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Home My WebLink About0040 POINT ISABELLA ROAD - Health 40 POINT ISABELLA ROAD, COTUIT A= 074 017 i 4 E 1 2 Ron d C,otuit ,Ma--s . 0263 5 UL On the above date, I Inspected the septic system at the above addreJss. 9 199 . This Gyatarn of the followIng: pro 1 . 1 -1500 , gallon septic tank . .2. 1 -Distribution box. 3 . 1 -1000 gallon leaching pit . 9 Based On my hnft,,�cflon, I certify the following conditions: 1 . This is a title five septic system. 78 Code 2. The septic system is in proper working order at the present time . 3 . No repairs needed at the present time . G NAT U R!-, : Name : J . P .'Iacomber Company: J . P . Macw)her Son IT n c . Addrdci3 ' CeIlL_&CVil-Le Mass . Phone:---5 C-Ia--7-7-5-3-3 3 8 THIS CERTIFIC,-'J'"'-'1-!,' DOES CONSTITUTE A CUARANTY OR WARRANTY A" SEPH R MACOMBER & SON, Tanki-Cestpools-Leachfields CON"� ER & 0 INC.1 N C La d t' &ch fI Put-np&d L Instilled Town Sewer Connection: P.Q.(). Box -56 Centerville, MA 02632-0066 775-3338 775-6412 U Commonweoftll of mossochusetls ExecutNe Office of Environmental Affairs Department of Environmental Protection . Trudy Cox WUl1am F.Weld � ,lor David B.Struhs /1rgoo Paul Ceiluccl C4mn `&1oc%( LL C33anrn41 s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORK! PART A CERTIFICATION PmportyAddros+: 40 Point Isabella Road Cotuit MassAddress of owner. Date of Inspootl 6/26,196 (If different) on Name of InsPootor.Joseph P. Macomber Jr. Company Name,Address and Telephone Number. J.P.Macomber & Som Inc. Box 66 Centerville ,Mass . 02632 508-775-3338 CERTIFICATION STATEMENT the sewage disposal system at this address and that the information reported below is true,atxurn I certify that I have personally inspected and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on•sita sewage disposal systems. The system: �asszs Conditionally Passes Needs Further Evaluation By the local Approving Authority Fails' Date: Inapoctot's9tyuat �'�;dzj� The System Inspocto submit a copy of this inspection report to the Approving Authority within thirty(30)syys of stem ownerating this shall submit the inspection. If the system is a shared system or his a design flow of 10,000 gpd or greater, the inspector and the system report to the appropriate regional office of the Department of Environmental Protoction. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A) SYSTEM PASSES: i� I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CUR 15.303. Any failure criteria not evaluatod are indicated below. B) SYSTEM CONDITIONALLY PASSES: _ Ona or more system components noes to be replaced or repairod. The system, upon completion of the replacement or repair, parses inspection. Indicate yes, no, or not determined(Y, N, or ND). Describe basis of determination in all instances. if*not determined",a=plain why not) (' ked, structurally unsound, shows substantial infiltration or ex:Mtration,-or taut failure is The septic tank is metal, cry imminent. The system will pass inspection if the existing septic tank is replaced with a Fonforming septic tank a,approved by the Board of Health. 1 (revlsed 11/03/95) One Winter Street 0 Boston, Masaachusotts 02108 FAX(617) $56-1049 9 Telephone(617)292.5500 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) PropertyAddre6w 40 Point Isabella Road Cotuit,Mass . owner: Floyd Wimberley Date of Inspoction:6/26/96 B] SYSTEM CONDITIONALLY PASSES (continued) d4� Sewage backup or breakout or huh static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced ` obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Ali? Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the envirorunent. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT TILE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT THE SYSTEM.IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. A4 The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well.The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 3) OTHER (revised 11/03/95) 2 D) SYSTEM FAIR: U11 • I have determined that the system violate&one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. 1 in he distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Static liquid level • Liquid depth in eeaapecl is less than 6"below invert or available volume is less than 1/2 day flow. / Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of tunes pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. �I 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 60 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for ooliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: The following criteria apply to large jystems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 !YY• the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area(IWPA)or a mapped Zone lI of a public water supply well) The owner or operator of any such system&hall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please oonsult the local regional office of the Department for further information.. (revised 11/03/95) 3 PropertyAddreazz' 40 Point Isabella Road Cotuit,Mass . Owner. Flyod Wimberley Date of 1nspoot1on:6/26/96 Check if the following have been done: pumping information was requested of the owner, occupant, and Board of Health. -,V—None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates ;A:a that period. barge volumes of water have not been introduced into the system recently or as part of this inspection. built plans have been obtained and examined. Note if they are not available with N/A , The facility or dwelling was inspected for signs of sewage back-up. _zThe system does not receive non sanitary or industrial waste flow The site was inspected for signs of breakout. All system components,'Jill luding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, matarial of construction, dimensions, depth of liquid, depth of sludge,depth of seam. ZThe size and location of the Soil Absorption System on the site has been determined based on existing information or a proximated by non-intrusive methods. L The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 vwucc. ' Date of Inspection: FLOW CONDITIONS RESIDENTIAL- Design flow: ?V gallons pe V-CA Y • Number of bedrooms: Number of current residents:014 Garbage grinder(yes or no): a Laundry oonnected to syste or no.):_ Seasonal use(yes or no): Water meter readings,if available: � 0 4f :s �. Last date of oocupaacy;1-4---% COMMERCIAL/I NDUSTRLAL Type of establisha),ent:N)9- Design flow: IIJII`l gall'1 ons/day Grease trap present: (yes or no)A/124 Industrial Waste Holding Tank present: (yea or no)" Non-sanitary waste discharged to the Title 5 system: (yea or no)&YA Water meter readings, if available: AV Last date of occupancy: N OTHER(Describe) ,4 Last date of occupancy: GENERAL INFORMATION PUMPING R1E/CJ,1R,��and source o ��ti n: System pumped as part of inspection: (yes or no) .- If yes,volume pumped: 1• -gallons Reason for pumping _ JJL?7 TYPE 9R SYSTEM _11"' Septic tankl'distribution bax/soil absorption system _A�Q Single spool _ A121' Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source of information: O" ♦Gj- Sewage odors detected when arriving at the site: (yea or no)A (revised 11/03/95.) 6 I_ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION (continued) pertyAddress: 40 Point Isabella Road Cotuit,Mass. ,ner: Flyod Wimberley .e of Inspection:6/26/96 'TIC TANK:/ T, A(l ate on site plan A below grade;_f /+ .erial of construction: //concrete _metal _FRP —other(explain) iensions:,51 7" ige depth: ;, :ante from top of sludge to bottom of outlet tee or baffle:- m thickness:_ .V :ante from top of scum to top of outlet tee or baffle:,` :ante from bottom of scum to bottom of outlet tee or baffle. nments: ommendation for pumping, condition of inlet and outlet tees or baffle. depth of liquid IPvel in relation to outlet invert, structural �rity, evidence of leakage, etc.) :ASE TRAP. 4biCi 1te on site plan) nth below grade:jJff/� erial of constri.lnion,j oncrete _metal _FRP _other(explain) R tensions- -n thickness:_ ance from top vi scum to top of outlet tee or baffle:j0fq ante from bottom nl crum to bonnet of outlet tee or bahle A14 .iments: )mmendation for pumping, condi—ij of in and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural rity, widence of/r ge, et Li__ ised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Address: 40 Point Isabella Road Cotuit,Mass . Owner. Floyd Wimberley Date of Inspection: 6/2 6/9 6 TIGHT OR HOLDING TANK (locate on site plan) • Depth below grade:d2h Material of construction? R concrete_metal_FRP_other(explain) AI A a1A Dimensions: A)R Capacity: AM gallons Design flow: A3fl gallons/day Alarm level: 14 Comments: (oonAiou of inlet tee,condition of alarm and float switches,etc.) 4 C rtilWeIV71 DISTRIBUTION BOX:.�e p (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER/ (locate on site plan) Pumps in working ordera yes or no) AM- Comments: (note coon of pump chamber;condition of pumps and appurtenances,etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) PropertyAdc1mm 40 point Isabella Road Cotuit,Mass . Owner. Floyd uJimberley Date of Inspection: 6/2 6/9 6 SOIL ABSORPTION SYSTEM (SAS):_1X0'7 '4w (locate on site plan, if poau'bls;excavation not required, but may be approximated by non-intrusive methods) • If not determined to be present,explain: Type: leaching pits,number: leaching chambers,number leaching galleries,number: leaching trenches,number,length: leaching fields, number, anions: overilow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) CESSPOOLS: I'� (locate on site plan) Number and configuration: 449 Depth-top of liquid to inlet invert: Depth of solids layer. 119 Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inIIow(cesspool must be pumped as part of inspection) �# Comments: note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) A Q�aa-M°A/23 PRIVY:AA/,e, (locate on site plan) Materials of construction:- 4W Dimensions•_ /IV Depth of solids:_QVV Co ts: condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.) n_ i4,04K yTs (revised 11/03/95) g JIR 'cot i • ' � � | � � � � } j | � � ; . ' /q A ■ ° ! ! � � ; � ; � � i � . � Wr� VI i THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21 A of the Ger,oral Laws. Issued by The Department of Environmental Protection.. June 8, 1995 Acting Director of the ion of Water Pollution C:or�, o1 I'UHN OF Barnstable BOARD OF HEALTH }9I113SIRIFACE SF.HAGF DISPOSAL ,SYSTEM INSPECTION FORM - PART D •-....-1-..;..... .. i. ......._.�TT��.'•..Tt�,T•r�iZ'•dTT— CEf,([I F1 CAT IOM -TYPE OR PRINT CLEARLY- �'T'r"'"''—•�*"*' - •� PROPERTY INSPECTED .. t STREET ADDRESS 40 Point Isabella Roa(I Cotuit Mass,. ASSESSORS MAP : 'BLOCK AND PARCEL # OWNER' s NAME {1 oyd WimV(erle -- PAIz7' D - CERTIFICATION -Y NAME OF INSPECTOR Joseph P.Macomber Jr. Y COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville ,Mass. 02632 Street Town or City COMPANY TELEPHONE ( ) Stat• ' , LIP 38 FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal s st this address and that the information reported is true , accurate, andy em at compleY.e as of the time of :inspection , The inspection was recommendations regarding upgrade , maintenance , and repair pare oconsisrmed te any with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check one: XXXXXXXYSystem PASSED The inspection crhich I have conducted has not found any information which indicates that the system fails to adequately healt}I or' the environment as defined in 310 CMR 15 , protect public criteria not evaluated are as stated in the FAILURE CRITERIA<,03 . Any failure section this form . of System FAILED* The inspection which I have conducted has found that the syste` ]protect t)Ie ptitilic health and the environment in accordance wi't,ti m,: fails to 5 , 310 CMR. 15 . 303 , and as- specifically noted on PART C v. • title CRITERIA of this inspection form , - FA.ILUR ' Inspector Signatur 7/1/96 Date , One copy of this rt.if - y f., ication must be provided to the OWNER ( where a pplicable ) and the BOARD OF IIZALI'll. , the B•UYls * If the inspection FAILED , or wit-hin one year of the date of theninsoectionatunl shall allowed ,, 'Y ' otherwise as p Pgrede the",0j7� tem Provided in 310 Ch1R 15 . 305 , or >^ �+r,gu i red "' Partd.doc �� LOCATION SEWAGE PERMIT NO. VILLA t E INST'A LLER'S NAME i ADDRESS vu _167 /ICI, <NPie All • U I L D E N/ OR OWNER Teh M LA"�'P LLT !!QA Wtc H ME DATE PERMIT ISSUED DATE COMPLIANCE ISSUED /j �3_ �'� Ali Ale Si e v Obi gv .........jam... . ....................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF........................................................................................ Aptiratiou for Dhoposal Worka Tomitrurtion "Jerutit V Application is hereby made for a Permit to Construct (�or Repair an Individual Sewage Disposal System at: .......... ...................... . ................. ...............................................;......... Location-Address or Lot No. ... .....r...... 9 .17/H&,Z�P Owner Address7 ... ........... ......................................... ------------------------ Installer Address Type of Building Size Lot............................Sq. feet U —Dwelling—No. of Bedrooms.....Z. ..................................Expansion..................Expansion Attic Garbage Grinder fo ) '_l P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P4Other fixtures ...................................................................................................................................................... Design Flow.......sx9aO I.........................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter.-.-..---.--_- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...-.-.-"----------.- Diameter.................... Depth below inlet.................... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ �--4 1.4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water...--................... 0-4 Test Pit No. 2................minutes per inch Depth of Test Pit................._.. Depth to ground water........................ ............................................................................................................................................................. 0 Description of Soil........................................................................................................................................................................ U --------------------- ------ ----------------------------*......"............*........*.......*----------------------------*-------------------------------*--------------- ...............I..................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable----------------- ........................................................................... ---------------------------- --------------------*---------------------------------*------------------------------*--------------------"---------------*--------------- Agreement: The undersigned agrees to install the,aforedescribed Individual Sewage Disposal System in accordance with the provisions of'I IL TI iE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has �bbee;n *Vsu El�;.the and o. h h. has AV Si n;ed. .. . .... .................... .... ...................................... .. .. ...... . .. to ApplicationApproved .. . .... .... .. ................................................................... ...... ..... . ..... ............... /X�D�Date e Application Disa r r the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ ........... ....................OF..........------.........................---.........................................._.._ Appliratiou for Uisvoii al larks Tomitrurtiou Prrutit Application is hereby made for a Permit to Construct ( r Repair ( ) an Individual Sewage Disposal System a : ..........,, :... s :r.��r..� - ---. '::�:�--------------------- ----------------------��`:_ : .......................................................... Location-Address or Lot No. / .��KavI.�t .--------•-------•---.._.... �`,�� .3.._ �1 1 �.1`eg_ H C .el ?�t f' Owner Address � ! a- ►.... =--------------------------------------- :. s�!.. � __ .... .................................. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms______�-..............................Expansion Attic ( ) Garbage Grinder Wo) Other—Type of Building No. of persons____________________________ Showers — Cafeteria Other fixtures ------------------•---•-----•••. • -• W Design Flow........". .V_________________________gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trenzh—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------------------_ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '~ Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------------------------------- •-•••............ ••••--•••-••••••._....... _•---...... -........ _... ..... -------------------- •..... _.... --------------------- 0 Description of Soil........................................................................................................................................................................ W ------------•----------------------•-- •---------••••-•------------••••-•-•------••----••-•••••••---...•------•••-•-•-----••-•-----••-•------•••----•-•••-•-••••-•---•-••--------•------•----•-•-------. UNature 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 TILT i E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been u b�the rd o h h. Si ned- .l ~ IX A lication A roved ------••-PP PPr�' Application Disa ro�e �he following reasons-----------------------------•--•----------------....------------------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................................1........OF..................................................................................... Trriifiratr of ToutpliFaurr I �OTIFY, That the Individual Sewage Disposal System constructed ( or Repairedby ._ �.� A at------ --Z... -- -----•---------------------- -• • -•---- In 1 ----- -•----------•---------...__---•- has been installed in.accordance with the provisions of TI�TrLE 5 of The State Sanitary Code cribed in the application for Disposal Works Construction Permit No....8.1...1� �__................ dated_.-.�� i�..�! THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................ lA\.:�al P`------ Inspector.................................. . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH a. ...........................................OF..................................................................................... Yd No...................:....:. FEE............ ... �i��la�ttl �r�� aat�#riuu Trutt# . Permission > ieby granted.... --------------------------------••-••----•--- --•-•------ ------------..... -------- to Construct or Repair anAdivid gage is sal Syst at No --- -- :...•• - - � :-.. eri Street as shown on the application for Disposal Works Construction Permit No---_--__-------- Dated................................._........ ------------------ �, �, ................................................... Board of Health 'rr DATE--------------------•-----------------•11/� ............... FORM 1255 HOBBS & WARREN. 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