Loading...
HomeMy WebLinkAbout0053 ABBEY GATE - Health 1 53 Abbey Gate, Lot 4 Cotuit A=022-112 J I 1' �I TOWN OF BARNSTABLE LOCATION fa --,4 c-..4 r- Rc L SEWAGE# VILLAGE Ca4u:i ASSESSOR'S MAPS&PARCEL INSTALLER'S NAME&PHONE NO. (3 t3 E-ycavwl i an Yl - 0GS3 SEPTIC TANK CAPACITY /000 90. LEACHING FACILITY. (type) _-ZA (size) /A/ X 20 NO.OF BEDROOMS 3 OWNER ; PERMIT DATE: G f' /y��2 COMPLIANCE DATE: Ja_ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private.Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Al AZ- , 3Z -)7 r-'Rofj r B3.3y A C3• °l y, C' Q c4 .3� , 3 I TOWN"OF BARNSTABLE LOi AT10N S3 AhV�A SEWAGE # 71 A VILLAGE 0-0 ASSESSOR'S MAP& LOT 0).`Z_U INSTALLER'S NAME&PHONE NO. f.gt✓a#c, A SEPTIC TANK CAPACITY /S, LEACHING FACILITY: (type) _-T0Q C:v OW44 ladC (size) - S�X 13 `2 �•XA NO.OF BEDROOMS-3 UDE J �I PERMITDATE: Z_ [1-1 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility . Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by oq- 411 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 53 Abbey Gate Road Property Addressy John & Lori Tarantino I -" Owner Owner's Name information is -J, required for every Cotuit ✓ Ma 02635 11-20-15 page. City/Town State Zip Code Date of Inspect)dnry 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 A. General Information filling out forms I4* 1 on the computer, use only the tab 1. Inspector: key to move your cursor-do not use the return Matthew F. Gilfoy key. Name of Inspector B&B Excavation reb Company Name 14 Teaberry Lane Company Address Sandwich Ma. 02644 City/Town State Zip Code (508)477-0653 -S113640 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 11-20-15 Inspector's Signature Date The system inspector shall submit a copy of this inspection-report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. oer'd VS t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM , 53 Abbey Gate Road - Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 , Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is Cotuit Ma 02635 11-20-15 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation.is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts M u Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: '* This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No" to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or ❑ ® clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more.than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® 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. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts _ Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town 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? El ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner) provided with El ® 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)] 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): 335 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d see below 9 ( Y 9 (gp ))� Detail: 2013-2014 (336 GPD ) Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste.holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Pumped every year(per owner) last pumped 5-18-15 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined?" Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: New leaching was added to existing tank 2012 Were sewage odors detected when arriving.at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2,6„ Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 2 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: 1500 gallon Sludge depth: 0" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts H W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name - information is Cotuit Ma 02635 11-20-15 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle NS Scum thickness U. Distance from top of scum to top of outlet tee or baffle NS Distance from bottom of scum to bottom of outlet tee or baffle NS 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.): At time of inspection septic tank appeared to be in working order with liquid level equal with outlet invert. Tank is not in need of pumping at this time. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. 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.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 01. 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.): At time of inspection D-box is in working order with no sign of back up or carry over. 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. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is Cotuit Ma 02635 11-20-15 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 1 field (24 quik 4 infiltrators) ❑ 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.): - At time of inspection leaching appears to be in working order with no sign of hydraulic failure. Leaching is was installed new in 2012. 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Fora _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i i Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title Official Inspection Form „a. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments yy� 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. Citylrown State Zip Code Date of Inspection -Q. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where.public water supply enters the building. Check one of the boxes below: Z hand-sketch in the area below r ❑ drawing attached separately At" '�•��, AZ 03 �-3.� gw i i t5ins•3N 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. City/Town 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: No Gw 120" 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: June-7-12 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: Plan on file with BOH Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 53 Abbey Gate Road Property Address John & Lori Tarantino Owner Owner's Name information is required for every Cotuit Ma 02635 11-20-15 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file P ,1 d, tV M1 sF t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 f �A� a% 12_-1x110 oy ollarI, e 'own oil° Departir wt of Regulatory Services /d nnw+ereate ^ Public Heall�t➢.� Division ]1�ate t67AM ,� 200 Main Street,Hyanuis MA 02601 rjKP�p � Data Scheduled_ / Tirne ! e Pd. Soil Suitability Assessmentfur Se'wage Disposal -')^N%;y_A -WllnessedBy: >ON bf7"-'Uv ��5 LOCATION' J[1rT][ORIVaTION LocdLion Address ^J / r c ��� Q /� Owner's Nante /�~ Ulf CJ e^�J• �Y-G.l�•/`-GC-. KfI co' / Address Assessor's Map/Parcel: �'l "1 _ Engineer's Name W 0W✓` ee NEW CONSTRUMUM REPAIR Telepltbne tl C� UO �kl d �uG land Use 1 %"�1 4,�C� Slopes(%) d^ Surface Stones � r Distance's front: Open Water Body ZZ� ft Possible Wet.Areu���y�� ft , Drinking Water Well ft Drata.ge li Way �- ft Property Une ��9 �✓� ft Oilier ft _ t•r M1 SKETCH, (Street name,dimensions of lot,exact locations of lest holes sc pert tes[s,locate wrdands'in pro xi[lily to Boles). (.j N''LZ 53 AA � 1 M _ ,�G� l[. 34 O X I >> Parent material(geologic)_ L'rjW/T�.,\4 ���� Depth IQ BWroclt, 7-Loo� Depth to Groundwater: Standing Water in Hole: Weepllig from Pit Roe �- Estimated Seasonal High Gioundwater -DIE,T]ERI1Hl\iA7['J[ON FOR SEASONAL )F)CIGJ(-IL WATER TABLE Method Used: Depth Observed standing in obs.hole: Y`We In, Ocptlt(o 5Q11 Dcptlfto weeping from side of obs.hole: _� h1 C7rlYl111dWItleY�d�l19lh1e[t„e� e.� Pt. Index Well M Reading Date: Index Well leval Adj,fr,.luov AJJ.C UP1.111CIWatel'UYLII IPE RCOLATION '7l'E Sir Observation J 2 Hole ff J Tinle tit 9" i1 Depth of Pert 130\' M(a Tin'iG 4l 61' _ Start Pre-soak Tinie @ 4� 1 PO... Time(9`4') End Prc-soak Ralc Min./Inch Silc Suilabikl.y Assessment: Site Passed_ V 5i1�Failed: Additional Tcsting Needed(YIN)_/ Original; Public>-lealth Diyiaion Observation 11o1e Data To Be Compktt td on Mack----------- ***It percolation test.is to be comidu➢cted vviLidu 100' of vve11B-andl, you must first uaoltupy We Barnstable Conservation Divis10i1 zit least Diic (1) vl'eck prior to begialtui➢.Og. Q:\S EPTIC\PER EFORM.DOC TIOLE LOG Depth from Soil Iforizon ��®l� # Surface(in) Soil Texture Soil Color (USDA).. Soil• Other } (Munsell) Mottling (Structure,Stones;Qoulders, Con isle c % ravel �L) Depth From Soil Horizon Hole Surface(in.) Soil Texture Sail Color (USDA) Soil (Munsell) Mottfin ref Other --- € sucture,S ones, Qoulders, QQ0319teocy %Crave) L -- S 2 ,.57 6 Aj t j DREPOBSERVATIONTIOLE LOG. Depth From Soil Horizon Texture Hole# -_ Surface Soil xture Soil Color. (USDA) Soil (Munsell) htr Mottling (Structure,Stories,Boulders. ('.onsistencY %Onvell a DIElEP ORS ERVATION TIO�,� ]LOG Depth From Soil Horizon Hole# Surface(in.) Soil Texture Soil Color (USDA) .. Soft Other (Munsell) Mottlln g (Structure,Stones;Boulders, ' •f Con ten c Y,e1� l�'Vm®d]f>tDsaau•aance][fate Above 500 year•flood boundary No__ Yes V 4 Within 500 year boundary No CS Within 100 year flood boundary No� Yp5 Dp tli of 1''1iquirQ711y_ c u_�ara>ira�1fD��vai o_ us 1V�aterta9 D"'at least four feet of naturally OCCUTTin erviou F area proposed f �P s material exist in all areas nbserv�d thrpu pout p p or the soil absorptions stem` the Y 2 If not, what is the depth of naturally occurring pervious mar8l,1611 N��T C�eHilfacation I certify that on Az . (date)I have passed the soil evaluator examination approved by the Department of Environmental.'Protection and that the above analy.;is was performed by me consistent with 1he required t expertise and experience descri ed in �10 CAdR 15.017•' 1 Signature Datb—(� Q:�SEMCTRRCI+oRM.DOC / No. jl j Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BA;RNSTABLE, MASSACHUSETTS ftpliCation for Misp0sal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 5 3 —Ab y -pc- &o Owner's';ame�ddress,and Tel.No. ? p Assessor's Map/Parcel 2 �) 01CCinjI(o 50k_ '�j 0-, g /I tall 's�ame,Address,and Tel.No. Designer's Name,Address, d Tel.No. 5 OR 3&2— icCq�Ct.-�t�f1 5�g- �7-�653 ma n Knee i 45y Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33 V gpd Design flow provided 3 3 gpd Plan Date (Q 17112 Number of sheets r Revision Date Title -rdl k 5 S I4 e_ Plan Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. 1 i Date Application Approved b Date os Application Disapproved by Date for the following reasons Permit No. ;�,C(��y �- (7 Date Issued tY------------------ T (/ No.1` T -w -6. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in compute Yes PUBLIC HEALTH DIVISION -TOWN,OF R,ARNSTABLE, MASSACHUSETTS �V IH r_ 4plication for MispoBaY opstern ConstrUctlon Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components !A Location Address or Lot No. rj 3 ,Ab Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 2 )` nLori � �L� z Installe 's Name,Address,and Tel. o. / Designer's Name,Address..and Tel.No. 5-09 2_ EXCnvcdion 60- - � 17-0663 �o�t�CL e. n�if7eP.l + y5y Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 23 D gpd Design flow provided 3 3 gpd Plan Date (0 11�:"l!1'?_ Number of sheets Revision Date Title �, S1A C (lfl Size of Septic Tank Type of S.A.S. . Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: S # 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. Date 6, 1 Z Application Approved b Date Application Disapproved by Date for the following reasons Permit No. /`� /Q '� Date Issued tY --------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(v/) Upgraded( ) Abandoned( )by -{'"l A 1� ,1 /ga-1 n n at + � h f_'\► �_�� j� has been constructed in accordance J with the provisions of Title 5 and the for Disposal System Construction Permit No. Ptated 6 j 21h Installer { k In ( Designer /-1 #bedrooms �_ Approved design flow _j gpj m The issuance of this permit shall not be construed as a guarantee that the syste will f i tion designed./ Date �-• Inspector No. ` / r Q 3 _ -- Fee: THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS bisposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair(✓) Upgrade( ) Abandon( ) System located at "� v� �.,�p 1 61 r k P--p an 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 b completed within three years of the date of this permit. Date /� �/ Approved y FROM :down cape engineering inc FAX No. :15083629880 Jun. 22 2012 02:23PM P1 ym " 1µ i (i�r %h� frlr A•'S�PtLL hF %�-V�� r��}..';\� a�r411?k'c��,ui}lv�e! �''i��• \ `fv y�;= � i � .. �. „ : « TP04)' J< -R a:'e'i<Ga Ti', aY.1,61 fi�,n.`o:9j$. i°62�FlII�. �2�i1.11:11.4 ` IlElII�Il6Till Thumau lur�'a•.�ul< • �QJ�� MN:alrrn t,�n-�efi,�3[yi�y)itoir;al f�Ytl;4,41;*.�rQiA f • OLiu ,: Fax: 08'J90 6301 Thl" tlDe>I• +, 11llu s ilk 1r R iuFit a ttaaa�rn .1�1vii nnn '9rw2i-e Per. mit# `��. �a 2^�rau�".a IIwo�oli}" lCU e y ngni.a n: U In1 r1 Q / J(unr;4�a➢.fin n• ICJ 'CCR ✓�t,/]10 !__"6 L�l._.: U '. .-- �.Ir�¢As s^�: I(. l °.°a 4.,i 7- EYL, +va:�T.��u.c_c1�t pc;T.>�t lu m^ta.11 n -• . - se.ptle.system at }i,lseH ai.� design dnmm'hy ^ T c ltify thin. Lht" scpbu, ,,ysLem refPeeJarc;d abovu: wm liw.Lalled. ;,Tah;fi �itiaJly :cr,orcling ts� t}.e des.ie , Widrh may i.rtclurfe, iuiuur appmvecl c} a;L�-�;es's�Ja.h :.s l�tet»i rolui'Liboll oi, ipli " di;iribr,.lioubu:(az).rl/or c; (ir.. Lank. cx:ltdy tbat..tlle septl.c sysfe.)ja o;Ii;rc::uccd above was.il7 Ied witl't•.ul,9jo:1 cllall ", !�'eateT thaii l 0' lateral relnc@t O>l of thlc SAS ur any vertica:[re.lncatic?.ri of�tLy cuFnpouc:,i�t Of thr septic systeaaa) f)ut;i�l ar..c.,o)rcl�u7r�e 'An'.1h St fc-, Loe'al R(:gldallwm- Plan revi;ir•rn-rn• x.i i ilecl.as-ht.til.L lTy deli. rier L6 :fol_low, Y, DANIFLA. n a n� (TT1iL�L1.lNr�a ;1 Tl�iLl!➢:l: CIVIL ei ' f V 9 No.4$502 Pw ULitc fl.tl, ;. 7lklilat«re) er's �tamh TTerc) TtRTTJVq TO B,,�RNSTABT,m, t TT .j-(: 19JL;AL'9 H DIVISION. is:rll'(0'.!_li(((.'A••1E U)0'. M1:PPVP,LfAI CE "Will, NOT .t Ffl71TJT_ 'UPa11L T'C9'I H 7 T S FC`rMY( ,4 Ntz -48-li1 W,A' ('Ad P-1+KU - T?F,rFIIT ETA 11Y TBIIJ UAR. S I('ATiT,V;�°Tr��,�a ��a��DTVVST - _. ........---- !t '-,TOial_TR,4 i`dA4;YOT7.. . r,..TT...,1.1.1!,...w,,,/1,.,..,nnn,../'nil.�,. .. 7'•,.-.,. '/!.(CIA.a n. ' ' NO. `77-/G THE COMMONWEALTH OF MASSACHUSETTS FEE d� BOAR OF HEALTH APPLICATION FOR SYSTEM CONSTRUCTION PERMIT Application Construct (') p 1 ) Upgrade ( ) ( ) / P t Y ❑Individual Components 5.3 o. _ I cv\_&4CUAI� ocation Owner's Name l��naQ- i 1 Map/Parcel# Address Lot# Teletne# { (� s, m ae Designer's Na ro re d�55 �—�212Address Telephone# Telephone# _ Type of Building: Lot Size DO,r4t5D Sq.feet Dwelling—No.of Bedrooms 3 Garbage Grinder ( ) Other—Type of Building No.of persons 1,0 Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min. required) fE6 gpd Calculated design flow 5, 50 gpd Design flow provided 3�'Sgpd Plan: Date Number of sheets I Revision Date Titl 3"O Description of Soil(s)a= "-( " ,wt t Sal,6al, v" Lou'-14 Soil Evaluator Form No. Name of Soil Evaluatorl7�_,.,,t"rJ Date of Evaluation �(-�°�-�1`� (�-gd•S3 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE S and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed S44P.4 Date Inspections 7 7 FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 a „f No. THE COMMONWEALTH OF MASSACHUSETTS FEE O� t BOAR OF HEALTH OF i APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (") Repair ( ) Upgrade ( ) Abandon ( ) - [�/Complete System ❑Individual Components 53 ocation Owner's Name Map/Parcel# Address t Lot# r,, Tele ne# e Ue Ce J + � st• ame Designer's Na i re © *—V- A Id ss .. Address o� �.3 9 �1�-7 21�Z• Telephone# ` Telephone# Type of Building: Lot Size �?OiF7),5D Sq.feet Dwelling—No.of Bedrooms, LIGarbage Grinder ( ) Other—Type of Building No.of persons Showers (� ), Cafeteria ( ) Other fixtures a. Design Flow(min.required)- _gpd Calculated design flow 530 gpd Design flow provided aJ�pd Plan: Date Number of sheets ' "'° Revision Date Titl Description of Soil(s)dl •a"-I sad "-I,v"IYIe1Loa"-1 (1� Sa..`�... Soil Evaluator Form No. rName of Soil Evaluatorl>•S x,A-_14 i Date of Evaluation x. -DESCRIPTION OF REPAIRS OR ALTERATIONS ' t The undersigned agrees to install the above described Individual Sewage Disposal System,in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date u Inspections � �"�"`" � � a I a-" 7 } FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 — No. _ � THE COMMONWEALTH OF MASSACHUSETTS FEE In- - BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑rIndividual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( "),Upgraded( ),Abandoned( ) by: at y has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) t Installer q (� Designer: Inspector 'fat Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 q No. �� THE COMMONWEALTH OF MASSACHUSETTS FEE a � BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( ) Upgrade I; ) Abandon ( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. 2�7- 7 dated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. Date j%n— 17- y Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 i FORM 1255 (REV 5/96) H&W HOBBSB WARRENrM PUBLISHERS- BOSTON i TOWN OF BARNSTABLE LOCATION -r 3 R,QV GQ SEWAGE # Of VIILAG ASSESSOR'S MAP.& LOT INSTALLER'S NAME&PHONE NO.-� Re✓ili!C�GA 33-yf9q . SEPTIC.TANK CAPACITY LEACIiING FACILITY: (type). c� 09346el& (size) _fit C�X ILA �.t "'Y'2 NO 'OF BEDROOMS 1.5 UIID OR OWNER co1A PERMTT.DATE: 9 R COMPLIANCE DATE:, ( _Separation Distance Between the: Maximimi Adjusted Groundwater Table and Bottom of Leaching Facility Feet PrivateWater Supply Well and Leaching Facility (If any wells exist, ' onsite'or within 200 feet of leaching facility) Feet Edg60:Wedand and Leaching Facility(If any wetlands exist wittii11100 feet of leaching facility) Feet . FurnI kited liy Fr%- 1 M Town of Barnstable I'# 10 .5 3 Department of Health,Safety,and Environmental Services Public Health Division Date 367 Main Street,Hyannis MA 02601 BARNWABM Date Scheduled Time .l Fee Pd. (� Soil Suitability Assessment for Sewage Disposal Performed By: U_e. �4( (7 Witnessed By: LOCATION & GENE LI FORMATION } Location Address 5-1t) - Owner's Name Address Assessor's Mar/Parcel: fv\a_,V ZZ e c—A k t Z— Lof 4 Engineer's Name Cap A F"i I INEW CONSTRUCTION V REPAIR Telephone# 4-1-1- -7 21 Z— Land Use Slopes(%) Surface Stones Distances from: Open Water Body R Possible Wet Area R Drinking Water Well R Drainage Way R Property Line R Other R SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert to ts,locate wetlands in proximity to holes) 3 . .� a 0 � tri O 2— W 3 r CD Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater TIETERIVIINATIOlri 'OR SEASOIVAL.HIGH WATER FABLE ' Me6hod Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment R. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ .PERCOLATION:TEST . Date Time::; Observation Time at 9" Hole# Depth of Pere y8 re Time at 6" Start Pre-soak Time c@i �;NSA Time(9"-6") End Pre-soak �• f Rate Min./Inch Site Suitability Assessment: Site Passed I/ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back— > Copy: Applicant DEEP OBSERVATION HOLE LOG Hole # Depth from Soil Ilorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° Gravel) 2.3�G i�— eo " G �r�.e 5q.J r2 51l 54w /o All G� n ole'w 7F DEEP OBSERVATION HOLE LOG Hole# _Z Depth from I Soil horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munscii). Mottling (Structure,Stones,D-oulderes. Consistency.%Gravel Lo 2—�(occ /3 �Sq�H. 1072 �1j6 Me—c/ /tlo li7 wK,al w �v DEEP OBSERVATION HOLE LOG Hole# Depth from I Soil horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°o Gravel) DEEP OBSERVATION HOLE LOG Mole# Depth from Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°o ravel I Flood Insurance Rate Map: Above 500 year flood bcundary No_ Yes Within 500 year boundary No— Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? YP f If not, what is the depth of naturally occurring pervious material? Certification 1 certify that on ��" 9 - f 7 (date) I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature Date i F i ALL SYSTES SHALL SYSTEM PROFILE ILE MARKED WITHC MAGNETIC TTAPE OR BE NOTES 1 �8 0 (NOT To SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS ASSUMED PROVIDE MIN. 20" DIAM. WATERTIGHT c ACCESS COVERS TO WITHIN 6" OF FIN. GRADE PROVIDE INSPECTION PORTS TO 2• MUNICIPAL WATER IS AVAILABLE C \ 32.2' WITHIN 3" OF FINISH GRADE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. Z MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS TO BE AASHO H-M •.a 29.7' 4"OSCH40 PVC 5. PIPE JOINTS TO BE MADE WATERTIGHT. PIPES LEVEL 1ST 2' SamPso17s Mi// 10" EXISTING 14" 27.0' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE O ,' WITH '••'' TEE SEPTIC TANK TEE 310 CMR 15.000 (TITLE 5.) Lo us 28.3 f*' 26.6;�' GAS BAFFLE::; °°o°oogog°o° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND 0.67' NOT TO BE USED FOR LOT LINE STAKING OR ANY 26.9' 26.73' 26.0' OTHER PURPOSE. ,' ':, ..•...,:.. . ..,.. .. ;: 1 WATER-TEST D'BOX ! '� FOR LEVELNESS 24 STD. QUICK 4 UNITS 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. pG 6" CRUSHED STONE OR MECHANICAL 6" MIN. SUMP ,(NO STONE PROPOSED) COMPACTION. (15.221 [2]) 12" MIN. INT. DIAM. 9. COMPONENTS NOT TO BE BACKFILL ss�f Q _ - ' CONCEALED WITHOUT INSPECTION BY BOO ORARD OF -q ' HEALTH AND PERMISSION OBTAINED FROM BOARD (3.3 X SLOPE) 7.5' OF HEALTH. ( 2 % SLOPE) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP FOUNDATION- EXIST. SEPTIC TANK 42' D' BOX 5' LEACHING CALLING DIGSAFE (1-888-344=7233) AND FACILITY VERIFYING THE LOCATION OF ALL UNDERGROUND & NOT TO SCALE * "INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL BOTTOM TH 1 EL. 18.5' WORK. i ASSESSORS MAP 22 PARCEL 112 UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE (OR H-20 11. ANY UNSUITABLE MATERIAL' ENCOUNTERED SEPTIC TANK IF IT WILL BE SUBJECT TO VEHICLE LOADING &,/OR > 3' BELOW GRADE). SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY.; LEGEND12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED ANb FILLED WITH CLEAN 99- EXISTING CONTOUR SAND. i SYSTEM DESIGN: X 99•1 EXIST. SPOT ELEV. ss PROPOSED CONTOUR GARBAGE DISPOSER IS NOT ALLOWED 198.41 PROPOSED SPOT EL l DESIGN FLOW: 3 BEDROOMS 0110 GPD = 110 GPD TH1 USE A 330 GPD DESIGN FLOW TEST HOLE ELEC. SEPTIC TANK: 330 GPD 2 = 660 2� SLOPE OF GROUND EACH UNIT IS 2.83' WIDE 1'39 33' HANDBOX ( ) C_(1) UTILITY POLE BY 4' LONG TEL I RE-USE EXISTING SEPTIC TANK** RISER 35 FIRE HYDRANT 24 QUICK4 STD. LOT 4 I I LEACHING: � INFILTRATORS 1" = 10' 20,217 $Ff �,� I I � _ ELEC METEFjl 4.72 SF/LF x 4 LENGTH 18.88 SF PER STD. -W WATER LINE QUICK 4`,UNIT -G GAS LINE I 330 GPD/0.74 GPD/SF = 446 SF LEACHING 1 ` -E REQ'D ELECTRIC LINE � "� NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING N / I , 446 SF/18.88 SF/UNIT = 23.6 UNITS TEST HOLE LOGS I / _ THEREFORE, USE GRAVELLESS SYSTEM OF (24) I �W to STANDARD QUICK4 UNITS IN FIELD CONFIGURATION ENGINEER: DANIEL A OJALA P.E., P.L.S., SE LIG TEL&CATV&ELEC I I" W SHOWN (SEE DETAIL) I PA ED WITNESS: DON DESMARAIS R.S. I DR] E Im Q + 24 UNITS x 18.88 SF/UNIT = 453 SF> 446 SF DATE: 6/4/12 L _ _ TOP STAN r 453 SF (0.74 GPD/SF) = 335 GPD (OK) PERC. RATE _ < 2 MIN/INCH EXISTING �v I-' '� _ - - Ir 1,. I I L�.1 co DWELLING ► �T �^ I� CLASS I SOILS P# 13657 EL. FN 2N2. ow { ELEV. ELEV. ; 4 4 BENCHMARK I_ J1 1-], - I 0 28.5 0 29.8 DECK COR BRICK STEP o I f-tu A A/FILL ELEV. = 32.52 GAS I MA LS LS / �/ METER SEWER LINE MUST BE APPROVED DATE BOARD OF HEALTH 10YR 3/2 10YR 3/2 \ ( N �\ h N N N ` I , 4i I SLEEVED FOR 10' EITHER SIDE 8 27.83 14 28.63 N N ti -`� I OF CROSSING WITH FILL B < _ _ , �� I WATERLINE TITLE 5 SITE PLAN \ -Eo ELq N3 �� I OF LS LS G �. `" I 60" 2.5Y 7/4. 23.5' 36„ 2.5Y 6/8 26.8' 2 53 ABBEY GATE ROAD fr , !A COTUIT, MA 41, o\ _ 2 ({C~ ({C� N� TTQ�V: GA ss�� PREPARED FOR PERC C C ) - \ r„ �� �y�v�s sq�y Q �ANIEL B ur,?�iELA. n &B/TARANTINO I�JAI� + " OJALA N M/CS M/CS No. c" L DATE: JUNE 7, 2012 off 508-362-4541 2.5Y 7/4 2.5Y 7/4 136.14' ZE sgcy ° DANIEL Ssgcy fax 508-362-9880 � �� I o OJALA ` A. downcape.com CIVIL ' OJAL.A . ro 502 No.4096 down cope engineering, iac. 120" 18.5' 122" 19.63' EXISTINGyo��s c'STER c� < o� civil engineers Scale. 1 - 20 oNAL E� ? s vEy- land surveyors GARAGE PORCH (�/r-Z �. _- s S �/ rS NO GROUNDWATER ENCOUNTERED 939 Main Street ( Rte 6A) 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P. S. YARMOUTHPORT MA 02675 L�L '2- ' 4 0 12-140 B&B TARANTINO.DWG n. r .knw. :.:..v...,a..;. ...w.e.a.r'Isew:ai.•.:.: xaw...vv .,tiY..v:4Z.Fi1 ']Mw'I.::r..a.. _. NOT TO .30ALE —� FINISH GRADE TOP FNON. FINISH GRADE OVER EL . 7�, FINISH GRADE FINISH GRADE OVER DIST. BOX OVER TRENCHES 7z ' o ?,p SEPTIC WANK , .. a,o•. c77x��Y�°1'fRt�7'7i'�� � • . -X YAV ter' �• 12 MAX. •Q' q 'p o,0 Q t off' .•� �.�: aC1,;6�.dh".i',,:,9..;4,og ti7•,ii�•;a..,;�L4,}p.„q,(y.'a.,, v' .�''�•V�.:QdO TO TA L ENGTH OF TRENCH p• a p, i , „ OUTLET PIPE LEVEL `� =a' (�'��o , � ` FOR 2 FT. MIN. ' - i a pO.D _ �.Q.' \.1 V off" w. fib. o bib p� U �e,'�° •i .4 to ._. • y D' '.v pb .� s j 00 po p.: ` 1 e---.'. Q•P . p i ,1— —. 0 ` �+.t,-•-T��,,_, , ,,°'a ,, ' Q9 '}i� •r ':�' V 7D /�5' o •+ ) OP IC b s �G ION 4 0pp / AA I p I p a'oe aOQ 4 L -1500 f`t L i./'!{9' by .�' TR BU TION BOX BSMT FL . °:o..o :a D.b. INSTALL ON LEVEL BASE EL . � �•� .;o:V;o� Ob +rSOU GALLON ORYWELLS „ ° I oaf sEC TC,�-; TE H— A 'f ZNF 0F1C L.J a.d±o:a.:=3.v,:b7:fl'�1,.�:,��,.';C'r-v,- V•,L'+'J!"E'a'�'.V vQ�•�Q•o4a,.Gh�4: .�-� .�,-.� 1� .. ..a:b••®. . .o.a.. .•�'., ,.: _ ..s. .: .�, �: ..b. . TRENCH SECTION =� -- E P T1 C T 'A N I'NS TA L L ON L EVEL BASE NO TE: EXCA VA TE TO EL EV. OR LONER TO REMOVE ALL IMPERVIOUS A N x MATERIAL BENEATH THE LEACHING AREA 4� DIAH. 12" MIN. REPLACE EXCA VA TED MA TERIAL KI TH a, 3" OF 1/8 "-1/2" �✓a'�.��- d�' n o CLEAN. CLAY FREE SAND • . .d,.;p o •• WASHED PEA STONE -../ •. t'1 , . 3/4" - ?-1/2" WASHED �.-• 0 ., '�~ CRUSHED STONE ••� a: �" � G � � 131 — '` _ ...... '. _ GENERAL, NOTES TRENCH WID TH 1. ALL ,ELEVATIONS 3HOWN ARE BASED ON ASSUMED NUMBER OF TRENCHES 1 2. ALL PIPES IN THE S YSTEM MUST BE CAS T IRON NUMBER OF DRYWEL L S 2 z r —o OR SCHEDULE 40 ,PVC. OBSER VA TION PI T -- - 3. THE BOARD OF HE,`�L TH MUST BE NOTIFIED = WHEN CONSTRUCTION IS COMPLETE PRIOR TO BACKFIL L ING PERGOLA TION RAT _..—! 4. ANY GRANGES IN THIS PLAN MUST BE APPROVED �2 MIN./IN. �"�� ` BY THE BOARD OF HEALTH AND CAPE 6 ISLANDS WITNESSED BD:' SURVEYING CO.. IaVC. GERRY DUNNING 5. MA TERIAL S AND IVSTALLA TION SHALL BE IN BARNS COMPLIANCE WITH THE 5'TA TE SANITARY BRO. OF HEALTH DESIGN DA TA _ - - DA TE.' O V. 19_1997 �=� - N 05'49_50 'E CODS: — TITLE V — AND LOCAL APPLICABLE — z �i -�9. 7' --------.�.� ' � �.�so. 7s RUL�'S ANf? REG�JL.� T.��ONS ,' ' � � �-,v -, '� '� `' ' 7 NUMBER OF BEDROOMS 3 - S. NOR7W ARROW IS eP*ROq RECORD PLANS AND � ,��� � ^� ( ��yR 2-1z j z, i�� � "'""� GARBAGE DISPOSAL NO IS NOT TO BE L SED FOR SOLAR PUR�'OS�ES L b� �y f j r_ 11 r •'/6 1. on „ !, ✓_ _---— _. a 7. FL OOO H�%'WARD ZONE C ,'NON-HAZARD) -A.,d y 330 GAL . DAILY FLOW - —7"OWJ�I—T, �, e », ra y n /� 1500 GAL . B. MA TE SUPPL Y 3G'' SEPTIC TANK REO D. -5��° SEPTIC TANK PROVIDED 1500 GAL . '0Y2 330 GPD. M c ca,V w LEA CHING REQUIRED o r«k rn AAel i v 152 sn h `e-i ,�Y R 4 qjqffWALL A E,04 + =S3'F2 S.F.X .F. GPD. .2rJOM ARE04 S.F. S.F.X G/S.F. GPD i y' N y- 7 I T�J-/% L EA CHING PRO VIDED GPD 4/c l PROPOSED ELEVATION -- EXIST.:NG CONTOUR SINGLE FA MIL Y RESIDENCE & OBSERVA TION PIT ❑ DISTRIBUTION BOX PROPOSED SEYA GE DISPOSAL SYSTEM OF x - --- . __/ PREPARED FOR r ABBEY GA TE Y o o SEPTIC TANK �.�s, ��4> JOHN TA RA N TINO L O T 4 (HOUSE NO . 53) A BBE Y GA TE' RESERVE AREA -CAM k °F ��, ; CO TUI T — BA RNS TA BL F — MASS. DAVID y ? PIPE INVERT EL EVA TION CHART E" sAc� 28085UF35 DA TE.' - �� y�9> CAPE 6 ISLANDS ENGINEERING i-& •�+ � � PLOT PLAN ' SCALE AS NOTED 133 FALMOUTH ROAD — SUITE 2E .;� � � �: � a l � ��. '�,-� ��,`�'�� t�+ s�`�i t ..,5-'G SCALP' 1 "� r_ o MAP _SEC PCL LOT ._..HSE '- PLAN NO. � y z i o 9 7 MA SHPEE, MA SS.