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HomeMy WebLinkAbout0124 PINE RIDGE ROAD - Health F ne Ridge Road - 009 TOWN OF BARNSTABLE LOCATION done P►dgQ PNJ SEWAGE# Z©Z 1 19 0 VILLAGE C�®��i�' ASSESSOR'S MAP&PARCEL NSTALLER'S NAME&PHONE NO. R060c 'g ©U'Z SbB-- y77—Sg�77 SEPTIC TANK CAPACITY 1000 11 LEACHING FACILITY.(type) (size) a��?lb .tor►—��J{��g NO.OF BEDROOMS �J OWNER Cf i2 e PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching 1facility) Feet FURNISHED BY � b�?�p T CO . I `�3 9 cp 49 Q� icy 'pine_ Ridge, M r r Town of Barnstable Inspectional Services Department RN as ' Public Health Division iK�. i639 10� 0 " 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 8371 April 7, 2021 BRADLEY, GEORGE R&ELAINE TRS 5476 BRUNSWICK AVENUE SAN DIEGO, CA 92120 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 124 Pine Ridge Road, Cotuit, MA was inspected on 03/19/2021 by Patrick Rutledge, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: ' • Static liquid level in the distribution box is above the outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF TH BOARD OF HEALTH Kean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\124 Pineridge Road Cotuit.doc r Town of Barnstable � 39 .b,qInspectional Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,Cn0 Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS QYE 1 YEAR DEADLINE CRITERIA Static liquid level in the distribution box is above the outlet invert due to an overloaded or clogged SAS or cesspool ❑ A portion of the SAS, cesspool; or privy is below the high groundwater elevation ❑ A portion of the cesspool is located within a Zone 1 to a public well ❑ A portion of the cesspool is located within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems'' (broken cover, relocation of a pipe; relocation ofa driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS doc r Dt g- 9 Commonwealth of Massachusetts 00 Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road rd Property Address Cynthia Joiner 4 Owner Owner's Name 1 information is required for every Cotuit ►� MA 02635 3/19/2021 ., page. City/Town State Zip Code Date of Inspection t i Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information 51 4f 5 a s I on the computer, use only the tab Patrick Rutledge key to move your Name of Inspector cursor-do not Title Five Specialists use the return Company Name key. 22 Taft � Company Address Dorchester MA 02125 City/Town State Zip Code rcPaa 5082374628 S114198 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310.CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ (Passes 2. El Conditionally Passes. 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. 0 Fails ;Z� 3/19/2021 Inspe ors Sig re Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/28=18 Trde 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is Cotuit MA 02635 3/19/2021 required for every page. Citylrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1,2, 3, or 5 and all of 4 and 6. 1) System Passes:- El ❑ 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: 2) System Conditionally-Passes:- ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ .N ❑ ND(Explain below): t5insp.doc•rev.7/M018 Tine 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 S Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 pipes).are replaced ❑ Y ❑ N . ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken.pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) 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. a. 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: t5insp doc•rev.7/OMI8 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 S Commonwealth of Massachusetts Title 5 Official Inspection Form All Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water El Cesspool or privy.is within 50 feet of a bordering vegetated wetland,or a salt marsh b. 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 aseptic 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this,form. c. Other. 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.M28=8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cunt.) Yes No ® ❑ 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 Yz 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 a cesspool or privy is within a Zone 1 of a public water supply ❑ ® well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ to The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® ❑ 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. 5) Large.Systems: To be considered a.large.system.the.system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems,you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section CA. 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 t5insp_doc•rev.7/26=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 f , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. C4/rown State Zip Code Date of Inspection C. Inspection Summary (cunt.) If you haveanswered"yes"to.any question in Section C.5 the system is considered.a significant threat, or answered "yes"to any question in Section CA above the large system has failed.The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes"or"no"for eachof the.following,for all inspections: 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) 0 ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ 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: ® ❑ Fycisting information. For example,a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation'of distance is unacceptable) [310 CMR 15.302(5)] t5nsp-doc•rev.712812018 Title 5 Official Inspection Form:Subsurfam Sewage Disposal System•Page 6 of 18 f Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is Cotuit. MA 02635 3/19/2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information . 1. Residential Flow Conditions: 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 Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No y Does residence have,a.water treatment unit? ❑ Yes ® No, If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection D Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® , No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Occupied Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 r Commonwealth of Massachusetts . Title 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. Cityrown State Zip Code Date of Inspection D. System information (cone.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? .❑ Yes .❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: ' Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: , gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 r , Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 4. 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/Attemative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach.a copy of.the DEP approval. ❑ Other(describe): Approximate age of all components,date installed (f known) and source of information: 1983 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 31 feet Material of construction: ❑cast iron 0 40 PVC ❑ other(explain): Distance from private water supply well.or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7126=18 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 2'feet Material of construction: ® concrete ❑metal El fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 25" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet.tee or baffle 14" How were dimensions determined? Tape 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 in good condition, No evidence of leakage, No issues noted, Recommend pumping every three years t5insp.doc•rev.72W018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is Cotuit MA 02635 3/19/2021 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑concrete [I metal El-fiberglass ❑polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7282018 Title 5 Official Inspection Form:Subrurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. City[Town State Zip Code Date of Inspection D. System Information (coat.) 8. Tight or Holding Tank (cont.) Alarm present: ❑. Yes ❑ No Alarm level: Alarm in working order. ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Damaged Distribution box., recommend replacement s. L5insp.doc•rev.7/W018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working.order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): If pumps or alarms are not in wonting order,system is a conditional pass. I I-Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: innovative/alternative system Type/name of technology: t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. City/Town State Zip Code Date of Inspection D. System Informatibn (cont.) 11. Soil Absorption System (SAS) (cunt.) Comments(note.condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of. vegetation, etc.): Hydraulic failure- High water mark in pit is above inlet pipe 12. Cesspools(cesspool must be pumped as part,of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments.(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): t5insp.doc•rev.7/28/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 18 1 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. Citylrown State Zip Code Date of Inspection D. System! Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp-doc•rev.7/28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately t5insp.doc•rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: >12'feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Septic plan on file Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2&2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 124 Pine Ridge Road Property Address Cynthia Joiner Owner Owner's Name information is required for every Cotuit MA 02635 3/19/2021 page. City,7own State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: �. A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed& Dated and 1,2, 3, or 4 checked C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist)completed ® D. System Information: For 8:Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doo•rev.7/26M18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 b , • 1� r 01 ow F ;� /1/`C�"9"'E• �'yl�'!48®r!�'TE` T� �'aL.Fs'Dr: .� +�ate► �9 I'��i _ e4T ale .L �_ .fir A�'EF'.�',� fiw� � W wr r7, Ode t ✓'Y 3 -4 i n i'a', W�'9�a�.'�d�"� ��/rr�'�'�e�"'�° ` 47 ooq ' x ,� TsV " �ia .�� A� �Ad� d0/d.�r�".yoc l "C9 r �� � � � .; rt� ,� �,�.d�e✓�/�"'�"+C"�/!/S''7',oF'4"/(G'"�"✓�s� !i�°�='�'�/►rl�'� "L�"7''Ls 'A�F'd'�9+�'! 3 a,� .,TM t '• {V! �/; raj,(IP9'�If�/-���II� '.:��'TPA".�451 1#;tlV Wi�'�y✓ , L , m rr:. _. - .— '� -a l"., ,. ''i: r' •.�;.' 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AIM�"'i p■ E�.� :.: � Ai, �.._ A i � ,i i.... d.-: �, k N4,yy���.'O �,y �uer� y�,• /�I�J`� 4 T e ��(.:, �� eJ /��r y�y 'k:4 /r/Y"_ /�' fDR�1 f ^s as a"Y� ., �'"V .� .�"7•i/ � TV:+i7�ir iJl��ui�"i-. /"' - yp[� yM�My + �MIi'T 'yAl �." r5P• �'ewer�7��i.'!°��- Pvr�/'.'W�Vf�� k a � '•ej � � � ;.� :n 7 '!� 1r�',� =t ` �qif�.y3� ��qr �/rg� f'.�•ryr4�y��+ ^t. � ��, A f�;;a�s�l[♦ R 'z y�.� 40, , No. ��I 66 _ 1�� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppliLation for Bisposal *pBtrm Construction 3permlt Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1-14 is tME R19CYE f•OAb Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 1919 j 4Zb ei@&A;54VhL< AMC 5A4 016j CfA Installer's Name,Address,and Tel.No. �`�`1"d—�41 1 Designer's Name,Address,and Tel.No. 500—;ZZ3 —03` 7 Type of Building: Dwelling No.of Bedrooms 3 Lot Size 1 Ai0®® # sq.ft. Garbage Grinder( ) Other Type of Building REF5l0&,J'T1tF4_- No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 o gpd Design flow provided 3�t9,�6 gpd Plan Date 02� rC(�a Number of sheets Revision Date Title ,`.4 PiV6_ Af Nie D Size of Septic Tank 1 - „ -wn Type of S.A.S. (2) S�_v C-4u-au 6YAk9aC$ Description of Soil i%u lufi� JI!o (w, � Nature of Repairs or Alterations(Answer when applicable) L)SE �u`�Z C�4. 1,ao j Fa a-6id '56TTLI-G Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date 5- a:i—.2oxl Application Approved by Date a'%, Application Disapproved by Date for the following reasons Permit No. 9 0��' 1 0 Date Issued � � 1 V. �„ m.• 11K•-.,^`..,,:�-....rsl �7^. .r j ,�. �,. No. Fee t ..� . THE COMMONWEALTH OF MASSACHUSETTS +Entered in computer: Ic • ,tee.; Yes'°„ y. PUBLIC HEALTH DIVISION" TOWN OF. BARNSTABLE, MASSACHUSETTS ' a ptic t on for VsOsal-*pstem.Construction Perinit 17-,, . Application for:a Permit to Construct(~)r Repair(k'j Upgrade( ) Abandon( ) ❑Complete System ❑Individual Component �� r. G�coa.�c�' '� g��OzEY TR�ss�'t~E5 �, Location Address or Lot No P IAJl woe E Owner's N e Address and Tel.No. Assessors Map/Parcel, r{.., 54112'&R&A6 KK MK SiW 01C (.A Installer's Name,Address,and Tel'No. SoQ` 1'1-e2 l l Designer's Name,Address,and Tel.No. 50$-;2?3"Q 3 Z7 ROOT°e� ouix- do "4 rc Ctc&1A1 IA & ZAX, Type of Building: Dwelling No.of Bedrooms Lot Size I 40 sq.ft. Garbage Grinder Other :> Type of Building REFS 1Ttk No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3.3O gpd .Design flow provided :3 +`�e gpd Plan Date Number of sheets Revision Date Title ,i�� e1AJ6 1q(DG:C R4pA?) doTut'*°° Size of Septic Tank , �� Type of.S.A.S. 41, 5U0 G�I.L.G�tJ P�.I�h9At8l C� Description of Soil Nature of Repairs,or Alterations(Answer when applicable) (. /,SZt�� t,�j _ _444Q . o� �� Pat) A�X �t-awl TC� 1�� 5= 64am"i 1->_0 L (A& Date last inspected: Agreement The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ' Signed Date • ��—.�0.�., Application Approved by Date, e� 6 —a Application Disapproved by Date for the following reasons Permit No. n Z " 170 0 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS,IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(�) Upgraded( ) Abandoned_( )by t�5 C o o& y �a a. (!0 with the provisions of Title 5�h�nI �TU System at aZ4 p/�� �(� 'T"' has been constructed in accordance Disposale for Construction Permit No. '�0 g/0 1 5 d dated Installer Row.T /3 ewk GJU Designer cTG a&)5dLkMLjfi X0 C. #bedrooms 3 Approved design?aw. (� gpd The issuance of tVvl it shall not be construed as a guarantee that the system will ft5nctio designe�. Date Inspector No. Pl Fee ( �Y THE COMMONWEALTH OF MASSACHUSETTS I� PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal *pstrm Construction 3oermit . Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at _I ;lq p I NS 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.! I r Date Approved_by ^' i Town of Barnstable o Regulatory Services Richard V. Scali, Interim Director } L a►ttxsrwate, v� MAW Public Health Division ' Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 6-7-21 Sewage Permit# 2.®Zt" t qO Assessor's Map\Parcel 18/09 Designer: JC Engineering, Inc. Installer: Robert B. Our Co., Inc.,(RBO) Address: 2854 Cranberry Highway Address: 363_Whites Path__ _ East Wareham, MA 02538 South Yarmouth,MA On RBO was issued a permit to install a (date) (installer) septic system at 124 Pine Ridge Road based n a design drawn by (address) JC Engineering,Inc. . dated 5-22-21 (designer) X_ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. r I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils i were found satisfactory. 1 I certify that the system referenced above was constructed i iance with the terms of the 1\A approval letters(if applicable) . "!„M ass9c r o �' 1 r JOHH L 1 U CHURCH1ILL copInstaller's ature) CA .�1 (D ner's Signature (Affix De 1 p Here) PL ` SE RETURN TO ARNSTABLE PUBLIC HEALTH D SION. CERTIFICATE QF_COMPLIAN—CE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc { 1 UNITED STATES POSTAL SEP YICE. >..F„first Class Mail Postage&Flies Paid < USPS-..:... ` -jPermit No;G-10�. • Sender: Please print your name, address, ar�'!=ZIP+4 i"his box • r �\ No cn r- Town of Barnstable t� c ,HealthDivision _-,200 Main Street 'ITyannis, MA 02601 (J r'a a 2 SENDER: COMPLETE T1J#c c=f-TIn1V COMPLE7E THIS SECTIO N ON DELIVERY ■ Comf)Iete items 1,2,and- a S item 4 if Restricted Delivery is desired: ^^�^^^ """^� gent ■ Print your name and addrp cp 1,14v@J ':Ky Addreqsee so that we can return the card to you. lo. ■ Attach this card to the back of the mailpiece, B. Re(e'v `b (7�I w,; Iva,aN` 7.k79'ejwery or on the front if space permits. �' l L� B� D. Is delivery address different from item 19 ❑ es 1. Article Addressed to: If YES,enter delivery address below: ❑ No (Ar 3. Service Type M Certified Mail ❑ Express Mail ❑ Registered E3 Return Receipt for Merchandise dnsyred Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number(Transfer from service label) 0 1q 1• , 102595-02-M-1540'i Certified Mail#7005 1160 0000 0191 2311 �optN�to�� Town of Barnstable yP o� Regulatory Services BARNSTABLE, �a MAS& Thomas F. Geiler, Director O i639• ��+ ATF°MAta, Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 7, 2007 George & Elaine Bradley 5476 Brunswick Avenue San Diego, CA 92120 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 124 Pine Ridge Road Cotuit, was inspected on May 1, 2007 by Timothy O'Connell, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the Town of Barnstable Code were observed: 170-10— Smoke Detectors and Carbon Monoxide Alarms. No CO detector provided on 2nd floor. You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by providing CO detector for 2"d floor. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Q:\Order letterMousing violations\Rental ordinance\124 Pine Ridge Road.doc c r Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. Eas RDER OF THE OARD OF HEALTH McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Tim O'Connell, Health Inspector Cynthia & Jeffrey Joiner, Tenant R QAOrder letters\Housing violations\Rental ordinance\124 Pine Ridge Road.doc l FOAM30 C&W HOBBS&WARREN T" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF TH Y' ~ CITY/TOW� W a w _ ,p PARTMENTP D QY_ (i�l� 1 ADDRESS t400 gG a Q']� TELEPHONE c Address 'I� � � - Occupant Floor Apartment No. 11/d No. of Occupants No. of Habitable Rooms 5 No.Sleeping Rooms No.dwelling or rooming units-✓^— No.Stories Name and address of owner -7,b Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den —Living Room Bedroom 1 : Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJUH INSPECTOR ` TITLE1 )WIN DATE G TIME A.M. THE NEXT SCHEDULED REINSPECTION 77 P.M. { 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions;when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety,and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation,any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity;pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns,shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by.105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. ti � Cerfified]Mail#7005 1160 0000 0191 2311 j P�01 rOy� Town of Barnstable Regulatory Services i DARNs'r BLF- . 9 MASS. Thomas F. Geiler,Director i6gq. �m o°pTfDMA�p Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 7,_2007 George &Elaine Bradley 5476 Brunswick Avenue San Diego, CA 92120 k NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HAB TATI AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property.owned by you located at 124 Pine Ridge Road Cotuit, was inspe 'd N on May 1, 2007 by Timothy O'Connell, Health Inspector for the Town of Ban ble. z' This inspection was conducted on the basis of the rental registration in accord `f' a with-6 } Chapter 170 of the Town of Barnstable Code. C. O The following violations of the Town of Barnstable Code were observed: 1§ 70-10—Smoke Detectors and Carbon Monoxide Alarms. N� detector provided. on 2„' floor. ontact the Town Should you have any questions regarding the above violations, please c Health Division and ask to speak with the inspector who performed the inspection. Q 1e PER ORDE R OF THE OARD OF HEALTH ��� / aWcKean,R.S. CHO r of public Health Director Town of Barnstable Cc: Tim O'Connell, Health Inspector C:vnthia&Jeffrey Joiner,Tenant 0 A ON, P It T N 'L C T ®o E A G E E V4LL GE s• ti INST AAlLER'S NAIVE ADDRESS ` cz� ® U I L D E R OR OWN Y Q �- ��DATE PERMIT. ISSUED DATE COMPLIANCE ISSUED { 1 u � 'l!` t No. .,) .. F....��............. THE COMMONWEALTH OF MASSACAUSETTS BOARD OF HEALTH .r%...'...............O F.............,�r�/.7!tok IFF�.� _`�3................. ,XOp1utttion for Bhivviial Works Tomitrartilan ramit Application is hereby made for a Permit to Construct (` ) or Repair ( ) an Individual Sewage Dis osal P System at: 2.T.. a pr<J...&............ .7l. ................................................................................................. Location-Address �P�:._ U, i!$'✓�. �` � .. . :o ......... ............ ................... 7.r ArI�r°t N ./�-�Prdfa2dt�lff- Address Installer Address /........................................................ Q Type of Building Size Lot... ,r...0!P ..Sq. f U Dwelling—No. of Bedrooms,____.... Expansion Attic ( ) Garbage Grinder )0 Other—Type of Buildi>i�C.i t1/YT . No. of persons..........a.............. Showers (Z-} — Cafeteria ad Z 3 ) Other fixtures .._.�.eM_&t t......•.., (/tnr---•'�O` r� { 4�...... • . •--.....•--- W Design Flow................. __..r�gallons per person per day. Total daily flow................33--P _ ._._........gallons., 1:4 Septic Tank—Liquid capacity.),act gallons Length..k f,!... Width.. .. .... Diameter--------- Depth_...,5 .�'. W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No._...._�...... Diameter-.1e.(4.4... Depth below inlet......li.1......... Total leaching area....2,, q. ft. Z Other Distribution box ( ,,�'_ Dosing tank ( ) R/170 Percolation Test Results Performed a l ......._..._ Date..._3 �3 i Test .............. Pit No. L �Z....minutes per inch Depth of Test Pit..1l�........_ Depth to ground wafer.,!�`v�.!Y�_�...0&,; Test Pit No. 2.<.._Z ..minutes per inch Depth of Test Pit.,I.Vff t�____ Depth to ground wateAX..e�' C4_vm?%•ot.,„ ------------------ ---------------- }}� .......................................................................... 0 Description of Soil.... .... ._3io..;�__._�QP_S�PL--- ___l .... w �:`-.. � Y._..1' rals��e !�r� ..2 ------�h----------------------------------------------------------- ----•------------------------•------•----•--•-•----------•-----•-•-•--------•------•--------•-•----•---•---------•-----------•-••••---------•---•-•-------------------------------------•--•-•----...... VNature 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 iIILLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a CertificaACompliancea n issued b the board th. • .k...... ...... ............ /O YApplication Approved By - ---•---•----.................... -•--•• ...--f4Date Application Disapproved f ................ ........................•--------------..........------•--•-----•---•-...._...---.............._ ---------------------•-----..........------------------------.....--••------•---••------.........._...-----------•-------------------------------------••---•--•-••--.................................. Date PermitNo.......................................................... Issued....................................................... Date i Y No..ri-_.7.: -- FR$...y�.----....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .0 ..............OF......... ��9-h �1��''/-� -..........-•--•------- Appliration for Biiipniittl Workii Tonfarttrtinn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Sys em at: l � ...... ... .. �i� .. .?.?it ----------------------------------- ---...--••-------.........-----...------. Location-Address Lot gyp. • �- - ----------------•-•--•-----•-•--- /..-•- `� � v..t'✓ cr ✓.�1�'..�6 /..� .-- -•--...... ner /eA! n TA'dd�ress ,yam --------•-------------•-•-------------•--•----------•---•.�/�� _..-v-vl �GL ✓'>`- C/V�....�11. �� ._ Installer Address Type of Building Size Lot............................Sq. feet a Dwelling— No. of Bedroom................. Expansion Attic ( ) Garbage Grinder ( ) --- ---•-•- a, Other—Type of Building f.......... No, of persons...........�............. Showers ( ?-)-.-- Cafeteria ( ) dOther fixtures j k/_1-Arx-_.-' .---....-pl'' ../ �fl'V.../�f�l- l/ ram-- •--•--...---••-----.....-•--•-... W Design Flow.....................:�'�.......gallons per person per 4ay. Total daily flow---_...........2-_3.0_..............gallons. WSeptic Tank—Liquid capacitv)(_P_V $t°.gallons Length__I�'..(p.._.. Width.. .20..... Diameter................ Depth.sr-z`.. x Disposal Trench—No. ......... ......... Width- ........... Total Length...._.___.......... Total leaching area....................sq. ft. N ..... Diameter..1 .. Depth below inlet... ._a e Pit o... Total leaching area__ TSqft. Z Other Distribution box ( Vr Dosing tank Percolation Test Results Performed by.. .�.,2�}-_..._.......�..._.. ... ��} Y-- ` `� --..._. Date 3 . a Test Pit No. 1.. it,--....minutes per inch Depth of Test Pit../_A/tff..�.... Depth to ground waterVrr' _r V&_ Test Pit No. 2 .Zl.....minutes per inch Depth of Test Pit._/. ____. Depth to ground waterN®� _ !` ................. x Description of Soil.. F� � �� ... ........�111/ ........................................... U --•--•----------•••-•-•---------••--. 1 V.....-- i+_ a.......... .gin.-... ------ w •---------------------------•---...••------•----•-----••-•---.......... ......................................................•...------•-----•••------••-....--•-••---•--•--••-------.._.............. V Nature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State SanitaryjCode— The undersigned further agrees not to place the Ste in operation until a Certificate of Compliance has . Issued /(t LY ............................ --------------- ----••----------------- ....--•. Application Approved BYlowing ---_' ...................................................... r, Date Application Disapproved for e f ..............................•--•----•------------------•--......•---------•-...._......__......._....-••---------------------------•-----------------•-••---•--•----------------••--....--------••--•- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF...........................I......................................................... Trr#ifirate laf Toutphatta TH.S IS CERTIF h� the Individual S ag isposal System constructed ( ) or Repaired ( ) b . ........ =- ....... . ... I�........... •--------------•---------------------•-•--•--•------••--------------.-••------•------.-- ����� alter a •-•-• . ..................•-------• ... -- .---------•------•----.... ..--•--•-•------- ------------------------------------------------- .........------•---.... .................. has been installed in accordance with the p visions of TIT1�3 5`. State Sanitary Cps e�in the application for Disposal Works Construction Permit No......................................... dated_.............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR AS A GUARANTEE THAT THE SYSTEM WILVIFYJNCTION SATISFACTORY. DATE....14.1119 ....................................................- Inspector....= - •---•-------.._..._...__................-----..........-----•--•----...-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 0 / / ...........................................OF..................................................................................... No......................... f FEE........................ Permission is h y gran to Construct ( ) or Repa''� ) a>fIndi �Ce�uy. �,pos stem / ✓ / V�/`i atNo. .......................•---------•--•--•-....... .................... ------•-----------------............._.........-------•-.....................-- Street as shown on/thepplicati for Disposal Works Construction Permi ----• Dated.......................................... -....----•-•• -------- ------•-------••••--•-•-----••------------------•--------•------....--•- Board of Health DATE-- / -- ........ ................................................. FORM 1255 A. M. SULKIN, INC., BOSTON trOCL�TI4N L �/ 5EWaC-4E PERMIT 1J0. -\/ILLAGE AWSTQLLER S U KAE ADDRESS --$UILDER 5 - Q &MF-- ADDRE-SS .-- -------- - _ DLs►TE -PERMIT U AT.E r I Wed A �60 )� Klow _ �bP • ,mot 7' -7 �77 %oo-ic% Y 7 ;X'1AoO'1SA1 V,--,oD7.IC 7,A7AoO'A.' 47 177,:117.i-A* A-IIAO' oc>,e C,47's 7 AS 10 Wr A00 446%5' 0. ,04 9P,.T 7 40Ak.-- Aeloov. q IL :5 94'5 17. C-X, Ole 4,14 7 LE 7 7-Q1A5 U 7740A/ /VS �-'474 4' 'oV W4E '&'C7'S*E lax 4A 7 400a 04 A/- /40 A COAO'CAF'AE 167 a/v. A1- /4 0 b.lo 4 77C MlAr 0,V 4 -AC' 7 IV07E e We- 171-4. LO71-:7 OR cz-.,qy /-,o W.—. ,oe 7 0 OW 7 A, M1770V .47>01' C44, Al �C4 v 7 10 A>1 r AE 447CAlloov<7 �f IW41.5.7- CogS.7-/.,eVA/ e. A74 4, -7- IA",S 4i74/_ OA/ AS.0.47A>AC� 40,oc' /V^fU%5'7 4&Iff /V40 0,&Se 49W4C7 .4>1 7 70 14 41.,Vq. -17 -,5- /A/ oc>4,17AI 7 .6,6 A7.-PODA V 0.9 '67,174;-.Al ;PA/40 Z;F; AE 46) IC019'A -0 0-'C' OA1 <A/, �-/V.A- S*,E7D AS y 7-/7-/ 4 OC,47/ "4;, "004 4. �01 6 L� , '%SIGAI � ,Z>. A q 4,14 e 4?4/4 4 T VA/40 4pE' 10-01 �9,7 0,4C' v'Cl7 7' A141AfA5 f' 4c 4 0 Al 7 %Te1,4'D,4-4> �,�Z,0714C 7,17AI 4-C7 CoVIAl -0 W.11 7 -W VOE'op Ao 44 Zor 9. 1 VA 77 4 E',17CA11-,Vq OPRO VAO IE AD CXAS 7//V(:F C40",r e-IR IC)IIVIE '00e ,AV 7 7 1:>,Oq>o A-IIA1114�,f Co 7- 0 .0 �5,.40 Z7 Ole 4e op I" fiF ff-4'T V,47-/"/,o IV /,V 40/,,o ��4 40 77, SACKY 7,4Z. 2 6#P 77 11v �o ;PA' 4 74 � FINISH GRADE OVER D-BOX= 28.3't PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE fT.O.F. EL.= 29.0 t FINISH GRADE OVER CHAMBERS= 28.8' - 27.9' GENERAL NOTES PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2% MIN. OVER SYSTEM 3/4 TO 1-1/2 DOUBLE WASHED WITH COVER OVER INLET 8� STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION RISER TO WITHIN 6"OF FINISHED GRADE OUTLET TO WITHIN 6"OF F.G. 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS FINISH GRADE .. METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL.= 28.4't F.G. OVER TANK EL. = 28.,3'f r5" DIA. OUTLET(S) MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2 OF 1/8 OT X DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. STONE OR GEOTEXTILE FILTER FABRIC i2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE PROPOSED 4" 3.6'MAX. TOP OF SAS= 24.30 PLACE RISERS ON ALL DESIGN ENGINEER. EXISTING 4" 4 5'MAX. CHAMBERS w/PIPED SE•thrtK PINE SCH. 40 PVC SEE NOTE 23 23.30' SEE NOTE 23 � INLETS TO WITHIN 6" 3- 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL � SEWER PIPE BREAKOUT EL= 23.80 SYSTEM UNLESS OTHERWISE NOTED. OF FINISHED GRADE - - -y- - 3" DROP MAX 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN �1 6" 3„ 3" g' L=23't 2" DROP MIN Mw.s�oPE�,% PROVIDE WATERTIGHT ! ELEVATION=23.80' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4" PVC IN FROM JOINTS (TYP.) <%wP 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 14" \._*24.0'� SEPTIC TANK 4" PVC OUT TO 0 0 0 O 0 0 C� 00 0 � 0 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR TO PROVIDE O LEACHING FACILITY oo o ° SPECIFIED DROP BETWEEN " oo °o 5. SLOPE ALL SOLID PIPE AT 1.0/o MINIMUM. INLET AND OUTLET CONTRACTOR „ CONTRACTOR SHALL OUTLET TEE 23.70' MIN. 23.53' oo °° 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48 VERIFY CONDITION OF � 2 � °°°° 0 0 0 0 � � o� 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6 CRUSHED STONE o 0 o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY oo °° o o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE AND DESIGN ENGINEER. $ 4.0' ----8.5'(TYP) - 4.0' 4 0' 4.0' LL=- OUTLET DISTRIBUTION BOX 4.83' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. SEE BENCHMARK ELEVATION AS TO BE INSTALLED ON A LEVEL STABLE 25.0' (TYP.) SHOWN ON PLAN. BASE. FIRST TWO FEET. OUTLET , GROUND WATER ELEV.= < 16.00' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. 21.30 12.83' 5' MIN. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK ( 2 - 500 GALLON CHAMBERS CHAMBER END VIEW THROUGH AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES `CONJRAG VOR TU VERIFY EXISTING I CROSS SECTION VIEW SEPTIC TANK PROFILF H-20 D 0 1 t- Ilb � I iU' - IN bUA DETAIL TYPICAL CHAMBER PROFILE H-20 CHAMBER OETA ILS TO THE DESIGN ENGINEER. ELEVATION PRIOR TO ANY WORK& !'11V1 t1 NOTIFY ENGINEER IF DIFFERENT NOT TO SCALE E ; 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. I NOT TO SCALE NOT TO SCALE ._ 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING NOTES: T D I T n A T MAP 18 + ' • I ST REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM - APPROPRIATE AUTHORITY. 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG LOT 10 � ; , 1 , PERC NO. TPT-21-92 THE TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. } ay •/; r," . ' ' • I INSPECTOR: David W. Stanton (BOH) 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED + / ` ` •' • ' ' UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR J ` ` •• ' EVALUATOR: Michael Pimentel, EIT, CSE 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE _ . • •'. j• . • TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. / � r' • �. •" \ Oct. 27 1999 LOCATION OF THE PROPOSED LEACHING FACILITY TO / ( \ ( C.S.E. APPROVAL DATE. PROPOSED 4" SCH. 40 PVC VENT; i ' (� • ." t ' :�; . 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON .� • r • + • EXACT LOCATION PER OWNER i t �------ - • � • . •• �. L. i • ,� { DATE: April 27, 2021 THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF M• !" . \ HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT PROPOSED •�•�,.'��� • �� '�• 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. DATA. INSPECTION PORT , PROPOSED TWO(2) •g . t-.+••• : 0 ,� 4�' i ELEV TOP= 28.00' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, I 500-GALLON H-20 LEACHING • • `t •'+•� • '• • ` FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN AN AQUIFER �. I ! + R • 1l °, _ .. ! • �` I ELEV WATER= < 16.00 CHAMBERS wl STONE rr . • - - - • PROTECTION DISTRICT. 28, ; , ° •!L - .A• _ . . - -- - ___ ; - 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN `" '�; r _ ' • j/"�►� , ' '• ;J�f'�r• • i` ! PERC RATE= SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. DEPTH OF PERC= 16• PROPOSED PROJECT IS LOCATED WITHIN: 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY 2) � �.. /L_ '' ��,� ��, =: .ya AS A COURTESY FOR THE INSTALLER. INSTALLER SHALL I �� I • • ' n _- (_ I /yJ o OQ� r-EXISTING LEACHIN'-' • - .- ,•_ • i . ____ .__ j VERIFY SWING TIE MEASUREMENTS IN THE FIELD PRIOR TO r 31, / PIT TO BE PUMPE[ �_� - /` '/`• TEXTURAL CLASS: I ASSESSOR'S MAP 18 LOT 9 INSTALLING THE SYSTEM. CONTRACTOR SHALL NOTIFY ( 7 r -- -- ~ . ."r t FILLED wl CLEAN •/ { - "Y• '' • •• ��-. f � �' t • �;. �. .� � •.• .�t OWNER OF RECORD: GEORGE 8 ELAINE BRADLEY TRUSTEES ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. t 3)( / i • TP 1 l SAND &.ABANDONED /5 • �� ' . • • • r i` BRADLEY TRUST AGREEMENT �,, LOCUS _-. Y _ of. 28.00 ADDRESS: 5476 BRUNSWICK AVENUE 1 \ r .. Loam Sand 6„ x0' 8 ,► �� tx � l' •� �' y� Al2" 10Yr 3/1 27�, SAN DIEGO CA 92120 % ,� ,\ v ) ) I �\ t;� ` FEMA FLOOD ZONE X 2 .0' \ ` , ; r g Loamy Sand COMMUNITY PANEL# 25001CO752J f \ 31 E ll 30" 25.50' 17. DEED REFERENCE: BOOK 7557, PAGE 103 Benchmark 6" \ ` P y' Bulkhead Comer ,, PROP. H-20 (4) \ 2" \ . *� 28 r; - t1+` �� . 18. PLAN REFERENCE: PLAN BOOK 371, PAGE 95 Elev. -28.00 a D-BOX _ _ 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. Approx. MSL 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY A; FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY \ FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. \ �•. ' 1 Medium Sand f • I $ i C 2.5Y 6l6 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A Rugg DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A / \ ,30` REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. HC-1-\ !r JJ DECK �, 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL o ' REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. / LOCUS PLAN 23. IN ACCORDANCE WITH 310 CMR 15.401 -16.405,THE FOLLOWING LOCAL UPGRADE ,� ry EXISTING SEPTIC APPROVALS ARE REQUESTED FROM 310 CMR 15.221(7): a _w ` ' '\1 GALLON SEPTIC � ? SCALE: 1"= 1000' co TANK TO BE USED 2 144" 16.00' ? (1.) A 0.6' WAIVER (3.0'-3.6') FOR THE MAXIMUM COVER OVER THE H-20 D-BOX. cn MAP 18 IN THIS DESIGN 0 (2.) A 1.5'WAIVER (3.0' -4.5') FOR THE MAXIMUM COVER OVER THE H-20 SAS. m LOT 8 ~ i No Mottling, Standing or Weeping Observed TOF=29.0't �� ,�, '� i DESIGN DATA T ?' t �T LEGEND 1 , I ; PERC NO. TPT-21-92 /-HC-2 I INSPECTOR: David W. Stanton (BOH) 50x0' EXISTING SPOT GRADE #124 1 \ NUMBER OF BEDROOMS (EXISTING) 3 EXISTING DESIGN FLOW 110 GAUDAY/BEDROOM EVALUATOR: Michael Pimentel, EIT, CSE - - - 50 - -- -- EXISTING CONTOUR 3-BEDROOM C.S.E. APPROVAL DATE: Oct. 27, 1999 ^- PROPOSED CONTOUR y ` DWELLING \, oa TOTAL DESIGN FLOW 330 GAUDAY DATE: April 27, 2021 -�" DESIGN FLOW x 200 % = 660 GAUDAY TEST PIT#: 2 50 PROPOSED SPOT GRADE 00 1 \\ \\ 2 USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP= 28.30' GAS - EXISTING GAS LINE ELEV WATER= < 16.30' ---- O/H/W EXISTING OVERHEAD UTILITIES A' � � �.A 1� � ,� � � ' V � �p-� PERC RATE _ <2 min./inch' 4 / \ / OQ INSTALL 2 - 500 GAL. CHAMBERS W/ STONE -W -W EXISTING WATER LINE c DEPTH OF PERC= "C"soil r \ j SIDEWALL CAPACITY TEXTURAL CLASS: I TEST PIT LOCATION O c (LENGTH + WIDTH) (2 SIDES) (2'HIGH) (0.74 GPD/S.F.) = GAUDAY (25.0' + 12.83')(2 ) (2' ) (0.74 GPD/S.F.) =112.0 GAUDAY - O EXISTING 1,000 GALLON SEPTIC TANK 1 Ott MAP 18 BOTTOM CAPACITY A Loamy Sand PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE LOT 9 \\ Q (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY 12„ 10Yr 3/1 27.30' 12,000+- S.F. \ �� (25.0'x 12-83') (0.74 GPD/S.F.) = 237.4 GAUDAY PROPOSED H-20 DISTRIBUTION BOX \\ 4� B Loamy OYr 5/6 d Q PROPOSED 500 GALLON H-20 LEACHING CHAMBER TOTALS: 30" 25.80' TOTAL NUMBER OF CHAMBERS 2 REV. DATE BY , PP'D. DESCRIPTION TOTAL LEACHING AREA 472.2 SQ.FT. -- - \ TOTAL LEACHING CAPACITY 349.4 GAL./DAY PROPOSED SEPTIC SYSTEM UPGRADE PREPARED FOR: Medium Sand ROBERT B. OUR CO., INC. C 2.5Y 6/6 00. � . \ � \ LOCATED AT 124 PINE RIDGE ROAD P/NP ` ` COTU IT, MA 02635 (40,w��OGF RO l SWING-TIES 14a" 16.30' - - ! SCALE: 1 INCH = 10 FT. DATE: MAY 22, 2021 CA),, T) AO / 0 5 10 20 40 FEET �� \ DESCRIPTION HC-1 HC-2 No Mottling, Standing or Weeping Observed �N °� "qs !/ \ CORNER OF STONE (1) 31.4' 60.4' RESERVED FOR BOARD OF HEALTH I JOHN L �� PREPARED N � USE U C CIVIL HURCHILL JR. H JC ENGINEERING, INC. E�FOF �\ CORNER OF STONE (2) 44.2' 67.9' NO. 1807 2854 CRANBERRY HIGHWAY p�V�'�F 1 " CORNER OF STONE(3) 52.3' 51.4' I EAST WAREHAM, MA 02538 SITE PLAN "T ` , Perc rate taken from Permit No. 83-937 dated 10-24-83 on file with the Barnstable ; 508.273.0377 CORNER OF STONE (4j 42.1' 41 0' _ _...._. __.__ SCALE: 1"= 10' Board of Health. prawn By: MCP Designed By:MCP Checked By:JLC JOB No.5670