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Home My WebLink About0029 CEDARWOOD ROAD - Health "ri29 Cedarwood_Road ll cotuit A = 020 128 i CERTIFICATE OF ANALYSIS Page: 1 ' Barnstable County Health Laboratory �A�yS Report Prepared For: Report Dated: 11/10/2003 MAP dZ- Order Number: G0323322 Anne Canavan --�---� P 0 Box 1655 PARCEL, .`_ 23 Cotuit, MA 02635 LOT 2Z Laboratory ID#: 0323322-01 Description: Water-Drinking Water Sample#: 23322 Samplim Location: 29 Cedarwood Road,Cotuit Collected 10/23/2003 Collected by: A.C. 020-128 Received 10/23/2003 Raqtine ITEM RESULT UNITS MCL Method# Tested LAB:IC Lab Nitrates 0.6 mg/L 10 SM 4500 10/24/2003 LAB:Metals Copper 1<0.1 mg/L 1.3 SM 3111B 10/27/2003 Iron <0.1 mg/L 0.3 SM 3111B 10/27/2003 Sodium 13 mg/L 20 SM 3111B 10/27/2003 LAB:Microbiology Total Coliform Absent P/A Absent 309 10/23/2003 LAB:Physical Chemistry Conductance 123 umohs/cm EPA 120.1 10/23/2003 pfi 6,5 pH-units EPA 150.1 10/23/2003 Note: Water sample meets the recommended limits for drinking water of all above tested parameters. Approved By: (Lab Director) f Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 THE- COMMONWEALTH.OF MASSACHUSETTS BOARD OF HEALTH NoiSSIM03 1,,,: .VAd3SN03 318VISNHVFJ ..........................................OF........... :.................. .... _NVV.;GaddV of 133rans Appliration for Dispoti al Works Cnnnit`nrtiun Vantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Ce��c.►- ocJ Rd -t7` M 9P a o .................. . . -••-•-------- Location-Address o Lot No. es Z, C19A/f3V14/✓ /S.MoRA�N& 57.._•/ IZock70A, ... r•...••• •• ....... -.._..... Address W Installer Address UType of Building Size Lot............................Sq. feet �. Dwelling—No. of Bedrooms.........�3...............................Expansion Attic (&'0) Garbage Grinder (Av0 `k Other—Type T e of Building No. of persons............................ Showers f� YP g ---------------------------• P ( ) — Cafeteria ( ) Pr Other fixtures .-----------•--• .......................•----- ----------------------- W Design Flow............................................gallons per person per day. Total daily flow-------330............................gallons. WSeptic Tank—Liquid capacity�Q!2 gallons Length................ Width................ Diameter--------.------- Depth................ Disposal Trench—No. .................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit. No.....--- ---------- Diameter................. Depth below inlet.....(.. .......... Total leaching area..a.od.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Rests Performed by.... ....10.--!------.------.. .................. Date_N°v: 1(...lg7�j -- c Test Pit No. 1....___..... minutes per inch Depth of Test Pit.... __.__... Depth to ground water----------- ---------- (s, Test Pit No. 2..C...A....minutes per inch Depth of Test Pit.... .... Depth to ground water........................ -............................................................................................................................................................ 0 Description of Soil.......M'-!:u_ta...5�nL".C/............................................................................................................................. W V ----•..........................................•••--•-•••---•----.......-•---•--•---......•••-•------•--•••--------•------------•--•----•---------------•----••-----.........-••------•-------•----••--- W x -----•-------------------------------------•--......-----------------•------------------••--------------------------------------- -•----. ------------------------ ----- - U Nature of Repairs or Alterations—Answer when applicableVQ� •---- ....................-..........•........................................................................................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of"IT1Z- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed "'?...C/3!v!q!i) / SCrve .2G g ) D e >--------- Application Approved By...... '-; '...--✓/. ------------------------------ ----•__.l�_,/Z�6e�.-------- Date Application Disapproved for the following reasons:........................................-....................................................................... ............................••------------------......-----------•---------...------------•----------....-----------•-------•----------------------------------------------------......-----•-------••-- Date PermitNo........................................................ Issued...............................................--------- Date of 3 S3 _ rs 0 N - ...... --- j -` '�D FEs...................._........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -•........................................O F..........................................---------------------------._._...............-- , ppliration for Dispiw al Works Tonstrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at Cc-�it;r �1o®rj Rd ca71vi " M,9p ;ZD LU-'s Je27, 77j --.......... ...................---•..,.,. ........................................... ------•..._.__....••-----••---•---...---------.............--••--..........._...............----_.. .� GR L ,aV.{rI Q�dress 16' NN-04 19x11/!► 57. +8;0 S; 4_rO.t/ Af 4 0 e L/G/ ......................—•............................. .-----••---••............................. --•...•-•------••------_..........._..........• --.._._...•-----•-----..........._...__......... Owner AdY dress W Installer Address o& Type of Building Size Lot__.........................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic (N� Garbage Grinder `4 Other—T e of Building No. of persons............................ Showers — Cafeteria Ga�11Other fixtures ---------------------=-------•---- W Design Flow................................. o¢ gallons per person per day. Total daily flow............................................gallons. x WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—N --- ---------------- Width__.,�...__.._._._.. Total Length........-..f._.-. Total leaching area.... sq. ft. Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing ank l '-' Percolation Test Resu .s Performed by'.......'f_'O.......................`..' .J�1 tf. !6 f�� W - ---- Date-----------------------•-------•------- Test Pit No. 1...<_:., _..minutes per inch Depth of Test Pit.....�.�, ...... Depth to ground water........................ PLI Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water................_....... P+ be �, ODescription of Soil - - ------ --- - ---- -- --------•-------------...._._.......----------•------------------ ...... .....-•-•----•----•-•-----------------------•--------•---•--•-----------------------------------•-•-----------------------------------•-••-•----•----. x W UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. SignedJ...••-------------------------------•----•---•---....--- --•-•• -•-.............---- ___..., /za D71 Application Approved By...- ------------------------------- -•..._- -. ................. Date Application Disapproved for the following reasons---------------••--...•..--------------------------------------•-------------•--•----------•--...------....--••-- ------•----------•--•---......-•------------•------------------------------------------------------------._.....---------•-•------•-•------------•----------------------------------------------.._....-- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ d.G...,'............OF..... GM1h..........lL:........................................ Trr#ifirFate of Clutpha tta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired'( ) bY--------------- ------------------ ----------- -•--•--•------------\-..................... ns ----.............. •-•---•----.................................................................................................................................................. Install at--••---------...01---�----2-�......---� ,gin? - ter. % has been installed in accordance with the provisions of TIT ` o .The State Sanitary Code as described in the application for Disposal Works Construction Permit No ... .. .___�_5. ........ dated................................................ THE ISSUANCE OF THIS CERT)FICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATI FA TORY. q DATE--••-•......................•-- J-�-. --1�- .............. Inspector........--------------- . � .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , .0..`!.rv........0 F..........--�� -�- �" -- No._.8/.. ..r� 3 FEE....-�............. Disposal Wor ii Tons#rndion amit Permission is reb granted ----------•-•-------------------------------------•-•-•-•-•-------.-•---.-.----.----•--•--•-•- Yg to Construct (� or Repair (,,) an Individua Sewag Disposal Sy�stem� at Street as shown on the application for Disposal Works Construction Permit No.............. Dated.......................................... Bo of Health DATE ` /� ..................g FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS l w Sewage Permit No. Location: 407- :7 7 CAMMAMOOI? RD Village: Co7TL;T MAC Installer's Name & Address HENRY C• LAt3to Th/r-- PI E mEf MAS RA€E A4,4 Builder's Name & Address TAMS S _CAM A VAN Lo r 77 CEPRIF,WomP D e',jTui T /f.4 Date Permit Issued ?W gi i Date Compliance Issued Nd i � 56 44 Not✓�S� o • /V O 7Z� Go,9M C oA�^ S�bso iL su�s S o rL ,6EY0AJ-> 400R& /0. s 5ELEc;Tot/Es TH/I�1N! !✓G - $i2USH/NG f� /NSTALL . OF 6J� GC. OltOC.S� 2or3i G • NC�rG,� TN !/1P.lf�,/C; � � MEN, � ti?ED• i 6f3 A)0 , S 11,v D _ - eo T le k i �6 22.3 20, 4 SO ± ko 0.30 144 %• 8 L %44 ' 9 eon �'c' /9 6 ZS-G PEA TO t�/N i2EC0RZ)S l.►a`LG �SJ� PeOPos } 25�- 0 1 �1- • 7 °s, D P TE 9 7 9 m '0' !'i2oP. • 7-0 /f.i / S NO 7- / � l�/A T E l�2 _ F� VA � ,-9 L-3 L � SE. 7-/3HCK kE�UI .E' F;`7c/l/TS 02 ! :.) i,.' 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