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HomeMy WebLinkAbout0100 POPONESSETT ROAD - Health -- -- --- - LA = pp�-e?tr�s ett,Road., 184033. 1 TOWN O"BAR�,N,,SgTABLE LOCATION a - ft� L G�' SEWAGE #,2tY.)S I�-� VLAGE ' M —II. ASSESSOR'S MAP & LOT ✓7 � INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ���✓` a� -� LEACHING FACILITY: (type size) y y NO.OF BEDROOMS . BUILDER OR OWNER PERMTTDATE; `'iL� � COJ',4PLIANCE 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 Evetlands exist within 300 fegpf leaching facility) Feet Furnished by �� 1ld T 7 &�,� A4V � ' 9 -421. TOWN OF BARNSTABLE LOCA71ON /G0 O LPO0On6SS� ��: SEWAGE # VILLAGE Cn+U;�- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /6M GAI- LEACHING FACILITY: (type) CO.SSPOb (size) S�x S NO. OF BEDROOMS 3 BUILDER OR OWNER /> AC-9Ar r 4, 1 F j PERMTTDATE: COMPLIANCE DATE: I Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 11 gl- 30 a .4 rA r.e- .3(p A A3- - a g3- �3 3 No. Fee i~ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes 9, ab "PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, M'ASSACHUSETTS 1,01pplication for 12; o0al * gtem Con5tructiott Permit Application for a Permit to Construct( )Repair(Apgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No D Owner's Name,Address and Tel.No. Assessor's Map/Parcel In is Naome,Address,and Tel.No. D,gSi er amess an el.No. _ CTK) - ed— Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) ^ Other F// res Design.Flom gallons per day. Calculated daily flow gallons. Plan Date '-© Number of sheets 21— Revision Date Title Size of Septic Tank ISOS Od0 -/ y e of S.A.S. ©d Description of Soil 1pla ( . 5'1,41-4 y� /a;-'� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigne ees to ens the co, s cti ii a tenance of thdkore described on-site sewage disposal system in accordance with,the pro,isio s of Titl 5 o t e iro al Code and n t place the system in operation until Cert' i- cate of Compliance has be y oar H th. Signed Date ' Application Approved by _Date Application Disapproved for the following re s s Permit No. Date Issued A nn5 Fee--�� _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS . 0'7� 01pplication for Mi0pooal 6potem Conotruction Permit 1v w Application for a Permit to Construct( . )Repair(Upgrade( ) b don( ) D Complete System D Individual Components Location Address or Lot N2�- Owner's Name,Address and Tel.No. Assessor's Map/Parcel Inst No. D n r' N dress Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Figure ' Design Flow gallons per day. Calculated daily flow gallons. Plan Date 0 Number of sheets 7i Revision Date Title 14 Size of Septic Tank rjOG' O O ,wt }ape of S.A.S. 6Z Sp6 Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersignedcagree es to a sure the cofistruc t p a in ntenance of thp,fore described on-site sewage disposal system in accordance with.the provisi ns of Tit 5 f t e viro e, tal Code and n t to place the system in operation u7/`�, Ce 'fi- cate of Compliance has be n-i y, 1�' oar of H lth Signed Date Application Approved by y / Date Application Disapproved for the following rea ns V , Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (tompriance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( )Repaired( ,,.)Upgraded( ) Abandoned(, )by _ ' 4— at 0 �b c?`3�^P �_� �" has en constructed in accordance with the provision of Title 5 and the for Disposal System Construction Permit N . r datedL ��� Installer i t Designer 0 1. The issuance of this pernut shall not be construed as a guarantee that the system will function as designed. Date � 1 fG Inspector—4 -- J ---- - — - - _.No.-----�—���--------------_.®®®. Fee-f-� - - / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mitpozar *pgtem Con5truction Permit b Permission is hereby granted to Co truct )Re air )Up rade ) Bandon ) / System located at C� ��T� � _. (� �E 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: Co s suctiont05 ust be completed within three years of the date of tjipermi. Date:_ Approved by -� 1 TOWN OF BARNSTABLE LOCATIONil SEWAGE# �- VILLAGE-- z A 7 _ASSESSOR'S MAP &LOT � INSTALLgR'S NAME&PHONE NO. 1 0 SEPTIC TANK CAPAC o LEACHING FACILITY: (type) size) J� e NO.OF BEDROOMS BUILDER OR OWNER PERMUDATE;e'13 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 f.e�ef 1 c t�aci ty) E ,f Feet Furnished by �C� I'to Set _. ,+� 30 14 33,-7 I- Town of Barnstable Regulatory Services • Thomas F.Geiler,Director Public Health Division a63 ►`� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer&Desiener Certification Form Date: rl �'a 0 Z 1 , 2,X 5 Designer: N10 D. COUGH INOWK Installer: H ,coNsyl im-flrot, Address: N WkC C 1W-16 Address: ( C G gAJL)W16H' MA 021563 On was issued a permit to install a (date) (installer) ' septic system at],90 CA2P-0/lA:—::'sSF--T- � based on a design drawn by (address) D tTVO D. COQG IM L 'dated i 1\,k W�� (designer) 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 p distribution box and/or septic tank. 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. VkCF �n t DAVID " cyN "* Q. ! (Ins COUGHS' ignature) #t ,."' ���, y k 9 IT A?-' 2 � (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH -THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Sotic/Dedper Cettification Fotm COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 100 Popponessei Road Cotuit, MA Owner's Name: Margaret W Litt Owner's Address: Same Map: U/% Date of Inspection: April 4, 2001 Lot: 7,5 Name of Inspector:(Please Print)Gordon E. Bumpus RECEIVED Company Name: Gordon E.Bumpus Mailing Address:" • •.215 Ost.-W. Barnstable Road Osterville,MA 02655 APR 1 3'2001 Telephone Number: (508)428-5640 ,, � TOWN OF BARNSTABLE "' HEALTH DEPT. CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes , Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: April 9, 2001 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 is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP: The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments 1,r,1 �3.,R�~r,�„rt�w�<;•,. -.__.t��i;i'} Wit:. - ., -- ___._ _ - _ o� �cwtF ,t. ***This report only describers nditioni at'the'time:of inspection and under the conditions of use at that time. This inspection does not address how the'system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 100 Popponesset Road Cotuit. MA -. Owner: Margaret W Litt Date of InsP p Inspection: April 2001 1 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: _B._ System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired: The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND),in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed'pipe(s). The system will pass ins ection if with approval of the Board of Health): _ broken pipe(s)are replaced obstruction is removed ND explain: 2 i 4 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - . PART A CERTIFICATION (continued) Property Address: 100 Popponesset Road - Cotuit• MA Owner: Margaret W. Litt Date of Inspection: April 4, 2001 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 2: System will fail unless}the Board of Health(and-Public Water Supplier;if ariy)`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 sysieih(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes,if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: R 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 100 Popponesset Road ry Cotuit. MA Owner: Margaret W. Litt Date of Inspection: April 4, 2001 D. System Failure Criteria applicable to all systems: You must indicate either`yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool' w - ✓ 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 '/2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion'of a cesspool'or privy.is within a Zone,l of a public well.. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater:than 50 feet from.a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform.bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. � You must indicate either `yes"or `no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered`ryes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B ! :CHECKLIST Property Address: 100 Popponesset Road Owner: Margaret W. Litt Date of Inspection: April 4, 2001 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 k i ✓ Were any of the system components pumped out in the previous two weeks? 1 ✓ 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 signsofsewage.back up;?,:' •' t✓' •` Was_the site inspected'for signs of break-out,? ✓ Were all system,components;excluding the SAS,'located on-site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)]. �}h ."iI.".`'J�t.:�.ta—/-�5, :<i ._3.-•If.9{ _. , .....:['-.<�.; Fti:.:,... , ,.tt .. G. ., .. _.. jux. • �s< .3` •Tl— �i • ,ice-.a. • + � . . 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 100 Popponesset Road Cotuit, AM Owner: Margaret W Litt Date of Inspection: April 4. 2001 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yps.or no): No [if yes separate_ inspection required] rY sy stem stem inspected(yes or no): No inspection. required] P Seasonal use(yes or no): Yes Water meter readings,if available(last 2 years usage(gpd)): 2000-81,000 gals.; 1999-58,000 gals. Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIALANDUSTRIAL Type of establishment: Design flow.(based on 310 CMR 15.203): pd Basis of design flow(seats/persons/sq$;etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) r >. „ Non-sanitary waste discharged to the Title 5 system(yes or no). Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: None on file-per treatment plant Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: _gallons--flow was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box, soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) :. : �. +.. ,. .: ... .`.s.. Tight Tank Attach a copy of the DEP approval Other(describe): . . r Approximate age of all components,date installed(if known)and source of information: Unknown Were sewage odors detected when arriving at the site(yes or no): ' No 6 Page 7 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C -SYSTEM INFORMATION (continued) Property Address: IOO Pop ponesset Road ""' '` 1. '' ;'�`_, _ g.• '.�+ ;rr'.i Cotuit. MA Owner: Margaret W. Litt ? Date of Inspection: April 4, 2001 BUILDING SEWER locate on site plan) . ( P ) Depth below grade: „ Materials of construction: _cast iron _40 PVC _other(explain): ' Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): ' SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 8" Material of construction: ✓ concrete _metal -fiberglass._polyethylene _other(explain) If tank is metal list age: - .___Is.age.confirmed by.,a Certificate,of.Compliance(yes or.no):,,! ; (attacka c9py,of certificate) Dimensions: 1000 gal. _._.._. _ <Tf ti ,# "~ .( (? ' :ti�"ibfi it ., i a'4i:'•,. Sludge depth: 2" Distance from top of sludge-to.bottom..of outlet tee or bade: 30" Scum thickness: 4" Distance from top of scum to top of outlet tee or baffle: 9" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): The baffles were present. The liquid level was even with the outlet invert. There were no•signs of leakage. Cs GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: r Distance from'top of scum to top of outlet tee or baffle:_ Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping,recommendat ions inlet and outlet tee or baffle condition,structural integrity,liquidllevels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C :. SYSTEM INFORMATION (continued) Property Address: 100 Popponesset Road Cotuit, AM Owner: Margaret W. Litt Date of Inspection: April 4, 2001 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): :DISTRIBUTION BOX:' •None if present must be_o ened locate on siteplan) , Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): i + i ,. ,� , 8 Page 9 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C t ;= =` • 1SYSTEM INFORMATION (continued) Property Address: 100 Po pponesset Road Cotuit. MA Owner: Margaret W Litt Date of Inspection: April 4, 2001 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number.: 1 -- - •- --- - --- .• Innovativelalternative system_-.-Type/name of technol,9gy:.- Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): The overflow cesspool had 2:60dter on the bottom.= he.scum line,was:dt the same,levels?There were no-signs offailure. The bottom to grade was approximately 7. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: _ Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: _ Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): - - Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION.(continued) Property Address: 100 Popponesset Road Cotuit. MA Owner: Margaret W. Litt Date of Inspection: April 4, 2001 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Goa(-A c _. A qi _ aS A3, a i f33- (03 10 i Page II of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM : PART C SYSTEM INFORMATION (continued) Property Address: 100 Popponesset Road Cotuit.MA Owner: Margaret W. Litt Date of Inspection: April 4. 2001 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet- Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the hi' h groundwater elevation: j Bottom of over/low cesspool to grade�was app. 7' Using Barnstable topographic map and Cape Cod Commission - water contour map Maps are showing app: 15'to groundwater at this site. 4 Z This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed,written or implied,relating to the system, the inspection and/or this report. 11 r �r 24 SCHOOL STREET PLAN REFERENCE CONTOURS 2°os4 f, _ _ PLAN BOOK 184 PAGE 33 EXISTING - - - - - - - 50 ��- ASSESSOR'S MAP: 20 FINAL 50 w i 20 \ Aa aoAD o 0 LOT: 75 LOTS TS l7 & l8 ceD Woo° \ \ AREA - 40280 cf •- COMBINED I&. LOCUS NOTES N o \ PONEETt R0� EXISTING 750 GALLON SEPTIC TANK IS TO BE PUMPED AND REMOVED 6� � \ \ N r` PROVIDE CLEANOUT PLUGS TO GRADE AT y 24 ft x 12.5 ft x 2.ft COTUIT. MA ALL 45 DEGREE BENDS IN SEWER LINE a 14 LEACHING GALLERY I 'C MAP IF A SEPARATE CESSPOOL IS FOUND SERVING SEWER `LEALUSNOUT(Typ AFr,�av L O C U S LINE a IT IS TO BE PUMPED, COLLAPSED AND FILLED. fir, ° " NOT TO SCALE FX/S r7JAV A Dft BUOYANCY CALCULATIONS IT °wFc°ROOM I500 GALLON I000 GALLON -�� " ��\t LEGEND SEPTIC TANK PUMP CHAMBER B `"'E ' - • EXISTING 750 GALLON - USE SHORE MFG INC. - USE SHOREY MFG INC. g2� `o-` - SEPTIC TANK ST-1500 ST-1000 i ?y O�A ® \ 1000 GALLON . \ESTIMATED SEASONAL ESTIMATED SEASONAL PUMP CHAMBER�c� � �� � � - , HIGH GROUNDWATER - 6.59 HIGH GROUNDWATER - 6.59 i p 1500 GALLON Fool BOTTOM OF BOTTOM OF / ~� \ SEPTIC TANK SEPTIC TANK - 5.55 PUMP CHAMBER - 5.25 \ 1 \ DEPTH OF WATER DEPTH OF WATER TEST o DISPLACED - L64 ff DISPLACED - L34 ff i I14 IS TI 1 ` TEST PIT INTERIOR DIMENSIONS OF INTERIOR*DIMENSIONS OF �5 i E A �-� I EL CHGPIT O SEPTIC TANK - 10 ff x 5.17 ft PUMP CHAMBER - 8 ft x 4,35 ft 4 / O 10 x 5.17 x 1.04 - 53.77 cu ft 8 x 4.35 x 1,34 - 46.63 cu ft I 1 UTILITY POLE $ �} 53J7 cu ft x 7,48 - 402 gal 46.63 cu !t x 7.48 - 349 gal DRAIN./ 3 � I / r 402 x 8 Ib/ gal - 3216 * 349 x 8 lb/ gal - 2792 N WATER ® 1 IO ) TREE 1500 I SEPTIC TANK '000 gol PUMP CHAMBER / GATE / /� ��J ""1°� T'DAPETEP q1I WEIGHS 11480 • SPECIFIED WEIGHS 8240 • �� N Nf3ES�r>Fr oec7E5 T re "f SPECIFIED � ,;� / TANK WILL NOT FLOAT CHAMBER WILL NOT FLOAT PLAN e GATE ��.�G 22 24 Z23 30 rf SCALE: ! in - 30 ft 10 �+ p a /6 to 20 OAV1D EDGE OF PAVEMENT D. FLOW PROFILE SSE T ROAD - ' # 1093 BENCH MARK POPONE ,� ;11093 RAISE COVERS TO WITHIN PK NAIL IN DRIVE r:+ NlTAV xx - TOP OF FOUNDATION ELEVATION -12.25 pS 6 in OF FINAL GRADE ! LSGS DATUMI ASSUMED ....� EL - 14.06 W ONE INSPECTION RISER FOR �/''� LEACHING GALLERY VENT �`l I `< 2.00 ' EL - 13,52 (B) I PPE 1775 CAST IRON COVER rLAYER of ve. SEWAGE DISPOSAL SYSTEM PLAN =41 / TO GRADE 1z' °'°'�� -TO SERVE EXISTING DWELLING'.. .. 3_ D FLOW ROP LINE /D-BOX � MAX 10 - 4- ! ROBERT & KATHLEEN HALLETT LEXISTING A) 48- GAS�� 100 POPONESSETT ROAD COTUIT. MA BAFFLE — PRECAST ,4-_I V4' ECO—TECH ENVIRONMENTAL ) 10.05 \ ORYWELL sTorf - EXISTING 6 in BOTTOM OF STONE I4.13 LEACHING SOIL ABSORPTION 43 TRIANGLE CIRCLE SANDWICH MA 0256 10.00 9.75 BASE SYSTEM 10.30 6 in STONE BASE 5.55 I4,So ! GALLERY 508 364-0894 w,00 S.o° h I500 GALLON 6 in STONE BASE 5.25 (END VIEW) 12.00 ETE-1960 I APRIL 9. 2005 1/2 f o) 02 (► SEPTIC TANK Lo r' 1000 GALLON 14•3 ft 1) 14 it 12,S t, THS PLAN IS TO BE CONSIDERED A DRAFT PLAN UNLESS IT' b� ► 1 n PLHP CHAMBER 'ti ADUSTED 6,59� BEARS THE STAMP AND SIGNATURE OF THE DESIGN ENGINEER -SEE DETAIL ON BACK SEASONAL KOH ORIGINAL PLANS INTENDED FOR SUBMITTAL.TO THE BOARD ` - OROLINDWATEF�__ _-__ OF HEALTH WILL BE SIGNED N SLUE AND STAMPED IN RED. j , SOIL TEST LOG DESIGN CALCULATIONS DATE OF TEST: APRIL 8. 2005 SOIL EVALUATOR: DAVID D. COUGHANOWR. RS DESIGN FLOW: 3 BEDROOMS X 110 GPD - 330 GPD WITNESS REQUIREMENT WAIVED - NO VARIANCES SOUGHT GROUNDWATER ENCOUNTERED AT 108 INCHES SEPTIC TANK: 330 GPD X 2 DAYS - 660 GALLONS TEST PIT I PARENT MATERIAL: PROGLACIAL OUTWASH INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) ELEVATION - 14.69 +_ PERC AT 78 in : 2 MIN/INCH IN C SOILS DISTRIBUTION BOX: USE 3 OUTLET D-BOX. DEPTH SOIL USDA SOIL SOIL, COLOR SOL OTHER (INCHES) HORQON TEXTURE #-U ELL) MOTTLING SOIL ABSORBTION SYSTEM: A 24 ft x 12.5 ft x 2 ft LEACHING GALLERY CAN LEACH 14.69 Abot - ( 24 x 12.5 ) - 300 sf 0-5 O LOAMY SAND 10 YR 2/2 NONE FRIABLE A s d w - ( 24 + 24 + 12.5 + 12.5 ') x 2 - 146 s f 5—IO E LOAMY SAND 10 YR 3/1 NOW FRIABLE A t o i - 446 s f 10-17 A LOAMY SAND IO YR 414 NONE FRIABLE V t 0.74 x 446 - 330.04 G P D 17-40 B LOAMY SAND 10 YR 4/6 NONE LOOSE USE A 24 ft x 12.5 ft x 2 ft GALLERY. Vt - 330.04 GPD > 330 GPD REQUIRED 11.36 _ 40-126 C MEDIUM SAND 10 YR 6/3 NONE LOOSE ~ � LEACHING GALLERY 500 GALLON DRYWELL 4•19 DIMENSIONS AND DETAIL s, CONSTRUCTION DETAIL USE h%v CW DRYWELL UNIT INSTALL ONE INSPECTION GROUNDWATER STONE RISER TO WITHIN SIX 2 f t E F F. DEPTH INCHES OF FINAL GRADE .AND INDICATE LOCATION A D�J U S T M E N T 24.0 f t 0 ON AS-BUILT PLAN OBSERVED GW: 5.69 INDEX WELL: MIW-29 ZONE: A N READING: MARCH. 2005 — 0 00 34 LEVEL: 7.1 ADJUSTMENT: 0.9 f t 3.5' 8.5' 8.5. 3.5- n �����opp0p 04� ADJUSTED GW: 6.59 24.0 tv NOT TO 5� SCALE 24 0 T E S PUMP CHAMBER DETAIL CHECK VALVE TO D-BOX 1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN 2) ALL _LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 24 �� 24 in RESERVE 3) ALLCOMPONENTS INSTALLED SHALL MEET THE MINIMUM REOUIREMENTS ALARM ON .OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15) 6 in 4) INSTALLER' TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES PUMP ON BEFORE EXCAVATING FOR SYSTEM. 6 in PUMP OFF 5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED L12in SUMP 6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE 7) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0" BEFORE PITCHING DOWN FORCE MAIN PIPE TO BE 2 in SCHEDULE 80 PVC WITH SEWAGE DISPOSAL SYSTEM PLAN 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES I CUBIC FOOT OF THRUST BLOCKING AT BENDS -TO SERVE EXISTING DWELLING AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK PUMP CHAMBER TO BE MADE WATERTIGHT AND TO CONFORM TO 310 CMR 15.221. 231. AND 254 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT CONTROL PANEL FOR PUMP OPERATION TO BE LOCATED ROBERT & KATHLEEN HALLETT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM, INSIDE DWELLING AND TO BE WIRED ON INDEPENDANT 100 POPONESSETT ROAD COTUIT. MA 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. CIRCUIT. HIGH WATER ALARM TO CONSIST OF AUDIBLE AND VISIBLE SIGNAL. 11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL USE 1/2 HP MYERS WHRE 5 PUMP OR EQUIVALENT. PUMP ECO-TECH ENVIRONMENTAL STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH MUST BE ABLE TO PASS 1 1/4 in SOLIDS. SIX 'INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING PROVIDE WEEP HOLE W FORCE MAIN TO ALLOW EFFLUENT 43 TRIANGLE CIRCLE SANDWICH MA 02563 1 2) EXISTING SEPTIC TANK TO BE PUMPED DRY AND REMOVED. TO DRAIN BACK INTO PUMP CHAMBER AFTER PUMP CYCLE ETE-1960 I APRIL 9. 2005 2/2