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HomeMy WebLinkAbout0027 WAGON LANE - Health 27 Wagon Lane A= 270— 190 Hyannis k , 1 i rc 4 i A 0?7R9-190 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Wagon Ln. Property Address CP Day * Owner's Name Hyannis V MA 02601 5/8/17 Cityrrown State Zip Code Date of Inspection �l Inspection results must be submitted on this form. Inspection forms may not be altered in any way. A. General Information sly l a3v 1. Inspector: Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth. MA 02536 City/Town State Zip Code 508.272.6433 Telephone 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 5/8/17 Inspect Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 27 Wagon Ln.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 /o V, " Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 CitylTown 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: ® 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: Pumping suggested every 3 yrs to prolong the life of the system 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. Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: n/a ❑ 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 pipe(s)are replaced ❑ obstruction is removed 27 Wagon Ln.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments a 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ distribution box is leveled or replaced ND Explain: n/a ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: n/a C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑. Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 27 Wagon Ln.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 27 Wagon Ln. Property Address Day Owners Name Hyannis MA 02601 5/8/17 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: n/a D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes . No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow ❑ ® Required pumping more than 4_times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the 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. 27 Wagon Ln.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems(cont.): Yes No ❑ ® 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.] ❑ ® 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 II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 27 Wagon Ln.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ti 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 Cityrrown 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 ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ED ❑ 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: ® ❑ 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)1 27 Wagon Ln.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 Cityrrown State zip Code Date of Inspection 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 Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No. Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: occupiedDate Commercial/Industrial Flow Conditions: Type of Establishment: n/a 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: Last date of occupancy/use: . Date Other(describe): n/a 27 Wagon l.n.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 Citylrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: No recent pumping per owner 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): Approximate age of all components, date installed (if known) and source of information: Original septic tank from 1983, new d-box and chambers 2014 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ® No 27 Wagon Ln.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments G M 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 24" feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: >10'feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 1811 Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) Covers raised If tank is metal, list age: yearn Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 1000g. Sludge depth: 6 Distance from top of sludge to bottom of outlet tee or baffle >1.2 Scum thickness 1" Distance from top of scum to top of outlet tee or baffle >2 Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Measured 27 Wagon Ln.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 Cityrrown 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.): Pumping suggested every 3 yrs to prolong the life of the system Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): n/a 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): n/a. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): n/a 27 Wagon Ln.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 Citylrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: ac t i Ca p ys 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.): n/a *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments (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.): H-20 box 30" below grade, cover raised, average condition for its age Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 27 Wagon Ln.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 4 ❑ 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.): Chambers were video inspected and are damp at this time, no indication of past backup 27 Wagon Ln.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 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.): n/a 27 Wagon Ln.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 T Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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. �C C� 63 Ia b G 27 Wagon Ln.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth-of Massachusetts- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 27 Wagon Ln. Property Address Day Owner's Name Hyannis MA 02601 5/8/17 Cityfrown State Zip Code Date of Inspection 'D: -System Information (cont.) Site Exam: ❑ Check Slope- Surface water Check cellar ❑ Shallow wells Estimated depth to high ground water: >126"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: 2014 NGW 126' 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: see above M 27 Wagon ln.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 TOWN OF BARNSTABLE LOCATION 6 r\, LcqU. SEWAGE# Li V) VILI AGE a\ ASSESSOR'S MAP&PARCEL -70 INSTALLER'S NAME&'PHONE NO. �C_� c'-c�A.y�. �1 L( a iGl SEPTIC TANK CAPACITY X� A-z- /ns�c6 4(36jC LEACHING FACILITY. (type) Co Can o ^' -tx�(size) H X J7 ao�K l$ ' NO. OF BEDROOMS OWNER \i PERMIT DATE. 1�4 COMPLIANCE DATE: l %% 1114 Separation Distance Between the: rI Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BYp P A s � �/ � cf r � tl} a� �, �' �e1 �;,� . � � � " .� . �C 1� o •� p ,a� e� � � � r t c� 0 1 �1 � �• � � �1 � -G' �. ,,; , •.. r NO. 1 r t Fee /V v Cad L./: THE COMMONWEALTH OF MASSACHUSETTS Entered in computer Yes � PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS RppliCation for -Mispo8al 6pstrut Construction 3permit Application for a Permit to Construct( ) Repair/ Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 0-1 7 Ll C_ Q(\ c.G\^A . Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 1 1 U Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: TO K Q C) 0 0 ko Dwelling No.of Bedrooms Lot Size f sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3,3 0 gpd Design flow provided � gpd Plan Date -r� ���s l Number of sheets Revision,Date - Title Size of Septic Tank g�k C 'b 0() Type of S.A.S. C_f C tNrwt^V� a L L .5 �- Description of Soil muj ca<rv---. Nature of Repairs or Alterations(Answer when applicable) Lcr, H ID 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. Si Date s- ) Application Approved by Date Application Disapproved b Date for the following reasons Permit No. Date Issued No. ZoI�I_ Fee /Vv THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftpYitation f0`r bisposar 6pstem Construction 3permit Application for a Permit to Construct( ) Repair/ Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No. a L13 C_ / Q(\ l c%t-,k, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel No. Designer's Name,Address,and Tel.No. V k TyPe of Building: �'��j o c) C,U�o Dwelling No.of Bedrooms y Lot Sizesq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures s Design Flow(min.required) �,� U gpd Design flow provided gpd Plan Date [ :5 y Number of sheets Revision Date Title t Size of Septic Tank y d o` Type of S.A.S. C L\ S (_ (.r) STOn-C Description of Soil (�� CG<J-<r� Nature of Repairs or Alterations(Answer when applicable) H oa Q �C1S �+ K 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 a Compliance has been issued by this Board of Health. Sig Date J V Application Approved by Date Application Disapproved b Date for the following reasons �x Permit No. 7,4(9 L�� Date Issued /e7/ 17o of 1 II F ---------- ------------------------------' ==------------------ ti THE COMMONWEALTH OF MASSACHUSETTS s BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V) Upgraded( ) Abandoned( )by SC c, C'w"VL at C,3C, G N/\.k k' has been constructed in accordance k. with the provisions of Title 5 and the for Disposal Sys em Construction Permit No.:?&4`y 6 3 dated f Z /0 2,04 y Installer�� l� ,�,` Designer _ iA G,GS #bedrooms Approved design flow d The issuance of this permit,yshal not b co trued as a guarantee that the system wi!: fu ctio jdesignede ! Date , Inspector / ' / /1 V I V V V V w v ------------------------------- ---------------------------------------------------- ------ ----/1 ------ --------- - No. _o I L " -1 1 j Fee'a too "J THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pste. Construction Vermit Permission is hereby granted to Construct( ) Repair lV ) Upgrade( ) Abandon( ) System located at � LX Q/\ L v�n 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 f Z ZD(Ll Approved by F A Town of Barnstable •.°FTME Two Regulatory Services Richard V. Scali, Interim Director saarrsrnacs. MASS. Public Health Division 039. Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: '508-790-6304 Installer & Designer Certification Form Date: Sewage Permitfr (fl Assessor's iaplPareel� cj� Designer: . 57z°,� A. f'c'-- Installer: -SC© M k/"- Address: g23 /2�,7V-7r= 6,4 Address: "'e'4 H �� NAB. ya�O L On �Lc,,)� W rt� was issued a permit to install a (date) (installer) septic system at c\,, Q r\ )��r\CS based on a design drawn by (address) � dated (desigrief) y I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by-designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the IAA approval letters (if applicable) ` OF (Ins 's Signa oN►t No.3wi (Designer's Signa e) (Affix Designer°s Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASepticTesigner Ce tification Form Rev 8-14-13.doc r DEEP-OBSERVATION HOLE.LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones,Boulders. Consistency,%t3ravel) LS DEEP OBSERVATION HOLE LOG Dole# 2— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.`YoGravel) i� DEEP OBSERVATION DOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION DOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) . Mottling (Structure,Stories.Boulders. onsi ten y Flood Insurance Rate Map: Above 500 year flood boundary No Yes ._.__✓__ ,'within 5.00 year boundary No '!� Yes Within 100 year flood boundary No ✓ Yes- 4-Depth of Naturaiiy 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? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environ ntal Protection and that the above analysis was performed by me consistent with . the required trainin x rtise and experience described in 5 10 CMR 15.017. Signature Date Q:ISEPTIC1%PERCFORM.DOC Town of Barnstable ViE w P#1 Department of Regulatory Services Public Health Division Date A " �� 200 Main Street,� Hyannis MA 02601 AlFU MAt -j' ' d /t Date Scheduled Time Fee Pd. So►il'Suitabili Assessment or Sew a is ` osa tJ' .f Performed By: A- //)`"'�'. /��. Witnessed By: - LOCATION&.GENERAL INFORMATION Location Address + ' G�� /�:• C.C`jtMQ, Owner's Name- �� Op% v 0 A�U °Address Assessor's Map/Parcel: "!. '� t Engineer's Name z ���, ,-S NEW CONSTRUCTION REPAIR Telephone#. Land Use � i r ��-� Slopes(%) z Surface Stones Distances fromi, Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line d t ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) *r " U' f C_ Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Pace Estimated Seasonal High Groundwater ,q DET +RMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: In. Depth to weeping from side of obs-hole: _— In, Groundwater Adjustment Index Well,", Reading Date: index Well le've! Ad1.1actor: a � Ad'],Grounclwutei Level s Observation ( ._ Hole# Timeat V Depth of Perc �L time at 6"- . Start Pre-soak Time @Time(911-6" End Pre-soak Rate MinAnch �Z Site Suitability Assessment:. Site Passed- Site Failed: Additional Testing Needed(YM) Original: Public Health Division Observation Hole 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:�SEPT[C\P ERCFORM.DOC �, R N LOCATION SEWAGE PERMIT MIT Q Ior 23,4 meAl ley � 3_SAY VILLAGE 11AAlrs INSTALLER'S NAME i ADDRESS ® U 1 L OR OWNER DATE PERMIT ISSUED fi 3 DATE COMPLIANCE ISSUED �/� w s CJ1 .. �1 } Y -� ;i N Fxn...4167 THE COMMONWEALTH OF MASSACHUSETTS V� BOARD OF HEALTH a /1i �0.� ��D .------...�..............................OF.................-...........--._.-.....-------...-......------------,...........-..------ rim Application for Mipaiial Works Tonotrnrtion Vamit �1 Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at w -. Via- �1 .Y.A...... ..............` 3 3 ..... -..--------------- Locat' ddres o Lot No. ------------------ .. ...... •-••--••----•-.................. -•••........••.. .. 9 rer ddress .............. �.. - ..1 :.. Installer dress 1 Type of Building Size Lot____.,�6.... � 5q. feet U Dwelling—No. of:Bedrooms_... ....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No..'of persons............................ Showers ( ) — Cafeteria ( ) Q, Other fixtures - --------------------------- W Design Flow.........�5:.........................gallons per person per day. Total daily flow......3.3.0.:......................gallons. G: Septic Tank—Liquid capacity.11fl-t.gallons Length-----8....... Width---r,-t�........... Diameter.. ...... Depth.: `"._-- W Disposal Trench _.__._.. Width.................... Total Length.................... Total leaching area....................sq. ft. Diameter.................... Depth below inlet....4............ Total leaching area..................sq. ft. Seepage Pit No... _. _..-.;-_.__.. p a Z Other Distribution box (,�[� Dosing tank ( ) Percolation Test Results Performed by..............................................----•-•---•-•---•........... Date........................................ Test Pit No. I.................minutes-per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water.......................... ----•-•----•----------------------••---.....-----..................-----------••••••-•••---•-•-••••••---••--•-•-•.................•-•---......•-•.....•-•--' Description of Soil................................................. W -------------------- -----------•-•-----•--•--•--------•-•-•--------------------------.....••---•---••--•••••--•--•-•--••-•••-•----•-••-•----••---••-----••-----••--•-••••--•--._........._............ UNature of Repairs or Alterations—Answer when applicable............................................................................................... ------------------------------------•------------------------------•--------------------....---.....-•------••--•--•-----------------------.....--------------------•-------------------...•---•---..•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in M ' operation until a Certific//igned s been ' sued by the board of Health. ^/� DeApplication Approved B ----•-------•---•---•-•-•..................••--......_........••. r l .............. Date Application Disapprovedasons-------------------•--------•---•----•---•........................................................................ -•••-••••-••--••...................••-•••---.....-•--..._............•-•••----.................-•---.............••••••---•---••--•---••-•••-•----•----•--•••-••--••-•--...... .................... Date PermitNo......................................................... Issued........................................................ Date L- -- - - Noll--DW. FxS...yc�_............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. .. ....................O F..........................................................------.........-----............ Applirttiion for Dhipati al Workii Tonotrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: . 2g.. . .anus L,. ...... ................... ... D..._....__......------..........----...--------------• Locat Addre o Lot No. s • Owner - �ddr.eiss d FInstaller d Type of Building Size Lot.. rSq. feet Dwelling—No. of Bedrooms-__-., ..................Expansion Attic ( ) Garbage�Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................. . w Design Flow.......... ......................... allons er erson er da Total daily flow...... gg P P P Y• Y 3•,3-C�>-'-......................gallons. WSeptic Tank—Liquid capacity-law— .gallons Length.....-....... Width._!.......... Diameter.:...... Depth.5744 x Disposal Trench—N . .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.___ f........_.... Diameter.................... Depth below inlet.... ............. Total leaching area..................sq. ft. z Other Distribution box O Dosing tank ( ) Percolation Test Results Performed bY............................................................................ Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...................... P: 0 Description of Soil.....................................•----------------------•-......---•--...--------------------------••----------•--•-----------------------......................._.. x U ...-••---•••••••-----------•---•-•------•----••--•••---•-••••-•-••--------•--•-••-•••--------•---•--•.....------••-•••-•.............••-•-----•.....-•---•-•-••••...••••••...................•--•-------- w VNature of Repairs or Alterations—Answer when applicable............................................................................................... .. --------•--•-•------------------------•••--•••-•--............ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T a 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance s been ' sued by the board of health. igned ............ .-• . . .................. ate Application Approved By.......•-• - ... .................................................•-•--•--•-•-•--.... .- .............. Date Application Disapproved r t following reasons-----------------------•-----•-••----......--•-------•--•------••----•--......................................... ......----•--------------------------•-•--•------------•-•-•••--------•-•.......------...............••..._...........---•--••-••-------•---•--•----•-••---•-----------••..-•-----•-•------•----...------ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS 1- BOARD OF HEALTH ..........................................OF..................................................................................... Trrtifiratr of f ampliana T S CERTIFY, That the Individual 'Sewage Disposal System constructed ( or Repaired ( ) by /ram. .,T ............................ .......... ----------------------------------------.------•----------------------- ... ..................... q Installer at.---- -=- ......... ............. .LeA.t... �._...._..... has been installed in accordance wZst l provisions of TIME 5 of The State Sanitary Co as e- ribed in the application for Disposal Works Coction Permit No._ ." "Z ............... dated_.7. .,�... ._ .:�.---................. THE ISSIJANC OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® A BJARANTEE THAT THE SYSTEM?I F NCTION SATISFACTORY. 2 DATE... .................................................... Inspector......... .. . ---•-......................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........OF........ ..................................................................... �j FEE--6Jrt_... ..... L �io�oo 1 0 �ono#rion �erutt# Permission is reby granted,--, .....•-•-----•-••-•••--------------------•••••-•----•-.............---.....................-•---•--- to Cons or / air ( a ,dual wage Disposal System at No.. o , •• �y'' 1 � � ` - -- --- ------•-•--------••-- Street /J as shown on/theap..lica n for Disp` al Works Construction Permit No............. ted_ 1 ..y. ................... DATE_ •------•--••---•-••-••---•-.s•--• ...... •••--•--•••-•-•-•••--•....-----•-••--•----•---....----••••. oard of Health FORM 1255 A. M. SULKIN. INC., BOSTON � `�1►���= FAMILY � � gEOR00M I.Jo G'Ac�BAGErjQa1JDE2 ' o�a►�.`( Fuow .: Ilo x 3 - 33oG.Pp IjEPT1G TP►JK = 330K15�'/• = A95G.R 2.23 E- U5 %000 ! ! o15Po5AL Pl•r v6E 1 v oo GAS. ►5o 5.f~ X 2.5 r 3?5 G.F''q 50TroM AREA= 50 S.F x I. o �. �o G.P p oTA1- oESIGN vs 42-5 G.?D. 99' Z -ToTAt_ DA 1 LY F�-ov! = 33o G.Po 4 — --- _. ` • _ ' iao'o �l 5 •EXIST. �o S.T. PE2CoLATION GZAT.E = 1''IN 2MIN o�►-655 \ FAD.: �N I 4 I w 'BM,y yy $ 1 4'r. of tilf:HARD ty� ALAN y�� \ 99-3 W. A. BAXTLR H JONES O 1 4 a T�avb� c24f T `�Tp/Gsy rG. = 99' S ToP FND=100.0 toad 4 loop ►N�. f, SU So✓ D 15T. G� ' ' BMX Q INV. laFpT1�C. 7' p /,S TANK •� Z ' I�P INV• �C,f7. LP!Tu INV.. INV. WITW I�3/9•I% WASI�IGD : . 6TvN6 � ,4 ya.19 Mc""� CE2TIFIGO PLOT PLAID S-fisQ7 P R U F I t_� L.o c A� I o N iy�/,Q.✓.Vi.S ryo � I.JO SCALE 5c,c.LE/'=c,/O.' �ATa G 7�3 r E ZE C.E• CsP-T1FY -THAT 'TNrc Fov Z>J4,T10t�.5HoWN HE.REoI�! GOMPt-`(5 YJI-ro-VHE �r7- AND 5675.CK ,Z,6C?u1Q.EM61`4Y!�- C) TNE- To W N O r- -I3a2nLS-rA3�,.� A ND 1 Lo�AT D 'WITN T E G: -oaD Pho.IN I DAT EG 1 ril A n vB A xT E rz.a r•.l Y E I N -13-g3 REG I S�V--Zr-,D �Aw o 5 u tzv EYoes (I p�.aN 15 NOrT 4� FD 40d AN C�STtcQ.VIL� NW.55. I. Tu15 5 i; I N'5T?-U ENT S u 2v> Y 'T I-lE D>'FSETS Suoul,� G4iPg2�5+4�Cr�SSUC�/�YG No-' 5E• 'u5ED'TO DETE.Rl^INE L L INE.S APPI-ICP I` i �j1►-,C��C FAM1��( - ,�'� BEORnoM No G'aI�gA6E �je.1�JDE2 � pia► �( FLOW .: 110 A 3 = 3306.PP SEPTIC. TA►JK 3 y5c- l000 GAIr. 2 2 I o15Po5A�- P►�' uSE 1000 S►Dar/ALL A¢Ea - 150 5'.r BOTTOM AREA= 220 S.F. "il 5 0 5.F x I o o G.P. Y �/o'�.- N 'IOTA O b -ToTA1.. 'S.T. � "... •S • ND,. PE2coLAT1oN RATE ] I"iN 2M1N o�►-�55 \ io�N 430< �! 916 G ' 99 . Z 3 3 FlCHARD w ALAN y� 99.3 II 539 � A. * W. BaXTER H )ONES No.24048 p @fsTe '• � ` b � �'•D $1jRV� 14Al • �W+I�YV ^'� ' TEST p�GsS G. 99-5 y 7OF FNP loo.o loop 1 N INS. °A'.' 97 7 z ' IOPO INV 97,5 T NK ► ( , 11c-.rv, INV.. INV. WITW 1�/ 9�,3 WASNI'i D ' 6TvN6 .19 Ao 7Cv ,2S.cY IMc� C.E9-,TIF•IGD PI-07 PI_A1,J s PRUPLG 400A✓7Z-et✓ Np SCALE SCALE/'< G� 7/�3 GE• ►. CERT1'FY 'THAT THE FDv�JDAT,nfJ.SNowN . }{E•RGo1J GOMPL`(5 YJtTNZHE. Slo�L1N� ��y�-- ��, AND SET5AGK R.6QU1R-EMfrNT� oF 'T 4 . .,. 'Ta W N C7 T3a�n1S-rA3�.►_- AND 1 S h1oT LoGAT D 'W1TN T G Glr.Oc�D P c.1N ` d AT EG 1 � KT G V-e. W E I N ! . -� e A Y �J-13-83 REG I�-z F—ZErD'LAW D 5 U 2N EYpe5 I PI.�.NI t �j NOT Q�SF p pad AN �STER.VILLlr MAss. IN5R.TuME6wr uevey `THE 0r' F5E75 6"OU►,D NoT_DE_'USE.DTh DE`TE R1^1►,1� L oT'C,I'NE j" APPLICANT �,PgT�eS„d'C'r95S��/,SIG - ACCESS COVERS MUST BE WITHIN 9" MINIMUM. - INVERT ELEVATIONS : DESIGN CR I TER I A : GENERAL NOTES 6" OF FINISH GRADE 3' MAX/MUM COVER FIRST 2' TO INVERT OUT SEPTIC TANK: 98.65 DESIGN FLOW: BE LEVEL MIN 2" OF PEASTONE INVERT IN DIST. BOX: 97.87 3 BEDROOMS AT IIO G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION OR F l L TER FABR l C INVERT OUT D I ST. BOX: 97.7 BEDROOM EQUALS 330 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY. 4' OIAM PIPE 3/4` - I 1/2' DIA. INVERT IN LEACH CHAMBER: 97.6 q DOUBLE WASHED STONE BOTTOM OF LEACH CHAMBER: 96.6 NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS 98.65 97 7 I2" 60 SET. SEE Sl TE PLAN: BAFFLE 97.87 � °� 7.6 96•6 ADJUSTED GROUND WATER: N/A SEPTIC TANK REQUIRED: 3 OUTLET 4 LC-6 LEACHING CHAMBERS OBSERVED GROUND WATER: N/A 330 G.P.D. X 20Ox - 660 GAL. J. ALL CONSTRUCTION METHODS AND MATERIALS AND EXISTING D-BOX W/4' STONE SIDES, 2' ENDS. ll 'r x 33*1 x 12"d BOTTOM OF TEST HOLE *l: 89.9 SEPTIC TANK PROVIDED: 1000 GAL. EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL 1000 GAL f/-20 CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL SEPTIC TANK 6" CRUSHED STONE OR COMPACTED BASE SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS. ' DESIGN PERC RATE C 5 M/N/I NCH PROFILE : NOT TO SCALE SOIL TEXTURAL CLASS - l 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER EFFLUENT LOADING RATE - 0.74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER 330 GPD / 0.74 GPD/SF - 446 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH- STANDING H-20 WHEEL LOADS. j PROVIDED 4 LC-6 LEACHING CHAMBERS \VI W/4" STONE SIDES. 2' ENDS. A-451 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR 451 S.F. x 0.74 - 334 G.P.D. APPROVED EQUAL. 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED SOIL TEST P I T DA TA & PRECAST CONCRETE OR APPROVED POLYETHYLENE. INDICATES p INDICATES BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER PERCOLATION OBSERVED TESTED FOR LEVEL WHEN THERE I S MORE THAN ONE _ TEST - GROUNDWATER OUTLET: TP P14560 TP #2 7. BEFORE CONSTRUCTION CALL 'DIG-SAFE". s f iaa.s r��yoFF 4 LC s CHAMBERS 0' HORIZON TEXTURE COLOR 100.4 0" HORIZON TEXTURE COLOR 100.4 1-888-DIG-SAFE AND THE LOCAL WATER DEPT. F,y�F W/4' STONE SIDES. 2' ENDS ^ LOAMY IOYR A LOAMY IOYR FOR L OCA T l ON OF UNDERGROUND UTILITIES. l 00.5 f-1 TP;t --1-., SAND 3/4 SAND 3/4 z• _ 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE ®� .. . 2..... 24'OAK` � 8` - - - - - - - - - - - - - - - - - - - - 99.7 8" - - - - - - - - - - - - - - - - - - - - 99.7 ; aaJ ��� p LOAMY IOYR p LOAMY IOYR DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION /c //� O SAND 416 o SAND 416 OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE 80' _ _ _ _ 98. 1 CONSTRUCT ION INSPECT IONS. :• ••.'•' •�lal.r C MED-COARSE 10YR C/ MED-COARSE- IOYR . •. ': SAND AND 6/6 SAND AND 6/6 9. EXISTING LEACH PIT TO BE PUMPED DRY AND 16-OAK ; � GRAVEL GRAVEL BACKFJLLED. v _ _ � -. - i01.1 51 I Q O� 101.3 i...,, / 42- LEACH PIT \ l _ - Ex/sillvc `�O P4�Foo \\ J I26" <, NO WATER 89.9 /20" NO WATER 90.4 SEPT I C\TANK y 9y DATE: OCTOBER 24, 2014 Q TEST BY: STEPHEN HAAS BM. `CORNER BH � W J TNESSED BY: DONNA M!ORAND I EL-IOl 12 \y� �\ / PERC RATE., C Z h(I NCI NCH 1 / LOT 2oza l l . 539 f S!F. 1 :. wp f' SEPT / C SYSTEIM DES I (3N 27 WAGON LANE . MAP 270 , PARCEL 190 Ra BARNS TABLE . CHYANNI S MA PREPARED FORle : O N LEGEND E S A B E T H D ,A Y 4 L OCU ■ CB CONCRETE BOUND Ij —W WATER LINE SCAL E : / — 20 0ECEMBER S . 2014 HYDRANT 3 —G GAS L l NE c OHW— OVER HEAD WIRES S T E P H E N A H A /`"'/�1 J F - LIGHT POST ENGINEERING , INC -- — UNDERGROUND ELECTRIC LINE / P . O . Box 16 —T— UNDERGROUND TELEPHONE L I NE �j~4� =�� S o u t h D e n n i s , MA 02660 r— —CTV— UNDERGROUND CA8L EVI S' ON LINE ti /i\�f �� ( 5 0 8 ) 3 6 2—8 1 3 2 +40.4 SPOT ELEVATION ..••.40--•.... EXISTING CONTOUR L 0CUS IVA P 0 10 20 40 -01 PROPOSED CONTOUR JOB N0: 14-083