HomeMy WebLinkAbout0135 POINT ISABELLA ROAD - Health _ 135 POINT ISABELLA ��® _.
AP-073 PAR-021
r
i
' - Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r r'
°M 135 Point Isabella
Property Address
Rgil Croff ?
Owner Owner's Name W
information is
required for every Cotuit P/ Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection �:XJI
_r
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. General Information
�3 a
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not Michael T Bisienere
use the return Name of Inspector
key.
Cape Septic Inspections
r� Company Name
624 Old Barnstable Road
Company Address
Mashpee Ma. 02649
Cityrrown State Zip Code
508-280-3356 S13938
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000). The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
08-19-2018
Inspector's Signature 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 should be sent to the system owner and copies sent to the
buyer, if applicable, and the approving authority.
****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.
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
r
Commonwealth of Massachusetts
w r Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
This 5 bedroom home has a H-10 1500 gallon septic tank and a D-Box feeding a 12 x 60 leaching
trench. At the time of the inspection there were no visible signs of past hydraulic failure.
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box,:or"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):
t5ns.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal-System Form -Not for Voluntary Assessments
M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ 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):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
Commonwealth of Massachusetts
H - Title 5 Official Inspection Form
Subsurface Sewage Disposal System,Form -Not for Voluntary Assessments
a' 135 Point Isabella
Property Address
RRgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply,
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for 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.
3. Other.
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or"No" to each of the following for all inspections:
Yes No
El ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/day flow
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
Commonwealth of Massachusetts
w . Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for 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.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA) or a mapped Zone II of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
G M , 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
❑ ® Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS) on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flaw Conditions:
Number of bedrooms(design): 5 Number of bedrooms (actual): 5
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 plus
GPD
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is Cotuit Ma. 02635 08-16-2018
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ 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: occupiedDate
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 trapresent? Yes No
p ❑ ❑
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is Cotuit Ma. 02635 08-16-2018
required for every
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information:
Was system pu-nped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quant:ty pumped determined?
Reason for purrrping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) 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):
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
1997
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 36"feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 24"feet
Material of construction:
® concrete ❑ metal ❑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
Standard H-10 1500 gallon septic
Dimensions: tank
Sludge depth:
1"
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form .
Subsurface Sewage.Disposal System Form - Not for Voluntary Assessments
M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
36"
1
Scum thickness
Distance from top of scum to top of outlet tee or baffle
5"
Distance from bottom of scum to bottom of outlet tee or baffle 12"
How were dimensions determined? Sludge Judge
Comments(on(pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
I would recommend the new owner put the tank on a maint. plan with a local septic pumping co.The
Barnstable Health Dept. has a list of local septic pumping co.
ti
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grader
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons
Design Flow:
gallons per day
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
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
0
Commonwealth of Massachusetts
w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
0"
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
The D-Box had no visible signs of leakage or evidence of past hydraulic failure.
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 working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins.doc•rev.W6 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length: One 12 x 60
❑ Ileaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
At the time of the inspection there were no visible signs of past hydraulic failure.
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of iquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of--esspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
. Title 5 official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
G M , 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewaga Disposal System Form -Not for Voluntary Assessments
�M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
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
t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17
Assessing As-Built Cards http://www.townofbamstable.us/Assessing/fWdisplay.asp?mappar=0...
TOWN OF BARNSTA/BIZ _
LOCATION 35' `Pa i�!�' �S A ALGA SEWAGE N ^ C3 S
VII LAGE ASSESSOR'S MAP&LOT
INSTALLER'S NAME&PHONE No. hugtes Sc/sr—04 I
SEPTIC TANK CAPACITY d R
O I
CpAjr-
LEACHNG FACILITY:(type) i e- (size)
NO.OF BEDROOMS / 0&wA//r&ri Qx�
BUILDER OR OWNS 1r"
PERMITDATE: g7 COMPLIANCE DATE: 9/oco(G S
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility i� Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) h O Feu
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching faci' ) //O ` Feet
Furnished by. 1/i9rlltc.
-
\J .
1 of 1 8/19/2018, 11:32 AM
Commonwealth of Massachusetts
H u Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high ground water: 10 plus feet
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:
augered a hole at a lower elevation and I shot it with a transit.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,M 135 Point Isabella
Property Address
Rgil Croff
Owner Owner's Name
information is required for every Cotuit Ma. 02635 08-16-2018
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
10 �►�1 ��
z�
t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17
AsBuilt Page 1 of 1
TOWN OF BARNSTABLE _
LOCATION f 3 S !'a i �" 9 S A 6,e 114 SEWAGE# ^
VILLAGE u,'{' ASSESSOR'S MAP&LOT
INSTALLER'S NAME&PHONE NO. 450k Thrimus SySr-OefI
SEPTIC TANK CAPACITY O D oI C /F
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNE f"PERMTI DA 9
TE: g7 COMPLIANCE DATE: �.f0 Ay
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) /7 O Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching faci ) Feet
Furnished by
ar'
http://issgl2/intranet/propdat,i/prebuilt.aspx?mappar=073021&seq=1 8/29/2018
i
TOWN OF BARNSTABLE _
LOCATION 3 ,�a �-1 f S A Ae SEWAGE #.
VII,LAGE �u�'f' ASSESSOR'S MAP& LOT
;:INSTALLER'S NAME&PHONE NO. CARP, T It u A iMs SY f'.0 911
SEPTIC TANK CAPACITY O O C IK �r
.,. ..LEACHING FACILITY: (type) a C (size)
::NO.OF BEDROOMS IJbur//,!
... .:::.BUILDER OR OWNE� /
PERMTTDATE: /3 7 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
..Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) /7 O Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching faci ' ) ��O — Feet
•.,::.Furnished by
r�
TOWN OF BARNSTABLE
qG 6`3
S
S, d�, g� SEWAGE # / ...
LOCATION 1
y
ASSESSOR'S MAP & LOT i
VILLAGE '�7�., d 21
INSTALLER'S NAME 6i PHONE NO.G
SEPTIC TANK CAPACITY nG
LEACHING FACILITY:(type)
NO. OF BEDROOMS d/ PRIVATE WELL O PUBLIC WATE
B 9LDER jjl
OR OWNER G
DATE PERMIT ISSUED:
r
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes N�
r
Z
_ TOWN OF BARNSTABLE
LOCATION �� 14 1.5 A Ae�L SEWAGE#
VILLAGE (�?o �t/ a'� ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. CAR T/frlaal AES 90,-048
SEPTIC TANK CAPACITY O o 4,d 6 G Aii—
LEACHING FACILITY: (type) /D7 Y 40 Pf e. (size)
NO.OF BEDROOMS h,,4&'/I aXA
BUILDER OR OWNED -& / /
PERMTTDATE. DI? COMPLIANCE DATE: q.!x0!4>
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) /1 Q Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching faci ' ) /0® Feet
Furnished by _� a 1S
t'n
4
14
r O
�j
• TOWN OF BARNSTABLE
LOCATION Z3S o; f ):gh a /,q SEWAGE #
. t
VILLAGE �O 7�u+ ASSESSOR'S MAP & LOT �3� d
INSTALLER'S NAME & PHONE NO.6 A e y e+lf,*p_kS SY£a'wl
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) tl per,l rirk o(size) 40
7 NO. OF BEDROOMS PRIVATE WELL O _PUBLIC WATE
BUILDER OR OWNER ®'
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: 'Yes l No
�� ._ �
� - � _
���
r,
I�ySE S50f1� I�r `
No. PARCEL N0; Fee
�—�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
ZippliLotion for Mid aal *pgtem Con!6t Ction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System 0 Individual Components
Location Address or Lot No. / j�,��C :gC� P Owner's Name,Address and Tel.No.
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
4A-97
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( y/
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow#/• 6 2V gallons per day. Calculated daily flow LL/ (pt% A461 ��y y0 gallons.
Plan Date 15 —/ S'= Number of sheets / Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil Sy,c(, /4Dg, &rcjye ( o l-e %-u,yj 5 g✓t Cl
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 o e Envir ental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by azd of h.
Signed Date X
Application Approved by Date 14?1,g4, ;FJ
Application Disapproved for the following reasons
Permit No. Date Issued 9 n
�--'� i. :�. w '� .. - w . .. Y »+.ram-. - t-....-;� ` w'fi.....^"-...,•..�.i.i.•tw.}-.,•..., lt. �... .+. p�a.. ;,✓ .. r. i
i yw No. ^ - O ` r Fee
THE COMMONWEALTH OF MASSACHUSETTS Enteied,in computer:
Yes
PUBLIC HEALTH DIVISION =TOWN OF BARNSTABLE., MASSACHUSETTS
2pprication for Oigaal *pgtem Congtrur'tio Permit
Application for a Permit to Construct( )Repair(. )Upgrade( )Abandon( ) .VJ Complete System .El Individual Components
Location Address or Lot No. /35/ a� �?��/� 62�� Owner's Name,Address and Tel.No. ®�O r— —
�v�v f- / �G;ti i7 f TSGPIIC�
Assessor's Map/Parcel 1
Installer's Name,.Address,and Tel:No. Designer's Name,Address and Tel.No.
' f �-e r.
Type of Building:
Dwelling No.of Bedrooms " Lot Size 1 6/ sq. ft. Garbage Grinder( r�
t Other' Type of Building No.of Persons Showers;( ) Cafeteria( ) I
Other Fixtures
Design Flow s l Y - G GG gallons per day. Calculated daily flow I - {E r�Ef( gallons.
Plan Date 9' -i 1;:- Number of sheets / Revision Date
r
F Titlez - 3
Size of Septic Tank ` * f 9 •� "" Type of S.A.S.
Description of Soil �� ;,r�,_ /mac. / 5 c. ✓f C'
P , . r�-YI S C+ �.0 V'dG�; �'.? .�
I
Nature of Repairs or Alterations(Answer when applicable)
rDate last inspected:
._._ Agreement:.. / I
-ne 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 of4he Enviro • ental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by c a and of Pe.hh.
Signed Date �A S 4)
Application Approved by _ - Da e
Application Disapproved for the following reasons
5
PermitNo. Date Issued Z19
THE COMMONWEALTH OF MASSACHUSETTS `�
BARNSTABLE, MASSACHUSETTS
r (fertif irate .Of Compliance
i THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( f/)Repaired( )Upgraded( )
Abandoned( )by
at a _t has been constructed in accordance j
with the provisions of Title 5 and the for Disposal System Construction Permit No. -1r j2Vated /`�
—T
Installer Designer
The issuance of this pe t shall not be construed as a guarantee that the system will function as designed.
Date �_ - �✓� Inspector _
IR r
No. -
�`/� � -------------------------Fees
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS
'Wioogal *pgtem Construction Permit
Permission is hereby granted to Construct( ✓ repair( )Upgrade( )Abandon( )
System located at �--] 4 6-1 ;
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date:
d Approved by
f
i
N®._.Sc'l ..0 FEB ... ..................
THE COMMONWEALTH OF MASSACHUSETTS
- BOAR® OF HEALTH
ptom--- --------------OF......... .................................................
Appliratiou for Bi,spuii it Workii Tomitrurtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Systemat:
............6........... ........................................... -------..........._.......-o`Z....------ -- ----------•-----........................--
Location-Address or Lot No.
.............................................. ----'(I've l ..... A...... ..................................
Ow
�er `dress
stiller Address
QType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (VO)
Other—T e of Building No. of persons____________________________ Showers — Cafeteria
a Other fixtures _________________________________ _
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
Disposal Trench—No_ ____________________ Width..................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit Not____________________ 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_-___--______________..-
(4 Test Pit No. 2................minutes per inch Depth of Test Pit____________________ Depth to ground water........................
a ----•--•--••--------------------------------•--•------------------------------..._..----..........._............................_............................
0 Description of Soil........................................................................................................................................................................
x
V --------••••---•------••-----•--•-----•...-------•-----------------•----•••--------•----------------------•-----•---•------•---•---------------
W ----- --------_------------- ------------------------------------------------------------------------------------------- ........................................
, 7
U Nature of Repairs or Alterations—Answer when a licable._.. �� - 0vz ---- -�
/PAP,.,
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions, of'TT'.p of the State Sanitary C — The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been ted d f h lth.
Signed..... --- -------........................... --- ......................... ................................
Date
Application Approved By............ = ---------- .....------ . "8,�
Date--------------
Application Disapproved for the following reasons___________________________
--------------•--------...---------•--------•----------------------------------------------•----------•----------•-------•-•-•••----------•-----------------------•-•----•-----•-----------•••----•-----
Date
PermitNo......................................................... Issued------------------nace--------•------•---------------
No... 0 .. Fxs...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....... .... ..OF...... .. .
Appliration for Biipooal Works Tonstrnrtion Urrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Sys at. ... .........................•-.. .. '
. sc ....
Location-Address or, t No.
..... .\... ................................................................. .--- � fv!.....- .`Y Aj��Aw.......................................
Owr er dre1sss �j
............................................ r .�3..... s �C.... '... -------•----•----------
I taller Address
UType of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms.................3
........................... Attic (` ) Garbage Grinder (WJQ)
P-1 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Q' 'Other fixtures ..................................
W Design Flow............................................gallons per person per day. Total daily -low............................................gallons.
WSeptic Tank—Liquid capacity------------gallons Length---------------- Width---------------- Diameter---------------- Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---_--------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
z Other Distrib--ition box ( ) Dosing tank ( )
`" Percolation Test Results Performed by.......................................................................... Date........................................
aTest Pit No. I________________minutes per inch Depth of Test Pit.................... Depth to ground water_-____---__-_____-__----
(i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_-________•_---.___--.
a ••-••-•••--••------------••-•--••--...---•--•--•-••--••..................•------•---•-••----....••--........................................................
r0 Description of. Soil........................................................................................................................................................................
sa x
- ---- /
U Nature of Repairs or Alterations—Answer when a licable-•---1 ' _ D:_! Q ........�Xt
.._ �iZe�.'".
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of:T`:
p 5 of the State Sanitary C — The undersigned furtl er agrees not to place the system in
operation until a Certificate of Compliance has been led 7 h Ith.
Signed--•- --- ............... ` .........................
Date
Application Approved By............ �...._..... Z ......
Date
Application Disapproved for the following reasons:.............. .. >-
........................................................................................................................
Date
PermitNo......................................................... IssuoL.......................................................
Date
THE COMMONWEALTH OF MASSACHUSE-TS
BOARD OF HEALTH
............./...g`..">`.":........OF........— + :.......................................
Trrtifiratr of Tomph anrip
THIS IS TO CERTIFY, at the Iyad vidual Sewage Disposal System constructed ( or Repaired ( )
by------------------' LoL
...
p -c- 0 Installer.. �--•
at................ •� 1 %. '.._.._..:._ ----------" ........ ....`........................
has been installed in accordance with the provisions of T rT, j of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No. ........... dated------------------------------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A dUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..:.........................�9/� /_. ----.------_------------- Inspector.......a'A�.......................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
,rf .........• " "..........OF..... .... ..:.... ..................................
N4 - .. ,. FEE .....................
. .
Disposal Morks Touts dwi n Vautit
Permission is hereby grante = --------•-------------•-••----•-•-•--•....................•.
to Construct ( o Re air ( �_ �i
. ew age Dis osal System
at No.
------------a. r- -•------- ..... --
----------------------------------------------------
Street
as shown on the application for Disposal Works Construction Permit No..............i...... Dated..........................................
' --
Board of Health
DATE................................................................................
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
LOCATION SEWAGE PERMIT NO.
P*. -s 6 ells
VILLAGE oL� GysT2 h'a�r�
INSTALLER'S NAME i ADDRESS
R map\ ►N .7 s r/��Xiys;
B U I L D E R OR OWNER
DATE PERMIT ISSUED _ ZG_ed,
DATE COMPLIANCE ISSUED
I'e
1�
�yy
1--
0
M
r
BAXTER NECK SYSTEM #2 SYSTEM #1
DESIGN DATA DESIGN DATA
_)3a SINGLE FAMILY- 3 BEDROOM
z __... NORTH SINGLE FAMILY- 4 BEDROOMS
WITH GARBAGE GRINDER
o BAY NO GARBAGE GRINDER
N DAILY FLOW = 110 X 3 = 330 G.P.D.
DAILY FLOW = 110 X 4 = 440 G.P.D. SEPTIC TANK 330 X 200� _ 660
i
SEPTIC TANK 440 X 200% 880"�O LOCUS q USE EXISTING SEPTIC TANK USE 1500 GAL. 2 COMPARTMENT SEPTIC. TANK
1ST. COMPARTMENT CONTAINS 750 GAL.
OLO LEACHING FIELD DESIGN 330 X 200 = 660 GAL. REQUIRED
G
7 ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED SEE NOTES
C.B. NO D.K. WITH CAPPED ENDS
USE 3 - 4" DISTRIBUTION LINES CULTEC LEACHING CHAMBER DESIGN
IN A 12'X 50' WASHED STONE FIELD AS SHOWN
LOCUS MAP LEACHING AREA REQUIRED RECHARGER 330R
SCALE 1 2 5,0 0 0 , 440 G.P.D./.74 = 595 S.F. ALL PIPES TO BE SCHEDULE 40 PVC. PERFORATED
�, N (12 X 50) 600 S.F. BOTTOM AREA
ASSESSORS
MAP 73 PARCELS 20 & 21 �, �" 600 S.F. TOTAL PROVIDED USE 1 4" DISTRIBUTION LINE IN 6 RECHARGER UNITS
cv IN A 12'X 40' WASHED STONE FIELD AS SHOWN
ZONE - LEACHING AREA REQUIRED
\ 3 330 G.P.D./.74 446 S.F.+ 50% = 668 S.F.
A.P. 3 12.Ioo' 2(40+ 12) X 2 = 208 S.F. SIDEWALL AREA
3' (12 X 40) = 480 S.F. BOTTOM AREA
RESIDENCE F \
MINIMUMS 50.00' 688 S.F. TOTAL PROVIDED
11 \
AREA = 43,560 S.F. C.S. FND.. . s TOTAL UNITS r STARTER.1 END. ;Sc 4 INTERMEDIATES.
FRONTAGE = 150' \ PLAN VIEW 330s TW. 3301 33M
= SCALE: 1" = 20' 7.5 5
6.25 s.2
FRONT SETBACK 30'
c
SIDE SETBACKS = 15;
REAR SETBACK 15 m\ ,,O 12.00'
BUILDING HEIGHT = 30
(OR 2.5 STORIES IF LESS) \ 0 38'-8"
a 40.00>
_ PLAN VIEW
SCALE: 1" = 20'
o TEST HOLE
\ \ 4 METAL FRAME 4" P.V.C. PIPE AUG. 9,1996
AI4D COVERS LOCATED TO FINISH GRADE x VENT BAXTER & NYE INC.
\ ' FIRST FLOOR = 27.76 2 ELEV. = 25.9'
\ F.G.= 26.1 F.G. 28'f F.G•=24' +) 0-SANDY LOAM
-2.
,• E-LOAMY SAND
RVv -10„
= 15W GAL LEACHINGiNv. - 22.2 ACHING CHAMBERS B-LOAMY SAND
w 23.0 INV = 2 COMPARTMENT 4 DiAA/ T asT. LE_ V.c. r -_ -24"
Q N 22.8 SEPTIC TANK INV. -INV. - BOX
N '' \ 22.fi 22.4v. = o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o v 4 0 -
o N' i O'MIN SEE NOTES .....�• ,-, 0 0 0 _o 0 0 0 0 0 0 0 0 0 0 _ o _o v'v v s C
a ^�.. ,.. a O Q v v os -: MEDIUM SAND
A
BOTTOM ELEV. EL = 20.0
M SYSTEM #1
-
o \ \ ' - -9'NO WATER
PROYHE
o ' \ •- EL. = 17
°' , , NO SCALE
Q I ` APPROX. HIGH WATER = 2.0'
J
TEST HOLE
TW OF EXISTING METAL COVER COVER LOCATED TO WITHIN AUG. 9,1996
\ , \ BASEMENT SLAB 12' OF F.G.
F.G,- 18 f BAXTER & NYE INC.
F.G.=18'f ELEV. = 16.0'
10YA , o , �10
\ \ 16.0 INV. - 4 a' t
UPLAND = 62,333 sq.ft. \ 15.8 EXISTING. �,�,. T DMT SCHEDULE 40 P.V.C. LEACH FIELD E12"
co \ SEPTIC TANK 5.6 INV. =15.4 BOX a s a a a a s a s a B
WETLAND = 2,357 sq.ft. INV. = a as as as a a as • a a da _ -24"
INY. =15.2 14.8 a a a �1 �1,+. a a a
\ Vi•• °4ae4aaa�aa i�►SH�D 11 It i�l 4aaadaag4a 61�
o TOTAL 1.48 AC. aaaaaa444 aaa as as aaa as aaa aaa aaa
c>a \ BOTTOM ELEV. EL = 13.8 __: G
m \ _ SANDY GRAVEL
\ � _ WITH
' \ ` SYSTEM #2 - = COBBLES
c� W -
W \ \ P$OIILt` -6'NO WATER
Q ' ` NO SCALE APPROX. HIGH WATER = 2.0' EL. = 10.0'
co ' \ PERCOLATION RATE 1" IN 2'
Z
� CLASS I SOILS
A��ea\ ,
'7
H
oe wC B. FND. y
' a C 6. FND. \ �\
ON_ HIT
22.4�� S 79
elec. box
t\(n�� ` 1� Paved Parkin
` 6 LE ; I
SYSTEM #1
SYSTEM 2 I.P. SET
# U) -__`n \ N AREA
15.0 `0o septic �� 'ROPOSED DRIVE
�F
\ �_ N �- M
R2 \ ABANDON FILLS septic o
DIST. V 9� 20.9 25.00, BOX' jWALK
to bo removed _
r1
SDI n o ' , \ o Pi
' Profane bric atk
Gy '� ZONE C & electric zo
to be�emoved o Z
Poo t 26 0
GARAGE P hous ° chai ° N
nk fence
0 FIRST
BUILDING R O D ADDI
T FLOOR
u,Z
eat°� f BASEMENT FLOOR
27.76
1 ny
STK. SET a `` �. \ \ ' cover / 8.65 /
� r
ELEV. 17.6 �8 o
.�\ `` \ patio EL PATIO pool
N \ / r ' 26.0 Proposed
f
C.B. FND. ZaAiE A11 ag pole
BRICK PATIO \, pool ` �° _`•C �.
25.8 existing \ \
7E Ape
-- C FIND. a,• ` '
- - 6 ���_ 79..._ \ BEG�dARK 11.0'
-'yY brick _ gate
beach _ �_ 1 ___ ~_ SET
house
- toi) - - -
.._._ eve
-T 6,
r.
Q \
OF
w +ela+AtaO St�AN
a N0.29T33 c
yo CIVIL
GisT�a�°,�
psi
PLAN �
0 20 40
floot
SCALE: 1"= 20' SITE PLAN OF LAND
IN
12' FIRM FLOOD INSURANCE RATE MAP
FINISHED GRADE COMPACTED FILL PANEL 18 OF 25 ( C 0 TU I T )
iv� 3' MAXIMUM Pier 250001 0018 D
"^ PEASTONE REVISED JULY 2,1992
wvvv T"" NOTES BARNSTABLE MASS .
vvvvvvvv .'vvvvvvvv
'vvvvvvvv vvvvvvvv 3�4" TO 1 1/2 "
•5 vvvvvvvv 0 vvvvvvvv
vvvvvvvv vvvvvvv FOR
vvvvvvv vvvvvvv 0 FOR ALL ASPECTS OF THE SEPTIC SYSTEM THE CONTRACTOR
vvvvvvv vvvvvv WASHED STONE
vvvvvv vvvvvv SHALL COMPLY WITH ALL GOVERNING CODES AND REGULATIONS. c.
IYOT-�" SIDNEY W. CROFF
52" IN PARTICULAR 310CMR 15.000 THE STATE ENVIRONMENTAL CODE TITLE 5,
THE TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS PART VIII: (1) PEtdOVt U€�SU TABLE SOILS BENE/.1 PROPOSED SYSTEM, B"-'-'.CKF ILL
END SECTION ON-SITE SEWAGE DISPOSAL REGULATIONS AND THE BOARD OF HEALTH �' �IE�I� CR°�� I ,�R t�fi,TEP " FfL C} �L GBALED F.S FOLLC>1k`. rC
1,=0: a- r<<4 �5% r:E- AINED ON N 4 Sig: L, N'OT MORE THAN 90 4 RETf N'-D SCALE: AS NOTED DATE: AUG. 15,1996
NO SCALE RECOMMENDATIONS FOR ACCEPTED PRACTICE. ON No. 50 SIEVE, OF FRACTION PAS:N , No. 4-, 10% OR LESS TO PtiSS No.
O2 TWO COMPARTMENT SEPTIC TANK REQUIRES 2 WEEKS OF LEAD TIME 1C? SIE'4� A'''t 5" "` LESS '` `''SC ' 2010 SIEVE, SOS TO BE APPr-;VEL'
BY ENGI€�iEER FCR 00M. I� CE PRIOR ,C r>LeCINf, ON SITE. BAXTER & NYE INC,
TO ORDER FROM SUPPLIER.
(2`) LOCATEON OF 1LIT€ s NOT SHOWN! c 1HIS PLAN, AT LEAST 72 HOU=s REGISTERED LAND SURVEYORS
O3 THE SEPTIC TANK'S FIRST COMPARTMENT SHALL BE SIZED FOR 750 GALLONS MIN.' PRIOR TO ANY EXCAVATION FOR THIS FFt JECT CONTRACTOR SHALL MAKE CIVIL. ENGINEERS
THE SECOND COMPARTMENT SHALL BE SIZED FOR 750 GALLONS MIN. PRI FPO,JIAN r�n-rj VATION TO TH S<<.rE (1 S aJ-322-48�at �.t�C A?PRCiC 1`%TE
ALL IN ACCORDANCE WITH 31OLMR 15.224 MULTIPLE COMPARTMENT TANKS. THE DI�TI'D „� ICATIOtII�E lIIG S E 08-� ,s ❑STERVILLE, MASS.
TWO TANKS IN SERIES MAY BE SUBSTITUTED SUCH THAT THE FIRST TANK
DEED REFERENCE: BOOK 10662 PAGE 63 IS 1500 GALLONS & THE SECOND TANK IS 1000 GALLONS AS PER 15:225.
#96089-50