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0145 MARINER CIRCLE - Health
4 Mariner Circle LA 'U" F/R = 023 ,052 �I i t TOWN OF BARNSTABLE LOdATION 145/ Marche, C,rcle SEWAGE# VIA�LAGE CO f U 1 r ASSESSOR'-S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY I D 0 D LEACHING FACILITY:(type) S 14'4 4W#6 �'/Oote (size) 3(9y- ZO F Z E NO.OF BEDROOMS 2' OWNER 7gck Hem cock PERMIT DATE: COMPLIANCE DATE: 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 PCU d-rPA 'Imp to TwK IN 0 OUT go)( o0 C �L-"7 � l� 5 W m ri iz w g C ( R i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms the computer, r, use 1. Inspector: U only the tab key to move your David D. Coughanowr cursor-do not Name of Inspector use the return key. Eco-Tech Environmental Company Name ru 43 Triangle Circle Alf Company Address Sandwich MA 02563 City/Town State Zip Code 508 364 0894 1328 Telephone Number License Number B. Certification r,; } 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 a� wasp performed based on my training and experience in the proper function and maintenance of on.sate sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340�of Title,5 (310 CMR 15.000). The system: 0 Passes ❑ Conditionally Passes ElFails 0 Needs Further Evaluation by the Local Approving Authority t 1h June 25, 2010 rn 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. j t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposa ystem•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every 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: Inspector's Note==> A septic system is deemed to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed below. The septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 f Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is Cotuit MA 02635 June 25 2010 required for , every 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every 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. l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 2.3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 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 136 gpd 9 ( Y 9 (gpd)): Detail: 2008-2009 Sump pump? ❑ Yes ® No Last date of occupancy: 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 Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c�M 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25 2010 every 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 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 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Age: 5+ years. Certificate of compliance issued 4/4/2005 (Board of Health permit#2005-116) Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): No evidence of leakage or backup into dwelling was observed. Septic Tank (locate on site plan): Depth below grade: 1 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5 ft x 6 ft x 5 ft(1000 gallon) Sludge depth: 6 in t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25 2010 every page. Cityfrown 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 28 in Scum thickness 4 in Distance from top of scum to top of outlet tee or baffle 8 in Distance from bottom of scum to bottom of outlet tee or baffle 12 in How were dimensions determined? Design Plan Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping is recommended at this time and maintenance pumping is recommended every two years. Tank and tees appear structurally sound and functioning as intended. No evidence of leakage in or out was observed. 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•09/08 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 ^M 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 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 °M 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert at 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.): D-box appears level with no evidence of leakage in or out. Few solids in sump. A bucket of water was poured into the distribution box and was observed to pass through in a rapid and unobstructed manner, and could be heard splashing down into the leaching gallery. 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): If SAS not located, explain why: t5ins•09/08 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 ey 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 1 ❑ 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.): Soils above leaching gallery appeared unsaturated. No evidence of surface ponding, breakout, lush vegetation, or other evidence of hydraulic failure was observed. An observation hole was dug into leaching gallery stone and no standing effluent or effluent contact staining was observed in the stone or overlying soils. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-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 �M 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every 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.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is Cotuit MA 02635 June 25 2010 required for , every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately CEAZN 1 t�lto tl C 64L6ZR� of o� TRNK OUT 1q%1 7%z — 0 TANKgox —. 1012 %2 SI C 8 A MtAizIN' � R C ( fZ w 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 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is required for Cotuit MA 02635 June 25, 2010 every page. Cityfrown 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: 30 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ® Accessed USGS database -explain: Town of Barnstable GIS Department records You must describe how you established the high ground water elevation: Approved design plan on file with the Board of Health shows no groundwater was encountered to a depth of 6.55 feet below the bottom of the SAS in a test pit on 3/26/2005. Town of Barnstable GIS Department records indicate that the property is over 30 feet above groundwater table. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 145 Mariner Circle Property Address Jack W. Hancock Owner Owner's Name information is Cotuit MA 02635 June 25 2010 required for , every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information — Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 N5.�UG ,� Fee THE COMMONWEALTH OF MASSACHUSETTS . Entered in computer:✓ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for 33i5pozaY *raem C on!Arurtion Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. j c,/S� j'•rl rs Pw h+p d-/'11C_- Owner's Name,Address and Tel.No.-7-iq tn e-r 14/1 tv 8f A IV Assessor's Map/Parcel a — s CA 4V Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.N . �0 36� 11��1 psh®tee CaG C04-jL4 tLn Type of Building: $U-- 70 y Dwelling No.of Bedrooms 1 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. 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) ti S U `r Iv 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 Certifi- cate of Compliance has been is e=byi H oar ealth. Signed Date 3I/G Application Approved by 2 Date 3 Application Disapproved for the following reasons Permit No. 2 V o S—1 l6 Date Issued o+ o _- 1 . , Fee�/D U- THE COMMONWEALTH OF MASSACHUSETTS Entered in computerE/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS application for nigooar *pMem Construction Permit Application.for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. j 4/S N p A j /C_ Owner's Name,Address and Tel.No:1—jq m P l N 1V H IU Assessor's Map/Parcel a 3 — s a G r �L�� 117 A/Z Installer's Name,Address,and Tel.No. ,(j� -V 7)- 017 Designer's Name,Address and Tel.N�. 5,. 7 �Zauls �xc�v �a�i;�� v /4 V-1/ 130 aak Lee G 307 U C0Y_ot4 tLb Type of Building: Dwelling No.of Bedrooms ,j Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 2 c7 gallons per day. C alculated,daily flow gallons. Plan Date _ Number of sheets Revision Date Title `f Size of Septic Tank Type of S.A.S. Description of Soil °14 Nature of Repairs or Alterations(Answer when applicable) ti t� fit. ( � O S U /u ft A-L,�, 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 Certifi- cate of Compliance has been issued by thi Board, I Health. Signed / Date, illo S Application Approved by L l� , Date Application Disapproved faY the following reasons Permit No. ?a Date Issued / S� --.------------. ----.---------- ---------- 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 h 1 a-� at I L/C— fYl►'1 11 r �j n r, h e Ile has been constructed in,accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 Gt.—//(, dated 3 3 / Installer s C v�,,� t, 1.44 1 Id r Designer r 'Q The issuance Ithis permit shall not be constt ed as a guarantee that the s em will funs lion asdesignedDate U Inspector �/�,, C — — --------------------—————— - No. /in C"— I l/- Fee r // — THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 'Wi5po5af *p! tem Construction Permit Permission is hereby granted to Construct( )Repair(__)-Upgrade( )Abandon( ) System located at I I/� d/a bi h i P h (1-I rZ C l e _ 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. Provided: Construction must be completed within three years of the date of t i ermi . Date: /f, Approved by �I e-,, r1, C �V �, - r. TOO,./ OF BA1L'`�STABLE j LOCATION .� J �'C� ,�d�� SEWAGE # a6JS VILLAGE ASSESSOR'S MAP & LOT' INSTALLER'S NAME&PHONE.NO. ; 71- SEPTIC TANK CAPACrrY /00(2 LEACHING FACILITY: hype) C 862,11 w..r � � -(size) f NO.OF BEDROOMS 7• BUILDER OR OWNER .ter ,/1 rl , PERMITDATE: 3 3 f COMPLIANCT:' DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of beaching Facility _ Feet Private Water Supply Well and Leaching Facility (If any wells exist ' on site or within 200 feet of leaching facility) — Feet &ige of Wetland and Leaching Facility(If any wetlands exist . within 300 feet of leaching facility) Feed A .,..� • III 2P l I � u ;i Town of Barnstable °BIKE ram, Regulatory Services P ti y Thomas F.Geiler,Director • BARNSTABE E. • XAS& Public Health Division q'ArFDb Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Designer: -/a/ Installer: /&11 'S Zit-WWI/ � Address: . �,�a 6A,17-1 I� Address: Xd)( //V/7 On 12ay,,S was issued a permit to install a (date) (installer) septic system at QL-cA based on a design drawn by (address) _y /�SS�C/®fps 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. _ 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. o AW tiN (Installer's Signature) d 0 VON HONE v #1068 o y F P� i a '4NI T AAUP ( esigner's Signature) (Affix Designer's Stamp 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. Q:Health/Septic/Designer Certification Form siisioi Notice: Thk Form Is To Be Used For the Repair Of Failed Septic Systems.Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, _1�/1'IG1 L. ��!✓ o/✓� �S,hereby certify that the engineered plan signed by me dated ,�_Z�'D , concerning the property located at -/ meets all of the f11I1. z3 OQl-re_l y Z following criteria:. g rtena: • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the,dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) i B) G.W. Elevation +ad' stir t for high G.W. DIFFERENCE BETWEEN A and B SIGNED : `�F DATE: �_ D NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:percexmp COMMONWEALTH OF MASSACHUSETTS -Sir EXECUTIVE OFFICE OF ENVIRONMENTAL AILJFAIRS BLE DEPARTMENT OF ENVIRd9kEN'TAL PROTECTION ?00,5 MAR 24 PM 2' 43 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION .AP Property Address: 145 Mariner Circle Cotuit MA 02635 f�M� Owner's Name: James Hannan Owner's Address: Same Date of Inspection: March 14,2005 Job#05-50 FAILED INSPECTION Name of Inspector: PATRICK M.O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD MARSTONS MILLS MA 02648 Telephone Number: 508-428-1779 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 DF.1� approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ����ti 0' •qs����i� Passes �•• s��'/ Conditionally Passes PAT Needs Further Evaluation by the Local An roving Authority Fail y '; L C' Inspector's Signature: Date: 3/14/05 �!�,�••� RTlF1���oQ�`� 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: Tank and pit full to top of structures. Leaching pit has no effective leaching. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 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. 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 year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Titles G inrnartinn Rnrm!./1 S/IMA 2 Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 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 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Titles G Tncna^t:n»Fnrm 411 ciInnn 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 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 '/2 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 I 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.] _Yes_(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. T41P S 1ncnPrtinn vnr !l1;Hann 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 145 Mariner Circle,Cotuit P Y Owner: James Hannan Date of Inspection: March 14,2005 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 Board of Health _X_ 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_ Have large volumes 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 they were 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? _X _ 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 _X_ _ Existing information. For example,a plan at the Board of Health. 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)] Titles S Tncnartinn P^—4/1 srnnnn 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): 2003—50,000 gal.2004—52,000 gal.= 139 gpd Sump pump(yes or no): No Last date of occupancy: Currently Occupied COMMERCIALANDUSTRIAL 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: Tank has never been pumped. Source of information: Owner Was system pumped as part of the inspection(yes or no): 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 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: Compliance date: 3/12/81 Were sewage odors detected when arriving at the site(yes or no): No Titla G Tncnartinn Pnr till;mnon 6 Page 7 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 BUILDING SEWER: XX (locate on site plan) Depth below grade: 1' Materials of construction:—cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: 30' Comments(on condition of joints, venting,evidence of leakage,etc.): SEPTIC TANK: XX (locate on site plan) Depth below grade: 1' Material of construction:_X_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: 8.5' long x 5.2' wide—1000 gal. Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle: - Scum thickness: 12" 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: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tank full to top of structure,structural integrity could not be verified. GREASE TRAP: No (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Titles C rno-firm 17nr AEI ci'Innn 7 Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 DING TANK: No tank must be pumped at time of inspection) (locate on site plan) TIGHT or HOLDING ( p p P 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: No (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.): PUMP CHAMBER: No (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.): Titlo S lncnarfinn Fnrm till Si�nnn 8 Page 9 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 SOIL ABSORPTION SYSTEM(SAS): XX (locate on site plan,excavation not required) If SAS not located explain why: Type _X_leaching pits,number: One 6x6 pit leaching chambers,number: 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.): Static water level is over pit cover. CESSPOOLS: No (cesspool must be pumped as part of inspection) (locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): PRIVY: No (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.): Titla C Tnonantinn Rnrm AEI;IMA 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 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. Mariner Circle Water service #145 25 Deck 42 Title S lnct%Prtinn 17nrm All S/7nnA 10 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 145 Mariner Circle,Cotuit Owner: James Hannan Date of Inspection: March 14,2005 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water 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) Accessed USGS database-explain: You must describe how you established the high ground water elevation: A perc test will be performed prior to repair to determine groundwater elevation. Titla G Tnonartinn Rnrm All V100n 1 1 ter '.SOWNI OF BI AJI `�STR.BLE n LOCATION .� � r�Iri n 7 � SEWAGE # P-bVJ "'_/4 '• ,i:i VIL.s.AGE— G+ d� -� 'C "PJ1 1 ASSESSOR'S MAP & LOTI�i Z ' INSTALLER'S NAME&PHONE NO. y� �s .+CA R/afi,T Vo -�/��-�l ` �2— SEPUC TANK CAPACITY LEACHING FACILITY: (type) C 10"1 e-r5 . (size) K NO. OF BEDROOMS M- BUILDER OR OWNER �t ffq /?l`'lj, PERMITDATE: 313, COMPLIANCE DA-It- Separation Distance Between the: `"I Maximum i d usted Groundwater Table to the Bottom of Leaching Facility __ __ Felt I'rivate.Water Supply Well and Leaching Facility (If any wells exist xEr do site or within200 feet of leaching,f cility) _: -- Feet` Y ge of Wetland and Leaching Facility(If arty wetlands exists.'•� 3 � r v ifhin 300 feet of leaching facility) ree k lmnlstl�d; ;. � I a e""` 2960 / LQjCATION SEWAGE PERMIT NO. H lLAGE I N S T A LLER'S NAME i ADDRESS , s r;® UILDER OR OWNER 17�N/i/(S S 7`f}/r Caiv S%/?�G�-/��✓ C'a�'/�a/?,�7`/oAli DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED r r✓ rtlec c ........ .. ..... Fms.............................. THE COMMONWEALTH OF MASSACHUSETTS ,�- BOAR® OF H ALTH 3�3'�L / .... . V.......-------------OF..... p ...... ....... ........... Appliration for Disposal Works Tonstrur#iun Vautit 13U�` Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at, Locatio ddress j, or t .. ..... .._ :. Y -.__..�{.�------------------ -•....• ..----------.............._..---- Owner � ress W ••• ........... ••- .... �.. .............. '............-•--•-----........----...--------••-•-•-•--•-•---..................................... a �� Installer Address �. Type of Building Size Lot__D�6_�� Sq. feet .......... U Dwelling—No. of Bedroo Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Buildin a yp g ........................................................... No. of.persons...........�O............ Showers ( ) — Cafeteria ( ) Otherfixtures .................•-•------ ----•- ------•-•--••••-------•---•------•--•----•-•----•- .............................................................. Design Flow............... .............gallons per person per day. Total daily flow.........0...................gallons. WSeptic Tank—Liquid capacitylMb.gallons Length.��?._l9__. Width._S........ Diameter................ Depth................ x Disposal Trench—No.................... Width.................... Total Length.....................Total leaching area....._ Seepage Pit No.........../........ Diameter........y/.--- Depth below inlet................ Total leaching area.S. .`;q. ft. Z Other Distribution box (`) Dosing tJ ) / ~' Percolation Test Results/ Performed by.._. 4(..................... ................................. Date_._�1__,= .? Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water--_Z�w rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water... � a O Description of Soil... x ------•-------------------•-----• .. .. ._ .._.. -- - - - - ... -U x . ---•-•--- --- . •--- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ...-•-•--•-------------•-----------------------------------------...-------------------------------••--••-••.--•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI1 5 of the State Sanitary Code—The undersigAed further agrees not to place the system in operation until a Certificate of Compliance h*beenssued by the b d of h lt' �Sig Date Application Approved BY ..... �-' `2 /......................aret�----- Applica.tion Disapproved for the following reasons-------------------------------••••••-•--•--------•---••------•-----------•••••••--••--•---•••-•--............._ ------••------------•..............................•----------------....--------•--•-•---......-----......--------------....-----•----------------------------------------------------------••----•••---- Date PermitNo......................................................... Issued........................................................ Date rAptd �5 --' No......... D �•_ r FIMs......3............... THE COMMONWEALTH OF MASSACHUSETTS ,�.-- BOAR®OF H ALTH t. �� ....... O F........ .. - y-. = Appliratiun for Disposal Works Tunstruriiun Prrmit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: .. ........._ ...._................ ... ....................... ..... ...- - • .....-----... "..r ll')) � Locatio2ye'.kddress,,//�� ` -- or Lot No. /f ...::....................GLl4J/�G.. ._` ._._._..._._._... \...... ....••.......................... == '_.. Installer Address U Type of Building Size Lot_.=-G .... feet Dwelling—No. of Bedrooms.........._J___..-_---•--_-___-.-.•__--___-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ..... No. of persons...........�Q_..--------- Showers ( ) — Cafeteria ( ) Otherfixtures •-------•----•----------• .............................................................. Design Flow................ _�._.................gallons per person per day. Total daily flow---- ......3., 0...................gallons. 9 Septic Tank—Liquid'capacity.l� ?.gallons Length_f ..f"... Width..." ---..... Diameter-______-•__...-. Depth................ Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area..... �J........... Total leaching area.: .._-/---6q. ft. Seepage Pit No............�....... Diameter.._...._ ..... Depth below inlet.... Z Other Distribution box (�)L Dosing t nk ( ) a Percolation Test Results Performed by----- ..................................................... ----- Date_......--•-.....?---.---�.....----- Test Pit No. 1................minutes pej inch Depth of Test Pit-------------------- Depth to ground water...t ...r:-!,� (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....... . _ x = Description of Soil.... ___� �"-%...... %P;i - /L��- --7�'-�11/f(`�---'r-f'!21 LG =-- ----••-----•----•-•••• •-• :;_-=------------ -- ------ U Nature of Repairs or Alterations—Answer when applicable................................................................................................ -------------------•--------•------••-----•---•-•------------------•-------------------•----------------•-------•----•------------...--------•---------•---------.........._•----------.............---• Agreement: The undersigned agrees t9,,4ilstall the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 ofjhe State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate oflCompliance has been,issued by the^board of health. Sig =-'..' --------'......... ....' ate Application Approved By....... ----f------•-- "_¢ Date Application Disapproved for the following reasons:--•.............•-•-----••-----•----.......-----.....---•••------•---•-•-----------•----•• ----........_ .....................•-----•-•-•--•---------•-----------------------.::.....---•-•--------•--•--..........--------------•-------•--•------••-•-----------------•---------•-----•----•---•.........--•--- Date PermitNo.......................................................... Issued....................................................... Date THE,,COMMONWEALTH OF MASSACHUSETTS BOARD�OF HEA TH a.. 1�� ..........0F..../��.fl' 'j !...: ........... .............................. Trrtif irtt#r l� , Tl mpliattrr THIS IS T4-CERTIFY, That they Individual Sewage Disposal System constructed O or Repaired ( ) 1 0 1 tt c.c �( -L ' :t..�..........................------- --------------------------------------------------------------------------------------- ,1 nstaller has been installed in accordance with the provisions of T ;�Af�he State Sanitary Cc)(� asksQri*Vn the application for Disposal Works Construction Permit No......................................... dated....../......................................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................... ......�71----....................................... Inspector_...._ :...--•---•-•---------.._......=---•------...--•--------•-----•----••--•--- THE COMMONWEALTH OF MASSACHUSETTS ( BOARD OF HEALTH fff 7Q�/ :'.4 !� .............OF......t.;.. .. 'f .. °` '....................... No......................... '' FEE........................ Disposalurk�- �un� tir�iu � r �nii# ,� Permission is hereby granted... , _... �-....=.�`_ ............. ...�`.! � ...._�- .................................. to Construct ()<, ) or Repair ( ) an Individual Sewage Disposal ysteiii -� Stree as shown on the application for Disposal Works Construction Pe 0.... ......... . ed......_................................... ........................................................ ............... -^ ( Board of Health ; DATE.------ ..................... "t-" FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS No............7 7d FIns............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .......... .....O F.......& AA............................................ Application for UiipnuFal Works Tnnitrurtiun Frrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: ' ocatio :Address or t No. .._ _. f ..._..----- ....... .-- ... ......... .••--• -..........------------------ ---------- r, d ress ---------------- ---------- ---------- ....... -..-------- ...........--..--------..---------..----•----..-.-..-.------.--------------- Installer Address UType of Building Size Lot.,c .�®o......Sq. feet Dwelling—No. of Bedrooms__-.......--�------_ ---__--_-.Expansion ttic ( ) Garbage Grinder ( ) pa, Other—Type of Building ��'�h%C�iG°! No. of persons--------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ....................... W Design Flow............. ...................gallons per person per day. Total dail flow.......r9.-AQ........................gallons. WSeptic Tank—Liquid capacity./100 dgallons Length..ff." . Width.#' �._ Diameter................ Depth......_......... x Disposal Trench—No..................... Width.................... Total Length................ Total leaching area....................sq. ft. Seepage Pit No--------I.......... Diameter......9-_-__._._. Depth below inlet...�,�.3...._.__ Total leaching area..................sq. ft. Z Other Distribution box (/) Dosing ( ) a Pe colattion Test Results Performed by tank Date.. ............... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..;��'---- fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •••-----•-••-•-------------•----....---.....-------- •..............---•---•----........................................................ O Description of Soil...:Q.-.dlt. ........&: 30"---....- --- ---- -------------------- -------------------- ---- -------------------------- --------------- x ----•-•--•-•-------------------3P----JWX----------; -.-� --- ' - - - - - ------------------------------------------------------------------...........--------------------------- V Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i1Tl LT. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b issuedhe oared of oealth. r, �? . N g .4. ........................................................ ... l Date Application Approved By.......... G��IIJ � ,�_, -,��.? ....... .......... ... .. .. .. ...� +J�._-C._...........__._.. Application Disapproved for the following reasons:__..... ..........................•••..........••....•-•--•............_.._..Date......--•----- ---------------------------------------------•-------••••-----....--••-••--------.....••------------•••-.-------•-----•----••-••----•••-----••-•--•------------•-------••-----------••••--•-----••--••-- / ,,p Date Permit No......................................................... Issued•-- .l'__'Z`._� 1 ..---- Date No......... ............ Fps............._............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....../G!J�......................OF..... (r'•tICSYjQ ?.!. ............................................. Applirtation for Disposal Marko Tom4.rnrtiun 1hrmit Application is hereby made for a Permit to Construct (� or Repair ( ) an Individual Sewage Disposal System at: 7 /7 ' f ,t .......... �fi�.C. .... ;cG�' / . f1 Loca or Lot No. �ddss •.............. ........•�.....�. .. --. `/y --...... :. --------•--- F �-•�/ /� ©wne� .> lt-�t•'�r�G'v""�'t-`Address ---_-•....... ............ --......_.... .........._............_....-^--• � - Installer Address Type of Building Size Lot._.9 G..�M(.......Sq. feet 1-, Dwelling—No. of Bedrooms............ ...........................Expansion Attic ( ) Garbage Grinder ( ) a aOther—Type of Building �i�_-____ No. of persons.........f_______________ Showers ( ) — Cafeteria ( ) Otherfixtures .._.... --------------•------------•---......---------------•--•--------------------•-----------------.....-••--•-•.....------•-••_----- W Design Flow.......... ........................gallons per person per day. Total daily flow........:: jc�........................gallons. WSeptic Tank—Liquid*capacityA�aj gallons Length__.._f2�f`_. Width'..,(n...... Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........1.......... Diameter...... ....... Depth below inlet._;............. Total leaching area..................sq. ft. Z Other Distribution box (r ) Dosing tank ( ) i aPercolation Test Results Performed by........ .......:2� ........... Date_ ..... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water.. • - _. Gr.1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ---•-------------•--•--------•..._..............----•---......•--------............_•---•-------------..__.....------........_----......_..._-•-•------_----- O Description of Soil...(^................................... e /, _____ v ...................................!_2. ;G ....-J'� /� ti-E'--.......-__---... ..._......-----------------......----.........- -...- - --- ----- -r - ----------------------------- �'t'= -1��r.�_.._....._ 1f U Nature of Repairs or Alterations—Answer when applicable............................................................................................ ----------------------------•--------------------...-------•------......----------------....---------------.....--------------------....---------------•-----------------------------._...--•--.....---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT:., -5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued b,, the board of health. Si 111/2 Gy g r �......----•.................... Date Application Approved By----- �" ' . =. .� ' ` �' .. Date Application Disapproved for the following reasons: -•----••--•.......................•--•--...---•------------•••-•---•-------._.....---...... ............................................................... ------ -•-------•------------------ 'k4 ......... ••---•......--•--•................. —--•--------- Date Permit No......................................................... Issued.:_.—_�.. � v Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH/ ..... ................ OF..... ... .}................................................................ (In ifirate of TuntpliFana 2 THIS IS TO &.6-RTIFY, That the Individual Sewage Disposal System constructed (jf) or Repaired ( ) - Installer at.......... /a /_ ilr'il ,c.b-= / fit/4_ is-:! has been installed in accordance with the provisions of TI"' S 5 of The State Sanitary Code as described in the application for Nsposal Works Construction Permit No.___Tr_._...7.?Gft_......_ ................. THE ISSUANCE OF THIS.,CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ' __-� .............................. Insp&tor..../,-.. �lG,rGIG THE.COMMONWEALTH OF MASSACHUSETTS DZ ...�, ,�• i BOARD OF HEALTH ..OF............ a .• ........ .......... dN • -- FEE. :- ..... .... �i��rr�tt1 nrk� �nn��ra�#ilan �ernti� Permission is hereby granted........1 •�"........�...... . a' c� ............................................................ to Construct. (X or Repair ( ) an Individual Sewage Disposal System dui . GPiit � l Street as shown on the application for Disposal Works Construction Pe -t No.�.. __.___ Dated.._l ._-3_.`.�'k............ . . .f Board of Health -�--------�••-•-•----•••� '"� DATE........ .r FORM 1255 HOBBS & WARREN, INC... PUBLISHERS lq TI.ON SEWAGE PERMIT NO. Lv VILLAGE �r /*, oa m Pt IN A LLER'S N ME ADDRESS R OIL E R 0 OWNER DATE PERMIT. ISSUED la - �d7y DATE COMPLIANCE ISSUED da,/ - � � ..�+ lA� I �a � � � �, � �� _. .� � �� ��" �/�-3 - , . r NOTE: Hatch door to be created in Provide Riser over D-box NOTE: To prevent breakout,final grade-of t l k t deco access outlet cover of Top of Foundation to within 6°of finish grade 98.5 to be carried.out a minimum 15' EL:102.98 existing septic tank per BOH. F.G.EL:101.Of beyond edge of leach facility. F.G.EL:101.5t F.G.EL:101.45t I ( ng) ��-- Maintain Min.2%slope over leach facility F.G.EL:101.0 Install risers w/covers o er inlet Min. 1 Inspection Port 12°To Grade E>asting &outlet to within 6"of fin h grade Min. 2" 1/8" i/2"Washed Stone EL 100.14 4 SCH 40 PVC L=20" L=5'(MAJ� 3/4" 1 1/2"Washed Ston 98.5(TOP OF PEASTONE) fl+ 6- 4"SCH 40 PVC 4"SCH 40 PVC 0 S=8.6%(2%M �o j4• @ S=13%(1R'oMIN.) s S=12%(0.5%MIN.) EL•99.03 EL=98.6 • - iv Install Gas Baffle fl a.. EL=98.77 EL.98.0 96.0 EL:99.28 PROPOSED D" 3 H-10'DISTRIBUTION BOX Use 3 Infiltrator 3050's with double washed stone NOTE Contractor to confirm (Install Inlet&Outlet Tees) 4'ends,3 sides 6.55' minimum 1000 gal.septic tank. EXISTING 1000 GAL Replace with min. 1500 gad.tank if H-10 SEPTIC TANK (30'Lx Loa A minimum of x 2'D) * Loading undersized or damaged. SEPTIC SYSTEM PROFILE H 20 5'of suitable soil EL.89.45 below leach Bottom ofTH-1 facility on location SOIL LOG N.T.s. of system to be confirmed attime w.a of construction. SOIL EVALUATOR: AMY VON HONE,R.S. DESIGN CRITERIA INSPECTOR: UNWITNESSED DATE: MARCH 26,20059:00AM ADDITIONAL NOTES PERCOLATION RATE: <2 MIN/INCH Number of Bedrooms: Existing 2 Bedrooms, Design for 3 Soil Type: CLASS I TP - 1 TP - 2 1. Contractor to confim soil suitability prior to installation. Contact BOH/Design Design Percolation Rate: 2 MIN./IN. EL.101.45 Sanitarian in the event of varying soils from original soil test. Daily Flow: 330 G.P.D. Design Flow: 330 G.P.D.(MIN. REQ'D) Sandy Loam 2. Pump and remove failed leach pit and all contaminated soil with 5'of proposed leach Garbage Grinder: NO 10YR3/2 facility. Leaching Area Required: (330)/0.74=446 S.F. 6^ 100.95 B 3. Final grade over proposed leach facility to maintain a maximum 3'of cover. Septic Tank Required: 1000 GALLON(Existing) Sandy Loam 4. Access hatchway to be created over outlet cover of septic tank located under deck per 10YR5/8 Board of Health. USE 3 INFILTRATOR 3050S WITH DOUBLE WASHED STONE: 36" 98.45 44'ON ENDS, 3'ON SIDES (30'X 10'X 2') Perc FLOOR PLANS Sidewall Area: 4(30'+10')= 160.0 S.F. C1 Bottom Area: 30'X 10'=300.0 S.F. 60. Medium Sand 2.5Y6/3 "'T'S' Total Area: 460.0 S.F. 1/2 Design Flow Provided: 0.74(460.0 S.F.)=340.4 G.P.D. Bed 1 Batt Living Porch Room Garage v H SITE AND SEWAGE PLAN 144" 89.45 Bed Batt Den associates PERC RATE:<2MI ("Cl" itchen 320Cotul Road LOCATION: 145 MARINER CIRCLE, B N/IN.(C1"Horizon) ARNSTABLE, MA (24 gallons in 6:52 minutes) SanndWd+,MA 02563 Family W8.&30041 PREPARED Ron's Excavating/Hannan No Groundwater Encountered Room Surveying by: FOR: DATE: 03 28 05 NOTE:Contractor to verify consistency of soils in location Teny A. Warner P.L.S. -- of primary S.A.S. compared with location of 22 Long Road Test Pit prior to installation. Horwich. MA 02645 -� 2 0¢ 2 (5D8) 432-a309 SHEET N0. f • r LOCUS ASSESSOR'S MAP: 23 GENERAL NOTES: a PARCEL: 52 o Ro a 28 1. VERTICAL DATUM: ASSUMED REFERENCE: Tube 167 r 2. MUNICIPAL WATER i-q_AVAILABLE. o FLOOD ZONE: C Town of Barnstable #2500010021 D (7/2/92) TGBF 3. SCHEDULE 40 PVC PIPE TO BE USED THROUGHOUT SYSTEM UNLESS OTHERWSE NOTED. ? Moori Dr. Zs� 4. ALL RECAST UNIITS 0 CONFORM TO Mari er Circle a AASHTO: H-10 & H-20 5. PIPE PITCH-1/4"PER FOOT UNLESS OTHERWISE NOTED. o0 0� H 6. ALL CONSTRUCTION DETAILS TO BE IN CONFORMANCE WITH MA ~ do ENVIR.CODE(TITLE V)AND LOCAL REGULATIONS. LOCUS MAP N.T.S. i' + + �P� 7. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR TO PK/SET ' I � CONSTRUCTION. 100,00 I LEGEND S 37°,31'07" E - o � Q\ �'-- 9y -1- PROPOSED CONTOUR 1 10.00' NOTE:This plan is to be used for septic 99 PROPOSED SPOT GRADE m tioo tioo system purposes ONLY and IS NOT to be — 40 EXISTING CONTOUR / I + + I considered a property line survey. -30.23 EXISTING SPOT GRADE I 10 / 1 , 5 2 1 TEST PIT I EXISTING WATER SERVICE ........... + / 1 cb I. .,..,.:. :.UU� I r o ....... t _ A M 40. Garage 00 0 AM(Slab) M Ss nt TER R Y+ �nP VONHONE 0 #106 WARNER 8 0oo No.3872111 Space too N 6b LO �—'24' 2 _ ,'— NOTE-..Pump and remove failed leach, ccn 1 I _..:: I ,, ,; 1 j !- `� pit if located within 5'of proposed lbv 1 NOTE:;lIatch door - , ,OP `each facility. r I C•,) o to be created over p pti 1 3/ 2 � l W 1 0 Lci existinioutlet tank `.. 10 i z i c°00v cover in'1deck for #145 'Existing Tank ,' 0 86 , �q 1 N TOF=102.98 to remain access. / I Ln (Assumed) I z I (Full Fnd.) SEPTICSCOV Lot 46 0 �o�`' a� 20,000±'S.F. moo/ v DATE: HEALTH AGENT: e TH-1 ,' 2� 0.46± AC. + ' I ��� �� moo Parcel52 Q SITE AND SEWAGE PLAN LO V H CR 60 � O'er' pti- � �` I C-4 N Ili 4 LOCATION: 145 MARINER CIRCLE I ci a i i1 ti�0�. BENCHMARK SET: o C associates o o Left corner bulkhead + i ti`Z , ,� z sEPRCSYSTEMDESIGNS BARNSTABLE, MA (c L � II , EL. 102.34 {ASSUMED) o~. � � ti i .320 Coon Road Lu � x 10 20 -f/ 0 Q SanMeh,AM 025M PREPARED Ron s Excavating °�;e \\-----------�59----- 160.00' ti° 0o soa.sUooas FOR: James Hannan qO) 81 ��� ————— + ti Surveying by SCALE: 1" = 20' N 37°31'07"W Terry A. �P.L.s DATE: 03/28/05 Scale: 1"=20' "(5W)' 2 02 1 of 2 t�� �2-Wa9 SHEET N0. . . t 'Y. 9 rq + F.. FL. ELEV.= - - — -- FINISH GRADE = �f {{._ FFINISH GRADE FINISH GRADE -- TOP OF FOUND. OVER TANK = 6-OV42 OVER PIT ELEV. ;' • 4�� r ��✓ Y•' `C CHIMNEY BLOCK C.I. 4• V C „ \ wNERE NEEOEo BACKFILL --+� 3" PEASTONE DWE.LLIN r q _V.CJ _ 2 YZS y i 0 o a a 0 O o �° b—_ O O OGALONCELLAR FLOOR a �' 3/4" TO I-I/2" ELEV._ 11425 REINFORCED GONG. d 4 o O (J O o �' CRUSHED STONE ASo P ' it In o O O O o 10v' D DIST. ''' c o O O o o ° � , • 1 • •+ BOX 0% O O O O O � I, � ne v • •. o 0 Q 0 o SEPTIC TANK p- ( TO BE LEVEL v Io o n Q O o 09 BOTTOM OF PIT AND STABLE ) , ° O O Q O o 5� 50 r - i �, �. SYSTEM PROFILE � N 0 T ro cA, t { 7 LEACHING PiT DESIGN CRITERIA -w� L ,3 T- 4 NUMBER OF BEDROOMS G A:- u N S PER DAY GARBAGE GRINDER TOTAL %AILY FLOW _.. _..��?_- .��' 0 LEACHING AREA PR0V7DED =-___-__J' c'�5 r-liPC2___ a ► '!EtiV'.o,a..t.. .b►4'w'.A• " LK'TT re{w-7-ts+ it -L uPL> n N W.- '5'50 bPO 05 n 5 a Pi.% 6f 1`t SOILS__ LOG ' � z..c -fl„ •..�K v _-- ,,, p.! • ONELEV. -- �► I PIT `sra L©T 12 Za. PROPOSED SEWAGE DISPOSAL SYSTEM �a ca `�'�•Tom. :l�•l►)Gc�{.a R„� �,.+� of '& PyC,. r�.t,•1A_7 + nth y E?�tN OF M c� PROPOSED DWELLING tN!3R�GTEO taYs � ca Sq ; NpRMaN r MASS. NOS DATE ��,', Gkoss#RAff v, .g GROSSM C c• tliftG L.A tON RATE �+ ' ¢!v IF, f ��G S AGF AS NOTED - DATE �._ _ __ _ _ _ �s Vi1�T't4T.�!'� lE�� MY!lyt. �+�.'T'v#.it Ana sua'I`Ic�` �����r0;�t;~ te��'���.• -• �t�LtJ ��•f1�7,e�a:��'�aAJ �✓ C"10.3 Vt^04 _-Tufts 1(.-7 1544 EFT KI0 , -a t 24 ,; ,• "`„ "'!r ►ram � ��:� _ I NORMAN GROSSMAN PE, R.L.S. '' �Nr.ar►:�4 �•Ssy air. ' ., �.�" �`��'• /�"T'C3 ,. �;*- ---�• �� 226 HOLLY Y POINT ROAD CENTERVILLE, MASS. sE Y4 ', p-•ffiITR.3" #• �' r•�' . y 4 r .t J «t ' _ ^I t t i ; ~�• � ---- - - - _ �;��� � `'J A.�� �:�.E�/ S�-�c��,�/►.� A2� MEn..J SEA �.��/E� -� _� � go•�E t� o r-1 V S C � Gi .5 vaT�►.-� DL�.►.l E �♦ -- ---- - --1�____ V- ZO"'-' PtTGN /�L� Ld►J ES p. Mt d kj t Nt L) � OF • / -. \ ��\ - - - L)r.1 L.CS'S Cn'�E�>�S E �f'E.Gt F=t��. PE S TO J►J O t tit T A,L_� Pt (J� 5ti STEM S µA,i_.l_ _ , ` � \ `� � - ---------- - - - - --- _- - �E GAST t M21J►,..� c� SC��DUL.E AO P �/.G . O � � � C� � AFL 3EPT�C TAd.11CS, C��'ST2t8JT►,p►J Box , At•�0 ___ ++ l�E I.0+-i►►.-16r P� S N A•L L aE �ES�G-r+.�E� F^02 -,• "i� tv .. - I � C� (on - 2.0 �../+•�EE:1_._ L p,s.fl►►J C-�S - - - - - - --- ® 5 sz�MvJE Aug vr.lSvdra�.� MA,TEiz�aUrJtt.s�.Tl { - � ,r -- �J J ® © �(J ® Tj-iE tw��/E2r EL-EVATto►3S OF UEAC141� Pr(S Fob _ COD - i S o A *�uS o s Agor�F w tTN Ct.,�y ;• s _ GO � ® - - nT E -- {. I�TO o U �Q� T`-4E B�`'' ►.1Tr: t�s� I-- N�.�.�TH MUST a 4'>� NCST-1 1~d E W h4El�J T�i� ��iS� E►"� lS N EAit. O/� O! 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O I&S E$ /o T"t o ► Z r -, (y C T lJ t T C C r- T ``€� j N�ASS. ��1�•�'-') I H.�F71 {`� r-_`-� -Ay 1�1.7�!d t���� `7 t- � y•�.' � i_� � - r � .� S C A,(AF A'S � O rJc. Fq 510M WALL AirL A � _f �.�rr • ti• 'r r,t�l.,� * d L vs. 1 5 C x A. vI ttiJ E i� . I7 1.1 . it t /4 h,l Co , 1,,,,,o�"' Nam... i, `f) Sc, C, P v i' - " ,6 :;r.� •�, rf,__ ; ., nc,r� E tJ Cc t►.,1�E�' i'.1 OQ M�.t� <�k?OSS►k"1 Att...S, Q E.. .J -`f-. ! f "7 �, `"` Cry