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HomeMy WebLinkAbout0040 CRAWFORD ROAD - Health 40 Crawford Road cotuit A _ 005 043 i T+D WI�1�1F BARNSTABLE SEWAGE 0. . - D�35TPNAIL dt PHONE NO SBtC TA1K CAPACITY r OR-Ow Wwo PE ii'I'131' .._.,,,..wcotO YA 1D14' ;...,._. . S�prtratlott�istwtne:B�tv�eeia�o ,• �, Maxiirum l�ojWbti Gtaunaw.4&.' a �a thG Battotri:ak X�:�Ghin l�sc ihtY peer P�fv '�J�tc-r Supply VJc�t astct Y�ettching l�ac�ty i��.nY a�Nt9s rxist' otit sate�c�v�thin xQ��tn�I�ttctutt�fs�ltt}�) . Ircl�r viz�i1�t9atid aad LeAC6tiu�r fi��c�1i��Y.�a►1y wtEllancls e��t ._..„..µw,..�._-..---,-..-�: t+lxiurl'iQt!tc.et pt:leac9srrig f� ry� 1 1Furn13bed by � r ' door E-I=q /4 3- 3 e' i Commonwealth of Massachusetts Title 5 Official Inspection Fora `N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a_s3 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is COtUIt required for every MA 02635 3-27-17 7_ page. City/Town State Zip Code Date of Inspection aa 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. A. General Information S/# /aaoq 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905. S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 3-27-17 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. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts fez Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Crawford Rd t J Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts I, Title 5 Official Inspection Form ; I Subsurface Sewage Disposal System Form Not for Voluntary Assessments 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 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 t5ins-3113 Title 5 Official Inspection Form:`.Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form �i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �s .p_J� ✓ 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts a=1 Title 5 Official Inspection Form wIf�'j Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4a_�se 40 Crawford Rd Property Address Michael Leblanc e Owner' Owner's Name information is required for every Cotuit MA 02635 3-27-17 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. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This, system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,. provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ' The system fails. I have determined that one or more of the above failure ❑ ® criteria exist as described in 310 CMR 15.303,therefore the system fails. The _ system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply- ❑ -❑ the system is within 200 feet of a tributary to a surface drinking water supply ' the system is located in a nitrogen sensitive area (Interim Wellhead Protection El ❑ Area=IWPA) or a mapped Zone II of a public water,supply.well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form f Subsurface Sewage Disposal System Form Not for Voluntary Assessments a% 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 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? I ® ❑ 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)] 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): 330 t5ins+3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts �;+ r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 page. City/Town ,, State Zip Code Date of Inspection D. System Information , Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: 3 Sump pump? ❑ Yes ® No Last date of occupancy: 3-2017 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts G� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is Cotuit MA 02635 3-27-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner--pumped 3yrs ago Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Crawford Rd � K Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 page, City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2002 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 42"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): . Good condition. Septic Tank(locate on site plan): Depth below grade: 36"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form r, ' , 11.1 Subsurface Sewage Disposal System Form Not for Voluntary Assessments �.,¢!✓ 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 page. Cityrrown 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 20" 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? Tape 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 is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 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: 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 Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Crawford Rd t J' Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 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 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.): Good condition with water at working level and no sign of back-up from field. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form �M Subsurface Sewage Disposal System Form -Not for Voluntary Assessments l �F. 40 Crawford Rd � Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3-500's ❑ 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.): Leach chambers in good working order and empty at inspection with no visible stain lines. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts 1a=1 Title 5 Official Inspection Form ��� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Crawford Rd t J' Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 page. Cityrrown 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: 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 f Title 5 Official Inspection Form �i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Crawford Rd Property Address . Michael Leblanc Owner Owner's Name information is required for every . Cotuit MA 02635 3-27-17 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 ` nL . I t 1 Q n 61e, �` e, r C2.� � -�1 - �� C9 �.r,r rrn rr 3 - 3e 15 3' ' YJ 46 i 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 A Commonwealth of Massachusetts 9+ Title 5 Official Inspection Form i]l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 40 Crawford Rd ` Property Address Michael Leblanc Owner Owner's Name information is Cotuit MA 02635 3-27-17 required for every page: City/Town State Zip Code Date of Inspection D. System Information (cont.) w Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 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: Originald design plans show no groundwater at 12'. } 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 4 Commonwealth of Massachusetts Title 5 Official Inspection Form �'�-i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a �.�_Jr!✓ 40 Crawford Rd Property Address Michael Leblanc Owner Owner's Name information is required for every Cotuit MA 02635 3-27-17 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 1e y' a WN OF BARNSTABLE � L:^rA�CN-Aeo��b� VILLAGE �'�".�t"� pt, ASSESSOR'S MAP & LOT. OiS—Oy 24STALLER'S NAME&PHONE NO.,,& SEPTIC TANK CAPACITY LEACHING FACILITY: (type) S�Q� (size) ;Lk � . NO.OF BEDROOMS BLUDER.OR OWNER PERIMI T DATE: Y//Z d;t, COMPLIANCE DATE: (I Separation Distance Between the: Tv"a iln`ni Adjusted Groundwater Table to the Bottom of Leaching Facility ; Feet r1rivaie'.Water Supply Well and Leaching Facility ;(If any wells exist + `6' site or within 200 feet of leaching facility)"' Feet =Edge o.fiWetland and Leaching Facility;(If any wetlands exist \�'llhtre 300 feet of leaching facility) Feet ' 1�dr�:i,he'i±hy - -- 'eAr Craw�er �• z F S 43 3 3 g �� rNo. THE COMMONWEALTH OF MASSACHUSETTS FEE �L�T' ' l�?l�1�� �-,/ � (���/�BOARD OF HEALTH llYlt_r 1— O FaqAJO� � APPLICATION FOR DISP07AL SYSTEM CO�TRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( Upgrade ( ) Abandon ( ) - Complete System ❑Individual Components .� N - � - l ►� �� ocation Owner's Q C� A i W^ Map/Parcel# Address !1 11 v Lot# Tel one# y Installer's Na�^ 1q C i Designer's Noe (� 1, `Address/lam b J (•l ddre s S'O 4 Ll-7-7 C) 1 `-1 7 ' Telephone# Telephone# Type of Building: Lot Size c 3►I QQ Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required)��gpd Calculated design flow � gpd Design flow provided Lko gpd Plan: ate_f�y�(,o-01 Number of sheets Revision Date Title Description of Soils a C�ea,It- ? ,) Soil Evaluator Form No. ` Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to pl9ce the system in operation until a Certificate of Compliance has been is ued/by the Board of Health. Signed Date / 6 FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 THE COMMONWEALTH OF MASSACHUSETTS FEECJ= j J 1 , BOA-IUD OF EALTH - OF APPLICATION FOR DISPO AL SYSTEM CONSTRUCTION PERMIT Application for a;Permit to Construct ( ) Repair ( Upgrade ( ). Abandon NComplete System. ❑Individual Components Wei do boa1 •n; . ;cation Owner's Name (R0 Gth ` Map/Parcel# Address � Row Is C tC1 roJ /,4' C , Tel one# Installer's Name Designer's N e Address Addre s S`o Q V-7-7 c) 1 -y m- Telephone# Telephone# • Type of Building: Lot Size'D I Op Sq.feet Dwelling—No.of Bedrooms Garbage Grinder'( ) Other—Type of Building No.of persons Showers ( ), Cafeteria Other fixtures Design Flow(min.required) '65 gpd Calculated design flowt.330 gpd Design flow provided 42_3 gpd Plan: ate ad(O-0) Number of sheets Revision Date Title,= . Description of Soil(sg �1C�v>, kSY1'Yl Soil Evaluator Form No. t Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued/by the Board of Health. .; Signed �v Date G C}/ G r a L; Inspections � f it FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 .,,* Vlg& THE COMMONWEALTH OF MASSACHUSETTS d FEE` �tnr BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ,V Individual Component(s) ❑Complete System L The undersigned hereby certify that the Sewage Dis.poossalll System;Constructed( ),Repaired( ),Upgraded( `),Abandoned( ) by: Sr"G .j. i r�li at G+ 7'/ ZA-r has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built. plans relating to application ;..Vi dated /s '- 4� .c Approved Design Flow (gpd) Installer Designer: Inspector �' Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 i / Yr� G% THE COMMONWEALTH OF MASSACHUSETTS FEE pf� NO.�r �'f� BOARD. OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair, ) Up ade J.A a.ndon .( ) an individual sewage disposal system at 4,110 as described in the application for Disposal System Construction Permit No.4`�!� � dated Provided: Construction shall be completed within three years of the date of this TV.All local conditions-must be met. Date-- �. / t�' Board of Hea1C-�1� i FORM 2 - DSCP DEP APPROVED FORM 5/96 j i FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON PWN OF BARNNSTABLE c LOCATION#Sr il—O{ Z'tii 5Z.)e-i`-A u{3CO—IdSEWAGE # VILLAGE� D�w t'� 141 ASSESSOR'S MAP& LOT OU —© INSTALLER'S NAME&PHONE NO.,lCok� Ar CQ.U441 O" = ; SEPTIC TANK CAPACITY „4202 ' LEACHING FACILITY. (type) S (size)'`J3f)C 33 e NO.-OF BEDROOMS BUILDER OR OWNER L PERMITDATE: d 2 COMPLIANCE DATE: 10 11/ 0 Separation Distance Between the: . Nlaximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet ?rivryte Water Supply Well and Leaching Facility. (If any wells exist C't Fite or within 200 feet of leaching facility)' Feet Edge df.Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Funushed�hy Rehr � � Cr�wF6orl R�. z s 43 3 3 . J t 5/25/01 NOTICE: This Form-Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION: TEST- AND-SOIL EVALUATION EXEMPTION FORM I, David Sanicki , hereby certify that the engineered plan signed by me dated 10/26/01 , concerning the property located at _ 40 Crawford Road, Cotuit meets all of the following criteria: • This failed system is connected to a residential dwelling only. 'There are no commercial or business uses associated with the dwelling. • The soil.is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. • There is no increase in flow-and/or change in use proposed • There are no-variances requested or needed. - - • The bottom of the proposed leaching facility will not be located less than fourteen - .(14) feet above the maximum adjusted groundwater table elevation: [adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation (using GIS information) B) G.W. Elevation + adjustment for high G.W. _ d DIFFERENCE BETWEEN A and B SIGNED : DATE: 11/2/01 NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:percump �Z-70 , LOCATION ' 0 S-EWAGE PE NMI T NO. V'tLLAGE I N S T A LLER'S NAME E6 ADDRESS E 1eY_6L 4 '11 U I L D E R OR OWNER '� A Ii4%Ip41.- L9&ANC DATE p I R A IT I.S.SUED �? � / 7 t2 DAT E COMPLIANCE ISSUED �3 �.VAC H P+T a OF- �oao�4 6Z� i . THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) DATA THE COMMONWEALTH OF MASSACHUSETTS -BOAR® OF HEALTH T.44v�c ...........OF......... �� / �.T ,�� ................•. Appliration for Uiipu,i al Works Tnntrurtinn Prrutit Application is hereby made for a Permit to Construct (&-15"or Repair ( ) an Individual Sewage Disposal System at: / r -•--....e�-0t�._'�.�..---..�.'f�w �l."W.....l.�r%i'.......C'���/..T..��...:CJl�'�---�'_�.___c_:. Location-Ad ess or Lot No. .... -1Y1 /.......�. .G---------- t.. ............. 6.r.....-------•--------•----•............................................... Ow er Address aver. 1YY.tam.a............................. ,,. Installer Address d Type of Building Size Lot...23f./DD.....Sq. feet U Dwelling—No. of Bedrooms............... .....Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria 0.' Other fixtures ------------------------•-------------- - W Design Flow...................�X..............__.._gallons per person per�da'. Total daily flow................24.3 ..............gallons. WSeptic Tank—Liquid capacity/D,Pk*;gallons Length._.Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No-------/........... Diameter...../0.!n Depth below inlet....... Total leaching area._417tiS�Aq. ft. Z Other Distribution box (✓_ Dosing tank ( ) '-' Percolation Test Results Performed by....... ................ Date......1 ��f �-...__.. a . Pit No. 1...4_Z_._.minutes per inch Depth of Test Pit...44-4."_. Depth to ground water.....XYaJ?.G Test Pit No. 2_-...Z....minutes per inch Depth of Test Pit___144."... Depth to ground water----A. e.__ P ..................................................:...�*.......------....-............................................................. -----.----- -••-------.........�..`......r..... O Description of Soil------------- y ��1v�?c�Q/.._.. . - �p 1 ¢... ..G�r �?n._. _...ty`�!r).`...-._.. x .; .. .... � i !.._.... .... _. c-� ------------------------- •--•--• . --------------- / W --•-••----------•------------•--•--- �s1r.t�ra0_.I�1/ r_cQ�XG.Gsu. _ 'r �t'---------------------•------------------------------------ U Nature 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 J.- l 5 of the State Sanitary Code—Th uncle gne th rees not to place the system in operation until a Certificate of Compliance has be i s d th ar t Sie ... ...... .......... ...... ----- Application Approved BY _ l� �---------- Date Application Disapproved or a following reasons-------------------------------------•-------------------------------------------•----•-•••-•••••..........------ .................•--.........•••-----•••••-•---.....-----•••••-•-•-•---••-----•-•-•--...--•---••••-•--••------••-•-•--••-•-•-•••••••----•-••----...-•-•--••-••-•--••-••-•••--••••----------•--••---•--- Date PermitNo......................................................... Issued-....................................................... Date NO' ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH e.P.44,)_&L�.......OF......... .................... . ... ..... .. ... Appliration for Uhipogal Works Tonstrurtion runfit Application is hereby made for a Permit to Construct _)tor Repair an Individual Sewage Disposal System at: / .................................... ....... �Locatioyi•Add or Lot No. Ow r Address 12. ....... -7 . ............ ........ ..../-1 .-,............................ 7 Installer Address Type of Building Size Lot.... ....Sq. feet Dwelling—No. of Bedrooms...................5.................... ...Expansion Attic Garbage Grinder ( 04 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( A4Other fixtures ...................................................................................................................................................... W Design Flow..................:!.52) ..................gallons per person per day. Total daily flow.................V_615?-.............gallons. 9 Septic Tank—Liquid capacity.A.4Qgallons Length___�f.--4 Width................ Diameter................ Depth....._.......... Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------/.......... Diameter.--.. Depth below inlet.._.__. ..4'2.. Total leaching area..2VLT4q. ft. z "'Other Distribution box ( Wr Dosing tank ( ) Fercolationm-Test Results Performed by........W1174 kll�?Z:W.6.��71................ Date.......1 as .x -7 ee- it No. 1... -.minutes per inch Depth of Test Pit.... Depth to ground water...... Z2.4—'_ #�-.�Test Pit No. 2.-.-<-.Z....minutes per inch Depth of Test Pit---- Depth to ground water..... ........................................................7......................................................................... ...... 0 Description of Soil................—2.. . ....... 1 .4- ------ ..................................2. ........ .......... .............................................. ...... U K-------------------------------- W A/e:�� cf,-7zz?n�... ;C-------- -------*-------- ------**"*"*------------------------- ---------------------------------------------- --­------------- ............................................................................ U Nature 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 ITTLE 5 of the State Sanitary Code-The nders*, ed them ees not to place the system in operation until a Certificate of Compliance has been i ue b e rd o I .. ..... . . ...... ­,_­1t--4=----—Application Approved By --- ......................................................................... ..... — Date--------------- Application Disapproved f o th following reasons:................................................................................................................ ........................................................................................................................................................................................................ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..............................................................I...................... Qlwrtifiratr of Toutpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constru-ted or Repaired by ... ................................................... ................... .......... le _fn --------- ----- .................. ......... n a-19 e� . .... . .............. at................. -f... ........iQ......... ....the pro e... .... ................................ ................ in accordance with th 0 Isi( has been instal e 0 Isions of TITLE 5 of T ��a de �A State Sanitary Code a e- b d in the application for Disposal Works Construction Permit No.____.(s/2--_76-S-------------- dated-------- ....I ---- ...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON STRU AS GUARANTEE THAT THE SYSTEM WIA FUNCTION SATISFACTORY. DATE... .... .. ........ ........... /�//yy --- Inspector..... ............. ............................................................. ............................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEAL ..OF......... ............................ No..4an-x.r FEE........................ Dispoiial ork (.16141notrudion "amit Permissionis h granted....... ... ... ..................... ... == .............................. to Construe Repair ( ' Indivi al ewa posal Syst atNo. ............ .. . ......... .. .......�­------------- ..... ...... ......... .. ...... ......... .... 1 .............. Street as shown on the application for Disposal Torks Construction Permit N ............. ate .......... ........................... • .................................... ......... ................................................... DATE................................................................................ J and of ealth FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS I _ SYSTEM PROFILE TOP OF NOT TO SCALE FOUNDATION FINISH GRADE FINISH GRADE OVER EL. 75.3 FINISH GRADE OVER EL. 74.0 SEPTIC TANK 73.8 DISTRIBUTION BOX 73.5 FINISH GRADE OVER TRENCHES 73.5 `RISERS TO 6" - - - OF FINISH GRADE —a ro o �� PRECAST CONCRETE p4^U'rr �'�•+''�i r '�o. �•.t7 r• b' RISERS TO 6" ,��'; b' 500 GALLON DRYWELLS 3"MIN. - OUTLET PIPES) LEVEL H-10 REINFORCED LOADING OF FINISH GRADE MIN.SLOPE 1% 13" ° j FOR 2'( MINA% SLOPE TRENCH LENGTH = 33'-6' MIN. MIN.SLOPE 1/° ° Q BEYOND y` _ O DRYWELL LENGTH = 8'-6" 13"MIN. ,. - , y �,+lO:r •r ,O:r i, i '+r O-r G,:a - +r �:r '`T4, +r c ° ° r.' r °• r. r S ° r. r .r 14' 6'SUMP 71.80 71.60 MIN. �\'�� PVC OR CAST IRON TEES <` 71.35 70.67 :i''t O,U:r 70.50 r Mho '.' <<` '-,6 '` �oico ,0�—�r0 r r -` °•� INSTALL GAS BAFFLE \�- - DISTRIBUTION BOX MINIMUM INSIDE DIMENSION 12" 3/4"- 1-1/2" DOUBLE EXISTING 3/4"- 1-1/2" DOUBLE w A' OUTLET INVERTS 2" BELOW INLET INVERT - WASHED CRUSHED 4' 0. o< o _4 MINIMUM CONCRETE WALL THICKNESS 2" STONE WASHED CRUSHED �000 GALLON STONE .!`. INSTALL ON COMPACTED LEVEL BASE BSMT.FLR. - PRECAST CONCRETE ELEV. 67.8 ooro 16 H-10 REINFORCED �^ r _ TRENCH SECTION I �..ir' r.',1' •iO °•' r�'a'p r r.f 'r`\��, r1�r`r �Qi ram,r.,.i r f ,`, 0'��' , r . NOTE: EXCAVATE TO =C= STRATUM IN ORDER TO SEPTIC TANK REMOVE ALL =A= &=B= IMPERVIOUS MATERIAL INSTALL ON COMPACTED LEVEL BASE WITHIN 5' OF THE SAS. REPLACE k"°JITH CLEAN, 9" MIN. 3" OF 1/8" - 1/2" CLAY-FREE SAND 4" DIAM. 36" MAX. DOUBLE WASHED PEASTONE CRAWFORD ROAD - ~`''" • „'Ojos 0 1 � -, . , K 3/4" - 1-1/2" DOUBLE ---------- 48'° 5'-2" 4 " WASHED CRUSHED 1 '\ TRENCH WIDTH STONE \\ I 1 13'-2" I \\ m I NUMBER OF TRENCHES 1 \ HSE.N0.40 I 1 GENERAL DOTES: 42 �' 1. ELEVATIONS SHOWN ARE!BASED ON ASSUMED NUMBER OF DRYWELLS 3 \ LOT m I \ 2. ALL PIPES IN THE SYST&MUST BE CAST IRON 1 'OBSERVATION PIT 23,100 SF. _ I ol? sG;-1DULE 4o Pvc. rn ' 3. HEALTH AGENT/CAPE & ISLANDS ENGINEERING MUST BE NOTIFIED WHEN CONSTRUCTION IS DR�VEwAy I COMPLETE PRIOR TO BACKFILLING. -74 \ \ I `\ I 4. ANY CHANGES IN THIS PLAN MUST BE APPROVED BY CAPE & ISLANDS ENGINEERING AND THE BOARD OF HEALTH. PERCOLATION TEST AND DESIGN DATA 5. MATERIALS AND INSTALLATION SHALL BE IN SOIL EVALUATION EXEMPTION ��\ I COMPLIANCE WITH THE STATE SANITARY CODE FORM ATTACHED 2a.3o' [TITLE V]AND LOCAL APPLICABLE RULES AND NUMBER OF BEDROOMS 3 720.00' REGULATIONS. GARBAGE DISPOSAL NO r 6. NORTH ARROW IS FROM RECORD PLANS AND IS > 21.00 _ NOT INTENDED FOR SOLAR ENERGY PURPOSES. DAILY FLOW 330 GPD. 7. WATER SUPPLY: MUNICIPAL WATER SYSTEM. SEPTIC TANK PROVIDED 1000 GAL. Q EXISTING DWELLING 1 8. FLOOD ZONE C [NON-HAZARD] LEACHING REQUIRED 330 GPD. 9. THIS PROJECT DOES NOT!INVOLVE ANY PHYSICAL \, \ 30.69' g gOr `° �' GROUND DISTURBANCE OR VEGETATION REMOVAL SOIL ABSORPTION SYSTEM OHS: WITHIN 1 00' OF WETLANDS,INLAND OR COASTAL BANKS OR FLOOD HAZARD ZONES. NI \i DECK_ W -12.2` SIDEWALL AREA = 186 SF. ° 186 SF. X .74 G/SF. = 1137 GPD. IM i l _� `�\ ,���� BOTTOM AREA= 441 SF. 441 SF. X 0.74 G/SF. = 326 GPD. \\ I I 34' o �T dent LEACHING PROVIDED = 463 GPD. \ I i o EXISTING 1000 GALLON LEGEND —13 � 13_-2'_.; SEPTIC TANK \ 52 PROPOSED CONTOUR SEPTIC SYSTEM UPGRADE \ I -�- --52--- EXISTINGiI CONTOUR - PROPOSED SEWAGE DISPOSAL SYSTEM \ ---------- OBSERVATION PIT \ - PREPARED FOR P I - RESERVE I r ; gar I ❑ DISTRIBU ION BOX .' r_ I` h ;`' 4 ` ' MICHAEL LEBLANC �•, � HSE.NO. 40 [LOT 42] CRAWFORD ROAD o 0 o SEPTIC TANK (� COTU IT,MASS. SHED i N i L�J SOIL ABSORPTION SYSTEM ! PLAN NO. 102901 SCALE: AS NOTED RESERVE FILE NO. 157BA DATE: OCT.26,2001 / I RESERVE AREA �� SEPTIC FILE N0. 70 PCS FILE: CRAWFORD RD PIPE INVERT ELEVATION CAPE & ISLANDS ENGINEERING z z z - ,��fi,1�7E F� 5143 42 40 o o c7 �t� � k � , �s, 800 FALMOUTH ROAD, SUITE 301C PLOT PLAN > > > � � MASHPEE,MA 02649 (508)477-7272 SCALE: 1" - 20' MAP SEC IPCL LOT HSE � uj f >=ter f - I SITE Pt AN T YPICAL PROF/L E L NOT TO SCALE SCALEF ,EL. 4o.ao /8"ST9. LT WGT C.I. MH COVER - ° c 4.,jj `., 4"BIT FIBER PIPE TIGHT ✓DINTS � FLOW INE ' OUTLET LEVEL X'O FIRST JOIN - DWEL L ING ro-- -___L-- - /--1 - O O ` .I. r£E ` C./. TEE 33 STANDARD PRECAST 4 s ce ✓` �?° 2" '; 1-�" N/ CONCRE, EIjAWGAL LON 33. SEPTIC TANK 8'�x7 3sY9 -_= B„ D/STRIBUT/ON BOX \ TO BE INSTAL L EO ON LEVEL, STABLE BASE. SEPTIC TANK TO BE INS TA L L ED ON LEVEL , STABLE BASE -' {_ \ ! �+ r ' 2"— //B TO //2" WASHED PEAS TONE LEACH/N(i P/T 3TD• P,e,EC�9,�T CcavC. L' EP1/� ALL AROUND FREE OF IRONS FINES L.Eq�C'�+••/<N<S ,8.9,3/U 1 �,r,�-.,c//,C/Ca A�E4 � AND DUST IN PL ACE ' BASE TO BE LEVEL. BRICK Q MORTAR CDURES �� j 3/4 TO l-//2 WASHED CRUSHED AS REDUlREO TO BRING COVER TO GRADE. 24"C-I. MH COVER STONE ALL AROUND FREE Of 1e� I j R AND FRAME s IRONS, FINES AND DUST /N PLACE. v IJ/.6T. x �Sr'.a. f:E'EGi7ST $. �� Co�✓c. i �,Qt. �EP7/G 7lQAA- d - -1-4;, - - LEACHING PIT SECTION- __,,_ 8' FLOW L!lVE - - 37x2 INLET PIPE L CONCRETE TO BE 4000 PSI 28 DAYS 4Y TPA '�`' �, ° 2. REINFORCED WITH 6" x 6" NO.6 GA. W.W.M. EC.38.Q _ \ ---'— 3. 2' AND 4' SECTIONS ARE AVAILABLE FOR GREATER r ;,; • DEPTH REQUIREMENTS. .� OPENING W/TH 4 1/8" 4. NUMBER OF PITS REQUIRED 0 P`eQ'p' i ' ' OUTER DIAMETER B 2G.0 ti /^ /-3/4" INSIDE DIAMETER NOTE: EXCAVATE TO ELEVATION OR LOWER AS , -_ __. 3— REQUIRED TO REMOVE ALL LOAM AND CLAY BENEATH Z,j7'•• 41 p -- Zo �;��—""�`� � � PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN Pk� F. GRAVEL TO DESIGNED GRADE 2f 39 . -- �_ 6'- 4'-0" --- --- -- O' o MIN. EFFECT/VE DIAMETER -• . _ . . -- (N07 TO EXCEED 3 TIMES EFFECTIVE DEPTH) WATER TABLE ` SOIL AND PERC. DATA GENERA L NO TES �a NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. _ PERC. RATE � < 2 MIN. /IN . Cif 4.ox �'� '�P Cg - SEPTIC TANK, DISTRIBUTION BOX , LEACHING PITS TO BE STANDARD W 1 A�/ 97427 ' S0" E /4�.00' 1 FL. 39. 7� TEST BY: _ �it/I77. �. 1�1/A.evY/Ck -- 4v — s-�---- \ PRECAST REINFORCED CONCRETE UNITS. x ' \ 39X3 3BXG ;9c.' WITNESSED BY _ /CO-V.9412 - ,�Z2 f3� _ ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE , TEST PIT GR EL.: '� DATE _ 23 8Z MINIMUM REQUIREMENTS FOR THE SUBSUFACE DISPOSAL OF TEST PIT NO. 1 TEST PIT NO. SANITARY SEWAGE EFFECTIVE I JULY 1977. 0„ — 0„_ i _ ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE C� l��l �-• ORL) j7/•-� � �j1O ✓�i/ ��✓.3.Sd/L BOARD OF HEALTH. Y /'� / T lJ/�-f `� !� '-S� AT COMPLETION OF CONSTRUCTION , PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES 1/4" / FT. UNLESS INDICATED OTHERWISE. i 44 -- --- -- ---- -- DESIGN DA TA - ;. BEDROOMS DISPOSAL EST TOTAL DAILY EFF _ 33c _ __GALS LEGEND SEPTIC TANK _/n� GAL SIDEWALL AREA -_2.5 GAL./SO FT • s BOTTOM AREA —___L_v_.____GAL./SQ. FT SEWAGE DISPOSAL SYSTEM ti oxoo EXISTING GRADE LEACHING REQUIRED— L?3,Oo SO FT ZONE �� - �' o� FINISHED GRADE ACTUAL LEACHING AREA __. L"l so SOFT FOR 0 0. oo INVERT ELEVATION DOMESTIC WATER SOURCE:` T wti WAT,E�2 i ___ __ . .___� ,GOT ,., *L QF.��ts,� . , G'�Z'L/ PROPERTY LINE / T PLAN REFERENCE LET 42 c�cr'uiT Co✓ES ��C_.7I� - r' `� , `. �` � 9 �� /82_ MEAN HIGH WATERR + ; ':* SCALE AS INDICATED DATE : —_.L / r BENCH MARK DATUM _ y�GS f�3L /929 -0,9rzjA A• ' i 4 MARSH k,, x ✓ ``"'nt�`WAt- WM. M. WIJRW/CK B ASSOCIATES ". IN:�" BOX 801 - NORTH FAL MOUTH ;, IWA755ACRUSETTS 02556