Loading...
HomeMy WebLinkAbout0703 MAIN STREET (COTUIT) - Health �703 Main Street (Cotuit) CotA P -- ------ - A = 036 011 j i I 1 ' li 1 TOWN OF BARNSTABLE LOCATION 703 nn:n 54 SEWAGE# ZOI$ -3"7S VILLAGE eo-wi4 ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) O C Z (size) 13 X Z5 X Z NO.OF BEDROOMS Z. OWNER mar R Kcr, C_ar cc� PERMIT DATE: JZ- 4 - I S COMPLIANCE DATE: J Z- ►'17- 1$ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 181 - 23` .B2- Z I A3-31 ' 83' 33 Tq OD� p �y - 33L O As.� ckar,ov'1 �ron� i No.�6'1 1���� ,. Fee �— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:_c PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppliLatlon for MispoBal 6pstem Construction permit Application for a Permit to Construct( ) Repair(-Jj Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1163 rnA'sn 54 C'o4u;4 Owner's Name,Address,and Tel.No. mar kJ Lc r r_cL0 Assessor's Map/Parcel 3 G t 1 ']03 rl av rn 54 Co4 v i+ Installer's Name,Address,and Tel.No. j3 6XCatjcL�j o^ Designer's Name,Address,and Tel.No. U, A S50C- I14Tcm5crry LN Forc5•la(o,Icso8y77.OGS3 3ZoCo4u,'i Ra,( SancAj;c1, S01S3300y1 Type of Building: Dwelling No.of Bedrooms Z. Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 5,�( No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Z 20 gpd Design flow provided gpd Plan Date 1 I - 2 y- 1,9 Number of sheets 2. Revision Date Title Size of Septic Tank /.SO O !oX.1 Type of S.A.S. S0Q 4 cPJ L j C 2 Description of Soil Nature of Repairs or Alterations(Answer when applicable) .S00 14 10 5'f ^ J)B 3 H 20 - 2 . 500!j0_1 LBc N20 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 Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date J2• ^IS Application Approved by Date t Application Disapproved by Date for the following reasons Permit No. 14(�� ��� Date Issued '�1 //��' fir. ak � ',.��^ rye •` No. Fee f .r— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for Misposal 6pstem Construction 3permit Application for a Permit to Construct( ) Repair( Upgrade,( ) Abandon( )""` ❑Complete System ❑Individual Components Location Address or Lot No. vlo3 MA,n 54 C0-1 Q -} Owner's Name,Address,and Tel.No. jG1G�T� L a r c a.U Assessor's Map/Parcel `j G 1 `703 ma:n S4 CoA(j;+ Installer's Name,Address,and Tel.No.�E4 Designer's Name Address,and Tel.No. 5£xc0.�l�on ' V. t� •A Sow• ! 1.�TcaScrr� tr.) �orC.Sio�o �� .So8y77 OG$3 320004U�4 Rc� SanoQ,J"C, N Sog'•33o0q Type of Building: Dwelling No.of Bedrooms 7 Lot Size - sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 2!Z n gpd Design flow provided y q gpd Plan Date 4.. 'R Number of sheets Revision Date Title -: Size of Septic Tank /Snr- --To ) Type of S.A.S. zoo 9; r )- ,— ) Description of Soil Nature of Repairs or Alterations(Answer when applicable) nri C� 33 W2� e 2 • <no f 14rki 2 C� i Date last inspected: jt Agreement: The undersigned agrees to ensure the construction and maintenance'of the afore described on-site sewage disposal system in r ' Accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by fq, G DateIF Application Disapproved by Date for the following reasons Permit No. `� �) Sc _ 2."'�`� 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�G off , ��G � has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No ated Installer Designer_jd� 14 p #bedrooms Approved design flow C1 gpd The issuance of this permit shall not be construed as a guarantee that the systetyrwil'1 funct• f►- s est e Date % L�� 1 z Inspector ----------- -------------------- ------------------------------------- ----------------------------------- -------------------- No. rl I _ 5 a = Fee -- T'-' THE COMMONWEALTH OF MASSACHUSETTS v PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal Opstem Construction permit Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at 77 GO (a 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. Provided:Construction must be completed within three years of the date of this permit. Date Approved by�, /ln CV d ��_� Town of Barnstable I Regulatory Services .� Richard V. Scali, Interim Director • aaRAts?asL& 9� MASS. �0� Public Health Division 13° Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: /L/ Sewage Permit# Z dif 75 Assessor's Map\Parcel 5� Designer: � d���lif installer: 7J1� 11 ®� Address: M2j� r Address: * r(-,e B On was issued a permit to install a (date) ,o (installer) ��aa- ��rr septic system at 7h� �✓m ��"T( , based on a design drawn by (address) 1111AN44'?71�s dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip o (if require ) was inspected and a soi were found satisfactory. * e fz ; e/7l . �� / /!GV yy � I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the terms of the IAA approval letters (if applicable) SSA o� AW cG , (instal ler s 1gnature) L v0111 HOPE -� #1068 , (Designer's Signature) (Affix D p 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 BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Designer Certification Form Rev 8-14-13.doc r 703 Main Street, Cotuit Septic System Installation by B & B Excavation December 14, 2018 4 fh ��p t�,�'hh' 'R'�.i4•Y'^rr il i'a'M geg FK � 14 11 Tn i4 5•k�. 1 317 .:. � ✓.. � -.4r,�„ ..��4tv�p,4 .u. �3a�t�i�f��.� �ti va.:�`'.� Installation of 40 ml Polyvinyl Liner for Breakout Town of Barnstable P# t 680 q Department of Regulatory Services O / BARNsrABLE, z Public Health Division Hate YI16 MAW. 200 Mai-Street,Hyannis MA 02601 0 MIS Date Scheduled O b` Time 1 Tee Pd. �' r h+, Soil Suitability Assessment for Se a Disposal ,. �' Performed By: /1 . YQ Am Witnessed By: LOCATIO & ENERAL INFORMATION Location Address Owner's Name ?D / 7 (pf f Address Assessor's Map/Parcel: �b Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Q f---)7 7* Land Use /gyp S'[GiYIt� Slopes(%) / Surface Stones-�J Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well' d1c (t Drainage Way n� 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) IN- Q4 #' ' f Parent material(geologic) fv Depth to Bedrock Depth to Groundwater: Standing Water in Hole: d[. // Weeping from Pit Face p(. Estimated Seasonal.High Groundwater '"�`T t DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: D i mottles: Depth to weeping from side of obs.hole: Groundwater Adjustrnent ft. Index Well# Reading Date: Index W e Adj.factor Adj.Groundwater Level PERCOLATION TEST DatefQ Time I �� Observation Hole# Time at 9" Depth of Perc Time at 6" . Start Pre-soak Time a, d; 10 Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation 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:\SEPTIC\PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) �Wkir DEEP OBSERVATION HOLE LOG Hole# 2— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel r � DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon . Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA.) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) Flood Insurance Rate May: Above 500 year flood boundary No Yes. ✓ Within 500 year boundary,.. No�/. Yes Within 100 year flood boundary No 1� Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perviou material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pe ious material? Certification / I certify that on /j?j`7(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 trainin ertise and ex erience described in 310 CMR 15.017. Signature (./ Date�,��� Q:\SEPTIC\PERCPORM.DOC; TITLE 5 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION RECEIVE® Property Address: 703 Main Street AUG 0 12003 Cotuit,MA 02635 Owner's Name: Harold and Linda Reilly TOWN OF BARNSTABLE Owner's Address: PO Box 1465 Cotuit,MA 02635 HEALTH DEPT. Date of inspection: 7/23/03 MAR j3(o T Name of Inspector:Janet E. Dupont ------�.,�. ,,,, Company Name:Wind River Environmental PARCEL, ®� Mailing Address: 120 Great Western Road LOT t South Dennis,MA 02460 Telephone Number: 508-760-4827 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems:I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: oZ 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. Notes and Comments: While I have not found any indications of system failure,it should be noted that. this system is an old cesspool style system with orangeburg lines and over the past two years;use has been mostly on weekends. A change in use might affect function. It should be further noted that this system is located very near the property boundaries,particularly the overflow cesspool. It is estimated that the overflow probably touches the rear property line. The house has a cesspool/drywell for the kitchen and when the system is pumped,both that cesspool and the main should be serviced. In addition,the house has a garbage grinder and I recommend that it be removed. ****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. OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 703 Main Street Owner: Harold and Linda Reilly Date of inspection: 7/23/03 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _X_ 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined" please explain. The septic tank is'metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with 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. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a yeai due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed - ND explain: OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 703 Main Street Owner: Harold and Linda Reilly Date of inspection: 7/23/03 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. • 6 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 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. r _ The system has a septic tank and SAS and the SAS is less than'100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other fa lure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 703 Main Street Owner: Harold and Linda Reilly Date of inspection: 7/23/03 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _X_ Any portion of a cesspool or privy is within a Zone 1 of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well: _X_ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal 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.] No (Yes/No)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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a`public water supply well If you have answered"yes"to any question+in Section E the system is considered a significant threat,or answered"yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in . accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 703 Main Street Owner: Harold and Linda Reilly Date of inspection: 7/23/03 Check if the following have been done.You must indicate"yes"or"no" as to each of the following: Yes No _X_ _ Pumping information was provided by the owner,occupant,or Boar&of Health Were any of the system components pumped out in the previous two weeks? _X_ _ Has the system received normal flows in the previous two week period? _X_ Has large volume of water been introduced to the system recently or as part of this inspection ? _X_ _ Were as built plans of the system obtained and examined?(If not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up? _X_ _ Was the site inspected for signs of break out? _X_ _ Were all system components,excluding the SAS,located on site? _NA 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 ? X_ _ 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: Yes No Existing information.For example,a plan at the Board of Health. to , _X_ _ Determined in the field(if any of the failure'criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] �I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION " Property Address: 703 Main Street Owner:Harold and Linda Reilly Date of inspection: 7/23/03 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_NA_ Number of bedrooms(actual):_2_ DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents:_2-5 occasional_ Does residence have a garbage grinder(yes or no):Yes Is laundry on a separate sewage system (yes or no):No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no):No Occasional year round Water meter readings, if available(last 2 years usage(gpd)): 200148,000 gal 2002—57,000 gal Sump pump(yes or no):No Last date of occupancy:Current COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): { Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings,if available: Last date of occupancy/use: ' OTHER(describe): GENERAL INFORMATION Pumping Records Pumped annually since 99 Source of information:Barnstable BOH Was system pumped as part of the inspection;(yes or no):Yes If yes,volume pumped: 500 gallons--How was quantity pumped determined?siteglass Reason for pumping:Cesspool check,for runback TYPE OF SYSTEM Septic tank,distribution box, soil absorption system _Single cesspool _X_Overflow cesspool Privy _Shared system (yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 30+years per owner and past T-5 inspection report Were sewage odors detected when arriving at the site(yes or no):No OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 703 Main Street Owner: Harold and Linda Reilly Date of inspection: 7/23/03 BUILDING SEWER(locate on site plan) Depth below grade:_22" Materials of construction:_X cast iron ._40 PVC other(explain): Distance from private water supply well or suction line: 20+' Comments(on condition of joints,venting,evidence of leakage,etc.):_Lines are caste to orangeburg_ SEPTIC TANK:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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: How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP:_(locate on site plan) Depth below grader Material of construction:_concrete metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 703 Main Street Owner: Harold and Linda Reilly Date of inspection:'7/23/03 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any, evidence of leakage into or out of box,etc.): r PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 703 Main Street Owner:Harold and Linda Reilly Date of inspection: 7/23/03 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: leaching trenches,number,length: leaching fields,number,dimensions: _X_overflow cesspool,number:_1_ 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.): CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: 3 Depth -top of liquid to inlet invert:_Cesspool#2 found full to top of outlet Depth of solids layer:_normal Depth of scum layer:_almost none in main,kitchen pool has several inches. Dimensions of cesspool:_400 kitchen cesspool,500 main, 1000-1500 overflow(8 X 6) Materials of construction: block_ Indication of groundwater inflow(yes or no):_No Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): Cesspool#1 is kitchen sinks only,grease and solids due to grinder,main was full,outlet of main is orangeburg sweep,overflow held 3.25' standing water 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.): s OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 703 Main Street Owner:Harold and Linda Reilly Date of inspection: 7/23/03 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. O �. 0 L.►1 r ►4R�K MA�I.l i A 4o51 t� � D ' a ` 4 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 703 Main Street `i Owner: Harold and Linda Reilly Date of inspection: 7/23/03 SITE EXAM Slope slight slope toward overflow, steep drop in neighboring property to back and side. Surface water none Check cellar dry Shallow wells none Estimated depth to adjusted ground water 15.8+ feet from bottom of SAS Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: 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) _X_Accessed USGS database-explain: You must describe how you established the high ground water elevation: House sits at top of steep incline. Visible drop is approximately 30' with no signs of outbreak. House is located in area monitored by USGS well MIW 29 Zone B Adjustment is less than 5' Bottom of overflow is 9.25' below grade 30—(9.2+5 )= 15.8 i e y r' fi Commonweafth of Massachusetts Executive Office of Environmental Affairs SEC IV Executive Department of r ° 2 r .19,9� Environmental Protection William F.Weld cts Governor Trudy Coxe �a Secretary,EOEA y David B.Struhs Commiaaioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 740-3 i 57—, ��? s`�:�,� Address of Owner: Date of Inspection: (If different) Name of Inspector: Company Name, Address an Telep one Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported belov+, is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site se age disposal systems. The system: Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: ' Gc \` Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 Department of.Environmental Protection. The origina! should be sen: ! me system owner and copies sent to the buyer, if applicable and the approving au:hori;y. CINSPECTION SUMMARY: Check A, B,C,or D: A] SYSTEM PASSES: � I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need.to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not) The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The"system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 8/15/95) One Winter Street a Boston,Massachusetts 02108 a FAX(617)SW1049 a Telephone(617)292-5500 i~J Printed on Recycled Paper ' i �" a f. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: �d G� l'� i�f Sj G D +'� Owner: C C) N Date of Inspection: BJ SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _ The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed k ' 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. — I 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Ihp svgem hat a septic tanK anu s0ii absorption system and iS wilimi 00 fcci to a suliacr- 'wd'ci SuaNl) or tribuzzary to a surface water supply. _ The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm• D] SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an 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. (revised 8/15/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Ad ess:W-3 Uer� Owner: elm Eg+1,� Date of Inspection: D] SYSTEM FAILS (continued): 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 1/2 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: �I The following criteria apply to large systems in addition to the criteria above: 1'+ The design floe, of system is 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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: The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 3 L SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: ©FF^1'ej 5T p vc Owner: Date of Inspection: Check if the following have been done: 4Pumping information was requested of th caner ccupant, and Board of Health. IZ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. VThe facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow The site was inspected for signs of breakout. ZAll system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by nun-intrusive methods. Zhe faci! y . occupar:;_, fro r ovine-! were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C K SYSTEM INFORMATION Property Address: 7 Q Owner: -t o l vu Arf Date of Inspection: _ FLOW CONDITIONS RESIDENTIAL: Design flow: allons Number of bedrooms: Number of current residents: Garbage grinder(yes or no):-4t4 Laundry connected to syst (yes or no):� Seasonal use (yes or no): A Water meter readings, if available: (I� Last date of occupancy: NT COMMERCIAUI NDUSTRIAL: Type of establishment: Design flow:_gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as pan of inspection: (yes or no) If yes, volume pomned gallons Reason for pumping: �-eel fk&L_ TYPE OF SYSTEM Septic tank/distribution box/soil absorption system _ V,Single cesspool S Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) Other(explain) C6ti4-e en,9-r'ry- APPROXIMATE AGE of all components, date installed (if known) and source of information: .?0 T r.S Sewage odors detected when arriving at the site: (yes or,no)]r` (revised 8/15/95) 5 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR_M PART C SYSTEM INFORMATION (continued) 7 Property Address: D 3 CS FF vvl of si <c'rvir Owner: �•t���►�j Date of Inspection: l-}-�3 � SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction: _concrete _metal _FRP—other(explain) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) GREASE TRAP:_ (locate on site plan) Depth belov., grade:6 Material of construction: concrete _metal _FRP _other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: � t rlictance from bottom N c t­ to hnrtnr. of c tjtle! tee o' b2111e. Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) NO e;=G\r-�.w ! (00.0 (revised 8/15/95) 6 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 7!�3 r� ifs co'K sr, C8 i Owner: 4C Date of Inspection: ra- �2 TIGHT OR HOLDING TANK:- (locate on site plan) Depth below grade: Material of construction: _concrete_metal _FRP —Other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan, Depth of liquid level above outlet invert: Comments mote ii ievei ano ciistriuul,ui: , e4 a , e'�;dcnce of so!id_ ca.r)o',er, evidence of leakage into or out of box, etc.) PUMP CHAMBER: fl`. (locate on site plan) Pumps in working order.(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 7®,�j 6�r4� i CO tt�'tiT' Owner: -p�v'tAq ql Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) IS CESSPOOLS: (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: 10 Depth of scum layer: 40 Dimensions of cesspool: 'STD Materials of construction: Indication of grounds%ate-. ^40tj+ inflow (cesspool must be pumped as part of inspection) 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.) ` a I , i (revised 8/15/95) B r ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: CUFF M ti+uu 51 CUT G i i Owner: C& flM4" Date of Inspection. a- SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' t dor,.;r :5 i 5 eP-t'a�je' CC 55 00o1S DEPTH TO GROUNDWATER WA�`�' �y �touvD e�e Zto�us Oc�vvt,a C;*,�� Depth to groundwater: __42feet method of determination or approximation: Q-S.c9c f 'sk (v-T IS WZSn (revised 8/15/95) 9 Low � ' e�Ave• LOCUS ASSESSORS MAP: 36 GENERAL NOTES: o. Pie' PARCEL: 11 ut>1a j REFERENCE: PL. BK. 511 PG. 4 1. VERTICAL DATUM: ASSUMED LCP 7034 B & C 2. MUNICIPAL WATER is AVAILABLE. FLOOD ZONE: X Town of Barnstable 3. SCHEDULE 40 PVC PIPE TO BE USED THROUGHOUT Co01id9 #25001 C0759J(07/16/14) %/////////j// SYSTEM UNLESS OTHERWISE NOTED. Stree j j/j�/j/�j/�j 4. ALL PRECAST UNITS TO CONFORM TO t;�lt AASHTO: _ H_10 & 20 5• PIPE PITCH-1/4" PER FOOT UNLESS OTHERWISE NOTED. eC so pad Sho � N\ck ood ///////j//// 6• ALL CONSTRUCTION DETAILS TO BE IN CONFORMANCE ay R // /%/ // // / NOTE: Confirmation of soils at WITH MA ENvIR. CODE TITLE 5 AND LOCAL W j% j% time of constructionq y required b REGULATIONS. LOCUS MAP N.tS. installer. 5' removal of unsuitable - 7. CONTRACTOR TO VERIFY LOCATIONS OF' ALL UTILITIES soils (Fill, A or B) may be PRIOR TO CONSTRUCTION. required along westerly end of leach facility. LEGEND: PROPOSED CONTOUR UP 99 PROPOSED SPOT GRADE / — 40 — EXISTING CONTOUR 20' Wide ROW j / Dirt Way X 30.23 EXISTING SPOT GRADE To Main Streeet / x 50.29 Er,'ge of Pale. x-48.2 x-49 78 ® TEST PIT r5021 x-45A6 ® EXISTING WATER SERVICE ,...�^ x-40:1" x-42 08E .: .09,38,,' � �vl, He e. J;PPX.4 — WORK LIMIT LINE 4 89 x 49 f9 ©^ `~ oI l tom,+ x 49:55 x-44-32" Save `x-49:6.5 1 Stone Mapleop — =x 5 .12 o AMY L. y� Onve: VON50.13 HONE Save L,r s Mtr. Elec. Mtr. Sp No. 1068 " OLb ak FL wEl Full r 6jSTERE� 62 97t1 1 ag 1 49.87 R� tt TH ..21 y( (x�3Jjo c "j J 0 1' A Exist. Dwell. v 0 2 09 J Top Fndn. / �6 Rhody ' i El. 50.3' Lot Area. o 1 65 88 eck 6,580t sf m NOTE: This tan is to. be used for septic X ' -1 ' I FL EL fi` P P Location of Vent at ¢� I s stem purposes only and is not to be i �— 9.21 Y P P Y 1 I i shr �,� used for any other purpose. Owner's discretion 25' � � Sried x 5.37 DeckCP , 703 MAINr STREET 4�i.41' •s0 6?2 \ xj 48.64 ,- li x3 .84 ` •.9 COTUIT, MA x 45.02 Benchmark: Car of PREPARED x 42.77 Wood Bordered associates Plant Area at !. ` '''��-w. sEP'nc SYSTEM 0MGNs FOR: Elev. 47.7 320 Cotuit Road Septic System Mark and Keri Lareau Maximum Feasible Compliance: sandwich, MA 02563 Site Plan P.O. BOX 75 Title 5, 15.405: (0) 508.833.0041 — 2' variance, proposed 5' 40 ml Liner for Breakout NOTE: Pump and backfill / (�) 508.274.007a COtuit, MA 02635 final cover over leach facility Top EL. 39.4, Bottom EL. 37.4 cesspools or remove as -✓' sur4eyin9 by: needed for new system. AHOjala surveying Arne K Ojala,P.L.S. 211 Woe Street DATE REVISED _ SCALE . SHEET NO. west�362�93 o2sse 11/24/18 1 = 20 1 of 2 ,. J f t a, I T.O.F. (Full/Crawl) " Provide Riser over D-b.oz ' NOTE: All, components to be marked .with NOTE: To prevent breakout, final EL. 50.3 to within 6" of final grade", magnetic tape or similar prior to final cover. . grade of EL. 39.33 to be carried (Cover to be watertight) out a minimum 15' beyond edge F.G. EL: 48.0- 49.0± F.G. EL: 45.5 F.G. EL: 43.5 Maintain Min. 2% slope over leach facility to of leach facility. Existin �- prevent ondin F.G. EL: 41.5-45.0 Exist. invert A Install risers w/covers over inlet and ! Min. 2" of 1/8" - 3/4" Washed Stone or Inspection Port within 6" to grade 4" Cl Pipe outlet to within 6" of final grade Geotextile Fabric / EL. 46.97 L=20' (Access Covers min. 20" diom. per Code) Tee 4" SCT71 P L=12' L=10' 3/4' - 1 1/2' Double Washed -Stone Top of Units EL. 40.6 4" SCH 40 PVC '. 4" SCH 40 PVC Top of'Peastone or Geotextile Fabric EL. 39.33 CAS=1 u• ®5=259� 1� s CAS=109 19avIIN eaa$aa® 24" Eff. Depth L=1 o a4" SC EL. 43.25 EL. 40.0MERottorn 37.0 nstall Gas Baffle EL. 40.17Exist. invert B ®S=2 PROPOSED DB-3 EL. 39.0 Use 2 - 500 Gallon Precast Chambers 2" Cl Pipe EL. 43.5 H-20 DISTRIBUTION BOX (H-20) with Double Washed Stone r4.8' EL. 47.97 Watertest for levelness 4' Ends, 4' Sides (Install PVC Outlet Tee) SEPTIC SYSTEM PROFILE c ) PROPOSED 1500 GALLON if more than one 25 x 12.83 x 2' EL 32.2 H-10 SEPTIC TANK outlet tom o f N:T.S. Bot TH-2 ADDITIONAL NOTES' DESIGN CRITERIA SOIL LOG ' 1_ Contractor to' confim soil suitability prior 'to installation. Contact BOH and Number of Bedrooms:Existing 2, Min. Design 3 Bedrooms SOIL EVALUATOR: AMY.L. VON HONEI, S.E. #2517° .Design Sanitarian in the event of varying . soils from '°original soil test. INSPECTOR: OONALD DESMARAIS, R.S., BOH Soil Type: Crass I ✓/ DATE: OCOTBER 24, 2018 10:00 AM = Percolation Rate: PERMIT: #15804 2, Pump •and backfill Cesspools. Any contaminated materials within 5' of <2 •min/Inch PERCOLATION RATE:<2 MIN/INCH IN C1 proposed Leach Facility to be removed. Replace with clean .fill per Title 5 specifications. } Daily Flow: - 110 G.P.D./Bedrm x 3=330 G.P.D. 3. Water line to be sleeved at an sewerline �`c Design Flow: TH 1 TH - 2 330 G.P.D. (Min. Required) - y rossings and within. 10' of any - EL. 44.2 EL. 43.2 P ar septic components, as needed, per Water. >Department requirements. Private Grinder: Not Allowed Fill Loam Sandy Loam Fill/A Sandy L Water line servicing Outdoor Shower at Rear Shed to be relocated an Garbage d i Leaching Area _ 10YR3 2 sleeved. Contractor to verify location of water Fine prior to ,construction. (33Q)/0.74 445.94 S.F. ,2611 10YR3/2 42.03, - 16" / 41.87 Required: B B 4. Septic Tank and Distribution Box to be placed on 6" crushed stone or 330 G.P.D. x 200% = 660 G.P.D Sandy Loam Sandy Loam compacted, level base. Septic Tank Required: Minimum 1500 Gallon (Proposed) 10YR6/6 10YR6/6 , 427, 40.7 32" 40.53 SEPTIC TIES °�, Use 2 - 500 Gallon Precast Chambers H-20- with C1 C1 Perc 'L. EL Full . ' Double Washed .Stone: :25' :x 12.83' .x 2' Fine Sand Fine Sand ® 44 4 ass.Z .. 2.5Y7/3 2.5Y7/3 49" Bottom i - 12i Exist Dwell Sidewall, Area: 2(25' + 12:83 )2= 151.32 S.F. Top Fndn. Bottom Area: 25' x 12.83'= ,320.75 S.F. i El. 50.3' 0 - Total''Area 472.07 S.F. 16, � i FL. E�L 47.63t Desi n Flow Provided: 0.74(472.07'S.F.)= 349.33 G.P.D. snr 703 MAIN STREET ' , I FLOOR PLAN 25 18 61-' COTUIT, MA ' N.T.S. : Dining �L associates PREPARED 124" 33.87 132" 32.2 Kitchen Room Entry Tic SYSTEM oE9GNs FOR: No Groundwater Observed No Groundwater Observed 320 cotuit Road Septic System Mark and Keri Lareau . Sandwich, MA 02563 (0) 508.833.0041 Site Plan P.O. Box 75 I <6" @ 4: 30 min. PERC RATE: <2 MIN/INCH C1 Horizon Living (c) 508.274.0074 Cotu it, MA 02635 Bath Room Bed 1 N, Bed 2 I, Amy L. von Hone, S.E., hereby certify that I am currently approved by Surveying by- the DEP pursuant to 310 CMR 15.017 to conduct soil evaluations and Den AHOjala Surveying that the above analysis has been performed by me consistent with the ArneH 0ja1d,P.L.S. requirements of 310 CMR 15.017. 1 further certify that I have 2nd Floor zit Maple sweet DATE REVISED SCALE SHEET NO, West Barnstable, MA 02888 successfully passed the Soil Evaluator's Exam on November, 1995. 1st Floor' 5W-362-0934 10/24/18 1" = 20' 2 of 2