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Home My WebLink About0209 RALYN ROAD - Health _209 RALYN ROE cl A=022.055 I 11 i i TOWN OF BARNSTABLE LOCATION O d SEWAGE# VILLAGE CAA ASSESSOR'S MAP&PARCEL INSTALLER'S NAff.ME&22PHONE NO. U( S SEPTIC TANKIIAPA3C�TY �- LEACHING FACILITY.(type) I- i e u 1 I.21IST' NO.OF BEDROOMS OWNER JbM PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Os 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 le "n cility) A I Feet FURNISHED BY II J Marv-jle i A2_3q A2'.39 3- 41 b-3- qD-7 4.' WNTAB f r3 ^i 1,OCA�'t'ION sEssOR'S D�1ST1�L1.Elli' NAB gc F1ElOIdE I�IQ 1117 SIc NO,CDF tOAMS ...._ ..-.-.. p ..-O.WOWNEFL. FI F�NI 'T COW tbC sdoh uda 1 ��stv�eei e Maxjt , Acljustet!Grpuatlw tec Tab ledathc:o6abtlotX.cachinglodly y 77 P►IvaB4VIaiOr SuPply,lfcll tt+ C eu >biag Facaltty (zany�vrlls t:xlst' &pt9 ari ttstG nr riltlun 2qn feoC af"lataof 08 fAq '11 Rc1Le crff V►l�t4and said;Leac{E>ip(tacxlltyar�tlands east ;i+ 4fattd'I QQ tc.et If ICAa tig, m�tY} )Furbished by �a f .i ( t O 7 -0. 6cl, 8-D- 410 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4pliLation for 3Bispo8al 6pstrm Cone-tCUttion permit Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) mple ote System ❑Individual Components s Location Address or Lot No. �LL Yn - Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel 622 Ei 1 i4mwl, o 32 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. NCO V3—EU5 Type of Building: Dwelling No.of Bedrooms p2 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures p Design Flow(min.required) 330 gpd Design flow provided ;3 O t—7 gpd Plan Date JJ116111 Number of sheets 2 Revision Date Title G C IV Size of Septic Tank Type of S.A.S. '' �� " Description of Soil ��i�T,d Q �(,� ,zd CoAc 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 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Halt Si Date O Ilk Application Approved by Date 1 Application Disapproved by Date for the following reasons Permit No. 2 Q ((Y—00 2 Date Issued —Z-- No. 00 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppliCation for Disposal &pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade'(/Abandon( ) omplete System ❑Individual Components Location Address or Lot No. Z dGt Fyn art 'Owner's Name,Address,and Tel.No. Assessor's Map/Parcel b2 2 - S; ZI 14M Jb�l'l pM 3a Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. -Po riya- 1 fr � rh Ynj Inc. -9 Kum' UV4.1 U C. Type of Building: .Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3.3 d gpd Design flow provided 3 u S, gpd Plan Date Number of sheets 2 Revision Date Title y' — C Size of Septic Tank Type of S.A.S. — .SaO Description of Soil CS l ll!h(1 lhT i.Q,Md• fCt h •' 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 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 Si A - Date 1 '� Application Approved by / f *� Date 1 Application Disapproved by Date for the following reasons Permit No. ? o 1,?—00 2 Date Issued r (T( r ----------------------------------------------------------------------------------------------------------------------------------------------- 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 j III Nig S F)�(nyd-hoh , <(kill )r�L at 2,C,(� � T� `has been constructed in accordance / J with the provisions of Title 5 and the for Disposal System Construction Permit No. o -( u dated Installer �, I pn ks E.Vul ll l v(<y ( Designer _ S #bedrooms Approved design flow gpd The issuance of this pe = it sha not be construed as a guarantee that the sysCwilltion as d ignedDate i Inspec K,,- )�� No. :0(])- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal *pstem ConstrUrtion permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( V� Abandon( ) System located at / �� h 61d .;t 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 I ,Y I i Approved by A-j r Town of Bair nstable ��°Pisa rogti Regulatory Services Richard ti:Scafi,Interim director t>'BARNSfABLE, F� .b 9 �0� Public Health DivisionArFO►oi° 'Thomas McKean,Direcior 200 Main.Street,Hyannis,MA0260I' Office: 508-862-4644 Fax: 508-790-6304 fnstallec 3rc'I,ett r Certification Form. Date: l la l I'7 SewagePeririit# OPLAssessor's_Map�Pareel Designer,, 'Criy',ne �;�,v Woi-bCs, CMG, ttstallci's; tµi nws OAc-gyut14rj9 Address:: I W, -cr ss=p,e.(d `tom Address. --;Sq E-10 �.v-G! Rau, gh5 99'Cgt 11V'g), was issued a perinit to install a Wait) (in"sta-ller) n septic system at Za 7�Q�Y!1 tst CO;%�' based on a design drawn by (address) Eti5 i ne ems,.i WurtLi 14 C, dated: (designer) X/- 1 certify that the septic system referenced above was instalIed;sit bsiant ally according to the,design, which may includeaninor'approved changes such asaateral ielocat on of he: distribution box and/or'septic tank. Strip Out (if required) was inspected-and the soils were found satisfactory, certify that the septic system referenced above wa's 'installed with major changes (i;e, greater than 16' lateral relocation of the SAS or any vertical retocation of any component of the septic system)but_in accordance.with State&..Local Regulations--. .Plan revision or certified,as-built by designer to'follow. Strip out(if required)was inspected and`theeso'i s were,found safiisfactoty. I certify that the system,referenced above.ryas.con'stiuct6 i'n e with the tMiis`. f'the_I\A a provai lettets(if applicable) LINO PETER.Y. '� M11cEN,TEE � CIVIL (Instaltet''s ign6ture) W 36109 gFQt91l w (Designer's Signature); (Affix Desi& tamp l-iere), PLEASE RETURN.TO BA INSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT RE ISSUED UNTIL HOTEL THIS FOR1kI; AND AS- BUILT CAWARE RECEIVED BY THE BA108TABLE PUBLIC REAL,TH DIVISION.. T.I3ANIc YOU. _ ,. Q';&p66DesignerCertification onn'-Rev8-1.4-Fldoe 7 � } , f��ta�a 571 /. dot1, ... a 3 6 cL [Ef r TI oor, f r� f � f H i Fr } L`= / 5 p^ kq .._..�. ..,-.sue--.�. .— .�-�--��--.:..�.�.�_-.-..-.—.V..._ ___._._.. .._................. .... .__._. .... .. _. .. _. } Building Sketch Borrower/Ma Cutrona &Freitas Livia A- NP;Y1ft9w 209RAmRd .` CdY Cohm CUM Barnstable SMO MA LP Code 02635 Cbd Cape Cod 5 Cents Savings Bank g. 15' ! 1 ! t" p - FirstFloorPorch Deck i� ! 60` 15' ® 9' IGtchen Batty Bedroom 12' � N N 'ILI Family N Detached Bedroom Living 1 Car Garage 20' tV 4W Basement 60° 12' Bath Spare Room v ry rn Recreation Room 1 Car Garage Spare Room �' tV 4V TOiAL9 b/abmile"4. Ar Caradaboos Summary Uvbv Area .. Ca101da fm Detaft First floor L520 Sq ft 24 x 20= 480 26.40=1040 ToM Living Area(RomrdeQ-. mo 5q R . Non-frvin9Area - .. ' 1(Ar Detached 276 Sq ft 23 x 12= 276 Closed Porch 240 Sq ft 16 x 15= 240 Basar�er[ Lim Sq it 24 x 20= 480 26-40=1040 Wood Deck _ 144 Sq it 9 x 16 = 144 Form SKULDSIG-`TOTAL°aWraisal soBwam by a la mode,inc.-1$00-ALAMODE Town of Barnstable P#_ gyp' ' Department of Regulatory Services ` svvsxeate Public Health Division Date2`T � suss A 1659• �e� 200 Main Street,Hyannis MA 02601 rf0 MA't� Date Scheduled Time ( I Fee Pd 11!C CT® , d ti Foil Sulitabiiity Assessment for S age Disposa Performed :BY Fe .r ( Lc S - i '� Witnessed By; l _ h L+ CATION & GENERAL INFORMATION Location Address Owner's Name D S V" CQ E-v + vt Address 2\ Wvo ak �4S �.� r r,ticzw� M R �l 3 Assessor's Map/Parcel: t1 Z2—�-55 Engineer's Name ^ G NEWCONSTRUCTION REPAIR _ Telephone# § 0� y7'7 713 Land Use ,-es, +TCr go Slopes _Z P ( ) Surface Stones Distances from: Open Water Baly7 100 ft . Possible Wet Area 7/0C�l tt Drinking Water Well?"U-0 ft Drainage Way_.2 L�_�A4� ft Property Line 16 l� ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands(n proximity to holes) 1 Parent material(geologic) OJ r-a, •` Depth to Bedrock f V CJjla T Depth to Groundwater. Standing Water in Hole: tr V CEN Weeping from Pit Face Estimated Seasonal High Groundwater I a '`Iy 1 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in, Depth to soil mottles: a in, Depth to weeping from side:of obs.hole: —in, Groundwater Adjustment,•_- ft. Lndex Well# Reading Date: Index V,'cll]evt! F� Adl, &ct,)r, Adj.'Groundwater-1-Val r� PERCOLATION TEST bate Tttne Observation Hole# ;� _ Time at 9" Depth of Perc _ Time at 6" - Start Pre-soak Time @ Time(9"•6") End Pre-soak Rate Min.finch. �L s - / Site Suitability Assessment: Site Passed Site Failed:— Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to]'be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) week prior to beginning. QAS EPT1C\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG :!Bole# Depth from Soil Horizon Soil Texture .Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Con istenc,,y.%Gravel) u 3 F- 4T C . ►wed S� 7 -5-y (1(4 DEEP OBSERVATION HOLE LOG Hole# `Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% ravel) DEEP OBSERVATION HOL E E LOG H(,,)le# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con iste c o Gravel) DEEP OBSERVATION HOLE LOG hole# Depth from Soil Hori zon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Motiling (Structure,Stones,Boulders, Consistency,R6 Oravel)____ Flood Insurance Rate Man: Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally 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 l� lac I certify that on , (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required tr ' •ng,expertise and experience described in 310 CMR 15.00. Signature_ Date—. t 7 Q%SBPTICIPBRCFORKDOC SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY 11111 Complete items 1,2,and 3. 54 Sig ure A Print your name and address on the reverse . ey-� Agent so that we can return the card.to you. D Addressee N Attach this card to the back of the mailplece, Received by(Prince N "e) C. Date of Delivery or on the front if space permits. L. ,J d A A4 s 1. Article Addressed to: D Is delivery address different from item 1? 0 Yes If YES,enter delivery address below: p No Alsk6XrnhamiMA bt4�a 3.II I lIIIlI lilt ICI I II II II I I I IIIII i IIII�Iil 111 III 0 Adult Sig Type' 0 Priority Mall i9 llr1w ® ❑Aduft Signature ❑Registered MaIITM� ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9402 1933 6123 1799 62 certin d Ma 1Restricted Delivery a um Receipt for ❑Collect on Delivery �erchandise aerie-Alumhor.trransfer_froinservicQ label ❑Collect on Delivery Restricted Delivery;q Signature ConfirtnatlonT"! 2. °' _a�•�q . .' O Signature Confirmation 7 015 1.730 0001 4990 3 8 9 9 1 Restricted Delivery Restricted Delivery_ i PS Form 3811,July 20115 PSN 7530 02-000-9053 { Domestic Return Receipt USPS . First-ClassWail Postage&Fees Paid c ko *rm 959.0 9402 1933 63 1799 62 SEP 3 U 2017 y, United States •Sender:Please print ur name,address,a ZIP+4®in this box; Postal Service -- .- d Town of Barnstable Health Division f 200 Main Street Hyannis,MA 02601 I t}M'1�'tl��.i }F !? � 17'l��il #:l� .i!} �l ijllll..11: i }ill!}! , Town of Barnstable Barnstable Regulatory Services Department Ahtnakal0j � iARNSTABL�. + . MAS& 039. ,m Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7015 1730 0001 4990 3899 September 26, 2017 JOHNSON, GLORIA D 21 WOOD PATH ASHBURNHAM, MA 01430 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 209 Ralyn Road, Cotuit, MA was inspected on 09/10/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching pit or cesspool with high liquid level,<12" below inlet (per Town Code 360-9.1). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH mas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\209 Ralyn Road Cotuit.doc - �T�ram, • Town of Barnstable XAS& Regulatory Services Department t63q. 1b�' �Ep M1d ' Public Health Division 200 Main Street,Hyannis MA-02601 Office: 508-862-4644 Richard ScA Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5111116 DEADLINES TO'REPAIR FAILED.SYSTEMS .(Town Code §360-44 and Title V: 310 CMR 15.000) _ An`x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground . ❑Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑Any portion of a cesspool within 50 feet of,a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). . TWO 2 LINE . q m e cesspool. c ❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components, etc) beaching pit or cesspool with high liquid level, <12"below inlet (per Town Code §360-9.1) ❑Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q\SEPTIG\DEADLINES TO REPAIR FAILED SYSTEMS.doc 022 - 0 • Commonwealth of Massachusetts s a=, f Title 5 Official Inspection Form - I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .. M s"J 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name 4„t information is wr required for every Cotuit y 4 ' MA 02635 9-10-17 ` page. City/Town State Zip Code Date of InspectionCTI i Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information S�.� 1 a67,9 9.. 1. Inspector: . t• Shawn Mcelroy ` t Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification . :•► I certify that l 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 16.340 of Title 5 (310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes , ® Fails:. • ❑ .Needs Further Local Approving Authority.- _ x spector'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 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. ****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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17' Commonwealth of Massachusetts 1a=1 Title 5 Official Inspection Form f: i�4, i41 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments L J{ 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is required for every Cotuit MA 02635 9-10-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/a/ways 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. r 'Check the box for"yes", "no"or"not determined" (Y,,N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): . t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 1 f M i •, f < Commonwealth of Massachusetts Title 5 Official Inspection Fora 4. a hI Subsurface Sewage Disposal System Form_-Not for Voluntary Assessments c �• ' 209 Ralyn Rd ' Property Address Janice Johnson Owner Owner's Name information is COtUIt r required for every MA 02635 9-10-17 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 pipes) are'replaced ❑ Y ❑'N ❑ ND (Explain below): ❑ ' obstruction is removed 1 ❑ Y ❑ N x❑ 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: L 6 , . t . , 1. System will pass unless Board of Healtfi'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•3/13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts lal Title 5 Official lnspec.tion Form f R+ 111 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �r 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is Cotuit " MA 02635 9-10-17 required for every page. City/Town 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: I ❑ 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. ElThe 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 ' ® ❑ 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 Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts +a= I Title 5 Official Inspection Form Gv : Subsurface Sewage Disposal System Form Not for Voluntary Assessments ' 209 Ral n Rd Y ' Property Address , Janice Johnson , Owner Owner's Name information is required for every Cotuit t' , MA 02635 9-10-17 , ' page. City/Town _ State Zip Code Date of Inspection B. Certification (cont.) Yes No ;• �.� - E ry El ® 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 El ® tributary to a surface water supply. r ❑ - lzr 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 � . ._ .c �,• s< 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 6 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- The system fails. Nave dkei rmified'that one or more of the above failure is ® : }. ❑ ' . criteria exist as described in 316 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., +r •. - ,. +sue . . , +,., , - ,; . E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000,gpd to I6,000 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 t the system is located in a nitrogen sensitive area (Interim Wellhead Protection ❑' ' ❑`' 4` Area' IWPA) or a mapped Zone II of a public water supply well f If you have answered "yes"to an question in Section E the system is considered'a significant threat Y Y any Y g , 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts ,a=1 Title 5 Official Inspection Form I 4+ ' hI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments o% 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name r information is Cotuit MA 02635 9-10-17 required for every ' page. City/Town State Zip Code Date of Inspection C. Checklist fi 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? S ❑ ® 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? r' ® ❑ 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. ® El 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 Flow Conditions: Number of bedrooms (design):. ? Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpdx#of bedrooms): 220 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form .N i t Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments , A. �_. 209 Ralyn Rd P_4 p L J' Property Address Janice Johnson t Owner Owner's Name information is required for every Cotuit r MA 02635 9-10-17 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? j ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? El Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? f �d,°:r ,. , ❑ Yes ® No Last date of occupancy: 9-2017 Date Commercial/Industrial Flow Conditions: Type of Establishment: , Design flow(based'on-310 CMR 15.203): "" ' Gallons per day(gpd) r, Basis of design•flow (seats/persons/sq.ft., etc.): . . Grease trap present?-c 7 ,• t . ❑ Yes ❑ No Industrial waste holding tank present?,- r -. _ ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? . ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17. Commonwealth of Massachusetts Title 5 Official Inspection Form �.1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _�.4�!✓ 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is required for every Cotuit MA 02635 9-10-17 ;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: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: 'gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool r - ® 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts ' \ laa Title 5 Official Inspection Form -I Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments '� �.4�!✓ 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is MA 02635 9-10-17 required for every COtuit 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: 1971 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan):- C V , Depth below grade: _ , . ,,\r 18"feet " Material of construction: \ ®'cast iron ®-40'PVC } "®_ other(explain): Orangeburg Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: N/A feet " Material of construction: t 7 - ❑ concrete ❑ metal ❑ fiberglass ❑,polyethylene ❑ other(explain) If tank is metal, list age: years- Is age confirmed b a Certificate of Com liance? attach a o 9 Y c of certificate ❑ Yes ❑ No P ( PY ) Dimensions: Sludge depth: ,- t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of,.17 it 1 Commonwealth of Massachusetts Title 5 Official Inspection Form f Subsurface Sewage Disposal System Form -Not for Voluntary-Assessments F 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is Cotuit MA 02635 9-10-17 required for every page. City/Town 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 Scum thickness t Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on-pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form W Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 209 Ral n Rd Property Address l Janice Johnson Owner Owner's Name information is - required for every Cotuit MA 02635 9-10-17 ' 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.): y Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow:- t 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora ' + I l Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments l F� 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is required for every Cotuit MA 02635 9-10-17 . 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 N/A 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(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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora +i1/1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Y' 1�7r 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is required for every Cotuit f .. MA' 02635 9-10-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: . 1-6x6 ❑ 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.): Overflow cesspool show signs of being filled beyond capacity with stain lines above inlet invert and solids laying on top of inlet pipe. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 2-Inline Depth—top of liquid to inlet invert N/A empty Depth of solids layer 12" Depth of scum layer 1" Dimensions of cesspool 6x6 Materials of construction Block Indication of groundwater inflow ❑ Yes ® No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17' Commonwealth of Massachusetts �a=1 Title 5 Official Inspection Form Rt "fE`i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _ 209 Ralyn Rd Property Address Janice Johnson �. Owner Owner's Name information is required for every Cotuit MA 02635 9-10-17 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.): Both cesspools show signs of being filled beyond capacity with stain lines above inlet inverts. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 f Commonwealth of Massachusetts r >> :a=1 Title 5 official Inspection Form F. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 209 Ralyn Rd "• ,. Property Address -.- Janice Johnson Owner Owner's Name information is Cotuit [ MA 02635 9-10-17 required for every page. City/Town t 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 • � t A L ID r 60 r- - AD ��,„yy ./l �.■■w.■�r�r�wsn r■ ■-srnw■w (��// J1w.�■iwis t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form :4 Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments, 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is Cotuit MA 02635 9-10-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) a Site Exam: ❑ Check Slope , , . ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed- Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database: explain: You must describe how you established the high groundwater elevation: USGS and town maps show groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts �aI Title 5 Official Inspection Form N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 209 Ralyn Rd Property Address Janice Johnson Owner Owner's Name information is required for every Cotuit MA 02635 9-10-17 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 OF E Cotuit Fire Department T U Fire, Rescue & Emergency Services �� j�' COM J 64 High St.. - P.O. Box 1632 U i9=Y Cotuit, MA 02635 �'•RES� Paul A. Frazier Phone (508) 428-2210 Chief of Department FAX (508) 428-0202 TO: Tom McKean, Director of Public Health Town of Barnstable, Board of Health P.O. Box 534 Hyannis, MA. 02601 FROM: Chief Frazier, Cotuit Fire Department SUBJECT: Tank Removals, et al DATE: December 23, 1998 The following tanks have been removed/abandoned since my letter dated September 15, 1998. If you should have any questions or need additional information, please feel free to call. Thank you. 7t_ O 22. OS`s NAME ADDRESS DATE NOTES Johnson 20 R yn Rd. 10/30/98 1000 gal. tank removed, Cotuit, MA. 02635 no contamination or odor present. Moore 33 Putnam Ave. 11/08/98 500 gal. tank removed, Cotuit, MA. 02635 no contamination or odor present. Brown 123 School St. 11/12/98 500 gal. tank removed, Cotuit, MA 02635 no contamination or odor present. Pappalardo 176 Cotuit Bay Dr. 11/24/98 500 gal. tank removed, Cotuit, MA 02635 no contamination or odor present. Mikutwizz 59 Point Isabella 12/15/98 1000 gal. tank removed, Cotuit, MA 02635 no contamination or odor present. SENDER: •o :Complete hems 1 and/or 2 for additional services. I Also wish to receive the •Complete hems 3,4a,and 4b. following services(for an ® ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. a •Attach this form to the front of the mailpiece,or on the back R space does not 1. ❑ Addressee's Address o ■ re permit.etum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery y a ■The Return Receipt will show to whom the article was delivered and the date delivered. Consult postmaster for fee. 3.Article Addressed to: 4a.Article Number /70 4b.Service Type ❑ Registered' ertified ¢ 20? J �;: ❑ EzpcessM4 '' ;� ❑ Insured _ ✓L ❑ Return Recent for Mertan ' de.6 7.Date of Delivery s 5.Received By:(Print Name) 8:Addresse dr eg e _------ -- --- ---- — and fee IS — = — 6.1 s ;, iPs Receipt uspswemmfi, First-Class-Mail Postage&Fees Paid Q� 9 S No.G-10' 9590 9402-1933 6 3v 1799 62 SEP 3 2017 United States •Sender.Please print ur name,address,a' ZIP+4®in this box• Postal Service SP5- Town of Barnstable 003 Health Division 200 Main Street Hyannis,MA 02.601 '#°uj ! " l(HE tpp,_ 7 Town of Barnstable v� 6 ,0� Department of Health, Safety, and Environmental Services Public Health Division P.O. Box 534, Hyannis NIA 02601 Office: 508-790-6265 Thomas A McKean,RS,CHO FAX: 508-790-6304 Director of Public Health August 27, 1998 Mr. Johnson Winthrop B. & Gloria 209 Ralyn Rd. Cotuit, MA 02635 NOTICE TO ABATE VIOLATIONS OF THE TOWN OF BARNSTABLE REGULATION REGARDING FUEL AND CHEMICAL STORAGE SYSTEMS Our records indicate that you have an old underground fuel oil tank located at 209 Ralyn Rd., Cotuit, MA . This tank is listed on Parcel 022 on Assessor's Map 055 and registered as tank tag 9677. This tank is located in a critical zone of contribution to our public drinking supply wells and is 20 years old or older. You must have your underground tank removed within 30 days from the receipt of this order letter. For the removal of the tank you must first obtain a removal permit from the Fire Department. I have enclosed tank removal information for you. Upon removal of your tank, please return valve tag# 677 to the Health Department. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) days of receipt of this notice. Sincerely yours, Thomas A. McKean Director of Public Health Enclosure: Tank Removal Information N LOCUS ® �a A O a �a 0 J m 1 C d Q U Pond 28�iOc s3 LOCUS MAP NOT TO SCALE -- 97--EXISTING CONTOUR x 100.98 EXISTING SPOT GRADE 97 PROPOSED CONTOUR S o W EXISTING WATER SERVICE LOT 17 --6.H.+J/-OVERHEAD WIRES 40,544 t SF ?3S��4° TEST PIT PAR L ID: 22-55 � BENCHMARK i WF-04 WETLAND FLAG 015.60 LEGEND Lp 1 p OD I \ • J///aj \\ \ \ \ \ ` 38.45 `\\GAR4G x\ .7 1 \ \` 34.61 \ \\ ••EE \\ ��8 � x 34.00 + N 27.66 ,. 1 \ 34.93 --3Z52-QD y - PORCH REPAIR SLOPE BY FILLING 27.46 ,. . 34.68 so x 33.56 IN SCOURED SWALE AND INSTALL LANDSCAPE TIE �� EXISTING\ �' `:` ,; _ _. - - - TO-DIVERT RUNOFF FROM :2?22�' ' HOUSE 209 REPAIRED SLOPE T.O.F.=J5. -tI w \ 'DRIVEWAY ` m CELLAR FL.=27.7 x 32.83- / �Z� 32.95 O / m31.95 1.67 >�PK SET '..':. \ 32.90' 3 .94 x 2.57 26.64.:; + x I /�I -� (O / \ 32.69 Cl) 26.13y+ ��- -- - x - 1\ Tp-2_S(B- 4, NO WORK SHALL BE PERFORMED WITHIN THE / PROP�SED EOTIC TANK 23.91 _�- --�-- 18' , 24.47 _ VEGETATED AREA OUTSIDE 23.65 - z3. �- IM 25,-:-• VEN OF THE WORK LIMIT � RK L W 9 O . 3 8' O• 22.26,: :; Chi 22.47 �. 22.03 ➢ ANT 22.20 Vski_ 7.44' �-% 5 EXISTING CESSPOOLS 21.74 TO BE REMOVED S 22-26-S" E�2 zi.S 41 75 ET ' `�3 (SEE NOTE 11-SHEET 2) OF %, 21.a1 >8 20.89 �O, 28.00, PETER T. BENCHMARK � ' N 22.2J_" So• McENTEE ► N MAG.NAIL SET Tp o CIVIL �.�' CATCH BASIN 0. 35109 EL.=21.75 20.99 20.00 f�IS1 RALYN ROAD E 11 20.03 r ( 20,31 i1C1(I ? 20.27 9.69H BASIN 1 11 OWNER OF RECORD x 20.32 11 WF-03 _-- JOHNSON, GLORIA D es OF B•V.W II 17.12 10 WOOD PATH WF-0 pGE ^ 16. ASHBURNHAM, MA 01430 is.7e1 s 11.37 E '-DER --� wF-04 �OF 15.60 WETLAND DELINEATION _..iEpGE JACK VACCARO WATER SURFACE, EL.=14.2 EXISTING OUTFALL 16 Oriole Drive . 10126117 INV.=15.Of Sandwich, MA 02563 (508) 274-0706 POND Engineering by: SCALE DRAWN JOB. NO PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. 1"=30' P.T.M. 272-17 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 209 RALYN ROAD, COTUIT, MA (508) 477-5313 11/10/17 P.T.M. 1 of 2 Prepared for: Janice Johnson, 21 Wood Path, Ashburnham, MA 01430 NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:22.5 ` SEPTIC TANK FOR A DISTANCE OF 15' AROUND THE INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S.A.S. PROPOSED S.A.S. AND SET TO 6" OF FINISH GRADE. PROPOSED D-BOX RISER & PROVIDE TWO ACCESS MANHOLES TO WITHIN 3" INSTALL WATERTIGHT COVER SET TO 6" GRADE OF FINISH GRADE FOR INSPECTION PURPOSES T.O.F.=35.0t CHARCOAL F.G. EL.=33.0t F.G. EL.=27.0t F.G. EL.=27.0t F.G. EL.=24 TO 29t VENT MAINTAIN 2% GRADE (MIN.) I OVER S.A.S. 20 ia�i, . CELLAR L = 25't' FLOOR ® S=1% (MIN.) L - 5' L = 5' 4"SCH40 PVC ® S=1% (MIN.) @ S=1% (MIN.) r. 4"SCH40 PVC 4"SCH40 PVC 6" 10"1 " 8208022 s O as 14" s mamma a INV.=24.00 aa' uoulD aaaaaaa go 3N35 LEVEL App 4' 4.8, 4' GAS BAFFLE INV.=22.27 PROPOSED INV.=22.10 INV.=23.75 D-BOX INV.=22.00 EFFECTIVE WIDTH = 12.8' PROPOSED SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN CONNECT lfU EXISTING SUITABLE SEWER H-20 RATED NEAR HOUSE AT, OR ABOVE, EL.=24.50 • TOP CONC. ELEV.=23.1 t BREAKOUT ELEV.=22.50 NOTES: INV. ELEV.=22.00 aaaa eases aaaBa 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE ease eases INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=20.00 4' 2 X 8.5'=17.0' 4' 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE 4' MIN. OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' TO GRADE ON A MECHANICALLY COMPACTED 6" CRUSHED PERVIOUS MATERIAL STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN. ABOVE GROUNDWATER LEACHING SYSTEM SECTION 3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTT. OF TP-1, EL.=14.9 - 4) CONTRACTOR SHALL INSTALL A GAS BAFFLE ON THE 3/4" TO 1-1/2" DOUBLE OUTLET TEE. I WASHED STONE 3" LAYER OF 1/8" TO 1/2" SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE (OR APPROVED FILTER FABRIC) SOIL LOG n EXISTING DATE: OCTOBER 13, 2017 (REF#15,495) A HOUSE(f209) SOIL EVALUATOR: PETER McENTEE PE(SE#1542) z T.O.F.= S.Of, WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT rrl CELLARW.=27.7 ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH 26.4 0" 27.5 0" FILL FILL ue�I 59 4 23.9 30" 24.3 38" A A LOAMY SAND LOAMY SAND -- 10YR 4/2 10YR 4/2 I I� 23.2 38" 24.2 40" 1 B01 LOAMY SAND B 1 LOAMY SAND PROP.SA _ Cl 10YR 5/6 10YR 5/6 I----25'---�� 22.4 48" 23.3 50" Cl PERCSEPTIC LAYOUT MED. SAND 42"/6/60" MED. SAND 2.5Y 6/6 2.5Y 6/6 GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. 14.9 138" 15.5 144" 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE NO GROUNDWATER, PERC RATE: <2 MIN./IN. LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: -310 CMR 15.405(1)(b): 1) A 2' variance, depth of cover over S.A.S., for 5' of cover. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR DESIGN CRITERIA DO SIGN NSPE GIN TION AND APPROVAL BY THE BOARD OF HEALTH AND THE R. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING NUMBER OF BEDROOMS: 2 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN SOIL TEXTURAL CSS: CLASS I ENGINEER BEFORE CONSTRUCTION CONTINUES. DESIGN PERCOLA ION RATE: <2 MIN/IN 5. ALL ELEVATIONS BASED ON ASSUMED DATUM (BARNSTABLE G.I.S.f). (0.74 GPD/SF LOADING RATE) 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF DAILY FLOW: 220 GPD THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. DESIGN FLOW: 330 GPD 7. WATER SUPPLIED BY TOWN WATER SERVICE. GARBAGE GRINDER: NO LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS .74 GPD/SF AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY DIRECTED BY THE APPROVING AUTHORITIES. PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY USE 2-500 GALLON LEACHING CHAMBERS IN SERIES THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE TOTAL AREA:.........:....................................................471.2 S.F. INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL. DESIGN FLOW PROVIDED: 0.74 GPD SF 471.2 SF = 348.7 GPD 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND / ( ) IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. Engineering by: SCALE . DRAWN JOB. No. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. N.T.S. P.T.M. 272-17 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 209 RALYN ROAD, COTUIT, MA k (508) 477-5313 11/10/1 P.T.M. 2 of 2 Prepared for: Janice Johnson, 21 Wood Path, Ashburnham, MA 01430