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Home My WebLink About0182 ZENO CROCKER ROAD - Health Z fill UPC 17534 No.2453COR its, KASTING8,UN i c Commonwealth of Massachusetts 024' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V 182 Zeno Crocker Rd. ;, Property Address RESIPRO Owner Owner's Name information is r• required for every Centerville Ma. 02632 June 24, 2019 d` page. City/Town 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. Inspector Information i9el 1-4- on the computer, Thomas Roux use only the tab key to move your Name of Inspector cursor-do not use the return Company Name key. 89 Mayflower Lane rQ Company Address East Wareham Ma. 02538 City/Town State Zip Code rem 774-678-9066 S14531 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);I have personally inspected the sewage disposal system at theproperty address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails �F AJL ® � 1 J 2� ,i Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) System S Conditional) Passes: Y ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;� 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) 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. a. 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: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 c Commonwealth of Massachusetts f Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name informrequired is Centerville Ma. 02632 June 24, 2019 required for every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for 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. c. Other: 4) 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® 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. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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 t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments e F' J 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: 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? ® ❑ Was the site inspected for signs of breakout? ® ❑ 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? ® ❑ Wasthe 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)] l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 452 gpd Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: 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: unknown Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is Centerville Ma. 02632 June 24, 2019 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: 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 below): 3. Pumping Records: Source of information: No records Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is Centerville Ma. 02632 June 24, 2019 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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: 34 years Design plan dated 4/17/85. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 2' Depth below grade: 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.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 c 4 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 1' Depth below grade: 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: 81 x 5.67'H x 5.67'W Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 23" Scum thickness 0" 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 24" How were dimensions determined? measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The outlet septic tank cover was replaced with a new H-10 concrete cover. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 L_ Commonwealth of Massachusetts Title 5 Official Inspection Form �= Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. 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.): The D-Box is brand new. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form 1= Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: The SAS was completely dessicated at the time of the inspection, with no evidence of hydraulic failure. Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u- 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma: 02632 June 24, 2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The SAS was completely dessicated at the time of the inspection, with no evidence of hydraulic failure. 12. 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.): t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts �o- - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 182 Zeno Crocker Rd. �v Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. City1rown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc-rev.7/26/201a Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owners Name information is Centerville Ma. 02632 June 24, 2019 required for every page. City(rown State Zip Code Date of Inspection D. System Information (cont.) 14. 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 P (a A t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) P_ronerry Address-,_.I" 7FNO CROCK ER ROAD, CENTERVILLE, MA SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' q -- O ` ---------- 26.0' \, 28.5" ( Garage 33.0" Leach Pit w ---------_ \ _ I D. Box Lot #127 #182 <l.s Acres 38R. j 50.0' O Dwelling Septic Tank ASHUIVET ROAD Job # 96S81 CENTERVILLE, MA. 9 AUG 96 to e- DEPTH TO GROUNDWATER Depth.to groundwater: feet method of determination of approximation: NO STANDING WATER IN LEACH PIT OR IN BASEMENT. Commonwealth of Massachusetts �m Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: below 12' 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: 1985 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: The Application for Disposal Cinstruction Permit indicates that a test hole was dug to a depth of 12' with no evidence of groundwater. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts �v Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �. 182 Zeno Crocker Rd. Property Address RESIPRO Owner Owner's Name information is required for every Centerville Ma. 02632 June 24, 2019 page. CityrFown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 I� k� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM /I PART A. u G 16 J1996CERTIFICATIONProperty Address: 182 Zeno Crocker Road, Centerville, NA Address of Owner: GMAC FinaDate of Inspection: August 9, 1996 (if different)Name of Inspector: Daniel A. Moniz 9 Company Name, Address and Telephone Number: Danson Surveying 8 Engineering, Inc. 201 Middle Street, New Bedford, MA 02740 (508) 994-6989 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: X Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: AUGUST 12, 1996 The System Inspector shall submit a copy of this inspects n report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a hared s tem or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to a appr priate 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 A) SYSTEM PASSES: X 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. B) SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined", explain why not. The septic tank is metal, cracked, structurally unsound, .shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) 1 i i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 182 ZENO CROCKER ROAD, CENTERVILLE, MA Owner: GMAC FINANCING Date of Inspection: AUGUST 9, 1996 B) SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken orA-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: 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 AMD 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 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 and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and 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. D) SYSTEM FAILS: 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. 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. (revised 8/15/95) 2 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 182 ZENO CROCKER ROAD, CENTERVILLE, MA Owner: GMAC FINANCING Date of Inspection: AUGUST 9, 1996 D) SYSTEM FAILS (continued) 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 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 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: The following criteria apply to large systems in addition to the criteria above: The design flow of system is 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: 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 (WPA) 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 8/15/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART 8 CHECKLIST Property Address: 182 ZENO CROCKER ROAD, CENTERVILLE, MA Owner: GMAC FINANCING Date of Inspection: AUGUST 9, 1996 Check if the following have been done: X Pumping information was requested of the owner, occupant, and Board of Health. X None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined. Note if they are not available with N/A. X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout. X All system components, excluding the Soil Absorption System, have been located on the site. X The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. X The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. X The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 182 ZENO CROCKER ROAD, CENTERVILLE, MA Owner: GMAC FINANCING Date of Inspection: AUGUST 9, 1996 FLOW CONDITIONS RESIDENTIAL: Design flow: 300 gallons Number of bedrooms: 3 Number of current residents: N Garbage grinder (yes or no): Y Laundry connected to system (yes or no): Y Seasonal use (yes or no): N Water meter readings, if available: 3500 CF IN LAST 6 MONTHS Last date of occupancy: JULY 1996 COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no) N If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM X Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: 1985 Sewage odors detected when arriving at the site: (yes or no) N (revised 8/15/95) 5 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (contirxied) Property Address: 182 ZENO CROCKER ROAD, CENTERVILLE, MA Owner: GMAC FINANCING Date of Inspection: AUGUST 9, 1996 SEPTIC TANK: X (locate on site plan) Depth below grade: Material of construction: X concrete _metal _FRP _other (explain) Dimensions: 4 x 8 x 6591 Sludge depth: YP Distance from top of sludge to bottom of outlet tee or baffle: 33H Scum thickness: 8H Distance from top of scum to top of outlet tee or baffle: 3" Distance from bottom of scum to bottom of outlet tee or baffle: 1" Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) SEPTIC TANK SHOULD BE PUMPED BEFORE HOUSE IS RE-OCCUPIED. OTHERWISE, TANK APPEARS TO BE IN VERY GOOD CONDITION. GREASE TRAP-_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP _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: 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.) (revised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 182 ZENO CROCKER ROAD, CENTERVILLE, MA Owner: GNAC FINANCING Date of Inspection: AUGUST 9, 1996 TIGHT OR HOLDING TANK:_ (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP _other (explain) Dimensions• Capacity: gallons Design flow• gallons/day Alarm Level• Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX- X (locate on site plan) Depth of Liquid level above outlet invert: oil Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) NO EVIDENCE OF SOLIDS CARRYOVER PUMP CHAMBER-_ (Locate on site plan) Pumps in working order: (yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (contirxied) Property Address: 182 ZENO CROCKER ROAD, CENTERVILLE, MA Owner: GNAC FINANCING Date of Inspection: AUGUST 9, 1996 SOIL ABSORPTION SYSTEM (SAS): X (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: 1 - 4" DIAMETER x 6" DEEP (600 GALLON CAPACITY) Leaching chambers, number: leaching galleries, number: leaching trenches, number, length: Leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) S.A.S. BUILT IN LOAMY SAND AND FINE GRAVEL. NO EVIDENCE OF PONDING ON PROPERTY. CESSPOOLS:— (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 (cesspool must be pumped as part of inspection) 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.) (revised 8/15/95) u 8 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 182 ZENO CROCKER ROAD, CENTERVILLE, MA Owner: GMAC FINANCING Date of Inspection: AUGUST 9, 1996 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at Least two permanent references Landmarks or benchmarks Locate all wells within 100' q — O 26.5' a Gorage [ra 33.0' 1 Le.—Pit x ---------- 0. Box Lot #1271a2 45 U 0.35t Acres 3eR 50.0' O Dwelling \/ /I Z 32.0' Septic Tank N 60.5' ASHUMET ROAD Job # 96S81 CENTERVILLE, MA. 9 AUG 96 DEPTH TO GROUNDWATER Depth to groundwater: 6'+ feet method of determination of approximation: NO STANDING WATER IN LEACH PIT OR IN BASEMENT. (revised 8/15/95) 9 ' OWN OF BARNSTABLE LOCATION Cro Z 2 E� C r'` AGE # Z' VILLAGE 6- ASSESSOR'S: MAP & LOT 1-1 o INSTALLER'S NAME & PHONE NO. Iz£ ►G �aE SEPTIC TANK CAPACITY )() LEACHING FACILITY:(type) It (size) 6 O NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER S DATE PERMIT ISSUED: DATE COIriPLIANCE ISSUED: S 2 VARIANCE GRANTED: Yes No f � o 2 ZEE R L04k� ION SEWAGE PERMIT NO. idka � Ps-' 4 2a VLLLAGE;.- � � 17o.�a7 INSTA LLER'S NAME i ADDRESS s U I L D E R OR OWNER S(o o S DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Sy- 24 - �?S -0 �L7' No... � ``L ►� F�$.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - .................................OF......... �1�,�. i' .ter ._.._...----- . ppliratiaan for Dispaaiitt1 Warkii Tnnitrnrtiun ramit Application is hereby made for a Permit to Construct ( -/or Repair ( ) an Individual Sewage Disposal System at: _ Location-Address C or Lot No. 4 f�^ dre s Owner 1.4� �� T._/...� GrL--[=- �-'• f ..�..��......................... Installer Address U Type of Building Size Lot__.�.�,,__f9--��----- ...Sq. feet -- --- Dwelling—No. of Bedrooms............_________________________________Expansion Attic ( ) Garbage Grinder 4 Other—Type T e of Building ______________ No. of ersons__________._____..____..._._ Showers — Cafeteria W YP g -------------- P ( ) ( ) 04 Other qY-res -------•---•--- -•----•------------•--•- -••---_. ..- --------•.._...-•-------•-----•------------------------------------------------------------ W Design Flow............. .....................gallons per person per day. Total daily flow........... ................gallons. WSeptic Tank—Liquid capacity,l _gallons Length.. Width................ Diameter________________ Depth................ x Disposal Trench—No. .................... Wid h__.................. Total Length..___..____._..:.__ Total leaching area____________________sq. ft. Seepage Pit No___________ ________ Diameter.___ _?-1...... Depth below inlet__._ _`___ Total leaching area _ �_.___sq. ft. Z Other Distribution box (�/S Dosin� tank ( ) f ( `"' Percolation Test Results Performed bya -� Ci..._.................... Date.... ........ -' ,al Test Pit No. 1___4�l nutes per inch Depth of Test Pit.......V�:...... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------- j ___-.._...-------- -------------------------------- ---....... •--------------•--------------- O Description of Soil '��-..................-`� < ' L� -----------------------------------•--••-•••------ -.. i. .........r•- ._._�_ ,--- °5................................................. ---•------••--------------------------------------------------------•---•----------------------------•----••••-----------...-------------------•--..................................................... U Nature of Repairs or Alterations—Answer when applicable................................................................ `..................._.......... ...---•---•••--•------•--------------------•--------•----•..._....._....._..._.._...................----....------------------------------------------•------------.-. --..-•-•---•-•-•-=............. Agreement: The undersigned agrees to install the aforedescribed Individ 1 Sewage Disposal System in accordance with the provisions of iITLI 5 of the State Sanitar*Ce he un rs' d further agrees not to place the.system in ion until sate of Compliance has by o of health. Signed --- --.. -•-------------------•---•-- - V A ate Ap cation Approved By................. ._..�-------------------•:..__...................._---•-- g Date Application Disapproved for the f of ing reasons:---------•----•--•---..----•--------------•------------•----...-----------------•-----.._..-------------------- ----...----•--•-•••-----•--•-•--------•------•-------------------------------•--------------.....---_....__....-•---------•----------------•----------------•--•--------•-----•------•-•--------------- Permit No......... S ` ��--------•-•-•---•-_. Issued............ )a� (; Date - - - st'^�,;;;> `"a No......................... Fps............................_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Dhcl. ....................0F........7f: ,{� -1 .�? ��,, ..... Appliratinn for Diopoo al Works Tonotrurtinn rautit Application is hereby made for a Permit to Construct (�or Repair ( ) an Individual Sewage Disposal System at: Location-Address � �. .O ... or ................... �t ^No. .............................. 'Ad ,a ..............:../........ ................................................... .............................................................. , Installer Address / U Type of Building Size Lotl__,r..�2c�v____Sq. f e Dwelling—No. of Bedrooms. ---------------•-•--•-••----Expansion Attic ( ) Garbage Grinder Other—Type of Building No. of persons............................ Showers — Cafeteria Q' Other es .••-•--..__...-••--•............ . W Design Flow............. .............................gallons per person per day. Total daily flow--------- .................gallons. WSeptic Tank—Liquid capacityco--gallons Length.'_;-�1 . Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Wid h ....... Total Length......._..____._... Total leaching area_-.---___.____---_-•sq. ft. Seepage Pit No........___�____-__-- Diameter....�.7.c_�__..... Depth below inlet_...��... Total leaching areaZ ......sq. ft. Z Other Distribution box (#/) Dosing tank ( ) UJ G � G�.r a Percolation Test Results Performed by.....aclzwl___ -...:......................................... Date___. Test Pit No. I...��inutes per inch Depth of Test Pit....... Z.._.____ Depth to ground water____..__"- -_. (z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a - •------- O Description of Soil----•-----•••••...�-1••-�•••.•-•--t-� ISJ �'V �-' w -------------------------------------------•------------------------------------------...-------------------------------------------------------------------------•----.......--••••-•••••......-•---•- U Nature 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 TITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in ation until -� 'ficate of Compliance has beefs ed�b' h `�bo` f health. " r " l 1 , Signed.. f f!1.+ .............................- � . , _.�'_ , �� g .. _.., . Date ...... A ion Approved B Date Application Disapproved for the following reasons--------------------------------------------------------------------------------•------------------•••-•••-.._.._ ---------------------•••••....-••••--•-•-.....•-•--••--•••••-•-•-•-••••-•••--•---._.........-••-••--•-•••-•--•••-•-••••••••••••-••-•••••••-•-•--•---•----------•••-•••-••--••-••----••-••-•-•--••-.••••. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARDIF9F" HEALTH ; ..........................................OF....... ...,.. ;,f....... . ............................... (YErrtifirtttle of i4a tv iFanrr THIS IS TO(CERTIFY, That the Individual Sewage Disposal System constructed (L or Repaired ( ) X4Z_.. Installer l '� at......---Xnestalled has bee in accordance with the provisions of TITLE 5 of The StatSanitary Code as described in the application for Disposal Works Construction Permit No--- _'`�zO.................... dated_:-------et::' _ws ----------------••--•••••----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO STRUE® #4 A GUARANTEE THAT THE SYSTEM WILLFUNCTION SATISFACTORY. DATE..........................---4 ��----•-..........---•------....... Inspector • - THE COMMONWEALTH OF MASSACHUSETTS µ,. BOARD IHEALTH ` ...........................................OF........11./.�� - f � :...------ ---:. .......... No......................... FEE........................ Dispiaual Worko Tonotrttrtuan amit Permissionis hereby granted.............................................................................................................................................. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo.............................................................................................................. •-----•-••••••--••----••---•-••-----•--•••••---•••-•••---•-••••......._...-•--•- Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... •---------------••--•---•------•----....-----•-----------------------------------•............•-•.---- ,. -.•-•-- Board of Health -FORM 1255✓A. M. SULKIN, INC., BOSTON 4� .r �5. SITE PLAN sHEEr l OF 2 SCALE: /OD, o0 _ yob 50 �iPEG95 T co". / oASox tiexv 1 h Q R.PEGAST:4_,o `C 3EPTiG...7.4AJ o z PROR. 9 re'e.okvL, z N fL, C/-, 52.0 N /o' /o /4 /4 z � Pe f �Z� q1 XS I . � /OD.DO q6 XI5 OF - y� .__ E/V O C'A;�'OCK 'ER l 0A D.wlwA�a . M ... ,VARWICK p No. 19771 LLIs LAH� FOR LE/3EL- SOLLOW.S REGISTERED LAND SURVEYOR LOT 927 ZEn/o GROGKER ZONE C __ 45,E' �'✓/Lc.E PLAN REF. DATE -- BENCH MARK DATUM F/ELD 5t/,f�1/EY WM. M. WARW/CK 8 ASSOC., INC. DOMESTIC WATER SOURCE ToW" WATER 8OX 80/ - NOR rH FA MOUTH FLOOD ZONE NON- hl,�Zff,�p, °G " MASS. '02556 (6/7) 563-2638 LEACHING . QASIN SECTION NOT TO SCALE i Shec� 2 o Z 24 C.1.MH COVER EARTH F/LL BRICK AND MORTAR COURSES AS R£0D• TO BRING q"• _ti• ,_ , COVER TO GRADE INLET iB,FLOW LINE - ; i' 2 TO WASHED PEA STONE FREE. OF IRONS, P/PE T; FINES AND DUST/N PLACE . OPENING WITH 4% ' l 34' TO I%2 WASHED CRUSHED STONE. FREE OF *V1 �� OUTER DIAMETER IRONS, FINES AND DUST /N PLACE ANO I'Y4"INSIDE DIAMETER I. CONCRETE TO BE 4000 PSI 28 DAYS 2. REINFORCED WITH 6"x 6° NO. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS '0 6 Iz 0 ' 3' 4, NUMBER OF PITS REQUIRED M Otis NOTE: EXCAVATE TO ELEVATION 32• OR EFFECTIVE DIAMETER j (NOT TO EXCEED 3 TIMES EFFECT/VE DEPTH) LOWER AS REQUIRED TO REMOVE ALL WATER raeLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. GL.E .SZ,O /B"STD. LT. WGT. C.I.MH COVER 61.o •• �' o- 50.0 4"8/T.FIBER PIPE OUTLET LEVEL DWELLING FLOW LINE r/GHT✓0/NT. TO FIRST ✓0/Nr 00 0 0 -- 1 10 (�O 0 1 r 4 C.I. TEE �� L�(p.2 110 10 0 1 1 1 j r 0 0 0 0 0 11 I I STO. PRECAST CONC. k10.l�I �pjST. BOX TO BE p ' if 000 00 1 f�QGAL.SEPTIC TANK : I I( 000 0 0 0 1 I I INSTALLED ON LEVEL, 1 11 0 0 0 0 0 0,1 1 1 9 .. �.. STABLE BASE 1 100 O 1 I II 0 1 1 \SEPTIC TANK TO BE 1 11 600 00 1 1 1 1. INSTALLED ON LEVEL 1 It 100100 1 1 ' STABLE BASE. 11600 r i 1 1 000 O0 0 1 1 1 1 ZEACHING BASIN , 1 0 0 0 0 0 0 0 BASE TO BE LEVEL O O .. SOIL AND PERC. DATA .PERC. RATE 2 MIN. /IN. 0„ TEST PIT NO. P 01� TEST PIT NO. 2 �� .Y..oP../ 5u13hdt TEST BY : E2y�� I-k��D L WITNESSED. BY _V-a1-I G.tr-1'oi�.q lGt,�AhJ Mr--DIuM TEST PIT OR. EL. DATE:- DESIGN DATA GENERAL NOTES BEDROOMS -3 NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL NoNrl- SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFL.320 GPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC. TANK GAL 'ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE SIDEWALL AREA!•5 GAL./SQ.FT. TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA I'a GAL./SQ.FT SANITARY SEWAGE EFFECTIVE ON JULY'I , 1977, LEACHING REQUIRED 2°Q SQ.FT. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. Q,FT. .-.,:.AT -COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE . hlv�rvo�t-L: 135,76f x7'r �i� g�I - BOARD OF HEALTH SHALL BE NOTIFIED FOR .INSPECTION. . =( PITCH ALL SEWER LINES 1/41 / FT. UNLESS INDICATED OTHERWISE. G,s,P.,o,e-►_tT 452-ja-)It%OF Y MARTAsVgc SEWAGE DISPOSAL 'SYSTEM IN • �` E. �,� FOR' S. � MORAN y 123417 1-oT ZZ7 Z�Gt�30 �IzO �f2 �o/�'[;;;, _. SCALE AS INDICATED DATE 1 1 f WM. M. WARWICK 8 ASSOC. INC. 8OX 801 - NORTH FAL MOUTH ` MASS. 02556 - (617) 563-26.38 PROFESSIONAL ENGINEER