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0354 MARINER CIRCLE - Health
354 Mariner Circle C)tuit P -- --- - --- �q = 024 115 0 t � 3 / -- No. � � Fee 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Application for ]Disposal 6pstem Construction hermit Application for a Permit to Construct( ) Repair(✓� Upgrade( ) Abandon( ) E2 omplete System ❑Individual Components Location Address or Lot No. 3541 MAR,i NOR GIRcLE Owner's Name,Address,and Tel.No. PA r#fMAP-Y CDNKL►V Go-ruvr MA. SS4 R MAPAWE C.1RGL.E Assessor's Map/Parcel 2-H Is 00*TU IT MA. Installer's Name Address,and Tel.No -r�W LA'S KENWC-DY -Designer's Name,Address,and Tel.No. EAS S UR V- X: Ghps G.0L�CcNSrrPWC�1o►�.1,zt�,. Sf41.T-ftwo lavitp tll9 5-r1 wtl.A VJSTV_9P •tr Sog-Sgg- 3b19 po 40 1'12. Type of Building Soggy 3t�a SAnrvvv«,vt, MA•OA6 rO Dwelling No.of Bedrooms Lot Size 29 y(dp sq.ft. Garbage Grinder 05r) Other Type of Building _VIoMIE — No.of Persons 1., Showers(rW Cafeteria(W) Other Fixtures W A Design Flow(min.required) 330 gpd Design flow provided 35,5 gpd Plan Date 2-2/ 2014 Number of sheets Revision Date q� ZO IV Title 15 9 4 O 4 2- Size of Septic Tank I Opp q0.1 Type of S.A.S. J(„*1(' 30 LeAchnR kedck�(i"Gt b►av Description of Soil C-�—M_—_d Jurn Sand Nature of Repairs or Alterations(Answer when applicable) :'A T LD L_-0kCWrA.(r, SYS-ry--tA Date last inspected: ;2.0 14 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has,been issued by this Board of Healt Si Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. `�(�/y ���� Date Issued r c - �4�W.-..r.d�+„ i No. t7 L t, Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:" Yes . PUBLIC HEALTH DIVISION '-TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for Zisposal 6pstem Construction permit ' Application for a Permit to Construct( ) . Repair(,-)-) Upgrade( ) Abandon( ) L� o�mplete System ❑Individual Components Location Address or Lot No: 31 5 H•, r 1 A P,i N UR C i RC.LE Owner's Name,Address,and Tel.No. PAT*:.MA RY Wfv 1C Li M COT-U1T ^4A. 35y MARINER Assessor's Map/Parcel 2L4 1 S ICOTU I T' MA. Installer's Name,Address,and Tel.No. T Rv rvq A5 K E N 06 Designer's.Name,Address,and Tel.No. E A S 5 U RV E Y, T: GRP�G�O1—FGoNS�T�IJLYIu��J ��vL. SAUT FO*oD pvoc> KL2 s,► w L_L_0U-js�►- � t+ 50�- 8SS- 3bt9 'TypeofBuilding: �Fi- 3��-'11-1-7 '50,NLAJ%(_A, MA 0,X'S 3, Dwelling No.of Bedrooms ti Lot Size sq.ft. Garbage Grinder(Ad) Other Type of Building _HOB"-E _ No.of Persons i Showers( Cafeteria(Rj) Other Fixtures �j A Design Flow(min.required) 3 3 0 gpd Design flow provided 3 5�c gpd' Plan" Date 2-2/ 2 01 y Number of sheets 2. Revision Date P�! q / 0 1 Title 1e.a p114 2- Size of Septic Tank l 000 90-1 Type of S.A.S. Y Description of Soil C i Nature of Repairs or Alterations(Answer when applicable) Tr A T t r- 1 �u s�� v_Sr�N\ Date last inspected:_3Z 2.2 / a 01�j Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system_in. accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of , Compliance has been issued by this Board of Health. Signed,, Date Application Approved by Date t/ Application Disapproved by r Date for the following reasons Permit No.- ��)o IV -S Date Issued -r / /C THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On ite Sewage Disposal system Constructed( ) Repaired(y) Upgraded( ) Abandoned( )by �U r-, CC �✓� . p 111111������ at f/ MU f r w- C,rr(.p has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. o l Lf_ dated _ I 3hul Installer Designer #bedrooms 3 Approved desi=flow 3 U gpd 11 The issuance of this p rt hall of X onstrued as a guarantee that the system w' n f 7dAFig (NN11 C Date Inspector No. , Fee GU THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal Opstem Construction hermit Permission is hereby granted to Construct( ) Repair!( ) Upgrade( ) Abandon( ) System located at S ►M b F r N 2,,, and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. ��p Date / ; t Approved by r Town of Barnstable Regulatory Services Thomas F.Geiler,Director Public Health Division 39. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: .Z 011( Sewage Permit# doh ` ssessor's Map/Parcel Installer&Designer Certification Form Designer: l�/kS �U � Installer: 4::��.G / ��► l�i + 11 Address: ` l 2 9 Address: On_ 3 G was issued a permit to install a (date) (installer) septic system at - M P P 1 nJ F P. G1.p-��� based on a design drawn by (address) ._D4U T- A48ah dated A3;POa r_ Z j J-ze)k h- (designer) 1 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. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation 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. Stripout(if require s ected and the soils were found satisfactory. `','A OF kf,4 sacs DAVID D. a FLAHERTY, JR. cn to ler' i ature) No. 1211 G/STEV- ' SgN17AR�� wiper's Sign tur ) (Affix Designer tamp 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. gAoffice fomsldesipercertification focm.doc TOWN OF BARNSTABLE LOCATION 3S 9 MJNRif4EB G i re—1 SEWAGE# A.014 15:S� VILLAGE C nTyi"T ASSESSOR'S MAP&PARCELVV INSTALLER'S NAME&PHONE NO. 142Mcif ne"11CC V&VT 364-0fteR SEPTIC TANK CAPACITY Joe5o eWi N•is /D x &-A6 LEACHINGTACILITY: (type)$ p pj,kize) NO.OF BEDROOMS 3 OWNER PaTr�c14 and Mce1 [4`.in PERMIT DATE: /•yIa T �pL� �JJ COMPLIANCE DATE: Jtay U,A0 tq 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 r . FA7 SAC of 14ousr- A c 4 4' 6G 3o' A 0 Wa' SD34' `. A E 69'7" QE wy' p A P (.4 7' 13F'L/19 AG 7�s,, aye I AH71 6N7Ys I At 79'e' BI 77' A v$3'7" BJ7g 'I A X &7'7" aK 734 J I Aa H c,00K pew ver I TOWN OF BARNSTABLE LOCATION 3,S 9 M 6RJ N E B G i re-le SEWAGE# A01 Li VILLAGE C ,676, r ASSESSOR'S M�AAP&PARCEL INSTALLER'S NAME&PHONE NO. �r»�a� XchN_e�TsS'a� 3oGZ-QqQ SEPTIC TANK CAPACITYC�) }•�•10 Q /�©X �-�b LEACHING FACILITY: (type)$AJ. EGADp ize) NO.OF BEDROOMS 3 OWNER PaTPicA and MjArq ConKL,in PERMIT DATE: /�yg 13)A014 J COMP_LIANCE DATE: 3„Z.•Z_� O Is 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 U o u' � o a a w 45 Q C� LU ` s H i-3 aC m CO DO , CO n m Ln M n _ _ r V Q w LL i Town of Barnstable �FTHE T Regulatory Services Barn Thomas F. Geiler, Director Iilt, meri Public Health Division sARNSTABLE, 9 MASS. g Thomas McKean, Director 2 q� 1639. i►`� 200 Main Street 007 AIFD MA'S Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 28, 2014 Sent Via Certified Mail— 70121010 0000 28512972 Patrick and Mary Conklin 575 Willow St. W. Barnstable, MA 02668 As of October 1, 2006 a new rental registration ordinance was put into affect requiring all property owners of rental units to register their rental units with the Town of Barnstable Health Division. According to our records, you own the rental property at 354 Mariner Circle, Cotuit, MA (Map-Parcel: 024-115). Enclosed is an application. Please use a separate application for each rental unit you own. Should you need more applications, they are available online at www.town.barnstable.ma.us. Go to the Health Division page by looking in the Department Menu. There is a link to the Rental Registration information on the Health Division page. You may print out as many as you need, and return them to the Health Division with the appropriate 2013 fee of$90 included. This must be completed within (14) fourteen days of your receipt of this letter. Failure to comply with this ordinance will result in the issuance of a non-criminal ticket citation in the amount of$100. Each day of non-compliance is considered a separate offense. Should you have any questions, please feel free to call 508-862-4644. Thank you in advance for your cooperation. Sarah Donnelly e/� V"'L" Division Assistant � ,n �. Public Health Division Direct#508-862-4072 B3 41th Master Detail Page 1 of 1 -rt- Logged In As: TOWN\health Health Master Detail Friday, March 21 2014 Application Center Parcel Lookup Selection Items i Parcel Septic Perc Well Fuel Tank Parcel: 024-115 Location: 354 MARINER CIRCLE, COTUIT Owner: CONKLIN, PATRICK &MARY 3 1 Business name: Business phone: Rental property: r Deed restricted: r Number of bedrooms : 0 Contaminant released: r Fuel storage tank permit: (- I _ _ Save Parcel Changes I .Return to Lookup Parcel Info Parcel ID: 024-115 Developer lot:LOT 96 .Location:354 MARINER CIRCLE Primary frontage:257 Secondary road:MOORING DRIVE Secondary frontage: 136 Village:COTUIT Fire district:COTUIT Town sewer exists at this address:No Road Index:0978 024115_1 ' Asbuilt Septic Scan: 02411.5_2 Interactive map Town zone of contribution: NP (Wellhead Protection Overlay State zone of contribution:IN District) Owner Info Owner: CONKLIN, PATRICK & MARY J Co-Owner: Streetl:575 WILLOW STREET Street2: City:WEST BARNSTABLE State:MA zip: 02668 Country: Deed date:11/19/2002 Deed reference: 15940/142 Land Info Acres: 0.53 Use: Single Fam MDL-01 zoning:RF Neighborhood: 0105 Topography:Above Street Road:Paved Utilities:Public Water,Gas,Septic Location: Construction Info Building No ear Buil Gross Area Living Area Bedrooms Bathrooms 1 1982 3044 1060 2 Bedroomsl Full + 1H Buildings value:$83,400,00 Extra features: $42,800,00 Land value: $112,000.00 http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=024115 3/21/2014 SECTIONSENDER: COMPLETE THIS SECTION COMPLETETMS ON.DELiVERV ■ Complete.items 1;2,9nd'3:Also complete s A. Sig ure item 4 if Restricted Delivefi'is desired. G ❑Agent a Print,your name and address,on the reverse x Addressee so that we can return the card to you. B..Received by(Printed Name) C o Delivery Attach this card to the back of the mailpiece, or on the front if space permits. IV I D. Is delivery address different from item?. ❑ s 1. Article Addressed to: If YES,enter delivery,address below: ❑No Patrick and Mary Conklin 1 575-Willow St.: ! 'W:,Barnstable, NIA 02668 .j 3. Servicerype 14 Certified Mail ❑Express Mail �T ❑Registered Return Receipt for Merchandise ❑Insured Mail C.O.D. 4. Restricted Delivery?.(Extra Fee) ❑Yes 2: Article Number I (O 12 101 p�0 0 0 0 2,851 2972 (rransfer from service labeo, <<< RS Form 3811. February 2004 Domestic Return Receipt 102595-02-M-1540. I UNITED STATES,pO$TAJ.,F$ERVICE First-ClassMail Postage&Fees Paid USPS Permit No.G-10 ° Sender: Please print your name, address, and ZIP+4 in this box • I I I Public Health Division i f B Town of I I Os I I 200 Main Street I Hyannis,MA 02601 I I I I I !!'�ll�'I'tl,INt,tj,l1,lid)1'I'�ilti!'ilia:Ijtl�ll,tlj„tt,tl,t I I � _ 1 Town of Barnstable Department of Regulatory,Services >a"MTAaM a Public Health Division D MATa Date ,� i639 1m� 200 Main Stree Hyannis MA 02601 rFC1 MAC h _^ Date Scheduled_ ) Time )(ee PC]. lab J Ctl SOU Suitability Assessment for Sep Dis 3 Perfonncd By: ) n � Witnessed By: . /. IN LOP ALTION,& GENE RALL]1VTORIVIAT ON f Location Address j 3' 411,dt Owner's Name Address4 /lv crf Assessor's Map/Parcel: �i¢� 442 "'YYY 6CY s�� � /JjA `� Engineer's Name � ✓ �75F NEW CONSTRUCTION REPAIR _ QQ Teleplione# Gam, Land Use 154041 (L� Slo cs 96 2 Surfac /Vv 01 Gu, ccd?&( P, ( ) Surface Slopes 1 Distances from: Open Water Body ft Possible Wet Area N/�' 2 f ft Drinking Water WeI��*k4t Dralhage Way !OG e ft Pro err Line 3 6�' K /(J ' p //VT lZu�pNo Y ft Other_ U cJe�O ft v 101�7CCL1:(Street name,dimensions of lot,exact locations of test boles&per tests,locale wetlands(n proximity to holes) _ 1 J 191,,,,,L,, J t a'A1-wrSo, C '' i �` Parent mate(lat(geologic) x ' Depth to BecIrock // p Depth to Oroundwater. SlandingWalerin Hole: Weeping ft'0111 Plt Piloe K)! EstimatedwSeasonal High Oroundwater > U DETER1V NATION FOR SEASONAL 1-HOR WATE,R IABLE't Method Used: _ Deptl� Observed s nding in obs.hole: C la, Deptlt to soil lnottl5; T bl. Dcpdr to weeping from side o obs.bole: bt, Oroundwnter AdJustment_1 ft. Index Well 1✓ Reading Date: lndex Well level Add,rhotor�,,___•� AeAj.GI• U11dwatef Lave) /(>. PER OLATION TEST watt. {'/d 'A'lwm,Q � Observation Hole {� Hole# s, �� Time at qu Depth of Pare Time At 6" Start Pre-soak Time @ ` 7 Time(9"-6") End Pre-soak Z / Rate Min./Tacit Site Suitability Assessment- Site Passed _ Site Failed: Addltional Testing Needed(Y/N)_`�+ V Original: Public Heallb Division Observation Hole Data To Be Completed on Back---+�--1--- 44:k4,1f Percolation test it to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) week Prior to beginning. Q:\.S EPTIC\Pr'RCFOItM.1)OC DEEP-OBSERVATION HOLE LOG Hole# /Y ?.e Depth from Soil Horizon Soil texture .Sdil Color Soil Surface(In.) Other (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. of ' teacy.q6 T3ravell 1 Z, lZy 4 " . p wrl Pv GU c/rJ, eY DEEP OBSERVATION HOLE LOG Hole#� �' • 1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o siste `% rave] a y�? 77 DE,EP OBSERVATION HOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(in-) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Cousisto cy,Qn arayo1l I DEEP OBSERVATION HOLE LOG Mole# Depth from Soil Horizon Soil Texture Soil Color Boil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, consistency, 6 a Flood insurance Irate]flap: Above 500 year flood boundary No_ Yes Witiun 500 year boundary No Yes Within 100 year flood boundary No_ Yes Death of]Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervi mtiterial exist in all areas observed throughout the area proposed for the soil absorption system? sQ If not, what is the depth of naturally occurring F, viotis matal ial? Certification « �� I certify that on (date)I have passed the soil evaluator examination approved by the Department ofAil mental Protection and that the above analysis was performed by ma consistent with . the required tratnin ,e ertise ex ri cc described in�1 10 CMR 15.017. Signatu Date �¢ Q:\S.EPTIC\PRRCPDRM RCPDRM.DOC t TOWN OF BARNSTABLE L ICATION � Q rill /Z, SEWAGE# V LLAGE 441 ASS SOR'S MAP&PARCEL OC;-V- S f�d'�`PAZZ S NAME&PHONE NO. C�Tt SEPTIC TANK CAPACITY J10010 LEACHING FACILITY:(type) QCj ,V �� (size) NO.OF BEDROOMS _ L OWNER PERMIT DATE: C _ [ 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 r t 468 54 34• 40 21 47 .. Water � it S,+r i v.,e Mariner Circle COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION 5�e TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 354 Mariner Circle Cotuit MA 02635 Owner's Name: Patrick Conklin Owner's Address: Same Date of Inspection: February 9,2007 Job#07-23 r 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 DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: __X_ Passes L Conditionally Passes Needs rther Evaluation by the Local App; ving Authority ;'-, Fails . ° . Inspector's Signature: Date: 2/23/07 ;t i wr The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of ealth or ,..r 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 offici 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: Tan is not in need of pumping at this time,leaching pit has 6"of 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. Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _XX_ 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: Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 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 and Public Water Supplier,if an 2. System will fail unless the Board of Health( pp Y)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: Page 4 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 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_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.] _No_(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with.a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ the system is within 400 feet of a surface drinking water supply eo. 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. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 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? 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? _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? 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)] Page 6 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents:4 Does residence have a garbage grinder(yes or no):Yes Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use:(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Two years total: 123,000 gal.=168 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 is pumped annually 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: 5/18/82 Were sewage odors detected when arriving at the site(yes or no): No • 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: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 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: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: XX (locate on site plan) Depth below grade: I' 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: 2" Distance from top of sludge to bottom of outlet tee or baffle:28" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle:6" Distance from bottom of scum to bottom of outlet tee or baffle: 12" 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.): Baffles are intact and clear,liquid level is at bottom of outlet invert. 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.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: XX (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: 0" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): No solids or high stains present. 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.): Page 9 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 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/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): Liquid level is 6"below top set of holes indicating pit has 6"of effective leachine. 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.): Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 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. AM 68 54 34 40 21 47 54 Water Service Mariner Circle ` Page I 1 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354 Mariner Circle,Cotuit Owner: Patrick Conklin Date of Inspection: February 9,2007 SITE EXAM Slope None Surface water None Check cellar Dry Shallow wells None Estimated depth to ground water: More than 20 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) _Checked with local Board of Health-explain: Checked with local excavators, installers=(attach documentation) _X_Accessed USGS database-explain: USGS topo map and town GIS You must describe how you established the high ground water elevation: Town groundwater contour map shows water below el.30 and topo map shows property above el.60. COMMONWEALTH OF MASSACHUSETTS EREVED EXECUTIVE OFFICE OF ENVIRONMENTAL AFFADEPARTMENT OF ENVIRONMENTAL PROTEC 2002R.NSTABLE DEPT. E. TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 354 MARINER CIRCLE COTUIT,MA 02635 OLH 11 S Owner's Name: MARY OLLERHEAD Q Owner's Address: 354 MARINER CIRCLE COTUIT, MA 02635 p Date of Inspection: 9/10/02 Name of Inspector: (please print) i JOHN GRACI Company Name: SEPTIC•INSPECTIONS 11C Mailing Address: '�'`, P.O:BOX'1119 TEATICKET,MA.02536 W , Telephone Number: 508-564,-6813'FAX 508-564-7270 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the,time of the inspection.The inspection was performed based on my training and experience in the proper function and'maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340�T,Title,5(310 CMR 15.000). The system: X Passes r _ Conditionally Pa 4zs _ Needs Further :luation by the Local Approving Authority Fails Inspector's Signature: Date: 9/10/02 The system inspector shall submit 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 '' SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING NOW AND THEN EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ****This report only describcstcodditsoias at the time of inspection and under the conditions of use al Ihnt lime. This inspection does not address how:,the,systean will perform in the future under the same or different conditions of use. d Page 2 of 11 OFFICIAL INSPECTION TORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 1 I.'4. :., PART A j CERTIFICATION (continued) Property Address: 354 MARINER t IRCLE-COTUIT, MA 02635 Owner: MARY OLLERHEAD Date of Inspection: 9/10/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D 9 r A. System Passes: t X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING NOW AND THEN EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components' s'�iescribed 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. zro . ) in the for the following statements. If determined"please explain. Answer yes,no or not determined(Y.,N;NG n/a The septic tank is metal and over 26'ears 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: n/a n/a 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 z, 6 r ; _ obstruction is removed distribution box is leveled or replaced ND explain: n/a n/a The system required pumping moire 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: n/a „ ,� Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A j` 'CERTIFICATION(continued) Property Address: 354 MARINER CIRCLE COTUIT,MA 02635 Owner: MARY OLLERHEAD Date of Inspection: 9/10/02 C. Further Evaluation is Requiredlby,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 3,10 CMR 15.303(1)(b)that the system is t,' 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 septi0ta ik'kh'd SA,S�land the SAS is within 50 feet of a private water supply well. o) 4v' _ 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 n/a "This system passes if ttie well Walter analysis,performed at a DEP certified laboratory, for colifort-n bacteria and volatile organic compounds indi4'ates 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 attache d`t'this form. 3. Other: ` n/a 1{{ ••t"1<;('�.,+.�.`If•., .'fin Page 4 of I l ,t y. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A l: CERTIFICATION(continued) Property Address: 354 MARINER CIRCLE COTUIT,MA 02635 Owner: MARY OLLERHEAD t Date of Inspection: 9/10/02 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 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 NO PUMPING INFORMATION. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspo'61g6r privy is w''ithin 100 feet of a surface water supply or tributary to a surface water supply. _ X Any portion of a cesspoo!Ipt privy istwithin 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 Jess 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 thaf facility"and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided thad no other failure criteria are triggered. A copy of the analysis must be attached to this form.] (Yes/No)The system faits. 1 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 systemi'mtust serve.a facility with a design now 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 X the system is within 400,feef of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a niltroge'n sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well' If you have answered"yes'4 toany question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large sy,Ien I as filled. The owner or operator.of any large system considered a significant threat under Section E or failed under Section D sliall upgrade the system in accordance with 310 CM It 15.304. The system owner should contact the appropriate regional office of the Department. t, Jril A kli I d i tt Page 5 of I I OF INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 354 MARINER CIRCLE COTUIT, MA 02635 Owner: MARY OLLERHEAD, Date of Inspection: 9/10/02 Check if the following have been done. You must indicate"yes" or"no" as to each of the following: k Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health 4 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 9 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`Soril Absorption System (SAS)on the site has been determined based on: Yes no X _ Existing infonnation. 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)(6)] lc, ' ti 1 v� 4 i 5 '';, e Page 6 of OFFICIAL INSPECTIONS FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ft PART C SYSTEM INFORMATION Property Address: 354 MARINER CIRCLE COTUIT,MA 02635 Owner: MARY OLLERHEAD Date of Inspection: 9/10/02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR1.15.203.`(for example: 110 gpd x#of bedrooms): 220 Number of current residents: 1 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), NO Seasonal use:(yes or no): NO; tf Water meter readings, if available(last 2 years usage(gpd)):tea.o I - Z�f�OQ Sump pump(yes or no): NO An W , �oO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL,',. Type of establishment: n/a Design flow(based on 310 CM•R€1 5:203): n/agpd Basis of design flow(seats/per'soiis/sgf,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank presen�t`(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: NO PUM3PING INFORMATION Was system pumped as part of the inspection(yes or no): NO kk If yes,volume pumped: n/agallons,,-How;was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X 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) j.; _Tight tank Attach a copy of the'DEP approval Other(describe): n/a 14, Approximate age of all components,date installed(if known)and source of information: 20 YEARS BY OWNER Were sewage odors detected when arriving at the site(yes or no): NO ik S Page 7 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354`MARINER CIRCLE COTUIT, MA 02635 Owner: MARY OLLERHEAD Date of Inspection: 9/10/02 BUILDING SEWER(locate onisite plan) Depth below grade: n/a Materials of construction: cas't��iron 40 PVG"Xother(explain): 20 PVC Distance from private water supply well or suction line: n/a Comments(on condition of joints-venting, evidence of leakage,etc.): TOWN WATER a%# SEPTIC TANK: X(locate on site plan) Depth below grade: 12" Material of construction: Xconcrete 'metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age conffemed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6" H W* 10"" Sludge depth:3" Distance from top of sludge to bottom of outlet tee or baffle:31" Scum thickness:3" Distance from top of scum.to top of,outlet tee or baffle: 6" Distance from bottom of scum,to bottom of outlet tee or baffle: 15" How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING,NlOW.AND THEN EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP:_(locate on.'' Depth below grade: n/a s. Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a t i ,; , Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom,of outlet tee or baffle: n/a Date of last pumping: n/a `r; "I" Comments(on pumping recommendations,,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a A '4 L.-s �'e �l` lid:. -7 Page 8 of I I 4 ' 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE-SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354 MARINER CIRCLE COTUIT,MA 02635 Owner: MARY OLLERHEAD'`` Date of Inspection: 9/10/02 TIGHT or HOLDING TANK: (tank must,be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A. Alarm level: N/A Alarm in;working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present-must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments(note if box is level and distribufion to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): D-BOX IS STRUCTURALLY SOUND., PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no)'NO' Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 1a i1!j1 '13 t ' •,!l' N. c R c. r Page 9 of 1 I F. 4 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354 MARINER CIRCLE COTUIT, MA 02635 Owner: MARY OLLERHEAD Date of Inspection: 9/10/02 SOIL ABSORPTION SYSTEM;(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system l Type/name of technology: n/a Comments(note condition of soil;signs of'hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE. PIT HAD 1' OF LEACHING IN IT AT TIME OF INSPECTION.STAIN LINES INDICATE PIT HAS NEVER HAD MORE THAN T OF LIQUID IN IT. BOTTOM IS AT 7'6". CESSPOOLS: (cesspool must`be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no):'NO Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) i e� Materials of construction: n/a ; Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,,signs of{hydraulic failure, level of ponding,condition of vegetation,etc.): n/n Q Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354 MARINER CIRCLE COTUIT,MA 02635 Owner: MARY OLLERHEAD Date of Inspection: 9/10/02 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal s ystem 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. A-6 �93 d AC, SDI 13A 30' W 39q BD 3LJ3 4 1. 1 1 to s s in Page 11 of I I s i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 354 MARINER CIRCLE COTUIT,MA 02635 Owner: MARY OLLERHEAD Date of Inspection: 9/10/02 SITE EXAM _Slope _Surface water _Check cellar _Shallow wells Estimated depth to ground water 12 feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system desi n Y g plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavator's, installers-(attach documentation) NO Accessed USGS database-'explains n/a You must describe how you established the high ground water elevation: HAND AUGER- 12 FT. N. LO AT ON SEWAGE PERMIT NO. VT E I N !M ER'S - NAME i ADDRESS B U I L D E R OR OWNER DATE PERMIT ISSUED /,Lv DATE COMPLIANCE ISSUED Z v<Qr y� 0 3 o /,A0 �� arc E No. • Fim. ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................OF....... Apphration for Disposal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal SYS•17 a,) .. .............................................................. n.. ..... . ........... ... ... -A ess, or Lot No. .. .. ........ ..... ..................................... ...... .s. e dress ....... . ......... Installer Address Type of Building Size Lot.. 7 ....Sq. feet U Dwelling—No. of Bedrooms-__.......: ...........................Expansion Attic Garbage Grinder aOther—Type of Building - ...... No of persons. &............. Showers Cafeteria Other fixtures ................... ................. .......................... ----------------------------------------- ...........*--------------Design Flow........._F3.......................gallons per person per day. Total daily flow.........3%� .....................gallons. WSeptic Tank—Liquid capacity./O.t!V.gallons Length...,?'_�r.._... Width.4'.'Y...... Diameter................ Depth................ Disposal Trench—No......................Width.................... Total Length.................... Total leaching area........._..........sq. ft. Seepage Pit No......../--------- Diameter.......J?........ Depth below inlet_..7!Jn.... Total leaching area..s.J'25. --....sq. f t. Z Other Distribution box (/) Dosing tank ( ) / '3 7 ............. Percolation Test Results Performed by-... - .......................444U---- .... ---_-------- Date..... .... ... .. Test Pit No. I................minutes per inch Depth of Test Pit.._.__.............. Depth to grouniwater ..... ............ Test Pit No. 2................minutes per inch Depth of Test Pit i................... Depth to ground water.._ ..... i- ----- --------- .......................................,------------------------------------------------------------------------------------- 0 Description of Soil.... ....................................I--------- ........... .................a,....... .................................... .............I ....... ...... ................. . ................................ U --- ------------------------------- ..... 4-1 .. ...... .. ................ .......................................................................... ................................. 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 TL I Tl LE 5 of the State Sanitary Code— The under igned further agrees not to place the system in operation until a Certificate of Compliance has been sued.by the, and dAiealfh. Sign ...................... .... 7, .............. (/ate ApplicationApproved By.................... ...... ......... .. ------------ .......;7..../---Date-- .............. Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued-.:..................................................... Date No....... Fps r..� .............. THE COMMONWEALTH OF MASSACHUSETTS t � >; BOARD OF HEALTH ..../rl/ :/tdf----------------OF..........�1'� /,........ .................................................. Appliration for Ii-opnoal Works Tonstrnr#inn rumit Application is hereby made for a Permit to Construct �) or Repair ( ) an Individual Sewage Disposal System at: ................_ ._.__. ....-• - •-- .............................. ...............•-•-•.........-•-•--..._....••••--•--........------................-- Location-A 'dress f or Lot No. �/ f - Address a -�1 L i d I f(it' llLGfif.Gf�-•!/1 .................. .........•----....-•----•--•----............-•----......-•----.................................... Installer Address Type of Building Size Lot..:)y..j�: ...Sq. feet U Dwelling—No.No. of Bedrooms.___..__._.:��_______________� g— ___.__....._Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of BuildingL...�.......... No. of persons...._...../.............. Showers ( ) — Cafeteria ( ) dOther fixtures -----------------•..... ----•-------------..........--.•-•-••-•-•--•-•..................--•-•-••----.....-•-••---••---•--.......-----..........••--•- W Design Flow.........:5-'5 ...........•.........._gallons per person per day. Total daily flow...___._.__?ff�._.___...•............gallons. WSeptic Tank—Liquid capacity.j, .gallons Length.__.f�.__ Width!�_Y Diameter................ Depth....._.__...... x Disposal Trench—No..................... Width.......'............. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... ...___._.. Diameter.......9._._...... Depth below inlet-.?':-t_'..__. Total leaching area..:..F-?.......sq. ft. Z Other Distribution box ( /) Dosing tank ( ) '-' Percolation Test Results Performed by._.. �:r` .fK! '4 '' t" �� '� ... Date.._..f� -' __...._..... a . ........................................... i'/ 7- ---------- Test Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-.���.___...... 94 ••-•-•••-••-----•--•••----•-•-••...............•-••-•-•--..........._....... ....•-••-••--•-......---•--•••--•••-•--•...._.._....-••••._....--••••..•--- O Description of Soil....1_- ... =- ..rlly(f. ,_... ell V ...................................dd_,_......._.._.__.__✓_.,_._. a"__-._-'__'__........_..._..............:_........................_........._......._.._._......................__.......--------.- UW ................................./ ---T•�-----••'=1!.t�...I?!....------...-----------•-••--•-•--•----•--•-•-----•------••------••----•-.....t_�____rt!!q ........................ 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 TITL: 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beenn,issued by the,bo rd�of health. Signed..�//. i�?i ,'"1�//� �Sr/,//,pCf Application Approved BY ---._-•--•• • -- // /' - ----------•------ -------f�`�1 ----------------- Date Application Disapproved for the following reasons-----------------------------•--•----•----•--•---------------.--•---------------•------••---•••••......__-----» .........-•---•-------•---•--•-------•---•-------------•--•-----•--•------•------•----....------.........--------•-----------------------•-•------------------.................................. Date PermitNo......................................................... Issued------•----..........----............................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �S. ................................C!ft ..OF..... ...............................- .. ....................................r� rrfifiratr of Tout lianrr THIS IS TO CER,TIFY,`That the Individual Sewage Disposal System constructed O or Repaired ( ) /7. . .l / f Y/�Llc_f_Grr�t l •-•••...............................f•----------••.........................................••. f � ( Installer at-----------------.----•----....:/� !{/r1. =r r�f l t ci�G ��� y,_..... .............•••---••-•......... -------------------------------- has been installed in accordance with the provisions of "' r of, he State Sanitary Code as d 'cr' ed in the application for Disposal Works Construction Permit ..----••... da.ted_..��`,l,,C ► f.........•..••••- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ .:_ . --•--_._. Inspector..--------••••...:_�. �_�i�� ...... t:A THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , r vv ..................OF.... 41..�; . :E,% ........................... FEE No._. --.. - - Disposal Worb Tnna#rurtion ranfit Permission is hereby granted ``-�..--- ,�i-` . ..... .r-J�._C._..._ -� ):.... -•--•-•........••- to Construct or Repair ( ) an Individual Sewage Disposal System _ at No..---.... •. . ................ •- -.-... Street.- as shown on the application for Disposal Works Construction Pe 't No. ............... ated.._., "°" -S_..... ....... /' •- <' .-. r Board of Health DATE VV FORM 1255 HOBBS & WARREN. INC., PUBLISHERS , 00 L=95.54 COTUIT 6' G 0 Cr LOCUS 5� G n z ' G 97 �P - DEC cow NORMAN GAR GROSSMAN PLAN 1970 59 C.BAS LOCUS MAP 354 �'�� RIM= �� 58.15 TCF=61.90 / o � ® LOCUS INFORMATION PLAN REF: TUBE 167 0 / TITLE REF: 15940/142 PARCEL ID: MAP 24 PAR. 115 DECK CO / q IN. ZONE II ZONING: "RF" "WP" / P FLOOD ZONE: "C" PINE P �O 00 COMMUNITY PANEL: 25001 5-0001-D DATED:07/02/92 Cn 0 SEPTIC SYSTEM TBM: COR. � S- %O 1000G TANK / / REPAIR PLAN CONC. PATIO O �"� (TO REMAIN) LOCATED AT: EL=59.37 Lp ABANDON / 354 MARINER CIRCLE PINE 0 1 LEACH PIT / COTU I T, MA. u'-LOT 66 PER TITLE 5 57 LOT 96\ // PREPARED FOR s, co /�° S. 57'0 AREA=29,460t S.F. / P A TR I C K & MAR Y 5� s / PI CONKLIN / ��'� 1 ` // APRIL 23, 2014 OF o� fJr lysycy `(H htaSs9 56 / o DAVID Gs� moo`' ED RD' oyG� it O D. VENT / o A. � / . FLA E R. STb.Nf=: 55 No ;28 0 _ ,� / F �� pp P O 54 76�oD J / o E. A. S. SURVEY, INC. GRAPHIC SCALE / 141 ROUTE 6A \ / SALT POND BUILDING 20 0 10 20 40 80 / P.O. BOX 1729 LOT 95 �— / SANDWICH, MA. 02563 ( IN FEET ) / 1 inch = 20 ft. , / BUS:(508)888-3619 CELL:(508)527-3600 SHEET 1 OF 2 J 1643 EL=61.9 TOP OF FOUNDATION (EXISTING HOUSE) 4" SCHEDULE 40 P.V.C. PROFILE OF (10' MIN.) MIN. PITCH 1/8" PER FOOT TIE N DS OF SEWAGE DISPOSAL SYSTEM 2" LAYER OF LINES ANDVENT 1/6" - 1/2" (NOT TO SCALE) WASHED STONE EL=59.6 EL= 58.0 OR FILTER FABRIC ::� ... .......... .. .........::�.. EL= 57.0 ;..............::� :............... 6" MAX.' ........ EL= 56.5 EL= 55.0 .......::8 .....::;::::;::::�;;::: ::::::::::r;:;;s:::;;;;;;;;;:::::::........,.,........ ......... . ...,,. INVERT 9" MIN. COVER _ .. ................:::� . . . RISER & .... • ....................... (EXIST) RISERS AS NECESSARY "„ 2.8 COVER CLEAN SAND FILL EL-- 56.91 (AS NEED.) LEVEL 3.3' ^� PER 310 CMR 15.255 4" SCH40 PVC FOR 2' TOP= 52.2 30' 0 S=.005 15' S= .28 -+.-I 7'(LONGEST RUN) S=.01 EMI LOW LINE T" END INV=51.00 14" FE ERT INVERT INVERT $"° °°° c° :°°o°�O°' °4o�a� cm�°° °°�oi�°c�+�o`�°o�y°6" EL= 50.5 55.66 EL=51.39 6" SUMP EL=51.22 4' GAS s" BASE of MECHANICALLY BEG INV= 51.15 7EX .83 BAFFLE COMPACTED SAND I PROP. D133 i INVERT DISTRIBUTION 30.0' 6" BASE OF COMPACTED SAND BOX W/"T" 3/4" To 1-1/2" SOIL ABSORBTION SYSTEM (FIELD) ui o EXISTING , Of DOUBLE 16.0' X 30.0' 0-WASHED 1 ,000 GALLON TANK (TO REMAIN) GENERAL NOTES - BOTTOM OF TEST HOLE 2 ELEV.= 45.1 ' 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 O FOR SUBSURFACE DISPOSAL OF SEWERAGE. SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED 2 ALL ACCESS PORBE ACCESSIBLE WITHIN 6" OF FINISH GRADE,OVER TANK TEESALL WITH ANY REMAINING BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE DESIGN DATA ACCESS PORTS BROUGHT TO WITHIN 6" OF FINISH GRADE. DESCRIBED IN 310 CMR 15.017. I FURTHER CERTIFY THAT THE RESULTS OF MY 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE SOIL EVALUATION, AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM, NUMBER OF BEDROOMS.........-- 3 CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE ARE ACCURATE AND IN ACCORDANCE WITH 310 CMR 15.100 THROUGH 15.107. GARBAGE DISPOSAL.................-- NO -- UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY TOTAL ESTIMATED FLOW MUST WITHSTAND H-20 LOADING. 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION (110 GAL./BR./DAY X 3 BR.) 330 OF ALL UTILITIES PRIOR TO ANY EXCAVATION. EDWARD A. STONE, CERTIFIED SOIL EVALUATOR 330GPD X 200% = 330 GAL 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE USE EXIST. 1000 GAL. TANK OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE TEST PIT RESULTS: P 1432.4 , OVER THE S.A.S. AND DISTRIBUTION BOX. INSTALL: 16 X 30 FIELD (W/6 CRUSHED STONE UNDERNEATH) 7. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF SOIL TEST DATE: APRIL 08, 2014 SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE REPLACE WITH CLEAN SAND PER 310 CMR 15.255 THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND SOIL EVALUATOR: EDWARD A. STONE SOIL CLASSIFICATION................_ 1_ _ LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN TOWN REP: DONNA MORIANDI I DESIGN PERCOLATION RATE..... <2 M-tN-I--/LN. 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT ; EFFLUENT LOADING RATE......... -_74_-- ELEVATION OF THE OUTLET PIPE. BACKHOE: JOEY DEBARROWS , 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. REQUIRED LEACHING CAPACITY.....330 GAfDAY 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS LEACHING CAPACITY PROVIDED.....35_5_GA�DAY TEST PIT BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. ELEV. # 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND 57.0 DEPTH (IN.) HORIZON TEXTURE , COLOR MOTT. OTHER BOTTOM: (16' x 30')(.74)= 355 GPD FIRST TWO FEET OUT OF THE DISTRIBUTION BOX SHALL BE LEVEL. 53.0 0-48" FILL -------- _---- 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION 51.0 48-72" B LOAMY SAND .5YR5 6 TO E.A.S. SURVEY INC. FOR B.O.H. AND DESIGN 47.0 72-120" C MEDIUM SAND 2.5Y7/4 ENGINEERS REVIEW AND APPROVAL. NO GROUNDWATER ENCOUNTERED 355 GPD PROVIDED - 330 GPD REQUIRED = 25 GPD RESERVE , CONSTRUCTION NOTES: ya �SHOFMq 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ELEV. TEST PIT 2 PERCOLATION RATE <2 MIN./IN. BOT ® 56" o�F? DAv Dcy SEPTIC SYSTEM DETAIL PAGE ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING 55.1 DEPTH IN. HORIZON TEXTURE COLOR MOTT. OTHER R #354 MARINER CIRCLE � WORK ON THE SITE. 54.6 0-6" OEA LOAMY SAND 10YR5 1 10YR4 3 y COTUIT, MA. 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE 53.1 6-24" B LOAMY SAND .5YR5 6 WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 6 60 SjE�"24-42 ClSANDY LOAM 1YR FGi APRIL 22, 2014 IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 51.6 / 3. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING 45.1 42-120" C2 MEDIUM SAND 2.5Y7/4 PERC SAN ARP TAPE OR A COMPARABLE MEANS. NO GROUNDWATER ENCOUNTERED cf SHEET 2 OF 2 J# 1643 Ail F.FL. ELEV.= ----- FINISH GRADE —FINISH GRADE FINISH GRADE--- - TOP OF FOUND. OVER TANK �� 0 OVER PIT = X' ELEV. = —�. CHIMNEY BLOCK 4 C.I. — 4� V.C. \� WHERE NEEDED BACKFILL 3� PEASTONE DWELLING -- ---- - 4 •p — -- _—, o O 0 O P v • o O ti 0 C CELLAR FLOOR 1CD�'�O GALLON -o. o 0 O �j , 0 0 0 3/4 TO I-I/2 ELEV = )Cd I' '.. d (, . . O o o REINFORCED GONC. ,; o G CRUSHED STONE cll� �o O O O o v �� o 0 0Q ._ e ODIST. BOX? � " r O O U 0 o QQ a o O O O o e- (TO BE LEVEL ` .d J o o C� �; O o (• a BOTTOM OF PIT SEPTIC TANK T_ -� - Oo AND STABLE) ��:� ° 'o O O o � ELEV. _ SYSTEM PROFILE 1 ' NOT TO SCALE) LEACHING PIT 6z ` 3k z �` DESIGN CRITERIA ,'\ 1 BE R OF BEDROOMS GALLONS PER DAY ------ � GARBAGE GRINDER = _�k�� .�+ ( ';ZX77 TOTAL DAILY FLOW LEACHING AREA PROVIDED = _50-�- .�1'a - FpQ s1 Or_W ►L� A.ex-,4, 2x A- x a u -7 Z x Z•S= Q S5.5 C P D �� o �' � � ► t0 o�C4 3 / (3cT"ro rvi .�12- - IT ) X i 'r '' . ��r1 ©' -- A It 0 0 V � SOILS LOG 0" ELEV;= '► �FAP M V � S? �� 1 6AiZ�' n /� C L:4.8 .S C.�c�e.R-SE l�9to GA ^t-'3 !3z OSED SEWAGE wl cel-va.15. DISPOSAL SYS T EM rGK E. INSPECTED BY '�►..�� [LUtZr2 PROPOSED DWELLING_ DATE 24 ► l •T�W.�.,.�` <<<7T+ t MASS. PERCOLATION RATE :G MIN./INCH SCALE AS NOTED DATE t - ZS ��j7�",i OWNED BY:j t-ACC.' r aC T� ) CGt� 1 I — �c�v.,T-1 0> � I: orJ M 51, QA.�tJ Ivk tN Of MAS �C� Z4 G ILc�hT Ior<J 1� f>� JC Z- Lo-r' S►�-�o w�J o•._� F�c�►,►.� Tc��..�e I G'7 S He c T eJ Q.` � �, 3- L7-F ZO 14ORMAN 4--" NU 1 I&J F (I TJ MAN — 5_ I`x I S'T, C LerV. =54-1 a � .p b0 4 NORMAN GROSSMAN_ P.E., R.L.S. vc—cAn V, = 5�oto A Q ��`r 226 HOLLY POINT ROAD (::pn.)iT?*ult :a(.t - 10*ALE CENTERVILLE, MASS: