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HomeMy WebLinkAbout0035 CAP'N ISIAH'S ROAD - Health 35 CAP'N IIiSIAH'S ROAD,COTUIT A= �i I I� r . �38 '0& CP 1b t Commonwealth of Massachusetts Executive Office of Environmental Affairs APp Department of Environmental Protection ' William F.Welder Governor Trudy Coxe Z j S.W.y,EOEA David B. Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION ' r t Address of Owner: Property Address: 3 j C���N =S ic�h ej �,O�U�ti Date of Inspection:3 - �- r� (If different) Name of Inspector�oS c . 2 Company Name, Address and Telephone Number: d1�,D—c v�Q>✓ p�� 6 w P- O y -7 7 F-6(17V CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: /Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Sign re: \ -, Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sera: to :re systern ov,ner and copies sent to the buyer, if applicable and tht approving au,`.or,•). INSPECTION SUMMARI': Check A, B, C, or D. A] SYST M PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. `t B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not) _ The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) 1 One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-SSW r i,Printed on Recycled Paper �jUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A _ CERTIFICATION (continued) L r Property Address: coT';<< Owner: Date of Inspection: ,3��F - ,, B] SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ 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. 1) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ l he o,-siern nay a septic tanK ana sou ausorpiiun system and is wriilin i Vv iCci to a aici suNN") of trib6ttar) to a surface �%ater supply. _ The syste❑i ha, a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The sysien, has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. (revised 6/15/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: q►., '� ' P 3J Ci4�TN t�. Ie.`S Owner:—T)-%V' j <<-5 Date of Inspection: 3-(F D] SYSTEM FAILS (continued): Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. j� Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. f Any portion of a cesspool or privy is within 50 feet of a private water supply well. [q Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flm% of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area (IWPA) or a mapped Zone II of a public water supply well' The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 3 J Ca�j`H SS�a.I�. C.-T t Owner—�ct n,,, LDS Date of Inspection: Check if the following have been done: V Pumping information was requested of the owner, occupant, and Board of Health. V None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. /Y�As built plans have been obtained and examined. Note if they are not available with N/A. ZThe facility or dwelling was inspected for signs of sewage back-up. v The system does not receive non-sanitary or industrial waste flow I'The site was inspected for signs of breakout. Z All system components, excluding the Soil Absorption System, have been located on the site. _/The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construct ion, dimensions, depth of liquid, depth of sludge, depth of scum. i! The size and location of the Soil Absorption System on the site has been determined based on existing information or Zapximated b\ non-intrusive methods. mteraci;i„ o..:•c ' o,c ��-.t , if d:~e.e .' fro r ov,ne-; \Here provided w h information on the proper maintenance of Sub- Surface Disposal System. k (revised 8/15/95; 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:3j .G 14 C c,7 v 7 Owner. ^n.i c`s Date of Inspection: 3-t -0 FLOW CONDITIONS RESIDENTIAL: Design f130 Gallons Number of bedrooms: 3 Number of current residents: Garbage grinder (yes or no): Laundry connected to system (yes or no): Seasonal use (yes or no):- Water meter readings, if available: Last date of occupancy: ({Se,, COMMERCIAUINDUSTRIAL: Type of establishment: Design flow: gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe; Last date of occupancy. GENERAL INFORMATION PUMPING RECORDS and source of information: p r1oV� I eeC, System pumped as part of inspection: (yes or no)_ If yes, volume p0mr-we gallons Reason for pumping TYPE OF STEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other (explain) APPROXIMATE AGE of all components, date installed (if known) and source of information: �S Sewage odors detected when arriving at the site: (yes or no)Ll (revised 8/15/95) S 1- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 3� CtgP�N �S oTv i Owner: .�.1 BLS Date of Inspection: SEPTIC TANK: (locate on site plan) !Ot' To Cv�'C— Depth below grader Material of construction: _c%ncrete _metal _FRP_other(explain) Dimensions: Sludge depth:_ Distance from top of sludge to bottom of outlet tee or baffler Scum thickness:_ Distance from top of scum to top of outlet tee or baffle: �t Distance from bottom of scum to bottom of outlet tee or baffle: tU Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet i vert, structural integrity, evidence of leakage, etc.) Qj� -c- S��T �ksr`-s ��411C .,-\, a tt,.\ G' he c-\ -_k �L Lc,.+1�,x� 1 .I J'o✓So GREASE TRAP:�— (locate on site plan) Depth belovi, grade: Material of construction: _concrete _metal _FRP —other(explain) Dimensions: Scum thickness. Distance from top of scum to top of outlet tee or baffle: rlicf2nrn from hOtt^m ro cram tn hntlnr^ of c`U?i?t tee o, b2'lie- Comments (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.i (revised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:7357 C%a,()Zt4 Owner:. ti i z`S Date of Inspection: 3-f a-ti7 TIGHT OR HOLDING TANK:1f (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP—other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_✓ (locate on site plan'. Depth of liquid level above outlet invert: ) &)tzyvv—�— Comments: (note if ievei and distnuui,:, : ryuc , e',Idence of sokoiz co:i1o',er, evidence of IeakagE Into or out of box, etc.) PUMP CHAMBER: (locate on site plan) Pumps in working order.(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:3j C A P—\N 7rt'k-'� C cT v t i Owners-,r\,(;--L S Date of Inspection:z5` 1`-y'7 SOIL ABSORPTION SYSTEM (SAS):,_ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) . . i CESSPOOLS: iY (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 ground•ate? inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY:— (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 8/15/95) B r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ✓7 CA(���N TzS`�c`h C�. v'�i Owner: -DC',n, c-L5 Date of Inspection: '5-!f-17 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' �f0-0 CT DEPTH TO GROUNDWATER Depth to groundwater: ,a- feet _ method of determination or approximation: Ja�'t��nr� o f S fry �3 ��J ►a 2 '�/ Tr�T �uQ /Ahn rt- li.`. C,:S. FIB, L, u,A r-rr A6SQSl4,1"�1 (revised 8/15/95) 9 No...-------_-----a F@$.......................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH d �.O A..................OF............,:" s= Appliration for Dispoii al Works Tonitrnrtion Prrmit Application is hereby made for a Permit to Construct (Vror Repair ( ) an Individual Sewage Disposal System at: ' 9 G. ._!'���_........�'.e�.!!-� !��............. � a�s�FiSKL... ��7-'-�)or l_!!U...t...........• ._...._. Location-:Address •. Lot No. i9(l� /4!Vi_S ................................. .... ..... ......................•--....---.._........_............ ............-------- -•----......_.....---------........--••--....------ Owner Address W Installer Address Type of Building Size Lot ZoA_16��______-Sq. feet Dwelling—No. of Bedrooms.........a...............................Expansion Attic ( ) Garbage Grinder ( ) C14Other—T e of Building No. of persons...._...�.:................. Showers — Cafeteria Q' Other fixtures ......................................... W Design Flow...................... ��.............gallons per person per s.day. Total daily flow__._........._. 9.................gallons. WSeptic Tank—Liquid capacity/0.9...gallons Length_c`- s'-9..... Width.4./d_.... Diameter................ Depth.2':r....._. x Disposal Trench-No. .................... Width.................... Total Length.........a----...... Total leaching area....................sq. ft. Seepage Pit No......... Diameter....12.__(-_ --- Depth below inlet.-4............. Total leaching area._.;94?o....sq. ft. Z Other Distribution box (V) Dosing tank ,a Percolation Test Results Performed by._r// ................................... .... Date.... ZZ-if Test Pit No. 1......79.......minutes per inch Depth of Test Pit_A04 y...... Depth to ground water--------- (i Test Pit No. 2....:...........minutes per inch Depth of Test Pit.................... Depth to ground water........................ _ ------------------------------------••--•----............................................................................................................... O Description of Soil._� z.0..7--......S'giv�......r�'3_.L�ev...../?t•..----•••-•-------•-----------•-----------------•-------•----...._--•-------•- V ••---------------------------•-----------•--•------------••--•-----......--------••-------------' ---------------------- W V Nature of Repairs or Alterations—Answer when applicable_______________________........................................................................ Agreement: The undersigned agrees to install the aforedescrib d Individual Sewage Disposal System in accordance with the provisions of'''ITTLE 5 of the Stake Sanitary Co The undersigned further agrees not to place the system in" op at -�ntil ificate Comp 'ante-has bee ued by e oard o ealth. � /i t Signed-•-- -• _.�- .. ....5.. { Date ApplicationAp ro By---------------- - •-----• ....:.... ......... 1.......................--- Date Application Disapproved f orT the f o l ing reasons:_..-------•---••----------------------------•--------------•---------------...-------------•---------••----•--- .................•-------------------•--•-•--•---•-------.....----------==:......-----•-•--••------.....----.......-•--•--------•------------------------------- ..............................•..... Date t Permit No. 5— 3-a-- •------------------------ IssuecL....-... .-...- Date No......................... FRis.......................... THE COMMONWEALTH"dF MASSACHUSETTS BOARD OF 'HEALTH .................... -OF..............:7 0; .................................................... Appitration for Mspoal Workfi Tonotrurtion Vamit Application is hereby made for a Permit to. Construct or Repair an Individual Sewage Disposal System-at: . I I Z 6 C�7 P A-) /S­/r1l/1-5 .............................................................................. ........................................ ..................................................... �9 Ij 7-,1 o lion-Address or Lot No. ................................................................................................ ..........7...................................................................................... Owner Address W ,, 1.4 " -1--------------- ........................................................................ -------------------------------------------------------------------------------------------------- Installer Address 26 UType of Building' Size Lot.......�0­4................Sq. feet Dwelling—No. of Bedrooms............................................Expansionekttic Garbage Grinder Other—Type of Building ............................ No. of persons........................_... Showers Cafeteria Other fixtures ----------------------------------------------------14-------------------------------------------------------313-a----------------------------- Design Flow..........................................gallons per personjjr.day. Total d4a% flow....................... .....................gallo-Ps. V Septic Tank—Liquid capacity-t.........gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench­NT ..................... Width.........__..___._.. Total Length. I ... Total leaching area sq. f t. �p /Z (. Length_.__._._ �4........ Seepage Pit No ............. et.................... --- ........ Diameter.._........._....... Depth below inI Total leaching area..................sq. ft. Z Other Distribution box ( V) Dosin&jWk Percolation Test Resultj�� Performed by........................................ Date-----.................................. J-4 .�K........................... '4 Test Pit No. I................minutesperinch Depth of Test Pit___.___............. Depth to ground water-___--____--- Test Pit No. 2................minutes per inch Depth of Test Pit..._...__..._._..... Depth to ground water................Pd ....................... 0 .......S / 72:...?­---------*------ Description of Soil.......................................................................................................................................... ............................. ....................................................................................................................................................................................................... U --------------------------------------- ---------------------------- ................. ---------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .................................................7....................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the pro.*-Ions -TITTLE 5 of the; I State Sanitary Code— The undersigned further agrees not to place the system in o e un rtifica-te4of Compliance has been iss y the board of health. Signed............. ............. ......... ........... ..... ......... . Applicat0 n App ved By ............. ......... ....... ...... 4' ....... ..........I---4 . ............ Date Application Disipproved for the fo o �ing reasons:...............................j..................................................... .......................... ......................................................... .... ...................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................................OF.................. .................................................................. T rtifiratr of Toutpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by-------------------------------------------------------------------------------------------------- Z....... ---------- ........ ....... .............. V ...........I................................................. at....... ..... .........., .. ....... ................. has been installed in accordance.with the provisions of TIT 5 of The State Sanitary Code as described in the application"for Disposal Works Construction Permit No........................................ dated_....._..._.-._._.________...__......._........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS RUED AS A GUARANTEE THAT THE RUED SYSTEM WILk_FPNC4tION SATISFACTORY. DATE............. 3/..9.5..................................... - Inspector............ .. . ..... . . . .. ..................... THE COMMONWEALTH OF MASSAC SETTS BOARD OF HEALTH ..........................................OF..................................................................................... No......................... FEE........................ Permissionis hereby granted..............................................I................................................................................. ...... to Construct or Repair an Individual Sewage Disposal System af"N,Q...................................................................................................... ...........................I............................................................. I NJ Street as Wdwn on the application f6r�Pi§posal Works Construction Permit No..................... Dated........................................... ....................................................................................................... DATE.__... -f Board of Health ............................ I...... FORM 1255 HOBBS & WARREN. INC., P-UBLI§kERS LOCATION 1oux 3S� 5EYJAGE FEOR 9; d ham. VILLAGE LCS I N S 7 A LLER'S NAME I ADDRESS ► 9UIL0FP. OR OWN El DATI:` PERIAIT ISSVEG 0 A T E r, 0APLI ACE ISSi! £ D� 3��� 3 � 6 w t a ��r rF q ' N /. I , r • S Ye%TEM PROFILE NOT TO SCALE TOP FDN. . V FINISH GRADEEL . " FINISH GRADE O ER FINISH GRADE OVER -0.. D.IST.' BOX �'l,040 FINISH GRADE OVER o SEPTIC 'TANK G"?'Ga+ LEACHING PIT ?.610 0 O .o �. VARIES .0 _ -. ': o•-:,�'?:, .._ _ -. : ., -- _ ya ra. ' as u - p,. ,. 4..�.P G '�o o: .Q:.,.D: D�.:d.�.D.9.:b••A':b�..C.P,,.�t',QQ O:v..:o,'.o:o .DQ , PRECAST CO!VC. OR _ WASHED PFASTONEa. otl'•:o•'''. ' •, '•: oo � :: ', .,BRICK ,6 MORTAR OUTLET PIPE LEVEL 4 ' TO 12" BFL Ol+� GRADE FOP 2 FT. MIN. (y-p,. •, e b':b:•:o.:,.:c6•b-o.•4.G,. o• :..'.D:.,a.o.o. :'O:e: L �.:0.'o Q. O..•o:.o so.. P.a..... 00 81) :'.o.'...o C. I. OR PVC TEES D 4 D� I Q BSMT. FLR. GALLON o — c D.l'S TRISUTION. BOX QQ , EL o . INSTALL ON LEVEL' BASE112 3/4 TO 1 PRECAST CONCRETEa: a PRECAST T WASHED Q- . .: qe , — ® REINFORCED :: CRUSHED I d• A a CONCREETE o a: S TONE a` :.'oc..,... .:. •::cs"•a':.. 'O., .G1•. .. -.o..b^a' ,:• .:0•:.4,.a.-o..o.. - r .O,•. .v.q C.o b. ..;. _ jS'.fj.. .o .. ,4, f b,-. - P ,O, .. : •: •: ..- d 4.. fl•..A;.o. ..O-.O-.o ...0.Q.o.. ..,p..Q..4. o . . .. ...4. ..D..- ,f I • H-/ t1 -REINF. " SEPTIC TANK INSTALL ON LEVEL BASE _t p o6,c o.. o: ,- .o• NOTE. EXCA VA TE TO EL EV. -51C OR b t•• _ _ LOWER TO REMOVE ALL "IMPERVIOUS -- — -- J_f, MA TEAIAL BENEA TH THE LEA CHING AREA 47 3 D REPLACE EXCA VA TED MA TERIAL ,WI TH C -6" ✓. - ,A CLEAN, CLAY FREE-SAND - 4� _ _ . .- . .c'�'_ e`. FFFEC TI VE DIAMETER - » / N . .. , o LEACHING PIT - '" --- q.5��•o GENERAL NO TES _ • ;: -- .say.pQ INSTALL ON LEVF_L "BASE. . . I A L L EL E VA TIONS SHOWN A RE BA SED ON -- 2. A L'L PIPES IN THE SYS TEM MUS T BE CA S T IRON OR SCHEDULE 4a P VC. .�'� © SER i/A TION PIT . 3. THE BOARD OF HEA L TH MUST BE NO TIFI ED 7 - P R ;S=T . ,�'Y' ... �, , WHEN CONS TRUC TI DN IS COMPLETE ETF_ PRIG PRECAST CONCRETE TO BA CKFIL LING PERCOL A TION AA TE,. -` t CHrNe prT .2 MIN. IN, ... . P V - 4. ANY CHANGES In THIS-PLAN MUST BE A PRO ED , / WITNESSED B Y. Y THE BOARD HEAL TH AND CAPE 6 ISLANDS .F> ` r R 4 , . ,� SURVEYING CO. ✓C A A A TION HA BE IN 5. MA TERIA L S NO INS T L L IO SHALL L B I C h '., BPD. OF HEAL TH 2 s� '�..,. 8 COMPLIANCE W� TH THE STA TE SANITARY DESIGN DA TA CODE TITLE V AND LOCAL :APPLICABLE..: s Lr� i 000�b`ALWV -.... � PULES AND F�EGUL A TIONS T_.�",S" r�_ .�.��'.�7 . R�CAS7 CONOR NUMBER OF BEDROOMS . �P 6. NORTH ARROW IS FROM RECORD PLANS AND ..._.. �, IS NO T TO BE USED FOR SOLAR PURPOSES GARBA GE`-DISPOSALo 7. FLOOD HAZARD ZONE G' DAILY FL Oh/ .�. GPD 8.' WA TER SUPPLY Tzs Wes.- � SEPTIC TANK RELJ D. -�' . " GAL /. .. ? !� 0 � •- �'' SEPTIC TANK PROVIDED /4c7<J GAL o - ,� ... ::;�'' °"• LEACHING REOUIPED GPD / 7 �,. ,R ty• c•� ,. / v 72 s" '"♦i/�1 SIDEWALL AREA = A 7 S. F. Z;t 7 S. F. X G/S. F. _ .•393,GPD. BOTTOM AREA 12..E S.F. ..— ---�-- ...,.., LEGEND I�f S. F. X �® G/S.F. = 1.2a GPD ,,. . ' . �" , 4a �7* : LEACHING PROVIDED = .� GPD . `� ✓'- C" PROPOSED EL EVA TION ✓` --6D-- EXISTING CONTOUR '00OBSERVA TION PIT DISTRIBUTION BOX ^s PROPOSED SEJVA GE DISPOSAL S YS TEM ool 59 OO LEACHING PIT ? PREPARED FOR ; w o o SEPTIC TANK T-49 - GERALD ANTIS ♦ ♦ , "' fRPi RESERVE PIT AREA LOT •50 CAP 'N IS.Z'AH. 'S ROAD cF� a, sy BA RNS TA BL E -- MA SS G'.✓f� PIPE INVERT ELEVA TION �� �. d ANr t ���.;�. rr�'x � _ '°•� CAPE -&' ISLANDS SURVEYING, INC. PLOT PLAN SCA L F• ? "=.,�o SCALE AS NOTED P. 0. BOX 334 MAP SEC PCL L O T HSE ` PLAN 7V0. T, TEA TICKET, MASS.