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HomeMy WebLinkAbout0183 MARINER CIRCLE - Health 183 MARINERS CIRCLE, COTUIT ; :J Town of Barnstable P# C-9�W Department of Regulatory Services Public Health Division Date l� 200 Main Street,Hyannis MA 02601 hq Date Scheduled G / Time Fee Pd. CJ CJ Soil Suitability Assessment fortBy: age Disposa Performed By: t/yl 'f r,0A M . mtqef- Witnessed LOCATION& GENERAL INFORMATION Location Address Owner's Name 1-1 599 Address Assessor's Map/Parcel: ��- l�-� Engineer's Name NEW CONSTRUCTION REPAIR Telephone# ) Land Use BSI EJ-P--rt A'2-" Slopes(35) Surface Stonesi� Distances from: Open Water Body ft Possible Wet Area `=ft Drinking Water Well ft Drainage Way ft Property Line 6 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlandsin proximity to holes) 9� r_J Pt Parent material(geologic) &OTWAS Depth to Bedrock Depth to Groundwater. Standing Water in Hole: f-IJ ID �- Weeping from Pit Face Estimated Seasonal High Groundwater t j �.:.� DETERMINATION FOR SEASONAL HIGH WATER TABLE _ ..7., _~ µ y Method Used: Depth Observed standing in obs.hole: _ _ in, Depth to soil moulds: Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level ..,, Adj,factor— Adj,GroundwatWLovel,, PERCOLATION TEST Ditto 5 /Thne..� Observation i Hole# ( Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ ? �7 'lime(9"41) End Pre-soak Rate MinJloch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) 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:\.SEPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. onsistency.%Gravel) D I- mk_ 4'5,P4,0 2.- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o si ten % rave lb q 12, DEEP O SERVATION HOLE LOG Hole# ALIA Depth from Soil HorizonN Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Oravel) DEEP OBSER TION HOLE LOG Hole# Depth from Soil Horizon Sot exture Soil Color Soil Other Surface(in.) (US ) (Munsell) Mottling (Structure,Stones;Boulders. Consistency. Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes , Within 500 year boundary No= Yes Within 100 year flood boundary No._ Yes _ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pe ious material? Certification I j) IGi I certify that on l (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 r uired tra ertise a e peri c cribed in 310 CMR 15.017 eq Si nature U. Date g c� �� y - Q:\,S.EFTICIPERCFORM.DOC f - COMMONWEALTH OF MASSACHUSETTS ExECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292.5500 TRUDT COKr, Secretary :;;GEO PAUL CELL UCCI DAVID B STRU ; Q error Contnussione: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION C i'rupc•sty Address: \83 1�t�t2,��Z�.rc`.c Name of Owner Co �v \� t q Addres3 of Owner: Date of Inspection: NoQ , i Name of Inspector: (Please Prirrt)2"cr 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Ma,Ting Address: '1 Telephone Number: 5 c&Q; {J —S.�1 i CERTIFICATION STATEMENT certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate send complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and ,i.aintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date: I he System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)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 original should be sent to ttre s(stern owner and copies sent to the buyer, if applicable, and the approving authority. r,vLS AND COMMENTS _ s�cc,\ C-) c•" �� v\��, G Sv lac. __V'� R1 O 9/2 j 9 B Page I of I I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A (CERTIFICATION (continued) •ope ty Address: I �i1e C C- _ C� •'�l .wner: G A� So 1 zC-1- Date of Inspection: x �� l C�-C INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 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. 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, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is 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 complying septic tank as approved by the Board of Health. 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 revised 9/2/98 P2ge2ofII I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Gat-t Ste. zC- Date of ksspection: I�l0� Ito �c�_C 1� 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 IN ACCORDANCE WITH 310 CMR 15.303(1)(b)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 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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has aseptic tank and soil absorption system and the SAS 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...press nce.of ammonia nitrogen and nitrate nitrogen is.equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: G Ac l Ste 7Z-0. Date of Inspection: D. SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: I have determined that one or more of the following failure conditions exist as described 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. Yes' No 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. �( 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 112 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. _ V// Any portion of a cesspool or privy is within a Zone I of a public well. J Any portion of a cesspool or privy is within 50 feet of a private water supply well. v 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: 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: The system serves a facility with a design flow of 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: 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 P2ge4ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. __Z' _ None of the system components have been pumped4orat least two weeks and-the system has beerr 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. _ The 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. _ All system components, eare4ndirfg the Soil Absorption System, have been located on the site. 1NC1�'S,^-S r 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. For example, Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)I _ The facility owner (and occupants,if different from owner) were provided with information on the proper maintenanceof SubSurface Disposal Systems. revised 9/2/98 P;Ige5ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION :property Address: Owner: Date of Inspection: FLOW CONDMONS RESIDENTIAL: Design flow: g.p.d./bedroom. Number of bedrooms(design):_ Number of bedrooms (actual): Total DESIGN flow Number of current residents: Garbage grinder(yes or no):_�,o Laundry(separate system) (yes or no):/-'0; If yes, separate inspection.required Laundry system inspected (yes or no) Seasonal use (yes or no):Nd Water meter readings,if available (last two year's usage (gpd): Sump Pump (yes or no):No Last date of occupancy: O n o ^S C O M M ER CIA LR N D U S TR IA L: Type of establishment: Design flow: gpd l Based on 15.203) Basis of design flow 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 part of inspection: (yes or no) iYO If yes, volume pumped: gallons 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) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed(if known)and source of information: �` / (�QAe/� �u` Rc cv2,)S Sewage odors detected when arriving at the site: (yes or no) revised 9/2/98 P2ge6ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: k 8 heat ;���� C����� — C�. . Owner: G A�z s o.,ZC Date of Inspection: BUILDING SEWER: Locate on site Ian) ( P Depth below grade:_ Y Material of construction:_cast iron_40 PVC other (explain) Distance from private water supply well or suction line Aelllq Diameter Comments: (condition of joints, venting, evidence of leakage,-etc.) SEPTIC TANK:_ (locate on site plan) Depth below grade: Material of construction:_concrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal, list age_ Wage confirmed by Certificate of Compliance_ (Yes/No) Dimensions: CR rg , Z- /0 ,r Sludge depth: i0'/ f�ti Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Sii 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 dimensions were determined: /�CAJ�i F�r�STrtq 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.) R(fCuM Ill y» /-6 -K-, i7�L�ri1/Arirc.e(l GREASE TRAP: /1/ (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: (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.) revised 9/2/98 Page 7ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C b 1 SYSTEMu � INFORMATION (continued)Property Property Address: O 3 M R��r�cr-j �;,r ' `o l Owner: �� So zC�- Date of Inspection: l�(o a6, TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or 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 Alarm level: Alarm in working order: Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:Jz— (locate on site plan) Depth of liquid level above outlet invert: �—�vc•A Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) - - 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.) revised 9/2/98 PaReBof It SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) -roperty Address: �� VA roc J C,'C\, — Cc�l� \ Owner: G�� S,Z_c` Date of Inspection: a�J \4':�L ct SOIL ABSORPTION SYSTEM(SAS):_ (locate on site plan,if possible;excavation not required, location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number:_ leaching trenches,number, length: leaching fields, number, dimensions: overflow cesspool, number:_ Alternative system: Name of Technology: Comments: Inote condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.) CESSPOOLS:_ (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 (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.) revised 9/2/98 Page 9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of Inspection: . _a� �C CC SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) i ,1 I Uv\R C� 30 `l revised 9/2/98 P2ge10ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ��11 Ownef: Date of Inspection: NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater 4�2 FeetrO� Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site (Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators, installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) 013 1" t�Prk, ;Z�c - 'YNA� revised 9/2/98 P2ge II of II 9-No. C9 G �. f—+� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes applitation for Disposal �*pstrm tonstrurtion permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. !f6 S MA Kt}!p-p- e 1 p.0 Owner's Name,Address,amtTel.No. Assessor's Map/Parcel 24 LPOA A f_ 0-DTV 1T �� (8 5 �t�:a� i-C;J C Installer's Name,Address,and Tel.No. Designer's Name,Address,an Tel.No._ T.D�T%6y, 24**, A-5 j): e k-p-/,66S�Z71 110 Type of Building: Dwelling No.of Bedrooms 13 Lot Size 2Q sq.ft. Garbage Grinder(t-rg Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �J ZS gpd Design flow provided IS A IA gpd Plan Date --1 �j 7- 11 Number of sheets ?I Revision Date Title Zkkgp , L Size of Septic Tank tCW 1!2.4-)-_ Type of S.A.S. "� �AC� L, t) Description of Soila��H 5 P Nature of Repairs or Alterations(Answer when applicable) �//��./ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o,bHealth. Signed Date a1 V"/_7- �j Application Approved by Date _} Application Disapproved by Date for the following reasons Permit No. ;?o f" ov Date Issued No. AA l Fee I �. THE COMMONWEALTH OF MASSACHUS&TTS Eiiteredincomputer: Yes PUBLIC HEALTH DIVISION"-s-TOWN OF�BARNSTABLE, MASSACHUSETTS Zpplication for Vsposal Opsteftt'CoI[strihioni rmit Application for a Permit to Construct( ) Repair(K Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. a ti�pJ 1Z. C 1 P-Ct Owner's Name,-Address,aril Tel.No. e tJF4 �v'vv1 t { Assessor's Map/Parcel 2 4 D, y .. 6 Installer's Name;"Address,and Tel.No. K Designer's Name,Address an Tel.No. , ham."i o� v Lf lta,k6 r T 6 e. A .Cl Type of Building: DwellingA No.ofr drooms Lot Size '9Q, l 'a -•sq.ft. G'arbage.Grinder(top Other Type of Building No.of Persons, _ ? how ( ) Cafeteria( ") �. Other ixtures -Design Flow(min.required) ZS gpd Design flow provided 3 r gpd Plan Date QQ 2 1 Number•of sheets -Revision Date Tit! ? a.J 5 Size o eptic Tank 1 CX OzV, 1'4. Type of S.A.S. Description of Soil • Nature of Repac or Alt ions(Answer when applicable) -� q/� /7�c / l�t_�,// , , f =' / __ • .i �-y Date last inspected: Agreement: t 1 The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system ins., accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of �.�,r !• * ..-..«."^.-err-.....v-. ... Compliance hasbeeri issued by this Board o ealth. r M Signed _ Date L,A.I r- Application Approved by Date - } Application Disapproved by t Date ' for the following reasons '' r Permit No. go �� " �ap Date Issued y THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS wp' Certificate ofgti mpfiante ( THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(1 9j Repaired( ' Upgraded Abandoned( )by 's v 7 , z , at KbS MR5Ur4g4&= C•t q_ , has been constructeclin'a'ccor8ance (' with the provisions of Title 5 and the for Disposal System Construction Permit No.aZ G dated .��-I� -gated nc yC Designer / #bedrooms Approved deign i'oi 1 � gpd ' The issuance of this permi hall no be construed as a guarantee that the system will i �; e gned. Date Inspector .P . .. ----- --------------------- ---- -`------- - -------------�---------------------- ------ --------------------Fee No. �---- . . � a� THE COMMONWEALTH OF MASSACHUSETTS PUBLICPHE�I;TH DIISIUN­ BARNST2�BLE;MSACHUSETTS 8is osa� pstem-Construction i3ermit ' Permission is hereby granted to onstruct( ) Repair(f�'j°" Upgrade( ) Abandon( ) + System located at ; s ,? 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 provisiorisor special-con itid ons. . \ Provided:Construction murs�t be completed within three years of the date of this permit,,,c.--r"" Date " O` O �'L Approved by LA 0j� i ) ' ToNm of Barnstable Regulatory Services Thomas F.Geiler,Director • searWescs, MASS �g Public Health Division Thomas McKean, Director - 200 Main Street,Hyannis,MA 02601 Office: 508-862464 4 Fax: 508-790-6304 Installer& Designer Certification Form Date: G a28-// Sewage Permit# D//-SOD Assessor's Map\Parce1Cb2 /—/ya Designer: Gv' \ �/1 Installer: wce Address: 80Y IV ' U Address: &7 02AO ST. ' �4�YQWW* DSCyr t7A O S S On c / eLco.I h., Icy was issued a permit to install a (date) (installer) septic stem at /�3 �/32�ncr kc /L y✓-_p y / based on a design drawn by (address) ../%E-��-2". A dated ( esiQnerj Yll__Vcertlf~f.that the sceptic system referenced above-,was installed:.substandally.according to the desip. which may tnclude minor approved chances such as"lateral relocation of the distribution box ands r 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. tGPL�N Sc9, ( staller7s Si;naturej r E u, No. 1140 � a (Designer's Sia*iature) - (Affi-K Desi� ii e).: .. . PLEASE RETURN -TO B TABLE 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 3=26-Odoc TRANS.NO.: CITY/TOWN: C&T U11- APPLICANT: ADDRESS: DESIGN FLOW: � gpd REVIEWED BY: DATE: N/A OK NO GENERAL a ;,. Legal boundaries denoted [310 CMR 15.220(4)(a)] Street,Lot,tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided 310 CMR 15.2204(t)] Plan proper,scale?(1"=40' for plot plans, 1"=20'or fewer for components) [310 CMR 15.220(4)] X Easements shown [310 CMR 15.220(4)(b)] X System located totally on lot served [310 CMR 15.405(1)(a)for upgrades]-if not, a variance is required 310 CMR 15.412(4)] Location of impervious surfaces(driveways,parking areas etc.) X [310 CMR 15.220(4)(d Location all buildings existing and proposed 310 CMR 15.220(4)(c)] Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] System Calculations 310 CMR 15.220 4 daily flow X septic tank capacity (required andprovided) 5< soil absorption system(required andprovided) whether system designed for garbage grindet North arrow 310 CMR 15.220(4)(g)] Existing and ro osed contours 310 CMR 15.220(4) X Location and log of deep observation holes(existing grade el. on each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220 4 h and i) Location and date of percolation tests(performed at proper x elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? [310 CMR 15.2421 Certification statement by Soil Evaluator 310 CMR 15.220(4)0)] Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3)and 310 CMR 15.220(4)(n Address , `� j�1�1 �_ �1iT V t j Sheet 1 of 7 N/A OK NO Location of every water supply,public and private, [310 CMR , 15.220(4)(k)] within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case — within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located[310 CMR 15.220 4 m (if water line cross see 310 CMR 15.211 1 [1 Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4) o Y` Stamp of designer[310 CMR 15.220(1)and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3 Test Holes adequate(two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2)or as (� approved for an upgrade under LUA at 310 CMR 15.405 1 k Test hole adequate to demonstrate four feet of suitable material? 310 CMR 15.103(4 Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75'of system 310 CMR 15.220(4)(g)] Materials specifications noted? [various sections of 310 CMR 15.0001 System components not> 36" deep (unless Local Upgrade jApproval or LUA requested) [310 CMR 15.405 1 b ] I 1 Address ��� � 11.9 a �(�. CdTu\ Sheet 2 of 7 N/A OK NO SEPTIC TANK Size OK? [310 CMR 15.223(l)] DC Inlet tee located ten inches below flow line 310 CMR 15.227(6)] Outlet tee 14" or 14"+5"per foot for increase ft depth [310 CMR 15.227(6) Outlet tee with gas baffle or approved filter 310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 15.228(1)] Separation between inlet and outlet tees(no less than liquid depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5))or permitted for upgrades under LUA 310 CMR 15.405(1)(k Minimum cover 9" (Tanks buried more than 9"must have risers on all openings and on the d-box) [310 CMR 15.2228(1)and 310 CMR 15.232(3 Three access covers(inlet and outlet must be 20" or greater)- >/11 middle access at least 8" 7/07 310 CMR 15.228(2)] Access to within 6 " of grade -one port for systems<I 000gpd, two fors stems>1000 gpd [310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211 1 Buoyancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources 310 CMR 15.211 Multi=Compartment Tanks --a: - Required when other than single-family dwelling or flow>1000 d 310 CMR 15.223(1) b First compartment 200%daily flow; Second compartment 100% v daily flow 310 CMR 15.224(2)and 3 "U"pipe through or over baffle, outlet of each compartment with as baffle or approved filter 310 CMR 15.224(4)] Address I y\da(L t (2 . `C6rt U Sheet 3 of 7 N/A OK BUILDING SEWER AND OTHER.PIPING- . Located at least ten feet from any water line? [310 CMR 15.222(2 Disposal piping at least 18"below water line(when water and sewer cross, see 310 CMR 15.211 1)11 Cleanouts required/provided? 310 CMR 15.222(8)] Thrust blocks specified in force mains?310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable 310 CMR 15.222(6)] X Proper pitch on all runs?(.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9)and 310 CMR 15.252(2)(c)] Siphonproblem/ leachfield below pump chamber Endca s or vent manifoldspecified? �C Size and orientation of discharge holes specified?(not smaller than 3/8"not larger than 5/8") [310 CMR 15.251(8)and 310 CMR 15.252 2 Materials specified (310 CMR 15.251(5) specifies various pipe types allowed 'DISTRIBUTION,BOX Stable compacted base [310 CMR 15.221(2)and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided?(when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if deeper than 9" 310 CMR 15.232 3 Inside minimum dimension 12" [310 CMR 15.232(2)(b Minimum sum 6" 310 CMR 15.232(3)(e)] Watertight cover if<2000gpd);waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] PUMP CHAMBERS.' -. , . Capacity(emergency storage above working=design flow)? [310 CMR 231 2 Proper setbacks 310 CMR 15.211 same as septic tanks ' Watertight 20-in minium access manhole at least 20"MUST BE TO GRADE 310 CMR 15.231(5)] Service components accessible(not too deep with piping, disconnects accessible) Alarm floats-alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. 310 CMR 15.231(6)and 8 �`— Stable Compacted Base 1310 CMR 15.221(2)] IBuoyancy calculations needed?Provided? [310 CMR 15.221(8)] Address ?2 (L�C 16L �`�'� Sheet 4 of 7 f N/A OK NO SOIL ABSORPTION SYSTEMS(S'AS) GENERAL Calculations correct? ,f 4 feet of naturally occurring material demonstrated? [310 CMR 15.240 1 Required separation togroundwater?[310 CMR 15.212 Aggregate specified as double washed 310 CMR 15.247(2)] System Venting required/provided?(system under driveway or >36" deep) [310 CMR 15.241 Inspection ports specified and within 3"final grade? [310 CMR 15.240 13 Breakout requirements met?(No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(l)[4] and Guidance Document GALLERIES,PITS,CHAMBERS.3,10 CNM-f5 253 ° �' Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253 6 Each structure with one inspection manhole(if>2000 gpd must be tograde) 310 CMR 15.253(2)] Aggregate I'minimum-4'maximum. 310 CMR 15.253 1 b 2' sidewall credit maximum 310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 s . ft. 310 CMR 15.253(6)] TRENCHES 310,CMR 15.251 ;� Width T minimum 3'maximum 310 CMR 15.251 1 b ] 100 feet-maximum length 310 CUR 15.251 1 a ] Minimum separation 2x effective depth or width whichever greater 3x if reserve between trenches 310 CMR 251 1 d Situated along contours 310 CMR 15.251(2)] Breakout OK? 310 CMR 15.211(1)[41 and Guidance Document BED;5AS(M'-imum_size ofebedror_feld'5'000gpd). minimum 2 distribution lines [310 CMR 15.252(2)(a) Maximum separation between lines 6' 310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 r CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6"minimum, 12" maximum. [310 CMR 15.252(2)(g)] Separation between beds 10'minimum. [310 CMR 15.252(2)(0] Bottom area used in calculations only 310 CMR 15.252(2) i Address Sheet 5 of 7 • a N/A OK NO DID THE PLAN INVOLVE 3 Pressure Dosed System ? Provided pump and piping calculations as required 310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2)and I/A Remedial Use Approvals] If used in gravelless system-make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd)or quarterly (>2000gpd)good to note on plan [310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255 3 ? Impervious barrier and/or retaining wall? Guidance Document] Impervious barrier installation must be supervised by designer 310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer 310 CUR 15.255 2) a /" Side slope not exceed 3:1 ? 310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2)and Guidance Document] x At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 2) e Gravelless System[IIA Approval Lettersf._ Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to scour soil interface I Alternative Septic System[UA Approval Letters] Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has applicant submitted a copy of a maintenance >X variances Are the variances listed on the plan ? [310 CMR 15.220 ,O (4)(q)] x RLS Stamp necessary on plan if a component is within five feet of property line 310 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 CMR 15.414] Address Cl �—OTV I j Sheet 6 of 7 N/A OK NO Nitrogen Sensitive Areas Is the system in a Designated Nitrogen Sensitive Area Zone II f y � g ( o a public supply well)?[310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216-also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well? i 310 CMR 15.214(2)] �G Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] Miscellaneous Pumping to septic tank? [310CMR15.2291 X Shared System 310 CMR 15.290 Address ��t� ` Sheet 7 of 7 i L0fCAT10 SEWAGE PERMIT NO- VId: IAG Ad�—� I N S T A LLER'S NAME i ADDRESS, ld B U I L D E R OR OWN ER DATE PERMIT ISSY E 14 DATE COMPLIANCE ISSUED ,D 'e �b 37 q3 at. No........ ...... Fzs........J61............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE LTH 7a ...............OF..... ApplirFa#ion for Uispoii al Workii Tonstrnrtinn Famit Application is hereby made for a Permit to Construct X) or Repair ( ) an Individual Sewage Disposal Systt at* •.z!......-.....,�11..../. .�...� J .._...� .. ..�...... .. .............. . ....... Coca res�` .^'�' .._ . es ;��6�11� or I.ot �............................... .........._ _.. _. . Owner ress Installer Address Type of Building Size LotJd.Q 9 Q Sq. feet Dwelling—No. of Bedroo ...........................Expansion Attic ( ) Garbage Grinder ( ) e of Building persons `o................ Showers — a Other—T YP g No. of P 1•--- - ( ) Cafeteria ( ) Other fixtures .. W Design -Flow...........,] ................gallons per person per da�v. Total daily flow...... 3 ......................gallons. WSeptic Tank—Liquid capacity,/M.gallons Length./4l._h... Width--r....... Diameter................ Depth............... x Disposal Trench—No.................... Width.._.f.............. Total Length.........lr........Total leaching area... ...sq. ft. Seepage Pit No.................... Diameter......6_........ Depth below inlet.............. Total leaching area..................sq. ft. Z Other Distribution box (� ) Dosingj ( ) q '-' Percolation Test Results Performed by..--�!�� ..--. •�............ a Date Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......a- V Test Pit No. 2................minutes per inch Depth of Test Pit.....................Depth to ground water._ .................... xODescription of Soil -� •• - �Q •--- ----•--•-•--------•-----•--•-----------------••••--•---•---------••-----------------------------...------------ _ •---- --.••- V ----------------•----•- . W ----••-----------------------•--•�6.._-�7_�...... L�.------......---------•--•----•-•-------------•-------•-•-----•-•-------...------------------------........... 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 TLNU 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance Abeened by the and of ealth. Sig G(/..............A lication A roved B / �� - D PP PP Y l.C%' -..... .. s/ Date Application Disapproved for the following reasons: -------------------------- •.........••-••••---•-•.......---••-••--...•••----•--•-•-•••-•-•-••••--••--•-•--•.....-••-•-•--•-•-••••-••-------•----•••-•---•---•---•----••----••-------•--------••••----------•--•--•--•-•-------•--- Date PermitNo......................................................... Issued....................................................... Date l THE COMMONWEALTH OF MASSACHUSETTS BOARD OF _HEALTH Appliration for Diipusal Workii Tonstrnrtiun ramit Application is hereby made for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal System at .... .... .... Locat/ion-Address_'—�- or Lot N / .......... ....... Ft.. ........I.r �/ f-'1� —,.._..._ c. ` �� ---•- r� ............. .. W -'s' �Iwner��C f --- �` = = /.1` J �j f= ... ......•..... ......................•.................. ....................................... ,-•-------••-•---------••............................. Installer Address U Type of Building -�, Size Lot_:� ,_�Q�___Sq. feet �-� Dwelling—No. of Bedrooms.....------ ___________________________Expansion Attic ( ) Garbage Grinder ( ) a aOther—Type of Building �__y`�'..��___. No. of persons_.__.__.fir-.-'_________________ Showers ( ) — Cafeteria ( ) Otherfixtures, •---------•---------•----------._...._..--•---•------------------ ................................................._........... W Design Flow_______________?__ gallons per person per day. Total daily,ily flow_._.._.-�-�. _____.................gallons. Septic Tank—Liquid'capacity_1 _gallons Length__,(4._.l_.. Width__,,,. Diameter________________ Depth................ x Disposal Trench—No. ................. Width.................... Total Length.................... Total leaching area.... ft. Seepage Pit No______________ _____ Diameter._.___/_.__._._. Depth below inlet___h��__._.___. Total leaching area..................sq. ft. Z Other Distribution box ( / ) Dosing to k ( ) / ''' Percolation Test Results Performed by..........................................................................Fa`. .................'_(__'� ' ��lr� �.._........................... a = -••••••• - = Date ,1..." Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water....... rZ,-�- 44 J Test Pit No. 2...____...______minutes per inch Depth of Test Pit................_... Depth to ground water..Z e... ' fx --•---------`----------•••••..................•----••••--•--.........-•••••••....._.._...---......._..........---...--_._......--••••••---•-•.....•-- D Description of Soil........ .............. ...�....� . w =� �i rr 11�rvt fe : �* UNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ -•---------------•----------•---•-----'------------------------._....-----------------=---.........-------------------------•------------'------------------------------------------------.._..._.--••- Agreement: The undersigned agrts to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE -"5 of the,State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ign, i' T if 1 .//i t ...f .. A lication A roved B '/ Dat ' -4d Date Application Disapproved for the following reasons------------------- ----------------•---------•-----------------------•----------•--.....---•-••--•-••-----...... ••-•--••----------------------------------•------------.-..-----=-------------------___:...•-------------------....--..-----------------............................................................. Date PermitNo......................................................... Issued-...............................................?, Date s:� _ THE COMMON,, H OF MASSACHUSETTS r BOAR� 4f „HEALTH l` 1� ....................................OF....,. ?................ .............................................. .Trr#if irate of from Aianrr THIS IS TO-CEO TIF��,`That ,the Individual Sewage Disposal System constructed ( or. Repaired ( ) by------------- -------------------------------------------•------••......---••-----•-.-----;----;................................................... f Installer i / / haasp been installedin accordance with the rovislons of o he State Sanitas -Coe as (kscribAd ip the a licatl n for Disposal Works Construction Permit No__________________ ________ d"-CJ ---••------ dated_--.--/ ------ ----...........--•-•---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY.. a DATE 7R V AW THE COMMONV EALTH OF MASSACHUSETTS k BOARD OF HEALTH ]►�2. C%......`.t..�:..-......OF.. c- tf .'....-�,.......................... No......................... FEE........................ Disposal Works �,an t nr#ua rrntit =� ' Permission is hereby granted.... �_:ll�-:----�.(_t�a �-J.��/........ ''�-----._.-•.................................:.............•--- . Sa tto Consfrtct or , ai e� R s �m at No. .#` f �C.�'%!l I �---: ` jl r/- -' ,�cov � .................. •.... --- -- �rn - ---••---J-• Street as shown on the application for Disposal Works Construction Per o___N.... Q�4�� ated_ ..... ......... ......... ___ ---------------- Board .... . ... ^eke« �•. of Health DATE---... ........................................... -------------------- 1, FORM 1255 HOBBS & WARREN, INC.. CPU@USHERS Ii- / COTUIT � Z 2 ' G o 11 & 1 Wo Z Of m // ,�F. G\\9�� \\ PARCEL ID: SP�PSO 022/143 66.2 /�h W LOCUS MAP , - LOCUS INFORMATION 66.1/ -__ - F PLAN REF: TUBE 167 TITLE REF: 12780/281 A C _ _ _ PARCEL ID: MAP 024 PAR. 142 3—BEDROOM = C,`��'� � FLOOD ZONE: C�LLHEAD PROTECTION ZONE" (WP) \ _= DWELLING-. 6° COMMUNITY PANEL: 250001-0021-D DATED:07/02/92 \ -= TOF=70.76 -= SEPTIC SYSTEM REPAIR PLAN EXISTING GAL. OAK LOCATED AT: \ #183 MARINER CIRCLE a \ \ TANK NKREMAIN PUMP CRUSH & COTU I T, M A. r \ , ABANDON LEACHPIT PER TITLE 5 PREPARED FOR COR BLHD °' T681 �� I PARCEL ID: LISA J. RUNCI a= , 0, TH sg�0 `.'/ OAK 024/142 GiSf AREA= 20,000± S.F. JUNE 3, 2011 FIRST FLOOR PLAN \\ ,o \ OAK 4� � r✓Ass� \ - NN0 ass \ 012 \�A \ r �`, o EDWARD W/D BATH \ ZAK ems\ s ® MEYER o A. \ +. `J' � �+ KITCHEN \ O\9S, No 1140 STONE GARAGE \ //.� 68 / �Q �No. 289800 �a, LIVINGROOM \ OAK DINING \ - o� SkNITAR�P� ENT. PARCEL ID: j6,\\ 1�h PARCEL ID: FRONT 024/141 °° 023/023 ° \ MacDougall Surveying SECOND FLOOR PLAN \ 67.9 & Associates BATH BEDROOM e ��j� P. O. B o x 2428 '°� I BEDROOM � GRAPHIC scam M a s h p e e, Ma. 02649 �cF I BEDROOM 20 0 10 20 PH. �508�4119-1086 fax 508419-1087 email: FRONT IN FEET macdougallsurvey©comcast.net ( ) 1 inch = 20 ft. SHEET 1 OF 2 J 1326 TOP OF FOUNDATION ELEV= 70.76' 2" LAYER OF 4" SCHEDULE 40 P.V.C. _ MIN. PITCH 1/8" PER FOOT 1/8" 1/2" DO 10' MINIMUM-� ORLFILTH ONE ERFABR C 12' EXISTING TO REMAIN EL= 68.7' EL= 68.2' ...................... ............ 6" EL= 68.0 '6" MAX.'.......... ;:,::: .;:\Z,., s" MAX. .. . ::.\`5:::::::::::::::::::............................ . ADD ADD ........ ........ RISER & RISER & INVERT„ "CLEAN SAND` FILL kr CONC. covE. COVER RISER & EL= 64.5 PER 310 CMR 15.255 33" EXISTING PIPE (IF NEC.) (IF NEC.) EL= 67.72 COVER LEVEL �Gj� S=0.03 19' S= 09 FOR ' LONGEST RUN 10' Q- EXIST. EXIST. " FLOW LINE EXIST. "�" S °1 EL= 65.25 INVERT INVERT t10 14" INVERT INVERT INVERT ° ° ° ° 0 0 0 o 0 ow o 00 EL=67.06' EL=66.64' MIN. EL=66.47 EL= 64.77' 6" SUMP EL=64.6' �� ° °° °o 0 0 4' ADD GAS 24 a te ° 6, C� D O O 0 C� O D O 0 'po 0'P BAFFLE B" B COMPACTEDSE OF MECHANICALLY ° ° °o o� °°j EL=62.5 & TEE PROP. DB3 DISTRIBUTION 4.0'0- --- 8.5' 4.0' /" TYP. EXISTING Box w T 3/4" TO 1-1/2" ( 25' DOUBLE WASHED STONE -50 GAL. H-10 DRY WELLS 4'-10" X 8'-6" X 2'-9" ir) 2 0 1 000 GALLON TANK ( � ( � (TO REMAIN) PROFILE OF SOIL ABSORBTION (TRENCH FORMATION) ui SEWAGE DISPOSAL SYSTEM SYSTEM (S.A.S.) 12.83' X 25' (NOT TO SCALE) GENERAL NOTES BOTTOM OF TEST HOLE #1 ELEV.= 57.0' (NO GROUNDWATER) 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. I CERTIFY THAT I AM CURRENTLY APPROVED BY THE DEPARTMENT OF TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMR 15.017 TO CONDUCT FOR SUBSURFACE DISPOSAL OF SEWERAGE.2. AT LEAST ONE ACCESS PORT OVER TANK TEES SHALL BE SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED DESIGN DATA: ACCESSIBLE WITHIN 6" OF FINISH GRADE, WITH ANY REMAINING BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY THAT THE RESULTS OF MY NUMBER OF BEDROOMS.........___3 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE SOIL EVALUATION, AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM, GARBAGE DISPOSAL.................__ NO CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE ARE ACCURATE AND IN ACCORDANCE WITH 310 CMR 15.100 THROUGH 15.107. TOTAL ESTIMATED FLOW UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY 330 MUST WITHSTAND H-20 LOADING. (110 GAL./BR./DAY X 3 BR.) _______ 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION 330GPD X 200% = 660 GAL OF ALL UTILITIES PRIOR TO ANY EXCAVATION. DARREN M. MEYER, CERTIFIED SOIL EVALUATOR USE EXIST. 1000 GAL. SEPTIC TANK 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. INSTALL: 2-500 GAL. DRY WELLS (W/4' CRUSHED STONE 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE OVER THE S.A.S. AND DISTRIBUTION BOX. ON THE SIDES, 4' ON THE ENDS) AND BACKFILL 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF TEST PIT RESULTS: P 13280 SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE WITH CLEAN SAND FILL PER 310 CMR 15.255 THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND SOIL TEST DATE: MAY 19, 2011 LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. SOIL CLASSIFICATION................ 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN B.O.H. AGENT: DON DESMARAIS, R.S. DESIGN PERCOLATION RATE..... <2 MIN SIN. 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT SOIL EVALUATOR: DARREN M. MEYER, R.S. EFFLUENT LOADING RATE.........___74___ ELEVATION OF THE OUTLET PIPE. 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. BACKHOE: JOHN CONDON REQUIRED LEACHING CAPACITY.....330 GAIDAY 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS LEACHING CAPACITY PROVIDED.....34_9 GALLDAY BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. TH#1 EL.= 68.0 PERC(g) 41 "- 57" 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND SIDEWALL: (12.83 + 25')x2x(2 SIDES)(.74)= 112 GAL/DAY FIRST TWO FEET OUT OF THE DISTRIBUTION BOX SHALL ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR IMOTTLING OTHER BOTTOM: (12.83 x 25')(.74)= 237 GAL DAY BE LEVEL. 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION 67.6 0-5" A LOAMY SAND 10YR4/21 TOTAL= 349 GAL/DAY TO MACDOUGALL SURVEYING & ASSOC. FOR B.O.H. AND DESIGN 65.25 5-33" B LOAMY SAND 10YR6 6 ENGINEERS REVIEW AND APPROVAL. 349 G D PROVIDED - 330 GPD REQUIRED = 19 GPD RESERVE 57.0 33-132" C M C SAND 2.5Y7 3 NO GROUNDWATER ENCOUNTERED ���ZNOFMgSs9C CONSTRUCTION NOTES: TH#2 E L.= 68.1 D; ��-N OF Ss9c SEPTIC SYSTEM DETAIL PAGE 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER N �� EDWARD y� #183 MARINER CIRCLE WORK ON THE SITE. 67.7 0-5" A LOAMY SAND 10YR4/2 MEYER o A. N COTUIT, MA. No. 1140 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE c, STONE WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 65.35 5-33 B LOAMY SAND 10YR6 6 _p �10 No. 28 804) JUNE 3, 2011 IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. G/STIE Po 1p 57.1 33-132 C M C SAND 2.5Y7 3 s'��'�ITARiPN T '• 3. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING TAPE OR A COMPARABLE MEANS. NO GROUNDWATER ENCOUNTERED SHEET 2 OF 2 J# 1326 ., tit OTE _-- - --_- --- �„t -- _- BASe T-) C)► U S. GI .5 . t rU�-� �1..�.,►.1 E I''Tc.W AL-. - ►J ES A Mt!,J !M o h� of Vei ,"/F 0c)T ::•. , - -.. . .. _ ! � + � '_" -'� � v��.,�ss OT�E'ew�sE �f'E,c.IF���. i o 0 1 c( )� 3a-- A _L. 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