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HomeMy WebLinkAbout0165 OCEAN VIEW AVENUE - Health 155 (beach hse-Ocean View - Avenue Cotuit F No� ` —3 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppfication for Migoal *pgtem Con5truction Vermit Application for a Permit to Construct( . )Repair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 16,'5_Q1CeA-X l"!iN%H1K- Owner's Name,Addres and Tel.No. /�t/s Assessor's Map/Parcel 41� �® 1o�a C®n� �.� &a fCQ G 3 3 0 3.S/3 Installer's Name,Address and Tel.No. Designer's Name,Address and Tel.No. �Z116-rr..e_ 1.`tacc�.l��Tzr Type of Building: Dwelling No.of Bedrooms 4r Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable)Tyo� fl_ O Ptm Ln Q Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu by this oard of a th. // Sign Date T_. , _^a Application Approved by Date Application Disapproved for the following reasons Permit No. -3 Date Issued.ems f cry --3 7o`� ®D N . `Fee 0 Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS Yes , .-PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE MASSACHUSETTS U LIC HE LS -- 2pprtcatton for Mtgpogar *pgtem ton!Aruction Permit Application for a Permit to Construct( . )Repair(V)1Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. j5 OeeA..r V to w A`c' Owner's Name,Addresk and Tel.No. Assessor'sMap/Parcel G 3mO 'a C4 -Ohs tt?n,qT1jA-i-- //') 1 C� Installer's Dame,Addresi,and Tel.No. Designer's Name,Address and Tel.No. l•�s� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons "Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Nurn er,of sheets Revision Date ' Title ' Size of Septic Tank Type of S.A.S. .Description of Soil Nature of Repairs or Alterations(Answer when applicable) �efla..f` O k Ais 'Date last inspected: ' Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system " in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- ' cate of Compliance_has been i�uhd �thhioard of th. -='- z i 1 , .( a fi'G�t'' ..:. - _. Sign d - DateTc_ Application Approved by Date Application Disapproved for the following reasons Permit No. f3 Date Issued ? o # HE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( )Repaired (tom"j Upgraded( ) Abandoned( )by .S Nt, CoZtj at 16S- aCCa" Vtew A.e, C_OZZ, T has been constructe in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a Ooq- )7�- dated Installer Designer ` The issuance of this p �ermtt shall not f construed as a g uarantee that the system will functi�On as designed. Date Inspector ' g . � ----------------------- - No. �� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS &5pogaf *pgtem Congtructton permit Permission is hereby granted to Construct( ,)Repair(k.1 Upgrade( )Abandon( ) System located at )Z,5— 00-M tL t r c,,) ro RL 7- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction ipust be completed within three years of the dat of this p t. Date:_. �y Approved by • TOWN OESARNSTABLE � LOCATIONf(IJ 4Ve SEWAGE # : VILLAGE ✓` / ASSESSOR'S MAP & LOT 0o2,6 INSTALLER'S NAME&PHONE NO. // tea/,S�t v?�Ste° SEPTIC TANK C 'PAC CU(5/9/ /-/-3/® LEACHING FACILITY: (type) SG b���• C� c (size) 07 ax 55 NO. OF BEDROOMS ` BUILDER OR OWNER PERMITDATE: Ak• L COMPLIANCE DATE: a o 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 f� =C!. Its t � A- o - - _ SQ., No. c9vo 3 U O / tr f Fee Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: "Yes—r� PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Application for 30igpool 6petem Com5truction Permit Application for a Permit to Construct( )Repair OO Upgrade( )Abandon( ) XComplete System ❑Individual Components Location Address or Lot No. CGS' �C'6 (� V/ Owner's Name,Address and Tel.No. Assessor's Map/Parcel Inst is Name,Address,and Tel.No. Designer's Name,Address and Tel.No. /WAi,U 1S' / osr 7.o19 a2G�S Type of Building: Dwelling No.of Bedrooms Lot Size 6��°�$t sq.ft. Garbage Grinder( ) Other Type of Building 0EXKff frousif�;- No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3�� gallons per day. Calculated daily flow gallons. Plan Date��i 9,/° Number of sheets / Revision Date Title Size of Septic Tank '47Vo (5�0 � Type of S.A.S. ,cry'&,-✓ 1,feG 0,'�8c�e,S Description of Soil .��4yLc72 — "iVe S 7V Id Nature of Repairs or Alterations(Answer when applicable) Y71 Tnc 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 Environment 1 Yode and not to place the system in operation until a Certifi- Ycate of Compliance has been issued this Boaz ealth Signedr, Date application Approved by Date Application Disapproved for the following reaso Permit No. aCDate Issued Fee t COMMONWEALTH OF MASSAFHUSETTS Entered in computer: les ✓ PUBLIC HEALTH DIVISION - TOWN OF BARNST'A BLE., MASSACHUSETTV', 2pplication for �iqoqal *pitem Construction Permit' Application for a Permit to Construct Repair()()-tJpgrade(I Abandon ArComplete System 0 Individual Components Location Address or Lot No. 16S— 006—,*4/ Kle-W loft/4�F, Owner's Name,Address and Tel.No. Assessor's Map/Parcel I 331Z-6 25*;.Vx1s-77:7 Inst er's Name,Address,and Tel.No. Designer's Name,Address and Tel.No._f bow j Z4(e 9"5 9 ^4 7-0 6-0 r sca 0 0�%Xl Type of Buildingt -7�2_9 Dwe4lii &A ng No.of Bedrooms Lot Size sq.ft. Garbage Grinder-(' Other -,'Type of Building ;RC',0?0,y 404e5&_ No.of Persons Showers(`I'Cafeteria Other Fixtures Design Flow 3-C gallons per day. Calculated daily flow gallons. Plan Date YI/a-N Number of sheets Revision Date Title Size of Septic Tank /Urvo 01-_G ----Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) al 77 77--9'A,-?c 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 Environment VI ode and not to place the system in operation until a Certifi- I'cate of Compliance has been issued this ar oft ealth yt is Bo d f V Signe < A Date Approved by D ate 4ppli6ation App, f IS —f VbG Application Disapproved for the following reasor2 Permit No. v Date Issued - -------------- PA/ 1171,; P, THE COMMONWEALTH OF MASSACHUSETTS r(/V-/ / BARNSTABLE, MASSACHUSETTS -J�6�4 Sq s Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired (Upgraded l'f i�VV(U� Abandoned( )by at )&,5- .,VP&--I (/ P`16- rt-e / 7- has been constructed n accordance 5111 with the provisions of Title 5 and the for Disposal System Construction Permit No. 9,60kq Y-7 dated 1 0/3 Installer ---Designer The issuance of this hall not be construed as a guarantee that the s func Zioa_gdesigned. Date Inspector Uv_i) NO. ----- ---------------------- ---��-- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwiopozal *pztem Construction Permit Permission is hereby granted to Construct( )Repair Upgrade Abandon System located at /0,5- e206-2�X1 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction fitist be completed within three years of the date of this Date: Approved by 197 415'1 r e' COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION FRECEIVED L 10 ?003OF HARNSTABLEALTH DEPT.TITLE 5 ._..___.. OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 165 Ocean View(Main House System) MAP ��� Cotuit. MA 02635 PARCEL 2 Owner's Name: Graham Miller LOT Owner's Address: Date of Inspection: June 5, 2003 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 OsterviUe,MA 026S5-0049 Telephone Number: (508)862-9400 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: ✓ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority F ils Inspector's Signature: Date: June 6, 2003 The system inspector shall sub a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to'the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I r Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 165 Ocean View(Main House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is.imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 165 Ocean View(Main House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 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(l)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I 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 Gom 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 165 Ocean View(Main House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than 'h 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 SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone I of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 165 Ocean View(Main House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 Check if the following have been done: You most indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping'information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection ? ✓ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ Existing information. For example,a plan at the Board of Health. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 1.5.302(3)(b)]. 5 r Page 6 of 11 .y. i OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 165 Ocean View(Main House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 5 Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 Number of current residents: 1 Does residence have a garbage grinder(yes or no): n/a 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 Water meter readings, if available(last 2 years usage(gpd)): 2002 613,000 2001 - 730,000 gals. Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCI LIMUSTRIAL 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 Source of information: Never pumped -per treatment plant 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: Nov. 97-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View(Main House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron 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: ✓ (locate on site plan) Depth below grade: 30" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 gal. (H-20) Sludge depth: I" Distance from top of sludge to bottom of outlet tee or baffle: 31" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 9" Distance from bottom of scum to bottom of outlet tee or baffle: 12" How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There were no signs of leakage Steel covers were to grade Recommend pumping. GREASE TRAP: None (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.): 7 I Page 8 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View(Main House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June S, 2003 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level and clean. No solids were present. The cover was 3"below grade(H-20) There were no signs of backup or failure from the leach field. PUMP CHAMBER: None (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.): M 8 r Page 9 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View(Main House System) Coto, MA Owner: Graham Miller Date of Inspection: June 5, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: I -6'x 6'(1000 ga1J ✓ leaching chambers,number: 6-cultecs with 3'stone-per design plans leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): _The pit had 4'of water on the bottom. The bottom to grade was 12'. The cover was 20"below grade. The leach field was located but not dug up. There were no signs of failure. The bottom to grade was approximately 6.5. CESSPOOLS: None (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: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View(Main House System) Cotuit, AM Owner: Graham Miller Date of Inspection: June 5, 2003 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. CAM SC 1 Q 30 s 0 a a3 3y y 3 .6 301 S p Y 3y 37 10 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View(Main House System) Cotuit, K4 Owner: Graham Miller Date of Inspection: June 5, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 35 +/- 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) ✓ Accessed USGS database-explain: topographic and water contour maps You mast describe how you established the high ground water elevation: Using the Barnstable topographic map and the Cape Cod Commission water contours map the maps were showing approximately 35'+/-to ground water at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 COMMONWEALTH OF MASSACHUSETTS AA'' t EXECUTIVE OFFICE OF ENVIRONI DdN CT10N DEPARTMENT OF ENVIRONMENTAL PROTECTION FT� *-R-Y-ASSE- � ® 0 ZOU3 TITLE 5 RN.STABLE DEPT. OFFICIAL INSPECTION FORM - NOT FOR VOLUS TS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 165 Ocean View Beach House System) Cotuit, MA 02635 Owner's Name: Graham Miller PJiIaP Q Owner's Address: PARCEL Date of Inspection: June 5, 2003 LOT Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 QWervHfe,MA 02655-0049 Telephone Number: (508)862-9400 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: , Passes Conditionally Passes Nee Further Evaluation by the Local Approving Authority ✓ Fail Inspector's Signature: Date: June 6, 2003 The system inspector shall sub ' a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 165 Ocean View Beach House System) Cotuit, AM Owner: Graham Miller Date of Inspection: June 5, 2003 Inspection Snmmary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 . OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 165 Ocean View(Beach House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 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 15303(l)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water ✓ Cesspool or privy is within 50 feet of.a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:. 165 Ocean View Beach House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or`nd"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z 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 SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone I of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [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.] NOTE: Single Cesspools fail in the Town of Barnstable. Also,the cesspool is within 50'of high tide. Yes (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd- You must indicate either`yes"or`no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well I 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. 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 165 Ocean View Beach House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 Check if the following have been done: You must indicate`yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection ? n/a Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components, excluding the SAS, located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ Existing information. For example, a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)(310 CMR 15.302(3)(b)]. 5 Page 6 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART C. SYSTEM INFORMATION Property Address: 165 Ocean View(Beach House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June S, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): I DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 110 Number of current residents: 0 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): Yes Water meter readings,if available(last_2 years usage(gpd)): 2602-23,000 2001 -22,000 gals. Sump Pump(yes or no): No Last date of occupancy: Beach house very little use ' COMMERCULANDUSTRIAL 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 Source of information: Never pumped-per treatment plant 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: Unknown-Approx. SO years old Were sewage odors detected when arriving at the site(yes or.no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean. View Beach House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Approx. 2'6" Materials of construction: _cast iron 40 PVC ✓ other(explain): Orangeburg Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): 1 SEPTIC TANK: None (locate on site plan) Depth below grade: Material of construction: _concrete metal fiberglass polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP: None (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.): 7 Page 8 of 1 l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View(Beach House System) Comit, MA Owner: Graham Miller Date of Inspection: June 5, 2003 TIGHT or HOLDING TANK: None (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: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): I 8 Page 9 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View(Beach House System) Cotuit, MA Owner: Graham Miller Date of Inspection: June 5 2003 SOIL ABSORPTION SYSTEM(SAS): None (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): CESSPOOLS: ✓ (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: I single Depth-top of liquid to inlet invert: — Depth of solids layer: — Depth of scum layer: -- Dimensions of cesspool: 5'Wx 5'Tx 7'6" bottom to grade Materials of construction: Cement block Indication of groundwater inflow(yes or no): Not at time Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): The cesspool was&fry with a sandy bottom. The cesspool is within 50'of high tide. The bottom to grade was 7'6". Assume that cesspool is in water when tide is high. PRIVY: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View Beach House System) Cotuit, AM Owner: Graham Miller Date of Inspection: June 5, 2003 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. 413 ae.6 ao Qeq� GrgsS -70 10 s Page 11 of I I G OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 165 Ocean View(Beach House System) Cotuit, AM Owner: Graham Miller Date of Inspection: June 5, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 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) Accessed USGS database-explain: You must describe how you established the high groundwater elevation: The bottom of the cesspool to grade was 76". The cesspool is within 50'of high tide. Assume that the bottom of the cesspool is in water when the tide is high. This report has been prepared and the system inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 No. 27 �. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(ppYication for Migool *p5tem (fongtruction Permit Application for a Permit to Construct( )Repair(1")Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No./6 S ®cell)n V't e.,J Ave, Owner's Name,Address and Tel.No. Assessor's Map/Parcel a 33— C)Z Installer's Name,Address,and Tel.No. Lj a 8�S6 Designer's Name,Address and Tel.No. ®2flG 11 Jv M f v 14 lbw.3 os eta,.. Type of Building: Dwelling - No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) - /,S'60 69 • 749, - D'Bo X. P CvR-cc o4— ,3/ S77prt e — � S-oaty- eout2-�✓t kjj','5r-tQAC Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss d by this Board of a Signed, Date /4 Q)- Application Approved by Date %6 `JT7� Application Disapproved for th ollo ng reasons l Permit No. / 7 - & Y-7 Date Issued oZ6 4 No. Fee , --- THE COMMONWEALTH OF MASSACHUSETTS T Entered in computer: t/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS ZlppYication for Mgogar 6petem Con5truction Permit Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. C e/4 n V i e .1 A vC Owner's Name,Address and Tel.No. co �,' Assessor's Map/Parcel`• a 3?S- V=Eb 01Z Insst�aller's Name,Address,and Tel.No. t ` 8,S6`! Designer's Name,Address and Tel.No. ISw._R>esr Type of Building: ' Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 4 D9,a>Aoe - 9 D0 6'61 7;�r/ " 0 $o —Cv/%cC 33o-$ S7o-4C — 3/� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss d by thissJBoard of Signed•_ �.,.4 Date Ala, 6,19 9 Application Approved by Date / Application Disapproved for th ollo ng reasons Permit No. 5' - G Y.-7 Date Issued - ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS _ Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(kl) Upgraded( ) Abandoned( )by _ at /&T 0 C e A n v t e-y ��e, Ce;i� r 7 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ?;7, Z dated z Installer Designer The issuance of this permit shall not be construed as a guarantee that the syste ill functio s signed, Date 7 Inspector ��Le...s , OM --------------------------------------- No. 9!7t Fees THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS lwigogai *p! tem Construction Permit Permission is hereby gr ted to Construct( > )Repair(Upgrade( ),Abandon ( ) System located at ro ©C?A n y k e v e - l b 6S , and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this p-eerrmiit. Date: �J -- �7 Approved by . i L © � t 10/9/97 • To Be Used For the Repair Of Failed NOTICIJ . This Form Is P Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) I, ofZAo &IS , hereby certify that the application for disposal works construction permit signed by me dated �Yo(/', 6� 9 9 ,concerning the property located at /6 ©C�,�c/ ULe� �� — Cvi�< � meets all of the following criteria: • There are no wetlands located within 100 feet of the proposed leaching facility • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will m9I be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) _` B)Observed Groundwater Table Elevation(according to Health Division well map) ^O SIGNED• DATE: //0 7 7 LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed Installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert / �� i �/7 �'� l f 1 _�- a p ��Q�a� C ��� .���� --_ / 1.OWN OF BARNSTABLE LOCATION �b C�coglJ l�';r Ayr. SEWAGE # -7-6 y 7' YII,LAGE 0C �T ASSESSOR'S MAP& LOT INSTAI;LER'S NAME&PHONE NO. ��7 �I�CAI�'STE2 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) C(I ZCCC` 330 s (size) NO"OF BEDROOMS S - BUILDER OR OWNER Ad /t7i/Z 2 PERMITDATE• COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist oii;site or within 200 feet of leaching facility) Feet Edge<of Wetland and Leaching Facility(If any wetlands exist sStivn 300 feet of leaching facility) Feet Furnished by oa-kr. :3y, r' .3q 9-Sax 3SI ��7 a3 C',ITec n . TOW/NN.OF BApR�NSTABLEi C ��/a X�i' I e(,J/"/ye SEWAGE # VILLAGE_ ? f� ASSESSOR'S.MAP & LOT 1133' INSTALLER'S NAME&PHONE NO.--ff../ftCa%��S 1c 492-65-CZ91 SEPTIC TANK CAPACITY CD C^Rl /-1-3w -. -- SG��� � / t:EACHING FACILITY: (type) I eG1, w/ rc-f (size) o7.S/x NO. OF BEDROOMS 1 BUILDER OR OWNER PERMITDATE: AlaV. - -S COMPLIANCE DATE: a Separation Distance Between..the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any well�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 r3 w c o TOWN OF BARNSTABLE ' L'GCATION l 06CA01 View /lVf-• SEWAGE # C97 6417 ._-1. VILLAGE CoTu� ASS SSOR'S MAP & LOT 033- Qce 6 IN NAME&PHONE NO.�1Am Qu re• 24 "1\ SEPTIC TANK CAPACITY �C/u �'7' a0 + LE ACHING FACILITY: (type) CAL; '330'S + ,p,��O (size) /Ob 6d NO. OF BEDROOMS BUILDER OR OWNER Grp M PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist: within 300 feet of leaching,facility) Feet Furnished by � /1&Pf-& l D+, D� t -07 B' a �G 3a 3 p a 3 Sy y 3 .6 30) s o y 3y 3-7 TOWN OF BARNSTABLE LbC;kTIOIv' �C 654 lied /4tir_ SEWAGE # 7- VILLAGE CCU` 7 ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. �1'ZgC'4ff,5TC1a SEPTIC TANK CAPACITY 4�-00 6119 LEACHING FACILITY: (type) Cc,/7PC— .330 s (size) ., NO.OF BEDROOMS S BtUDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the. Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r rPl- 30 Q f s �� � ��. r 3y (56 1 's 9-_O-x 3qi' a3� aly CoYTec,(, � Q ', - r OF� B �Sr1T���� F. � C LOCATION' y� Cd SEWAGE # VILLAGE ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITYO� —� = • LEACHING FACILITY: (type) ` ize) �D4 ty NO.OF BBEDROOMMS BUS�II,DER OR PERMIT DATE �j���' Z S� COMPLIANCE DATE: 14 JP? 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 • I y • TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE A�S�SESSOR'S MAP& LOT ZNG pG"-TOR'$r='NAME&PHONE N (p�( c4�,�-c� � .�7C,—E 26, SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) �`r„X Ski NO.OF BEDR BUILDER R OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 0 3 5t ' 53� ^" TOWN OF BARNSTABLE � Y LOCATION /� '�4 6,,eg� ��,u�-��_ SEWAGE # VILLAGE C� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIAN c.E GRANTED: Yes ���L� a 6 R4(.-e �>0 Ao - '� "o v S e /6 y . c FAQ 1/1ew AVe TOWN OF BARNSTABLE LGCATION l 000Amvtew AK, SEWAGE # VILLAGE C dnu,l ASSESSOR'S MAP & LOT 0 33—Qa 6 INSTALLER'S NAME&PHONE NO. 13eAd I—JQfIL SEPTIC TANK CAPACITY S71,14 C¢s—p,000_. LEACHING FACILITY: (type) (size) NO.OF BEDROOMS_ BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facilitx1, / Feet Furnished by ��OC fia. re�G__ House- \ 413 -I _. -PO , QeAt� GrASS "7 tw4Ter t 34.5 5.5 INLET & OUTLET T COVERS TO BE FINISH GRBROUGHT TO �� TEST PIT #3 GRID. EL. TEST BY: TEST PIT #1 GRD. EL. TEST BY: EL.=11.1 L-14 S- .02 EL.=111 FINISH GRADE 2°e MINIMUM FINISHED GRADE OVER LEACHING AREA PROVIDE INSPECTION PORT 1. UNLESS OTHERWISE NOTED, ALL CONSTRUCTION GW. EL. N A WITNESSED BY: GW. EL. WITNESSED BY: FIRST TWO FEET TO _ WITHIN 6" of FINISH GRADE METHODS AND MATERIALS SHALL CONFORM TO 11 "' DATE: 8 8 03 MOTTLING EL. N/A CERTIFIED BY: DATE: 8 8 03 MOTTLING EL.- CERTIFIED BY: (rn'•) `' BE LAID LEVEL TITLE V OF THE STATE ENVIRONMENTAL CODE AND ELEV. SURFACE SOIL SOIL SOIL SOIL ELEV. SURFACE SOIL SCiL SOIL SOIL 7.84 7.55 34 29 TOWN OF BARNSTABLE RULES AND REGULATIONS. �(�� DEPTH HORIZON TEXTURE COLOR MOTTLING OTHER DEPTH HORIZON TEXTURE COLOR MOTTLING OTHER ° 1500 GAL. 1000 GAL. 4.46 34.5 5.5 8.1 .;, 34.17 SEPTIC TANK :`. 7.59 : PUMP CHAMBER ►---- H_10 32.17 '' GROUT TO BE USED AT ALL POINTS WHERE PIPES �I i 7.3 14' MAX. 0"-5" q SANDY 10YR 3 2 - p"-4" B COARSE 10YR 6 5 - 14' (2) LEACHING CHAMBERS ENTER OR LEAVE ALL CONCRETE STRUCTURES IN I,I 34.1 LOAM / 5.2 SAND / 2 ----•• FOUNDATION ORDER TO PROVIDE A WATERTIGHT SEAL. 5"-13" B1 SANDY 10YR 4/3 - 4"-72" C CSAND 10YR 6/4 - `THIS IS A PROPOSED INVERT OUT. VERIFY :3. ALL SHIPLAP JOINTS IN SEPTIC TANK SHALL BE / C o t u 1 t 1 33.4 LOAM SAND FEASIBILITY PRIOR TO INSTALLATION OF ANY TO BE INSTALLED ON A TO BE INSTALLED ON A SYSTEM PROFILE GASKETS OR Boy LOAMY - BOTTOM PORTION OF SEPTIC SYSTEM. LEVEL & STABLE BASE. LEVEL & STABLE BASE. NOT TO SCALE CEMENT TO PROVIDE SEALED WITH EAEWATERTIGHT SEAL.HALT " \ { 13 -72 62 SAND 10YR 4/4 WATER OBSERVED ® 60 -,EL. 0.5 N,G.V.D.) �• DESIGN A N A YS I S INLET & OUTLET COVERS TO BE \ 28 5 MED.-COARSE NOTES: ��. PRECAST CONCRETE SEPTIC TANK, DISTRIBUTION 72 -78 C SAND E 10YR 6 4 - BROUGHT TO 6" OF FINISH GRADE. BOX AND LEACHING FACILITY TO WITHSTAND H-10 11 PoMt 1. CONCRETE - 5000 PSI MIN. 28.0 TEST PIT #2 GRD. EL. 1•2 TEsr BY: DESIGN FLOW: i1'_p 6„ N A' A STRENGTH O 28 DAYS I. LOADING UNLESS UNDER PAVEMENT, DRIVES OR OCu �\ BOTTOM PERC RATE: '� A - I s" MIN. 8• a \ TRAVELLED WAYS WHEREIN H-20 LOADING SHALL �......- WATER OBSERVED ® GW. EL. _.L._ WITNESSED BY: �- �o'-o" --�-, covER � a 2. STEEL REINFORCEMENT - 8803 N/A 3 BR x 110 GPD/BR - 330 GPD ASTM A-615, GRADE 60 APPLY. w // MOTTLING n 0 EL._._ CERTIFIED Y: _LL_ CE ED B NONE C U D NOT PR S A DATE: " S sons O L E O KCotult _ I ) I .�• •: �:,o„•�::.. .::•:,•..�•.... - � 4 PVC PIPES IN THE SYSTEM SHALL BE ELEV. SURFACE SOIL SOIL SOIL SOIL 24 D A. MANHOLE COVE 6" FLOW-TOP OF 3. COVER TO STEEL - 1 MIN. 5. ALL y High/and /s/ond DEPTH HORIZON R COLOR MOTTLING OTHER SEPTIC TANK REQUIREMENTS: , , a " ZABAOOLTER- ^ 20" ' � SCHEDULE 40. (� 11.2 ZO TEXTURE ING ER _ _ 330 GPD x 2 = 660 outLEr TEE w/ExTE sIDN `; "; B �6. WASHED CRUSHED STONE SHALL FREE OF ALL //L Beach 0"-3" q LOt,MY 10YR 3/2 - - I INLET 4•-1• m PLM VM DIRT, DUST AND FINES. ■■//��■■ 11.0 SAND USE 1,500 GALLON SEPTIC TANK a :? TEE LIQUID DEPTH /// LOCUS MAP 6" MIN. 3/4" TO 1-1/2"STONE " " :.., 5 DIA. KNOCKOUT 5 DIA. KNOCKOUT Y �,.� TYP TYP AT ALL POINTS OF INTERSECTION OF WATER LINES LOl M II I B 1oYR 5/3 - 1 : .•::�:'::::•:�•:::<.::�;::::::;:::•:;::;:;::::;;:::•:::::::;::::>:;:•:�::::•:•:::�:•:;::;:;:::. AND SEWER LINES, BOTH PIPES SHALL BE CON- Not To Scale 10.4 SAND PRECAST CONCRETE SEPTIC TANK e 2" -�" STRUCTED OF CLASS 150 PRESSURE PIPE AND ARE TO e• BOTTOM ON LEVEL STABLE B S ..• 10"_72„ C MED.-COARSE 10YR 6/4 _ NO WATER LEACHING FACILITY REQUIREMENTS: REINFORCED WITH STEEL R SECTION VIEW BE PRESSURE TESTED TO ASSURE WATERTIGHTNESS. Assessors Mop 33 Parcel 26 5.2 SAND ENCOUNTERED PLAN VIEW C OSS S 0 j BOTTOM SIDES: 2(25+12.83)(2)=151 SF (.74)=111.9 GPD 3) INLET AND OUTLET TEES TO BE CAST IRON " + 8. SEPTIC TANK, DISTRIBUTION BOX, ETC. SHALL BE WATER OBSERVED 0 PERC RATE: BOTTOM: 25xl2.83=320 SF (.74)=237 GPD NOTES OR SCHEDULE 40 PVC. " + 8»1 -2 MANUFACTURED BY ROTONDO OR AN EQUIVALENT 1) SEPTIC TANK TO WITHSTAND H-10 LOADING TEES TO BE CENTERED UNDER MANHOLE COVERS. a MANUFACTURER. Fn1 NONE (COULD NOT PRE-SOAK) TOTAL: 348 GPD UUNLESS UNDER PAVEMENT, DRIVES, OR TRAVELED WAYS, WHERE BY H-20 LOADING,SHALL APPLY. » » j 2 ALL PIPE CONNECTIONS AND CONCRETE CON- NO. OF GALLONS: 1500 4� �2 AREAEXCAVAND BACKFILL ATE ALL UNSUITABLE WITH MATERIAL AS DESCRIBED ���AL IN LEACHINGi1H Ur MAss9, �kv% OI Mq ARNE H. LEACHING FACILITY PROVIDED S UCTION TO BE WATERTIGHT. SEC" A-A WC*� ON PLAN. � o,,�� o� P ARNE J USE (2) 500 GAL. LEACHING CHAMBERS � BOX �A� CIVIL y o OJ H. SEPTIC TANK DETAIL "0.30792 9 Na.t2ssa CB Water (ACME OR EQUAL) WITH 4' STONE ALL AROUND. NOT TO SCALE DB-3 10.HEAVY EQUIPMENT SHALL NOT BE ALLOWED TOo� FCI R�0 0 R=.35.4 - NOT To SCALE - OPERATE OVER THE LIMITS OF THE SEWAGE DIS- STE 9 Gate Eli N�S� ® 'Town Wok PROVIDE VENT WITH CHARCOAL POSAL SYSTEMS DURING THE COURSE OF CON- STRUCTION OF THE SYSTEMS. pilfea _ To �lrp\\r' 912dE'3 G>r�IC�N9uPERV�S�� FILTER AND BUGSCREEN Y D SLOPE SURFACE TO DRAIN 11. NO FIELD MODIFICATIONS TO THE SEWAGE DISPOSAL 0 cj 36" \ `o EL. 37.0 S APPROVAL OF THE ENGINEER AND THE 0.02 SYSTEM SHALL BE MADE WITHOUT PRIOR Project Title �l p, Maple \O Evergreen \``o� BOARD OF HEALTH. . Z X Miller ,r BACKFILL WITH EL. 35.0 12.THIS SYSTEM SHALL BE INSPECTED AS REQUIRED BY O EXISTING SOIL ACCESS t�r,� TITLE V. 0� COVER o MIN. 2" LAYER OF 34.17 4" DISTRIBUTION PIPE 1/8"-1/2" DOUBLE 13.A CERTIFICATE OF COMPLIANCE AS REQUIRED BY ® a QQ I p, I - o t WASHED STONE TITLE V AND AN AS-BUILT PLAN Residence o's OF THE SYSTEM MUST BE OBTAINED BY THE 3/4"-1 1/2" DOUBLE WASHED STONE ? CONTRACTOR UPON COMPLETION OF THE ABOVE WORK. Grovel I N I o (2 ON ENDS) Entrance o p 114.THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE �' N 0 N 0 (3 ON SIDES) 165 c, 1 .. �"' EL:32.17 DISPOSAL UNIT. S °\o �\ Water ��� 15.ALL UNDERGROUND UTILITIES SHOWN WERE COM- • r ° \o Gate Landscape PILED ACCORDING TO AVAILABLE RECORD PLANS O�►^� � W _ re UNDISTURBED EXISTING SOIL AND ARE APPROXIMATE ONLY. SEE CHAPTER 370, �r i "" Q / Q cam, y`q�� �' �° _ a oyo Apo Q /o' \o \ (MEDIUM TO COARSE SAND) PROPOSED LEACHING DETAIL EL 0.5 - ACTS Oi:' 1963, MASSACHUSETTS GENERAL LAWS. o , / a� o WE ASSUME NO RESPONSIBILITY FOR DAMAGES o / ° / o, e �m /a 9 c o�� \ NOT TO SCALE j! INCURRED AS A RESULT OF UTILITIES OMMITTED OR { o �_� " © °�c o v \ PROPOSED VENT(FINAL GROUNDWATER ASSUMED venue Park Evergreens ( / Q o,wa / o y ; �� .\ ( AT EL. 0.5 (TIDAL INFLUENCE)II INACCURATELY SHOWN. THE APPROPRIATE PUBLIC 12" / Q�\ o \ PLACEMENT BY CONTRACTOR a \ ENGINEERING DEPARTMENT SHALL BE CONTACTED AS y ,� ° Gp \ � �\ WITH HOMEOWNER -� Sty �� \e WELL AS DIG SAFE (PH. NUMBER 1-8�30-321-4844) / ,. . I CON TA N)CBAH � -\ Fnd �•n.9 s / / ; \ sfep \� - I i i \o � ; /Ac* / (igh "�,•o °' / / i , ! Ma 12" Qom, 00 b � ww "� I I I I / Pole F b fij r j e , 1 �`'�� �° �'3 i I I I ' / / �\ •' �--- /' TOWN BANK l �+ oak ogwoo / 0 pn'w / 5 P 4" / c '� PRO OSE I I I ► I Cr / �', i 0 k' 4 4 e i STATE BANK Prepared For Dogwood`'N\ / �4�p��0 �l' y \o LEACHING I P / I n t i s 11 ( �.2+- /i � � � o � �•�� �. ? e \! quo h gc CAMBERS , "�g I / ,, �� �rh �O `ems i' ,• I ,�� , ; / c\ , � , O� 1k Patricia S. Miller ZONING SUMMARY / PROPOSED - 5" / N- - ----� '° A o / / / ,� i s - \,, _ ° n�eht STATE & TOWN BANK 4 �. ti �\o Q / D-BOX / 2" FORCE MAIN �0 ,�p�rrlc�i�/ �/. �� �� /. 1 (�,�' P.O. Box 1022 ZONING DISTRICT RF RESIDENTIAL DISTRICT m r\ st l i / �/ / � '/16l,�nx �S/' � .�� .' ,\� -�Ow�N B K � I CB J � COtUIt MA 02635 I MIN. LOT SIZE 43,560 S.F. `' �o \ l\ J ^� ^� / l / / i . i , i r'� -- / t` R=14.2 ' I \ 0 i L o n / / , �- -20-- "+..o� I Wa er f \ / / / / / / / / ,� ` - --- -�' 3, Meter Pit MIN. LOT FRONTAGE 150 `� c0 i \ ,��, I / i / TP a / /� // //// i i ,/ ,� 9,,-�-�- "-- e I I i ti� MIN. FRONT SETBACK 30' ti I \\ g m l ' _ / / / ' / / / / / i / ' / \ 2 FOR,CE MIN' ....>--� `� Hydran� MIN. SIDE SETBACK 15' � \oo� V \ 0 / � / / / � i � ' -- ----- -s=� � � �...� _. I G'ra 3261 Main Street a B,ENCHMARbf ---_ / .� k ♦ I \ o i / / / i / ° G)9 / Barnstable, MIN. REAR SETBACK 15' step p/ones I \ \\\ 4t�' ��°' / F!F. ELEV. AT 4p�6' �0 2 / t I / /i i i/ i/ ,/ // �i' /i' /�'/ -_--- _-_ /Igo ��\\\� 15 �� Fnd ' 9 o203o E .G.V.D. I 1 m o I / / , j // // ,� �! Za yr/n00 �t� NOTES. L a w n I tF / / / / \ =� �°ba :, t `t:�:' :..,:tc': ''.+;:'• r:::�::' A/°nts � � o� / / / � ro � / / / / / / / / / ,/ ,� i ,� \\ ,--� � �\ �`q� No / 'i" ';`'i� ';ti�: ';..• ';;: 1. THE EXISTING CONDITIONS SHOWN HEREON ARE THE RESULT I Allfo l ' l / / / / / / // / / / .' �' �' PROPOSED TPA OF AN ON-THE-GROUND SURVEY PERFORMED BY DOWNCAPE Half �e °'� '`l l �`° /' l °• / ,// ' / ' / ,' ,� '� '' '' i� -�/ ly1• Q �'�� / / , - / / / / / / / / , �i , R I 1,000 GAL. e e STATE-d1;1N BANK �/� / A. 11M. sCfl Associates Inc. ENGINEERING INC. ON OR BETWEEN 3/17/03 AND 6/13/03. C8/0H �`�� l / i/ i i ; ' / / ,� ��' ,� �.'� - fis PUMP CHAMBER S­ ,dye a -''= EL. 12 Fnd �8\ / flogpafe , l / / /�q�V�i i / i t1p9 Ce d'f!✓°° f10-~' `� \ f / \ GN 375 0327 / FAX 376 0329 2. ELEVATIONS ARE BASED ON N.G.V.D. �,, a'v // �i l t' //%i/ / / // ,' ��1s l ° a tom.,°-q's tt s 1 ° , ° . ■ ° . e1 �-� , o ° � 1,.590'�AL � - ° Drawing Title / / / / / / / / / , / / / , 0 /• PROPOSED 3. LOCATIONS OF UTILITIES SHOWN HEREON ARE APPROXIMATE / Arbor ,' / / ' / / / / / / / / 0 / / / ' / a� ,-'9� / ONLY AND ARE TO BE VERIFIED IN THE FIELD. ' / ' ' 0 SEPTIC T��NK \ / Plan s I ° g / / 'h / i / / / / // / / / � / •� � � to Flog�fbne i/ ,/ ' // /� '/i % i % %% i i �' / /� 'vry Gala Ste , Deck PROPO W & Patio 11 a/w �/ `n9 it\9 p , N� 36. .'°>k / �/ ,'�,/ /' / i �/ / / , / / / i / i� / ��- �' ��gt HAY,BALES INVERT ELEVATIONS �� - , , / , , / / , // / / , P E a E 4' de y' / / / / / / , 0 STATE & 0 .� \ i ..,,..,`STATE ' TOWN BANK •/ 1�5oden WoIR 4 INVERT AT BUILDING 8.1 F - / ,� / i i , / / / / / // / ��' L o w n r- 7--- ` ' I Aft _ r / , / , / / / , •''''' I - - s s ' Subsurfimv * Access Cover To Be - / / , , / /, , / , �.- I \ r 0 1 THIS IS A PROPOSED INVERT OUT. VERIFY FEASIBILITY PRIOR TO Supplied By Pump 10 G INSTALLATION OF ANY PORTION OF SEPTIC SYSTEM. Manufacturer'`- cd''/ / , :! ! I I I / / /•/ o �'�/ �'�/-- �' �`- `J ��'�/' ,� „ '�.�' /' / I I i •� 1 E% se erg• �� ?� - /- g _ 6--- I Sewage 4 INVERT AT 1500 GAL. TANK (IN) 7.84 2 PVC Schedule 80 ?,,ry � � ( i /°, , ,��,,.•'� V 1 e% ✓ / F ` ��' � --- \ -- PVC Conduit To Slope to Drain Back To \ \ t" d,. I I ZONE / � - ,�' ,/ �1�, °1� Control Panel Pump Chamber \� \ \ " s� ( / ° )� �' / �- _I► --_ /' r Disposal 4" INVERT AT 1500 GAL. TANK (OUT) 7.59 `. �\ \ \\ \ i e/`a 'r �,� ; ,' `� /5/ �- Non Shrink Grout \\ \ \ \ S / // _ ,� /• �4 (2) Lifting (Typical) \ \\ \ \ °�Z• ii ,� ,�/ 0 h , -- ���/ 4" INVERT AT 1000 GAL. PUMP CHAMBER (IN) 7.55 7.55 Chains \� \\��� '�`� //r �/ e 0 ,' / �i •• , , Inlet Weephole \/ , , / \ - Design 4 INVERT AT 1000 GAL. PUMP CHAMBER (OUT) O , - 'r 2 2 Dla Schedule 80 /6 �� Threaded Discharge Pipes ___�/ ���� Q 4 INVERT AT DIST. BOX (IN) 34.46 „ " WITHIN AREA SHOWN, ALL UNSUITABLE MATERIAL (A & B CBIVH 'Q°so I ,/ /' / �/ ALARM ON 8 (2) 2 Galvanized Pipes HORIZONS) TO BE REMOVED AND REPLACED WITH SOIL Fndalb 4" INVERT AT DIST. BOX OUT 34.29 CONSISTING OF CLEAN GRANULAR SAND, FREE FROM ORGANIC (OUT) MATTER AND DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS db`,�--__ I / ON 4" 1,000 Gal. Min. M , �. Septic Tank OF DIFFERENT CLASSES OF SOIL SHALL NOT BE USED. THE FILL INVERTS AT LEACHING FACILITY: SHALL NOT CONTAIN ANY MATERIAL LARGER THAN 2 INCHES. A -• __ ' -�' / „ - p_ ' 4 INVERT AT BEG. OFF 8 SIEVE ANALYSIS, USING A #4 SIEVE, SHALL BE PERFORMED SCcIe.1 '- 20 34.17 --_� '' LEACHING FACILITY ON A REPRESENTATIVE SAMPLE OF THE FILL. UP To 45% BY WEIGHT Mercury Float Concrete Fillet OF THE FILL SAMPLE MAY BE RETAINED ON THE #4 SIEVE. \ 0 10 20 30 40 50 FEET 4" INVERT AT END Switches SIEVE ANALYSES ALSO SHALL BE PERFORMED ON THE FRACTION OF �bb�d LEACHING FACILITY 34.17 Notes: MYERS RG-10 1 HP PUMP OR APPROVED EQUAL THE FILL SAMPLE PASSING THE #4 SIEVE, SUCH ANALYSES MUST 1.) Pump To Have Lift Out Guide Rail System DEMONSTRATE THAT THE MATERIAL MEETS EACH OF 8, V� Date Aug. 19, 2003 Drawing No. 2.) Pump Shall Be Installed In Accordance With Manufacturers Specifications. THE FOLLOWING SPECIFICATIONS: Design A,M.W. ELEVATION AT BOTTOM 32.17 3.) Exact Location Of Control Panel And Alarm To Be Located Prior Installation. EFFECTIVE % THAT MUST Check OF LEACHING FACILITY 4.) Installer's Responsibility to Determine Adequacy of Electrical System For Pump Installation. SIEVE SIZE PARTICLE SIZE PASS SIEVE 7 OBSERVED GROUND WATER ELEVATION 0'S PUMP CHAMBER DETAIL 50 0.30 MM 10%- 100%. Drawn J.V.B. 100 0.15 MM 0% - 20% Job. No. 2.1321.00 TP#1 NOT TO SCALE 200 0.075 MM 0% - 5X& Last Rev. of 1 ILLER BASE.DWG