS
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COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS John Graci
DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector
ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119
TeaTicket,Ma.
(508)564-6813
TRUDY COXE
Secretary
ARGEO PAUL CELLUCCI DAVID B.STRUHS
Governor Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: 53 SUOMI RD. HYANNIS
Name of Owner MR.AKUFO RECEIVED
Address of Owner: 8 JILL CIRCLE NORTH READING MA.01864
Date of Inspection: 6/21/99 N O V 13 2000
Name of Inspector:(Please Print)JOHN GRACI
I am a DEP approved system inspector pursuant to Section 15.340 of True 5(310 CMR 15.000) TOWN OF BARNSTABLE
Company Name: n/a
HEALTH DEPT.
Mailing Address: n/a
Telephone Number: n/a
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 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:
X Passes The inpection is based on criteria defined in Title V
Conditionally Passes code 310 CMR 15.303.My findings are of how the system is.
Needs Further Eval ati n By the Local Approving Authority performing at the time of the inspection.My inspection does
_ Fails not imply any warranty or guarantee of the longgevity of the
septic system and any of its components useful life.
Inspector's Signature: Date:6/22/99
The System Inspector shall ubmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the
system owner and copies sent to the buyer,if applicable,and the approving authority.
NOTES AND COMMENTS
THE SYSTEM PASSES TITLE V INSPECTION.SEPTIC TANK NEEDS TO BE PUMPED NOW AND THEN MAINTAINED EVERY TWO YEARS.
I
revised 9/2/98 Page 1 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
INSPECTION SUMMARY: Check A, B, 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:
System passes Title V inspection
B. SYSTEM CONDITIONALLY PASSES: .
nLa 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.
nLa 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.
nLa Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)
or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).
broken pipe(s)are replaced
obstruction is removed
distribution box is levelled or replaced
n(a 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 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
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 the public health,safety
and 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 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 n(a-(approximation not valid).
3) OTHER
nLa
revised 9/2/98 Page 3 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
D. SYSTEM FAILS:
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
X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
X Discharge or ponding of effluent to the surface of the ground or surface.waters due to an overloaded or clogged SAS or cesspool.
X Static liquid level in the'distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped n/a.
X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
X Any portion of a 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 I 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds,
ammonia nitrogen and nitrate nitrogen.
X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure.
E.. LARGE SYSTEM FAILS:
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
X the system is within 400 feet of a surface drinking water supply
X the system is within 200 feet of a tributary to a surface drinking water supply
X 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)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412). Please consult the local regional office of the
Department for further information.
revised 9/2/98 Page 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
Check if the following have been done:You must indicate either"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 None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates
during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
X As built plans have been obtained and examined.Note if they are not available with N/A,
X The facility or dwelling was inspected for signs of sewage back-up.
X The system does not receive non-sanitary or industrial waste flow.
X The site was inspected for signs of breakout,
X All system components,excluding the Soil Absorption System,have been located on the site.
X 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:
X Existing information,For example,Plan at BAH,
X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)
[1 5.302(3)(b)).
X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of
SubSurface Disposal Systems.
revised 9/2/98 Page 5 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR:AKUFO
Date of Inspection:5/21/99 -
FLOW CONDITIONS
RESIDENTIAL:
Design flow:-Q g.p.d./bedroom
Number of bedrooms(design): 3 Number of bedrooms(actual):3_
Total DESIGN flow: Q
Number of current residents:11
Garbage grinder(yes or no):hLQ
Laundry(separate system)(yes or no): NQ If yes,separate inspection required
Laundry system inspected(yes or no):JLQ
Seasonal use(yes or no):..pLQ
Water meter readings,if available(last two year's usage(gpd): nA
I Sump Pump(yes or no): NQ
Last date of occupancy: 3/1/99
j COMMERCIAL/INDUSTRIAL
Type of establishment: nLa
Design flow: nLa gpd(Based on 15.203)
Basis of design flow: nLa
Grease trap present:(yes or no):M
Industrial Waste Holding Tank present:(yes or no): hn
Non-sanitary waste discharged to the Title 5 system:(yes or no):NQ
Water meter readings.if available:nLa
Last.date of occupancy: nLa
OTHER: (Describe)
nLa
Last date of occupancy: nLa
GENERAL INFORMATION
PUMPING RECORDS and source of information:
NOT IN THE LAST YEAR
System pumped as part of inspection:(yes or no):NO
If yes,volume pumped nLa_ gallons
Reason for pumping: nLa
TYPE OF SYSTEM
XSeptic 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: n/a
APPROXIMATE AGE of all components,date installed(if known)and source of information:
SYSTEM IS 10 YEARS Of
Sewage odors detected when arriving at the site:(yes or no): NQ
revised 9/2/98 Page 6 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
BUILDING SEWER:
(Locate on site plan)
Depth below grade: $_
Material of construction:= cast iron X 40 PVC _ other(explain)
Distance from private water supply well or suction line: TOWN
Diameter: nta
Comments: (condition of joints,venting,evidence of leakage,etc.)
Wa
SEPTIC TANK: X
(locate on site plan)
Depth below grade: L
Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain)
Wa
If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): h Q
n&
Dimensions: L 8'6"H 5'7"W 4'10"
Sludge depth: E
Distance from top of sludge to bottom of outlet tee or baffle: 2 E
Scum thickness: 5"
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle: Jr
How dimensions were determined: MEASURED
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.)
SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.SEPTIC TANK NEEDS TO BE PUMPED NOW,THEN MAINTAINING EVERY
TWO YEARS,
GREASE TRAP:
(locate on site plan)
Depth below grade:
Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain)
nLa
Dimensions: n&
Scum thickness: nLa
Distance from top of scum to top of outlet tee or baffle:_Va
Distance from bottom of scum to bottom of outlet tee or baffle Wa
Date of last pumping: nLa
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.)
nLa
revised 9/2/98 Page 7 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
TIGHT OR HOLDING TANK: NQ (Tank must be pumped prior to,or at time of,inspection)
(locate on site plan)
Depth below grade: nta
Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain)
nLa
Dimensions: nLa
Capacity: IiLa gallons
Design flow: nLa gallons/day
Alarm present: N_Q
Alarm level:j3La- Alarm in working order:Yes_No_ NQ
Date of previous pumping: Dia
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
Wa
DISTRIBUTION BOX: _
(locate on site plan)
Depth of.liquid level above outlet invert:Wa
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
12La
PUMP CHAMBER: NQ
(locate on site plan)
Pumps in working order:(Yes or No): NO,
Alarms in working order(Yes or No): tYQ
Comments:
(note condition of pump chamber,condition of pumps and appurtenances.etc.)
nLa
revised 9/2/98 Page 8 of 11
1
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 53 SUOMI RD.HYANNIS ..
Owner: MR.AKUFO
Date of Inspection:5/21/99
SOIL ABSORPTION SYSTEM(SAS): X
(locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods)
If not located,explain:
nLa
Type:
leaching pits,number: nLa
leaching chambers,number: 4-FLOW DIFFUSERS
leaching galleries,number: jiLa
leaching trenches,number,length: nLa
leaching fields,number,dimensions: nLa
overflow cesspool,number: nLa
Alternative system: nLa
Name of Technology: ..jLa -
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
THE LEACH FIELD IS FUNCTIONING PROPERLY.BOTTOM OF FLOWS IS AT 4'.
CESSPOOLS: _
(locate on site plan)
Number and configuration: nta
Depth-top of liquid to inlet invert: nLa
Depth of solids layer: nLa
Depth of scum layer. nLa
Dimensions of cesspool: nLa
Materials of construction: nLa
Indication of groundwater:.nLa inflow(cesspool must be pumped as part of inspection)nLa
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nLa
PRIVY: _
(locate on site plan)
Materials of construction:nLa Dimensions:nLa
Depth of solids: nLa
Comments.-
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nLa
revised 912/98 Page 9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 53 SUOMI RD..HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 1 00'(Locate where public water supply comes into house)
n/a
&CI
c3 c
CA Y�
revised 9/2/98 Page 10 of 11
f
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
NRCS Report name: nLa
Soil Type: n1a
Typical depth to groundwater: n/a
USGS Date website visited: n(a
Observation Wells checked: MQ
Groundwater depth:Shallow _ Moderate _ Deep _
SITE EXAM _ Slope
_ Surface water
_ Check Cellar
Shallow wells
Estimated Depth to Groundwater 8 Feet
Please indicate all the methods used to determine High Groundwater Elevation:
_ Obtained from Design Plans on record
X Observed Site(Abutting property,observation hole,basement sump etc.)
Determined from local conditions
_ Checked with local Board of health
_ Checked FEMA Maps
Checked pumping records
_ Checked local excavators,installers
Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
GROUNDWATER AT 8+FEET,DUG 4'BELOW BOTTOM OF FLOWS AND NO WATER WAS ENCOUTNERED.
revised 9/2/98 Page 11 of 11
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COMMONWEALTH OF MAS SETTS 1
EXECUTIVE OFFICE OF EN VIR RS John Graci
DEPARTMENT OF ENVIRONMENTAL P ON DEP Title V Septic Inspector
ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119
TeaTicket,Ma.
(508)564-6813
TRUDY COXE
Secretary
ARGEO PAUL CELLUCCI DAVID B.STRUHS
Governor Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: 53 SUOMI RD. HYANNIS
Name of Owner MR.AKUFO
Address of Owner: 8 JILL CIRCLE NORTH READING MA.01864
Date of Inspection: 6/21/99
Name of Inspector:(Please Print)JOHN GRACI
i am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000)
Company Name: n/a
Mailing Address: n/a
Telephone Number: n/a
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 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:
X Passes The Inpection is based on criteria defined in Title V
Conditionally Passes code 310 CMR 15.303.My findings are of how the system Is
_ Needs Further Evalliatien By the Local Approving Authority performing at the time of the Inspection.My Inspection does
_ Fails not Imply any warranty or guarantee of the longgevity of the
septic system and any of Its components useful life.
Inspector's Signature: Date:6/22199
The System Inspector shall ubmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the
system owner and copies sent to the buyer,if applicable,and the approving authority.
NOTES AND COMMENTS .
THE SYSTEM PASSES TITLE V INSPECTION.SEPTIC TANK NEEDS TO BE PUMPED NOW AND THEN MAINTAINED EVERY TWO YEARS.
revised 9/2/98 Page 1 of 11
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 63 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:6121/99
INSPECTION SUMMARY: Check A, B, 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:
System passes Title V inspection
B. SYSTEM CONDITIONALLY PASSES:
nta 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.
Wa 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.
nta Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)
or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).
broken pipe(s)are replaced
obstruction is removed
distribution box is levelled or replaced
nta 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 912198 Page 2 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 63 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:6/21/99
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 the public health,safety
and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 16.303(1)(b)THAT THE SYSTEM IS
NOT FUNCTIONING IN 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 nLa-(approximation not valid).
3) OTHER
nLa
revised 9/2/98 Page 3 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:6/21/99
D. SYSTEM FAILS:
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
X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool.
X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped n/a.
X Any portion of the Soil Absorption System,cesspool or privy is below,the high groundwater elevation.
X Any portion of a 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 I 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds,
ammonia nitrogen and nitrate nitrogen.
X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure.
E. . LARGE SYSTEM FAILS:
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
X the system is within 400 feet of a surface drinking water supply
X the system is within 200 feet of a tributary to a surface drinking water supply
X 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)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the
Department for further information.
revised 9/2/98 Page 4 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 63 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:6/21/99
Check if the following have been done:You must indicate either"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 None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates
during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection.
X As built plans have been obtained and examined.Note if they are not available with N/A,
X The facility or dwelling was inspected for signs of sewage back-up.
X The system does not receive non-sanitary or industrial waste flow.
X The site was inspected for signs of breakout,
X All system components,excluding the Soil Absorption System,have been located on the site.
X 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:
X Existing information,For example,Plan at B4O,H,
X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)
[1 5.302(3)(b)J
X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of
SubSurface Disposal Systems.
revised 9/2/98 Page 5 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 63 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
FLOW CONDITIONS
RESIDENTIAL
Design flow:-=g.p.d./bedroom
Number of bedrooms(design): 3 Number of bedrooms(actual):I
Total DESIGN flow: 3.3.Q
Number of current residents:0
Garbage grinder(yes or no):NQ
Laundry(separate system)(yes or no): NO If yes,separate inspection required
Laundry system inspected(yes or no).M
Seasonal use(yes or no):M
Water meter readings,if available(last two year's usage(gpd): n/a
Sump Pump(yes or no): NQ
Last date of occupancy: 3/1199
COMMERCIAL/INDUSTRIAL
Type of establishment: n&
Design flow: Wa gpd(Based on 15.203)
Basis of design flow: n/a
Grease trap present:(yes or no):DLO
Industrial Waste Holding Tank present:(yes or no): &Q
Non-sanitary waste discharged to the Title 5 system:(yes or no):MQ
Water meter readings.if available:n&
Last date of occupancy: n/a
OTHER: (Describe)
Wa
Last date of occupancy: n&
GENERAL INFORMATION
PUMPING RECORDS and source of information:
NOT IN THE LAST YEAR-
System pumped as part of inspection:(yes or no):NO
If yes,volume pumped n/a_ gallons
Reason for pumping: n&
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)
I/A Technology etc.Attach copy of up to date operation and maintenance contract
Tight Tank Copy of DEP Approval
Other: WA
APPROXIMATE AGE of all components,date installed(if known)and source of information:
SYSTEM IS 10 YEARS OLD_
Sewage odors detected when arriving at the site:(yes or no): NQ
revised 9/2/98 Page 6 of i 1
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 63 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:6/21199
BUILDING SEWER:
(Locate on site plan)
Depth below grade: E
Material of construction:_ cast iron X 40 PVC _ other(explain)
Distance from private water supply well or suction line: TOWN
Diameter: n(a
Comments: (condition of joints,venting,evidence of leakage,etc.)
nta
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 Certificate of Compliance(Yes/No): NQ
nLa
Dimensions: L 9'6"H 6'7"W 4'10"
Sludge depth: E
Distance from top of sludge to bottom of outlet tee or baffle: 2L
Scum thickness: 5"
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: it
How dimensions were determined: MEASURED
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.)
SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND SEPTIC TANK NEEDS TO BE PUMPED NOW THEN MAINTAINING EVERY
TWO YEARS.
GREASE TRAP:
(locate on site plan)
Depth below grade:
Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain)
n/A
Dimensions: nLa
Scum thickness: Wa
Distance from top of scum to top of outlet tee or baffle:iaLa
Distance from bottom of scum to bottom of outlet tee or baffle nta
Date of last pumping: n&
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.)
nta
revised 9/2198 Page 7 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 63 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:6/21/99
TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection)
(locate on site plan)
Depth below grade: nla
Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain)
Dla
Dimensions: nta
Capacity: nla gallons
Design flow: n!a gallons/day
Alarm present: NO
Alarm level:jiLa- Alarm in working order:Yes_No_: MO
Date of previous pumping: n/a
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
n/a
DISTRIBUTION BOX: _
(locate on site plan)
Depth of liquid level above outlet invert:n/a
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
IlLa
PUMP CHAMBER: MO
(locate on site plan)
Pumps in working order:(Yes or No): NO
Alarms in working order(Yes or No): MO
Comments:
(note condition of pump chamber,condition of pumps and appurtenances.etc.)
Wa
revised 9/2198 Page 8 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21199
SOIL ABSORPTION SYSTEM(SAS): X
(locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods)
If not located,explain:
nLa
Type:
leaching pits,number: Wa
leaching chambers,number: 4-FLOW DIFFUSERS
leaching galleries,number: jila
leaching trenches,number,length: n&
leaching fields,number,dimensions: nLa
overflow cesspool,number: Wa
Alternative system: n&
Name of Technology: j3La
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
THE LEACH FIELD IS FUNCTIONING PROPERLY BOTTOM OF FLOWS IS AT 4'
CESSPOOLS: _
(locate on site plan)
Number and configuration: nLa
Depth-top of liquid to inlet invert: nLa
Depth of solids layer: Wa
Depth of scum layer. nta
Dimensions of cesspool: Wa
Materials of construction: n&
Indication of groundwater: Wa inflow(cesspool must be pumped as part of inspection)n&
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
DLa
PRIVY: _
(locate on site plan)
Materials of construction:Wa Dimensions:Wit
Depth of solids: Wa
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
Wa
revised 912198 Page 9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21/99
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 100'(Locate where public water supply comes into house)
n/a
&CIL
�ec�
t3 c
g
� C 6�
CA Y�
revised 9/2198 Page 10 of 11
r
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 53 SUOMI RD.HYANNIS
Owner: MR.AKUFO
Date of Inspection:5/21L99
NRCS Report name: nLa
Soil Type: Wa
Typical depth to groundwater: nLa
USGS Date website visited: Wa
Observation Wells checked: No
Groundwater depth:Shallow _ Moderate _ Deep _
SITE EXAM _ Slope
_ Surface water
_ Check Cellar
Shallow wells
Estimated Depth to Groundwater 8 Feet
Please indicate all the methods used to determine High Groundwater Elevation:
_ Obtained from Design Plans on record
X Observed Site(Abutting property,observation hole,basement sump etc.)
Determined from local conditions
_ Checked with local Board of health
Checked FEMA Maps
Checked pumping records
_ Checked local excavators,installers
_ Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
GROUNDWATER AT 8+FEET,DUG 4'BELOW BOTTOM OF FLOWS AND NO WATER WAS ENCOUTNERED.
revised 9098 Page 11 of 11
v Y .y� -l WN OF BARNSTABLE
. LOCATION _SEWAGE #
VILLAGE 404ASSESSOR'S MAP & LOT
INSTALLF,R'S NAME & PHONE NO. Vvlaa . 6f0S
SEPTIC 'TANK CAPACITY
LEACHING FACILITY:(tyl;e) (size)
NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT 1S SUED:
___4g
DATE COMPLIANCE ISSUED_ --�
VARIANCE GRANTED: Yes No
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: �
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No......�1.....Ll...1
THE COMMONWEALTH OF MASSACHUSETTS
tD d BOARD OF HEALTH
ApplirFation for DiopooFal Workii Tonotru'dton Prrmi#
Application is hereby mad or a Permit to Construct 4�) or Repair ( ) an Individual Sewage Disposal
System at: J u off► Ad
Lots 48 & 49 Barnstable, MA.
................__......_.......0.......................•.......................0.............. .....-••••---........................................... ............-.......................
Barnstable Holciftloo;dine. 100 West Main Stree iFigannis, MA
......................-................................-.........................................' ...................-.............................................-..................-............
W Robert Our Co. Owner Great Western Rodd;rffarwich, MA
,-� •...................................•-•--...-----------•-•--........--••...-•-.................... ................................-...........-
.........0.......
Installer ..:..,
� Address
U Type of Building Size Lot.._:ZL3:10:::_ Sq. feet
�-� Dwelling—No. of Bedrooms.......... ...............................Expansion Attic (�1�) Garbage Grinder )
i
a
Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria )
POther fixtures ------------------------------------•-••---------------------------------------------------------•------------•--------------.....------------------.
g ��.�� ...................gallons per person d Total d�i�y fow__�f��?S��z.2rd'_ �.r__gallon4.
Design Flow____._.... 6j
WSeptic Tank—Liquid'capacity_ .gallons Length_.__...t.. Width.......P.. Diameter--- Deptl�_�._..
x Disposal Trench—No. ......... ......... Width.................... Total Length .. Total leaching area............... sq. ft.
3 Seepage Pit No-------------I------- Diameter-__-:1 ....... Depth below inlet.._.... _.__.___... Total leaching area......6 s r
Z Other Distribution box (�) Dosing tank
0-41.4 Percolation Test Result Performed by -k�� ..r`t.._ .... Date.�_'(�_`�_
Test Pit No. 1................minutes per inch Depth of Test Pit..lQ'_5V...... Depth to ground water_._�v
tz, Test Pit No. 2_./--�-..�_-...minutes per inch Depth of Test Pit.. .c.2 ..... Depth to ground water.....A1................
--------------
t ---mod--- -
escr`tion of So - ` P .. ,
�_" �Us, _ .w ' _z .
w
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
••-•--•-•-------------------•--•-----••----------------•---•---•-•----•-•--•-----------•------...... ----.--.----------------•--------__----•---•--------------------------------
Agreement: .
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
�'1T�'1T•-�
the provisions of '� t:.:±. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
.operation until a Certificate of Compliance has bee �11 d of 1 lth.Signed---.0 �f`- U</d�l
-------------
Date y
Application Approved By............�?=""'.. --�-. .......... a .- �/-----
Date
Application Disapproved for the following reasons:....................-..................................--------------------------------------------------
.................................................................................•--••---------..0.....
--------------•---
Date
PermitNo...........� .............--••••••.. Issued-----.....---------------...---------------------------
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD /�OF' HEALTH
<fiL�.......OF....... . ..... f,. w:l AND CEP l =w' e;l °:::
� '
p., = .;%-;,T °,,�•UVRS--1-►Z7STALLED iiV STf'1ICT
C r if grtttr of Tom�tli ieA CE TO PLAN,
THIS IS T=Ej. TIFY That the Individual Sewage Disposal System constructed (y) or Repairedby....................... ..__. ..l�c�....--•-----....-..-.............................................................................. ...............................
q Installer
has been installed in accordance with the pro sions of TITLE;, 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No........ ..Y......... dated.......................................:........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.......-........-...................................------••.................... Inspector........------------ ...........................•...............................
t
No........... :...:. ' ( Fus............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
ApplirFation for UhiposFal Work
s Tonstrurtiun Prrmit
Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal
System at:
Lots 48 & 49 Sauna Road, Barnstable, 11A
.-- .....-----•---.....•... --•... .............••---.........----.---•-- . ... .. ..... -•-- -------••-•-------•.
Barnstable HoldftebAdhW. 100 West Main Strege tl gannie, MA
......................
W ...........ow ner-••-•...._....---•--•--•-•----.......•----
Robert Great Western Road rftarwich, MA
,.� ......................................... .........
Installer Address �---
Type of Building Size Lot_<z4 Sq. feet
U "
�. Dwelling—No. of Bedrooms........ ..................................Expansion Attic ) Garbage Grinder 1))
a`4 Other—T e of Building No. of persons.......................... Showers )
YP g •--•--•-•-•---•-----••------ P -- ( ) — Cafeteria
Otherfixtures = ------------------••••••-•---------------------------------------•----------•- ...........----.---•---
w Design Flow........ .-5.0....................gallons per person pe� dlay. Totally uow.I,.. J �=.G ��r...gallo'.
WSeptic Tank—Liquid*capacity1 --gallons Length._,O.�(p _ Width...... 0... Diametervn—...__.__. Depth,
x Disposal Trench—No..___.... ..... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No...........J. __._ Diameter..... Depth below inlet_... g area..... , �..3t......... Total leaching .. . . _.
Z Other Distribution box ) Dosi g t,a�nk ( ) G-'
'-' Percolation Test Results Performed b3
Date. `t'S"�J y. _�1r��Z1J1
Test Pit No. 1.41-'_._.minutes per inch Depth of Test ...• Depth to ground water__ ......
LL, Test Pit No. 2._A.�...minutes per inch Depth of Test Pit.�y._�_FQ...... Depth to ground water.....�t.�..._____.
P; ,.........•. .
..... r t
x s�ri�(ionpfc�Sbl I�` • -�--�--��...a--- --J
w
......•••••-••••••••-----•••-••--•••......•• ------------•---•.----...------------------b. j-----....'T�.D..tJM / 1 ---------------------..--------------------
UNature 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 LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has_beqpitsMd d of health.
Signed......•--•-•. •• • ............... .. .. .,----:;-.....__...:. :._. 71
..� ..
�"'.� Date
Application Approved BY - --• .............
.................. --------------
--------------------------
•---------
1 _ ato-
Application Disapproved for the following reasons------------------------•---••-------•--•----:_......--•-------•-----------------------------------......_..._...
.. .................................•--•----..........------------...--••--.....------------...-•----------•.•----•-•---•---•--•••-•----•-•••-•-•--••--............-•••-•............•----•......-----......
Date
PermitNo.......... __ _:__9.__.:/......................... Issued.......................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.:...............OF........r.:.. ..............� t
�rrtifirate of hunt li�anrr '
THIS IS PTO, CE(RTIFY, That the Individual Sewage Disposal System constructed ( ) or. Repaired ( )
by =' 1 it
E t .rt.�:...
Installer
has been installed in accordance with the provisions of TIT E �blfhht Staf,6 tanit�& Qg4g,"kscvi.�k in the
application for Disposal Works Construction Permit No. 1�,,{__.tt,.,��_____________ dated.................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE`COI+ISTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................:..............•-------._...---- Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
/ �� ........ ( !/:r :................OF............... /'................................... FEE._
Disposal Works 0-Fnntrurti it rrntit
Permission is hereby granted--------- "Q--�....C�4'::-•=--•--.---•-•---...--:••------------------------------------------------------------------------------
to Constructer). or Repair ( ) an Individual Sewage Disposal, System
atNo....... -•••-•••--•• J .1-... ......IJ1Y t..........._... . L;,< --=--------•--•----•-----------------------------------
Street _ .r..
' -'-ks shown on the application for Disposal Works Construction Per it Na J 5�., . Dat .
AID/// - -- •' ...---._^•.--—
DA V th
/ '!�' Board o�Lieal
FORM 1255 HOBBS & WARREN. INC.: PU.B.LISHERS
i
-zo SOIL TEST
p, p' DATE OF SOIL TEST-- '15'�� t#jp � �orteD)
I' 10' 14414. PRECAST CONCRETE RISER —
�2SEE NOTES 2 & 3 c:;`t WITNESSED BY _ T• Unl� tend
A` -� PERCOLATION RATE MIN./INCH
4" SCH. 40 PVC PIPE
MIN. PITCH 1/8- PER FT.
CEAN SAD OBSERVATION HOLE 1 OBSERVATION HOLE 2
ELEV.- " ,J ELEV.—
( c r�✓'
ICJ I,0t0-pp �` '$tJt l V —450 -mfl
TD
1� PITOH � �, :,. :.r•;r/ � ,:s. .. — F
1�4- PER FT. ROW LINE OF 6, 1 —//�L 51q ITONEA-TxL-
o
(00 0 ,✓ EVEN+ N ,"1a 32 'Afl*w a o"�i N 3
Y
DESIGN CALCULATIONS :
4'_0. _� Lr.L�_.�.
1/2
EVE WASHED SSTONE NUMBER OF BEDROOMS
DISTRIBUTION' � � � GARBAGE DISPOSAL UNIT
BOX TOTAL ESTIMATED FLOW
GAL/BR./DAY X =-_ BR.) GAL/DAY
REQUIRED SEPTIC TANK CAPACITY 1 5x3 >= 5 GAL
ACTUAL SIZE OF SEPTIC TANK 000 GAL.
LEACHING AREA REQUIREMENTS
IDLb GALLON SEPTIC TANK SIDEWALL AREA GAL./S.F.
BOTTOM AREA _ GAL./S.F.
LE)kCHING CAPACITY (BOTTOM + SIDEWALL.) �GAL
SEWAGE DISPOSAL SYSTEM PROFILE ------ �` --J 7�' � ' '` 1 7 ; -- ` , � /,4 "``-
R "VE LEACHING CAPAOTY GAL
NOT TO SCALE BOTTOM OF TEST HOLE;
BREAKOUT CALCULATION: LEACHING PIT NOTES:
1. ALL WORKMANSHIP AND MATFJj ALS SHALL CONFORM TO D.E.Q.E.
TITLE 5 AND THE TOWN OF .15 ;r _y,. RULES AND
DI lei 'b i Gn X S ' G REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE.
2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO
WITHIN 12" OF FINISHED GRADE,
A67�A L D 19T',= 3 f 7 7.S \ 3. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE
4. SHALL
COMPONENTS MORTARED
OF THE PLACE.
A SANITARY SYSTEM SHALL BE CAPABLE
5 r.--- OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR
WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING
\ SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR
N ! PARKING.
5. HORIZONTAL AND VERTICAL CONTROL, SEE LEVY, ELDREDGE
& WAGNER FIELD NOTEBOOK
r4
74
r Aw 2l, 3ft�yf�
1 IA�� UN
� � _ -- � t / � c' � �t1107 �'=�_7�-'C ��' ,p, 113��'t�' ��!•2
LEGEND:
--
24` CA�-T' ?ATPI EXISTING SPOT ELEVATION OOXO
EXISTING CONTOUR-------00-----
1 LIN FINAL SPOT ELEVATION [�
FINAL CONTOUR
LOCATIONSOIL TEST
TOWN WATER W
SEPTIC TANK L�
DISTRIBUTION BOX ❑
52\ ` ` o_ PRIMARY LEACHING PIT nn
RESERVE LEACHING PIT (x
D
INITIAL ISSUE L
f, .✓ NO. DA TE OESCRIP 77ON BY
L.0T s49
g, N 5TPt?,L� SAC YA4. jIs ��� MA
Fv
�1
t/A ciC�. Ot L i `F
SCALE: 1"=30' JOB N0. 13 I3
iASSClATcES4pVd
PAIJL
ofv APPROVED: BOARD OF HEALTHLEVY, ELDREDGE & WAGNER . .
DATE AGENT EAfi1 m IANDBCAR ARCHITECTS PLr)19m Im SG'RPBm
LOCATION MAP 889 WEST MAIN STREET CENTERW.LE MA. 02632