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HomeMy WebLinkAbout0020 BAYBERRY LANE - Health 20 Bayberry sane Cotuit A= 019-123 i 1 TOWN OF BARNSTABLE LOCATION a 0 Zc A %3e s Pv k e►tiA SEWAGE# 201 o 3 8 7 VILLAGE C.T ASSESSOR'S MAP&PARCEL 1Q - 12;ice INSTALLER'S NAME&PHONE NO. Ccs- eL4,�dp5�',n�,o!cTr,%e S SEPTIC TANK CAPACITY 1S 00 l-\ %O LEACHING FACILITY.(type) Iq A rC g(o 1kp (size) 1.5 x Zs- NO.OF BEDROOMS .3 OWNER VU L-,kxr PERMIT DATE: 1,o COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility o 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 S Ao ab �\ ;�7•y F�2 32 3z 3�•� pvS 1g.s 3rA to . o 76-L9 a 6 I - Commonwealth of Massachusetts 9— /a-`3 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane ' Property Address ' h� MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name rCy information is required for every Cotuit Ma 02635 5/5/19 page. City/Town State Zip Code Date of Inspection C" 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 on the computer, use only the tab Michael DiBuono key to move your Name of Inspector cursor-do not DiBuono Sewer And Drain use the return Company Name key. 35 Content Lane Company Address Cotuit Ma 02635 Cityrrown State Zip Code 508-364-9587 SI 13522 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property 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 5/5/19 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 I Commonwealth of Massachusetts I,P Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. Cityrrown 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: ® 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: System contains a 1500 Gallon septic tank as well as a concrete distribution box and 19 Arc 36 Infultrators 2) 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): l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 J Commonwealth of Massachusetts Title 5 Official Inspection Form I;o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS,WILLIAM L TR& BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. Cityrrown 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 IIII Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every COtUIt Ma 02635 5/5/19 page. City/Town 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 I 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 c Commonwealth of Massachusetts , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments „V 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. City/Town 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 Y2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. Cityfrown 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 break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 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 l� ! Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS,WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 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 flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: Vacant 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 ears usage d 159 Gpd 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ❑ No Last date of occupancy: Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts - (P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every COtUIt Ma 02635 5/5/19 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: Not Provided Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for um in : p P 9 �- t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. Cityrrown 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: Installed 2010 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): _ Depth below grade: 1.5 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.): System is vented at the roof line. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 1 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1,500 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Sludge depth: 3 Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 30" How were dimensions determined? Tape Measure Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tees in place at time of inspection. Tank is sound t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form - Not for Voluntary Assessments U 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is Cotuit Ma 02635 5/5/19 required for every 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 r Date of last pumping: f 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 Commonwealth of Massachusetts Ip Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 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 Level and at normal level 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.): l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ' a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Barberry Lane Property Address MATTOS,WILLIAM L TR& BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. Cityrrown 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: 19 Arc 36 Infultrators Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 11.5x25' - ❑ 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 ,ip Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every COtUIt Ma 02635 5/5/19 page. Cityrrown 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.): Functioning as designed 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.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4� 20 Bayberry Lane Property Address MATTOS,WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. Cityrrown 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts icp Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. City/Town 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 5/7/2019 Assessing As-Built Cards TOWN OF BARNSTABLE LOCATION a o Bq�j J(TW Jr SEWAGE# aS��y - 3 8 7 VILLAGE Cho w�� ~ASSESSOR'S I AW&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY XSton 1'!1O LEACHING FACILITY:(type) t9 AfC OW-1 p (size) _\\,S Y zS NO.OFBEDROOMS OWNER W t\�,nw. PERMIT DATE: Z,L.to COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 40 �- Feet Private Water Supply Well and Leaching Facility Of 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 leachiiJng�facility) Feet FURNISHED BY .w1��G•y �llZc� l�:L Y s At too B\ 07•y A2 %7 9-t 31.0 7 as sus 153 51.a • , R4 78,o ay 7�•b �S iff.S (3f 71.b a ,6.k, A-f �s.1 61 t4 v.1 a 1 6 R https://townofbamstable.us/Departments/Assessing/Property_Values/HMdisplay.asp?mappar-019123&seq=1 1/2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owner's Name information is required for every Cotuit Ma 02635 5/5/19 page. Cityrrown 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: 10+ 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: 9/22/2010 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: Test hole data provided 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 �y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments l� 20 Bayberry Lane Property Address MATTOS, WILLIAM L TR & BOWLER, PAMELA Owner Owners Name information is required for every Cotuit Ma 02635 5/5/19 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist pp Complete all applicable sections of this form inclusive of: p ❑ A. Inspector Information: Complete all fields in this section. ❑ B. Certification: Signed & Dated and 1, 2, 3, or 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 No. � Fee hV IE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppYicatiou for Mid opal 6 item Cougtruction Permit Application for a Permit to Construct( ) Repair Yj. Upgrade( ) Abandon( ) X Complete System ❑Individual Components Location Address or Lot No. Z.o 3 ( ��� L4-,,, Owner's Name,Address,and Tel.No. P44" 30 w le4 Assessor's Map/Parcel 19 e-im t -:, iL p le-*-F A sr- s—. IZ3 nZ _ Installer's Name,Address,and Tel.No.C Ae4--a J.Z Cn ��j'1 Designer's Name,Address and Tel.No. ' —c— ? v 11 2s S-y U,2,be,,•t Ao" Type of Building: Dwelling No.of Bedrooms Lot Size 2(P, 2-Co-7 sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 -so gpd Design flow provided 3 3"Z . y gpd Plan Date 9 — 13 —2o%n Number of sheets 1 Revision Date Title ZO -giat, Size of Septic Tank Type of S.A.S. 5 jZ1►•,a �eS t Description of Soil SAD 42!4-► I Nature of Repairs or Alterations(Answer when applicable) t G 40 r t Date last inspected: 2,0 to 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 Boar f ealth. q Sign o ate Application Approved by ate Application Disapproved by: Date for the following reasons on Permit No. Date Issued r No. Fee. " fHECOMMONWEALTH OF MASSACHUSETTS Emred in computer: PUBLIC 4 HEALLTH DIVISION - TOWN.OF BARNSTABLE, MASSACHUSETTS Yes Ropitrat tt f Or i �lO�AY �p tCm Con5trUctto ' rltiit Z. Application for a Permit to Construct( ) Repair ox) Upgrade(' )'" Abandon O © Complete System ❑Individual Components Location Address or Lot No. Z 0 tS yr ,c"��'� a ,i Owner's Name,Address,and Tel.No. N '1 P d.r yr Assessor's Map/Parcel I<9 Installer's Name,Address,and Tel.No. �i Designer's Name,Address and Tel.No. S L Type of Building: `. Dwelling No.of Bedrooms Z 2.g � Lot Size � sq. ft. Garbage Grinder Other Type of Building -� �a.�.' No.of Persons Showers( ) Cafeteria( ) Other Fixtures f Design Flow(min.required) 3 gpd Design flow provided 3—I • �( gpd Plan Date 9 - - 2 o �o Number of sheets 1 Revision Date j r 13 Title 2 'a Size of Septic Tank I S I1- U Type of S.A.S. "Description of Soil � a - i Nature of Repairs or Alterations(Answer when applicable) 0 Date last inspected: Agreement: r 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 Boar 6f Health. - d q � ZOIY Signc) , Date Application Approved by /? , . ate Application Disapproved by: f / Date for the following reasons Permit'No. Date Issued r k THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewa e Disposal System Constructed ( ) Repaired ( �) Upgraded ( ) Abandoned( by C�,O.F ), c � 10V c j r ) L L �- at has been constructed in accordance with the provisions of Title 5 and the for (Disposal System Construction Permit No. dated Installer 1 p,,�G�tL��/I-1 ,p t� • �`��� Designer J ��h #bedrooms , Approved des'gn flow,, gpd The issuance of this ermit shall not be construed as a guarantee that the system wil f\cfion as de igned. Date 1a 1 tV Inspector ✓ , l s ----No. �•� � �� -----.—,—.�—_. ---r— �_--,—,--- �=Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 1=i5po5al 6p5tem Construction Permit Permission is hereby granted to Construct ( ) Repair O Upgrade ( ) Abandon ( ) System located at 2 0Qa�u✓v� (,,p�,c_ C o �T and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction st be c mpleted within three years of the date of thisii�t Date V Approved by ,y �r• Town of Barnstable Regulatory Services Thomas K Geiler, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Ot'tici;: 10-802-4644 Uatc: '7. iU Sewage Permit# 2®1D 3197Assessor's Map/F'arccl 19 . Installer & Designer Certification Form 1)esi�trrr; =SC—E��Jc r�e eri r' ,I ��c_.L._. Installers C6)0c ;,;c1e_ Address: Z�Sy Address: a E'aS A LU 0'e Wn ryl l•t A c 153� �j L! � _..._.._..._._.._.....- - __ --- ..-...._...._............_.._........ -�^- ."�,..__,._..,..�.. On q�2Z IV � -T �t vas issued a permit to install to (date) I instal ler) srptic, system at based on a design drawn by (-I nL c(rl �... V-1 C dated _ bey= 13 �c>t 0. (desilner) V _ i "miry that the septic symern referenced above was installed substmitialiy according. to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic conk. Stripout (if required) was inspected and the soils v,c:re 16und satisfacimry, _ I certify that they septic system referenced above was installed with major changes (i.e. greener than I(f• lateral relocation of the SAS or any vertical relocation of any component cif the septic system) but in accordance with State & Local Regulations, Plan revision, or certified as-built by designer to Follow. Stripout (if req 4 nspected and the sks were foLmd satisfuL:tory. "+OF"OHN � "I CHLN,'!•h..L j CIVII v.I ( - - Iles s Scl;n crcj_ No a,arr 1 43rR;rk•.�`� r,. nl. )e,sugner s Signatui-, (Affix esi er s nip Here) LASE RE'TUI; N "I C) BARNSTABLE PUI3 ' H ° I.,'I'LI DIVISION. CERTIFICATE OF C()M1'[,IANCE WILL NQT 13E ISSUED UNTIL. BOTH T ]S FORM AND AS- QUILT CARD ARE. RIB"..(.'TIVED BY THE BARNSTABIX PIJ:131,IC r.�r,.�I.,"l'1� 151VISION.. TIJANK YOU i., Pll t.t tt 6t% To 'd 2-920 2 _z 809 8NIN33NI8N33r Wo 90: TT 0T0z_8Z—d3S Town of Barnstable P# 3 L 3 Department of Regulatory Services Public Health Division Date rFn •`�� 200 Main Street,Hyannis MA 02601. Date Scheduled 1 Time 0 ol" Fee Pd. Do Soil Suitability Assessment for Sewage Disposal Performed By: 6r,,dLq ff. &rledb i t t_— c5,E. Witnessed By: Ala ya ly. 5 125, LOCATION & GENERAL INFORMATION / Location Address O j Owner's Name qjf 6a Laill e.. Co�V" ( Address 2-0 Boybzrrr Zw,--�.Fvi-vii-1 ('t.�1 Assessor's Map/Parcel: D `�^ /a Engineer's Name C r�/y�WI Gh h �C E'015(�e� NEW CONSTRUCTION l REPAIR x Telephone# 50 b,V'S'0'�,7 7 Land Use 9(S[deVl4'IU.1 j I A W n Slopes 0"3 Surface Stones 6 in Q Distances from: Open Water Body ®o ft Possible Wet Area ' U� ft Drinking Water Well �(Lft Drainage Way ft Property Line ' 10 ft Other r- ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Sew a[1QA�W_ Oer, 1 I Parent material(geologic) QIA ` &a Depth to Bedrock -7 120 �S .. .__... Depth to Groundwater: Standing Water in Hole:—Al oyl e Weeping from Pit Face Estimated Seasonal High Groundwater > a t t p V S DET RMINA IbN FAR S AS.ONAL:HIGH`V ATER'-A Method Used: Dtceci--Obse VC-40sl Depth Observed standing in obs.hole: 7(26 In, Depth.to sail mottles:. 7(.L6 ln. Depth to weeping from side of obs,hole: + I In, Groundwater Adjustment ft• Index Well# Reading Date: Index Well level Adj.factor �_ Adj.Groundwater Level_= PERCOLAVON TEST ut� a t� Observation Hole# Time at 9" Depth of Perc -�(1 Time at 6" Start Pre-soak Time @ ° Time(9"-6") End Pre-soak hqq' Rate Min./Inch Site Suitability Assessment: Site Passed X Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# L Depth from Soil Horizon Soil Texture Soil Color Surface(in.) Soil Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel S— 6 Y(L3 y0 �i LS 10 R 6 y©- 130 DEEP OB.SERVA.T ON HOLRtOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) - Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel g !Z LS /6(0 2 10 k SIC a S --11-413 DEEP`OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel DE T:OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Sol] in. Other Surface (in.) (USDA) (Munsell) Mottling� g (Structure,Stones,Boulders. Consistency,% r y Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes_ e _Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv'pl us material exist in all areas observed throughout the area proposed for the soil absorption system? T I If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with th e required training ex ertise andex erienc e described in 310 C MR 15.017. Signature 9 9 i g Date Q:\SEPTIC\PERCFORM.DOC TOP OF FOUNDATION = 32.2'± FINISH GRADE OVER D-BOX= 31 .5 ± 4"SCHEDULE 40 PVC MIN. SLOPE 1 FINISHED GRADE OVER BIODIFFUSERS= 31 .70 - 32.43 GENERAL NOTE S f_ PROVIDE EXTENSION RISER SLOPE @ 2% MIN. WITH COVER OVER INLET& FINISH GRADE OVER TANK EL.= INSPECTION PORT WITH \61. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION OUTLET TO WITHIN 6"OF F.G. , ACCESS BOX TO WITHIN METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE 31 ,0 ± REMOVABLE WATER-TIGHT COVER OVER @ FOUNDATION = 31 .0'± " 3"OF F.G. (ONE PER ROW) CODE AND ANY APPLICABLE LOCAL RULES. -__ _ -_ __. RISER TO WITHIN 6 OF FINISHED GRADE _ _ -_ --- 20"MIN.ACCESS 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE COVER(3 TYP.) 36"MAX. 1 DESIGN ENGINEER. 9"MIN. SEE (NOTE 21 SEE NOTE 21 PROP. PVC 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE PROP. PVC 42:"MAX. 60"MAX. TOP OF SAS/B.O. _ �, ' SEWER PIPE 5"DIA. OUTLET(S) SYSTEM UNLESS OTHERWISE NOTED. 2"DROP MIN. PROVIDE WATERTIGHT 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN �r EXIST �FtNER P! MIN.SLOPES t% 6" 3" 3"DROP MAX. 3" 9" L=23'± ELEVATION =27.43' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLOPES 1% JOINTS (TYP.) 10" 4"PVC IN FROM 1.33' 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 14" 27.50' SEPTIC TANK 4"PVC OUT TO 0 0, (TYP.) 10.75 (TYP) 1 THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. . LEACHING FACILITY all + 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 27.75' 12" 6" 27.00' �- 26.10' laid flat 2.875'(34.5" CLEAN SAND 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 48" OUTLET TEE 27.25' MIN. - 27.08' .0' (TYP.) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK GAS BAFFLE 6" CRUSHED STONE (TYP.) 5'MIN. 11.5' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS OVER MECHANICALLY REQ'D NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 11.0'TO FND COMPACTED BASE VARIES(SEE PLAN) AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX 8. ELEVATIONS BASED ON AN APPROXIMATE M.S.L. DATUM OF 35.00' 6" CRUSHED STONE OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= < 21 .00' BIODIFFUSERS (END VIEW) ESTABLISHED ON A NAIL SET IN A TREE AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLETCOMPACTED BASE PIPES TO BE LAID LEVEL. 19 - BIODIFFUSERS PROFILE 9• CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PROPOSED 1,500 GALLON CONCRETE SEPTIC TANK (H-10) (PROFILE) THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT " ' " ' " (Dimensions perWggin (BY ADVANCED DRAINAGE SYSTEMS, INC.) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES LENGTH ,10 6 WIDTH 5��`8 DEPTH � precast Corp., Pocasset, MA) CROSS SECTION VIEW TO THE DESIGN ENGINEER. `CONTRACTOR TO VERIFY THIS ELEVATION SEPTIC TANK PROFILE DISTRIBUTION SOX (DETAIL (H-20\ 19 - ARC 36HC (#3616BD H-20 BIODIFFUSERS & REPORT TO ENGINEER IF DIFFERENT NOT TO SCALE NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING NOTES: j { ���,. �• ,`',c � �✓ TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM 1 r yf' • r o • PERC NO. 13053 APPROPRIATE AUTHORITY. 1.) MAGNETIC MARKING TAPE SHALL BE PLACED I • a as INSPECTOR: David W.Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS ALONG THE TOP EDGE OF EACH SEPTIC SYSTEM I � ` • �! LOCATED UNDER PAVEMENT DRIVES OR TRAVELED WAYS IN WHICH CASE I� COMPONENT. � �, „ �..� EVALUATOR: Bradley M.Bertolo, E.LT. • •*• r THEY SHALL WITHSTAND H-20 LOADING. • '• • •r • rr• -s_ C.S.E. APPROVAL DATE: Aug. 2003 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. MAP 19 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN �,,� '- -, DATE: September 9, 2010 THE LOCATION OF THE PROPOSED LEACHING •` ``� Y O �• • TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE S , PARCEL 108 ,-: • 69 34' FACILITY TO ENSURE CONSISTENCY WITH TEST PIT MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. oo, DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER �Op / • « ELEV TOP= 31.00 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,F / + AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT i ••+ «*+ ELEV WATER= <21.00' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). t CONSISTENT WITH TEST PIT DATA. • 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN o • � PERC RATE _ <2 min./inch N « , •• ( • • SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. PROPOSED PVC VENT PIPE / O • +" f _ " - • �•• !• 4 DEPTH OF PERC = 42" 60" ? 16. PROPOSED PROJECT IS LOCATED WITHIN: o (LOCATION PER OWNER) /,. �' - • '`" «• �`� �'; TEXTURAL CLASS: 1 ASSESSOR'S MAP 19 PARCEL 123 . LOCUS ; Q 1 / TREELINE J i "« ` ' a- PROPOSED INSPECTION , .. OWNER OF RECORD: WILLIAM MATTOS& PAMELA BOWLER LO PORT WITH ACCESS BOX Y TO GRADE (TYP OF 4) �� " �' • • $ 0" 31.00' ADDRESS: C/O L&M PROPERTIES O 4; • O PROP. TOTAL 19 ARC 36 HC > � � � $�� � �� � ti� �b • Fill � 21 PLEASANT STREET m (#3616BD) H-20 BIODIFFUSERS 2S 9, 11.5 Benchmark • t �` , 8" Loamy Sand 30.33 NEWBURYPORT, MA 01950 IN A FIELD CONFIGURATION f • at - �. • A Nail Set in Tree � • �'-- � • _ r • • ,,,/f 14" 10Yr 3/2 ' FEMA FLOOD ZONE C Elev. =35.00' « .��1 � ' •.� 29.83 I Approx. M.S.L. . ,ty 1 • • •� %: B Loamy Sand COMMUNITY PANEL# 250001 0021 D ' t6 o « 10Yr 5/6 17. DEED REFERENCE: BOOK 13251, PAGE 85 cv o < - • - • t ��� . r t ,I+ 40" 27.67' PROPOSED H-20 \ / N SWING-TIES MEASUREMENTS `''�, til � r « # ' r j 42" 27.50' 1 18. PLAN REFERENCE: PLAN BOOK 159, PAGE 91 DISTRIBUTION BOX � � Perc DESCRIPTION HC1 HC2 0 t� ` - r 60" _ 26.00' TP 2 • \33 1 11 t't + 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 3 tit 1` k_ D • . t o �\ 31.5' n° w SEPTIC COVER IN (1) 27.6 25.0' 11 • / f 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY h = II 1 ; Medium Sand .� s o \ SEPTIC COVER OUT(2) 33.4 28.6 +� , ( ll / 2.5Y 6/3 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. EXIST. CESSPOOL TO Bit Cn N cl TP 1, \ - * J .+_- '`� PUMPED AND FILLED WITH •0 _j \ 1 BIODIFFUSER CORNER(3) 60.1 47.5 s / 1 f 21. IN ACCORDANCE WITH 310 CMR 15.401 -15.405, THE FOLLOWING LOCAL UPGRADE CLEAN SAND (TYP OF 2) \32\ BIODIFFUSER CORNER(4) 78.5' 66.6' APPROVALS ARE REQUESTED FROM 310 CMR 16.221 (7): PROPOSED 1,500 H-10 Pl (1.) A 2.00'WAIVER(3.00'-5.00') FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM. GALLON SEPTIC TANK 1 BIODIFFUSER CORNER(5) 80.4' 75.0' LOCUS PLAN_ (2.) A 0.50'WAIVER(3.00'-3.50') FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. � 1 BIODIFFUSER CORNER(6) 56.0' 52.8' SCALE: 1"= 1000' ! 120" 21.00' cy CO DECK " No Mottling, Standing or Weeping Observed o Co SWING TIES PLAN - _ -- - _ - -------------- - - - ---------------- -_ MAP 19 B , c _ SCALE: 1" = 10' DESIGN DATA TEST PIT DATA LEGEND PARCEL 122 #20 PERC NO. 13053 ( EXISTING (5)-,*' INSPECTOR: David W.Stanton, R.S. 50x0 EXISTING SPOT GRADE 3-BEDROOM MAP 19 DWELLING (4) NUMBER OF BEDROOMS (DESIGN) 3 EVALUATOR: Bradley M.Bertolo, E.I.T. - - 50 - EXISTING CONTOUR TOF = 32.2'± PARCEL 107 C.S.E. APPROVAL DATE: Aug.\ DESIGN FLOW 110 GAUDAY/BEDROOM DATE: September 9, 2010 50 PROPOSED CONTOUR TOTAL DESIGN FLOW 330 GAUDAY\ TEST PIT#: 2 G/H/W EXISTING OVERHEAD UTILITIES DESIGN FLOW X 200 % = 660 GAUDAY ELEV TOP= 31.50' 3 STONE DRIVE -W-W---- EXISTING WATER LINE USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV WATER= <21.50' GAS EXISTING GAS LINE o I PERC RATE _ Q MAP 19 DEPTH OF PERC = TEST PIT LOCATION " (6) (3) INSTALL 19 - ARC36 HC (#3616BD) H-20. DIFFUSERS TEXTURAL CLASS: 1 C\C-DP EXISTING CESSPOOL PARCEL123 � 26,267 S.F.t SYSTEM CAPACITY a (TOTAL L.F. OF BIO'S)(4.8 SF/LF)(0.74 GPD/SQ.FT.)=GPD 0" 31.50' COO PROPOSED 1,500 GALLON SEPTIC TANK / L_10 1.57, t (95.0')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 337.4 GAL. LEACHING/DAY Fill R=gg 1Y�,62 8" Loamy Sand 30.83 PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE �, , A L' 4.29' 10Yr 3/2 30.50' PROPOSED DISTRIBUTION BOX R= 5 !_ TOTALS: 12" ❑ TOTAL NUMBER OF BIODIFFUSERS: 19 Loamy Sand EDGE OF TRAVELLED 1NAY -- _�� TOTAL NUMBER OF COUPLINGS: 0 B 10Yr 5/6 Q PROPOSED ARC 36HC (#3616BD)H-20 BIODIFFUSER TOTAL LEACHING AREA: 456.0 40" 28.17' BAYBERRY ENE a �� TOTAL LEACHING CAPACITY: 337.4 REV. DATE BY APP'D. DESCRIPTION (40 WIDE LAYOUT) PROPOSED SEPTIC SYSTEM UPGRADE (2) NOTE: A,,F 44 PREPARED FOR: EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE C Medium Sand DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER 2.5Y 6/3 ! CAPEWIDE ENTERPRISES O "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003 (LAST MODIFIED �� "' LOCATED AT (1) FEBRUARY 18, 2010). TRANSMITTAL NUMBER=W000052. 20 BAYBERRY LANE COTU IT, MA - SCALE:Y 1 INCH = 20 FT. DATE: SEPTEMBER 13, 2010 120" 21.50' 0 10 20 40 80 FEET No Mottling, Standing or Weeping Observed HC2 -- 77 -- PREPARED BY: RESERVED FOR BOARD OF HEALTH USE JC ENGINEERING, INC. 2854 CRANBERRY HIGHWAY Hc1 EAST WAREHAM, MA 02538 SITE PLAN / 508.273.0377 SCALE: 1"=20' / Drawn By: BSM Designed By:BMB Checked By:JLC i JOB No. 1873 I