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0114 UNCLE WILLIES WAY - Health
L cle Willies Way 003013 f I I I I ., TOWN OF BARNSTABLE LOCATIONEWAGE ' f.ZOB�'®� . VILLAGE47 ASSE SOR'S LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY >� -� � LEACHING FACILITY: (type) m/ /ext S (size) NO.OF BEDROOMS _ r �/® BUILDER OR OWNER PERMITDATE: �" 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 a Feet Furnished by IANeI- wtL LICs WAY A F fl i' No. d`C ) +� Fee �� ✓ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC-HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppfication for niopogal *pgtem Conotructiou Vermtt Application for a Permit to Construct(.;_)Repair(X)Upgrade( )Abandon(X) ❑Complete System 5�Individual Components Location Address or Lot No. 114 uncle Willie' s Owner's Name,Address and Tel.No. (5 0 8) 7 7 8—1415 Assessor'sMap/Parcel Way Susan M. Berger,. 114 Uncle Willie ' 292-003-013 Way, Hyannis, MA 02601 Installer,/ ss� .�LdG�� /� ,A A Designer's Name,Address and Tel.No.Ronald BukO Sk1 CGE Engin. , Inc. , POB 456 , Sagamor �-7 MA 02561 (508) 833-2250 Type of Building: Dwelling No.of Bedrooms 3 Lot Size 14, 670 sq.ft. No Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 330 gallons. Plan Date 1121103 Number of sheets 1 Revision Date Title Septic System Repair Design Size of Septic Tank Existing 1, 000—gal Type of S.A.S. Infiltrator Description of Soil 0-10" A - Loamy Sand, 10-126" Cl - Gravelly Sand 126-150" C - Gravelly Sand High groundwater estimated at 126" (10 . 5 ft) Nature of Repairs or Alterations(Answer when applicable) Failed 1eachi ng pit-t i-o he replaced by Infiltrator absorption system in Bed configuration. 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 Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b o ���� Si ne Date 7 Application Approved b Date 7 -a-a a-3 Application Disapproved for the following reasons Permit No.0= --3_ Date Issued "7d Pz�-2:�-/0 25 g a No. Fee .,\ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes -PUBLIC-HEALTH DIVISION -TOWN OF B.ARNSTABLES MASSACHUSETTS r x ZIppYicatton for Migogar 6pgtem Construction Permit Application for a Permit to Construct ZKX)Repair(X )Upgrade(„ )Abandon(X') 4❑Complete System X1 Individual Components Location Address or Lot No. 114 Uncle Willie' s Owner's Name,Address and Tel.No. (5 0 8) 7 7 8—1415 Assessor'sMap/Parcel Way Susan M. Berger, 114 Uncle Willie's ' 292-001-013 Way, Hyannis, MA 02601 ' Installer's N td ss. d Tel Isio' Designer's Name,Address and Tel.No-Ronald Buko ski �� � CGE En in. Inc. , POB 456 Sa amor Pv 3 �'�i�-S' J p•/�'S g ► i 9 -Z:r3 2- MA 02561 (508) 833-2250 Type of Building: Dwelling No.of Bedrooms 3. Lot Size 14, 670 sq,ft, No -Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow' 3 3 0 gallons per day. Calculated daily flow 3 3 0 gallons. ' Plan Date Number of sheets Revision Date Title ep lc System Repair Design Size of Septic Tank Existing 1,000-,gal Type of S.A.S. Infiltrator Description of Soil -- P-10"A"- Loamy Sand, 10-126" Cl - Gravelly Sand r. - - GraveIIy Sand - High, groundwater, estimated at 126" (10 .5 ft) Nature of Repairs or Alterations(Answer"Ww en applicable) Failed leaching pit to be replaced by Infiltrato`r�ab gpptgpn- system in Bed configuration. Date last inspected-,III 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 0 'j Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b >t_his ��-/�3 Si ne Date 7 Application Approved b Date as C 3 Application Disapproved for the following reasons Permit No. GLCO 3 3 -7 Date Issued - . -4-a' C, THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired (XX) Upgraded( ) Abandoned( X)by at 114 Uncle Willie' s Way, Hyannis has been constru ted i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 200 3-3 37 dated 7 12 U I Installer Designer R. Bukeski., CGE Engirt. , Inc. The issuance of this ermit shall not be construed as a guarantee that the syste tion s d ed►. Date-7 - "o 3 Inspector ---------------------------- — -- No. 2-V)3" 33r1 Fee - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC H.; LTH DIVISION - BARNSTABLE, MASSACHUSETTS s Miqogal bpztem Congtruction Permit Permission is hereby granted to Construct( )Repair(X�Upgrade'( )Abandon(X ) System located at 114 Uncle Wil-lie' s Way;, Hyannis and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of thr e Date:_ -7 /tea`` c' Approved by TOWN OF BARNSTABLE /f LOCATION ! ✓f CG EWAGE #J''&4.3— 3 VILLAGE_4 ASSE�SOR'S MAP A LOT INSTALLER'S NAME dt PHONE NO. SEPTIC TANK'CAPACITY /fd0 e�z I LEACHING FACILITY: (type) �61A'�S (size) NO.OF BEDROOMS _ BUILDER OR OWNER PERMTTDATE: .COMPLIANCE DATE: IL d d 3 Separation Distance Between the: � Maximum Adjusted,Groundwater Table to the Bottom of Leaching Facility � ��' �r 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) a �� Feet } Furnished by ��.��l�c k LJ 4 4 I l s i I o`,H,E r Town of Barnstable PH ti I Department of Regulatory Services a�alvarear� i Date 7 �r,17 � 19AMIL Public Health Division .� `bJ0 ►��� 200 Main Street'Hyannis MA 02601 rEo tM'1 S o 3 Time Fee Pd. Date Scheduled _ Soil Suitability Assessment for Sewage Disposal �> n •1C0�K( /�.f !1P• Witnessed Performed By: I�Gn�Ac i'F i ., 6 fEl P.1 ti,� rJvmer's Name Lora Nddress I ly uh e l Wi 4er U7 &7 )"1 _fVr r Address l 14 O Ucter h 14,1 s VA ��' 1' Assessor'sMap/Parcel: 7- i 2 UO 3- 01 3 Engineer's Name !oNNcO 3u146rK r ' NEW CONSTRUCTION REPAIR V Telephone# as SI _Z� 0 Slopes /o LE'b6L Surface Stones AT�RED -/�OME Land Use 'F��rin�wria� P (° ) , Distances from: Open Water Body ?/00 A Possible Wet Area T� ft Drinking Water Well �0O ft > I Drainage Way 7/ao ft Property Line �10 SW-ft Other ft i I SKETCH (Street name,dimensions of lot,exact`lcations of test holes&perc tests,locate wetlands in proximity to holes) • k . 1.=1 `TDE OG SLO PE f �I I - - - ._ . ._ __ .•_f _.. _ �_ - _SHED e �... -, - -. - .=�I7:0� - . -., --� - �. - I o I Lt RCK+.JG F+'r-y O I f trtiJ nr+G I ' O I�000•'GAL 1} DECK _ J �RI VFNRY + I BITILI I A�iAb Uf.�77✓/}P Depth to Bedrock NoT E�Cou�T6Qe� i Parent material(geologic) /- y {{ Depth to Groundwater: Standing Water in Bole: /3Z ��� /0 �fiN_ Weeping from Pit Face Estimated Seasonal High Groundwater IMSMIMM 11W, l 11 M. - +; x V' �. •., Method Used: • • r %.: `~ in. Depth Observed standing in obs.hole: in. Depth to soil mottles: /7� - R in. Groundwater Adjustment Depth to weeping from side of obs.hole: Adj.factor Adj.Groundwater'Level Index Well# Reading Date: Index Well level F 1 I Observation ,.\' �P — .,w• �,, 't Time at 9" r •-. I Hole# Time at 6" Depth of Perc I Start Pre-soak Time® H24 Time(9"-6') End Pre-soak 1 H S Zs &t dDs 29-GRL Rate MinAnch / Additional Testing Needed(YIN) Site Suitability Assessment: Site Passed V Site Failed: r►.:";"sl• r,iblie Health Division Observation Hole Data To Be Completed on Back--- L T all, a 'Depth from Soil,Horizon Soil Texture Soil W'rSoil Other Surface(n.) (USDA) (Munsell) Molding Structure,Stones,Boulders. Consistent %Gravel ARea 6L- ,! M STRAT�f�E''.o ouTwAtN. lid " C/ A?ACIV il raja is Y19 fPA V0� c- y�/8 Npe/P0P60 Ges1dEL��l 6 e�� SHME w1AO4TIo v ,4r C/, IN —114'0' C 2 2AUE'LL d g vp /0 AgsE,�cE of Ga�4v a7m,�aa �ca6 @/�� GL6YaD—L.Cef Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling' Structure,Stones,Boulders. Consistency,%Gravel T1 Soil Other Depth from Soil Horizon Soil Texture Soil Color Surface(in.) (USDA) (Munsell) Molding Structure,Stones,Boulders. Consistency,%b Gravel MIAM �4 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistene % ravel Flood Insurance Rate Map: &.001 XA YO/ Jae 2I /9�2 Above 500 year flood boundary No_ Yes t/ Within 500 year boundary No� Yes Within 100 year flood boundary No Y Yes Depth of Naturally Occurring Pervious Material. Does at least four feet of naturally occurring pervious material exist in all azeas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on 9� (date)I have passed the soil evaluator examination approved by the Department of Envrronmental Protection and that the.above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. "�� Tate 711-1fd—? s /01 sji FORM IL. $01L.EVALUATOR FORIA Page 1. No.. ... Date........7/18/03......... Commonwealth of Massachusetts Hyannis-Barnstable, Massachusetts .Soil Suitability Assessment-for On-site Sewage Dispos i Performed By: .........Ronald F. Bukoski, P.E., L.S.P. Witnessed By: Samuel H. White, R.S.- Barnstable,Health.JnApector..... ::.. ...._. a.,.. ......:. .. . ....................................................................... .............................................................................__.._........................................................................................... Lawa+ 114 Uncle Willie's Way a—'.N • Susan M. Berger Map 292, Parcel 30, Lot 13 Addn".ii0 114 Uncle Willie's Way 14,670 s.f. T°k°�° Hyannis, MA 02601 (508) 778-1415 New construction ❑ Repair Office Review Published Soil Survey Available: No ❑ Yes Year Published 1993 Publication Scale .....1.:25,000 Soil Map Unit ....EaA_ Drainage Class Exc./Rapid Soil Limitations .....R isf.dreinase..#oc.septic.sxss.�m�,............................ ............ Surficial Geologic Report Available: No Yes ❑ Year Published Publication Scale .................. Geologic Material (Map Unit) ......... ..: Landform '............ .. Flood Insurance Rate Map: 250001 0016 D, July 2, 1992 Above 500 year flood boundary No ❑ Yes Within 500 year flood boundary No.- ® Yes ❑ Within 100 year flood boundary No ® Yes ❑ Wetland Area: N/A National Wetland Inventory Map (map unit) ........................................................................................................ ... Wetlands Conservancy Program Map (map unit)...................-. ............................................................................. Current Water Resource Conditions (USES): Month ......jMfle.2003 . Range : Above Normal ® Normal ❑ Below Normal ❑ Other References Reviewed: Hyannis USGS Quadrangle Map 1979 . E FORM 11-SOIL EVALUATOR FORM Page 2 On-site Review Deep Hole Number TP-1 Date: 7/18/03 Time: 1000 Weather Clr, 80s F Location(identify on site plan) Land Use Residential Slope(%) Level Surface Stones None Vegetation Lawn- Sparsely grass&weed covered. Landform Glacial Outwash Plain Position on landscape(sketch on the back) Distance from: Open Water Body >100 feet Drainage way >100 feet Possible Wet Area >100 feet Property Line 40 feet SW Drinking Water Well >100* feet Other *Town water. Surface Elevation: 91.0 ft-Assumed datum. DEEP OBSERVATION HOLE LOG Depth from Surface Soil Soil Texture Soil Color Soil Other (inches) Horizon (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency,%Gravel 0- 10" A Loamy Sand 10YR2/2 None Area previously mined for ' gravel. Loam placed for lawn. 10- 126" C1 Gravelly 10YR5/4 gradational Stratified outwash. Sand Gravelly Sand,c-f Sand, 5- 15%c-f subrounded Gravel, <2%nonplastic Fines, damp,light brown to tan with pronounced to faint gradational mottling 10YR5/8. 126- 150" C2 Gravelly 10YR6/4 None Gradation same as Cl. 1 Sand Absence of gradational mottling at 126",gleyed- like soil. Bottom of TP(in.) 150" Dimensions: Length(ft) 7 Width(ft) 6 i Parent Material(geologic) Glacial Outwash Depth to Bedrock: Not Encountered Depth to Groundwater: Standing Water in Hole: 132"@ Weeping from Pit Face: 144" 10 min. t Estimated Seasonal High Ground Water: 126" I FORNI U EVALUATOR FOPM Page 3, Determination for Seasonal High Water Tab e_ Method Used: D Depth observed standing in observation hole-...132.... inches - Depth weeping from side of observation hole....��44.... inches 0 Depth to soil mottles ...1.4..... inches ❑ Ground water adjustment feet Index Well Number Reading Date ................... Index well level ................. Adjustment factor Adjusted ground water level ................................._..................... Depth of Naturally Occurring Pervious Material I Does at least four feet of naturally occurring pervious material exist in all areas ► observed throughout the area proposed for the soil absorption system? YES If not, what is the depth of naturally occurring pervious material? Certification I certify that on 4/95 (date) I have passed the examination approved by the. Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience } described in 310 CMR 15.017. { Signature �, �L�-..•� Date 7/18/03 C•�eJ _zziw *Estimated seasonal high groundwater at 126" below grade, elevation 80.5 ft, July 18, 2003. Based' on the July 7,1983 groundwater assessment associated with the original septic system design, no groundwater was encountered to 13.5 ft below grade, elevation 75.77 ft. The calculated high groundwater level used in the original design was elevation 80.0 ft. 1 I b I FORA4 12 - PERCOLATION TEST t I Location Address or Lot No. 144 Uncle Willie's Way COMMONWEALTH OF MASSACHUSETTS Hyannis-Barnstable. Massachusetts Percolation Test' Date: _71.18/03.. , Time:. 1112 hrs,,,:..,. Observation Hole # TP-1/13-1 Depth of Perc 22 to 40"- Start Pre-soak 1112 hrs End Pre-soak 1.114 hrs 25" (24 gals) Time at 12" Time at 9" Time at 6" Time W-61 Rate Min./Inch < 2 min./in. " Minimum of 1 percolation tact must be performed in both the primary area AND reserve area. j Site Passed Site Failed ❑ Performed By: Ronald F. B ikoski. P.E.. L-IS_P_ w tnessed By: Samuel H. White, R.S. - Barnstable Health Inspector v � Comments' for <2 min./in.,.... . _.. � n.. .m..m..„ �..,.. ,�wµ_._ w.,.».,...,.. .. DBP APPROVED FORM•12MI" I i 3 ROWS OF 8 STANDARD HID INFILTRATORS WJ 6 END PLATES CONFIGURATION: 9.5' WIDE 50' LONG S 14'36'55" W 115.00' J wow CHIPS ��— ___ o � T — VENT WITH CARBON FILTER D-BOX OBSERVATION PORT P-1 _ EXISTING _ 91 411 {--� - TOE OF SLOPE SHED FINISH GRADE 2X SLOPE SW °—"t EACHING PIT 91.0 TO 90.0 8E PUMPED i WITH SANG � TO TITLE 5 RESERVE AREA- SPARSEUY GRASS 9.5' X 50' AND WEED LOX*, COV ED Z In EXISTING_ EXISTING ,. _a V InP, 0' 1,000-GAL. N q SEPTIC TANK ` I V N in a V p 01_ N DECK DRAIN 0 TOP OF FOUNDATION 91.50 ASSUMED 90.5 86.0 #114 3 BEDROOMS i�8x3 RAISED RANCH G w DRIVEWAY LAWN BITUMINOUS N PAVEMENT W 115.00' uP N 14 36'55" E ---G —c 's,_i EDEGE OF PAVEMENT UNCLE WILLIE'S MAY SITE PLAN SCALE 1 " = 20' r oFINE•�,ti Town of Barnstable Department of Health, Safety, and Environmental Services BMWffrABM MAN. i639. Public Health Division ♦0 ArFa'A°'sp 367 Main Street,Hyannis MA 02601 Office:.508-790-6265 Thomas A.McKean FAX: 508-775-3344 Director of Public Health March 25,2005 Liberina Pinheiro 5 Alicia Rd. Hyannis,MA. 02601 NOTICE TO ABATE VIOLATIONS OF THE TOWN OF BARNSTABLE CODE 4360 20 (I) AND4170-1 The property owned by you located at 114 Uncle Willie's Way,Hyannis;MA. was inspected on March 21, 2005.by Donald Desmarais,Health Inspector for the Town of Barnstable because of a complaint regarding overcrowding. The following violations of the Town of Barnstable On-Site Sewage Disposal Systems Ordinance, §360,Town of Barnstable Rental Property Ordinance §170 were observed: §360-20 (I): Criteria for Determining System Repair or Replacement There were a total of seven(7) bedrooms observed in this dwelling;three were upstairs, and four were within the basement. However,the existing septic system was not designed for seven bedrooms. The septic system which was installed July 30,2003 was designed for three(3)bedrooms. $170-1: Posting of Name of Owner: Name, address and telephone number of owner not posted on a twenty(20)square inch sign outside the dwelling adjacent to the main entrance.. You are ordered to either (A) upgrade your septic system to accommodate seven bedrooms (which would require hiring an engineer to design the upgrade and an installer to put in the system. You also would be required to apply to the Board of Health for permission to have six (6) or more bedrooms.) or (B) remove the bedrooms from the basement by removing entrance doors, by removing the beds, and by opening all door-way entrances (by partially removing walls) to each room in the basement to minimum of five feet wide openings within ten days of your receipt of this letter. You are also ordered to post your name,address and telephone number on a twenty(20)square inch sign outside the dwelling adjacent to the main_ entrance within twenty-four(24)hours of your receipt of his letter. You may request a hearing before the Board of Health if written petition requesting same is received within seven(7)•days after the date the order is served. Non-compliance will result in the issuance of non-criminal ticket citations of$100.00 each. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF T BOARD OF HEALTH rnmas A.McKean Director of Public Health T r -10-N-WEAU-1H OF AC EXECU-T;VE OFFICE OF ENVIRONMENTAL AYFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION s� TITLE S OFFICIAL,INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A � /J� CERTIFICATION C ill lJC1 g 3 Property Address4-6 . ett � % Owner's Name: Owner's Address !! Date of Inspection: na Mime of Inspector:jplease print) Company Name: �-� ; ! _= „„; Mailing Address- Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the inf ion reporoed 'below is true,accurate and complete as of the time of the inspection.The inspection was performed ased oncitiiy 11 tt'aining and experience in the proper function and maintenance of on site sewage disposal systems. am a DEP approved system inspector pursuant to Section 15340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails s Inspector'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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the feature under l conditions of use. er the same or different , -title 5 10t*.tWn Fort: 6I15/2000 page 1 r� r l?age 2 of l I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUIRSURFACE SEWAGE DLSPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: �frvn Owner: Date of Inspection: 7j3,C _ Inspection Summary: Check A,B,C,D or 1 ALWAYS complete all of Section D A. System Passes: 403 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 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"se need to be replaced or repaired.The system,upon completion of the replacement or repair,as approv v the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the fo statements.If"not determined"please explain. The septic tank is metal and over 20 years old* a septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic as approved by the Board of Health. *A metal septic tank will pass inspection if it' structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 ye old is available. ND explain: Observation of sewage ackup or break mtt or High static water level in the distribution box due to broken or obstructed pipe(s)or due to roken,settled or uneven distribution box.System will pass inspection if(with approval of Board of He ): broken pipe(s)an replaced obi is removed distribution box is leveled or replaced ND explain: system required pumping more than 4 times a year due to broken or obstructed pipes).The system gilt pass on if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 i Page 3 of t: OFFICE INSPEf--,IQN FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORIM PART A CERTIFICATION(continued) Property Address:L- � Owner: n — Date of inspection: C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order t 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 0 CMR 15.303(l)(b)that the I system is not functioning in a manner which will protect public healt ,safety and the environment: I — Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated tland or a salt marsh 2. System will fail unless the Board of Health(an ublic Water Supplier,if any)determines that the System is functioning in a manner that protects t public health,safety and environment: _ The system has a septic tank and soil sorption system(SAS)and the SAS is within 100 feet of surface water supply or tributary to a s ce water supply. The system has a septic tank an AS and the SAS is within a Zone I of a public water supply. _ The system has a septic and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septi 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' the well water analysis,performed at a D£P certified laboratory,for coliform bacteria and volatil organic compounds indicates that the well is free from pollution from that facility and the presence of onia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria triggered. A copy of the analysis must be attached to this form. ddd i 3. Other: 1}} a 1 f 3 e a - i Page 4 of l 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ' q SUBSURFACE SEWAGE Ili POSAL SYSTEM INSPECTION FORM PART. - CERTIFICATION(continued) Property Address: l c`t! Wr•(clS Gc��y Owner: 446 r4A,wireo } Date of Inspection: IV k D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No -jr 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 5"below invert or available volume is less than'/s day flow Required pumping more than 4 tunes in the last year NOT due to clogged or obstructed pipe(s).Number Of times pumped 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 i of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.(This system passes if the well water analysis, performed at a DEP certified laboratory,for coMrm bacteria and volatile organic.compamods 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 S ppm,provided that no other failure criteria are triggered.A copy of the analysis must he attached to this form.} /I(YeslNO)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. �II E Large Systems: To be considered a large system the system must serve.a facility with a gn flow.of 10,0W gpd to I5,M You must indicate either`yes"or"no"to each of the following: (Me following criteria apply to large systems in addition to. criteria above) j yes no the system is within 400 feet of a s drinking water supply — the system is within 200 feet o tributary to a surface drinking water supply — ` the system is located in ogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public supply well If you have answered"y to any question in Section E the system is considered a significant threat,or answered "yes"in Section D e the large system has failed The owner or operator of any large system considered a. significant threat Section.E or failed under Section D shall upgrade the system in accordance with 3I0 CMR 15.304.The sy in owner should contact the appropriate regional office of the Department. 4 Page 5 of 1 l OMCIAL _INSPECTION E(IR�vI IiIGT FOR VOLUNTARY ASSESSMENTS $UIBSUR—I?ACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM � PART B CHECKLIST Property Address: 0140 !d/r6l1�5 ®wrier: it-!�► c i f'�D Date of Inspection: Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No — Pumping information was provided by the owner,occupant,or Board of Health _ Were any of the system components pumped out in the previous two weeks?. 4 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? i Were as built plans of the system obtained and examined?(If they were not available note as N/A) _ Was the facility or dwelling inspected for signs of sewage ba&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 afB of the bes 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 m tenance of subsurface sewage disposal systems? The size and location of the.Soil Absorption-System(SAS)on the site has been determined based on: Yes no Existing.information.For example,a plan at the.Board of Health. d _ Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance ptable)[310 CUR I5.302(3)(b)] I �I 5 Pie 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR YOI UNTARY ASSESSMENTS SUBSURFACE SENYAOE DISPOSAL SYSTEM INSPECTION FORM PAIN C SYSTEM INFORMATION Property Address: 1/4VA 1��1 X/ al4 y Owner: `rd Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual):_, DESIGN flow based on 310 C I5203 (for example: 110 gpd x#of bedrooms):"d Number of current residents: Does residence have a garbage grinder(yes or.no) 4W Is laundry on a separate sewage system(yes or no): ArO[if yes separate inspection required] Laundry system inspected(yes or no):AV Seasonal use:(yes or no): kO Water meter readings,if available(last 2 years usage(Gggpd)): Sump pump(yes or no):AV Last daze of occupancy: COMMERCL VIN DUSTRIAL Type of establishment: Design flow(}used on 3I0 CMR 15.203): opd Basis of design flow(seats/persons/sq c.): Grease trap present(yes or no): Industrial waste holding tank p ent(yes or no):_ Non-sanitary waste dischar to the Title 5 system(yes or;no): Water meter readings,if "lable: Last date of occupan use: OTHER(desc ' ): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):_0 If yes,volume pumped: gallons—Mow was quantity pumped determined`' Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption.system Single cesspool Overflow cesspool _Privy Shared system(yes or no)(if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval _Other(describe): ti Approximate age of all components,date installed(if known)and source.of.information: Were sewage odors detected when arriving at the,site.(yes or no): /V 9 , 6 page.?of I I { OFFIC'AL L'SPECTION FOB'_NOT FOR VOLUNTARY ASSESSMENa rS SUBSURFACE SERFAGE DISPOSAL SYSTEM INSPECTION FORM PART C INFORMATION INFOATION(continued) Property Address; / !r I SYSTEM) t!s Lis Owner: Date of Inspection: 6 BUILDING SEWER(locate on site plan) . k Depth below grade: oZ� Materials of construction:_cast iron 4 40 PVC_other(explain): 1 Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc..): SEPTIC TANK: K (locate on site plan) DO Depth below grade: c Material of construction: concrete—metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):certificate) `(attach a copy of . Dimensions: Sludge depth: 3 u Distance from tap of sludge to bottom of outlet tee or baffle: f7 Scum thickness: ness: Distance from top of scum to top of outlet tee or baffler Distance from bottom of scum to bottom of outlet tee or affle: How were dimensions determined: �t[ �/'k�� Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as relatedIV outlet in eM evidence of leakage,etc.): s GREASE TRAP:—(locate on site plan) Depth below grade:— Material of construction, concrete metalXf1i' alaSs I e le e(explain): ,_po y thy n `other Dimensions: F i Scum thickness: f Distance from top of scum to top of aZettee baffle: Distance from bottom of scum to b om of outlet tee or baffle: Date of last pumping: Comments umon ( pumping reco endations,inlet and outlet tee or baffle condition,structure!integrity,Iiquid levels as related to outlet invert, Bence of leakage,etc.): l 7 a Page's of I 1 , 4 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS 111. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued). I'roPerty Address:.. i/Y. r Owner:. Date of Inspection• ci TIGHT or MOLDING TANK: (tank must be pum at time of inspection)(locate on site plan) Depth below grade:. Material of construction. concrete rn r fiberglass_polyethylene other(explam): Dimensions: ' Capacity:- ons ; Design Fiow: aIIons/day Alarm present(yes or no):. Alarm level: . Al in working order(yes or no): { Date of last pumping: Comments(conditio f alarm and float switches,.etc,): . f DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Qt/ewl Comments(note if box is.level.and distribution to outlets.equal;any.evidence rof solids carryover,any evidence of leakage intq pr out of box,etc_): T� f� �u s is a PUMP CHAMBER: (locate on sit an) Pumps in working order(yes or Alarms in working order(ye r no): f Comments(note conditio of pump chamber,condition of pumps and appurtenances,etc,): l 1 F i Page 9 on.1 UF.F$�LA,INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SE*AGE 'SPOSAL SYSTEM INSPECTION FORM PART.C' SYSTEM INFORMATION(continued) Property Address: Owner- Date of Inspection: SOIL ABSORPTION.SYSTEM � •SAS . ( )• (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number leaching galleries,number. leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number innovative/alternative system Type/name of technology: Comments(note condiiion of soil,signs of hydraulic failure,level of ponding,damp.soil,condition of vegetation, re CESSPOOLS: (cesspool must be pu d as part of inspection)(locate on site.plan) Number and configuration: Depth—top of liquid to iniet in ------------ Depth of solids layer. Depth of scum layer: Dimensions of cesspoo Materials of constru on: Indication of gro water inflow(yes or no): Comments(not water of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): i PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of.solids: Comments(note Condit' of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 a — Page 10 of I I OFFICIAL,INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS � SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: /j,4/ Owner: > Date of Ins peetion: $ SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks...Locate all wells within 100 feet.Locate where public water supply enters the building. ;e 5 i I I r I 1 f I i pap I faf I I 0CL4LL INSPECTION FORM—NOT FOR'VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEMINFORMATION(continued) Property Address:�[ !/ 4y Owner: e i-0 --- �" Date of Inspection: SITE EXAM Slope P. Surface water 00 Check cellar A5 Shallow wells !" Estimated depth.to ground water o feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed:. Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USES database-explain: You mast describe how. established the high groundwater elevation: { it LOCATION �(� SEWAGE PERMIT NO. VILLAGE m�. INSTALLER'S NAME i ADDRESS 1tl Arc) B U I L D E R OR OWNER J _ Flew S 1Ce41I y DATE PERMIT ISSUED DATE COMPLIANCE ISSUED - r Q� W 3Y � OF Fizz COMMONWEALTH OF MASSACHUSETTS 0. BOARD OF HEALTH PAU LROGER 6 MICHNIEWICZ Town G3 No.113014120 CO V11 ......._.Town..---------. _0F.........BArn5t.atkle............I................ L Appliration for Dispmal Works. Toutitrurtion "pamit AL aCa Application is hereby made for a Permit to Construct ( x) or Repair an Individual Sewage ispos System at: Uncle Willie's Way- /0-/Z.93 Hyannis, MA Lot 13 ................... .............................. .................................................................................................. pf L cat' -Address -4. r N A OwnerAddress................ ...... .... .. .. ... ........ Installer Address Type of Building Size LotJ4_,.670............Sq. feet Dwelling—No. of Bedrooms............3........... ..................Expansion Attic Garbage Grinder (NO ) 0) PL4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) Otherfixtures ........................................................................ ............................................................................. Design Flow......... ......... ---------------gallons per person per day. Total daily flow----130................ ---------------gallons. P4 Septic Tank—Liquid capacityJQqP.gallons Length._8`6...... Width--- Diameter-..--.----___- Depth... Disposal Trench—No..................... Width............._...... Total Length..---............-_. Total leaching area....................sq. ft. Seepage Pit No..........1----------- Diameter........P-1----- Depth below inlet....!..AZ Total leaching area.-IM.........sq. f t. Z Other Distribution box (x ) Dosing tank ( ) Percolation Test Results Performed by...---_J Monah-.-- n,--..Jr.. - - q . .................................... Date.....UY83..................:.. Test Pit No. I......2 1-3!5'.........minutes per inch Depth of Test Pit..... ..i---- Depth to ground water------------------------ (T4 Test Pit No. 2.......2.......minutes per inch Depth of Test Pit-.._. ........ Depth to ground water........................ P4 ............................................................................................................................................................ * Description of Soil.._T.P.#1 011-1611 course sand w/ gravel trace- 16"-36" course sand and -.............................................................................................I................................................................ * gravel._w/._Fe02j. awid... race I- Q _6 p- nand.. ...... ...... wLZ3:aVe1....L -;...T.-T.-J2...0 c- ur - a d.. and-____r__av__e__1_;__, 12"-24 course__---aa)1d---an_d..9.r.a.V_P_1---W/---F.e-02-;---2A":n72_'_I...med......aarid..wl..g r,a.v P_ -.t x.a.c e &4 9a___.W Answer when applicable-------_--_.----_-----.._-_----_----_-----_-_-------------------------------------------------------------- U Nature o RepaiFs or X ions ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLITHL- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beeR issued by the boardPM)ealt�7 i ig" gned = .......... ... ... 3 ----•-----•---•--••--•-•---......•••-•-••-•-•••---•-------•-•-•Approved 134y.. ... .................................................................................. .................. Date Application Disapproved t following reasons:......................... ...................................................................................... ................................................................................................................................................................................I........................ Date PermitNo......................................................... Issued_....................................................... Date No................--•-••-•• c�1. ` F$s............... OF�,�� THE COMMONWEALTH OF MASSACHUSETTS 0�. BOARD OF HEALTH ROGER g OGE o AUL I MICHNIEWIC Z ....Town....... .....OF.... Q 0 .. ....... .... zzzts. abl ... o.30420 . . .. . . . CIVIL 1O ��'�ST Appliratilan form i #ail 3 �r ', r r ilan Plitt Application is hereby made for a Permit to Construct (x ) or Repair ( ) an Individual Sewage ispo System at: Uncle Willie's Way- p ,0'12.8,3 Hyannis, MA Lot 13 .......................� ..... .._..--•"-..........._.......-•----•._............... :"-:-"--..:---"----...._..----"-------or.._......._..___...----•----.....•-------.....---_•- i Lat Address Owner _ Addre s qd Installer Address d Type of Building Size Lot.1_4 jt?�_..________'Sq. feet aDwelling—No. of Bedroom .......... .Attic ( ) Garbage Grinder (bQ) aOther—Type of Building ........................... No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures -----------------------------------"-------...---"----...-----"-""------- Design Flow.........5....5...............................gallons per persone�er day. Total daily flow.....-334 . 1 gallons. WSeptic Tank—Liquid capacity.1444 gallons Length....•.6...... Width-.4 4����. Diameter .............Depth-'-_`�11..... x Disposal Trench—No. .................... Width ............. Total Length_._...._......R.... Total leaching area_._._..._._.._......sq. ft 3 Seepage Pit No---------- ------- ft. z Other Distribution box (x ) Dosing tank ( ) Percolation Test Results Performed b .. J. Monahan, Jr. 7/7/83 Y ----------------------•- --- Date -"•- •--- a Test Pit No. 1................minutes pe-r inch Depth',of Test Pit....135 f._.._._ Depth to ground water........................ (i Test Pit No. 2................minutes per, inch Depth of Test Pit....1..�_.._... Depth to ground water........................ O T P. 1 4" 16" "course sand wj""gravel trace; 16'` 36"" course sand"and""""" Desch tion of Soil._ ......................... x grav i w/ Fe02 36'' 1�?+' med,, saud w/ gravel_trae�.._T__P.#2 V-12" loose course sand W H# gravel; 12 -24-- course sand and gravel ) ve(l2, 24" 7l" med a sand w/ gravel trace; g 9 i6 ra. u: fat = - ......... U Nature o5t Repairs or %terations—Answer-when--applicable.: --------- --------- --------- --------- --------- ----."-.-..--__.--_-___-. .....................................................----"----------------------"--------------................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with P'1T 11'-^ the provisions of Ty.r:; 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian e has been issued by the board of lth. ' ! Signed "- ----•• --••-••----• ..�� Application Approved B}l' 4" ----"-. """-------------"-•-"-""-"--"-"- ' f Date ` Application Disapprove/d/for fze following reasons:..............................=................................................................................. ......................................................................................................................................................................................................... Date ' PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................................._.OF........................ ..................................................... �Pr ifiratr of (lumpliana T I IS: O CERTIFY]- hat the Individual Sewige .isp sal,Syste onstructed or Repaired ( ) J N. by " - .... = ---� nstaller l ..................................................... f ff at r = ................................--"------- has been installed in accordance with the provisions of T '!� ro T e State Sanitary Code as described in the application for Disposal Works Construction Permit No .------.I ---------•-.... dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST UE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............•----_.s, =g ..................................... Inspector.....-•-------- -- ----- - ----- -- _--------------------- THE COMMONWEALTH OF MASSACHUSETTS c / BOARD OF HEALTH ..........................OF...... ----.. �l� No. ................ f~ 'r i .i FEE i� to Construct or 'a` an�� . Permission •s rebY gr. ed�= = ' =,-. G ,_ / .. at No. Street as shown on the a licati for Disposal Works Construction Permit- ..... . Dated.......................................... .............••. ............-......----------------------------------"------•••------•----•_____----- DATE_.? Board of Health ... -------------"-------•-•--------------------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS q - i TP-1 Soil Profile Depth Soil Bottom Elev. Soil Color Notes (in.) Horizon (Surface Description 91.0') 0-10" A 901, Loamy Sand 1OYR2/2 Area previously mined for gravel. Loam for lawn 10-126 C1 Gravelly Sand 1OYR5 4 Stratified outwash. Gravelly Sand, c-f Sand, 5-15% c-f subrounded Gravel, <2% nonplastic Fines, damp, light brown to tan with pronounced to faint gradational mottling 1OYR5/8. 126-150" C2 78.5 Gravelly Sand 1OYR6/4 Gradation some as C1. Absence of gradational mottling at 126". SEPTIC SYSTEM DESIGN CRITERIA 1) Soil evaluation refer to soil evaluation and percolation test report prepared by CGE Engineering, Inc., July 18, 2003, performed by Ronald Bukoski, PE, LSP and witnessed by Mr. Samuel H. white, Health Inspector, of the Town of Barnstable Board of Health. 2) General soil profile at TP-1. Surface elevation 91.0 ft, based on assumed Bench Mark (BM) top of foundation (91.50 ft.), as shown on the Site Plan. i 18" WATER TIGHT RISER TO PROPOSED FLOW LINE GRADES WITHIN 6'* OF FINISH GRADE DISTRIBUTION BOX .. ..., 4" OBSERVATION MATCH TOP OF FOUNDATION ELEV=91-50f f F.G.=91.2't "' - 4" WITH 2.0' WATER TIGHT RISER AS NECESSARY' TO WITHIN 6- OF FINISH PORT TO WITHIN 6" OF FINISH GRADE EXISTING GRADE SURFACE TO I - PROPOSED - F. = G. 91.p' ,DIA. SCH . 40 PVC GRADE - -_ -. _ BE LOAM,& > A INV. - __ . AT FOUNDATION EXISTIN( - 89.02 VENT :.:.: SLtDED- -; _ ... -- _ :- . 1.0 F.G.=9° 90.0 2`e SLOPE ---► 70 SOUTHWEST B - INV. - INTO SEPTIC TANK = -EXISTING 88.28 C INV_ OUT OF SEPTIC TANK - E><ISTING 88.03 4" DIA• SCH. 40 PVC 2' LEVEL MIN. 4" ORDINARY FILL STANDARD H10 INFILTRATOR D INV- INTO DISTRIBUTION BOX 4CI'© 1.0% 87.88 01A. CHAMBERS SAX RL11V 6. E INV. OUT OF DISTRIBUTION BOX 87.71 A EXISTING B 1 ,000-GALLON SEPTIC TANK o a o o E o o 0, o F INV. INTO CHAMBER 87.64 n 10 C CLEAN GRANULAR j � /� G BOTTOM OF CHAMBERS i 87.10 SAND FILL PER 310 CMR 15.2 j\ o o \ TOP OF CHAMBERS � j\//,/�\ l�\/� \�� G H HIGH WATER TABLE NO WATER/MOTTLES ENCOUNTERED ABOVE 80.50 10' MIN. __J omwVOco vno mo v ��o n°n F 6" OF 3/4"-1.5" UNDISTURBED C1 CRUSHED STONE: ON A J B SOIL HORIZON PREVIOUSLY EXCAVATED COMPACTED BASE H SYSTEM PROFILE Percolation rate in C1 layer from 22-40", <2 min./in. Groundwater seepage, with standing I NOT TO SCALE water after 10 minutes at 132". Estimated seasonal high groundwater at 126" below grade, elevation 80.5 ft. used for design. Based on July 7, 1983 soil evaluation, no groundwater was encountered to elevation 75.77 ft. - calculated high groundwater used in original desig-1 was 80.0 ft. 3) Estimated Hydraulic Loading: Type of Establishment: Residence. Design Flow: Three Bedrooms Loading rate per bedroom - 110 gallons/day per Title 5, 310 CMR 15.203. 3 bedrooms x 110 gpd = 330 gpd. 4) Septic Tank: Existing 1 ,000-gallon concrete septic tank to remain, if in good condition. If not usable, to be replaced with new 1,500-gal septic tank. 5) Soil: Class I, perc. rate <2 min./inch. 6) Proposed primary leaching area: Infiltrator system, pursuant to Massachusetts Department of Environmental Protection's (DEP's) Certification for General Use, Transmittal No. W023699, February 21, 2003. This design uses the Standard Infiltrator Chamber in a Bed configuration. The System uses an open -bottom leaching structure which has been approved by the DEP for installation without aggregate or distribution pipes as in an absorption trench, bed or field. 7) This system is not designed for a garbage disposal. 8) Total leaching area: Bottom: 501 x 9.5' W = 475 sq. ft. Sidewall: 119 LF x 0 = 0 sq. ft. Total Area: 475 sq. ft. 9)Leaching capacity: State Environmental Code, Title 5, 310 CMR 15,242 Effluent Loading Rate for a Class I soil with a percolation rate of <2' min/in is 0.74 gpd/sq.ft. Leaching capacity: 475 sq. ft.x 0.74 = 351 gpd and is greater than the required design flow of 330 gpd. According to DEP's certification for General Use of the Infiltrator Systems, Section II - Design Standards, Paragraph 9, the effective leaching area for the Standard Chamber is 4.72 sq. ft./lineal ft. when used in a bed configuration. -this provides an equivalent total leaching area of 29.5 sq. ft./Standard chamber, with a total of 24 Chambers proposed, this equals 704 sq. ft. of absorption area, or a maximum design flow capacity of 523 gpd. This additional theoretical absorption capacity should extend the working life of the absorption system with added protection to the environment and public health. 10) No public wells are located within 500 ft. No known private wells are located within 200 ft. There are no inland banks within 200 ft.; surface waters within 200 ft; nor surface drains within 100 ft. of the septic system. 1 1) All system components and construction shall be performed in accordance with the Massachusetts Sanitary Code Title 5, 310 CMR 15.000 and Barnstable Board of Health Regulations. Any change to this plan must be approved by the Barnstable Board of Health. The Barnstable Board of Health must be notified a minimum of five working days, or as required, prior to the start of construction. To obtain the Barnstable Board of Health certification, the following inspections must be completed: a) Excavation of unsuitable materials (absorption system bottom inspection), b) Upon completion of placing backfill materials, and c) Upon installation of the system with all components exposed for inspection and preparation of the "as -built" Plan by the design engineer. 12) The contractor shall notify Dig Safe prior to start of any excavation work in order to verify the locations of existing underground utilities. Underground utilities as shown on the Site Plan should be considered approximate locations and verified in the field at the time of COrlStructlon. 13) Excavation of unsuitable soil within the footprint area of the absorption system is only anticipated to the bottom of the proposed Infiltrator Chambers, elevation 87.10. Any other unsuitable soils below this elevation should be removed and replaced with soil consisting of clean granular Sand, free from organic matter and deleterious substances. Mixtures and layers of different Classes of soil shall not be used as Fill. The Fill shall not contain any material larger than 2 inches. A sieve analysis, using a #4 sieve, shall be performed on a .representative sample of the Fill. Up to 45% by weight of the Fill sample may be retainE'd on the #4 sieve. Sieve analysis also shall be performed on the fraction of the fill sample passing the #4 sieve, such analyses must demonstrate that the material meets each of the following specifications: Seive Effective Particle % That Must Size Size mm Pass Seive 4 4.75 100 50 0.30 10-100 100 1.15 0-20 200 1 0.075 0-5 GENERAL NOTES: Record Owner: Ms. Susan M. Berger 114 Uncle Willie's Way Hyannis, MA 02601 (508) 778-1415 poi Assessors Reference Map 292, Parcel , Lot 13 2) Flood Zone: FEMA Zone C, Property located outside 500-yr flood zone, Bcrnstable Map 250001 0005 C, August 1, 1985. CHAMBER CROSS-SECTION STANDARD CHAMBER BED - NO' TO SCALE ESTABLISH VEGETATIVE FINISH GRADE COVER CLEAN GRANULAR SAND FILL TO MATCH PER 310 CMR 15.255(3) EXISTING 2% SLOPE �GR4DE i T- -I 34' f�' -171 ii -l-i TYP. STANDARD INFILTRATOR 0.5' (TYPJ (TYP.) TOP VIEW INSPECTION PORT NOMINAL CHAMBER SPECIFICATIONS SIZE (WXLXH) 24%75%12" 12" ° i wpum 6.5" INVERT EFFECTIVE LEACHING AREA ° BED .......................4.72 SF/LF TRENCH...................6.53 SF/LF r- 75" I (EFFECTIVE LENGTH) INVERT ELEVATION 6.5" SIDE VIEW POSILOCK END PLATES OPEN .................... PART STDEO CLOSED .................. PART STDE STANDARD,_ 1 s II��I IL T RATOR CHAMBER �r 34 " --{ CROSS SECTION VIEW NOT TO SCALE i WEATHER CAP X45 THREADED .PLUGACTIVATED CARBON 2.5" SCREEN PLATE NOTE: USE ENGINEERED SPECIALTIES CORP. 101 COMMERCIAL WAY, EAST PROVIDENCE, R.I. OR EQUIVALENT VENT CAP. VENT CAP DETAIL NOT TO SCALE VARIANCE REQUEST S No variances are requested from the State. Environmental Code Title 5. SUGGESTED SYSTEM MAINTENANCE 1) Provide a permanent septic system chart/plan at a location near the building sewer exit which shows the as -built location on the lot of the septic tank, pump chamber, .distribution -box, and the primary leaching area. 2) Suggested System Inspection: At a minimum, an annual inspection of the septic tank and pump chamber should be performed by a qualified person. The septic tank should be pumped at the owner's expense every one to three years, subject to use or when the combined E depth of the sludge at the bottom of the tank plus the depth of scum at the top of the tc_-�k is greater than 1.0-foot. EXISTING LEACHING PIT TO BE PUMPED AND FILLED WITH SAND PURSUANT TO TITLE 5 Ld o � N LC) CV in r_ 30 1/2" 3, 5" DIA. INLET 15 1 /2" rlll INLET i I 5, 5" OUTLETS ?" WALLS W/SPEED LEVELER I I f�f IN! 0 J m 6.. i 8" 2,. 020o020•0000000000�- - BASE 'SET ON 6" OF 3/4" STONE PRECAST DISTRIBUTION BOX DB-5 OR EQUAL W/BAFFLE OR INLET TEE CONCRETE MINIMUM STRENGTH - 4,000 P.S.I ,L' 28 DAYS STEEL REINFORCEMENT - ASTM A-615 GRADE: 60. V MIN. COVER DES:_-N LOADING - LIGHT DUTY DISTR18UTION BOX DETAIL' NOT TO SCALE 3 ROWS OF 8 STANDARD H10 INFILTRATORS W/ 6 END PLATES CONFIGURATION: 9.5' WIDE 50' LONG S 14'36'55" W 115.00' J WOOD CHIPS _T �I VENT WITH CARBON FILTER D-BOX OBSERVATION F3RT t P-1 I EXISTING 31xt '-- _-- - - TOE OF SLOPE SHED I FINISH GRADE 2% SLOPE SW '�� I __1 4;- i 91.0 TO 90.0 RESERVE AREA - S1ARSEJY GRASS 9.5' X 50' AND WEED i COV RED ...., , 0.00' Z EXISTING _ 0 1,000-GAL N U; SEPTIC TANK I v N 0 ! cn w -40 J V DRAIN 2°';0�{ � DECK B.M. I --- TOP OF FOUNDATION 91.50 ASSUMED 90.5 #114 3 BEDROOMS E13r:i RAISED RANCH / G W DRIVEWAY LAWN o BITUMINOUS PAVEMENT N W 1 15.00' N 14'36'55" E UP c c EDEGE UNCLE WILLIE'S WAY SITE PLAN, SCALE 1 " = 20' N cti � RrF RO 3? ALICIA RD�J S _ FP`MOUjN RD RTE 28 UNCLE WILLIE'S WAY SITE tYFST �lq/h ^ LOCUS MAP NOT TO SCALE LEGEND 89.0 PROPOSED GRADE UOxO EXISTING GRADE W,G.F UTILITIES TEST PIT AND PERCOLATION TEST LOCATION REVISIONS No. Revision _ _ - _ Date _ I BOARD OF HEALTH STAMPS ENGINEER'S CERTIFICATION I HEREBY CERTIFY THAT THE SUBSURFACE SEWAGE DISPOSAL SYSTEM SHOWN HEREON HAS BEEN DESIGNED IN SUBSTANTIAL CONFORMANCE WITH THE STATE ENVIRONMENTAL CODE, TITLE 5, AND TOWN OF BARNSTABLE BOARD OF HEALTH RULES AND REGULATIONS. � �_1t1 OF 4f4,90, RONALD F. o BUKOSKI CIVIL "' ' No' 32024 Q/S 6 RONALD F. BUKOSKI, P. DATE SEPTIC SYSTEM REPAIR DESIGN 114 UNCLE WILLIE'S WAY, HYANNIS, BARNSTABLE, MA 02601 0WNEr': MS. SUSAN M. BERGER 114 UNCLE WILLIE'S WAY, HYANNIS, BARNSTABLE, MA 02601 ENGINEERING FIRM: CGE Engineering, Inc. Civil ♦ Geotechnical ♦ Environmental DATE: 71191 ,03 CONTACT PERSON: RONALD F. BUKOSKI, P.E., L.S.P. ADDRESS: 21 HILLTOP DRIVE, P.O. BOX 456 SAGAMORE, MASSACHUSETTS 02561 TELEPHONE: (508) 833-2250 DR. BY: 3RAWING NO. 1 I CKD. BY: RFB I CAD FILE NO: 030713 PROJECT NO: 030713 SHEET 1 OF 1