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HomeMy WebLinkAbout0490 COTUIT BAY DRIVE - Health 490 C®tust Bay Drive -----� COtu it '055.034 cam\ Commonwealth of Massachusetts A96-�s-' o s q fn Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry ,Owner Owner's Na Enformation is Cotuit Ma 9/9/2020 required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. Inspector Information 614r 1�e filling out forms on the computer, use only the tab Chad Hathaway key to move your Name of Inspector cursor-do not Hathaway Septic Inspections-All Cape Septic and Survey use the return Company Name key. Company Address Forestdale Ma 02644 City/Town State Zip Code r � 774 274 2581 12866 Telephone Number License Number ,1k 6 i -ems ' v u -UN 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 9/9/2020 Inspector Ignature Date The system inspector shall su it a copy of this inspection report to the Approving Authority(Board of Health or DEP)wit ' 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. t5nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 o i' 90 C tut Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: This inspection is not a guaranteeand applies no warrantyof the described septic components in this report including but not limited to piping structual intergrity of components and life exspectancy of leaching and described components. This inspection is to describe conditions witnessed at time of inspection only. Regular tank maintenance and water conservation can prolong life of septic systems Information on care and do's and don't's can be found at town health dept or mass.gov 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): t5insp.doc-rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is Cotuit _ Ma 9/9/2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): C 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for everyotuit Ma 9/9/2020 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 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 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No El Static liquid level in the distribution box above outlet invert due to an overloaded ® or clogged SAS or cesspool 99 P ❑ ® 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 t5lnsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 r c Commonwealth of Massachusetts Title 5 Official Inspection Form 1' wa Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. City/Town 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)] t5insp.doc•rev.7/2 6120 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �- I Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1, 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. CitylTown 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: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: 1s laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date t,gnsp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is required for every Cotuit Ma 9/9/2020 page. City/Town 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: pumped june 2019 owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for everyotuit Ma 9/9/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: tank older Dbox and leach 2004 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: ee Material of construction: ❑ cast iron ®40 PVC ❑ other(explain). Distance from private water supply well or suction line: 26'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): none t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 f c Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 gal If tank is metal, list age: years- Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'6"x5'6" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness less then 1" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? tape and sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): pump every 2-3 years under normal use. outlet tee has filter reccomened cleaning filter every 6 months to prevent possiable clogged filter and over loaded tank. tees in place. risers in place no major decay visable t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts rn - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �a 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.). 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day l5 nsp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 c Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): ' Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Dbox in good condition with light scaling of concrete. normal for Dbox 16 years old. Dbox is solid with no cracks or leaks riser in place I t5insp.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 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. City/Town 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: Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 c Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments „ l 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is .required for every Cotuit Ma 9/9/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 25'x13'x2' leahing bed with 2 500 gal leach chambers. riser in place. 3"of water in bottom of chamber clean sidewalls over current level. leaching in good condtion 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.): t5 nsp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 I� c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 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 I c Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 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 b GkGL / O O 9(\Yka3)r t n Coup—r 2vcTy 3 � ' 62 t , R 3 - �' C00-' 63- !D IDr11 C'cwQs� ve d5 t5Ensp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts !P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for everyotuit Ma 9/9/2020 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: 30' 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: 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: el. area of septic per GIS maps 44' low in direct area 10' bottom of SAS 5' below grade Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I� la Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address Perry Owner Owner's Name information is C required for every otuit Ma 9/9/2020 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 I Commonwealth of Massachusetts. W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 490 Cotuit Bay Drive ... Property Address 4 Robert Grady ' L-4 Owner Owner's Name �tr� information is required for every COtUIt Ma 02635 8-14-17 page. City/Town State Zip Code Date of Inspection 1*5 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. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Matthew Gttfoy use the return key. Name of Inspector i B&B Excavation Company Name 374 Route 130 Company Address Sandwich Ma 02563 Cityrrown State Zip Code (508)477-0653 S113640 Telephone Number License Number B. Certification 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 8-14-17 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. � Us tSins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Di os�al stem•Pa e 1 of 17 P 9 P 9 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 ` page. Cityrrown 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: f- System was in working order at time of inspection. B) System Conditionally Passes: El 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 _ I Commonwealth of Massachusetts w Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 490 Cotuit Bay Drive Property Address Robert Grady _ Owner Owner's game information is required for every Cotuit Ma 02635 8-14-17 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 I t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 L Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 page. City/Town a 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: r 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is Cotuit Ma 02635 8-14-17 required for every page. City/Town 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. ❑ Z 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.] El ® 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 f ❑ ❑ 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 ❑ El 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. 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 490 Cotuit Bay Drive M Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 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? a ® '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)] 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): 349gpd t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 490 Cotuit GSM Bay Drive '- Property Address Robert Grady Owner Owner's Name information is Cotuit Ma 02635 8-14-17 required for every page. Citylrown State Zip Code Date of Inspection D. System Information . s Description: Number of current residents: 0 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 (9P ))� Detail: 2016-55,000gallons 2015-27,000gallons Sump pump? ❑ Yes ® No Last date of occupancy: July 315`Date Commercial/Industrial Flow Conditions: Type of Establishment: NA 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 A 8-14-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information ti Pumping Records: Source of information: Owner- last pumped 6 months ago 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) El 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 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 2004 per COC Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan)` Depth below grade: 2 feet Material of construction: - ® concrete ❑ metal El 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: 1500gallons Sludge depth: 3 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 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 33" Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 15" 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.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank is not in need of pumping at this time but should be pumped every two years for maintenance. Grease Trap(locate on site plan): Depth below grade: - NA 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 490 Cotuit Bay Drive Property Address - Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 page. City/Town 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: NA 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 - 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 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.): D-box was in working order at time of inspection with no sign of past backup or carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: F ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): NA 4 * 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: =:5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 40 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is Cotuit Ma 02635 8-14-17 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.)' Type: ❑ leaching pits number: ® leaching chambers number: (2) 500 gallons ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ 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.): Leaching was in working order at time of inspection. No high staining, damp soils or lush vegetation were present. Chambers were dry when viewed.; Cesspools (cesspool.must be pumped.as part of inspection) (locate on site plan): Number and configuration NA 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 Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 i 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.): Privy (locate on site plan): . Materials of construction: NA 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 490 Cotuit Bay Drive M Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 page. City/Town State Zip Code Date of Inspection D. 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: ® hand-sketch in the area below ❑ drawing attached separately REAR I • Rear garage Al-25,6" A2-62' A3.74'4" B1-39' 82-54't" 133-59,6,' t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 N Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °w 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 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 @ 16' 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: 8-4-04pate ❑ 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °w 490 Cotuit Bay Drive Property Address Robert Grady Owner Owner's Name information is required for every Cotuit Ma 02635 8-14-17 page. City/Town 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 iL TOWN OF BARNSTABLE LOCATION � �n/[,/% � oiff t/6 SEWAGE # VILLAGE_ ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. At� 0gli c� `!SEPTIC TANK CAPACITY ��a(4S� f /570 i%4 LEACHING FACILITY: (type)42 Sb�C16►f (size) �.S i V>- NO.'OF BEDROOMS? BUIL6ER OR OWNER PERMTTDATE: °I O t. 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 A3� i` 63-e r, 3 � l .t No. L O Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIPPrtcation for Mioonl *paem Construction Permit Application for a Permit to Construct( , )Repair( pgrade( )Abandon( ) []Complete System El Individual Components Location Address or Lot No. 4/90 ,U(, !f ¢� O�y�e�lr�s e,9Oddreress&nd Tel.No. Assessor's Map/Parcel ��` " .�l 4(10 _ cr Installer's Name,AddrAs&#'eCAN`+O Designer's Name,Address and Tel.No. 350 Main Street 0i43 Cn-1 . W. Yarmouth, MA 02673 g$$ -36(4 Type of Building: Dwelling No.of Bedrooms_—3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow .3 gallons per day. Calculated daily flow d gallons. Plan Date Ig Iq _ Number of sheets Revision Date N Title Size of Septic Tank /�DD FX%t�%ems Type of S.A.S. .Sao S Description of Soil {_/` �lAi'I 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 E ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by is o of ealth. Signed Date 018 Application Approved by Date Application Disapproved for the following reasons ` Permit No. � �� Date Issued d" ; «,tI ­7101 Fee /4no THECOMMONWEALTH OF MASSACHUSETTS Entered in computer Yes PUBLIC HEALTH DIVISION =TOWN OF BARNSTABLE} MASSACHUSETTS Application for ;)igpozal *p5tem Construction Permit Application for a-Permit to Construct( . )Repair( pgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. ner's Name, dress d Tel.No. u be/+ ellA c K (; Assessor's Map/Parcel ��—_ r C�`�V p ✓i{- 13 a-y Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 688 -360 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other TI pe of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow -� 9 gallons per day. Calculated daily flow gallons. Plan Date 87 -773 Number of sheets Revision Date Title Size of Septic Tank /SOO �,t %s<�• s Type of S.A.S. SQ D S Description of Soil Nam• Nature of Repairs or Alterations(Answer when applicable) 4 r /'14 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 E ironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue�bys of ealth. Signed {,d .l Date 9 !`/ Application Approved by Date T l��" Application Disapproved for the following reasons � 1 i Permit No. C 1 Date Issued ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (&- Upgraded( ) Aban oned( a by e-/ G) at 90 d�u�1' d AV, �� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. uo q'S I�' dated�l °I/V Installer Designer The issuance of this nermilt 4hall not be construed as a guarantee that the sy to ill f`nc�tion as dde�gnnedl. Date 1 1 I 'Inspector t.�-�Y kw. --------------------------Fee lCIO THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,~ MASSACHUSETTS Digozal *p�tern Congtruction Permit Permission is hereby granted to Cons t( ),Repair( Upgrade( )Abandon System located at �� . �4 ,�`- and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must Pe completed within three years of the date f this permi . Date: / '/ 0 Approved byyZ Town of Barnstable oFtHE r o Regulatory Services Thomas F. Geiler,Director MAW. Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Designer: 4�/j � �SZ7 9 Installer: 4"/W T d Address: aZs63 Address: On - 5=U Q • pg)eq-A160 was issued a permit to install a (date) (installer) septic system at -#11579P CvTlJi� 6q � vr' based on a design drawn by • ��S� SS o�1 (address �2'�p SS �{�cE2 �� �zJ2Y �y dated I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution.box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral:relocation of the SAS or any vertical.relocation of any component of the septic system)but in accordance with State &.Local P<, ns. PI r certified as-built by designer to follow. �-�N OF Mass q R E Cn . 1140 ( staller's Signature 9 •p. o \ GISTS '9qN/TAR\ (Designer's.Signature)` (Affix Designer's Stamp Here) PLEASE RETURN TO BARNS ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS - BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. p. Q: Health/Septic/Designer Certification Form c� TOWN OF BARNSTABLE L • LOCATION 1�' �� �tS�[�/s% � �✓�f�� SEWAGE IV VILLAGE COTS/% ASSESSOR'S MAP.& LOT I sF.+A INSTALLER'S NAME&PHONE NO. —?-7r',) SEPTIC TANK CAPACITY LEACHING FACILITY: (type),:2- 67.1mri'd —VjjA-4S (size) • NO.OF BEDROOMS J BUILDER OR OWNER PERMIT DATE: 6`1 O t.I if COMPLIANCE DATE: A'.�-'OY Separation Distance Between the: Maximum Adjusted GroundwateT'Iable 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 i 02" OF Viz, 7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...'. ........... .OF......... .:........................................ i Appliratiuu -fur Dhipwial Works C onMrurtiou' prruiit L,/ Application is hereby made for a Permit to Construct (\/) et'—�r ( ) an Individual Sewage Disposal System at: ( 1- 0-6 {� �. TV i Jl� ( k'i��L 6 oi'.. Z� �Ur'f 1 Aa� IJAi�'�. '� tJl�T" • '7" 1 ------------------------------- . --------...-----•-- ---- - l !��=---VGLFG J oca 1✓!'� �eS `v....................... L— MCJc.-.1 r��`f^c,.or v���. VACA � vl..�7(,�F—�, Oyvner tidress p� A � Installer Address UType of Buildin Size Lot.....Zg4- ......Sq. feet jp,Dwelling—No. of Bedrooms_____________ _________________________Expansion Attic (w®) Garbage Grinder (�o) a4 Other—Type of Building .:____ -ittteN_-_--__-- No. of persons........ -............... Showers Cafeteria ( ) a' Other fixtures ---------------- ---------------- w Design Flow-----------5V.........................gallons per person per day. Total daily flow........30P--------------------------gallons. WSeptic T utk—Liquid capacityJAPP.gallons Length................ Width................ Diameter........_. ..... Depth--.._____--.---- x Disposal Trench—No- -------------------- Width-------------------- Total Length-----------_........ Total leaching area------------- ......sq. ft. Seepage Pit No.AOd C%____ Diameter.................... Depth below``inlet.................. TNW,01�- ]tits area.--_-.----..---._.sq. ft. z Other Distribution box ( ) Dosing tank ( ) 0 i -R - 11"A,T-7G aPercolation Test Results Performed by----------------------------------------,............-.................... Date---------------......................... Test Pit No. 1................minutes per inch Depth of "Pest Pit.................... Depth to ground water...._---_----_-._--. -- rXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-._.---______-.__-__.. ..............V , r-------•-------•-- --- O Description of Soil O ...._. d _... _.......1'-t - �i� `"� - 3- ' �a" ... . ---- 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 Article NI of the State Sanitary Code— The undersigned fur r agrees not to place the system in operation until a Certificate of Compliance has been issueADI he oar of e th Si new " - �. ..... ..................... Date Application Approved By-----... . t;,((rk1L1 ,. ------------------- '-1.2 7 ---------- (/ Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------•-----------------•- -------------------------------- Date PermitNo.......................................................... Issued........................................................ Date �� J No.......kl- .......--- FE�.......:.�................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................oF....... 'S t/.d 44' .............................................. Appliration -for Ui.ipoottl Workii Tomitrurtioo Vrruift Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Loca' n-Address � or of -o. •. d:--G�c.�........----.�o�rr� ---------------------------- 7. It R, s �a: ..-. vK �,e ........ �- Ow er ,'/Address / ............ F4. ��?.N ,Z �ot�e___� .` �(64 ToaIS e�q .........• -- ...... ----- •.•-••- Installer Address Q Type of Building Ir Size Lot......z� ......Sq. fee Dwelling-4,Ko. of Bedrooms--------------------------------------------Expansion Attic Qt(b) Garbage Grinder ( Other—Type of Building //��-- �!4Mr, p �- Showers ( Zj — Cafeteria ( ) C>i YP g -J�--------------------- No. of er�oll5------------•----.._._...... Q' Other fixtures ---------------- -------------- - - W Design Flow...._.___...5.............................gallons per person per day. Total daily flow..........��P---___-_.-_____---_.....gallons. WSeptic Tank—Liquid capacitVIOP!2gallons Length................ Width................ Diameter---------------- Depth._-___.__.-.--. x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No..__l_009?..... Diameter.................... Depth below inlet.................... Total lea liitl area..--- ............sq. ft. z Other Distribution box ( ) Dosing tank ( ) p /✓ ,�' dYe 76 Percolation Test Results Performed by-------........................................... .............................. Date........................................ a a Test Pit No. 1................minutes per Inch Depth of Test Pit-------------------- Depth to ground water-..___._-.-____.__--_..- fl, Test Pit No. 2................minutes per inch Depth of Test Pit....._...-..._-.-.-. Depth to ground water................-------- (Yi .-----------•---•----------------------- Description of Soil O ------ � .---- +� `� -------- --- —-------------------------------- - ---------- �4 f----------------------------------------------------------•--------------------------------------------------------------..--------•--------.._...----------- w VNature 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the b rd f a ` ` 3��r " 5 Sig ed ----�!.-. -------------------- ------- ----------------- D Application Approved By------- -- - -------1 __u/1�S- '✓ .'.�r' 7 Date Application Disapproved for the following reasons:--•------------•----------------•-----------------•-----••----•-•-------------------•---..-------------••------- ---•--•.......................... ...........•------------- Date PermitNo----------------........................................ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH . .................oF......../7Ai TA0�14........................................... mprrtifiratr of f1.1oluphaurr THIS IS TO CE."CIFY, That the Individual Sewage Disposal System constructed (}�) or Repaired ( ) r .. ---------------------------- -- . ------------------------------------------------ ------------------------------ p 0 i?l ��Y bie N ............... Insctaller�_ at.---•---- .-!_.(_�..........C? ' ................ ` —'.E_..� 4_fJ..(. .[..f has been installed in accordance with the provisions of Af. X of The State Sanitary Code as d_ i- ed in the application for Disposal Works Construction Permit No------------------ ................. dated...-.. .. .......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRAJE ,-AS �GUA ANTEE THAT THE SYSTEM WILL FUNCTION SA ISFACTORY.DATE................ �...-------------��---...._..-----------�.... Inspector-------------------------- -..................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 77 cr� ......... .............OF..........'J.�+ 5 ��� ...................................... u-r� No......................... FEE-----..............---- �i� o tti rk , TToo rurtiou Vrrmit _ ti� Permission Is hereby granted _ ��' { u •---------------------•-------...--•------------...--•--...................----- to Construct (�O or Repair ( ) an Ind vidual Sewage Disposal System at No.••---4q/--------�V?�.!"......& ..------4J�i_!/ ............Ctt0_Tcs< f - -------------------•----------------.....---...------------•-•-----•-••-•--•-..... Street as shown on the application for Disposal Works Construction,Irmit o.. U� .. Dated_.3_-�_�_��.�............. -------------------------------- Board of Heat DATE-------------------------------------------------••---•-• ---------------------- Board 1255 HOBBS & WARREN. INC.. PUBLISHERS t .. \1�5G•g l . V �V o,/Q � � r,t►1., tb CD Cl ' Zu5 YnLLtAM is Y F. {l -�!' ts� C.EtZTt two pL.6-r ;5,L-./5.W vv I CMIZTIF,/ Ti4AT T{-ice V:iOOLVATK-1)5S Q ��l..At l lz s;r ayewCa. W$-:,e aMW C.OAAPL-VS vV ITtA AWt> SET13AC4 VC-4PICEMEWT4 :[yF TNT .*-7 DATr= B�.XTEt� �. uYt` tkiG_ tZE6tS7UzSC> "Wo 5uevaYotzS TW-S Dl-Aw IS LINT SASSV 064 A&.i oSTEiZV1l.L.E o 14CA55. tW5-M lAAEtJT 50ZVM`? 4 Tt4E c3;rc"5F--rS S'ADWW QPPU CAI. r 5c>VEQ ENT(5?,. t�,bT SS USEc> To t)e:rev_MtN1r-- LO'T L.tWa-5 L 0� �17!0 f� �=-�LJ � }fSEWAGE . PERMIT N O.. VILLAGE ,T,Al l l C R'S bl✓��'A ME & ADDRESS B UP E R 01 OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED c !( ,� ��.� - ��? (��" �� � .� �. t l� '+:av+rVe"`",.`B: :, ': ..,-a+Y'P+r>: ►r+47«r....,?bY+kasw..xrza.^aww+; �+:x.°eamKrAl+ w ..ws+.'4q'aLe '^:.un .. _ -. .... _. 'sgs»^a: :.. .... .. .. M WON iZ T\ { � STANDARD\ A D D NOT ES ES \ \ I) THIS PLAN IS FOR THE INSTALLATION OF A ,SEPTIC SYSTEM. 2) ALL INSTALLATION PROCEDURES AND MAT%'RL4LS SHALL CONFORM TO 310 CMR 15.000, THE STATE ENVIRONMENTAL CODE, \ \ TITLE 5, AND THE TOWN OF _�3 �. _ SUBSURFACE DISPOSAL REGULATIONS. G���,� �\ \ 3) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE OF A VAILABLE PROPERTY INFORMATION WITH RECORDED DEEDS NIP,\ \\ OR ZONING REGULATIONS. \ \ 4) TOWN WATER DOES MW SERVICE THIS PROPERTY King- - • 5) THERE ARE NO EXISTING WELLS WITHIN 200' OF THE PROPOSED SOIL ABSORPTION SYSTEM. Map 55 Pcl 33 0 91 e0' \ \ 6 ) ALL COVERS OF SYSTEM COMPONENTS SHALL BE BROUGHT TO WITHIN 6 " 01, FIN/SPIEL? GRADE ' 7) ALL SYSTEM COMPONENTS SHALL REMAIN ACCESSIBLE FOR INSPECTION. NO STRUCTURES SHALL BE LOCATED DIRECTLY IN, UPON OR ABOVE THE COMPONENT ACCESS LOCATIONS, WHICH WOULD INTERFERE WITH THE PERFORMANCE AC b CESS,, INSPECTION PUMPING OR REPAIR. 8) NO DRIVEWAY, PARKING OR TURNING AREA, OR OTHER IMPERVIOUS AREA SHALL BE LOCATED ABOVE A SOIL ABSORPTION 71'56'01 _ Y\\ \\ SYSTEM, EXCEPT WHEN VENTING HAS BEEN PRO VIDED. N TBM EL - 100.00 \ Top of Foundation \ \ 9) SEPTIC TANKS, GREASE TRAPS, DOSING CHAMBERS AND DISTRIBUTION BOXES 'SHALL BE PLACED ON A 6 STONE BASE fi \ \ \ TO ENSURE STABILITY AND PRL VENT SETTLING. Pump and fill Existing OUTLET DISTRIBUTION IJNES SHALL REMAIN LEVEL FOR A MINIMUM . �l \_. - \ \ 10) OF THE FIRST TWO FEET OF.THEIR LENGTH.�1 existing \ \@� g pit as 1,5OO Oral \ \ 11) ALL SYSTEM COMPONENTS STfAI,L BE CAPABLE OF WITHSTANDING H 10 LOADING UNLESS' THHL Y ARE ' CT t'P Ti i/P5" \ \ \ \ UNDER OR WITHIN 10 required P S— Tank \ \ \ \ OF DRIVEWAYS OR PARKING OR TURNING AREAS, IN WHICH CASE H-20 COMPONENTS SHAL L BE USED. 12) ALL BUILDING SEWER LINES SHALL HA VE AN INNER DlAb1ETER OF 4" AND SHALL B -- E CAST-IRON OR SCHEDULE 40 PVC r ►�O 1 \ \ \ \ \ 13) THE DEPTH OF THE TOP OF ALL SYSTEM COAfPONEN " AMAN.DA � � TS SHALL NOT EXCEED 36 UNLESS VENTING HAS BEEN PRO VMED. \ \ 14 IN THE AREAS OF "CA NATION, EXISTING GRADES SHALL BE REESTABLIS Ise) R = 75.00 ` / � - - -� �- \ � \ \ ) 7� HFD UNLL SS 110TI,D 11 S PR0I�OSI,71 CON7'O URS. CO UI�'1 10 t \ L = 68.00 � a a <U \ \ \ X .� \ \ Lz) IF sOI1S A.R6' ENCOUNTERED DURING THE EXCA NATION OF THE SOIL ABSORPTION SYSTEM THAT DIFFER NOTABLY FROM THE DEEP OBSERVATION HOLE LOG, CONTACT THE ENGINEER BEFORE PROCEEDI i Proposed Sa ve exrsting \ \ 16 1�G p \ „ . - C? \ ) CONTRACTOR TO VERIFY LOCATION OF ALL UNDERGROUND UTILITIES. � OSe 8 Ines ; ' �42 6'f \ 01•0 �1 ; , V m I DEEP OBSERVATION DESIGN DAB A HOLE L0 Test Hole #1 \ \ (,)_ :..:.,. Test Ply \ Number_ of Bedrooms. .�� n , 2 5 \ ,0 Tel, sadl soil sou 1 Loco tlon \ Dp�th rt to �; \ _ ( ) riaon T zt Color C _ \ Garb e - s . \ a Grinder. ::... usD ,- \ \ d r PROPOSED LEACHING FACILITYJ Desi n Flow o o� Lo _ .�a,� EN s o - f , \ r 110 dal/BR/Dayx Number of BR — L�c u� : ,' U MEYERCn A � Two 500 Gal cone eharnbers ,..g \ \ o . _ ( ) �3,r� � -�,� .r�s,�� No. 1140 . (or similar with 4 stone \ o Septic Tank. , `�" U �32 �3,b 'Gorsc 2`s�-� f � � rc:..akr• F�- �� GIST, ( Total Dim 25 x 13 ) \ - �o � = Des' n ,. r s l " ~- - - - - - - - ( T Flow x 200�) C n t 5 T d o ��� d-sr(: Aw o r nt-4 n�o �'�d� c ^+ r � ` - Leaching Area: -z�( —. _ Deep Obe Hole.Date: � I `�1 G 4 . Gc'�V-e 'tr/ 2 ,�? s`s� 9 S ide wa ll: T U G<// .�) 'rot ✓f 1 .S�f `9e$ 4 4 Soil sse fir`� t•�_ Witnessed / 7, Pere Rate: _ S M I N l f �o d NIF (2 5idewalls x _ Ft x Ft + --- � ' Soil Survey Description: CARVER 1571.3` Geologic Material: OUTWASH - _ Oche (2 Endwalls x !2..Qj�1—F'�' x -Ft) Depth to standing linter. NA _ Depth to Weeping hater: NA Ma 55 PC] 39 . N/ r .88 P Bottom: 3 2 O .? Depth to Mottllng(Color): NA F j' L� c� Eat Seasonal High Gl� NA C1; MSS O i i+ 2 5 USGS Observation Well NA Robinson }f. ----Ft t 2. ) t j^y —Ft [ ` r-� Data of Last Measurement NAoD'JVAf?C� �lJTn g �� Comments: /< A. Ilia 55 Pcl 35 �l Long Term Acceptance Rate (LTAR): 0. 74 > STONE p �U ���� 3 ?� � �3 a {� Leaching Area Design Capacity �. 1 No. 280so'; � h t�C� -� .� � C. 4, (Side/wall Area + Bottom Area x LTAR Fss G IS TVR 5 TOP OF FO UNDATION EL r o p t o D Raise co to hin 6 of finish grade all risers as needed :. .. - • ��-5 N.G. GROUND SURFACE ELLc-'10 -_2__ t > r GROUND SURFACE PROJECT LOCATION " MIN 4. N ST A l_ OUTLET PIPE LEVEL , ? FIRST TWD FEET 2'2' N VEVT REQUIRED ASSESSORS MAP Jt` LO% rj ( 9<P�F 2"MV--3"MAX TOP EL MIN 2' LAYER DOUBLE WASHED AIN INVERT EL lis'- 1/2- STONE 9 I 3 T -- APPLICANT.' A INSTALL / . G' �`y EFFECT_'VE INVERT EL �` ` GAS BAFFLE �' SIDEWALL `� w �F B" MNA BASE INVERT ELF INVERT EL ! Proposed G l 3 �U�v r 0 CI G �--. (� INVERT EL �QNC. 3/4 - i i/2 DOUBLE PA i4l `D — Box C t.�n^-.� *:,� g �r' <, t r + �4�' WASHED STONE �. TNVERT EL PREP14RED BY j _ �-x r �� '� ! '.�.r s;-1-1 �-•� „ �`,�•ot,�� C�J--{l� xY�-�o''� Z-�� 5,�{ _ �� � % L C ram,, 1 r�l l Pal� �•!1 1 U I /r t Lal .S'epdic Tank BOTTOM EL �� � o`e c d, 13uy. 17ZO - .. .EL 130TT0/!✓J OF TFST NOTE �* Ea�I� ��� , � -' S/},hfQ6+l1tGf0� MA r — ( �d Gt c� vla.-c-e�- soy- ��a-3�r9 � , II � s M.t��C-' v� rt o , 3 l 5� S�tG�r' �► o �'