HomeMy WebLinkAbout0064 UNCLE WILLIES WAY - Health 64 Unclewillies Way
Hyannis
A= 292- 321
I
TOWN O BARNST'ABLE
��i3OCAi vN L CQ `f (fi�P b SEWAGE# 7 0W,6 �f
VILLAGE � y� v� �t-�S ASSESSOR'S P&PARCEL --3AY
INSTALLERS NAME&PHONE NO.
SEPTIC TANK CAPACITY QQQ
LEACHING FACILITY.(type) V� ":V!f6� (size) 7� /®� K
NO.OF BEDROOMS
OWNER
PERMIT DATE: to— a (p COMPLIANCE DATE:
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
d
0 �
SCPTl(-Tn
Commonwealth of Massachusetts
Title 5 Official tnspection Form
a Subsurface Sewage Disposal System Form Not for Voluntary Assessments
Property Address: /•//!A vr1 Ai I..Sle v-
Owner Owner's Name
information is _ 01119
required for �aNhl1 State Zip Code Date o Inspection
every.page. City/Town
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important: A. General Information
When filling out i
forms on the
computer,use 1. inspector:
only the tab key
to move your ��� oISe-
cursor-do not Name of inspector
use the return jC�VV/O — Tf C
key.
Company Name p
cif I se I I '22 O
Company Adds L
City/Town State Zip Code
�-5 o g ) 7�S 7��Y , - /o/4
Telephon Dumber License Number
U.J - B Certification
t. - .
I certify that I have personally inspected the sewage disposal system at this address and that the
a ~= information reported below is true, accurate and'complete as of the time of the inspection. The inspection
wr wa"s.performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of
Title`5 (310 MR 15.000). The system:
Conditional) Passes ❑ Fails
c a Spa 1 . Passes ❑ y
❑ Needs Further Evaluation by the Local Approving Authority
aj /0
Inspe tor's Signature Date
The system inspector shall submit a.copy of this..inspection report to the Approving Authority(Board
of Health or DEP) within 30 days of completing this inspection. If the system 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.
****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.
t5ins•09108 Title 5 Official Inspection Form:Subsurface Sawa Disposal System•Page of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form • Not for Voluntary Assessments
'aim` �f LII4G !2, ��llr�s (,✓�
Property Address
e Is le
Owner Owner's Name
information is Q�6 oI 110LI-V
required for `� a yl 0
every page. City/Town State Zip Code Date of In pection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/ always complete all of Section D
A) System Passes: s
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:
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.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for 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.
❑ Y ❑ N ❑ ND (Explain below):
a
15ins-09r08 - Ttue 5.0fficial Inspection Form:Subsurface Sewage.Disposal system•Page 2 of 17 -
Commonwealth of Massachusetts
kipTitle 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Property Address I
�G� ISIer -
Owner Owner's Name �� f,D
information is
required for ah n State Zip Code Date f Inspection
every page. Cityrrown
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup
or break out
brokeinhsettled o water
unevenlevel
in the distributiondistribution
box System due
will
to broken or obstructed pipe(s)or duet a
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ 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 ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
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
Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 3 of 17
l5ins•09/08 a
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
64 11 c Ili cs"
G t�
Property Address lk/I k
Owner Owner's Name114)
information is 917 a N J01 /"1— O�LL 0/
required for State Zip Code Date ofAnspe6on
every page. City/Town
B. Certification (cont.)
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 indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or "No" to each of the following for all inspections:
Yes No
El Backup 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 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 '/2 day flow
Title 5 off cai Inspecuon Form:Subsurface sewage Disposal System•Page 4 of 17
t6ms-09108
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -,Not for Voluntary Assessments
Oki cle-
Property Address 1- els lev-
Owner Owner's Name ,�/J
information is A14
required for
every page. Cityfrown State Zip Code Date of nspe Lion
B. Certification (cont.)
Yes No
❑ Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ E___ Any 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 water supply.
❑ Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ (� Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ lam' 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 fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ L�' The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ 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: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
Yes. No
0 ❑ 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.
ge Disposal System Page 5 of-V
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewa •
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
Property Address /
e
Owner Owner's Name
information is N�s /A4 0.2601 0 I�
required for - State Zip Code Date f In ection
every page. City/Town
C. Checklist
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
e
Yes No
[t� ❑ Pumping information was,provided by the owner, occupant, or Board of Health
❑ �� Were any of the system components pumped out in the previous two weeks?
❑ �� Has the system received normal flows in the previous two week period? `
❑ ❑/Have large volumes of water been introduced to the system recently or as part of
this inspection?
Were as built plans of the system obtained and examined? (If they were not
Iu� uu available note as N/A)
��❑ Was the facility or dwelling inspected for signs of sewage back up?
❑�❑ Was the site inspected for signs of break out?
[��❑ Were-all system components, excluding the SAS, located on site?
[. �❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of 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:
0� ❑/ 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(5)J
D. System Information
' Residential Flow Conditions: •
Number of bedrooms (design): Number of bedrooms (actual):
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms):
l5ins•09108 7Ue 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System form Not for Voluntary Assessments
4
Property Address
Owner Owner's Name
information is n N f ,� 0.�6,0l *olf
required for State Zip Code D
every page. City/Town
D. System Information
Description: / / Od / _a ��p �� -y
(r h
/ rS 7��r �� 10 196
O
Number of current residents:
Does residence have a garbage grinder? ❑ Yes [5"No
Is laundry P
on a separate sewage system? (if yes separate inspection required) [IYes Quo
Laundry system inspected? ❑ Yes Ey No
Seasonal use? es No
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
Sump pump? vDate
-6`
Last date of occupancy:
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow (seats/persons/sq.ft., etc.):,
Grease trap present? ❑ Yes ❑ No
Industrial"waste holding tank present? r ❑ Yes El No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
(Sins•09/08 •Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Property Address
Owner Owner's Name -
information is �L1 a ri h/f A� 0 /v /9
required for State Zip Code Date df Ins ection
every page. Cityfrown
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
P 9
Source of information: -
Was system pumped as part of the inspection? ❑ Yes �No
f `volume pumped:I yes, p p gallons
How was quantity pumped determined?
Reason for pumping:
Type of Syst m:
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) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other (describe):
Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 8 of 17 y
t5ins•09toa
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
Property Address
Ale If /e !--
Owner Owner's Name
information is /f-'� a Hh s //V
required for State Zip Code Date of In pection
every page. City/Town
D. System Information (cont.) P����� - e 6- a 9
Approximate age of all components, date installed (if known) and source of information:
%a � L � �t i,�a�.. /j/P c.� !�-��� — .Sid•S
Were sewage odors detected when arriving at the site? ❑ Yes l-No
9 - ,
Building Sewer(locate on site plan): it
Depth below grade: feet
Material of constructio�40
cast iron �PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage,
Septic Tank locate on site plan): LILDepth below grade: feet
Zroncrete
eial of ruction:El metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: //,,
_ `/
Sludge depth:
t5ins•09108 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
Property Address
A?f S le v-
Owner Owners Name
information is A//¢ p
required for a H n i
every page. Cityrro`wn State Zip Code Date'of Inspection
D. System Information (cont.)
Septic Tank (cont.)
Distance from top of sludge to bottom of outlet tee or baffle
Scum thickness 8„
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
How were dimensions determined?
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence,of leakage, etc.):
H Wr i N ✓lO
h�e�eC/ Gs T Itr` 41,,1I-,
h C
/ - - ✓* OO C/
C.o�d�Tto✓�. /� LeG��
.e
Grease Trap (locate on site plan):
Depth below grade: feet
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: Date
Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
t5ins-09108
r
,
Commonwealth of Massachusetts
In Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
Property Address
Owner owner's Name
information is
required for State Zip Code Date f Inspection
every page. City/Town
D. System Information (cont,)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
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: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level. Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc'.):
' Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑" No
<
t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 .
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
(�0 G/2
Property Address
Owner Owner's Name A
information is �iT• Doi 6 OI �O
required for �` H State Zip Code Date of Insp coon
every page. City/Town
D. System Information (cont.)
Distribution Box (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 og f leakage into or out of box, etc.):
-eve,
Pump Chamber (locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Soil Absorption System(SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•09M Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Notl for Voluntary Assessments
V
Property Address lie is Ile
;
Owner Owner's Name
information is /L'L P1#1 Is �l� O"L f7� Z.V
required for State Zip Code Date of In ection
every page. City/Town
D. System Information (cont.) f/V x I
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
El 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.):
h e q,� So C(i°G h G w O�l
�s o
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 ❑ No
15 ns•09108 4Title 5 official inspection Form:subsurface Sewage oisposal system•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
Property Address
Q/SIC✓ .
Owner Owners Name
information is AhN f / '� Qd-60 1 f 0 /0
required for State Zip Code Dat of Inspection
every page. City/Town
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (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.):
t5ins•M08 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 14 of 17
k
a
f -
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Ps t4lle-i
Property Address
1�e�sl�e�
Owner Owner's Name
information is 1� Ua b 0/ �f l0bp
required for h I
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont
Sketch Of Sewage Disposal System: Provide a view of-the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where p c water supply enters the building. Check one of the boxes below:
hand-sketch in the area below
❑ drawing attached separately
a ,4 c 4__1
3 .4
a
t&ns-o9*8 '. Title.5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
Property Address
Owner Owner's Name ,Q
information is /��/ Qoz 6 0 /0
required for
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health - explain:,( , l
❑ Checked with local excavators, installers - (attach documentation)
❑ Accessed USGS database - explain:
You must describe how you established the high ground water elevation:
w, V7 s C. Ile ��� �01
—T_4
S�
s
\ n next page.
Before filing this Inspection Report, please see Report Completen
ess Checklist o p 9
15ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17,
Commonwealth of Massachusetts
• Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
Property Address
Aelf lek -
Owner Owner's Name
information is �j¢ 0.2601 -4,e�/o 1y
every page City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
Inspection Summary: A, B, C, D, or E checked
Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
2"'S-ystem Information- Estimated depth to high groundwater
ketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
9/16/03
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 ,-3 0_.h . concerning the property located at
CA- O n el e k �5lneets. 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 classified as.CLASS I and the percolation rate is less than or equal to 5 minutes
per inch. The applicant may use historical data to conclude this fact or may conduct deep
test holes and percolation tests.at 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 facility will be located no less than five feet above the
maximum adjusted groundwater table elevation. [Adjust the groundwater table using the.
Fri mptor method when applicable]
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information) (0 9 O
B) G.W. Elevation AJ- +adjustment for high G.W. = Z.,3
DIFFERENCE EN A and B
SIGNIrD : DATE:
NOTICE
Based upon the above information; a repair permit will be issued for bedrooms
maximum.. No additional bedrooms:are authorized in the future without engineered septic system
plans.
gASeptic\perc"emp.doc
No. '1' Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pplication for �Digozal 6pztem QCon5truction Verna
Application for a Permit to Construct( ) Repair( ) Upgrade') Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No.(14 /K.4li f)h f Jr " //'' Ownerel' Name,Address,and Tel.No.
sLe.r
Assessor's Map/Parcel a -321 I O/ Q t�-
Installer's Name,Address,and Tel.No. (50 g�0-1 'Yf I gg 8 Designer's Name,Address and Tel.No.
'AuLk, , P.D. a rw,S �.s ,.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33o gpd Design flow provided :3 F2 gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
JL
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by his Board of Hea h.
Sin% Date
:Application Approved by Date
Application Disapproved°by: Date
"'for the_following reasons
Permit No. Date Issued
No. O
Fee�V
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ZippYication for bigpogar 4p!9tem Construction Permit
Y
Application for a Permit to Construct( ) Repair( ) Upgrade ) Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No.l h� (,�/Y_he Owner's Name,tiddress,and Tel.No.
Ne Ise rr
Assessor'sMap/Parcel a —32' I J q
Installer's Name,Address,and Tel.No. (50 g)1 FI j Des' ner's Name,Address and Tel.No.
pe(Ws . P-o- 6� 551, o1rUs � C
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33o gpd Design flow provided gpd
Plan Date Number of sheets_ Revision Date i
Title
sr
Size of Septic Tank Type of S.A.S.
Description of Soil
i
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board
lAofnHea h, n
_.r S' need )l.( 1 vL !/ Date
Application Approved b 1H el Date
Application Disapproved by: Date
I
for the following.reasons
Permit No. Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CERT FY that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( Y1
Abandoned( )by W ,
at L Y)d-,P_ �0 1 1 e S 16 r o n n 1S has been cojistru ted in accordance
with the pevisipns of Title 5 and the for Disposal System Constru tion Permit No. x dated
Installer Vwnns /,��j Designer �_ �v✓1
#bedrooms Approved-design fl w., gpd
C �� -
The issuance of this permit shall not be/construed as a guarantee that the system will fu ction as designed.
Date � i' � f,9 Inspectors
—-—-—————- L——-——————————— — ——— — — ——— ,
No: Fee /
THE COMMONWEALTH OF MASSACHUSETTS .. -
q PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
� Miq0$al �&pgtem (UYY$truCtioYY Permit
Permission is hereby granted to CoL,nstr�u/ct ( ) Repair ( ) Upgrade ( 'Abandon ( )
System located at U 7 I�t.{ ti j t I e S ��LI Q�l%1 aQ Q n n
A
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title S and the following local provisions or special conditions.
Provided: Constructi n mustibe completed within three years of the date of this p )
Date 11-47 0 Approved by es
Town of Barnstable
FTHEr
do Regulatory Services
Thomas F. Geiler, Director
R BABNSTABLE,
9�AN039.
An Public Health Division
Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: (t2— IS- Dxp
Designer: Shay Environmental Services, Inc. `Installer:.
Address: P.O. Box 627 Address:
East Falmouth, MA 02536 r.
�A P,
On J', (-�, a � S c\ C was issued a permit to install a
(date) (installer)
septic system at �2 S based on a design drawn by
(address)
Shay Environmental Services, Inc. dated (0 (D
(designer)
I certifythat the septic stem referenced above was installed p Y d substantiallydin
according to
the design, which may include minor approved changes such as lateral
g Y pp g a relocation of the
distribution box and/or septic tank.
E
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow.
CN OF Also
q
o` CARMEN c 5
G�
( ns er's Signature) �� E.
0 : SHAY
No. 1181
0
�FGISTS
8A Al IPN
Ji4igner's Signature) (Affix Desi p Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:Health/Septic/Designer Certification Form
11<20L5 e .?6,-- 6
LOCATION SEWAGE PERMIT NO.
7TL- 9g
VILLAGE
l 0
IN TA LLENIS NAME & ADDRESS
o� n .e-
hl�®..w��,�_ ,trL�S
BUILDER OR OWNER
DATE PERMIT ISSUED ZZZ /-7s-
7 -
DATE COMPLIANCE ISSUED
1
�S�
��I
a1
,�a�L� �
V � �
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�ti a �
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.� ��,�s
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No.7.__...�......�.. r Fimic 'Zv..................
THE COMMONWEALTH OF MASSACHUSETTS
q BOAR® OF HEALTH
�56 ApplirFa#ion for UiipnsFal Workii Tomitrn.rtiun jJamit
Application is hereby made for a Permit to Construct (7/)' or Repair ( ) an Individual Sewage posal
System at
i .....�f %8-______--____ -5-------------------
Locat' Address or Lot N
..YA9 a_�
Owner Address
Installer Address
U Type of Building Size Lot....
/0)_.77.....Sq. feet
., Dwelling—No. of Bedrooms.........�_�.............................Expansion Attic ( ) Garbage Grinder (N4
'.-IPL4 Other—T e of Building No. of persons............................ Showers — Cafeteria
a' Other fixtures .......................................
De," nv.i"
W Design Flow................Re................... per fo"an Fier.day. Total dai1�Y flow____........._.a3.C-__................gallons.
R: Septic Tank—Liquid capacity.1.00.gallons Length'a:' ..._.. Width!_---- Diameter................ Depth. Q......
W Disposal Trench—No..................... Width.......`l..._..._.. Total Length.__..............._ Total leaching area.................... ft.
x -
Seepage Pit No......2............. Diameter-_ Q_.. Q..... Depth below inlet_.6__��._._.... Total leaching area.. _l... ft.
z
Other Distribution box (t✓r Dosing tank ( )
'-' Percolation Test Results Performed by.. _���dj' 4' 4t �: s3 ....•. Date....�/ 017 ...................
Test Pit No. 1UR1 "__minutes per inch Depth of Test Pit----12'0_..._ Depth to gr > aa� er.)Vvrle_:�°XI�
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth t �PcZlpttd1 ...........
------------------------------------------------•-------------------------------....._.._--••---_._--•- .••••--•. -_-•--.. �`--•----•---_..._.
• o -•-DANA q-'-----•---------
Description of Soil._...r�.�G:_ 1a'�.i�.......................:........•-•--••--•---•------_..--------------------...----- -�---- -
U M_R-E- FPdiE— ,
W ...........................................................--....---•-•----.......----•--•------"--....._.. a_7A70A ...
.. N �@
U Nature of Repairs or Alterations—Answer when applicable_____________________________•__--.__-__-_ Q�F��S��4 . ...................
......................... ........................---- -••--------•----- ••---------------------------
Agreement s �l
The undersigned'agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions 'f TLI' 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until',a Ceriificate of Compliance has be d the boar health.
rk. S• d. .. ....... ---•••. ...............•--• ----- Y �---
ApplicationApproved By....... ............. .... .. . ... -.....----•-•---.............. ...... ............. ..........
Date
Application Disapproved for the following reasons---------------------------------------------------------------•••-----••-•••••-••-••....... ---•••-•:..-_••-•-
----•-•-•---•....•••---••----•••--••------•---•••---•---•-•-•---•--•••.......---•...........-•-•................••---•-•----•--------•-•••--••--•--•-•--•••-••-••---------•----••-----
Date
PermitNo......................................................... Issued.......................................................
Date
No................._....... Fss....'7 .�-.....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.........rtrv.n--------------OF.............
Appliratiun for Uhipuutaf Works Tonstrurtiun Prrutit
Application.,is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal
System at tk
Locata Address or Lot N
. ....... ........
.......�' ...`.� ''Y-1-��'i........
s Owner Address
W .
Installer ' Address
UType,of Building Size Lot....14322.....Sq. feet
Dwelling—No. of Bedrooms...........=5............................Expansion Attio ( ) Garbage Grinder (jVt)
a04 4 Other-Type of Building No. of persons............................ Showers — Cafeteria
Pa Other fixtures 33.0
W Design Flow................Jl_�t
....................gallons per person' per day. Total daily flow................ . '_..___.._._.._.gallons.
WSeptic Tank—Liquid capa - :city.10-OO.gallons Length -16 I..... Width .--M1: Diameter................ Depth.A.*.-O ..--
x Disposal Trench—No. .................... Width.................... Total Length............. Total leaching area....................sq. ft.
Seepage Pit No.......I............. Diameter...e({ .�" " :. Depth below inlet... ' Total leaching area... ....sq. ft.
Z Other Distribution box (j,--) Dosing tank
a Percolation Test Results Performed _i�. . ...... Date.....,f f '� ...............
1,
Test Pit No. 1 Ohckr ._minutes per inch Depth of Test Pit....12._D..... Depth to ground ater.A0 1a.0-12C,
(z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to gr r - ----------.-------
----------------
H
0 Description of
F� Soil.....-Jee.. .13.n....................................................................................... ......IDAWN.A........rn\............
-
McKECHNIE•---
1.
W •------•---•-----------------------•-----•-•-----••---•••.......................................
•••----------------------------
•------••------------ �--• •--•--....
V Nature of Repairs or Alterations—Answer when applicable............................... ..... �c.G........t ,. .,..........__.
...........
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITY-E 5 of the State Sanitary Code-The undersigned.further agrees not to place the system in
operation until a Certificate of-Compliance has be s d b the board health. ,,�f
................................. .....
Application Approved By •------- -•---- •.-- . . .••. `................................ •-- " .............
2 Date
Application Disapproved for the following reasons
... y ....<,........ . r ............r... ..............................-- .... -------
Date
ry • � U �
PermitNo.......................................... ............. r Issued.............. ---•--. •-••-.----•-.............
Date W
'» THE COMMONWEALTH OF MASSACHUSETTS a
BOARD; OF HEALTH
Q_
l..Y...W ..............OF.:...F..... ....... ...........
Trrt firaIr of Tontpfiattrr
THIS IS TO CERTIFY, That the •Individual Sewage Disposal System constructed or Repaired ( )
by--------------------......................................... ---- ------------..................----------------------------------...-----------------.............:................---•-----------
1 ` staller w
at. - •.� �
has been installed in accordance with the provisions of ` Ofle State Sanitar Code as described in the
� y
application for Disposal Works Construction Permit N _:_................................ dated_.. �``_;T, '_'_...................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM\MILL FUNCTION, ..SATISFACTORY.
{
DATE... ...�.L.. 7. •------•----...-••-•...-•••••••.... Inspector•-- - j -- -------
y
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF >HEALTH
74
No......................... FE ...V .w..........
Biupuuaf. urku Cnonstrur#iun Vamit
Permissioni hereby granted............................................. ----•-•--------•--••----------•..........--•-------. :.........................:...._-......... a.
to Construct ( r Rep it ( ;) �n Individual Sewage D' posal�;Systec
� ';J G,
at No.---, .._.. -----r!�.:.....- i Street..?r.I............................ -........
as shown on the application for Disposal Works Construction. Perm N41 �N
t Dated �, 7#-, .
..:.. ....... ........�
oard�e
DATE....................•------•-•...............,.............--••---•---........
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
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1 ; I_ - j ° 1000— -GAL. d as.rt,��1a'',._1.I t,�.
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,j . SEPTIC I , o°°e,I BLOCK ° '" t ,A
I TANK I °° o, I SEEPA-G{E PIT ! F_ 7
t _._ - _ I.I e_° °� fla./Ltl��s/jj�!!P�' /f?p0$r� D ° �LI4D•
20 MINIMUM - —_ _ ' ,' . o' 7M4/= A` i
i r, L-1_ __ 4 --y_j r
R .�
' FOUNDATION
1.
I I %z WASHED STONE '--..- . 70.
; . . . .
ELEVATION SKETCH
f._______ I----- I0' --------- P�RC. RATU 1 wo-el z..-..-. -ea4.t4
I .j m'--»L .. ''. ._.
,TEST BY : sEr _r.✓car/ry/d^}4o<e;fg y 4
SCALE I": 4 - ,
TOWN INSPECTOR !!74uff- ,'ep?,llJs4-!?4 ,
r fi 7� .t BACKHOE OPERATOR.: J ,4. 0,4'.V 7f3/.2 _'.-- - a
4 JJ e rike , o- TEST MADE ON _,+J.r.../ o� 1.- :7:
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SCHEDULE t»tea , x , , y '
j ,� ` " � Y { r ` PRO:POS.EQ .`31�'€..•'. PLA- - `Y` - r'-
C , i.. .{-. �E ). �" y S ''i '(', t t _ < _ 'I.. f r,..:,^_v*%�....
v s;'�' '�.�`Y '.a r t'xx '�!-4 ffs �i,.'�� r .�� �, �c,' s L`3" -�'_ x s
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5. INV INTG SEErPAGE . Pt'T � a - _ f' �+ G
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`' _ ` .. / - �j_3� ,Rx 4 r_ ,,':..¢ r q .; ROU,T•E 1.32' ''. ... w •'i. _
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8.. B'OTTO,M ' OF STONE LAYER "' `r t F , 4 . C' '
- -
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SECTION A -A ALL OUTLET PM nm THE
*NOTE. ALL PIPES ARE TO BE 4' SCHEDULE 40 P.V.C. DNStR TION Box SHALL 1Y CONCRETE COVER "'' "
�h,.se10' min. from PROFILE VIEW OF ADDITION TO LEACHING SYSTEM SET� �AT LEAST z� � ? R
to septic tank D-BOX cover must be ��_ t` AMAOger
Existing Foundation took covers must be 6 M. of finished grade 3-r OUTLET " "s= F('ni
�V 3' of 1/8' - 1/2' Washed Peaston r KNOa(OMS _t
T.O.F. elev. = 100.00 withM 8 M. of fMlshed erode Grade over SepticTank- �� pods over D-Bar-99.00 over sAs- 99.ao 3/4' to 1 1/2 ' Washed Crushed Stone \• ss• f 1Y saET �i ��NPb J #r`
OUTLET '� °I
PENN r PVC(CAPPED)MSPEC" PORT TO BE r - 6' 0' ` ; Ed n
•_ JJ
s 0.02 3 HOLE Top OF System- Elev. -96.75 INSTALLED AND TO BE NI M 6.OF GRADE ,. .y��^+.' r pW�adkA n �
t o 14' S•0.01 a greater (H-'20)_olSt sox 3' '^""'coves •
NY Effeaths Depth 15 5 1.73•
v i \
• N EXIST. 1,000 GA _ s."� root
PEE �' PLAN SECTION CROSS-SECTION ;
FROM FOUMDATlOt lh SEPTIC TANK r r
o' H-10 i cma o 0.83' (10 inches) 5 Units 2 6.25' = 30' cn Erdn t
n an sft rC fG p ,l Ttano •A
CONCRETE Sue FouNOu►
n
n n
of 'rr 3 3>.2s' s 3 HOLE H-20 DISTRIBUTION BOX :, ; �•+w'ap
• n _..___.�. tl m Miry Arlr+LA + f
SYSTEM PROFILE " °' 37.25' NOT TO SCALE xoR ",M� -j
Not to Scale o o 3.5' 3,� 3.5' p Effective Length rn�asawfyslc.�yltzels `rr
0 0' 'oo SOIL ABSORPTION SYSTEM (SAS) GENERAL NOTES
Q Effecthre Width •
6 M.of 3le-1 1/2" 9 o INFILTATROR HIGH CAPACITY (H-20 LOADING)/ GEORGE ❑'BRIEN 1. Contractor is responsible for Digsafe notification, Verification of Utilities
NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6 BELOW GRADE compacted stone o w Bottom or rest Hole 1 Elsv.-8800 m (OR EQUIVALENT) Not to Scale and protection of all underground utilities and pipes.
Grae,a.ater Observed - ,ONE OBSERVED 2. The septic"tank on j distri ution box shall be set
NOTE: OVERALL HEIGHT OF INFILTRATOR IS 13' /EFFECTIVE HEIGHT IS 10" level on 6 of 3/4 -1 1/2 stone.
3. Backfill should be clean sand or gravel with no
stones over 3" in size.
PERCOLATION TEST 4. This system is subject to inspection during installation
by Carmen E. Shay - Environmental Services, Inc.
5. The contractor shall install this system in accordance
Date of Percolation Test: MAY 26, 2006 with Title V of the Massachusetts state code, the approved plan
Test Performed By. CARMEN E. SHAY, R.S., C.S.E. and Local Regulations.
Results Witnessed By. WAIVER (Per Barnstable B.O.H.) 6. If, during installation the contractor encounters any
EXCAVATOR: Shay Env. Svcs. I soil conditions or site conditions that are different
Percolation Rate: Less Than 2 MPI 0 36" LOT #19 from those shown on the soil log or in our design
installation must halt & immediate notification be
Test Hole Test Hole made to Carmen E. Shay - Environmental Services, Inc.
No. 1 No. 2 LOT #20 PROJECT BENCH MARK 7. No vehicle or heavy machinery shall drive over the
DEPTH SOILS ELEV. DEPTH SOILS ELEV. TOP OF FOUNDATION I septic system unless noted as H-20 septic components.
0 99.00 0 99.00 ELEV. = 100.00 (Assumed) 8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
9. All Distribution Lines shall be 4' diameter Schedule 40 NSF PVC pipes.
Sandy Loom $O"ay LOOm p ' 00 ( 10. All solid piping, tees & fittings shall be 4" diameter
10 YR 3/2 10 YR 3/2 106.66 r I Schedule 40 NSF PVC pipes with water tight joints.
0'-6" As 96.50 0"_6" As 8.50
Loamy �� � v I I � 11. Municipal Water is Connected to ALL OF The Residence and Abutting
ndyi i i Properties Within 150 Feet.
10 YR 5/6 10 IR 5/0 f I I THE PROPERTY LINES ARE APPROXIMATE AND
6'- 36" Be 96.00 SHED Failed i I
g'- �" B. �•� Leach Pit I COMPILED FROM THE SURVEY PLAN GENERATED BY
Medium/Coarse Medium/coarse I I BCAPE COD SURVEY CONSULTANTS OF HYANNIS, MA
Sand Sand j I I ENTITLED "CERTIFIED PLOT PLAN OF LOT #18 UNCLE WILLIES WAY
i I I HYANNIS, MA, DATED FEB. 20, 1978
25 r 7/4 25 r 7/4 i 0I i I 36'- 132 G 36"- 132 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
C,
unkipat-yyat6f,.Etne. -..- IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
I
f164 I I Q THE SEPTIC SYSTEM INSTALLATION.
r I---,
i LQ__J 2E ISTING LL EXISTING LEACH PIT TO BE PUMPED OUT AND FILLED IN PLACE
EDROOM
D-Box EXI T. 1,000 GAL HOUSE I y
SEPTIC TANK I ( t- NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
TEST HO�E #1 = FROM THE EXIST. CESSPOOL LEACH PIT TO BE DISPOSED
LOT #17 ELEV.- '99.00 - I I ( OF AS PER BOARD OF HEALTH SPECIFICATIONS.
i b -HERE ARE Div 'WETLANDS ARE PRESENT WtTHMI- 200' OF THE PROPERTY
Perc #1 � .`.. . �• i DECK PORCH
Depth to Pere: 36' to 54" I
Perc. Rate= 2 MPI -r. -_. I I ASSESSORS MAP 292 PARCEL 321
Groundwater Not Observed C ' • ` T S' - --} LEGEND
No Observed ESHWT 1 O M ".% I 26, v
ADJUSTED H2O Elev. = None O f. • t GARAGE
DENOTES PROPOSED
�;_ • TEST HOLE #2 104X 1
�l SPOT GRADE
4.5'
2-1e"aAet• ACCESS MANHOLES /� ELEV.= 99.00 '�/ .� t � DENOTES EXISTING
L
--'�LOT #f8 SPOT GRADE
f0,377 Square Feet +/- PL PROPERTY LINE
OU11 JETi N30.52' i --I96� PROPOSED CONTOUR
V ,HE ACCESS COVERS FOR 1NE SEPTIC TANK, / --- -- -gq EXISTING CONTOUR
g oISIRNBUTIon Box AND LEACHING COMPONENT $�� /
SET DEEPER THAN 6 INCHES BELOW FINISHED
'''=•`'" ^ '"~� Ae GRADE SHALL BE RAISED TO WTHM 8'OF 99
STEEL REINFORCED PRECAST CONCRETE FINSfED GRADE - 9 '� DEEP TEST HOLE &
PLAN VIEW I+SMAUL 7W-WM 03 BAMES OR EQUALS PERCOLATION TEST LOCATION
�-3-24•REk1ovANBE COVERS-� �I�IA s S� +S� pL►A OJO .---. 6 FOOT STOCKADE FENCE
- (40 FOOT RIGHT OF WAY)
-, a d�
•mkt.clearanceLn
`' 13' tMltT
OUT 8'min(- Y mk4 Net to ommem s.
ouna f
P LOT P LAN
E# g' 2, " d°p""` '
OF PROPOSED SEPTIC SYSTEM UPGRADE
11
_ PREPARED FOR
g-D- 4'=1 MR. WILLIAM T. HEISLER
CROSS SECTION END-SECTION
AT
TYPICAL 1000 GALLON SEPTIC TANK #64 UNCLE WILLIES WAY
NOT To SCALE HYANNIS, MA
t Bedroom
Design Calculations D Kitchen/ o m tta of PREPARED BY:
Number of Bedrooms: 2 Bedroom EXISTING
Garbage Grinder No m CAR li N E. SH Y
Leaching Capacity Required: 330 Gal./Day (MIN. PER TITLE V) �G
m
Septic Tank : - 2 x 330 Gal./Day = 660 USE EXIST. 1,000 GAL Septic Tank. '` ENVIRONMENTAL SERVICES, INC.
SOIL ABSORPTION AREA: Using percolation rate of C2 min./inch 0 iv, Bedroom
Roo �'
Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallons X f[Bedroom �. 1
Sidewall Area: 0.74 al./sq. ft. x 78 sq.. ft. _ 58 gallons _ P.O. BOX 627
g g 0 20 40 50 OI s?IER�o EAST FALMOUTH, MA 02536
Providing: = 331.80 gallons S
2 BE HOUSE FLOOR SCHEMATIC ANITAR�P TEL/FAX 508-539 7966
Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, "
TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE (Description Provided By Owner) SCAL 1 --
20 DRAWN BY: CES DATE: MAY 30, 2006
ON THE ENDS. NO STONE UNDER. SCALE: 1"=20' PROJECT#SD922 FILENAME: SD922PP.DWG SHEET 1 OF 1