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HomeMy WebLinkAbout4930 FALMOUTH ROAD/RTE 28 - Health 4930 Falmouth Road (route 28) Cotuit P A = 609 001002 �I �TOWN OF BARNSTABLE LOCATION 7 ! O /P rep- S7 SEWAGE # VILLAGE C" D ` y 17' ASSESSOR'S MAP & LOT NSQ£C/o_s INS-P,L-L€R`S NAME&PHONE NO. SEPTIC TANK CAPACITY £ f 7--'� EACHING.FACILITJY::(type)' =(siie) `Y40.OF BEDROOMS BUILDER OR OWNER C 4'461PI� L' AP Pe£lf 7— PERMIT DATE: DATE: 1 v 42."g 3 / 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 ,� M ...... 0 �\ __11 V _ > Q� O �v � e A �� � � �. s.. j TOWN OF BARNSTABLE LOCATIONi`�® �Q Vr� �G/ SEWAGE # VILLAGE C•O f U// ASSESSOR'S MAP & LOT j pj INSTALLER'S NAME PHONE NO. A & B CANCO 775-6264 -SEPTIC TANK CAPACITY •LEACHING FACILITY:(type�� S� e��S (size).3.3X NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER 4Ob -ee / DATE PERMIT ISSUED: /7 g DATE COMPLIANCE ISSUED: y / -9 W VARIANCE GRANTED: Yes No 0 w to Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name1 information is required for every Cotuit MA 02635 7/30/2019 _ page, City/Town State Zip Code Date of inspection c: 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: Was system.pumped,as part of the inspection? E Yes ❑ No If yes, volume pumped: 1500 gallonsgallons How was quantity pumped determined? site glass Reason for pumping: maintenance t5insp.doc r rev.7/26/2018 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 8 of 18 Tripp,Vanessa From: AMY CLARK <aclarkcapecodseptic@gmail.com> Sent: Monday,June 22, 2020 1:47 PM To: jdc2801;Amanda Kundel;Tripp,Vanessa Subject: 4930 Falmouth Rd, Cotuit Septic Inspection Revision Attachments: 4930 Rt. 28 - Revised page 8.pdf Good Afternoon: It came to our attention that there was an error on page 8 of the septic inspection for 4930 Route 28 in Cotuit. Please find the revised page attached. Please call me with any questions or concerns. Thank you, Amy Clark Office Manager Cape Cod Septic Services Inc. 350 Route 28 W Yarmouth MA 02673 Phone - (508) 775-2825 Fax - (508) 775-0424 CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! i I 0 �L\ Commonwealth of Massachusetts _ Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4930 Rt. 28 Property Address — f Patricia Cabral Owner Owner s Nape s f Information Is ✓ required for every Cotuit MA ow 02635 7/30/2019 page. City/Tn State Zip Code Date of inspection Inspection results must be submitted on this form. Inspection forms may not be altered n_any way. Please see completeness checklist at the end of the form. Impgoutf When A. Inspector Information fillip out forms on the computer, I �f use only the tab Douglas Brown key to move your Name of inspector cursor- et not return y the Cape Cod Se tic Services Inc. key. Company Name 350 Main St. Company Address _ West Yarmouth MA 02673 City/Town State 508-775-2825 Zip Code Telephone Number SI4297 License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. El Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Ins ors Signa ur� 8/7/2019 Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and,under the conditions of use at that time.This Inspection does not address how the system will perform In the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit MA 02635. 7/30/2019 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: System in working condition. 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): 15insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts . 16-9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is COtUIt required for every MA 02635 7/30/2019 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): ❑ 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 x Title 5 Official Inspection Form �' ra Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit MA 02635 7/30/2019 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. El 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 Commonwealth of Massachusetts ,9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is COtUIt required for every MA 02635 7/30/2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth,in cesspool is less than 6" below.invert or available volume is less than '/2 day flow 0 ® 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. ❑ ED The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead.Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 0 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit MA 02635 7/30/2019 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 recent) or® Y y as part of this inspection7 ® 0 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is COtUIt required for every MA 02635. 7/30/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 110x3= Description: 330gpd Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? El Yes ® No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? El Yes ® No Water meter readings, if available(last 2 years usage(gpd)):. 2017=47gpd Detail: 2018=58gpd Sump pump? El Yes ® No Last date of occupancy: Unknown Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 --r, Commonwealth of Massachusetts ,p Title 5 Official Inspection Form ! Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit -MA 02635 7/30/2019 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 ElNo Water treatment unit present? El 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: No Records 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit MA 02635 7/30/2019 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: 2003 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 24" feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: +10' feet Comments (on condition of joints, venting, evidence of leakage, etc.): Line checked with sewer camera and was found to be clean, properly pitched and found with no root intrusion. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 r— Commonwealth of Massachusetts 11? Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit MA 02635 7/30/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 1211 feet Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene El 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: 1500Gal. Sludge depth: 4-511 Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 2-311 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Estimated Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 1500Gal tank in good condition. PVC tees in place and clean. Tank at normal operating level. Covers at grade. t5insp.doc•rev.7/26/2016 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is COtUIt required for every MA 02635 7/30/2019 page. City/Town 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 El 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'y El other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts ,� Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every COtUIt MA 02635 7/30/2019. page. City/Town 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 oil 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.): H-10 DB-3 with 1 line in and 1 line out in good condition. Box is clean and level with minimal solids carryover. No sign of overloading or hydraulic failure. Cover 16" below grade. t5insp.doc•rev.712612018 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 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit MA 02635 7/30/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: * ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 3-500Gal ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7120018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts l? Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is COtUIt required for every MA 02635 7/30/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 3-500Gal chambers with stone. No standing effluent in units during inspection. No evident stain. Soil was clean. No sign of overloading or hydraulic failure. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): ' Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7I2612016 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 0 Subsurface Sewage Disposal System Form-Not for.Volunta Assessments is 4930 Rt. 28 Property Address Patricia Cabral. Owner Owner's Name information is COtUIt required for every MA 02635 7/30/2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is COtUIt required for every MA 02635 7/30/2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 16 of 18 Commonwealth of Massachusetts x = Title .5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit MA 02635 7/30/2019 page. City/Town 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: 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 Ian reviewed: 2003 p Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Test Hole data per plan on file at BOH. Hand auger did not encounter water at 10'.'Max bottom of leaching is 5'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4930 Rt. 28 V Property Address Patricia Cabral Owner Owner's Name information is required for every Cotuit MA 02635 7/30/2019 page. City/Town 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 - Page 1 of 2 "tOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE CDT/T- ASSESSOR'S MAP&LOT ' /sxs W NAME&PHONE NO. SEPTIC TANK CAPACITY �LEACHING FACILITY:(type) (size) "` NO.OFBEDROOMS BUILDER OR OWNER C 446"' PERMITDATE: DATE: 7 'il•? 'd 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 i �,�• 39 i O t) https://townofbarnstable.us/Departments/Assessing/Property_Values/HMdisplay.asp?mane... 7/11/2019 COMMONWEALTH OF MASSACHUSETTS z w EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION A I.� f � v0 oqM Sab 350 MAIN STREET WE �Q � WEST YARMOUTH,MA w1AP \" 508-775-2800 PARCEL TITLE 5 LOT OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 4930 ROUTE 28 -/t';�_V� COTUIT,MA 02635 Owner's Name: CABRAL,ROBERT RECEIVE® Owner's Address: 4930 ROUTE 28 COTUIT,MA 02635 Date of Inspection JULY 22,2003 AUG 18 2003 Name of Inspector:(please print) JAMES D.SEARS TOWN OF BARNSTABLE Company Name: A& B Canco HEALTH DEPT. Mailing Address: 350 Main Street West Yannouth,MA 02673 Telephone Number: 508-775-2800 CERTIFICATION STATEMENT 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 perfonned based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: The systeniinspector 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 tot he buyer,if applicable,and the approving authority. Notes and Comments ****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. Title 5 Inspection Form 6/15/2000 1 Page 2 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 4930 ROUTE 28 COTUIT,MA 02635 Owner: CABRAL,ROBERT Date of Inspection: JULY 22,2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any infonnation 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: B. System Conditionally Passes: N/A 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. Answer yes,no or not determined(Y,N,ND)in the 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 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. ND explain: _ 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 obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 4390 ROUTE 28 COTUIT,MA 02635 Owner: CABRAL, ROBERT Date of Inspection: JULY 22,2003 C. Further Evaluation is Required by the Board of Health: N/A 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 salt marsh 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 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Title 5 Inspection Form 6/15/2000 3 Page 4 of I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 4390 ROUTE 28 CABRAL,ROBERT Owner: JULY 22,2003 Date of Inspection: D. System Failure Criteria applicable to all systems: N/A 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 pit is less than 6"below invert or available volume is less than %z 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 N/A An portion f y p o cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply N/A Any portion of a cesspool or privy is within a Zone I of a public well N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well N/A 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this fonn.) NO (Yes/No)The system fails. I have detennined 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: N/A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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 11 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 is 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. Title 5 Inspection Form 6/15/2000 4 Page 5 of I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 4930 ROUTE 28 COTUIT,MA 02635 Owner: CABRAL,ROBERT Date of Inspection: JULY 22,2003 Check if the following have been done. You must indicate"yes"or"no"as to each of the following Yes No ✓ Pumping infonmation 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 nonnal 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)has been determined based on: Yes No ✓ 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(3)(b)] Title 5 Inspection Form 6/15/2000 5 Page 6 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 4930 ROUTE 28 COTUIT,MA 02635 Owner: CABRAL,ROBERT Date of Inspection: JULY 22,2003 FLOW CONDITIONS RESIDENTIAL 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 Number of current residents: 2 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): YES Seasonal use(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): 2001 62,000/2002.84,000 Sump pump(yes or no) NO Last date of occupancy: PRESENT COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of inf'onnation: N/A—PUMPED AFTER INSPECTION Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: gallons—How was quantity pumped detennined? 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) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 1998 PERMIT#98-365 Were sewage odors detected when arriving at the site(yes or no):'` NO Title 5 Inspection Form 6/15/2000 6 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4930 ROUTE 28 COTUIT,MA 02635 Owner: CABRAL, ROBERT Date of Inspection: JULY 22,2003 BUILDING SEWER(locate on site plan): ✓ Depth below grade: 81, Materials of construction: Cast iron V'40 PVC other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): ✓ Depth below grade: 12" Material of construction: ✓ concrete metal fiberglass polyethylene _ other(explain) I f tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1,500 GALLON PRE CAST Sludge depth: V, Distance from top of sludge to the bottom of outlet tee or baffle: 29" Scum thickness: I" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 181, How were dimensions determined: ASBUILT AND 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.): MAIN TANK AT WORKING LEVEL.T STEEL COVER ON INLET.TWO INLET TEES.ONE OUTLET. NO SIGN OF OVERLOADING OR LEAKAGE. GREASE TRAP(located on site plan) N/A Depth below grade: 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 Page 8 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4930 ROUTE 28 COTUIT,MA 02635 Owner: CABRAL,ROBERT Date of Inspection: JULY 22,2003 TIGHT or HOLDING TANK: N/A (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/day Alarm present(yes or no) Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alanm and float switches,etc.): 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.,): DISTRIBUTION BOX IS 16"x16", 16"BELOW GRADE.ONE LINE IN,TWO LINES OUT. BOX IS CLEAN AND SOLID.NO SIGN OF OVERLOADING OR SOLID CARRYOVER. PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alanms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 4930 ROUTE 28 COTUIT,MA 02635 Owner: CABRAL,ROBERT Date of Inspection: JULY 22,2003 SOIL ABSORPTION SYSTEM(SAS): ./ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: J leaching chambers,number: 3 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 IS THREE 500 GALLON DRY WELLS,33'x I'x2'. LEACHING IS DRY. LEACHING IS 33"BELOW GRADE WITH 18"CEMENT COVER AT GRADE. CESSPOOLS: N/A (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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation etc.): PRIVY: N/A (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.) Title 5 Inspection Form 6/15/2000 9 Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 4930 ROUTE 28 COTUIT, MA 02635 Owner: C.ABRAL, ROBERT Date of Inspection: JULI'22,2003 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a:ketch of the sewage disposal system including ties to at least two.pernianent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I 1 i i ;` -------------------- Title 5 Inspection Form 6/15i2000 10 page 1 I of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 4930 ROUTE 28 COTUIT. MA 02635 Owner: CABRAL, ROBERT Date of Inspection: JULY 22,2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to no.:roundwatcr 1 I feet please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked.date of design plan revic\.\,ed: V Obsery�ation site(obuttimU property observation holc within 150 feet of SAS) Checked with load Board of Health-explain: Choked with local excavators,installers-(attach documentation Accused USGS database-explain: You must describe how you established the high ground water elevation: TEST HOLE I I NO WATER. TEST HOLE 6' BELOW BOTTOM OF LEACHING. A D , G N� U-14%£� Title 5 Inspection Form 6/15/2000 1 l a7 YS TE PROFILE i NOT 71�_ SCALE TOP FNDN. FINISH GRADE EL . FINISH GRADE G: o FINISH GRADE OVER FINISH GRADE OVER OVER TRENCHES 3 .• DIST. BOX 'R•4 o SEPTIC TANK o:: o •� 12" MAX. ` ` • �aG Q�Q•„p a• 00 , '.. •'i �: 00;AC.AJ'Y 4'::Q,e��.�s•v.Qp o+b,p0't,'. . e.ti.ti_. i 0 3,• OUTLET PIPE LEVEL TO TA L ENGTH OF TRENCH s >. FOR 2 FT. MIN. IF t.J—ti•' i• • ' �Oo �AfP• •e •rvd• �� I, •• A• �'�• .0 14 6a a o�0 CAP E G/30o' a • '•• °' � '' D 0 ::'. p 't .n:• .;:. :b•:..:o.•: .. . .. . . N °da : C. I. OR PVC TEES e: ob bP Go 0 0 e,po$ .o pav:p: p0. �A 1 b. y ' BSMT FL . 500 GALLON.•a a o,p po. L���5 TI�IB+f�T.:�ON BOX y EL . - e ' INSTALL ON LEVEL BASE "500 GALLON OR YWEL L S " PRECAST CONCRETE H-/ 0 REINFORCED a• ao o• �r,bw o.vi',`-0;.Op'��C4.:O�b::O•a�R�.4,aV�+rj p�a•�q j•ap�Q; SEP TIC TANK TRENCH SEC TION G o INSTALL ON LEVEL BASE ,��� \ 70` NOTE. EXCA VA TE TO EL EV. OR LOWER TO REMOVE ALL IMPERVIOUS MA TERIA L BENEA TH THE L EA CHING AREA 4 DIAM r r 12 MIN. REPL A CE EXCA VA TED MA TERIAL WI TH . 3" OF 1/8"-.i/2" '" �� 'S"'` �a CLEAN. CLAY FREE SAND 4 •'�.ra••G'• ° b '�:°'°'A �r � WASHED ,6EASTONE \ 3/4" - 1-1/2" WASHED '� °•a.' CRUSHED STONE \ \ / GENEPA L NO TES '- TRENCH WID TH 1. AL L EL EVA TIONS aHO.VN ARE BASED OH ASSUMED NUMBER OF TRENCHES 1. P. A/_L PIPES IN T; S'Y T'lF',9J lUS'r BE CAST_ .,"PlN OR SCHEDULE 46 PVC. 3. THE BOARD OF h �'L TH MUST BE NOTIFIED OBSER VA TION PI T U WHEN CONSTRUCT ON IS COMPLETE PRIOR P-5650 v ' TO BA CKFIL L INC PERCOL A TION RATE., .s' " 4. ANY CHANGES IN 'THIS PLAN MUST BE APPROVED <2 H,'IN./h`!. Y.• _ BY THE BOARD O,•" HEALTH AND CAPE 6 ISLANDS WITNESSED B 0 `�� ' w v SURVEYING CO., aTNC. T.McKEAN r 5. MA TERIALS AND NSTALLA TION SHALL BE IN BARNSTABLEBRD. OF HEAL TH DESIGN DA TA COMPL IANCE WI Tt 9 THE STA TE SA NI TARP o o N S •� ✓UNE 13, 1986 m R 4 G b w CODE - TITLE V - AND LOCAL APPLICABLE DA TE.' - RULES AND REGUJ,A TIONS 3 l ' 6. NORTH ARROW IS FROM RECORD PLANS AND NUMBER OF BEDROOMS O v} ° GARBAGE DISPOSAL NO IS NOT TO BE USED FOR SOLAR PURPOSES ,a Top3, � I F 0 7. .FLOOD HAZARD ZONE C (NON-HAZARD) s S u bs� , , DA IL Y FL ON 330 GAL . ��) ! 8. WA TER SUPPLY TOWN WA TER zy ' SEPTIC TANK REQ 'D. 1500 GAL . SEPTIC TANK PROVIDED 1500 GAL . LEA CHING REQUIRED 330 GPD. J ivi e-d I u Sq d SIDEWALL AREA = 152 S.F. IS.F.X 0. 74G/S.F. = 112 GPD. J N o BOTTOM AREA = 329 S.F. LEGEND 329 S.F.X 0. 74 G/S.F. = 243 GPD v LEACHING PROVIDED = 355 GPD PRti /.5"� ' W _ �0 7 r-s�w7'fI•. —0— POSED EL EVA TION -- �c -- EXI�S'TING CONTOUR — SINGLE FA MIL Y RESIDENCE C �•-. 4 r �f r,,, ,� OBESE RVA TION PI T G G \ ® DI TRIBUTION BOX / wrr n PROPOSED . SEPIA GE DISPOSAL SYSTEM r= PREPARED FOR o o sEl-�,rlc TANK ROGER T CA BRA L 4910 FA L MOUTH RD. — RTE. 2B RESERVE AREA BARNS TABL E — CO TUI T — MA SS. PIF'E INVERT EL EVA TION DAvID tic PLOT PLAN ` CAPE 6 ISLANDS ENGINEERING SCALE: -vo ' y ,_ z ti9id , ` SCALE AS NOTED 133 FALMOUTH ROAD - SUITE RE ,_9 '/1 MA SEC PCL L OT HSE r PLAN NO. s o� ii 9f3 MASHPEE, MASS.