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HomeMy WebLinkAbout0150 HUMMOCK LANE - Health WF150 Hnnirilock Lane �. Cotuit c 053- a Commonwealth of Massachusetts a�� t Title 5 Official Inspection Form I" Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r t J 150 Hummock Lane Main House { �Y Property Address i4 Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 , page. City/Town State Zip Code Date of Inspection' Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information filling out forms on the computer, use only the tab Chad Hathaway key to move your Name of Inspector cursor-do not Hathaway Septic Inspections use the return Company Name key. P.O.Box 151 " V Company Address Forestdale Ma 02644 City/Town State Zip Code 774 274 2581 12866 Telephone Number 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); I have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 9/16/2020 In Ign Date The system i spector shall submit a c of this in pection report to the Approving Authority (Board of Health or DEP)within 30 days of ompleting t inspection. If the system has a design flow of 10,000 gpd or greater, the inspec r and th tem owner shall submit the report to the appropriate regional office of the DEP. The origina 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 18 i r c Commonwealth of Massachusetts Title 5 Official Inspection Form l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every 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: ® 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: This inspection is not a guaranteeand applies no warrantyof the described septic components in this report including but not limited to piping structual intergrity of components and life exspectancy of leaching and described components. This inspection is to describe conditions witnessed at time of inspection only. Regular tank maintenance and water conservation can prolong life of septic systems Information on care and do's and don't`s can be found at town health dept or mass.gov 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to b' 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"nol_ determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. Cityrrown 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 Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. Cityrrown 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 El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.) ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails.The system owner-should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"'yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts �m Title 5 Official Inspection Form j Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ❑ ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example,a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 r c Commonwealth of Massachusetts Title 5 Official Inspection Form 1. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every 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): 330 min. Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ -Yes E No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: seasonal Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts fn ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. Cityrrown State. Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding.tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: unknown 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 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. Cityrrown 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: 1989 Were sewage odors.detected when arriving at the site? ❑ Yes. No 5. Building Sewer(locate on site plan): Depth below grade: 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.): no signs of leaks or poor venting. Sewerage ejector in basement an water till it cycled t5insp.doc•rev.7/26/2018 Tine 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 r Commonwealth of Massachusetts !n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 2'4" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Heavy Duty 1500 gal with risers with steel frame and covers just below grade located in driveway If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'6"x5'6"x48" Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness less then 1"thick Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? . tape and sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): tees in place liquid level at bottom of outlet pipe no scum light sludge. no visable cracks or leaks t5insp.doc-rev.7/26/2018 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 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee.or baffle. Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 I • Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information. (coat) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes [ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Heavy Duty H2O Dbox no decay or visable leaks located in driveway with steel cover close to grade t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 I • c Commonwealth of Massachusetts r� Title 5 Official Inspection Form Y Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 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: ® leaching galleries number: 5 ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 • Commonwealth of Massachusetts Title 5 Official Inspection Form l� Subsurface Sewage Disposal System Form-Not for Voluntary Assessments V 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): cover located in shrub bed next to driveway steel cover at grade. Galley is clean and dry. clean sandy bottom 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 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 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 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 i . arrx 2 LIe P2 S �3 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 • c`�, Commonwealth of Massachusetts �a Title 5. Official Inspection Form f' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 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: 20'+ 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: area of Septic is el. 30' bottom of SAS el. 22' per town GIS mapping bottom of SAS is greater then 4' above GM Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 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 150 Hummock Lane Main House Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. CitylTown 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 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 r 063, oo2i c Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Na information is Cotuit Ma 02601 9/16/2020 required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information �'� filling out forms on the computer, use only the tab Chad Hathaway key to move your Name of Inspector cursor-do not Hathaway Septic Inspections use the return Company Name key. 151 VQ Company Address r� Company Address Forestdale Ma 02644 AA City/Town State Zip Code 774 274 2581 12866 Telephone Number 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. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 9/16/2020 In 4p TcToitnature Date The system in ector shall submit opy o Is inspection report to the Approving Authority (Board of Health or DEP)within 30 days f eting 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 18 Commonwealth of Massachusetts 1� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. Cityrrown 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: ® 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: This inspection is not a guaranteeand applies no warrantyof the described septic components in this report including but not limited to piping structual intergrity of components.and life exspectancy of leaching and described components. This inspection is to describe conditions witnessed at time of inspection only. Regular tank maintenance and water conservation can prolong life of septic systems Information on care and do's and don't's can be found at town health dept or mass.gov 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 r - - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (coot.) 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 1� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 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 ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well 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 1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. Cityrrown 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 r ElB® Pumping Information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ❑ ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 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 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 m'n. Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ❑ No Does residence have a water treatment unit? ❑ Yes E No If yes, discharges to: is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes E. No information in this report.) Laundry system inspected? ❑ Yes E No Seasonaluse? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 2 + years seasonal t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts !n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding-tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: unknown Was system pumped as part of the inspection? ❑ Yes Z. 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 �n Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every 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: 1989 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 3' Depth below grade: 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.): no signs of leaks cottage is on slab t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owners Name information is required for every Cotuit Ma 02601 9/16/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 2'4" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Heavy Duty 1500 gal with risers with steel frame and covers just below grade If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'6"x5'6"x48" Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness no scum 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? tape and sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): tees in place liquid level at bottom of outlet pipe no scum light sludge. no visable cracks or leaks t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 9 P Y rY 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 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 ❑ other(explain): Dimensions: Scum thickness Distance from top.of scum to.top of outlet tee or baffle. Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural.integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons,per day l5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Heavy Duty H2O Dbox no decay or visable leaks t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. CityTTown 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.): pump system has relay box ran a automatic cycle by lifting on/off floats and tested alarm. Also ran a demand cycle using panal. pump works well has weeping hole. Audio viz. high water alarm tested and works 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: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 C Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 4'x6' precast pit with stone around it. steel cover close to grade. pit is dry and has clean sidewalls . system in good condition 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.): l5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 I c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 19 cave` � _ So, - --� l 3 - y o'3 r' MLf^ I C)I , 611 !� 0 IF tr y 0 V J o R u t5inspAoc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 • Commonwealth of Massachusetts • �� Title 5 Official Inspection Form 1' a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is Cotuit Ma 02601 9/16/2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 11' area of leach pit 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: bottom of leach pit is 66" below grade. shot high water line with transit and is 4'6" below bottom of pit Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 • Commonwealth of Massachusetts 4 ° Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V � 150 Hummock Lane Cottage Property Address Steven Cooper Gould Trust Owner Owner's Name information is required for every Cotuit Ma 02601 9/16/2020 page. Cityrrown State . Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 TOWN OF I3ARNS`TABLE LOCATION d- .� /r e,' a��_______SEWAGE #as -01 �k VILLAGE „ ASSESSOR'S MAP L(?T�_ 1 INSTALLER'S NAME & PHONE NO: 3,/61Q SEPTIC TANK CAPACITY jSG��9i/ /7 "'u` U LEACHING FACILITY:(type) ��1 l'f� (size) ® � NO. OF BEDROOMS�L PRIVATE WELL OR PUBLIC: WATER)Dzi BUILDER OR OWNER__ -d A/33f.'.S � ( _ DATE PERMIT ISSUED: / in%qy DATE COM)"LIANCF_, ISSUED_____ VARIANCE GRANTED: Xes M__�_No ✓'~ _^ �� qol rX �4 6^ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town..... ..._...................OF..........Barnstable..-................................................ 111 iration for Uhyviial Works Tonotrurtion 1hrutit Application is hereby made for a Permit to Construct ( ) or Repair * an Individual Sewage Disposal System at: ...Hummock Lane....Cotuit ---•--... tlssessoz: ._Mag._ --UL..2,7.........................•••••--.....---.. •••-•...._...... ............ c tion-Address or Lot No. James & Anne Go&a .................ummo Lane,_-CotU:L MA .............• -- .. --- .... . -- ...........---.......................... ... Owner Address W 1.4� Installer Address � Ac. d Type of Building Size Lot...L._7...............gir Fit Dwelling—No. of Bedrooms..............1............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ------------------------------------ w Delf 04 Sesign Flow.....____tic Tankq_.___._1.._.._..1-.._.-_..gallons per ja=x per day. Total daily flow........110.............•-•--•-P...._.gallons. w D sposal T enchJi Nouid ca aclty.-50 Widthns Lent Total Leng h Width----...-......Total leaching area.•De th_._...sq ft. Seepage Pit No--------------------- Diameter..........$.------- Depth below inlet........ 4........ Total leaching area._150........sq. ft. z Other Distribution box (X ) Dosing tank ( ) 1-4 Percolation Test Results Performed by....... ichael... ..I....Dono.van........................ Date.......9127/$H................ 1 Test Pit No. ,k' ..,2_...__..minutes per inch Depth of Test Pit.................... Depth to ground water........N/A......... fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-••-------------------------•-•--•-•--•----------••-----...--•---------........-•-•-----.........--......................................................... 0 Description of Soil........ 0 _medium sand_ _ .._._-_____•____•_ -------------------------------- x c, w UNature of Repairs or Alterations—Answer when applicable.._Replace existing system__with Title V-_--. system. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIli U 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b the board of h5 . Signed:._:: ......................•--`----1 -- ---------•-----.....---.._.... ^-� Date Application Approved BY .... -------------------------------- .... ......... Date Date Application Disapproved for the following reasons:.............................................................................................................._ ............................•----•----------------------•--...---•--------------.....:-..................--•---............•--••--•-•--••----•----•-------•-••--•••--•----------••••---------••--------- Date PermitNo...... ------------------- Issued....................................................... Date No....�................_t` y Fizz.................. ... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town ...........OF.........Barnstable... ,pphratiun for Dis#n'�att1 19orks Tonstrurtion rrrmit Application is hereby made for a Permit to Construct ( ) or Repair (k) an Individual Sewage Disposal System at Assessor's Map„53_1ot,27 -Humrrrock Lane--Cotu3 C.............. -----------•- - - ..............-------..........------•- gr o tion-Address ....- HtBi1�'I k Lane....Cotult.,t ...................... -James & Anne Gou Owner Address W --.• Address Installer t, Type of Building Size Lot..1 9 .. C aDwelling—No. of Bedrooms......................:....................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ................................... -------------------------------------------•--_-•-- W Design Flow.............................................1gallons per4XIGM�nday. Total daily flow.._.........._._.........__......_.__.....-.gallonbi W Septic Tank—Liquid capacity_...........gallons Length.......:........ Width...6_......... Diameter................ Depth....__"`ll 1500 1l x Disposal Trench—No..................... Width..... Total Length.----_---.-i----- Total leaching area.-------------------sq. ft. Seepage Pit No.---.•------------ - Diameter.........$........ Depth below inlet......._4......... Total leaching area..150........sq. ft. Z Other Distribution box (X ) Dosing tank ( `" Percolation Test Results Performed by......MieY>la�� J.•...DOnoVot?•--•••......---••••--.___ Date......9�27,88 W Test Pit No. 4..............minutes per inch Depth of Test Pit.................... Depth to ground water........ /A......... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------------------------•----•--•---........------•-----.....-•-•-•••••----.....--••--.............-•••••-•--•-.......•-•-••................•-•---...... 0 Description of Soil.......O — 0.5. op and subsoil: 0.5 - 8.0 medium sand x t _ . --------••••••-•................••.....--•-••._................••-•--........ V ........................•------•........•--•-------•••--•••--•---•-•-•---•--•••----••----•-...........•----•-----•------......--•-••••---•--•-•-••--•-•••....-----•••....--••••......•--.........----•••- W U Nature of Repairs or Alterations—Answer when applicable--Re la t'-?131r rlg 3yStEtt1 tdth Title V system. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code--The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued y the board of h Signed. -- --.--.•-...--...........................•...-P•------ ------- 'Date ^------ ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:•-------------•----•--•--..........---.............----------------•--------•---•-•------•--...........•-•--- ......-••••-••.......•••••••••-•--•••-•..........•••---•-•-•-•••••..............••••-•--........•••--•••.---••••••••••-•••.....•----•----••••---•.....-•---•-•-•--•••...------•.............•--•-....._ Date PermitNo..................................................._.._ Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (Inrtif ratr-of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by........................................................................................................................................................................................ ..._..._ Installer at....................................................••-------•...•••-•-•••--•-•-•--•---------•----••••---•--•....-•---........_...-••-.....•-•••--••-•-••-•--.........•---• ---••-•-•---•----•-- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated....------..-.,.................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................/....... �. ..�-, ............,......... Inspector ............................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH s��E �t t ..........................................OF.........................................................................�........:.C e� 04 ... Disposal orks o �iun rrmtt sr�, �qZ Permission Is hereby granted..:_: f. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo...............•--............-•••-••••---••••••....•-••••-•-•-•--•--••-•-•-•-••......-••-•-......••• ------------------•......----•------...........-•-•--•......._........................ Street as shown on/thn application for Disposal Works Construe mit No.........�_.... D -4a...........................-•....••••. (35 DATE.._.. .. .. oard of Heal FORM 1255 A. M. SULKIN, INC.. BOSTON Oc5: - o a 1 :'OWN OF BARNSTABLE LOCATION C HCi srJ, �'�T A� SEWAGE #008 VILLAGE �Q7 d ASSESSOR'S MAP.& LOT INSTALLER'S NAME &.PHONE NO. . ii l/d SEPTIC TANK CAPACITY �-/� (size) � / LEACHING FACI;,ITY:{type) �Q NO: OF BEDROOMS_j_PRIVATE WELL OR PUBLIC WATERZ& C . BUILDER.OR OWNER DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No i e L, r i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............................OF............BARN.STABLE.............................................. f Appliration for Disposal Works Tonstrurtion Vvrrmit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: Hummock Lane Assessors Map 53 Lot-2 ....:..........._----.......---.........---•---...:-----.........-----•----.............._....... ..•--•-••----•...----••-•---- ...... -- .......-----------.........-- Location Address or Lot No. Mr. & Mrs . James Gould P.O._ Box 161 . Cotuit. MA .02635_- ---•---•..............---•---••-•-............••---•-•-------------•---••••••-••---•-•--..-.....• ...... ..------•••- Owner Address W Installer Address Type of Building Size Lot......8 5, 813.±-Sq. feet U Dwelling—No. of Bedrooms..................3---:....................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of BuildingNo. of persons............................ Showers Other fixtures . --------------------------------•-----------•—-- -------------------------:-------------- ( > — Cafeteria.(.....). Design Flow............110______________•...•----gallons per person per day. Total daily flow................33.0............--......gallons. WSeptic Tank—Liquid capacity.l S Ngallons Leyth..........11. Width........ ...... Diameter................ Depth...6.----1�� x Disposal Trench—No. ........I.......... Width......... 1.0..... Total Length.........26...... Total leaching area.........332.--.sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (X ) Dosing tank ( ) ~" Percolation Test Results Performed by....U ................................. Date........12/l"81..._......... Test Pit No. l...!2........minutes per inch Depth of Test Pit..10.t.5....... Depth to ground water...... YA.......... Test Pit No. 2................minutes per inch Depth of Test Pit.-10 ...... Depth to ground water.....N/A......... a -------- --•......... ...........•----------. .....-....••••---...---•-••....---•---•--........---•••----••-•--•-•--••----..._....... 0 Description of Soil......................Medium - Coarse _Sand x ---------------------------------------•---------•---------------•-•-•--.........----•------- W ----•----------------------------------------------------------------------------------••---........-----------------------------------------------•--------=----------------------------------•--•••... UNature of Repairs or Alterations—Answer when applicable----------------,--..----_-...............---...................................-..+.......... ----------------------------•--••---••-•---•------------•--•--------......----------•••••-••-•----••----•---•--------------•-----------------•...--•---......-----------------------------.....•---•---- Agreement: + The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of iITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the b9PL of health. �S Signed .... - ^---------• '�1.. ..-------•---- f ------ ---�--- ----- -_--•- Date Application Approved By............V\ - --- ................................. ......... ••-•-. Date Application Disapproved for the following reasons:.............................................................................................................. .........................•-•-•----•-•--•------------------•--••-•....-...••--•-----••-----•••-----------•---....-••---.........-•--••-•--------•----------•---•----•-------------•-----•---•----•------- Date PermitNo....... -..s �a"�---•----------------------. Issued....................................................... Date ��.�.. ---------------------------------------- --- I � a THE COMMONWEALTH OF MASSACHUSETTS '-' BOARD OF HEALTH rr BARNSTABLE A.� Appltration for Disposal Works Tonutrur#ton Frrutt# Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: Hummock Lane Assessors Map 53 Lot 27 ....:...........__.............................................................................. ..................... Mr. & Mrs. amesddaBuld P.O. Box 161 °0oluit, MA 02635- ......•-•••--•......_.__.... ............ .............................................. ................ .._..------•......�... ._- ---................-----........._.. Owner Address . W ............ Installer .............Address Type of Building Size Lot...._.85 813 Sq feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—T e of Building No. of persons............................ Showers —Type g -------------------••------- P ( ) — Cafeteria ( ) dOther,fil ures ------------------•-------------------------••-----•-..------•-•-----------------------...........----•--•••....... W Design Flow.................................... gallons per person per day. Total daily flow.............._330........_ lons�� WSeptic Tank—Liquid capacity.... gallons Length..........11 Width......... Diameter................ De th . �1 x Disposal Trench—No. ........ _......... Width.........ld.-... Total Length........2:6...... Total leaching area---------.-32...sq. ft. 3 Seepage Pit No_____________________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (X ) Dosin tank '"' Percolation Test Results Performed by...�!....1.. ......................................................I1t1 Date.......12/8�$?.........-... a <2 . NSA Test Pit No. 1................minutes per inch Depth of Test Pit................._.. Depth to ground water......... f%4 Test Pit No. 2................minutes per inch Depth of Test Pit..10 .. _ Depth to ground water........11 ........ a .............................-....... D Description of Soil •-----•-•--Medium - Coarse Sand ... ......................................................... x .............••••••••-••-••.............................................................................................................. V .......... .....----------------------- ------------ ......---------- --------------------- ------------------ •------- ---•---•----------- --------------------------------- W VNature of Repairs or Alterations—Answer when applicable.................................................:............................................. •----•------------•--•-•-•--•--------------------------------------------------•--...-----------•••-••--•...._....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I T IS 5 of the State Sanitary Code—The undersigned further agrees Inot to place the system in operation until a Certificate of Compliance has been issued by the boar of health. Signed............ 11.... I..... .. Date Application Approved By............ .. ------------•---•-------------•- ........ y-_ .IS.._.... Date Application Disapproved for the following reasons---------------••-------•----------•---....-•-----•--......-•--•-•------------•-•----............--•••-------- .................................. -------•--------------------••.....---•--....-•-•-•------------.......----•--••--.....--------------•---......------•-••---------•---...-•---------••----•-••---...------. Y_tit....�nL. Date Permit No.._.... - ....... -_._.. Issued.. - .................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . -'G I t......OF......... Trr#iftrair of Tompliaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed JD!) or Repaired ( ) by-----------------------------•-•----•----.--------.---•-------------•-•-----------------------•---•--------------- .._.._::........... ........ .......... ................. Installer has been installed in accordance with the provisions of TIT F 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------- ------- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................... -_2._`�L.:. .............. IInspector................ •-4 -------...........•---••-----•-•----.......---.••... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No... ..:. !kt..............OF.......... a:�*- ...................................... F ..�..,,5............ Disposal Yorks Tons#.rudion prrmtt �- Permission is hereby granted................ ` to Construct or Repair ( ) an Individual Sewage Disposal Syst atNo.......C a - � ..:r To ...... a,,........... ........................................................... Street as shown on the application for Disposal Works Construction Permit or�:)72_... Dated........................ ----- -- .•---•..................•--....•--_...._ . ... .... . ..... DATE.. Board of Health ........................c�.. ..................... FORM 1255 A. M. SULKIN, INC., BOSTON APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS _I LOCATION NO. G 7 9 VILLAGE''— �'vr�r,�' _ DATE APPLICANT FEE 176 _ ADDRESS TELEPHONE NO. (Non-refundable) ENGINEER , TELEPHONE NO. DATE SCHEDULED 1 ,1_0-K:2 (Applicant' s signature) • . • • • .ES OSOR O O'S O O ObiAP O . O&• O OLOT O O NO O :O O O • • • O O O • O O O • . • • • • O ... . O ... . . O O O ASS .S 3�Z`7 SOIL LOG SUB-DIVISION NAME DAT E 6 5 7 TIME /6 'O U EXPANSION AREA: YES NO v _�- .� . Lac,uc, J ENGINEER l;, TOWN WATER ' PRIVATE WELL CAS, Lj �Lj Lj BOARD OF HEALTH EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) NOTES: /S o.ao 7z N N TN . z 20f � y e , iX PERCOLATION RATE: L Z AWAII!'IC A TEST HOLE NO: / ELEVATION: 34,7,t- TEST HOLE NO: G ELEVATION: t 1 TU PSog s v/L 1 F- 2 :537 2 Zs. 3y, � 3 3 4 ,v/EA ���" 4 5N� 5 �b C_ _. . .__ _.... 6 6 �� 7 8 8 9, 9 10 10 2 5.Z 12 Nb W A 7 Ez wit lOJ(/IERE� kj 12 13 13 N1v_,)optC: C� 14 .. 14 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD BLEACHING PITS `'' LEACHING TRENCHES ✓ UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P, E. AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT TELEPHONE(617)227-31 17 MICHAEL J. O'NEILL ATTORNEY AT LAW SIMONS&MARCUS 15 COURT SQUARE BOSTON.MA 02108 I SOIL TEST PIT DATA: MANHOLE ooVEl« TO P'lNssI III t NO. OF OUTLETS: 3 �ISKxtB ' MANHOLE COVER TO GRAD T POSED GRADE DATE °EscalaTloM NOTES :DM �--`T�-7�-_____ tNDICATLti - -- -____ 10 �-12"MIN. 1. DISTRIBUTION BOX TO WITHSTAND H-10 om INDICATES OBSERVED P'EBC FrCROUNDRATER COVER - ---- LOADING UNLESS UNDER PAVEMENT. DRIVES - `ay r OF / rw..n_-, �- ., _ .- OR TRAVELED WAYS WHEREBY M-20 LOADING • I PEAS TUNE - - - - - -- - - -I { - ' SHALL APPLY. ! 1' I +' 4 INLET �( , ( 15 ! t '-TEE I 2 1. PROVIDE INLET TEE AS SHOWN WHERE e ; ( --� z l TP Nta. �'. _ TP No. _ , �cwoTcp SLOPE OF INLET PIPE EXCEEDS 0.08 FT/FT I IN�E ' E--- J t -� r F -- OR IN A PUMPED SYSTEM. 9.0 GRD EL I I50v ,l; 1 .d '� MtLCAST, STEEL I•- ,_j fs ' e ,I r_ 6 UTLEL ^ 5'-1'' PLAN VIEW J. FIRST TWO FEET OF PIPE OUT E THE G1f'.EL._-N/A GW..E'L_�..,-._ REINFORCED DISTRIBUTION Bar To BE LAID LEVEL 3/4' -1 Il2 • I �4 / OS TERVILLE 0 __ -� r , SEPTIC TANK 5 4 9 , TE ET 4'-O"MIN. OL 6- WASNE U I TOP 6 SUBSOIL , H - ?r; TEE 4. RECOMMENDED MANUFACTURER - GRAND $5 l LIOUID DEPTH a ROTONDO OR APPROVED EQUAL I S T JNE " E co 1 ►BLAND ' 4 4 6'MN.3/4"T'01-I/2"STOLE 3/4" f-REMOVABLE COVER 2 2 i L �_ e ` ^ ..'. � . 5"DIA.UUTt1_ET(S) BOTTOM ON LEVEL STABLE BASE -�- � 1' �v LOCUS � '' - 6" �('� J' PROVIDE „ . �r 0 o u 0 4c _ .o T / WATER T IGHT OC G o I �pI 24 aA. MAI►i!'IOtE COVER ---- - 3 FINE SAND 3 � - • � � f w .IgNTs dTYEI � 1 I� p �3� S{ HANDY 4 4"INLET `� _.� -- -- __--- L , POINT References PLAN VIEW CROSS SECTION VIEW I, 2„ I 4 OUTLET I y r_ 1. �_ 6 I-� 5 5 NOTES. 7!2 2' S ,,' .�---- -.-----.__--- g' -3 COTUIT TOPOGRAPHICAL PLAN OF LANC. ...1�-.�_�a •. 1. SEPTIC TANK TO WITHSTAND H-10 LOADING J. INLET AND OUTLET TEES TO BE CAST IRON L_ - INLET BAY � Kl�GSBIJRY SURVEYING CO. INC 6 6 UNLESS UNDER PAVEMENT. DRIVES OR TRAVELED SCHEDULE 40 PVC OR CAST-IN-PLACE CONCRETE i- BOTTOM ON < 9/8/1987 WAYS, WHERE BY H-20 LOADING SHALL APPLY. TEES TO BE CENTERED UNDER MANHOLE COVER 2' '•. LEVEL, 7 7 BABE STABLE " 1a Ab. let 2. ALL PIPE CONNECTIONS AND CONCRETE CON- 4. RECOMMENDED MANUFACTURER ROTONDO OR 6"MINI 3�4"TO _ BOTTOM HOLE I p 8 STRUCTION TO BE WATERTIGHT. APPROVED EQUAL H- 20 CROSS SECTION VIEW mitt STONE H 20 ASSESSORS MAP 53 LU1' 27 S NO WATER a SEPTIC TANK DETAIL NO. OF GALLONS: 1500 _ DISTRIBUTION BOX L_ cACHING PIT DE ._. DETAIL --_ TAI ! LOCUS MAP ENCOUNTERED N07 TO SCALE NOT TO SCA, I NOT TO SCALE 10 � 10 _ SCALE. 1'=2()83 DESIGN ANALYSIS 12. __._.__.._.. P 70$9 DATE: DAT-�.. 24�� OPENING ABOVE FOR M.M. SYSTEM PROFILE nEs/GN FLOW: I I o GPD/BEDROOM 9/27/$$ FRAME AND COVER ---- - 7 - - --�b, i� I BDRM X 110 GPD/BDRM = I I 0 GPD NTS TEST ST:M.J. DONOVAN TEST ST. _- ROTUNDO = •E� PUMP CHAMBER 1 ALL MANHOLES AND COVERS BROUGHT Pr'0�(� T�tie' WITNESSED Or.- WITNESSED BY.' I ' TO FINISH GRADE (TYP) MIN. 2% GRADE OVER G. DUNNING INLET-4•'PVC PIPE - 4 5 EXIST APPROXIMATE LOCATION OF HEAVY � BLDG. FINISH GRADE FINISH GRADE LEACHING FACILITY SEPTIC TANK REQUIREMENTS: t t 0 PEJtC. ,GATE: P£XC- RATE: BLACK PIPE TO SUPPORT FLOATS - -- - - - ----- - --- `' - t .4 6' FIRST TWO FEET TO -I I O GPD X 150 % = 165 GAL. PUMP POWER CABLE 8 FLOAT 2 KIN,/'1NCN �BftNIINCH CONTROL CABLES TO BE L_ - _ - - _ , -�3 _-_ BE LAID LEVEL 2' LAYER OF PEASTONE USE 1500 GAL. TANK SUITABLE FOR DIRECT BURIAL OR L. PLACED IN CONDUIT IN ACCORDANCE 6 -J ; 724 6.99 15 77 r 15.60 15.50 3/4"- 1 1/2" WASHED STONE WITH LOCAL BUILDING S WIMNG CODES. PLAN VIE W TP No. TP No. 150U GAL. 6.90 DISTRIBUTION 4� - GRD_EL_ GRD.EL r-PROPO;ED F{NISH GRADE GW-EL. GW-EL. _ -� F-2 MIN.COVER 4xINViNO SEPTIC TANK BOX / l SEQIRE CHAIN TO WALL OR _. L- 0 0 -"--1 MANHOLE FRAME 1 I =76 BOTTOM EL.= 11.50 LEACHING FACILITY REQUIREMENTS: 4"INLET-)NV.EL-t�` -+ TO DIST BOX 77T1- - 1 27 PUMP TO BE SECURED AT TOP PVC DISCHARGE PIPE 6' DIA., 4' DEEP PIT W/I� STONE O B BOTTOM S PUMP CHAMBER PUMP LEACHING PIT L.G T INV= J` 2 MERCURY FLOAT (LEVEL CONTROL) -HOT DIP GALV 410MACHINE CHAIN CHAMBER SIDE AREA =25.1 (4')= 100.4 SF(2.5 GPD/SF)= 251 GPD I� � ',( - 2 SCH.80 PVC THREADED PIPE .41 TO BE INSTALLED ON A 3 __J BOTTOM AREA= 50.2 SF i I.0 GPD/SF)= 50.2 d G N 3 ALARM LEVEL. a � 4 LAG PtJIgP ON £L 5 4! 2 MYERS PUMPS LEVEL, STABLE BASE TOTAL 301.2 GPD y j - -�- � ; ; - I A 9 PUMP ON EL T i SRM 4M 4AC3 HP '� I 5 PUMP OFF EL 430 40 GPM AT 13 BOTTOM EL 3 4' 6•MIN vuSHEO STONE . ,`-ft. 'a T 7 SECTION LEACHING FACILITY PROVIDED: PUMP CHAMBER DETAIL NOT TO SCALE I-6' DIA., 4' DEEP PIT W/I' STONE � z CAPACITY PROVIDED 301 GPD CAPACITY REQUIRED 110 GPD to - 10 5 11 1t 7 ._._-..�_._..-....._-. ._ .. -.._ .. 12 tG NOTES DATE' DATE-' LITTLE 1 UNLESS OTHERWISE NOTED, ALL CONSTRUC- PREPARED FOR: -"rEs T BT: rEsr BT: RIVER TION METHODS AND MATERIALS SHALL CON- FORM TO TITLE V OF THE STATE ENY'lRON- MENTAL CODE AND ANY APPLICABLE LOCAL WITNESSED BY WITNESSED BY. 9SAy9` \ Is 12 a s 4 \ ' RULES AND REGULATIONS. JA M E S 8c A N N E G OU L a - \� 20 16 14 to , 2.0 \ GROUT TO BE USED AT ALL POI h'TS WHERE PI 1t.tT8 PERC. RATE. 2 22 �o \ \ PIPES ENTER OR LEAVE ALL CONCRETE `�p% I I / STRUCTURES IN ORDER TO PROVIDE A WATER- A/JNJINCN tY►N,/tNCH 2\ 2� \ \�Fiy�} \ �\ \ ` , d\ TIGHT SEAL. 2\ 30 3 ALL SHIPLAP JOINTS IN SEPTIC TANK SHALL \ \ BE SEALED WITH NEOPRENE GASKETS OR I\ ate\ i 38 36 34� \ \ T PQS \EI�Q.,4\�DEEP 13O\ �- 2 ASPHALT CEMENT TO PROVIDE A WATERTIGHT SEAL INVERT ELEVATIONS �`S j� \\ \ `,LEDGE of o \ AREA ' P OF BANK MARSH� � \ \ \ \ \ 4 PRECAST CONCRETE SEPTIC TANK. DISTR/BU- 4' INVERT AT BUILDING(EXIST) 7.6 40 LOT J _ �� \ TION BOX. AND LEACHING FACILITY TO WITH- 4' STAND H-10 4-OADING UNLESS UNDER PAVE- \ 1 .9 _ A \ \ \ 2p I \ ( MENT• DRIVES OR TRAVELLED WAYS WHEREIN A.M. WI�S011 HANDY POINT H-20 LOADING SHALL APPLY. I' INVERT AT SEPTIC TANK (eN} 724 HUMMOCK � � � � � O AVC � � \` \ \ R \ Associates 4'/NVERT AT SEPTIC TANK (out) 6.99 _ \ ,` \ \ \ , 1 \ \ \ TP \ S ALL PIPES 1N THE SYSTEM SHALL BE SCHED- Inc. PUMP CHAMBER (SEE DETAIL) EDGE \ \ \ I 2.0 P \ ` ULE IO OR EQUAL INVERT AT DIST. BOX (in) I5.?(-,_ PAVEMENT \\ \ \ \ \ \ W 'V B R T 1 b WASHED CRUSHED STONE SHALL E FREE OF 4' INVERT AT DIST. BOX (out) 15.60 I >•' I PROPOSED \ ���+ \ �UMP CHAMBER f� t ALL DIRT. DUST AND FINES. 911 Main Street J I I \ \ + �� 7 AT ALL POINTS OF INTERSECTION OF WATER OsterAle/MA 02655 INVERTS AT LEACHING FACILITY: i I \ APF?OX. NLOCATION �/ LINES AND SEWER LINES, BOTH PIPES SHALL t LANE �i/ 1\ \ PROT,OSE(�N 1 00 GAI EXISTING SEPTIC SYSTEM BE CONSTRUCTED OF CLASS 150 PRESSURE 4' INVERT AT BEGINNING OF / \ \ Y TI1 W (TO 13"' D) / PIPE AND ARE TO BE PRESSURE TESTED TO - 5.50 _ ASSURE WATERTIGHTNESS. Drawing TIt1e LEACHING FACILITY I ` _ � ,\ IST " i�l'V. AT BLDG. =7.6± � COTUIT BAY 4' INVERT AT END OF �\ 8 SEPTIC TANK . DISTRIBUTION BOX, ETC LEACHING FACILITY N/A __ 40 � _ () � SHALL BE MANUFACTURED BY ROTUNDO OR ELEVATION AT BOTTOM OF k / AN EQUIVALEVT MANUFACTURER. R LEACHING FACILITY 11.50 38 tO�I 9 EXCAVATE ALL UNSUITABLE MATERIAL INI � `'"'�� � � LEACHING AREA AND BACKFILL WITH CLEAN GRAVEL OR COARSE SAND. OBSERVED ED GROUND WATER NOT ( / �, �� ELEVATION ENCOUNTERED SEWAGE 36 34 TO OPERATE OVER TH JO HEAVY EQUIPMENT SHALL NOT BE AALLOWED, LIMITS OF THE NOTES SEWAGE DISPOSAL SYSTEMS DURING THE 32 COURSE OF CONSTRUCTION OF THE SYSTEMS. DISPOSAL DESIGN � / , 30 / / / y, LPN / 1) TOPOGRAPHIC AND PROPERTY LINES TAKEN FROM11 11 NO FIELD MODIFICATIONS TO THE SEWAGE 28 / TOPOGRAPHICAL PLAN OF LAND , KINGSBURY DISPOSAL SYSTEM SHALL BE MADE WITHOUT' �) P G R A [�E 26� / SURVEYING CO. INC., DATED 9/8/1987. PRIOR WRITTEN APPROVAL OF THE ENGINEER 96 24 2)PROPERTY LOCATED IN A F. E.M.A. FLOOD ZONE AND THE LOCAL BOARD OF HEALTH. 4,�µ 22 2018f V 17 , EL. 14'. 12 THIS SYSTEM SHALL BE INSPECTED AS RE- mKmmt. 16114 3) SEPTIC TANK AND PUMP CHAMBER TO QUIRED BY SECTION 2.10 OF,.TITLE V, Ix V , 1210 6 / / BE PROVIDED WITH SEALED COVERS TO 339 ` 4 / / ASSURE WATERTIGHTNESS AGAINST FLOODWATERS 13 A CERTIFICATE OF COMPLIANCE AS RE- QUIRED BY SECTION 2.8 OF TITLE V MUST BErD OBTAINED BY THE CONTRACTOR UPON COM- PLETION OF THE, ABOVE WORK. IF AN 'AS BUILT' PLAN IS REQUIRED DUE TO CONTRAC- Scale. I"s AS NOTED TOR DEVIATING FROM THESE PLANS, WORK FOR SUCH 'AS BUILT" PLANS SHALL BE COMPENSATED BY THE CONTRACTOR, 0 FEET 14 THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL UNIT. Date 11/7/88 Dwg No: 15 ALL ELEVATIONS ARE BASED ON N G V D Design M J D DATUM. Check: M R F Drawn: M J D Job No : 2.0300.0 Sheet I of I a Y , x, m. ik Revisions= f All DESCRIPTION I t f tt yi s MO�J © y 6/30/8t <, ' m M 0Ab DRYWtLL5, HAYGALESl 0- SEPTIC,;8YSTEM, LO/24/ ' •`A"�fNG, •CHANGED.;, � a GT'# t References: 4 \ t J ¢' I ' i TOPOGRAPHICAL :"PLANE 0r-',:: D 12 10 _ 20 18 /6 2.0 KWOSBURY SUf VEYING CD " NC., q _ „ . , \ ...; 24 cS' 14 \ 6 439 \�F SEPT. 8. 26. 22 28 32 0\ 30 34 x, CMP � IA.,6 D t YW E 3 I �31,T5 � ?ON 38 tNV� o ' 2.0 ` . TOP WALL 3 --- �, s P F BA NK Project Title: T� (32.5) 6 t • 2 -- J ) G VEL j ,. � _ l r ,J• A �. i. O TH 2 rL Q c� 4,• , � , PT Q C ' C R H U YEAR M � N D Y POINT oFLOOD GOUL µ ENV F SEPTIC S T , FOR m DETAILS SE NA LES 2.0 EDGE PAVEMENT -- EQ ., ., x„ � ,\ STAKED \ P e §n t l F2 HE 20 F o 4 E'T a =�- s . . '. -.. I .<} ,:,k ..s. .. ':• 1, 't.' f ,;,: .. <. 0 , r t O ! iV , .t Q Vti L FOR ROOF �U RAV Y , f, G E RIVE ,€€ ry J� . 2 STO 6 WA TER � N C i t n J , {{ a .., ." -.., ..r NE , PR0P � O D i 6 PVC D 1 _ . 2 w � s 0 _. T . �.... _ r. J � V H _ 00 t ti r l ,._. t 0, L CHI GEP � ,7 A. � ON 4. 22 M ( -1 Q _ O C� 2 _ , 40 I O C. BOX _ - _ .' .� ,. „" z" , i ELEC. ' p 38 p POSED,, GVAL `v / PR X/ARIESa l T P wjL�( WIL SON,= ASSOC ," �lr A I N f P '',�" 02�55 , 36 ,. ' PREPARED FOR 34 32 �- JAMES a NNE. . 00)UL"D` , 30 26 4 �; INSET A LOCUS MAP L ZONING DISTRICT RF 28 22, 20 LEG ND18 SETBACKS FRONT 30 EXISTING CONTOUR l6 / SIDE 1"ta Drawing Title REAR 15 p PROPOSED ELEVATION ( 12.0�) 14t PROPOSED CONTOUR L.J_ 12 6 !, FEMA `FLOOD' ZONE- V 17 EL.= 14 „ OYSTER 4 2 HARBORS / S � T� LAN 0 O m O CG �. OSTERVILLE N FUTILITIESikv, NOTE LOCATIO S 0 UNDERGROUND GRAND ARE APPROXIMATE .AND SHOULD 3E ' � Q ISLAND VERIFIED IN THE FIELD BEFORE �.ONSTRUCTION. 1� raArLoR j z F, No 2374 7 d CONSTRUCTION TO BE DONE IN I�CCORDANCE ; WITH ORDER OF CONDITIONS FROM ARNSTABLE CONSERVATION COMMISSION DATr-D OCTOBER 4 1988. C S SCALE - 1, 2000 I , ' Sca► ,,,1 -20`: � j i;'.i < ;Ate: No. N O V. r Check' Drawn R E` _r �.A. r Job No: �. a �' � �.,..�" . .; et�, �,, �'''`ry I , SOIL TEST PIT DATA: MANHOLE oo To FINISH GRADE 15,�211 No. of OUTLETS: 3 - Revisions _ I I NOTES. + - DATE DC:iCA1PT10tV %VF 'i. , �f l� • �Y 1�..1. -. �I [ �2 '1 . ��SRIBUTION BOX TO WITHSTAND N-!0 PSAC COVER .---- LOADING UNLESS UNDER PAVEMENT. DRIVES N.T.S. FINISH GRADE 2% MIN SLOPE _- INDICATES OBSER ,r GROUNDWATER • , •• _ - • / I OR TRAVELED WwiYS WHEREBY H-20 LOADING -- ------- . . .._ _. L v 4 ?/88 ANGt t7.77 1 - j 4INLET K � � / ,. fr 12 „t- EE 15 2 2, PROVIDE INLET TEE AS SHOWN WHERE _ / '�- /211 12" M I N. 4" 2 LAYER OF t/1/8 8 EL Evr g w, I4�J19+. •. °iY .id, '� tt :.i . �.. �, �f � ( .... ..... ._...% � I � ]7,n SLOPE OF INLETPIPE EX E I FT TP No• p 1V0. 1 , , d .� d L!s[[_iwrEtl� CE DS 0.08 FT/ 3, ' i� iL V.l AIGL�, t ��ULLJ H-20 _ 31, r OR IN A PUMr E.a SYSTEM. WASHED STONE ,, a 3 -- • , 99A {� • I am... „ , i I 4J ! IC . I .{.. , 11 ,..e .., {I t3l _ Up 11 �w�, � w, ,� I IC�ITi ITHL l- _ �. -� ( J. WiT� ���� � p�PE aUr vE 7N1i ,- -- _)� - I, � � _ �� �• , 6 �- 1 11 DISTRIB I END-'S€CTION� 3/4- REINFORC[D- 5-I PLAN VIEW UT ON BOX TO BE LAID LEVEL GW.EL. N/!� GW.EL. N/A ..� _ SEPTIC TANK - 51_01, 1 11 s NLET d M OUTLET n 1 11 1 1 112 1 11 0 p 4-9 TEE 4-0 MIN. TEE 6-I 4. RECOMMENDEDi MANUFACTURER - ( , I I 3-31/2 QO f" • LIQUID DEPTH -^ ROTONDO OR APr�ROVED EQUAL. (TYP) q STONED I I 1 TOP 81 1 TOP 8� I " 1 13/" REMOVABLE COVER I ( •J o�� I � • o COTUIT SUBSOIL SUBSOIL �- - - - - - - - -- - - - - - - - -- :' 6 MIN.3/4 TO 1-1/?"STONE 4 " I , , O r BAY 5 - 3 4 4.: ..: :,• d) DUI,OUT - � . .� •� LET S -,- 3 : 2 -. i fi f . P. 34.1 �' BOTTOM ON LEVE STAGE BASE �L611 ;:. PROVIDE 3 33.7 35 o o o • .o .. qoCENTER . 24"DIA.MANHOLE COVER 8 WATERTIGHT I SECTION 1 ' CROSS SECTION JOINTS (TYF') q�l 4 HANDY 4 4"INLET Odd OUTLET 3� (TYP) ( N.T.S. PT ).OSTERVILLE 4 PLAN VIEW CROSS SECTION VIEW 1 71/ " 1 ,d MEDIUM MEDIUM- 1 GRAND References. 5 5 NOTES: 2 2 - 5 �2 l "Dw1- dISLANDSEE SHEETCOARSE COARSE 1. SEPTIC TANK TO WITHSTAND H-10 LOADING J. INLET AND OUTLET TEES TO BE CAST IRON, ;:: ... . ,::.: '' INLET , - - - - 7 LOCUS \ 6 SAND 6 SAND UNLESS UNDER PAVEMENT, DRIVES OR TRAVELED SCHEDULE 40 PYC OR CAST-IN-PLACE CONCRETE. !• vyh• '--�T 4 n t 0- WAYS,WHERE BY H•20 LOADING SHALL APPLY. TEES TO BE CENTERED UNDER MANHOLE COVER. • LEVEL.STABLE &! t ' 7 2. ALL PIPE CONNECTIONS AND CONCRETE CON- I. RECOMMENDED MANUFACTURER - ROTONDO OR " " 4 -! \ STRUCTION TO BE WATERTIGHT APPROVED EQUAL. CROSS SECTION VIEW tfi MIh1. 3/4 TO 8 , H- 20 • 1.1/z"5TONE IO --'� - 9 9 SEPTIC TANK DETAIL` No. OF GALLONS: 1500 DISTRIBUTION BOAC DETAIL LEACHING' GALLEY DETAIL LOCUS MAP , • NOT TO SCALE NOT TO SCALE NOT T.rJ C - '►SALE SCALE: 1"-2Q83 } r , ♦ } �. �, wit �$ ' -:x .xaop, n. k,}...rk 9... ,+rw, HY1+-:'wk^k.r'.a<•uk..,.N ,a,.,.*k4,#. m <<" ,A.aarw,. � a ., .,..,.. . k, - . , .._.. .....xl .<u:uh .1„ p x ,.3..•:n .,41x + :..., .r r e-, k+4 a pmY,_ . # YA. :+�±.'A+'+-a.P.fR. r. .,.#n�A�dk a. a. ukh +k_. Lan. ... ;i,.n.,,,,• ,a,- ...:, .+s 5 BOTTOM MOLE 25.7 4 25.2 11. NO WATER 11 No WATER y DESIGN ANALYSIS ENCOUNTERED ENCOUNTERED 12, 12 P 6793 • DESIGN FLOW: W/GARBAGE GRINDER ' DATE:. : DATE: � 12/8/87 12/8/87 _ 3 BDRM X 110 GPD/BDRM = 330 GPD Tfff Ifs ` Project Title: WITNESSED 8r. WITNESSED Dr. G. DUNNING G.DUNNING SEPTIC TANK REQUIREMENTS: i PERC.JUTE: PERC. RATE: WITH GARBAGE DISPOSAL UNIT IN,/INCH {2 MIXIINCH 330 GPD X 200 % = 660 USE 1500 GAL. SYSTEM PROFILE ' TP No. 3 TP No. NOT TO, SCALE 9.0 - OW-EL. N GW.EL. GOULD RESIDENCE MANHOLE ,AAJD COVER 0 --- 0 LEACHING FACILITY REQUIREMENTS. TOP 81 SUBSOIL 5 BROUGHT TO FINISHED GRADE I 8 _ -_ ° iG GPD X 150 `'/°= 495 GPD . _ _ _ - _ FINISH GRADE TO HAVE MIN. 2 /o _ w _ OP rOUNDATION - 34,150 FINISH GRADE 00 SLOPE OVER LEACHING FACILITY 4' X 4' G 'ALLEY WITH 3 STONE - s'cE AND 2 { , ; a 1 i fi kkII f - - - _ f 3 : S11J AEA - 6.6 2.5 - - 6 GPD/ LF I/4/FT-+• ;. 1/4"/FT --�- FIRST TWO FEET ... •. .... TO BE LAID LEVEL BOTTOM AREA= I0.0(I.0)= 10.0 z 4 4 - A..,. - " • 29.30 2 .05 d , •0 16.6 SF/ LF 26.5 GPD/LF t 9 28:97 �, �, H- 20 28.80 5 5 27.50_ 495 GPD/ 26.5 GPD/LF = 187 ` 1500 GAL v 329 •� 6 6 BASM. Fl_.25. r - DISTRIBUTION , c • 29.50 REINFORCED CONC. BOX tlD o• ao SEPTIC TANK TO BE INSTALLED ON A 3/4 -1112 LEACHING GALLEY LEACHING FACILITY PROVIDED: BOTTOM EL,=24 21 � � 5-4 X 4 GALLEYS WITH 3 STONE " , 8 BOTTOM HOLE 1.0 8 - :. • ,, . ,. . LEVEL, STABLE BASE WASHED STONE g N 0 WATER PROVIDED CAPACITY 332 SF 530 GPD ENCOUNTERED 9 REQUIRED CAPACITY 495 GPD �• z,: 10 10 11 11 i _ N6-rt§ P7089 DdTB: DATE: - 9/27/88 1 UNLESS OTHERWISE NOTED, ALL CONSTRUC- - TION METHODS AND MATERIALS SHALL rEsr Dr: .., a rEsr sr: , M.J,;DONOV N FORM TO TITLE V OF THE STATE ENVIRON- MENTAL CODE AND ANY APPLICABLE LOCAL WITNESSED sY: ;t WITNESSED BY• . RULES AND REGULATIONS. G DUN NI NG 1 GROUT TO BE USED AT ALL POINTS WHERE J'E1�C.RATE: ^ PERC. RATE: PIPES ENTER OR LEAVE ALL CONCRETE STRUCTURES IN ORDER TO PROVIDE A WATER- �2 XIN,/INCH` A(IN,/1NCH TIGHT SEAL. 3 ALL SHIPLAP JOINTS IN SEPTIC TANK SHALL BE SEALED WITH NEOPRENE GASKETS OR A. M. WILSON & ASSOC. INC. ASPHALT CEMENT TO PROVIDE A WATERTIGHT J I I MAIN STREET INVERT ELEVATIONS SEA ' t' ; , L 4 PRECAST CONCRETE SEPTIC TANK, DISTRIBU- 0 S�ERV)L L E M 4 INVE ?"A BUILDING TION BOX, AND LEACHING FACILITY TO WITH- I R 29.50 STAND H-10 LOADING UNLESS UNDER PAVE- MENT, DRIVES OR TRAVELLED WAYS WHEREIN H-10 LOADING SHALL APPLY. t°``,, 4"INVFRT AT SEPTIC TANK (out) 29.05 . PREPARED FOR: S 1 ALL PIPES IN THE SYSTEM SHALL BE SCHED- ULE40 INVERT AT DIST. BOX (in) 28.97 40 OR EQUAL. N DOULD , a r µ f � w 4 INVERT A A1ST. BOX (out) 28.80 ALL DIRT, DUST AND FINES. AT ALL POINTS OF INTERSECTION OF WATER INVERT AT LEACHING FACILITY: LINES AND SEWER LINES, BOTH PIPES • EGINNING OF SHALL BE CONSTRUCTED OF . CLASS ISD PRESSURE I I INVERT AT 6 PIPE AND ARE TO BE PRESSURE TESTED TO LEACHING RACILITY 27.50 .n ASSURE WATERTIGHTNESS. Drawing Title: t { z` 4 INVERT :IT END OF LEACHING FACILITY N/A 8 SEPTIC TANK , DISTRIBUTION BOX, ETC. SHALL BE MANUFACTURED BY ROTUNDO OR " ELEVATION AT BOTTOM OF AN EQUIVALENT •,,.;. .° , r. ' L G'FACILITY 24.20 Q MANUFACTURER. EACHIN UE3Sl�RFJAC 9 EXCAVATE ALL UNSUITABLE MATERIAL IN a • LEACHING AREA AND BACKFILL WITH CLEAN 'fir MR f I vH RON ill, T, ELEVATION N/A 10 TOVY OPERATEMO�R THE L SHALL IMITS OF T BE ALLOWED E SEWAGE DISPOSAL SYSTEMS DURING. THE DISPOSAL � , COURSE OF CONSTRUCTION OF THE SYSTEMS. �L,,ll �"�I,,JJ ("� 11 NO FIELD MODIFICATIONS TO THE SEWAGE -_ d, • - DISPOSAL SYSTEM SHALL BE MADE WITHOUT PRIOR WRITTEN APPROVAL OF THE ENGINEER ;, -- - --- -- - a, - 4ND THE LOCAL BOARD OF HEA TII«_ - - - - _- - - ----- -- - - -