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HomeMy WebLinkAbout0010 QUEEN ANNE LANE - Health Queen—A' Lane (CotuitD. { y iff I,1 ..I TOWN OF BARNSTABLE LOCATION �a tet~� nhe 1�/ SEWAGE# VILLAGE ®�(.,-i f' ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. D"A t")ft y SEPTIC TANK CAPACITY i LEACHING FACILITY:(type) (size) $S"k NO.OF BEDROOMS , y OWNER g`-� K.,cnm e PERMIT DATE: 11 l g i 1�2 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) ®® Feet FURNISHED BY �•�!— �;ti v � � r r�✓&b,W7 f/ y� � No. 3 Fee Lf 0 C� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppliLation for Zkriposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(') Upgrade( j) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 92 k ri VWeA4'\ N6(\e LA Owner's Name,Address,and Tel.No. Assessor's Map/Parcel --f 2 2 �Gc C Gt n011 L✓'' Installer's Name,Address,and Tel.No. y S Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms 7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 7 �y gpd Plan Date A /7 1, Number of sheets Revision Date Title Size of Septic Tank Ilood Type of S.A.S. J 6e,11&sue C ILy'7arls Description of Soil Nature of Repairs or Alterations(Answer when applicable) Zee- k t'e 1 3 Oc' l Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage.disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health C / t 3— >7 Sigrie Date Application Approved,by � Date Application Disapproved Date for the following reasons Permit No. 3 Date Issued Zola -------------------------- -- - i No-!/'01 4-3,i Fee r Entered in computer: . .THE COMMONWEALTOF-MASSACHUSETTS Yes PUBLIC HEALTH DIVISION - TO OF BARNSTABLE, MASSACHUSETTS Application for BIBp 6pBtem Construction Permit Application for a Permit to Construct( ) Repair(`) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �72 a`eq Gnt� '`ln Owner's Name,Address,and Tel.No.V4ab j'A4 Cr/h a Assessor's Map/Parcel '22—/Z T Installer's Name,Address,and Tel.No.Sb g2C 94 f d'7 Designer's Name,Address,and Tel.No. ft+e\/0c eh-L1 );,Q ,tea J v ?���;M� f 2 Gu clogf-I/a 1240 jv✓ Types of Building: l i Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( Other Type of Building No.of Persons Showers yp g ) Cafeteria( ) 1 Other Fixtures �., Design Flow(min.required) gpd Design flow provided �.J �/ .'Y� gpd Plan Date �Q`/7 � Number of sheets Revision Date Title / Size of Septic4ank j-, Dc) � .�$'+<�� Type of S.A.S. .SVv 6,0064 CA Ar-70D',f ,q Description of Soil �f 1/ / Nature of Repairs or Alterations(Answer when applicable) N''�W 2-t�4-G n �'p��! 6-�G�f j. �h�✓✓1 2„cr's ,�✓t S�� . ,/L Gr,u U S6�'�'� �,�� Date last inspected: . 1 a ` t Agreement � •. •` The,ii dersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with, he provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt Sigfie"d� Date Application Approved by /� - . , ,Y- t Date gs 7v 1 7 Application Disapproved 0( � ` Date for the following reasons Permit No. -WI,7- Date Issued a 7"01-7 t THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate Of Compliance THIS IS TO CERTIFY that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by �� �-�►h O ��.✓ tJ� t -,/� (�(G��� at A &U 4!Cm Rn n Z.,ej has been constructed in accordance f with the provisions of Title 5 and the for Disposal Sy to Construction Permit No�!�( - �{ dated jt,�J`� i Installer D tt(6 c.Ata/10 5e"./-V 41� Designer r: ��I,e�t el"50'A"I'S #bedrooms L� Approved design flow _ ��a gpd The issuance of this permit shall of be construed as a guarantee that the syst m we _illfuncti as desi�d. Date ��� � Inspector �_ - r - f - - Qp - ----------------- -ti -- --------- ----------- ------- --------------`�-y--e------- No. f 6 a 3 1 Fee` /((ICJ THE.COMMONWEALTH OF MASSACHUSETTS. PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS MisposalOpstem OnstrULtioli 'vPrmit Permission is hereby granted to Construct( ) Re air( � Upgrade( ) Abandon( ) System located at b 10�e>e ti Airy A, and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date f I7--014 Approved by l November 7, 2017 Dear Mr. Parziale, Please note that my home at 10 Queen Anne Lane,Cotuit has been a four bedroom home prior to 2008. Please let me know if you have any further questions. hank you, e orah Kenney, caner I r - ' ovyn of $ Y nsta•ble s RegulatorV,Services Richard V; nte.. a: run 1331ettit' BA34Y6'I`ADLE; m"S& a Public Health'Division. t63g �0 Thomas-INTt;Mean Director 20,0 Atom Streef,tiyamlis NIA,62661 C)ffic c 5087A2'4644 Fac; 50 3-790-53 t12 ( l T.nstaller�:;.UcsigncrC.crtifeatton;Fiirin ' Date:" SoiMtge.i'et•niitt Assesspr.'s l'Ja lPttrcel �2"`�ZZ` Desitiner n< nee_ ^,nv tUo",-i;s n.0. Installer: •,l3'�e�.o ¢ r �.- a Aiia►ess: !`G W, " Crbs <;e(c� 12c1 Addf6ss: 3S nl+cv.t- (AV4 niSF,,AcclQ MA 6zz-,4� M.14 �ZbTom! 011 Dt 30m, yyas issrtcc a permit to install ii: OnAaller.) �- septicsystetn:ait ,,�Q. v � -^: � .� basec(.o❑a design drt>jn.by .: i j f 7 A �dcstgner� ' 1 ecrfify.tliat the septic systym t terencecl rboye°:was installed sulistandall �according to: ttit _cstan wli.ich-rnay ticI a nunri�.1pj royed'ch -such as_lateral rclzrcatiort oi'the discribiittoii >;oa ador sepck. t'r -ou (if rccuied' ted and the:~oit , t s, tia M,,found,sattsfacioiy;, 1 c ratify iliac ft Systel]t rePei-eetced 1bo�':i wzs anst:allee{ with majcit'c.h.utcs (ie•. gteatdr'than 16' I tteral,relot thou of fhz<SAS of ally arttcl relacat�ion of alny eonlponen[- ofthe septic sysTeIn)l Lit ip acco{d�ince w�tth Stair, Lac, l'iZrgulations. Plan revision or ter:1 ftcd as built U} designer to ful(cr��. Strip out";(tf regtiiyc ci}was'inspttteif and the,soils, ert found satr stac tor),. I certtly that the systc-i'. e v was e(5nstructc( tict:'with the;:terms of the.{ 4 a prop e p )a rc� � s� POE CIVIL, Instatfei's Sigttaaxtrel.Y M3.4�#pIj rs>•t t+ esigner s.Sigriatur. }: ('A:Ilia Designer PT EASE RI-A Ult"{\' `6:BAR,N S'TABL T'G23f]C I3:E�i..Tt1.:UT"VISION. CERTIFICATE OF CO'.,\I I-;I-A,.�CYE-WILL NCI [. E TSS'UEll U"v TIL BOTR TETIS TORN AND 1S-- BU,L'T CARD ARE RECEINVER BY.THE BARNST'BLlE PUBLIC HEA -TH DIY ISIONT:.: `T TEAM£YOU. Q:15c�tia,Dacign"cc Cc�tet'i6i�t�n.I onri Itz+'i t�-t:i.8oc': November 7, 2017 Dear Mr, Parziale, Please"note that my home at 10 Queen Anne Lane, Cotuit has been a four bedroom home priorto 2008 , Please let me.know if you have any further questions. hank you, , -- e orate Kenney, wner i { ' I I f I ri � Y k F tom` .�8v'�.. �' "4�.J\ C � \,� ��i\ 5�� � �:_ � :k.=' ram i a r� -- � \�sue. � � �, �� .:� i�,t� ...:t; � .� �... � � ��. x _��_, �: �a�. � � _�. �, � v S ,.�yk � a 4x�- ..:gip � �� i. •�: �.,: � `�'� ti- �`'4�.. ��'; be., s - .. �_ o .. �' _ � � � � k`s- �-�:...:' _ -T x �� �"���t r4-.+'�` .tea � b<: w � � �_ 5 �_ ��.._ _:�� . _s � � � � �' \ �� -� �" .� ". x--. _�=. e. - = ==-_ >._ =f.. -emu - ter=`- �' "- - - ' N,' =�w R r _: �. ^' s ✓-., %' sec �, __ �. e`,�2'�' _ �' � ,,. S u __ J ,1x,,x-� _ ,.. __ y _ v_. v ;" � �,; r"- P � � ' 7 �� „x. ", -L .max ... u;ri n, v''-��y�.. ,�.C. Y a x= z `r T ,u e` -1, P-z i re Town of Barnstable p# $ Department of Regulatory services • &UWSTABLE, Public Heallth Division Date -to12 r7 � _�_ t ,19• �� 200 Main Street,Hyannis MA 02601 Date Scheduled Time Fee I d. 6— Soil SuitabilityAssess went or Sewa e Dis o.f g sal Performed B 4 r' --- � � Witnessed B.y: f2©y!eL/G( `'kt•/41.�& � Y OCATION & GENERAL INFORMATION Location Address p QuIleeh Arvo e/_ Owner's Name, �. q�e �1 12#`charml (fO7LVi Y--'/ � / /1— Address fo Ov-R-CVL / nv� (4►�e Assessor's Map/Parcel: r ' Nan MA- Engineer's 6� NEW CONSTRUCTION REPAIR Telephone# _ DS'—��?— '� Land Use _- <�St�i><G•�e�i�1� t Slopes(�Ya) �—y. Surface Stones ©� Distances from: Open Water Body �W fit Possible Wet Area_!!2�/t4j ft Drinking Water Well _!.Zs'oft Drainage Way AIP ft Property Line -Z6;4f"ft Other __ ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands(n proximity to holes) I ro aj V� Parent material(geologic)!�`"__"�—� Depth tq Bedi __,AJo �•( _T _ T Depth to Groundwater: Standing Water in Hole: /V C)&r- Weeping from Pit:Rice luCre--, _^ Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing;in obs.hole: � �-.- in, Depth to soil mgtti�,.s; Depth to weeping from si 3e of obs.hole: 4 _e in, Groundwater Adjustment_ ­ft. Index Well# Reading Date:____- Index Well level_— Ad.1,raetor,.,,-- Adj.Groundwater 1 wel^ PERCOLATION TEST bale�,..� Thilc,— Observation 1-7—.0 Hole# ® p�Jf Tithe al 9" Depth of Perc Time at 6" Start Pre-soak Time @ _0 M ` }" Time;(9"-6"), _ End Pre-soak _ _ Cf Rate Min./Inch. Site Suitability Assessment: Site Passed Site Failed:__ Additional Testing Needed(Y/N) I Original: Public Health Division Observation Hole Data To Be Completed on Back------------ ***If percolation test is to be conducted within 1.00' of wetland,you must first notify the Barnstable Conservation'Division at least one (1) week prior to beginning. i Q:1SEP'11CVERCFORNI.DOC I DEEP.OBSERVATION:HOLE LOG Elole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsistency.%Gravell t_o 'f(2 4)-Z __— ---- DEEP OBSERVATION HOLE LOG Hole#7_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottli:rg (Structure,Stones,Boulders. _ ) Consistency,%Gravel)__ Lac, -lid V 1� -Zsy /4 t .. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc o GravptL,_ ,r• i DEEP OBiSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil , Other- Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Cons ,tenU %-GraveB__:___,_ Flood Insurance Rate Man., Above 500 year flood boundary No— Yes Witlun 500 year boundary No Yes Within 100 year flood boundary No Yes _ Depth of Natural)<y Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? _ Certification I certify that on _(date) I have passed the soil evaluator examination approved by the Department of En ronmental Protection and that the above analysis was pe-formed by me consistent with the required t 'ng,expertise and experience des�ritied in 10 CMR 15.01'1. / Signature. — -- Date !9 f 1 /7 QAS EPT1C\PERCFORM.DOC LOCATION SEWAGE PERMIT NO. VILLAGE INSTVLLER'S NAME i ADDRESS S UILDER OR ,OWNER 7 DATE PERMIT ISSY E DATE COMPLIANCE ISSUED �_ze/o _7C , la "ri THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTHH Appliration for Dhipaii al Works C>zomitrurtivit ranfit Application is hereby made for a Permit to Construct ( �or Repair (,�an Individual Sewage Disposal System at: 1i( .�wz _..a......`1._L...........� �' u � ................. Locatioonn+-A,ddrr+ess, �.,or Lot No. .'� .� .. drl-' .................. ............ � i hJ•b+ ............................ ...............�? --G.l /1�.�l �.fG�J� .� -��.ARF•[ �;, Owner Address ✓✓✓YYYsss Installer " Address Type of Building Size Lot_____.�S_�..Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------•-----------------------------------------------------•-----•-------------------------•------------•--••-•----•- W Design Flow.................. ...............gallons per person per day. Total daily flow____._... J_©_...............__gallons. WSeptic Tank—Liquid capacityZS!54allons Length.lQ:="__!�Width._J:_.U-_ Diameter-:-.___-.____•_-_ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................:.. Total leaching area....................sq. ft. 1 Seepage Pit No............/____. Diameter..... Depth below inlet.....&mt<.... Total leaching area..XaZ,...sq. ft. Z Other Distribution box ( ) Dosing tank lei`II'-7 7 aPercolation Test Results Performed .... Date...... ......... Test Pit No. L....7 ......minutes per inch Depth of Test Pit------/Z,,..... Depth to ground water-__-���� �. lz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....______-•-------_--. O Description of Soil .�--w yr ��......•..... �r `a i�, �� < , r'�, UW ---------------------------------------------------------------------------------------------------------------------------------------------•-•------•-•---•-•---•-•-••--•-------------•-...._.._•-•-•- 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'ITL 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 issued b the board Mof , lth. Signed.......... �'..... ................................ Date, -� Application Approved By... . . ll� ...............:. ----• 17 r Date Application Disapproved for the following reasons:................................................................................................................ ----------------------------••-----•-----..._._....---------...-------•--•--•--•-------............-----•••-••-•--•----••-•-•••--•-------•--- -------------------------•------------------••--•--••---- A`��,\�� Date PermitNo......................................................... Issued_..(,6� FEz . ................ �r ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............?7 --..--.OF............../��d ��U1'T. 1� 1 - ` ................... Apg iraflott for RspaoFal Works Tnnstrnrtion Prratit Application is hereby made for a Permit to Construct (&<or Repair �a Individual Sewage Disposal System at: b Locatio?�-Address or Lot No. i1c, ............................. ....••--.._.. .� .._ "Td Owner Address l` '_.. ................................................. .•----•------•-------------••••-•-•-•-----•--••-•-----••--•------••-•--•-•-•••-•-------••------•-- Installer Address dType of Building Size Lot___-_�.,5YOS...Sq. feet aDwelling—No. of Bedrooms.___.___.._____________________________Expansion Attic ( ) Garbage Grinder ( ) p 1 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------•----••-••-•••--•••••-••• - - W Design Flow.................._ ."................gallons per person per day. Total daily flow.............. _..................gallons. WSeptic Tank—Liquid capacityX .t'J allons Length emu_-__` Width_S._d.... Diameter................ Depth................ xDisposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area..................:.sq.-ft, Seepage Pit No__________ ______ Diameter....l_G..- Depth below inlet___.Q_-4......1Tjota lea hin area.-4° ____Sq:ft. Z Other Distribution box ( ) Dosing tank ( ) ob, /U-i/ 7 7 _ y,; . r..-� � a Percolation Test Results Performed by..... / r /5!r?s6d___. J",l '�1, ';____ Date....../:___6°-�/__________22......... 14' Test Pit No. 1....;gn__.....minutes per inch Depth of Test Pit-----/2....... Depth to ground (s, Test Pit.No. 2................minutes per inch Depth of Test Pit.................... Depth to,ground water........................ O Descrippt�ion of Soil - .•-� - ......... =Su 3 x Coo z�a.P � r /, W ----------------------------- ---'--- ................................... ..y.. U Nature of Repairs or Alterations—Answer when applicable...................................................... ___________________________________________________________________________________________________ r ........ ------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue the board o lth. ------------------••--- Date Application Approved By 4�/_ %f j !�f........ ............:._..._...... l .............................. Date Application Disapproved for the following reasons_.... ---------------_.......__.................................................................................... 3., Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH..OF MASSACHUSETTS -5" BOARD OF HEALTH ......./r........Z..!.............OF.......�. .....'e:' ............_-•---............................... v Tatifiratr of fl�antpliFana _THIS fkS TO CF,�RTI Y, ��ha� the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by j! —. ....................... ` i f }' , e )-....Installer f X k; 7 ......�_ ._ ,Q G' has been installed in accordance with the provisions of T_ r 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.______----.�_Al.7_____________ dated--- ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL. FUNCTION. �ISFACTORY. `<�� ,DATE .. .. ...._.------•-•••••-•--_•-•-- Inspector...... ? _.. ..••..................••-••- THE COMMONWEALTH OF MASSACHUSETTS ��� BOARD O HEAL lam' ........... lt'Gf/I't.......OF.......... �. 'l�LL /� G ................... _ d No......................... FEE.../j �i��a�-tt1 nrk� ��an��rnr�inn Trani# Permission I reb ranted to Con r ct or epalr Indi al Sevc�age isposal'Syst \ ' at .._'S °........ ,p �' a.... __4 �= .---- � ................................ Street r" as shown on the application for Dis osat'Works Construction P It Nd Dated d........_....................... ..... -•-•------ - ---- ---------- --------------------•- gip` Board of iYe, It DATE----- FORM 1255 HOBBS & VQR 'EtREN• INC., PUBLISHERS - - - • COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS w F DEPARTMENT OF ENVIRONMENTAL PROTECTION q� w m � � C r w• r TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A 0A. CERTIFICATION Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner's Name: JOAN DOSCH Owner's Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Date of Inspection: 7/2/01 Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS Mailing Address: tP.O. BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 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: X Passes _ Conditionally Passes _ Needs Furt er valuation by the Local Approving Authority Fails Inspector's Signature: Date: 7/2/01 The system inspector shall submitz 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 ,k SYSTEM PASSES TITLE V RECOMMEND PUMPING EVERY TWO YEARS TO MAINTAIN SYSTEM. ****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. Titlr 5 Incnartinn Form A/I 00W1 I Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X 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. z Comments: SYSTEM PASSES TITLE V RECOMMEND PUMPING EVERY TWO YEARS TO MAINTAIN SYSTEM. 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. n/a 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 tanklailure 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: n/a n/a 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): 4 broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a rt a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _obstruction'is removed ND explain: n/a �4 Page 3 of 1 I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 . >> C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require furtherevaluation 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 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:tan,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 n/a "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: n/a Page 4 of 11 OFFICIAL INSPECTION,FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for alLinspections: Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped 1998 BY ARC'O. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or p(ivy is,within 100 feet of a surface water supply or tributary to a surface water supply. _ X Any portion of a cesspool,or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well _ X 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.l (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 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. 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 X the system is within 400 feet of a surface drinking water supply _ X the system is within 200 feet of a'tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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 Sectiop p above tite large sy§tem`ha fainO: Thy 0wnl r 0r 0pralor 0f any ldrg@§ysl@Ill E011gltl@l'@(1 d slglllruIll lllful under gection 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. S Page 5 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 Check if the following have been done:.You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection'? .X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS,located on site? X _ 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? X _ 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 _ X Existing information. For example, a plan at the Board of Health. X _ 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)] t. E . i 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: 2 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no):NO Seasonal use:(yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title'5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a r GENERAL INFORMATION Pumping Records Source of information: 1998 BY ABCO Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 22 YEARS Were sewage odors detected when arriving at the site(yes or no): NO f . Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 BUILDING SEWER(locate on site plan) Depth below grade: 18" Materials of construction:_cast iron _40 PVC Xother(explain): 20 PVC Distance from private water supply'well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 12" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explai.r)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6"H 5' 7" W 4' 10"," Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 1" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 0" How were dimensions determined: MEASURED 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 SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND APPEAR TO BE FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO PEARS TO PROLONG THE SYSTEM'S USEFUL LIFE GREASE TRAP: _(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal fiberglass_polyethylene_other(explain):.n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,s; uctural integrity, liquid levels as related E to outlet invert,evidence of leakage,etc.): n/a f i . 1 • i t Pdge 8 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10 QUEEN ANN LANE'COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal—fiberglass_polyethylene_other(explain): n/a Dimensions: n/a _ Capacity: n/a gallons , Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must,be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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.): DISTRIBUTION BOX IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY. E PUMP CHAMBER: _(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): n/a .y t�+ Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why- n/a Type 1000 GAL 6' X 6' Teaching pits, number: n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a ;innovative/alternative system ,Type/name of technology: n/a Comments(note condition of soil,signs ofYhydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT SHOW NO SIGNS OF HYDRAULIC FAILURE. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a . Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no):NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a 1 Page 10 of I l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 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. prc k 1 .0 �h Y Fool 13 C C)® h6 3a AC 3 L�� AO �� � a9� �aa`nn s` 'r in Page I 1 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 10 QUEEN ANN LANE COTUIT,MA 02635 Owner: JOAN DOSCH Date of Inspection: 7/2/01 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12 feet r Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record- If checked,date of design plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators; installers-(attach documentation) YES Accessed USGS database-explain: n/a x You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS- 12 FEET f ,s t. i 7 l i RECEIVED AUG 0 3 2001 TOWN OF BARNS i Ad LE HEALTH DEPT. N EXISTING SEPTIC TANK. BENCHMARK �D TOP OF TANK, EL.=41.45 OUTSIDE CORNER OF °i LOCUS a INV.(OUT)=40.10f(VERIFY) CONCRETE SLAB EL.=41.57 0 8 EXISTING S.A.S. _ TO BE PUMPED, FILLED -WITH- c SAND AND ABANDONED N 61.12 47 E / 4, _ 17 6.59 \ r, _ a l Pond ` W x 47,67 44.47 x 45.43 �( r- 46 \ 44 LOCUS MAP \J NOT TO SCALE 42- _ -- -4 -- 44 -- EXISTING CONTOUR N rx i-� � .. . -� x 100.98 EXISTING SPOT GRADE 41,67 44 PROPOSED CONTOUR 37.24 /, /i / \_ \:: ;; .,\ U UNDERGROUND WIRES p• x 42,20 W EXISTING WATER SERVICE "� 43.64 { pN 6A�T �, G EXISTING GAS SERVICE x 41,38 4 '2ACm�cS�&TP-2 TEST PIT 40,97 �.' BENCHMARK °a 43,61 43.74 v K x ECK 4L05 LEGEND L 0 �e �u WA 4 B�\ Shy. \ ` i1?a o ry GENERAL NOTES: 38,34 v / '' . M � �� W ,� 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL x 43.47 0 ��8� 24, ;y r7 BOARD OF HEALTH AND THE DESIGN ENGINEER. 1 12 �o • EX/ST/NG 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS / / T X I LEVEL OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE / 0 LOCAL RULES AND REGULATIONS. / MOUSE(#10) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR / T.O.F.=44.3f(MID LEVEL) TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE I 43.81 1 J DESIGN ENGINEER. 1,1 / 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING p,GE / FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN x 42.87 92 GAR/ 1 1•1�` ENGINEER BEFORE.CONSTRUCTION CONTINUES. 39.05 �I, l LO.T /B EL.f 41.64 G 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. cr �° 21,505 f SF / 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 41,47< -:<: THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF �\ PARCEL ID. 22- 11 ZZ i HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. \ x 42,28 C) x 43. 2 :.• .'p` .;: 8. THERE ARE NO WELLS WITHIN 100' OF THE PROPOSED S.A.S. D 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS ya / :.:. 39,65 TTI.•' •;':1.. AGREED UPON BY .OWNER AND CONTRACTOR OR AS OTHERWISE \S 3$ J 39,90 DIRECTED BY THE APPROVING AUTHORITIES. 39.34 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY " THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING F � x CONSTRUCTION. i 41.32 OF MAS 4 .02 .11 / 1 - 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). y 37,2� o PETER T. �, - 012. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE McENTEE INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. v CIVIL "' - /NZ 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND No. 35109 �=UO . 20 00, IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. W�� �50" BOX13 46 RFG/STE�`� �Q R,1 1 , � . .�. sslo�n�� � 38.71 PROPOSED SEPTIC SYSTEM UPGRADE PALN 34,36 q QUEEN ANNE LANE COTUIT MA SIDEWALK I O 37.87 edge of paVerr'eot 35.41 Prepared for: DiBuono Sewer & Drain, 35 Content Lane, Cotuit, MA 02635 OWNER OF RECORD f`1 36.98 SCALE DRAWN JOB. NO. KENNEY, DEBORAH J & Engineering by: RICHARD M Engineering Works, Inc. 1"-20' P.T.M. 267-17 10 QUEEN ANNE LANE LANE COTUIT, MA 02635 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. t (508) 477-5313 10/17�17 P.T.M. 1 Of 2 NOTE: TO PREVENT BREAKOUT, FINAL GRADE SEPTIC TANK SHALL NOT BE AT, OR BELOW, EL.=39.0 INSTALL RISERS & COVERS OVER INLET & FOR A DISTANCE OF 15' FROM THE EDGE r , OUTLET AND SET TO 6" OF FINISH GRADE PROPOSED D-BOX OF THE PROPOSED S.A.S. INSTALL RISER & COVER PROPOSED S.A.S. DESK I �I SET TO 6" OF GRADE INSTALL RISER & COVER OVER ONE CHAMBER AND (above) T.O.F=44.3t SET TO 3" OF F.G. TO SERVE AS INSPECTION PORT I--10 I Lq F.G. EL.=43.5f F.G. EL.=42.0t F.G. EL.=98.0f F.G. EL.=90.0 to 1'00.0t i co I mm I M ff MAINTAIN 2% SLOPE OVER S.A.S. EXISTING TRI—LEVEL �. �• D L = 22' L = 23. /HOUSE&10) s=l% (MIN.) 0 S=1% (MIN.) 2" LAYER OF 1/8" TO 1/2" T.O.F.=44.3f(MlD LEVEL) v --- 4"SCH40 PVC 4"SCH40 PVC V g' DOUBLE WASHED STONE H- 10"1 B aaaSaaa (OR APPROVED FILTER FABRIC) 14" 0630013 aaa a as - EXISTING 48" LIQUID aaaaaaa ---3/4" TO 1-1/2" DOUBLE pjro OPO . . PRSES 4' 4.8' - 4' WASHED STONE GARAGE + LEVEL ADD INV=3917 _ INV.=39.00 = GAS BAFFLE INV.=40.10f 12.8' SLAB EL./41.7f D BOX EFFECTIVE WIDTH . (VERIFY) 3 OUTLETS INV.=38.50 H-10 LOADING EXISITNG SEPTIC TANK 3-500 GALLON LEACHING_ CHAMBERS SURROUNDED WITH STONE AS SHOWN NOTES: SEPTIC LAYOUT 1 CONTRACTOR SHALL VERIFY ALL EXISTING PIPES & TOP CONC. ELEV.= 39.3f BREAKOUT ELEV.= 39.00 INVERTS EXITING HOUSE, PRIOR TO INSTALLATION. INV. ELEV.= 38.50 as®®® aaaaBaaaaaa 2) D-BOX SHALL BE SET LEVEL AND TRUE TO aaaaaaeaaaa GRADE ON A MECHANICALLY COMPACTED SIX BOTTOM ELEV.= 36.50 INCH CRUSHED STONE BASE, AS SPECIFIED 4' 3 x 8.5' _ '25.5' 4' ®®®® 0 IN 310 CMR 15.221(2). 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 33.5' ®®® 3) INSTALL INLET & OUTLET TEES AS REQUIRED. PERVIOUS MATERIAL 33" 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 5' (MIN.) ABOVE G.W. N > ®® �®®® ® ®® 3 LEACHING SYSTEM SECTION ®LTa AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. BOTTOM OF TEST PIT, EL.=30.4 = Z 102„ SEPTIC SYSTEM PROFILE . 4" KNOCKOUT SOIL LOG 20" DIA. COVER DESIGN CRITERIA DATE: OCTOBER 13, 2017 (REF#15,494) SOIL EVALUATOR: PETER McENTEE PE(SE#1542) 4" KNOCKOUT / 4" KNOCKOUT 62 NUMBER OF BEDROOMS: 4 WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT SOIL TEXTURAL CLASS: CLASS I 0 ELEV. TP— 1 DEPTH ELEV. TP-2 DEPTH 4" KNOCKOUT DESIGN PERCOLATION RATE: <2 MIN/IN 0 0 1 (0.74 GPD/SF LOADING RATE) 42.0 ALOAMY SAND 41 9 I LOAMY SAND DAILY FLOW: 440 GPD 10YR 4/2 10YR 4/2 41.5 g„ 41.2, 8,. . DESIGN FLOW: 440 GPD B B GARBAGE GRINDER: NO MED. SAND MED. SAND 500 GALLON CAPACITY, H-10 LOADING LEACHING AREA REQUIRED: (440 GPD) = 594.6 SF 10YR 5/6 39 7 10YR 5/6• 26 A A, pc EXISTING SEPTIC TANK: 10004 40.0 24GAL ON CAPACITY 0 PERC 0 CHAMBERS PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS 20"/38" N.T.S. USE 3-500 GALLON LEACHING CHAMBERS IN SERIES PROPOSED SEPTIC SYSTEM UPGRADE PLAN SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES MED. SAND MED. SAND 10 QUEEN AN N E LANE, COTU IT, MA SIDEWALL AREA: 2(12.8' + 33.5') X 2 = 185.2 S.F. 2.5Y 6/6 2.5Y 6/6 BOTTOM AREA: . 12.8' x 33.5' = 428.8 S.F. Prepared for: D1Buono Sewer & Drain 35 Content Lane Cotuit, MA 02635 TOTAL AREA:............................................................. 614.0 S.F. 30:5 138„ 30.4, 138„ Engineering by : SCALE DRAWN JOB. N0. Engineering Works, Inc. N.T.S. P.T.M. 267-17 DESIGN FLOW PROVIDED: 0.74 GPD SF 614.0 SF = 454.4 GPD PERC RATE <2 MIN/IN. "C" HORIZON g g / ( ) es Cross field West Cfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. NO GROUNDWATER 'ENCOUNTERED (508) 477-5313 10/17/17 P.T.M. 2 Of 2 X'Osask 6X � ! _FiAv+SN GVADO• 44X5 Fl/v4SN CRrIt�E P'IAdl1 O vElt Tip N K or To P o f�s v-V v� ., G�e✓•s cilill � �/W�.�'��a/'.�►�,�/l��//x.J/:�•Yf -Jj� '►�tX��/J��./,Y.*1/6�X.�'�ylf��it,� -Pa,Aar..Yi `42X2S �1 r-- 4 CdfLI-A Ft ftE✓ + 3&� i /%3'OG 6At f o o � a �i � �'•� t'a r�t D 1ST C3 C XI O O O I A G�a:lNfrs Syb.vAr o p i 1 / -�Ef'TI C TAN K s- - --_� "____-•ra ME L.G"Vi�- � [ o 0 0 0 A r v srAsso j � • � 1 v if �fo7'1Z►N oI sir /VaT TO .T C.4L!F ----— ---- i L EAC HI Ak5' fW/T DES� G�✓ C.P� T'E�/�9 �;�T GAL. �&;C nR y : 330 r� _ - G-AROVgG-E 6-&1wz2AFoe 7'10"4 o.414 y FLoW- 33o L ERE N/NG 14'vei9 .PE4' p •.�2dJ m <.. R 4- L EAGNUd� r4?6A 'Aw'dwDED41+6 : '�i �;' ` l otr •, �: SEEN. v �Q• El.L �� � � � � � C!W gr fiV r,-AC. Agi•J//� 4cr44LA A APe49,4L �, / —�q,c6 C�' y ,A t.$o r. 8 +1 4+- 4° .10 Ta A, 5 FINE• 4pp OP F•iwE 144 J i�,V•"�''j f'e,OR,OS41 0 SjCW4C'E 01S,0. SA4 �avC - t�4Q,v_ r3 fl. F 112;42-7W �'iPOf?DSL�L� I�!•1�EL L/NG D.4 r,fr /e-i/-?7 .P/L S7A13L A VEICc. ,P.v rE: G 2 i`l�N�i✓ s,►C ALF% �.i,�c� ' aA T't'= ucT/j, /,9?0 -----_� �M,o r N+ •.r QWJ1�.L�`P • .tea/.j E",E_'� Zb�a�:+y + 'y M011MAN oWr-cl- 44-YO; E•Y!J'T E�eEd. cTr4�aC�7!C� .�G/�/i1/ .'6.?i4S:S`• • NORMA 1 3,4eaa4:M MOis1MAN ) AIO PMAN t,(o PE aye 4. Q SU