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HomeMy WebLinkAbout0225 LITTLE RIVER ROAD - Health 225 LITTLE RIVER RD., TUIT _ 0.5 q 0 GZ 0 i TOWN OF BARNSTABLE LOCATION 446F L 1 #J LPL 1R3 U��2 SEWAGE# Qn14 -1-11 VILLAGE C40_11.Q, I ASSESSOR'S MAP&PARCEL Z INSTALLER'S NAME&PHONE NO. 5 i 2:T—ot By (�_�� SEPTIC TANK CAPACITYt�Cr��R2_1 ��� LEACHING FACILITY:(type) (size) ax t �� NO.OF BEDROOMS J�, K L-0 =3 v i-�—''5—a e X_ OWNER L PERMIT DATE: ...1- - COMPLIANCE DATE: 7/ Separation Distance Between the: It t Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ' Sv Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Dd Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 4— Feet FURNISHED BY s 13 a� �y- Y6 & i O s t r I 1�� No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Nplitatlon for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �G K 07e 'sName,'Addrefydrss, d e .Assessor's Map/ParcelC11 /""' ���XY64eV ll Installe ' Name,Address,and Tel.No. �-�°j 1 9 Designer's Name,Address,and Tel.No. 9fL99 W ICI 244 00 TI pe of Building: 1411 �/� Dwelling No.of Bedrooms Lot Size �� sq.ft. Garbage Grinder(/Y Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Enviro ental ode and not to place the system in operation until a Certificate of Compliance has been issued by th' Board of H e Date 7/ / Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. Fee > / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yest PUBLIC HEALTH DIVISION'- TOWN OF BARNSTABLE, MASSACHUSETTS 2pplicatlon for —Misposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair(: ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components g Location Address or Lot No. Owne 's Name,Addes s nd T o. D Assessor's Map/Parcel D5 D InstalleN$Name Address,and T !4i 71-9 Designer's Name,Address,and Tel.No. 45 _--rQZq". ✓W AfAiXJ vVv ' Type of Buiil\lding: Dv elling No.of Bedrooms Lot Size 77 �7 sq.ft. Garbage Grinder(/I' r Other Type ofBuilding No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided O gpd ti. l ., Plan Date Number of sheets Revision Date Title Site of Septic Tank i Type of S.A.S. Description of Soil l Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: ? The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in i accordance with the provisions of Title 5 of the Enviro' enta ode and not to place the system in operation until a Certificate of Compliance has been issued by t ' Board of th. e Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. LO Date Issued -------------------------- THE COMMONWEALTH OF MASSACHUSETTS / BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by at l� has been const uct ac e with the provisions of Title 5 and the for Disposal System Construction Permit No ated Installer Designer #bedrooms Approved design flow g d The issuance of this pe it s all not be construed as a guarantee that the system ftionps,de igne x DateInspector ---------------------- ' - - '- =------------------------------------- --------------- --------------------------------- -- C No. / Fee �- THE COMMONWEALTH OF MASSACHUSETTS U S PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS r Nsposal *pstem (Construction Permit Permission is hereby granted to Construct( ) -Repair( ) Upgrade( ) Abandon( ) System located at L 1 11L``JZ111-. �� Gf1_T_Q `7 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. f Provided:Construction mW:_Df ��fpleted within three years of the date of this permit.Date 7 Approved by i Town of Barnstable Regulatory Services Richard V.Scali,Interim Director VAR., ' 1, Public Health Division ►O�Q �0 °TForAAy° Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508462=4644 Pax: A9-790-6304 Installer& Designer Certification Form Date: Sewage Permit# Assessor's Map\Parcel Designer: T,>v►4 )). Cou�hag2t-vr K Installer: Address: F.O. go r< lWg. Address: W05f C4.061, IV A 02&,l On was issued a p erm_,ii to install a _ (date) (installer) septic system at � e )r�C �NA based on a design drawn by i (address) NU'Id bj CoJgk46WY- ZS dated I (designer) I certify,that the septic system referenced above was installed subsianiially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was. inspected;and the soils were found satisfactory. I.certify that the septic system referenced above was installed with major changes(i.e. greater than 10' lateral relocation bf the SAS or any vertical relocation.of any.component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspccted.and the soils were found satisfactory. 3 [certify that the system referenced above was constructs ice with the terms of the RA approval letters(if applicable) vt assy ' a a� , }DavfD ��� Installcr;s i nature N& 093 ( b )fit 2 .. (Designer's Signature) (Affix Design Limp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION: CERTIFICATE OF COMPLIANCE--WILL NOT BE ISSUED UNTIL BOTH THIS-FORM AND., AS- BUILT CARD ARE RECEIVED-BY THE BARNSTA13LE PUBLIC I•IEALTH DIVISION. THANK YOU. QAScptic\besigncrCcnilicatinn Fomt Rev 8-14-13.dne r TRANS.NO.: CITY/TOWN: f�)41 V\.5 9lb APPLICANT: K,cky-e{ t -TVg l! ADDRESS: 22S CAT Tt r- RIVC-K RO b DESIGN FLOW: gpd REVIEWED BY: DATE: N/A OK NO Legal boundaries denoted [31.0 CMR 1�5220(4)(a)• Street. Lot, tax parcel number and lot number noted on plan CMR. 15.220(4)(u)] V Locus Provided 310 0AR 15 2204(t) Plan proper scale?(I"=40'for plot plans, I 20' r fewe r for components) 31.0 CMR 15.220(4)1 Easements shown 310 CM:R 1.5.220(4)(b) System located totally ou lot served [310 CMR 15.405(I)(a)for u grades - V'nol, a vrn'ionce is t egUil-cd 1310 CMR 15.412(4)] Location of impervious surfaces(driveways,parking areas etc.) 310 CMR 15.220(4)(d) .Location all buildings existing'and proposed 310 CMR 15.2200)(0 f Location and dimensions of system components and reserve areas. 310 CM_R..15.220(4)(e) i System Calculations 310 CMR 15.220(4)(0] t/ daily flow t/ septic tank capacity (required andprovided) w soil absorption system(required and rovided) whether system designed for garbage grinder North arrow 310 CM.R 15:220(4)(t); Existing and proposed contours 310 CMR 15.220.(4)(t;) Location and log of deep observation.holes(existing grade el. on. each test) 31.0 CM.R 1.5.220(4)(h.) Names of soil evaluator and f3014 representative[31.0 CMR a ;- 15.220(4)(11) and(i) Location and date,of percolation tests.(perfortned at proper / elevation?) 31.0 CMR 1.5.220(4)(i) V Percolation test results match loading rate? 310.CMR 15.242 Certification statement by Soil Evaluator F310 CMR 15.220(4)(i)] Observed and Adjttsted groundwater(method for adjustment given or indicated) [3.10 CMR. 15.1.03(3)and 310 CMR 15.220(4)(n Address 2� Lt fC Vow D-7 Sheet I of 7 i \!A OK :NO Location ofevery water supply,public;and private. 1310 CMR 15.220(4)(k) wit.lun 400 feet of the proposc&syste n-location in thc.cease . of surface water supplies and gravel asked public water supply within 250 feet of the proposed system location in the case t� within 150 feet of the proposed systemlocation in the case of-privatc water supply wells Location of all surface kvatcrs and wetlands located up to 100 ft, beyond setbacks listed In 310 CAR. 1:51.21 I and any catch bmins located within 50 ft. [310 CMR 15.220(4)(1) Waterlines and other subsurface utilities located (310 CMR j 15.2200)(m)](if water line:cross ice 310 CMR 15,21 1(1)[1'_) Profile of system showing invert elevations of all system / components and the bottom of the SAS 310 CMR I5.220(4)(o) V' Starrip of designer 310 CMR, 15.2200)and 3.10 CMR I5,220(2) Stamp of Registered Land Surveyor(required if construction i activities within 5 ft.off iot.line) 310 CMR 15 2200) 1/ Test Holes adequate(two in each of the primary and reserve unless trenches as permitted in 3.10 CMR 15.102(2)or as approved for an upgrade tinder LUA at 310 CMR 15.405(1l)(k). Test hole adequate too demonstrate four feet of suitable material? 310 CMR 15.1.03(4). t/ Test:1-lolcs adequate to confirm adequate groundwater separation? 31:0 CMR 15.103(3) V Benchmark within 50-75'ofsystem [_310 CMR 15:.220(4)( ) Materials specifications wted? [various sections o1'3 LO CMR 15.000 ✓ System components not>36" deep(unless Local Upgrade Approval or LUA requested) 3 1.0 CMR 15.405 1(b) Address 2Z LUTLC R(U JK l OAOII CoTu( f Sheet2:of'7 i NUAoKN SEPTIC TANTK 3: Size OK,? 1310 CMR 15.223(1) Inlet tee located ten inches below floe' line [310 CMR 15.227(6) . t/ C7utlet tee 14"or 14"L 5" per foot for increase ft depth [')10 CMR 15.227(6)] OLItlet tee with gas bat'fle or approved filter[310 CMR 15.227(4) Note re.garding instal lation on stable compacted base''[310CIMR 15.228(1) Separation between inlet and outlet tees.(no less than fiquid / depth) [:310 CMR 15.227(2)] V Initt7(7utlet clevations at least 12"above 17igh.groundwater (c tic.ept as described 310 CUR 15.227(5))or permitted for u g� ides rmc3er'LUA 310 CMR 15.405(1}(k) MHurnunl cover 9" (Tanks [aimed more than 9" must have risers. on al.l-openings<and on the d,-lox) ( 10 CMR 15.2224(1}and:3:10 CMR 15.23.2(3)(f) t/ Three access covers(inlet and outlet inust be 20" or.greater)m middle access at Least 8" (b 7107) 310 CMR 15-.228(2)., Acc ess,t.o within 6"of grade -one part for systems<1000gpd, / two fors stems>1000 g d 10 CMR 15,228(2) .All at-grade covers secured to unauthorized access? [3*10 CMR- j 15.278(2)' > 10 ft from bLI ilding foundation 310 CMR.15.211(1) Buoyancy calculation Required/Done 310 CMR 15.221(8) H-20 Where appropriate? 310 CMR 15.226(3) c/ Setbacks from resources 31.0 CMR 15.211 M.Ulti-Coin` artni,-h T hksQ¢ =` " .Required when other than single-family dwelIingorflow>1000 g;pd '31,0 CMR 15.22'W)(b) f First compartment 200%daily flow; Second compartment 1.009/6. daily flow 310 CMR 1.5.224(2)and(3) "U" pipe through or over baff7c,outlet ofcaeh compartment with gas baffle or approved filter 310 CMR 15.2:24(4) Address 25 L( lE' ,U� °t ,� C. ft1 f t Sheet of N/A OK NO 'BUILDING SEW—*ER AND-.OTHF,,R,,,P.1' ING P J Located at le.1st.Icii f'cet from any water 1,1110 [3 10 CMR 15.222(2)'] Disposal piping;at least 18" below water line(when.water and sewer cross. see 310 CMR 15.21 I(I)[l 1) Cleanouts required/providcd? [3 10 CMR 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] V/ Slope of sewer line not less than 0.01 (1 1/8"/ft) 0.02 preferable [3 10 CMR 15.222(6)1 Proper pitch on all runs;. (.005 within gravity-distributed trenches and beds) [3 1.0 CMR 15.251(9)and 310 CMR 15.252(2)(c)l V/ Siphon problen-Y(leachfield below pump chamber) Endcaps-or vent manifold specified? Size and orientation of discharge holes specified?(not smaller than 3/8" not larger thart 5/8") [310 CMR, 15.25 1(8)and 310 CMR 15.252(2)(h)] IMaterials specified (310 CMR 15.251(5),specifi.es various pipe types allowed) DISTRfBUT]ON-.BOX A5— Stable compacted base [3 10 CM R, 15.22](2)and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet]provided.?(when- pressure sewer to d-box or steep pitch of gravity sewer) (3 10 CMR 15.323(3)(a)) Riser if deeper than 9" [3 10 CMR.15.232(3)(Oj Inside minimum dimension 12" 1310 CM-R 15.232(2)(b)-i .Minimum sump 6" [3 10 CM.R15.232(3)(e)] Watertight cover If<2000gpd).- waterproof manhole if>2000gpd 310 CMR, 15,232(3)(d)] PV-,NI.PC"-AI:B-E,RS Capacity(emergency storage above working=Oesign floxv)? [310 CMR.231(2)) Proper setbacks [.3 1.0 CMR 15.2 11 (same as septic tanks)] f Watertight 20-in mirnLIIYI Access manhole at least 20" MUST BE TO GRADE [3 10 CMR 15.23](5)] Service components accessible(not too deep with piping, disconnects accessible) Alarm floats -alarm on circuit stparato from pumps specifiled? J Exceeds two units 111LISLhave two pumps operating in lcad-lag mode. [3 10 CMR 15.231(6)and Stable Compacted Base [3'10 CMR 15.221(2)] Buoyancy calculations.needed Provided? [3,10 CMR 15.221(8)] Address 06k)1 Sheet 4 of 7 r N/A OK NO SOIL ABSORPTiONT7SYSTEMS;,(SAS)OE\`:ERA;L �_ n `� A �°_` f Calculations correct? 4 I-e>et of naturally occur-ring material demonstrated![310 CMR / 15.240(1)] V Required sc aration togjrou'n'dcvater? 3.10 CMR 15.212_)]' Aggregate s ecificd as double.washed 3 0 CMR 15.247(2). System Venting required/provided? (system under driveNvay:.or J =36" deep) 310 CMR 15.241 tl Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] Breakout recluu'entcutS met?(tin violation of breakout elevation within 1-5 ft of SAS unless barrier) 1310 CMR 15.21I(1)[4]and Guidance Document GALLERanES,I'ITS,CHA1 9i3ERS:t3t0,C:M 2,14;253=°.,, ule, Chambers and Gal. in trench configuration supplied with,inlct every 20 ft. [310 CMR 15.253(6) Each structure with one Inspection manhole(i.f>2000 gpdtmst / be to grade) 310 C:MR 1 s.253(2) Aggregate 1'minimum-4'maximum. 310 C:MR.15.253(1')(b) T sidewall credit rnaximuin '310 CMR I S 25:3(1)(a) 1n-bed configuration, inlet every 40 sq, tt [3 L0 CMR 15?53(6) TREt\�CHES�3�0,C1•�R.°r15`.2S1 .�. �,�,�.'.k*��`�` ��'rt����,r :��,�' 1,��.���, '��.«_,�,«�.,,-�� Width T minimum 3' maximum 310 CMR, 1,5.251(t)(b) 1.00 foot- maxiirru111 lentzth 1310 CMR 15.251,(1)(a) Minimum separation 2x effective depth or width whichever: greater(3x if reserve between trenches) .10 CMR 25)1(l)(d) Situated along contours 1 310 CMR 1.5.251(2.) Breakout OK? 310 CM'R 15.21 1(t) 4 and Guidance Ocicurnent. BED�SAS-(i Iaiimum{size:o.f bed.6f.fiel- .5000 naiITim,tun 2 distribution lines [310 CMR 15:.252(2)(a); VII Maximum se; aration between lines 6' 310 CM RM5;252(2)(.0 NMaximum separation between lines and outside of bed 4' (31,0 CMR 15:252(2)(e) tl Aggregate depth below discharge pipes 6" mininuun, 12" maximum. 310 CMR 15.252(2)(g) Separation between beds. 1.0'minimum. 310 CMR..1.5.252(2)(0 bottom area used in calculations only 310 CMR 15.252(2)(1)] c' Address Z5 t�' �e RrV'Bf t ° L)t Sheet 5 of-7 f /A OR NO Pressure Dosed S)stein ? Provided pump and piping calculations as aC uirec 310.CMR 15.220(4)(r) l/ Pressure(losing required on all systems>2000gpd or altertiative systems under rernedial approval [310 CINAR 15;2.54(2)and'[/A Remedial Use.Approvals If used in gravelless system - make sure jet is directed as notLto scour soil interface Guidance Document l�nspections°once per year (sy tems<2000 gpol)or quarterly (>2000 )d) good to notes on plan [3.10 CMR 15,254(2)(d)] Construction in fill. -Did the plan,specify that the till shall naeet f the specification oF310 CMR 15.255(3)? Impervious barrier and/or retai'ni ag:wall ? ;Guidance Document' Impervious barrier installation triust be-sttpervised by J designer 31.0C,IVIR IS.255(2)(b)]. r/ Retaining wall must be de-signed by Registered Professional Engineer 31-0 CMR 15 255(2)(a) Side slope not exceed 3:1 '? 1'310 C'NIR, 15.255(2)] Breakout:requirements met? [310 CMR 1�5.252-(2)and Guidance Document At least 5 ft. From impervious barrier to edge ot'SAS ('10 ft. recorna ended) 310 CIMR 15.255 (2)(c) : . jq-- Cess$:stem 3- Check DEP Approval letters for credits and design conditions t/ If used with pressure dosing do not allow pressure discharge to scour soil interlace Alt�rii tiYe`S 1CG Sys eirr-111A Approtiral Was DEP Approval Fetter provided and/or have YOU. 1 reviewed the letter for conditions? V fs.the technology being properly applied and does it meet all DEP A roval.Conditions? Is there a note on the plan regarding the requirement for perpetual me►sntcnanccagreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance- manual? Has applicant submitted a copy of a maintenance V�71C11tGG'5 s ;'Po ; Are the variances listed on the plan ? [310 CMR 15.220 t (4)( ) d R:LS Statnp LJJOCCSSary on plan if a component is within rive feet of prop6rt y line [3 10 CMR 15.412(4)] New construction.or increased low proposed- [Refer to 310 CM.R.15.414 address 2�5 UI Sheet 6 of 7 N/A Ox NO IYIITOf,%e r'Seiis five ireas n .: 4 `.r,' ' 4 tex= I's the systern in a Designated Nitrogen Sensitive area(Tone 11 for. 4 a public supply Well)'? [310 CMR 15.214,310 CM,R,l5.215 anti 310 CMR 15.216-also refer to Palmy ru2arding upgrades of such / existing;s stems] 1s the system proposed an the sairne lot as served by private well,? 31.0 MR 15.214(2) Are the nitrogen loads proposed'in compliance? [310 CMR 15.216(11 /SCt�Ila/7eo,/tS•, s, , s.t�= ma',�'§. P.: �` :;'"o pum in, to septic tank? 31.0 CMR 15.229 Shared System [310 CMR 15.2%) Address -22 S G 1l e �r UQ fir_ rL __co YO Sheet 7 of 7 wl ISTIa ���i bZ �Vlrl f1UZ 22_5 L►7TTL,E_ V f- stt> GCI vv P _ ti NL AP rp Ism 3 �w 4t14 r (J) �jr-'tjr:5 ) �Z` LIITIX �Av6-2 RD f Town of Barnstable P# Q Department of Regulatory Services . Public Health Division Date ,tip' 200 Main Street.Hyannis MA 02601 Ed Date Scheduled 5 I d Time /Q Fee Id Soil Suitability Assessment for Sewage Disposal t Performed By: AVID � ( LJIYN�/A�f��t-[t�) Witnessed By: ilotl4'd DsG'NQ1q� LOCATION&GENERAL INFORMATION /.Location Address 7,Z�i L`r++� Ownees Name ZtkOVA f 1 l or y QiG A CO+0 i''t Address -lag (_ f E 1 e R;vc r R4 Assessor'sMap/Parcel: 54 12-5 Engineer's Name OR"%14 CaYgHanar� NBWCON9MUCnON —111— REPAIR V Telephone# m6 364 Oligt Land Use P.eS ldet4 i/I l jWbodeq slope,(96). 0 Surface Stones w e Distances from: Open Water Body. UO+ R .Possible Wet Area J_R Drinking Water Well' R Dmihap Way (t Property une to+ R Other A SKETCH:(Street name,dimensions of W.exact locations of test holes&pert tests,locate wetlands in proximity to hales) c- IC -4 m a �' _. ..� -- lip £ tw � J t Parent material(geologic) k7 rjd�oft uk Depth to Bedrock inOKQ .., . Depth to Groundwater.Standing Water in Hole:h 6 UP _- Weeping from Pit pace ©�Q- t Estimated Seasonal High Groundwater 61,971Pi�y—�"r''1 7 t N 'f rof►� S u I`1`Q Ce DETEWM[INATION FOR SEASONAL-HIGH WATER TABLE Methodused: tM'941111<x h0�e -� ISO Depth Observed standing in obs.hole•. In, Depth to soil moulox In. Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date Index Well level-:' Adj.factor - Adj.Groundwater Level,, PEIRCOLATIONTEST bate 'I I ,n— to AM Observation ^�4 Hole It Tinto at 91, Depth of Pere -t'� nme nt 6" Start Pre-soak Time @ 0-00 Time(9"-6")� End Pre-soak Rate MinJlnch Site Suitability.Assessment: Site Passeif Site polcd: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back ***If peicolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:IS EPTIGVPERcrORM.DOC 7_r )• • -fir •. DEE'ROBSERVATION HOLE LOG Hole# _ Depth from Sell Horizon Soil Texture .Sdil Color Soil. - Other Surface(in.) (USDA) (Mansell) Mottling . g (Slrnreture,Stanes;Boulders. tsill 1_Ry%Otavell l — t(7 F I LL ID - IZ 0 U'a . t.anim Its i�.?/2 �W1tP ��igylP- . F�t14111 IP 22-48 H w SgQS/g Ft,A(¢ 40-Is0 C Ncr��� Sou 101R C/4 `�'. loose DEEP OBSERVATION HOLE LOG Hole#A Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stance,Boulders. n i e 96 Oravell 0-3 0 aloud tom',, 10 •$( Nd it Fr;a b fe 3 - Ln4tAv l,,. tD R `-A 6le q A • m X 579d tD a-3Z LoRe,: �C DYtQ ��� 32, IS0 L Mediu»l t) (OYQ- 64 1It Looslp DEEP OBSERVATION HOLE LOG Bole# Depth frntn Soil Horizon Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Mansell) Mottling (Stoehr*,Stones,Boulders. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munseil) Molding (Stuehre,S(ones.Boulders. i Flood Insurance Rate Man: Above 500 year flood boundary No— Yes Within 500 year boundary No—t//�� Yes Within 100 year flood boundary Nor Yes�. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? V eS If not,what is the depth of naturally occurring pervious material? Certification I certify that on date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise an experience described iin/n 10 CMR 15.017. /L Signature ( 46 4►`a t Date ��, e0lT Q:1S,BP nC1PERLFORM.DOC . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 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. General Information filling out forms / on the computer, use only the tab 1. Inspector: v key to move your cursor-do not Ricky L. Wright use the return Name of Inspector key. B & B Excavation, Inc. rab Company Name 14 Teaberry Lane Company Address Sandwich MA 02563 City/Town State Zip Code 508-477-0653 S14595 >, Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address land that4rte information reported below is true, accurate and complete as of the time of the inspection. The0spe on was performed based on my training and experience in the proper function and maintenance don SM sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.40 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the LocaI Approving Authority 6/6/11 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal Sys tem-�a age 1 of 17 r f Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old' or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): . F t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 L Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 225 Little River Road Property Address Eric Giessler- Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ ,Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for colifo(m bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: a: Yf4 �ti, 5.rzf F. t ra si `' tf 66 i ¢ i tr t nnn r t ha6" � Rm,�•p t� fi� e WWII + �(�R� ;a�f 4 frflA, ll�h h r I 1 a b t r e ap „in 10 '1010 It�' th E atf try an 0'" F Qd.�dir` Id �� Statia liquli JW In the d n ktAM apov�w �1�At,I� ��t l�u�t�Rn 0v�flp �od a ;l9w � raQi tL I� tn5 �� )it tr . Ifl� Per . ;,,; ' + i Commonwealth of Massachusetts - W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 225 Little River Road Property Address Eric Giessler Owner Owner's Name i information is required for every Cotuit Ma M635 6/6/11 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® • Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd_ 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) .Large Systems: To be considered a large system the system must serve a facility with a - design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply . ❑ , ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection 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 has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is.required for every Cotuit Ma 02635 6/6/11 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® 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 ® El approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. Citylrown State Zip Code Date of Inspection D. System Information X Description: s Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d n/a 9 ( Y 9 (gP ))� Detail: Sump Pump? ❑ Yes ® No Last date of occupancy: . t current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of,design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑, Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 225 Little River Road Property Address P Y Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) . Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: . . Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and ,r maintenance contract(to be obtained from system owner) and a copy of latest inspection of,the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: May 1999 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: >20feet Comments (on condition of joints, venting, evidence of leakage, etc.): At time of inspection building sewer appeared to be in good shape no signs of leakage or blockage. Septic Tank(locate on site plan): ` Depth below grade: 2 feet Material of construction: 4 ® concrete El metal ❑ fiberglass ❑.polyethylene ❑other(explain) - e If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 5.8x5.8x10.6 Sludge depth: no sludge t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle no sludge Scum thickness no scum Distance from top of scum to top of outlet tee or baffle no scum Distance from bottom of scum to bottom of outlet tee or baffle no scum How were dimensions determined? scour stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): At time of inspection tank appeared to be in good shape tees present no sign of back up. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete .❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum.thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .' 225 Little River Road ' Property Address Eric Giessler ' Owner Owner's Name °. information is required for every Cotuit Ma 02635 6/6/11_ page. CitylTown State Zip Code Date of Inspection D. System Information (cont.)- Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural'integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): } Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present:' ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): g .. a i r *'Attach copy of current pumping contract(required). Is copy attached? El Yes ❑ No y t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 , Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 225 Little River Road Property Address Eric Giessler Owner. Owners Name information is required for every Cotuit Ma 02635 6/6/11 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert - 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): At time of inspection d-box appeared to be in good shape no sign of back-up or leakage. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): 4 If SAS not located, explain why: r l5ins•og/68 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection .Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °�M s 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type. ❑ leaching pits number: ® leaching chambers number: 2-500 gal. ❑ 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.): At time of inspection leaching appeared to be in good shape no sign of staining or hydraulic failure. 4 Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):. Number and configuration Depth—top 'of liquid to inlet invert a Depth of solids'layer Depth of scum layer Dimensions of cesspool ' Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17. . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 225 Little River Road 1M Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction. Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): F t5ins-09108 1 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is Cotuit Ma 02635 6/6/11 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the,sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately r A 1 =7 � f, A2- 2 A 3 2g t . t _B I = 35 -B2 t t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is required for every Cotuit Ma 02635 6/6/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: >12feet 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: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 225 Little River Road Property Address Eric Giessler Owner Owner's Name information is Cotuit Ma 02635 6/6/11 required for every page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I y t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE � LOCATION �r��� i � SEWAGE # / ' Z`6 k VILLAGE G�)��.-i ASSESSOR'S MAP & LOT "-0 � INSTALLER'S NAME&PHONE NO. 4 p SEPTIC TANK CAPACITY 1 J d 0 LEACHING FACILITY: (type) Z) -�:—oU 0 r V VeZZ (size) NO.OF BEDROOMS BUILDER OR OWNER 13�--i e— PERMITDATE: COMPLIANCE DATE: d G7G' MY Separation Distance 31tween 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 pf leaching facility) Feet Furnished by `; �� �� � "�r Z , Z 4 0 �` •; i. y Z�I er 7 a t f I �` ' . � �. � Nu. � Fee 7 2/2 o F THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIppffcatfon for 30f 6po�al *pgtem Con�tructfon Permit Application for a Permit to Construct(V)Repair( )Upgrade( )Abandon( ) Id Complete System El Individual Components Location Address or Lot No.1W L IMF—2 I Vr-je 12-b Owner's Name,Address and Tel.No. 7 7/ Assessor's Map/Parcel dLaT 60 Td /T- Dua . )591 C In Designer's Name,Address and Tel.No. 7 7:S —0-7 3 57 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of BuildingWO07) FR-4419 No. of Persons Showers( ) Cafeteria( ) Other Fixtures 1 Design Flow 3 8F h 5 IM gallons per day. Calculated daily flow 319 D gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank f SOD a4lL0AJ Type of S.A.S. Description of Soil e46 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title A c the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu by ' oard Health. Signed Date Application Approved by Date �—/( - ' Application Disapproved for the folio ' g reasons Permit No. Date Issued F'Nb. / ` / J; Fee �'Jd D l 1 - Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS i PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MAO ACHUSETTS J 0(pprication for,Mtgpozaf bpotem C6n5tructiou Permit Application for a Permit to Construct(V)Repair( )Upgrade( )Abandon( ) I/U Complete System E]Individual Components Location Address or Lot N4W L/7TtE- VG le !C ' , Owner's Name,Address and Tel.No. 7 V / I J 'a &0Tu IT Assessor's Map/Parcel ASS/ 00a 6/9SSL c10 ' 814Y5 16 f InstallerRNN�a1me, ddress,and Tel. olf Designer's Name,Address and'Tel.No. -7 7 5- s 0 7 3 S� Type of Building: t Dwelling No.of Bedrooms 3 Lot Size sq. ft. �'�;'Garbage Grinder( ) Other Type of Buildin 00 b FR1`1O F No./of Persons Showers( ) Cafeteria( ) Other Fixtures t-' Design Flow 3 b- &P' I/D gallons per day. Calculated daily flow 330 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /5'Oa Type of S.A.S. Description of.Soil Acy' 11-09ry Nature of Repairs or Alterations(Answer when applicable) IC A 4. i '~ Date last inspected- Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system { in accordance with the provisions of Title the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss by .'s 'o d of Health. Signed Date - Application Approved by Date —A P-r F Application Disapproved for the follo Ung reasons Permit No. ll 1 Date Issued i THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site ewage Disposal System Constructed(✓ )Repaired ( )Upgraded( ) Abandoned( )by .�,1. i UE/?_ 6671 17' has been constructed in accordance with the provisions of Title 5 and the'for Disposal System Construction Permit No. dated Installer r Designer 4 , h a The issuance of this permit hall noV e -onstrue&as a guarantee that theJ�jxl '11 unction as designed Date p I �"1 V 11�,: t/ 1 / 7 Inspector 1J l�l �! r ---------- .----°=--------------------/--- No. Fee I THE COMMONWEALTH OF MA,SSACHUSETTS PUBLIC HEALTH DIVISION"- BARNSTABLE., MASSACHUSETTS wigonl *� pgtem �Con.5trurtiott Permit Permission is hereby granted to,Construct(V)Repair( )Upgrade( )Abandon( ) System located at H6 L f 17 L,!~ R 1 V Qe_ X 6 C.07U 1'7" and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. G Provided: Construction must be completed within three years of the date of this permit. a� Date: �P�r' - � J Approved by SOW TOWN OF BARNSTABLE r0 / LOCATION 4G,17NS SEWAGE # VILLAGE 0,)�r,. � y ASSESSOR'S MAP & LOT r h INSTALLER'S NAME&PHONE NO. n SEPTIC TANK CAPACITY ISO d� LEACHING FACILITY: (type) (Z) S 0 Q Veil (size) NO.OF BEDROOMS BUILDER OR OWNER��JC- PERMITDATE: COMPLIANCE DATE: MY Separation Distance ' tween 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 pf leaching facility) Feet Furnished by_ � - Z T yr t 1 ZIP U xi t G a 0 � �`� � �° � � � � �� ' �° c�ti � � � ,fig � �� �� pW r �- �� � �� � f � .� c�I(d� r 5 �' � r � � rQ� o �� wiN� �ti � s -ern C'�� � �/ tips n � 3-���-r ��-h��ti�a 3� �`�� _ �� fi� ..- , �-� �d` �� ��� � � �. _ �\r. ��' �.,�J "1 \. �t� al p� vl�o`��Ol� � c��'� �� � � �� �'� - � ,���w yti; �� � - �-� x \�,�� ��� x Pv��� Town of Barnstable P# L3T Ln Department of Health,Safety,and Environmental Services !� mot % Public Health Division Date 3t� 0 367 Main Street,Hyannis MA 02601 + BARNWABLB, 165 d l d h S Date Scheduled �� ° ED MK't / Time , © Z> Fee Pd. /4;V v Z�, Soil Suitability Assessment for Sewage Disposal Performed By: � Witnessed By: DAM, .. LOCATION & GENERAL INFORMATION Location Address Owner's Name ,�°A Z Z 5, 4�l7711c e- 00,t5-.�z ° Address �'�g3�irTZ 4 /LLB Assessor's Map/Parcel: 14, ✓( , � �� ^� Engineer's Name l t�CGCFcf� .��Sc3Z, NEW CONSTRUCTION _J!�'� fREPAIR n Telephone# 22,-p �� Land Use d, W V{}p(9�[j Slopes(%) ►D 1 9� Surface Stones lath-Q, Distances from: Open Water Body Wk ft Possible Wet Area ft Drinking Water Well 9Mft Drairiage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) a5' iC . Parent material(geologic) &. Depth to Bedrock . 7714 Depth to Groundwater: Standing Water in Hole: 1("Q_ Weeping from Pit Face 11 OA.Q, Estimated Seasonal High Groundwater 1A, DETE 1YATtO11 FOR SEA5011Y I,DtG;H`WAT t T'AI t E Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well#___......._ Reading Date: Index Well level_.__ Adj.factor Adj.Groundwater Level_ . ;PERCOLATION:TEST: Date .. 06 Trrae Observation Hole# 1 Time at 9" t/ Depth of Perc 116 Time at 6" r Start Pre-soak Time @ 10:26 Time(9"-6") i End Pre-soak ®� Rate Min./Inch / Site Suitability Assessment: Site Passed `✓: Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°°Gravel) 3a' BW 13a� F. - M ...... ....... -............ .... .. DEEP O........ BSER...VATION H.....OLE LOG....... ..... Dole.# .............................. .. . - .. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistenc %Gravel) 61 a w a Voig 3a - X° r. a� -2� DEEP OBSERVATION HOLE LOO Hole r Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel .__........................................... ._ .. .............. ........................ ........ _......,,,_ .......... . .... ...... ......... DEEP OBSERVATION HOLE LO<G hole# . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°o Gravel Flood Insurance Rate Man: ` Above 500 year flood boundary No_ Yes Within 500 year boundary No_ Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on q (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature v ® Date LSV34 36 46� THIS IS A p p p_ 2 _ 28 • ROAD LS L� A T§OUV LS• U �1 V� l /38 °O CO O U #LOOT§ S R�ALMOUtH � NOT Oka TO ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS J SCALE (BOTTOM OF PIPE) EXPRESSED IN DECIMAL FEET / ` PLAN WATER LINE _q­ SEWER LINE OUT EXISTING / USE COLOR PLAN ONLY WATER GATE ® V. SEPTIC TANK IN 37.90 - MINIMAL / FOR INSTALLATION GAS LINE GRADING SEPTIC TANK OUT 37.65 PROPOSED a, W 40 FULL DETAIL IS BEST TELICABLE TVA VIEWED IN UTILITY POLE D-BOX /N 36.30 GARB ` FULL COLOR J D-BOX OUT 36.13 G R ?� JQ FIRE HYDRANT - pp� LEACHING SYSTEM /N 35.65 OT k0 P BOTTOM OF LEACHING 33.65 A OWED �%` � / \ 42 OLD POST COTUIT. MA .. AL ® Cl1S IViAP PAVED DRIVEWAY 44 9FS NOTES EX/STING DISTRIBUTION BOX /S TO BE REMOVED AND TO BE REPLACED O.• LL 0 T 22 44, WITH A NEW DISTRIBUTION BOX. SEE PAGE 2 FOR SPECIFICATIONS. I k� O AREA = 44748 sf f REMOVE STONE FROM SOUTH END OF THE EXISTING LEACHING GALLERY. INSTALL THREE ADDITIONAL DRYWELL UNITS AS SPECIFIED V �� V. LAND COURT PLAN 17287—E ON PAGE 2. INSTALL PIPE AND RESTONE PER DIAGRAM. Q Q O 7 �,. '�; \\Assn MAP 54 Pa 2-5 ' ANY SOILS REMOVED IN THE PROCESS OF AUGMENTING THE I 0�; �C I • / SOIL 'ABSORPTION SYSTEM ARE TO BE REPLACED WITH �� Q O CLEAN MEDIUM SAND PER TITLE 5. • 32 o� \ L O ELEVATION ' ll I d ®� I / a r 4 2. 0 0 - I w OF P I /J� 0 \ `r FOUND EXISTING 1500 I I O GALLON SEPTIC TANK• \ EXISTING 9° 9iG� �js \ ` ®• BOXR 8 OI BE 42 �tH Of MAssgr �p`(H OF MgSsgC9 °O _ REMOVED) , p DAVID dG p DADVID G� 1 `in r o9O�GF GF G t — G HAND DIGGING OF TRENCH J / O� COUGHANOWR n COUGHANOWR n �` �` - DF O�\ EXISTING SOIL RECOMMENDED HERE /`� No. 1093. No. 461 siG FG L TPz /Cb' �A� FTgT ABSORPTION 4-D ® �FC IST ER s gPPRo Q�L� FD SYSTEM ;- ''� N SgMT R\F� °�� EVAIVP� 463° \ gTFO Tl 9 F�GF i, TPI P\r\G I5-0 LOTQp �j L��j OF p-0 G T Gam- 32 \ D / /� [ &N AREA 44748 Sf f INSTALL NEW J� Q THIS PLAN 15 INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM / - DEPICTED ON IT. FOR ANY OTHER CHANGES TO THE PROPERTY INCLUDING 34 ♦ 0 DISTRIBUTION Q � Q n PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS, OWNER k 0 BOX HERE O� \\ SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. � SEWAGE DISPOSAL AR EA 36 \ 40 SYSTEM PLAN 390 ° C PROPOSED -WP PL� Q �° - -TO SERVE EXISTING DWELLING 00. TP3 I RICHARD AND TRACEY AUGMENTATION TP4 ® / / _ BROCHU 38 / SCALE: 1 i n - 2 0 f t \\ •. OWNER(S) OF RECORD TO SOIL / 0 •20 40 •" l 225 LITTLE RIVER ROAN! ABSORPTION COTUIT MA 9 SYSTEM 0 10 20 WESTP.O. BOX 1265 PROPERTY ADDRESS -SEE DETAIL 40 02669 DATE• MAY 21. 2014 ON BACK 508 364-0894 E-3818 - t .i I • _ - �'OoRrTIOoN ���TCM 1 SOoI-L TEST (�00g - .. .. ..._ •'. DM ON ' .. -_-'. _ ,. D/STRIBU.TION SOX !� -- • 6 BEDROOMS MS X = 660 GPD Owe DESIGN CA � CULATIOo NSI SOIL EVALUATOR: M. O'LOUGHLIN DESIGN FLOW. 110 GPD WITNESSED BY: DONNA MIORANDI, HEALTH DEPT. SEPTIC TANK: 660 GPD X 2 DAYS = 1320 GALLONS 4 NOT EXISTING LEACHING GALLERY , TEST PIT iPI NO GROUNDWATER ENCOUNTERED = TO 16 in 12.83 ft 2 MIN/INCH IN C SOILS USE EXISTING 1500 GALLON SEPTIC TANK IF IN SCALE IS SHOWN IN'PURPLE. ` SOUND STRUCTURAL CONDITION. IF NOT, INSTALL ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER NEW 1500 GALLON SEPTIC TANK. r -> ` _ '4.0. 4.83 4.0 INCHES' HORIZON TEXTURE (MUNSELU MOTTLES -� f t. ft ft rt' DISTRIBUTION BOX: INSTALL SHOREY DB-6 H-20 FROM c 37.2 0-3 O c TANK , c TO DRYWELL 3-6' A LOAMY SAND 2.5 Y 4/1 SOIL ABSORBTION SYSTEM: O SAS a UNIT (TYP) LO THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE Q a. 6-9 E LOAMY SAND 2.5 Y.6/1 SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES O , 9-32 B LOAMY SAND 10 YR 5/B PER INCH = 0.74 GALLONS PER DAY PER SQUARE FOOT. PROPOSED AUGMENTATION OF. 34.5 ,'' �� 6 in STONE BASE co - ND 2.S Y 7/4' THE LEACHING GALLERY DEPICTED BELOW CAN LEACH: A THE LEACHING GALLERY MEDIUM SA ND 32 132 'C ME �v, o 26.2 29, in 2 CROSS SECTION VIEW NO GROUNDWATER ENCOUNTERED BOTTOM AREA = (17x12.83)+(12.83x33)=641.5 sq. ft. IS DEPICTED IN BROWN. TEST PIT 2 SIDEWALL AREA = (12.83+29.83+33+ I N 2 MIN/INCH`IN C SOILS ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER 12.83+20.17+17)x2= 251.3 sq. ft. _ STONE INCHES HORIZON .TEXTURE (MUNSELL) MOTTLES 9 TOTAL AREA 5 892.8, sq. f! ��I L A �,��R P T r N W � 20.17 ft 40.2 0-3 . :. 0 -,; i FLOW CAPACITY = 0.74 x 874.3, 660.7 gal/day ���1::� �J ,.; M oy .� 5 T E M o�J LIJI� rt 3-6 A LOAMY SAND 2.5 Y 4/l. : ° i INSTALL THE 'L' SHAPED LEACHING GALLERY AS CONFIGURED BELOW. FLOW CAPACITY.= 660.7 gal/dog WHICH EXCEEDS. 00 •• 6-9 E LOAMY SAND 2.5 Y 6/1 THE 660 gol/dog REQUIRED FOR A SIX BEDROOM DESIGN. , * m -• O O : CV 37,5 CO z 9-32 B LOAMY SAND 10 YR:5/8 __-- SQ0 GALLON DRYWELL 32-120 C MED-FINE SAND 2.5 Y.7/4 DIMENSIONS & DETAIL^ INSTALL ONE INSPECTION # o 302 RISER TO WITHIN THREE 150000 GALLON SEPTI `�T�ANK USE ' INCHES OF FINAL GRADE s n & INDICATE LOCATION - ' ON AS 4.0 8 ft ft5 8;5 ' 8.5' fft ft t t UNl T s SOIL EVALUATOR: DAVID D.' COUGHANOWR. LSE-461 33' ft WITNESSED BY-" DONALD DESMARAIS.,HEALTH DEPT-- � In � NOT NO GROUNDWATER ENCOUNTERED ^ TO p - TEST PIT 33 - TAPER , ' r PERC AT 50 in 2 MI !INCH IN C SOILS « SCALE I DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER' ELEVATION MOTTLES I r - INCHES HORIZON TEXTURE �, (MUNSELU- "' . �r• _ 3Y-80 1-10 FILL .. ct 5 ft- . . „a CROSS SECTION VIEW '(SECTION-A-A) -INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE 10-12 O WOOD LOAM 10 YR 2/2 NONE FRIABLE o 8 /n 12-16 E LOAMY SAND 10,YR 4/2. NONE FRIABLE INSTALL AN APPROVED GEOTEXTILE ,_ .. "'" FABRIC.OVER STONE -ALL COMPONENTS.ORNSTALLED SHALL MEET THE MINIMUM �. :y b - REQUIREMENTS OF MASSACHUSETTS .TITLE-:5 SEPTIC, STARTING: N 16-22 A - 'LOAMY SAND; 10 YR 4/4 NONE FRIABLE .. . CODE (310 CMR 15).. 22-40 B LOAMY SAND 10 YR 5/8 'NONE FRIABLE _ - - 36-47- f ,. /$ - w e , -INSTALLER BEFORE OR SYSTEM.ER 40-150 C MEDIUM SAND 10 YR 6/4 NONE LOOSE r_ f(C q e 24 in a q' 4GROUND "• 27.30 1O ft� GJ 28 I-1/2 in�GA�El EFFECTIVEQ I-2 in�GRAOVEL = -ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION 6 in DEPTH o OF LOW 'FLOW-FIXTURES & :APPLIANCES, AND PERIODIC NO GROUNDWATER ENCOUNTERED _ n �` p I PUMPING OF THE SEPTIC TANK. 15 TEST PIT, :4 TP4 _ PERC AT.50 in - 2 MI /INCH IN C SOILS r „ SYSTEM.IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER INLET ,. -CENTER OUTLET 48 in 58_in 48 `in . DO NOT PARK OR DRIVE VEHICLES OVER'SEPTIC SYSTEM. INCHES HORIZON- TEXTURE (MUNSELU MOTTLES COVER' COVER COVER 39:45 _ " y 154 in s' 0.3 O, WOOD LOAM 10 YR 3/2 NONE FRIABLE `, i-;:_.__, AGGREGATE TO BE•DOUBLE WASHED AND FREE 3=4 E LOAMY SAND 10 YR 4/1 NONE FRIABLE 3 /N DROPFLOW LINE OF IRONS. FINES, AND.DUST IN PLACE. °' f -► 4-9-; A LOAMY SAND 10 YR 4/4 NONE FRIABLE FROM r = Y 1 in O 14 TO 9-32 B LOAMY SAND 10 YR 5/8 -NONE FRIABLE BUILDING !n 36.12 D-BOX 32-150 C MEDIUM SAND 10 YR 6/4 NONE LOOSE 48 in GAS ., 4 I! 26:95 ' LIQUID _ ;:,BAFFLEn ems. - *� TOP OF FOUNDATION ALL PIPE TO BE SCH. 40 PVC ". S E RAI COVERS TO °WITHINUj. L EL 42.- 0 +- AND TO`PITCH AT 1/8 in/f! MIN -r _ - 6 in OF FINAL GRADE 38.75 w; 6 in STONE BASE IF NEW SEPARATION BETWEEN .INLET & OUTLET D-L OX - _3' TEES NO LESS THAN LIQUID DEPTH . USE H-20 - MAX EXISTIN� TEE 36.4 CROSS- SECTION VIEW EXISTING c��00 ������ 9 PRECAST �''_ a oa o n.-r . 37.90 SEPTIC TANK 37:65 36:13 0. 11 ��ofl DRYWELL $a� . �,, EXISTING SEE DETAIL ON BACK 36.30 STONE 35.65 SOIL ABSORPTION BASE (+ SEE DETAIL EXISTING 6 in STONE BASE 39 ,ft 11-18 ft ������ ON BACK 33-65 NO GROUNDWATER MOTTLING OBSERVED _ 26:.95 IN TEST PIT 4. SEWAGE DISPOSAL SYSTEM PLAN 225 LITTLE RIVER ROAD COTUIT. MA�MAY 21. 2014 ETE-3818 PG 2/2 " TEST HOLE LOG DATE:—h'�.!' 30� /3P7-- /F=-. SOIL EVALUATOR: o.l� iffc� /... WITNESS`-----: �� _ f/4�A9-W—g:..._. PERC RATE:.._ Z.yiv/ivG+r _ . 3" o a ti �,s - 3 i9 2-.S, Z. � 3z" %y�� 3�•� .3z` l�y�� a c,e,,✓E- c Asao, ,6101e101 5%40 DESIGN DATA DAILY FLOW: (3)BDRMS.z 110 GPD=33o GPD SEPTIC TANK. 336 GPD z 200%a l(a GPD • USE: /.Soo GALLON PRECAST SEPTIC TANK LEACHING FACILITY: -:- -_ CAPACITY: ����te o► �4 s9 SEDEWALL:-. -- ��� �G BOTTOM:_/j_X W. TOTAL:-'-- 3 - y NOTES: •' 1. ALL PIPE TO BE 4"DIA.SCH 40 PVC. 2. PIPE TO BE LAID LEVEL FOR 2'OUT OF DISTRIBUTION BOX. 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN 6"OF FINISH GRADE. 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL. 1 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED ON A 6"LAYER OF STONE. 6. INSTALL GAS BAFFLE IN OUTLET TEL 2•LAYER OF 318•PEASTONE OVER A'-1 112•WASHED STONE ALL AROUND I TOP OF FOUND. @ EL yZio 10" Iu• / 3lv,�o BST • 7g SEPTIC SYSTEM PROFILE z6-Z pE�rr/ o� c t.4y� SITE SEWAGE PLAN GENERAL NOTES FOR 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR TO ANY EXCAVATION OR CONSTRUCTION. � YJ 671)a ?,, Z—S 2. SEPTIC SYSTEM TO BE INSTALLED INCOMPLIANCE WITH PREP D POR 310 CMR 1&00:TITLE V. 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE DETERMINATION. 4. ALL DISTURBED AREAS TO LOAMED AND SEEDED. DATE: SCALE: 5. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY REQU INSPECTIONS OF �O BRAMAN CyG� CIVIL V N9.32686C y 'Q o P • WELLER & ASSOCIATES FT1645FALMOUTH ROAD CENTERVILLE, MA. 0263211 EL: (508)7754735 FAX: (508)775-0754 APPROVED BY: /7772, - A4ml °O Q 1 l � Q 1 J N i S k . Z � i \o a �j TEST HOLE LOG DATE: SOIL EVALUATOR:-/-./ o Go ,y •s/ • WITNESS._��_..�f/G�.q•�•?�•4__ . PERC RATE:_- c Z34 yi.✓�i<vc. _ F41 s - 3 h e—S, +G,S- 9" Z,. y, 9` Z,sr� ,8w --.s, 3z" %y�� 3�•� 3z`' l�yl� � AV ov MEp�S�rO DESIGN DATA DAILY FLOW: (3)BDRMS.z 110 GPD=33a GPD SEPTIC TANK.3,3o GPD z 200%= dZa GPD USE:/.So o GALLON PRECAST SEPTIC TANK LEACHING FACILITY: USE:�z.. ._SXZ� Soot cJELt,S _... . .._ - w` y.: of STot/E-•--__----- CAPACITY: `{N OF Mgss4c SIDEWALL:_;t�-X Z_x 0,2 _ a.�Z• ____._ ag BOTTOM:_/_Jj K-ZS/X--D_1-7-k W. TOTAL::--- . 3 c� GG NOTES: 1. ALL PIPE TO BE 4"DIA.SCH 40 PVC. 2. PIPE TO BE LAID LEVEL FOR 2'OUT OF DISTRIBUTION BOX. 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN 6"OF FINISH GRADE 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED ON A 6"LAYER OF STONE 6. INSTALL GAS BAFFLE IN OUTLET TEE 2'LAYER OF 318'PEASTONE OVER 3/4'•1 ll2'WASHED STONE ALL AROUND I TOP OF FOUND. 3611 25, BsMT 3�,So . F1,c�3y3 �7 ZS 3G•oa• 7 8 , SEPTIC SYSTEM PROFILE z6 z pE�7;/ oA c G4>O'&Z SITE SEWAGE PLAN GENERAL NOTES FOR 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ALL UTILITIES,ABOVE AND UNDERGROUND,PRIOR TO ANY EXCAVATION OR CONSTRUCTION. g� E 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH PREP D FOR 310 CMR 1&00:TITLE V. 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE .G7 DETERMINATION. - ��p 4. ALL DISTURBED AREAS TO LOAMED AND SEEDED. DATE: • -/�'» //�y SCALE: 5. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY REQU NSPECTIONS. OF BRAMiJi CIVIL y , V ND.32686C y WELLER & ASSOCIATES FTIE645FALMOUTH ROAD CENTERVILLE, MA. 02632EL: (508)7754735 FAX: (508)775-0754 APPROVED BY: I I I try J - • /l -- 1 � � . J O \ V a �( v � �j G