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Home My WebLink About0136 UNCLE WILLIES WAY - Health 136 UNCLE WILLIE WAY,HYANNIS A 292 003 - i I o I I I e TOWN OF BARNSTABLE LOCATION L3�'n Wd e-s W SEWAGE# e� VILLAGE AI AIDS ASSESSOR'S `MAP&PARCEL /y 'INSTALLER'S NAME&PHONE NO. CV V ('�'d S�:PrG D 7 S-'2-9 2.Jl SEPTIC TANK CAPACITY 0(Uf0->C lobo! ,,y( }- %ODp yA-( LEACHING FACILITY:(type)CD) L C (size) 5U�A I I ,A NO.OF BEDROOMS y OWNER PERMIT DATE: /�� ,`j�' COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility .64 � 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 facili /jam Feet r FURNISHED BY Gl,� J � � r a Go cr � � o c CIO TOWN OF BARNSTABLE L�Dr,.,ATION I/�lra 'LU ® / .- SEWAGE # VILLAGE IPIt /< ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY law LEACHING FACILITY: (type) "IA"d`X&I;0RS (size) �� 0 lJ _ NO.OF BEDROOMS BUILDER OR OWNERIIZAC� 4-&4911&J 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 fee f I Wchicility) Feet Furnished b If - =1 tAt, Z ��,� � �� ... � � r � � � � � �� c; \� � � � � ' � _ -� No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 9ppliYation for Mispo8al 6pstem Construction Permit Application for a Permit to Construct( ) Repair(l<'Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No./ uOt/e corn 6Co2V '�P Owner's Name,Address,and Tel.No. GC o 791 3 Assessor's Map/Parcel :? o®3 Installer's Name,Address,and Tel.No. -Svc— t79 "'?� Designer's Name,Address,and Tel.No. J yTT 3��J� .. C7a 1 d�•rG Cr�a/ ,yr'�dh C Type of Building: Dwelling No.of Bedrooms Lot Size 2 7� �yJ sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required �>�� gpd Design flow provided L�9 3 gpd Plan Date /2 ''�� Number of sheets 2 Revision Date Title Size of Septic Tank — /O 6 O /�� Type of S.A.S. Description of Soil r t Nature of Repairs or Alterations(Answer when applicable) f // oo�4 cp ee-a 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 of Health. Signed - n Date �/ :Z�/��L r Application Approved by `t�_ Date 1-2 Application Disapproved by ( Date for the following reasons Permit NO. Date Issued 0_ *^'vf ..'{ems.-'',.t. .} Trvr+:_ro4.'F.rl�(,t. .^.,..�4�y.,'� 'sidbG,i•i.'r-,,,,!'..r'rtn.. h •+;A'+`M,:, .t.4 ,q,..RY?w.l {M..y,i,,,.,:.s•n'°e�" '1..,� r...,,,••'' .�.s'` ,.:".^v"-r r { Y No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes 1/ V..' PUBLIC HEALTH DIVISION DOWN OF BARNSTABLE, MASSACHUSETTS Owplitatlon for Mfso,osal *pstem Construction Permit Application for a Permit to Construct( ) Repair( pgrade( ) Abandon( ) Li Complete System El Individual Components t Lobation Address or Lot No:/ 74' a4-'1e Owner's Name,Address,and Tel.No. 7s3-GG o- 79`7 o Assessor's Map/Parcel .? e 0 3 Installer's Name,Address,and Tel.No. '��" r�� '" Designer's Name,Address,and Tel.No. J-d' yTT- S a/Jo /� / .-e-eo, �'a✓<''c vain. c'c,�ac S�'rt.-c •a9 r'wE�er�'•jy cr�c��✓r,s f_a - 'e/ S-7- 11,7 Type of Building: , Dwelling ,No.of Bedrooms Lot Size a 7,'�y'/ sq.ft. Garbage Grinder( ) Other Type'of Building No.of Persons Showers( Cafeteria( ) Other Fixtures Design Flow(min.required r,/�� ...`' " gpd ' Design flow provided 41 � gpd Plan Date /Z� j//y Number of sheets Revisio Date Title Size of Septic Tank Type of S.A.S. Description of Soil /,•�, �'�,� /y �' -' Nature of Repairs or Alterations(Answer when applicable) / ✓.Ucf,( 5; te.>.6.A // �X_j'O c 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 o f Health: Signed .� f n Date / .? /. Application Approved by _(-,L,.Q- li_?'. Date - Application Disapproved by { Date for the following reasons Permit No. epof ic, Date Issued THE COMMONWEALTH OF MASSACHUSETTS f BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by at has U'een constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. adl r 71ted Installer -�_- �as"' '"" - Designer #bedrooms Apprpved'd`esign_ flloow, 41 y? gpd The issuance of this permit s fu shall not be construed as a guarantee that the system will ncti igned. Date Inspector / - . . . -- ------- --- -- --- --------- ----- ------- -------- ---------------------- No. 'PDl 3 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pst m Construction Permit Permission is hereby granted to Construct( ) Repair( !i) Upgrade( ) Abandon( ) ' System located at lr <r�`�//�✓t r�.�r�.��— ��/�p �,.r>- r and as described in.the above Application for Disposal System Construction Permit. The applicant recognized 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 this permit. Date ? - / !n Approved by (�✓� "Cw t'L / f Town, of Barnstable M RqulOory Services, Richard`V. Scali,Interirti Dieecfo° 4. Publae Health Die'isiion Ennnas° T"homas,McKean,D.ir,ector '200 Maim StreetiHyaiink,r'VIA;02GO.i Off-ice: 508-862-4644 1 ae: :j05 790 ba)4 Inst:Aler&Desij4ner CertiEuttion Forrrr 7 C� l Date: S"ev►wa"ge•Permit# �ai�.s. 3�'�Assessat-'s 14 a.p�I'areel `� —�'0 G I( Designer: ~` s�,�. lCnsta°ller: yr'zi? t earth s" g address: 1Z t�l "Cs � lc1 Address. aU J ►. � ;1 -= Ors. t __:)vas issued a pierall"to izjsta;lf a 'I (date), (installer) septic>systen5 at >(c opt14 ba5i ct on a design"dra��n;by (address), ,.. .. ' l -- --' f �—°dated Ws'i.bl er) - "I ccrtifi% ttiat'fhc septic system reletenccd above,wasuastalied sirbStar,tially according to m the des gii;vvhi c h may iricl;utdQ minor approved ohartbcs sitcli as later reltication,of the distribution box.,and/or septic tank. Strip out (i.f iequii'ed) was inspected and tlae'.soils i were.found satisfactory. i i. I certify that,,the septic System r�;('er'hced'above tivas raastalled: with rx�a�or changes :(i.e. greater-than 1 Q;' lateral relocation",of the SAS or airy v ertfcal'relocatioil:of'�aray eonaporient , t of the eptru system}but.in accordance with State &'T oGal R.�,;ulation.s. Pian_revision�i e r�rfied as-b>ialt t?y cuesignet to�fa'llotu. Strip out,(if redu red)vas inspected and thesoil5 were found satisfactoay. i I.certify that the system refer enc etl`above vvas, constructed ria- with the tern nos of the I`ll appwall letters (if applicable) �(Ins_t, et s Sam nature) CNtt: (DesrgI®r. rier s Si xilature si tr S (AtlrxDesrgne • err) A PLEA, RETURN TQB:ARNS'IABLr PUBLIC HEAL DI.VIS.ION. CERTIFICATE OF CO1iPLIANCE AVILL NOT BE ISSUED UNTIL BOT}I THIS ]FORA'I AND AS- ' AU-IL T C IIZD ARE RECE.IVED.I3Y THE BA:IZNSTAI LE PUBLIC HEALTH DIVISION TIIA?Y'lt 1'0U. nee'C;ertification F, -m Rev 3-14 1 ..dou;,, Engineers note.,This certificatroet is limited to an as buih inspectlen of system tomocrienis as installed prior to backfiil.The;' engineer did not supervise construction of the'system.Thelnstailer,assumes responsibility ror all:r iatarialt,workr ahship,backlilling to"specitied grades w r ith propecampae ion and°sPtt;ng risers/covers,as shawil on the,des gn<plan:` J a c � � C� t co a V N h wJ y } , jS- ci c a 4�o-Jt %�, Town of Barnstable P# ! f? --3 Department of Regulatory Services aexrtsMtn. Public Health Division Date 10 twcav- F 4yy 200 Ma nStreet,I Hyannis MA 02601 f�s Date SCl)eduW ! A - Time. � � Fee N. �� Q®c•.C�� Soil Suitability Assessmentfor S wa e Disposal. Performed By:f'Q K✓^ ,v`Gy 1 5tj-z- Witnessed By: y LOCATION& GENERAL INFORMATION Location Address 1� U rLC,,� ,��.�S Owner's Name j —OeG,vt e4 4 ttL4(4 t'S ` Address. �3�¢ U.,G lA`W,t'S Assessor's Map/Parceh ^� (( i" Ye4A0,y ► A QZ.� Zq Z—(�B S [lgineir'S.iJuRlc evi9 ee �1 - � s.✓i �b�.y Cl- NEW NEW CONSTIRUCTION REPAIR W Telephone# Land Use, IC+e�r :�t�a-rc, Slopes{9o) t/ Z Surface Stones Distances.from: Open Water Body atJ :ft 'Possi6le'Wet Area 7 cJ ft Uxinking'Water'Well Drainage w4y—�Y ft Property Line ft Other ft SKETCH:(Streetname,dimensions of lot,`exactlocations of test holes&'perc tests,locate wetlands in proximity to holes) v • r q Parent.material(geologic) 5 CCJ 1� Depth to•Aedrock Depth to Groundwater. Standing Water in Hole: 1�d G-;^ Weeping from Pit'Fnce iVb1_1_L Estimated Seasonal.High Groundwater ?i� c. DETERMINATION TOR SEASONAL HIGH WA.TER TABLE Method Used: Depth Observed standing in obs.hole: _ __-__ __ in. Depth to soil mottles: y Depth to weeping frcim_side of ob_s.hole -. in, "C3Yt7und:water Adiusthtcnt m _ft• ~Index Well# � Reading;Date: � Index-Well level, :_ Ad) 'f%cto �T Adj.Clroundwater1evel PERCOLATION T9ST Date Thule Observation Hole# �1 — ( UU 'Cime etW, Depth of Pex: 3 7 -53 Tirrie at 6'. Start Pre-soak Time CQ �_ \�CVk`^-'$ Tim.e(9"-6") End Pre-soak RateMin./Inch Site SuitabilityAssessmcnt: Site`Passed Site Failed: Additional Testing Needed(Y/N) .� Original; Public Health Division Observ.afion IIole Data To Be Completed on.Back----------- *If percolation test is'to.be conducted within 100' of Wetland,you must first notify"the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:1S E PTICSPERCFO RM.DOC DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. /n� pConsistency,%Oravel a j d ' ��1�✓� -c EZq DEEP OBSERVATION DOLE LOG Hole# 'U Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsetl) Mottling (Structure,Stones,Boulders. Consistency,% rave s " DEEP OBSERVATION MOLE LOG Hole# _ Depth.from Soil Horizon Soil Texture Soil Color Soil Other Surface(hr.) (USDA) (Munsetl) Mottling (Structure,Stones,Boulders. Cons'stency.%Grave A tUA K ( (2 q, z `_ r C DEEP OBSERVATION HOLE LOG Hole# � Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) .(Munsetl) Mottling (Structure,Stones,Boulders, onsi ten ra L's Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year.boundary NoA Yes Y Within L00 year flood boundary NoA Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material?.r Certification I certify that on (date)i have passed fire soil evaluator examination approved by the Departtnent,of Environmental Protection and that the above analysis was performed by me consistent with . the required ining,expertise and experience described in 10 CMR 15.017. Signature A _ Date QAS,EI'TICTERCFORM.DOC Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments �M 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name information is Hyannis Ma 02601 4/28/2014 required for every H Y - page. Cityrrown State Zip Code Date of Inspection 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:when filling out forms A. General Information - on the computer, I use only the tab 1. Inspector: g key move your our , cursor-do not Sean M. Jones use the return key. Name of Inspector S.M.Jones Title V Septic Inspection - ITV Company Name 74 Beldan Ln. Centerville Ma 02632 Cityrrown - State Zip Code - 774-248-4850 smjonestitle5@gmail.com SI4522 Telephone Number License Number B. Certification " I certify that I have personally inspected the sewage disposal system at this address and that the ' information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ®; Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 4/28/2014- InspectorsSignature Date The system inspector shall submit a copy of this inspection report to the Approving Aut�ority'(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 stAbmlt;@4 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., f the same or different conditions of use. U t5ins-3/13 Title 5 Official Ins a io rm:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 136 Uncle Willies Way Property Address PISKURA, JOHN.J III Owner Owners Name information is required for every Hyannis Ma 02601 4/28/2014 page. City/Town State •" Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: a ® 1 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: The dwelling located at 136 Uncle Willies Way Hyannis is served by a Title V septic system consisting of a 1000 gallon septic tank, distribution box and 4 flowdiffusers'in a 38'xl2'xl'trench. The system,` was found to be improper working condition at the time of inspection. s 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. 3 *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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 S. C r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4M ,. 136 Uncle Willies Way - Property Address PISKURA, JOHN J III Owner Owner's Name information is Hyannis Ma 02601 4/28/2014 required for every y page. Citylrown y , State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational.System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken'or obstructed pipe(s) or due to a broken; settled or uneven distribution box. System will. pass inspection if(with",approval of Board of Health): ❑ broken pipes)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): El broken pipes)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y' ❑ N ❑ ND(Explain below): t 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 El Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh { t5ins•3/13 Titles Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 • I r, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 136 Uncle Willies Way Property Address r PISKURA, JOHN J III Owner Owners Name information is required for every y H annis Mar02601 4/28/2014 , page. Citylrown State Zip Code Date of Inspection 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: 0 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 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 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 ElBackup 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 '/z day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name " information is required for every Hyannis Ma 02601 4/28/2014 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than times 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. El Z Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surfacemater 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.. ❑ ® 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.] ❑ 0 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 ❑ ❑ 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 Il 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4 M , 136 Uncle Willies Way ° _ - Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You,must indicate yes" or"no"as to each of the following: Yes No i ❑ ® Pumping information was providedby 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 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: Z ❑ 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)] D: System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 gpd t5ins•3/13 Title 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 M 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 4 R Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ® Yes ❑ No Last date of occupancy: current - Date 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? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes'❑ No Water meter readings, if available: t5ins•3/13 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 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/user Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How 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) 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): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: original system 1990 Were sewage odors detected when arriving at the site? ❑ Yes Z No Building Sewer(locate on site plan): 101, Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain):- Distance from private water supply well or suction line: feet Comments(on condition of joints,venting, evidence of leakage, etc.): Joint were ok, no leaks, vented.through the roof Septic Tank(locate on site plan): Depth below grade: 5 feet Material of construction: ® concrete ❑ 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: 1000 gallons w - g Sludge depth: . t5ins.3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 r Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. CitylT'own 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 3" •Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6,. Distance from bottom of scum to bottom of outlet tee or baffle 1011 How were dimensions determined? opened covers, took n measurements Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): ; Tank needs to be cleaned soon and again every 2 years for proper maintenance. water level was even with outlet, tank was not leaking and was structurally sound. Outlet baffle was intact but was rotting. It should be replaced with a pvc tee. 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 t5ins•3113 s Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. City/Town State Zip Code Date of Inspection 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: f - ❑ 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•3/13 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 GSM , 136 Uncle Willies Way ` Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): 0„ Depth of liquid level above outlet invert Commenis (note"if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): . - Distribution box was functioning as intended. S 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.): F v * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS)(locate on site plan, excavation,not required): If SAS not located, explain why: t5ins•3/13 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-Not for Voluntary Assessments 136 Uncle Willies Way Property Address PISKURA JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. City/Town State Zip Code Date of Inspection D. System Information(cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4 flowdiffusers ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields` number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): s.a.s. consists of 4 flowdiffusers in a 38'x12'x 1'trench. At the time inspection the s.a.s.had 3"of standing water with no signs of past hydraulic overloading. s.a.s. has 2 observation covers on risers. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration w 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M , 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma . 02601 4/28/2014 y page. Cityrrown State Zip Code Date of Inspection 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 136 Uncle Willies Way ` Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis Ma 02601 4/28/2014 page. Cityrrown 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 public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately oa A_I 2S j A-Z Z3 6 r3-Z 311'6 f3 3 A•Y 30 G i, A-5' y3 6 5- 7 q'b t5ins-3/13 Title 5'Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts F Title 5 Official 'lnspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 136 Uncle Willies Way Property Address PISKURA, JOHN J III Owner Owner's Name information is required for every Hyannis - Ma 02601 4/28/2014 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope . ® Surface water ❑ Check cellar ❑ Shallow wells 124 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 1990 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: • ❑. Checked with local excavators, installers-(attach documentation): ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. I Before filing this Inspection Report,.please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 136 Uncle Willies Way ` Property Address - r PISKURA, JOHN J III Owner Owner's Name information is Hyannis Ma 02601 4/28/2014 required for every H y ' page. Citylrown 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 ® System Information-,Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file S t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 i DATE: _6/2/98 PROPERTY ADDRESS: 1-36 uncle Willies Way Hyannis,Mass. 02601 On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 1 -1000 gallon septic tank. 2 . 1 -I)istributibn box. 3 . 4- Flow Diffussors Packed in stone. Based on my Ins;;action, I certify the following conditions: 4 . This is a title five septic sytsem. C `�78 Code ) 5 . The septic system is -in proper working order at the present time. 6 .- Should have two new septic tank covers installed. 7 . Pumped septic tank as part of the inspection. 51GNATURr-: Name: J. P .Macomber Jr.. / -------s--------------- `�• P_Macoruber & Son-_Inc . Company:_ Address:_-Beat-gb------- ----.-- Centerville LMass__0.2632 Phone:---50.8, 75-.3338------- - ► THIS CERTIFICATION DOES NOT -CONSTITUTE A GUARANTY OR WARRANTY r t . r�e . 1 JOSEPH P. MACOMBER & SON,. INC. 9 Tanks-Cesspools-Leachfields Pumped & Instslied Town Sewer Connections P.O. Box 66' Centerville; MA 02632-0066 775-3338 775-6412 i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292-5500 WILLIAM F.WELD TRUDY COX Govcmor Sccrcta: ARGEO PAUL CELLUCCI DAVID B.STRUH Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commission( PART A CERTIFICATION Property Address:1 36 Uncle Willies Way Hyannis Address of Owner: Date of Inspection: 6/2/9 8 Mass. (If different) Name of Inspector: ber Jr. 1 am a DEP a�pPproved system inspector pursuant to Section 1S.340 of Title 5 (310 CMR 15.000) Company Name: J.P.Macomber & Son Inc. Mailing Address: BOX 66 Centerville,Mass, 02632 Telephone Number: 508-779-- 3338 STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: l Date: The System Inspect shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: AI SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: BI SYSTEM CONDITIONALLY PASSES: 1� One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. ,1 The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of r Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; dr the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tanits�f failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank ` as approved by the Board of Health. (revised 04/25/97) :Page 1 of 10 DEP on the World Wide Web: http:Nwww.magnet.state.me.us/dep aj Printed on Recycled Paper • U SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:136 Uncle Willies Way Hyannis,Mass. Owner: Michael Lima Date of Inspection: 6/2/g g B) SYSTEM CONDITIONALLY PASSES (continued) &D Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: JI1L Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: A Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50'feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. .�111 The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system.has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance -Vi¢ (approximation not valid). 3) OTHER (revised 04/25/97) Pegs 2 of 10 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 136 Uncle Willies Way Hyannis,Mass. Owner: Michael Lima Date of Inspection: 6/2/9 8 D) SYSTEM FAILS: You must indicate ei;+.er "Yes" or"No" as to each of the following: —Q I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No / Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the d' to ution box above outlet invest due a overloaded or clogged SAS or cesspool. �1�FXoen d ,Za of`, a 1}t��yv4Ti Liquid depth in ieesspeel is less thaw invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped 01. L Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. if the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: / The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes Np„ 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Fey• 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST PrbpertyAddress: 136 Uncle Willies Way Hyannis,Mass . Owner: Michael Lima Date of Inspection: 6/2/9 8 Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Yes No _ Pumping information was provided by the owner occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. Ma_ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. JV All system components,4* luding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened,and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. —The size and location of the Soil Absorption System on the site has been determined based on: The facility owner(and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. rl/ _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)J (zevisod 04/25/97) P&q• 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Properly Address: 136 Uncle Willies Way Hyannis,Mass . Owner: Michael Lima Date of Inspection: 6/2/98 FLOW CONDITIONS RESIDENTIAL: Design flo" _33D g.p.d./bedroom (or S.A.S. Number of bedrooms: 3 Number of current residents: Caroage grinder (yes or no).,!>D Laundry connected to syste (yes or no).�m Seasonal use (yes ad Or not.�� y 9�� ater meter readings, if available (last two (11 year usage lgpol: _ �— _y y � Sump Pump (yes Or no):�� •�� y r!" :asl date of occupann• COMMERCIAUINDUSTRIAL: Type of establishment: IVA De.srgn flow: AJI� gallons day Crease trap present: (yes or noLV2 � industrial Waste Holding Tank present: (yes or nowt �on•sanita� %ante discharged to the Title S system: (yes or no) '" water meter readings, if available.k&;* AM Las: Cale of oCcupancy:—AA OTHER: :Descr,bei Last date of occupancy GENERAL INFORMATION PUMPIN ECORDS and source of information. , System pumped as pan of inspection: (yes or no) If yes, volume pumped: Ilons Reason for pumping TYPEYSTEM Septic tank/distribution box/soil absorption system AlQ Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, anach previous inspection records, if any) VA Technology-e(c. Copy of up to date contrast Chher AP ROXIMATEEAA�E of all components, date installed (if knuwn) and source of information: —"Z 0� — S,e .age odors detected when arriving at the site: (yes or no) ir.rs..a o�r�sis�l v.9. 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1.36 Uncle Willies Way Hyannis,Mass. Owner: Michael Lima Date of Inspection: 6/2/9 8 BUILDING SEWER: (Locate on site plan) Depth below grade: 7" Material of construction: _cast iron Z40 PVC_other (explain) Distance from private water supply well or suction line _ Diameter y Comments: (condition of joints, venting, evidence of leakage, etc.) Joints appeartight- No si (ins of 1 PAkarra The sTtAm is uQnte63 - thrn»gh the hpiiqe ant - SEPTIC TANK:-&L (locate on site plan) Depth below grade:�yVAwe Material of construction: Zoncrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list ageOA Is age-confirmed by Certificate of Compliance,(/-4 (Yes/No) Dimensions:�6Nl �b Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle:0 Scum thickness: 0 0 Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bono�ftlettee or baffle:_O_ How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Pump tank every 2-3 years. Inlet & outlet tees are in place The tank is structurally sound and shows no signs of 1PAkag0- The two covers on the Semi r• tank shntil rl hp rP=1 arPrl GREASE TRAP:dkL� (locate-on site plan) Depth below grade:t)V Material of constructionit/4concreteA),4metal/4FiberglassNA Polyethylene 4�4other(explain) JJA Dimensions: Scum thickness: R> 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: YQ/7 Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,-etc.) Grease trap is not present (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 136 Uncle Willies Way Hyannis,Mass. Owner: Michael Lima Date of Inspection:6/2/9 8 SOIL ABSORPTION SYSTEM (SAS): 7^ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ / leaching chambers, numbe,:AFL4J qt//��H$SDI• leaching galleries, number: en leaching trenches, number,length:—�--- leaching fields, number, dime ions: y overflow cesspool, number: Alternative system: Name of Technology:ZLtQ0d� Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Loamy sand o boney tine sand. No signs ot hydraulic taiiure or ponding All vegetation is normal. CESSPOOLS:J,!W/d (locate on site plan) Number and configuration: 0 Depth-top of liquid to inlet invert: AM Depth of solids layer: AJ#Q ✓._ / Depth of scum layer: /U14 ., Dimensions of cesspool: 4 Materials of construction: Indication of groundwater: AW inflow (cesspool must be pumped as part of inspection) Cesspools are not present Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Cesspools are not present PRIVY:_42we, (locate on site plan) Materials of construction: Dimensions: itli� Depth of solids: NA Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Privipc arp not nrpspnt (revised O4/25/97) Dag• B o1 10 U SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propeny Address: 136 Uncle Willies Way' Hyannis,Mass. Owner: Michael Lima Date of Inspection:6/2/9 8 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) . v AP , s UAlcLe - :w ay' (r•vi..0 G�/ZS/97) P.y• 9 of 10 SUBSURFACE SEWAGE DISP SYSTEM INSPECTION FORM I C SYSTEM INFOI: ION (continued) Properly Address: 136 Uncle Willies Way Hyannis,Mass. Owner: Michael Lima Date of Inspection:6/2/98 Depth to Groundwater �W Feet Please indicate all the methods used to determine High Groundwater Ov.ation: /'Obtained from Design Plans on record t/ Observation of Site (Abuning property )observation hole, basemtri sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers use uSGS Data Describe in your own words how you established the High Grouncl,/atcr Elevation. Must be completed) Used water contours map. Gahrety & Miller Model 12/16/94 ' �>•r.T.nr+r>-nl•rr.-.�-,�,nT:mrnmr.a-nrtrnt•.rrr.,rr.�l••r+,vrrl�rr*n+rm m-rw-as rra-�r.sn mn .. TOWN OF Barnstable BOARD OF HEALTH SUIISURFACF SEWAGE DISPOSAL SYSTEM IN9I'FCTION FORM - PART D •- CERTIFICATION F-'t••l-T•••:'t-T.IIT.-.TTTl.7TlRI'R.'fSI TIR 4TIT.Tp•'RT'r•.t'IT1VTTti.R1.P'TP1R�'pp�'.}�pp��\ • r"nei'mmnnT°�Tr+:+rr+r.•.T.nrr'rT.�l._... -TYPE OR PRINT CI-EARLY- PROPERTY INSPECTED STREET ADDRESS 136 Uncle Willies Way Hyannis,Mass. ' ASSESSORS MAP, BLOCK AND PARCEL OWNER' s NAME Michael Lima PART D - CERTIFICATION r NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J•P•Macomber.& Sorrinc. COMPANY ADDRESS Box 66 Centerville,Mass. 02632 street Town or City COMPANY TELEPHONE (508 1 775 - 3338 FAX state ZIP ( 508 1 790 -1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and complete as of the time of -inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check one : Sys teui PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public healLh or the environment as defined in 310 CMR 16' . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have con Lcted has found that the system fails to protect theElublic health and the environment in accordance with Title 5 , 310 CMR 15 , 303, and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . "r Inspector Signature Date One copy of this certification must be provided `to the OWNER, the ( where ay�plicable ) and the I30ARD OF 112AL7II, BUYER * If the inspection FAILED, th-e owner or" perator shall u d within one year of the date of the inspection, unless allowed ortrequiredm otherwise as provided in 3.10 CMR 16 . 305 . partd . doc r w � 7C7 z b THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE S SYSTEM INSPECTOR as provided in 310 CMR 15 . 340 and Section 13 of Chapter 21 A of the General Laws. Issued by The Department of Environmental Protection. nctilig Dircct< r of tltc.1 iurt�Olwa=,:"10=11-fion �- I TOWN OF BARNSTABLE LOATIO L'G/!46— /�[/ SEWAGE # D/ al 13 VILLAGE J ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. = �' 4® CC SEPTIC TANK CAPACITY 000 pf6leusoAr LEACHING FACILITY:(type) � (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ��Q�(�(�`�/2 ®�4 zwxlh:� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� C V �� `A� _ ] '! ' III V \ I p ' t. ��./ !J ASSESSORS MAP N0: ciff P-ARCEL Id0: 1 ;r THE COMMONWEALTH OF MASSACHUSETTS A Bb�ARD OFt�'1=1�ErALTH r TOWN OF BARNETABLE Appliration for Disposal Works Tonstrnrtuan Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individ ge Disposal System at: 000l 3(� cation-A ress o t o. .:. ... /{/.,/' �j �//+� ............. L' l_�----al..v G" !V....--�......... ...`.... il5 ner Address / W Installer Address d Type o uilding Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...... .............._____..._ Expansion Attic ( ) Garbage Grinder ( ) pa, Other—Type of Building /�_1Q - No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures . ------..-------•-•-•-------•-----------------------------•-----------•---......_---- W Design Flow............................................gallons per person per day. Total daily flow......................................._._..gallons. WSeptic Tank—Liquid capacity............gallons Length........:....... Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching.area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water--___________-__-__-.." (1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •------------------------------------------------------------------------------- -------•-------------------------------------------------•-------------•---- 0 Description of Soil...............................................................---•----••-......-------------------=--------------...-----------------------------------.............--- W - c� ---------•------•-----•••-•-----------•'•-----------------------••-•••-•--•-•••--------------•-•----------•-•-----------------••----•----•------•---•---......_..._..•-------•---•---.....------........ W UNature of Repairs or Alterations—Answer when applicable..............:................................................................................ ---=-----•--•---••----------------------------------------------------------------•--•-------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage D' posal System in accordance with the provisions of LE 5 of the State Environmental de—The under g d further agrees not to place the- stem in o ti nu til a of Complia c s een ' at f health. Signe - � ---- A plicatio pproved BY �. Date Application Disapproved for the following reasons- ------------------------------- ...................... --------..........------------------------------------------------------ ------------------------------------------------------------------ -------- ----------------------------------------------------------------------------------'----------............................... --------------------------------------- Dare Permit No. r� ��----------------------- Issued -- ------- a .. '-----'------`-----..-...-----..- .. Dace t-----:_r _ ) fib THE COMMONWEALTH OF,.MjkSSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Applirution for Disposal Works Tonstruetiun rrutft Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual_Sewage Disposals'. System at: ----! �.�..... _...tea .... ' / --- - c tion-Address or At No. --- i ss O ner Address _ ............................................................................................ -•..._...._•••--•--••----•-•••-•-•-•-•••- Installer Address Q • ,,Type of Building Size Lot___________________________Sq. feet V Dwelling No. of Bedrooms______�_................................Ex anion Attic� g— p ( ) Garbage Grinder ( ) a ' Other—Type of +Building _PtQ�d _ No. of persons___________________________ Showers ( ) — Cafeteria ( ) d 10 Other fixtures .......................-----------------------------------------------------'.............................................................. ,- W Design Flow............................................gallons per person per day. Total daily flow_`__.._._____________________..____..____=_:gallons.,. WSeptic Tank—Liquid capacity............gallons ' "Length________________ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length----------_---_-- Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by_s A----------------•---•-•--••--••-••------•-----•-•...•-----••-••--•_. Date..................................... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ rZq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_-.____-_____________--. P ---•------------------------------------------------------------------------------------•-----------......................................................... 0 Description of Soil...............-...............................................................-----------------------------------------------------------------------._.._........__. x U ••••------•--••----•-•-----•-•••---••--•-•••-•-••-•••--•-•-----•-•---••-•-••••••-•-•-••••••-------•-••---••----------••-•---•••---•••--•-•-•----•-•................................................... VW ••--•••-----------------•---•-----------------•---••---••----•--•-•-----------------•-••••-•--•------•-•----•-••---------•-••---•----•-•----•-•••--••--•-•-•-•---•-•-•-•---•-•--•---••-••-•----•-_•-•--- j Nature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisi s of/I' TLE 5 of the State Environmental�de—The unders'n further agrees not to place the system in o atio ntil a i'te of Compliant "s Seen i s"uQ&-by bo�(rd of health. Signed. -- ... �/J. ...1' l��C .. ../ . �- 1. --._.Daf pPlication Approved B ��.. . ...._ :. �j°` PP Y r_.... v— --------------a---- =�� ...----�--------------. --------------... Application Disapproved for the following reasons: ......... .. ............... -- .............................. ...... -... ..Dater - Dare Permit No. ��.''.. ��----------------- --- - Issued � ..... t '' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (gez#tftrate of 10.1parajalianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b ................................. - Installer at -- y ...��/ u.;. ✓f��1 --,✓�-:..... / � ....--. - � 1 �1 has been installed in accordanc with the(,provisions of TITLE 5 of The S`�te Environmental Code as described in the application for Disposal Works Construction Permit No. ST ........... dated ....�lsf THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONRUED..AS A GUARANTEE THAT THE SYSTEM WILL { FUNC ON SATISFACTORY. DATE........ �..� U/ Inspector ......: 1,...-.o`" v THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No......•••............. FEEd?.'._=. . 14uposal Works Tonstrudiott pautit Permissionis hereby granted.............................................................................................................................................. to Construct (V) or Repair( ) an Individual ewage D. sal System at No..•--L _ __.� a�± _ ,� . _ ? ..... �� *.. � s! ..�( . .............. / Street as shown on the application for Disposal Works Consruction Permit N\ !! 9 Dated.____��a' Board of Health DATE...................----•••••-••._...--•• ..................................... FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS 01de Boston Engineering Co., Inc. LAND SURVEYING-CIVIL,SAN11ARY AND ENVIRONMENIAL CONSULTANTS 172 William Street - New Bedford,MaS.Sadl Ll sells 027,10 Tel: (508)997-6410- Fax: (508)997-9656 October 17., 1990 ' Thomas McKean, Director N t% "ry Barnstable Health Department Barnstable Town Hall Barnstable, Massachusetts RE: FILE # 877 CLIENT- Braintree Co-op Subsurface Sewage Disposal System As-built Verification LOT # ''B'' STREET-Uncle Willies Way, Dear Mr . McKean, At the request of our client , we have checked the septic system components' invert elevations , their location and the foundation grade of the above-referenced septic system design plan . Attached and made a part of this letter, is an as-built plan dated October 17, 1990 and given drawing # 877-2A. Based on our knowledge, information and belief, the following facts were determined: 1 , locations of septic tank, d-box, and leaching facility relative to property lines and the existing foundation; 2 , invert elevations of all outside septic system plumbing lines and components that were exposed at the time of the as-built survey ; 3 . calculations of all applicable exterior plumbing line slopes ; Based on the facts above, it is our opinion that as of this date the system appears to have been built in substantial accordance with the design plan dated 3/16/90 and is in general conformance with the Commonwealth of Massachusetts State Sanitary Code, Title V, and the requirements of the local Board of Health governing on site subsurface sewage disposal system installations , at the time of design, with the following exceptions : continued on to page 2 Oide•Bbston Engineering Co., Inc. ` LAND SURVEYING'CIVIL.SANITARY AND ENVIRONMENTAL.CONSUI_TAN 13 172 William Street New Bedford,Massachusetts 02740 Tel: (508)997-6410 Fax: (508)997-9656 File ## 877 .2A continued from page 1 1 . The leaching area was installed in the reserve area rather than in the primary area, however the ten foot overfill surrounding the leaching Diffusors was enlarged by an addition 5' on the side and 7' on the end to allow for more overlap into the primary area . 2 . The Septic Tank was relocated to the rear of the house to simplify the interior plumbing. The exterior pipe lengths and slopes were adjusted to accommodate the change . ---GENERAL EXCEPTIONS--- A. No excavations were made beneath the surface of the leaching area or into the material surrounding the leaching area, thus , there is no information regarding the amount - of original material removed, or quantity and quality of fill material utilized. B. No inspection was made of the interior plumbing. C . No expressed or implied warranty is given as to the capability or life expectancy of the system in the future . Respectfully yours , r Kenneth R. Ferreira, R.L . S . Principal Engineer r r I William F. Smith P.E. Senior Engineer LEGEND N 0// -- 100 -- EXISTING CONTOUR :2 x 100.98 EXISTING SPOT GRADE _ W EXISTING WATER SERVICE rn G EXISTING GAS SERVICE N �� -e.H. W.--OVERHEAD WIRES `L °Qle { q/s TEST PIT y BENCHMARK LOCUS LOCUS MAP 100,03 NOT TO SCALE J /r,_, /� EXISTING SEPTIC TANK 75'23'00 jl TOP OF TANK EL.=105.40f 99.76 x 103.33 57, 12� W INV.(OUT)=104.55+ • f � _� • f f ( / it f i S IP KE 4.91 (/ 106.51 / f f 99.49 r i i 105.96 \ \\ ) f I 104.72 ... f f / \ / .. 41 : :D j ' 10 ,Oi 106.65 ) i m :I: VE4Y:.:.:. :• ; SHED i p 99.38 co o . r.::; RINSE 1 .41 CRUSHED / / STONE I i ^ i I� 'r PATIO 107.20 106.6� 10789 104}21 2.85 / / o r E O , / p r r f 106. / / \\ X TING FNDTION 105,98' r 103,96 i 104.98 r ! \ v r EXIS / � 112,58 � HOUSE(#136) \\ x ; `y 1 T.0.F.=106.6t 7 10.10 �04.69 + 05.40 ! 5,00. \ r $/fi DECK ' - BM 99, i x 100.�4 �� \ 16. 106,21 3 CATCH BASIN f 104.62 x i Q) \ 10519 99.09 \� x 104,96 x 1�1,46 I I / 4l PROPOSED 1000 Q!o GALLON SEPTIC ��\ -�\ in b TANK I� SERIES �\ 104.5 �` \\ / ��-'4 ( - 101.38 \\ \l ` O x �\ i O 99,59 �� iTP-1 o �\ \\\ I � f I'I BENCHMARK `o i 103,52 i ;o O r 6\0 \� II 10, i ORANGE SPIKE/RR TIE 540' i x TP-20 N Or \\ l� i � I EL.=106.21 • � r , r � \ \ 11 � 9979 0 x ; O TP-3 I i EXISTING S.A.S. 102.26 \ �106,31 SI TO BE ABANDONED I TP-4 I i x 10 9 x 100,69 x 1D4,89 \�\ rr Of 100,22 1 .x ----- 102.05 102,80 (FO PARCEL LOTS 11 & 12) 27,89,1±S.F. o PETER`T. s \\\ x 102.69 �\ \) x 107.26 McEN CIVIL E "' \\ CB 35109 �%S \\ C3 0 `�r' 1 107.17 �R x 103,05 ISl p 93.08 O r82.53'52" W. 106.28 w..� S - \\ overrment 101.45 edge of p C I D r T-EI OWNER OF RECORD 102.48 �� 7�T� T S 11,1/ 1J F lv 1 BEAN, SUSAN C & OOREEN J PARCEL ID: 292-003-011 �' 136 UNCLE WILLIES WAY HYANNIS, MA 02601 Engineering by: SCALE DRAWN JOB. NO. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. 1"=20' P.T.M. 271-1 8 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEEIF NO. 136 WILLIES WAY, HYANNIS, MA (508) 477-5313 12/6/18 P.T.M. 1 Of 2 Prepared for: Cape Cod Septic Services, 350 Main St, W. Yarmouth, MA 62673 ,) NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL: 103.35 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANKS PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL RISER AND COVER INSTALL RISER & COVER OVER ONE CHAMBER(MIN.) OUTLET.AND SET TO 6" OF FINISH GRADE SET TO WITHIN 6" OF FINISH AND SET TO WITHIN 3" OF FINISH GRADE TO SERVE GRADE AS AN INSPECTION MANHOLE. F.G. EL.=105.7t F.G. EL.=104.5t to 106.3 EXISTING F.G. EL.=105.6t F.G. EL.=105.7f L = 16' L = 16' L =.30'(MAX.) ® S=1% (MIN.) (MIN.) ® S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC 6" ^ 14" 10"I " s E3 O E3 TO 1/2�RDOUBLEB„ INV.= 14" 12 "!E____31 WASHED STONE 103.75 48" LIQUID (OR APPROVED FILTER FABRIC) ADD LEVEL PROPOSED INV.=103.17 3' 4' „- // cAs BAFFu_ GAS BAFFLE D-BOX EFFECTIVE WIDTH = 11' DOUBLE 1'j2' ED INV.=103.34 H-10 RATED INV.=102.85 STONE EE IX STING r SEPTI INV.=103.50 USE 7 LC-6 LEACHING CHAMBERS IN SERIES PROPOSED 1000 GAL. SEPTIC TANK TANKWITH 4' OF DOUBLE WASHED STONE-ALL SIDES INV.=104.55t H-10 (VERIFY) H-10 RATED NOTES: TOP CONC. ELEV.=103.67 __ ___ -BREAKOUT 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=102.85M E3 E3 E3 O E3®® ELEV.=103.35 INVERTS, PRIOR TO INSTALLATION. EM E3®E3 E3 E3 EM I 2) SEPTIC TANK D-BOX SHALL BE SET LEVEL & TRUE BOTTOM ELEV.=101.85 TO GRADE ON A MECHANICALLY COMPACTED SIX 4' 7 x 6' = 42' 4' INCH CRUSHED STONE BASE, AS SPECIFIED IN 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 50' 310 CMR 15.221(2). PERVIOUS MATERIAL 3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' (MIN.) ABOVE G.W. 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM OF TP„ EL=93.4 = LEACHING SYSTEM SECTION AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. SEPTIC SYSTEM PROFILE N.T.S. GENERAL NOTES: SOIL LOG 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. DATE: NOVEMBER 1, 2018 (REF 15,823) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SOIL EVALUATOR: PETER MCENTEE PEfSE#1542) OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR Elev. TP- Depth Elev. TP-2 TP-3 TP-4 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE Depth Elev. Depth Elev. Depth DESIGN ENGINEER. 104.9 A 0" 105.1 A 0" 107.9 A 0" 107.8 A 0" 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 10YR 4/2 10YR 4/2 10YR 4/2 10YR 4/2 ENGINEER BEFORE CONSTRUCTION CONTINUES. 107.5 B 5 104.E 6 107.4 6 107.3 6 5. ALL ELEVATIONS BASED ON. AN ASSIGNED .DATUM..- -- LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 10YR 5/6 10YR 5/6 1OYR 5/6 1OYR 5/6 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 103.4 18 103.4 20 106.6 15 106.5 16" HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. C C1 C1 PE RC PERC 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 30"/48" 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE MED. SAND MED. SAND M-C SAND M-C SAND DIRECTED BY THE APPROVING AUTHORITIES. 2.5Y 6/4 2.5Y 6/4 2.5Y 6/6 2.5Y 6/6 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. 93.4 138" 93-6 138" 97.9 120" 97.8 120" 14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC NO GROUNDWATER OBSERVED PERC RATE 2 MIN/IN. (MED. SAND) SYSTEM COMPONENTS NOT SHOWN ON THE PLAN DESIGN CRITERIA ---- 4'KNOCKOUT , 1 20'OW COVER NUMBER OF BEDROOMS: 4 ,3 MAIN HOUSE+ 1 IN-LAW APT. _ SOIL TEXTURAL CLASS: CLASS I 4-KNOCKS 4'KNOCKOUT DESIGN PERCOLATION RATE: <2 MIN/IN DAILY FLOW: 440 GPD 4" J DESIGN FLOW: 440 GPD I GARBAGE GRINDER: NO-AND NOT PERMITTED WITH THIS DESIGN 72' 1 EXISTING SEPTIC TANK: 1000 GALLON CAPACITY PLAN VIEW PROPOSED SEPTIC TANK: 1000 GALLON CAPACITY 17-1 r------- --------i LEACHING AREA REQUIRED: (440 GPD) = 594.6 SF ® ® ® ® ® ® ® 22' ® � .74 GPD/SF IN2RT i ® ® ® ® ® ® ® USE 7 LC-6 LEACHING CHAMBERS IN SERIES 72• 36' WITH 4' OF DOUBLE WASHED STONE-ALL SIDES SIDE VIEW END VIEW SIDEWALL AREA: (11.0' + 50.0') x 2 x 1' = 122.0 SF BOTTOM AREA: 11,0' x 50.0' = 550.0 SF ' WIGGIN LC-6, H-10 LOADING TOTAL AREA:........................................................... 672.0 SF LEACHING CHAMBER DESIGN FLOW PROVIDED: 0.74 GPD/SF(672.0 SF) = 497.3 GPD N.T.S. Engineering by: SCALE DRAWN TDB. NO. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. N.T.S. P.T.M. 271 -18 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. 136 WILLIES WAY, HYANNIS, MA (508) 477-5313 12/6/18 P.T.M. 2 of 2 Prepared for: Cape Cod Septic Services, 350 Main St, W. Yarmouth, MA 02673 _ r ` F. SYSTEM PROR LE 6 A R E A PLAN &F,INISH GRADE`- 25 pp _ NOT TO SCALE F �tP -� FINISH , SCALE : 1 40 .. FINISH GRADE OVER TANK = 25 t' + /Mho w�(, /''' 4 �^' ,y��t p/.*y� ,4.Ha�� GRADE OVER TRENCH _ �J ', LOTT # Yr � V �✓ f 1 +v" 1 11 1 T..' 4 �' y,d T'c..-.( ► t ��•u.` '#.l '} !.�/ I `I {. ,r � T4J ,... SCH 4 ...P. . C.r � -� 0 V.C. NOT I Kj i HL= t"�s ��1•�', L. P"' 6•,�,. •� � �`�� .0 ��Y•=.:, "� _ I OC� �C30 �'"i �. ��,. �V,d � OR r r + Y �, �_C. I. TEES .'2.�5 pa4�,,oQ�pQ v o ...� '0 C O t �,- . 1 BS i O-KI A. '0,/AJ_ � t u0 -�s►�r � • * ? 2 �O�o p0O$Sft t �T ' . T' 0 ,p t _ a are °� TC `�( K 4` Y, 1 / `L_ !� �t t. -..:. � } �,� ��' F;'tos ' REINFORCED D ( ST. . BOX ND R E I N F ooC ' , g WAL I_ '` CONCRETE _ s°oo°� �✓� � :.'.2..5 TO BE INSTALLED ON 4 ''? LOCUS xll} A LEVEL STABLE BASE S o r^� r SE P T I C TANK ' r 51 M VA one TO BE INSTALLED ON A TRENCH LENGTH LEVEL STABLE BASE � 5 sT N_ DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM i �,ti' 1h In 16 i 4 MIN. HEIGHT / wErI.A�1D/UFl-1�ti O L►N O FLAG,5 SET � I CBY ® � ��' -r►�'"� °� �,�� T $� , I LEACHING TRENCH SECTION ABOVE OBSERVED WATER LEVEL _+ ► NOT TO SCALE 51 s °C. �� I� �jCAI E t = 2OC3CJ �lji -+''� 1 ;�". FOR FIN. GRADE SEE SYSTEM PROFILE SOIL AND PERCOLATION �•c-r,-v� DATA 1-0 T �� T1�Vz:"r—fit 12 M in.LOT#"2 � + iga„ ...• '` z . l �gl �� - Min. 2�� I�$ _ 1�2 PERC. RATE: < 2 MIN./IN, 4 Dia. Pipe : �. 'H .'' --�___�r._.'___._ ► )a .4 G O `�' S.1 Washed Stone TAKEN B Y E l� �. .: c° € " lc,l N = ► car I. 3' - ' �'�x• 'gyp ` r� Natural Soil' V Min. Effective +1 ��• I Depth WITNESSED BY: fl sr ry � k 34'� I2� DATE: 2cc �,1" 6_1i 19t�.�� +1 LOT I o - j Washed Stone TEST PIT-GND ELEV. `}' Excavation Sidewall 1 3 LOAM � TS IIt 3E3.1�, "SSA, t7'± �' ts�t; ; ,,�o 5�.e'. soc1 p MEL)I i )�A .. -------- Effective Width 1000 GAL. PS4E� 't' COMC�.,�--Ti IZ7 k C.. TANk, sC—F_ _. - `.' 2 PRic�Wiz''"' �; c`��s~..t"b.-..-e"Fa •>�--�4'�� ,� _ _ � � _ -----_ ;_.> _:. _ NUMBER OF -TRENCHES 4i. ACz A 1 �AC.H ISAc-* T• �.tVG�-! 3 \&'IEW ) 2 DErEP '/ 1 Alsb 2S' L4lStsl TOTAL f\t� h= 1Fs7 F. — ' w � S. F. SIDEWALL AREA GO 2,5 GALS,/S.F2` GALS. �-' �•- -- wftXm 4 I omwor mw%wn 20 DESIGN DATA : 2 �4 ,—} �� `r-0 �� .,_.,,, __ 75 S. F. BOTTOM AREA @ 110 GALS./S. F. ? � GALS. 3 • .� M � � t� � � WO DISPOSAL ED AREA PLAN M. NOTE: IDS. F. TOTAL AREA TOTAL''" GALS. EST. TOTAL DAILY EFFLUENT 33�,GALS. SEPTIC TANKL_ GAL. ARD-) �'1�AN Pry :PAR;�13 _FROM AL.L ��.Ia�A�'��I�:, ARC � r�� e�� -n-4t�` S U�L) I V I S 1 N ? "�fi ? R, 1�'1 1 l Z . . . _ ON THE ` t3 � � GENERAL NOTES p { I. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN . S®� �,.F•^-.�> �.m � ,.zw f.. ,AR ��"�I�Q 4�y �y"`. .:�� 16.r/t �i.J DF»- i ' AND ON-S1Ti• SUP.VE`' I Z. 5� 1 18� F-FFC- _- I I /� 7`3 2,35` "�' NOTE ACCORDANCE WITH TITLE 5 OF THE STATE SANITARY CODE �^ I �.�` " �/ -( IC. ' I-. A%—r - aR '«» �.I '� � 3 l0 EXCAVATE TO ELEV. 0R* LOWER AS ,,�,� 1< �� ¢ �1�� ► -� � DATED JULY 11977 & ANY LOCAL RULES APPLICABLE. , ,;, � x � «' w� -�- c G P ice► �=. 'o., 1Cq lam: REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPR'D. BY THE MATERIAL BENEATH THE LEACHING AREA. REPLACE EXCAVATED BD. OF HEALTH. MATERIAL WITH CLEAN, CLAY FREE GRAVEL, MECHANICALLY 3 WHEN CONSTRUCTION IS COMPLETED PRIOR TO BACKFILLING COMPACTED IN PLACE. } PLAN fin ` NOTIFY BD. OF HEALTH FOR INSPECTION. CONSERVATION NOTE * 4. FOUNDATION ELEV. MUST BECHECKEDWHEN COMPLETED. 5001C J A � ��m fin. .�� 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT BOARD I EIS -l�l E..mB—I N� AI�:I� TH I NJ lQ l t'AG ANIC3 OF HEALTH APPROVAL. "¢-ANBLA T..1•_A,., 1I, 4 � {� " ' ' -� 'i LEGEND 6. BOARD OF HEALTH INSPECTION READ. WHEN EXCAVATED. r I t I S, 1-ECRU E"5TFU, �X t "r 1 tQ a ' L) H W ► l_.L_ Pt1 �a�..:�-1�;� /E` .� Alert 3 #rt ~;' .f .. ' �,:^ t - + 50.0 EXIST. GROUND ELEV. APRP_0V1p G�HF?.,k��"�'. } A�....L. �� ,�� 50.0 , FINISH GROUND ELEV.�lUNDERLINED" OWNER* fz ' REV. DATE DESCRIPTION ' - N #Y.x4 �. `T�FtE1IPIVI` �O +Il�l,� 47 50 PIPE INVERT. ELEV. AT POINT SHOWN T.P. 0 TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM Y FOR / - 0 0 SEPTIC TANK MR. JOHN H. HAVENS na t- • : '" " DISTRIBUTION BOX LOT?13 Sm, I TH STREET ---- 4" C. I . OR SCH. 40PV.C.PIPE �_ \ S I MMONS POND " ten .' �, H YAN N I S POR T MA. '02 64 7. - -�}�-IL�- 4 BIT FIBER PIPE-TIGHT JOINTS o ,, ;�n � � —_ PROPERTY LINE '`v.�! Nn. 7468, DESIGNED: C.D.SPOHR DATE:4 STPT. 'R3 DRAWING NO. 28.s 2 t t3l..c�t� 3 A /szE�`F . MAP �C1.. AI FA LOT HOUSE MIN. CODE DISTANCE °fsS�� L-�• : DRAWN: C.5 ' SCAIE:ASSHOWN 9 3 CHECKED C. D. S.