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0243 SANDALWOOD DRIVE - Health
1.43 SANDA L�NOOD DR1� &diUIT 633 TOWN OF BARNSTABLE ,:.LOCATION 2 y3 G"c (,,k)onD Or SEWAGE# VILLAGE Cod'V;I- ASSESSOR'S MAP&PARCEL 0a'�--033 '-INSTALLER'S NAME&PHONE Nd�'Q� c J� nr SEPTIC TANK CAPACITY( ( t t eJ LEACHING FACILITY.(type) SC7O crcelllw ('k061 (size) NO.OF BEDROOMS OWNER &),2U PERMIT DATE: j ( 1 )H 1/ `S COMPLIANCE DATE: 1 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 B ]�(d W eJ a kc 13 A' 0OT 31 FEE] $h')c "kt O.,C) No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in co puter: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 1 \ 01ppliLatioii for MispoBal *pstrm CoiietrUPtioii Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) El Complete System El Individual Components Location Address or Lot No. 2 K 3 54,,Ae uAsmc7 Dir_ Owner's Name,Address,and Tel.No. Cod c��t IVoVJc,_k Assessor's Map/Parcel O Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. t' &Ar-t) A Type of Building: Dwelling No.of Bedrooms 3 Lot Size 2a,o vc? sq.ft. Garbage Grinder( ) Other Type of Building �An02,x!! No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 ^7 c3 gpd Design flow provided 3 5 , "� gpd Plan Date to i 1:3 Number of sheets '2--- Revision Date Title Size of Septic Tank e41 S+-r,,e Type of S.A.S. 5Coo 2,/11,z X2S K 2— Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1&S t-c,,_k\ p L,,-) S. A �J 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 issuedZbthis Bo Health. gn o Date // / Application Approved by Date Application Disapproved y Date for the following reasons Permit No. Date Issued No. Fee ✓ THE COMMONWEALTH OF MASSACHUSETTS Entered in co puter: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes aptJYItatlOn for M1st108aY *pstetn Construction Permit Application for a Permit to Construct( ) Repair((Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2 y'S 5G. C)1 P Wer c) Df. Owner's Name,Address,and Tel.No. Cod v�fi Nov.�a 1C.. i Assessor's Map/Parcel O2S_ Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ►b•rzk-) A 1so8-Lloc7- 7/s5 __' - .-r,Pr!'N3 ",-)e5 Type of Building: Dwelling No.of Bedrooms" 3 Lot Size 20,ooc:P sq.ft. Garbage Grinder( ) 3 Other Type of Building 11C_� .� No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3 s 7, 'S gpd Plan Date 10111, 1 1: Number of sheets 'z- Revision Date Title � Size of Septic Tank e X i r n)r 11� �� r` Type«o�S A!S�l. Description of Soil C1'�, s Nature of Repairs or Alterations(Answer when applicable)jra f r,_\N tj,4) C- , A S Date last inspected: Agreement: r�4� 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 Bo Health. t. Sign a Date Y' Application Approved by Xl� Date Application Disapproved y Date for the following reasons I Permit�0. Date Issued -----------------------=-------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliante THIS IS TO CERTIFY,that the On-site Sewage Disposal system.Constructed( ) Repaired(!/�upgraded( ) Abandoned IJ e c 4 at ? N C:-JCAr_ t 0C 2r) has been con ted'n ac ot�3 ce with the provisions of Title 5 and the for Disposal System Construction Permit No ated In tape 4 Designer „�� �.� IC e o s Approved 'esl flow gpd Th issuance o this 't sly not be construed as a guarantee that the syste l u ft ,?as��esi�ne,. U' Date Inspector J 1%�1� - - -- ------�-----!-- ` �- _— - -- - _- - / No. 3 - 0 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS bisposal 6pstent nstrUttion Permit f Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at Z`/;3 �i �/� Gtl�v� Jai �c f-Jr /- 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:Cons ctio ust be completed within three years of the date of this permit. = �-- Date Approved by 11/18/2013 Oe:51 50e4775313 ENGINEERING WORKS PAGE 01 'down of Barnstable ' Regulatory Services $ Richard Y, Scali, Interim Director . u�uxmra�s_ Public Health Division ► '' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 F= 508-790-6304 Installer& Des' er Certification Form Date: M% T !3 Sewage Permit# CV[3� sessnr's Map2arcel, 2-5-- ®i 3 Designer: Installer: _-P.A Address: i 2 .fAxp3 Address: p a +�• 1 �l pr. 9. / - 1�4Z was issued a permit to iIIStS1I a (date) (installer) septic system at Z�� qM-�w�v `�'' r' G4%lt- Based on a design drawn by (address) n ' nr cL ti.1sW � dated (designer) oC -I certify that the septic system referenced above was installed substantially according to the design, which -may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) Avas inspected and the soils were found satisfactory. I certify that the septic system referenced above was instated with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of auy component of the septic system) but in accordance with State & Local Regulations. Plan revision ar certified as-built by designer to follow. Strip out (if requited) was inspected and the soils were found satisfactory. f I esrUfy that the system referenced above was constru with the terms of the Y1A approval,letters(if applicable) PETER Y- McENTEE CIVIL 190.�1f19 q er S1 Ti,.'kure) Q,a,��IST L� •18N14t�N� tignces Signature) {Affix Designers Stamp Here PT,F,ASF, RETURN TO BARNSTABLE PUBLIC HEALTH DMSI N. CER�'MCA.TE. OF CON2LIA-NCE WILL NO BE ISSUED UNTIL BOTH THIS FaItM AND AS- BUILT CARD ARE R,ECETYED BY'T'IIE BARNST,ABLE PUBLIC T�EALTH DT VYSION. TR NX You. Q:lSeptic\Desipw Ceidficaton Form key$-14-13.doe AsBuilt Page 1 of 1 LOCATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME i ADDRESS B U I'L O E R OR OWNER DATE PERMIT ISSUED _ 7 DATE COMPLIANCE ISSUED r-,z2-�jC• http://issgl2/intranei/propdata/prebuilt.aspx?mappar=025033&seq=1 10/8/2013 Department of Regulatory Services i ,� ,AE �: _ Pl�blic Heali�h D><oison;. __ . . :Date � • I h- 200'Ma n Street Hyannis'MA-02601 bate Scheduled [`CfCJ c CyL� � L ` Time � _ Eee Pd Soil Suitability Assess*&nt for Sewage lsposal Performed By: s2f Witnessed By: U�- f '; `. LOCATION&.GENERAL INFQRM�TIO�I I.ocagtin Address: y 3' � �1_� Owner's Name r Address l t q ��-< w:Jew call Assessor's-Map/Parcel. 2 13 Engineer's Name NEW CONSTRUCTION RBPAIR\_A. ,- Telephone# 5�111 737�Y7 6' Land Use. R+ Slopes(30 Surface Stones Distances:from: Open Water Body /J ft Possible Wet Area.N ft Drinking Water Weil ft Drainage Way / ft Property Line ft :Other` ft SKETCH:(Street name,dimensions of lot,exact tlocations of testholes tit pere tests,locate wetlands fn proximity t(i`holes) — - = 1 Parent material(geologic) Depth t0 Bedrock, ,( J _ O Depth to Oroundwater. Standing Water in Hole: Weeping from PItPace � Estimated Seasonal High Groundwater DETERVIINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In, Depth to soil mottles:' In;� Depth to weeping.from side of obs.hole: in Groundwater AdJustntent' fry lndex.Weli:#_ Reading Date:_., Index Wellle4el Actl-fa ctor ,_T,�..Xd;!licnitdw,tsr! p!„�, s PERCOLATION TEST bate TIM Observation U" Hole# Time at 9" Depth of Penc. ,Z6 t S (ILA (,4,6(, t 6" Start Pre-soak Time® �� 9". "� End Pre-soak Rate Min.11nch L Z 177 Site Suitability Assessment: Site Passed. +K 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. Q:ISEPTICIPERCFORM.DOC DEEP.OBSERVATTON HOLE I:OG Hole# C_ Depth'from Soil Horizon Soil Texture Soil'•Color. Soil Other Surface(in.) (USDA (Mansell) Mottling (Structure,Stones;Boulders: Amp ,�f-3 d•. � - 5� a �,s 3 C iA _ DEED'�OBSERVATION'HOLE BOG :Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface.on.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. I Consistemicy VI va DEEP OBSERVATION HOLE LOG Hole# Depth;fro m Soil Horizon. Soil:Texture Soil,Color Soil Other Surfai a(in.) (USDA) (Munsell) Mottling '(Structure,Stones;Boulders: Consistena e7. .. DEEP OBSERVATION HOLE LOG Hole# Depthfrom Soil.Horizon. Soil Texture Soil,Color Soil Other Surface(in:) (USDA) (Munseiq Mottling (Structure,Slopes;Boulders. Flood ra�nce Rate:Map: Above 500 year flood=boundary. No Yes! ,. Witliiu S00 yearboundary No— Yes.:..r With inr 100 year flood boundary No� Yes De th of Nahtrall�Occurrme Pei<wious Material Does a>k least$four feet of naturally occurring pervious malarial.exist in ail areas;observed ihrouglout the area proposed for the soil absorption system? If not,-whaCs the depth of naturaily occurring envious material? _... ...,.. 4r . C6&. 0eation I ce +that©n ` (date)I have passed the.sotl evaluator examination approved ,,Y, e �d Department of Envir mental Protection and that the above analysts was performed by me`consistent with ..{ : the=required'°training;expertise and.expecience desenbed inl0 CMR 15:01'1: Signature Date f Q.�S$MCIPBRCFORM.DOC Y Commonwealth of Massachusetts Title 5 Official Inspection Form t- I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments jQ 243 Sandalwood Drive t i V Property Address h-d Michael Curtis Owner Owner's Nam information is Cotuit t� Ma 02635 8-5-19 required for every _ page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information on the computer, Brett Hickey use only the tab key to move your Name of Inspector cursor-do not B&B Excavation use the return Company Name y 374 Route 130 a Company Address Sandwich Ma 02563 City/Town State Zip Code rrty (508)477-0653 S113747 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑■ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Brett Hickey °'°'�"`re�00 e-"" 8-5-19 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 r c Commonwealth of Massachusetts �R Title 5 Official Inspection Form 1. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: The system was in working order at the time of inspection. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive v Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2 System Conditional) Passes (cont.): y y ( ) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 3) 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. a. 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: l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 c Commonwealth of Massachusetts �a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ or Cesspool privy is within 50 feet of a surface water P P Y ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: '*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ O Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ El Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/2 612 0 1 8 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 16 Commonwealth of Massachusetts �- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .243 Sandalwood Drive u Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every St page. City/Town ate Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ Q Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow ❑ ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ E] Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Q Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ El Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ El Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ El The system is a cesspool serving a facility with a design flow of 2000 gpd- 10 000 gpd. The system fails. I have determined that one or more of the above failure El El 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. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form I. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,v 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No El ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ El Were any of the system components pumped out in the previous two weeks? ❑ El 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? O ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ El Was the facility or dwelling inspected for signs of sewage back up? El ❑ Was the site inspected for signs of break out? ❑ Were all system components, excluding the SAS, located on site? El ❑ 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? ❑ a 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: 0 ❑ 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 <20-X, Commonwealth of Massachusetts 1p Title 5 Official Inspection Form to Subsurface Sewage Disposal System Form-Not for Voluntary Assessments P Y 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotpuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 3 Number of bedrooms(design): Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 357/GPD Description: . II Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes 0 No Does residence have a water treatment unit? ❑ Yes 0 No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes 0 No information in this report.) Laundry system inspected? ❑ Yes D No Seasonal use? ❑ Yes 0 No Water meter readings, if available(last 2 years usage(gpd)): See below Detail: ***2017- 5,000gallons 2018- 5,000gallons*** Sump pump? ❑ Yes ❑■ No Last date of occupancy: weekends onlyDate t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 c Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: NA Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner- last pumped 5 years ago Was system pumped as part of the inspection? ❑ Yes ❑■ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive �V Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: El Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 2013 Were sewage odors detected when arriving at the site? ❑ Yes ❑® No 5. Building Sewer(locate on site plan): 3, Depth below grade: feet Material of construction: ❑ cast iron ❑■ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town waterfeet Comments(on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments l 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 2' Depth below grade: feet Material of construction: ❑■ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 1 Dimensions: 000gallons 711 Sludge depth: 2911 Distance from top of sludge to bottom of outlet tee or baffle On Scum thickness NS Distance from top of scum to top of outlet tee or baffle NS Distance from bottom of scum to bottom of outlet tee or baffle measured 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.): The tank was in working order at the time of inspection. The tank is not in need of pumping at this time but should be pumped every two years for maintenance. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: NA 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 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, Liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u� 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): 0" Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): The d-box was in working order at the time of inspection. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts �m Title 5 Official Inspection Form I; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments L 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): NA * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil SAS stem Absorption Sy stem y (SAS) (locate cate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: (2)500 gallon chambers rX-1 leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 n Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The SAS was in working order at the time of inspection. Chambers were dry when viewed. 12. Cesspools (cesspool must be pumped as part of Inspection) (locate on site plan): NA Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth-of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): NA Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 TOWN bF BA.RNSTAJB ,& l-TUAGP.a✓t3 Ss:" W r1 Sl JSUk' b ivtrll"&,Pr1 CC I oLS__..._ .. TNSTALLE S,NAM.E&#qoN' NCf. 3�P'i'1C"TANK C;APACTTY `-f 5 f i+�. h ACHNGr:FACtT,1`r"y. rYT'e} '++ .t5iz } _ .. ... 'NO-OFBEDR~;Olid: LiW � � �t tl ?: cOM rtl"lcE:i:3ATE. t:t `S+�a�xtztoaa i3Sst�ztee"9iY`virraext tttc� ^�%��c' a�a�_ N-t't='f::W� fiaxr wn Ad usted i;rnntdwntet:lawae to.the r'wtn,of t tcilirr cep_- _ Feet. i';rate iiVVme:Supply Wcll aad eschwg F*,i iiivllf any,vV~lls crisr on Stye;oVrilthinc260'I xt.af 1e•.teh'inj raciliL"j" Eil�'at Wztland-axeii'txaeltirg Faczlllyqlfwt v wetlan&wast within, 3t�7 fxv t:af tenclnrs fac,l,ty3. e Fl lKSl4£ 'ri tluf-,is i •' �;�.�1L 4 �tn=Viz, I 15insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 • Commonwealth of Massachusetts �T Title 5 Official Inspection Form ±= Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive Property Address Michael Curtis Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: 0 Check Slope Surface water ■❑ Check cellar Shallow wells . �Estimated depth to high ground water: No GW @ 138"feet Please indicate all methods used to determine the high ground water elevation: El Obtained from system design plans on record 10-16-13 If checked, date of design plan reviewed: pate ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: A plan on file at the local Board of Health was used to determine high groundwater. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Sandalwood Drive Property Address Michael Curtis « Owner Owner's Name information is Cotuit Ma 02635 8-5-19 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: A. Inspector Information: Complete all fields in this section. ❑� B. Certification: Signed & Dated and 1, 2, 3, or 4 checked R C. inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6(Checklist)completed M 0 D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2016 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 LOCATION SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME & ADDRESS B U I-L D E R OR OWN ER DATE PERMIT ISSUED 7 DATE COMPLIANCE ISSUED ,, '1� �' �� i � 1 � `-�' - - �� � �2, No.. F��................'...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ .._.... .. . ...._.... ... .OF..................................... ......................... ............_......_... Appliratinn -fur Bi"vfial vrk� nnMrnrtWn,Vrrnti Application is hereby made for a Permit to Construct ( ' or Repair ( ) an dividua ewage Disposal System at: , ---------------- 7L .------•�/---..�1._,iml(.����0's ®t� i 7-'/fLocati n-Addres or Lot No. ' � .-; �i .. cz._7, � -------- ? W Ow r I �a'l+�l .... -------_'kC:'Y. --.-: Installer Address Type of Building Size Lot............................Sq. fee U Dwelling—No. of Bedrooms-----�3 ....................... ......: Expansion Attic K16' Garbage Grinder aOther—Type of Building ____________________________ No. of persons...._------------------ Showers ( ) — Cafeteria ( ) 0.' Other fixtures ------------------------------ -- W Design Flow......... ........................gallons per person per day. Total daily flow.............. ________..__.-___gallons. WSeptic Tank—Liquid capacit-0040_gallons Length................ Width................ Diameter--------------:_ Depth_.______.__... x Disposal Trench—No_ ____________________ Widtli__.. ___:..___ _- Total Length.................... Total leaching area.............___-._-sq. ft. Seepage Pit No---------/--------- Diameter_4(1.--h _ ...... Depth below inlet.................... Total leaching area__._.-..________-.sq. ft. z Other Distribution '.box ( � Dosing tank ( ) &__ 10J/ '7 7 ~" Percolation Test Results Performed by----------- LY..0..KLXJ- _ Date---------------------------------- W Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water..._._._.___-_.._..-__.- ;14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground a' � a...! water._.____..__.___._____._. � ----- O Description of Soil-- .... x � � . `�J/ W U Nature of Repairs or Alterations—Answer when applicable._________________________________________-------------------------_------___------------------- -------------- -----------------------------------••---......_..._..._....--•---....---••---•-•--••------. --•------------------•-----------•------•-------•-----------•---------------=--------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until A Certificate of Compliance has been issued by the board of health. Signed. -��.nc� --l� `"�--�?��.__R�� 0&. ���� e Application Approved By-----..... C ---------- e Application Disapproved for the following reasons:.___ y__.�� ___�� t.e._____ } `___ _______.� �dj.�`iE.. ...........................................................................-----•---- 0 ------Z)06�-•---1"r A)LZW to .Permit No......................................................... Issued---------------------------------- .................. Date K i 0)7 No.. .��............. Fw$..... ................. THE COMMONWEALTH OF MASSACHUSETTS fi BOARD OF HEALTH _.. OF................................................................. 1:, - Appliratioo -for M,q .aottl Workii Tonstrortion Puntit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: Locat' n Addres Own r A4dressi a . .. Installer Address UType of Building Size Lot----------------------------Sq.P07 .q Dwelling—No. of Bedrooms------ ------------•__._---__-__.----.-.--Expansion Attic � Garbage Grinder aOther—Type of Building ---------------------------- No. of persons...... ----------------- Showers ( ) — Cafeteria ( ) dOther fixtures ••-----------------------------•----•--------------------------------------------------------------------------------- w Design Flow---------4... .......................gallons per person per day. Total daily flow--------------- -----------------gallons. WSeptic Tank—Liquid capacitp/4W—.gallons Length---------------- Width................ Diameter----.__.._.----- Depth..-.-----___--- x Disposal Trench—No. .................... Wid li---_ ------------ Total Length-------------------. Total leaching area--------------.-----sq. ft. Seepage Pit Nc........../--------- Diameter.�A _--__ Depth below inlet ................ Total leaching area----- - ---------- ft. z Other Distribution box ( Dosing tank ( ) 4 aPercolation Test Results Performed by._..... _ dh,�c .....G`t t jY __its�y. .Date._. a Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth.to ground; water_..---_____--..-_.-__. fA Test Pit No. 2................minutes per inch Depth of Test Pit.------------------- Depth to ground water.-:--._---_._--.----_._ P4 f� p Description pf Soil " -.__ __ G .* f� 4 w UNature of Y epairs or Alterations—Answer when applicable` -------------------_----__-_.-..-.--_-_ --------------------- -------.------------------ ------------------------------------------- .. ---------------------------------------------- Agreement,.-, ts. s The undersigned .agrees to install the aforedescribed IndividiialfMSewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code- The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by�the board of'health, --Si nede� ~ Da e Application Approved`By-- .7. !� ------ % - --f..... . Z-7----- Date Application Disapproved for the following reasons:-----•-•------•--------•--------•-----•---- ----------•-- ---•---------------•---•--•--------------------------- ---.--•-_------_--•---------•---------------•---------- --•------------...•--•---•-------•••-•--------•••--•------•-----•-•-----..•------•-•-----•--•---•--•-------------------......----------•-•.----- Date PermitNo......................................................... r Issued.......................................................... Date THE dOMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��1 .A}.... ........ OF.- ....................... Trrtifirote of f.11outphaurr THIS IS,TO ZERTL Y, T at the Individual Sewage Disposal System constructed (P�`or Repaired ( ) b ................. -- Inst ler � `� at---•--••---•-•--- =- l t l/J � e --- --� t-------------_ � ��. ---------------------••------------------ has been installed in accordance with the provisions of ALftgj le//XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.C.�!...�_?_7------------------ dated__//?!1 w__;_7`...................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.........................................................................-----• Inspector..............------------------ --------------. i THE COMMONWEALTH OF MASSACHUSETTS,' BOARD OF HEALTH U.± .......... .. .OF......... II�'1 rr .��.. :.����.°................. No. FEE.................. Di-tivolial luorkg LUootrurtion Vamit Permission trhereby granted > > = "" • to Construct ) or Repair ( ) an Individual Sewag DispoS System /` t r; at No. 1- - - •l' .1 ( ,c) -----------_-------44.-(� ----� I .................................... Street as shown on the application for Disposal Works Construction Perm'V o_______ ____ _ _____r ated.._. f` ..___.__...._______.... -- t� fw DATE ��� ,- /� Board of Health ,. --------------------- -------------------------------- FO.k2M, 1255 HOBBS 8 WARREN. INC.. PUBLISHERS- �, CO\I_10\NM LTH OF MASSACHLSETTS r EkEcumE OFFICE OF EI VIRONMENTAL A IRS DEPARTMENT OF ENVIRONMENTAL PRO ti-� ON ONE RI\TER STREE . BOSTOK I`L4.0210c r61'1 292-55�0 �6 Z 1999 10(�IHNftrl TR11 OXr Secre ARGEO PALL CELLi CCI > a 7-uc � DB S D. �Z TP�... , Governor Comtnissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION 24.3 Sandlewood. Dr. , Cotuit erty Prop Address: Name of Owner Benjamin Lim Jr d—3 O Address of Owner: Date of Inspection: Name of Inspector:(Please Prirn)Wm. E. Robinson Sr. I am a DEP approved systerq inspector pursuant to Section 15.340 of True 5(310 CMR 15.000) m CornpanyNae: Wm. E . Robinson eptic Service Marling Address: PO Box 0- 9, C ent e ry i 11e_,�VlA Telephone Number: 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _4, Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: u7 6 Date: r The System Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty (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 Department of Environmental Protection. The original should be sent to tfte system owner and copies sent to the buyer, if applicable, and the approving authority., NOTES AND COMMENTS i revised 9/1/9E Page Iof11 ' �i ''r•"'ed or,Recycird Panr,',- .. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) 'roprt A ddress:243 Sandlewood. Dr . Cotuit owner: Benjamin Lim Date of Inspection:!l-3 U-4 % INSPECTION SUMMARY: Check A, B, C, or D: SYS PASSES: 7 I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. An failure e criteria not evaluated are indicated below. COM ENTS: B. SYS M CONDITIONALLY PASSES: ne or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon ompletion of the replacement or repair, as approved by the Board of Health, will pass. Indicate es, no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If "not determined•, explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached)indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if Iwith approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if (with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed revised 9/2/98 Page 2of11 •� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 243 Sand.lewood. Dr .' , COtuit" owner: Benjamin Lim Date of Inspectional I—3 0 C. RTHER 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303.0)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of 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 IAND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less then 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER I revised 9/2/98 YPge3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 243 Sand.lewood. Dr . , Cotuit ° Owner: Benjamin Lim Date of Inspection:.)G �,of D. SYSTEM FAILS: You mu indicate either "Yes" or "No" to each of the following: have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this termination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility-or system component due to an overloaded or-clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters.due to an overloaded or clogged SAS or cesspool. 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 1/2 day flow. _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is.within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LAR E SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: he following criteria apply to large systems in addition to the criteria above: he system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 stem is located the system in a nitrogen sensitive area(Interim Wellhead Protection Area- IWPA) or a mapped Zone It of a public water supply well) The o ner or operator of any such system shall upgrade the system in accordance with 310,CMR 15.304(2). Please consult the local regional office f the Department for further information. V re ised 9/2, 98 Page 4of11 . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART B ' CHECKLIST Property Address: 24.3 Sand.lewood. Dr. , Cotuit Owner: R� Date of Inspc4Etf j amin Lim Check if the following have been done: You must indicate either "Yes" or "No"as,to each of the following: Yes/ No _ Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been-receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection., _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was,inspected for signs of sewage back-up. The system does not receive non-sanitary or industrialwaste flow. _ The site was inspected for signs of breakout. All system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. `` The size and location of the Soil Absorption System on the site has been determined based on: v _ Existing information. For example, Plan at B.O.H. L _ Determined in the field(if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) ' (15.302(3)(b)] _ The facility owner (and occupants,if different from owner) were provided with information on the proper maintenanr.&-0f SubSurface Disposal Systems.. revised 9/2/98 Page 5ofIII 'g SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION 4opertyAddress: 243 Sand.lewood. Dr. , Cotuit Owner: Benjamin Lim Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: G 0 g.p.d./bedroom. Number of bedrooms(design): Number of bedrooms (actual): Total DESIGN flow 3 6 o Number of current residents:A A Garbage grinder(yes or no): LP Laundry(separate system) lyes or no):ZI/O; If yes, separate inspection required Laundry system inspected (yes or no) Seasonal use lyes or no).A— O Water meter readings, if available (last two year's usage(gpd): c :� 1 qq _�Q 32, 000 g21 . Sump Pump (yes or no):A�6 Last date of occupancy:-&Mk—gq 1997-98 �5, 000 gal. COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: qpd ( Based on 15.203) Basis of design flow Grease trap present: lyes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)_ If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach-previous inspection records,if any) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed(if known) and source of information: - — Sewage odors detected when arriving at the site: (yes or no)_ revised 9/2/96 Page 6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION leo"dmied) 4operty Address:243 Sandlewood. Dr. , Cotuit � owner: Benjamin Lim Date of Inspection, —00— BUIL ING SEWER: U oca a on site plan) Depth below grade:_ Mater 1 of construction:_cast iron_40 PVC other(explain) Dist ce from private water supply well or suction line Dia eter C ments: (condition of joints, venting, evidence of leakage,etc.) SEPTIC TANK: (locate on site plan) Depth below grade: / Material of construction:$- ncrete - metal Fiberglass Polyethylene_other(explain), If tank is metal,list age_ Is.age confirmed by Certificate of Compliance_(Yes/No) Dimensions: 4 Sludge depth: —6/ Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: , s Distance from bottom of scum to bottom of outlet tee or baffle:,6 How dimensions were determined: 74 w lC 'omments: (recommendation for pumping, condition of inlet and=outlet tees or baffles,,�jepth_pf)iquid level in relation to outlet invert,,structural integrity, evidence of leakage, etc.) f3-®—C� �.ti j, ��+�. l� /�✓l' �i' �w �10lb C-e GREASE TRAP: (locate on site plan) Depth below grade:_ 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: 4 Comments: (recommendation for pumping, condition;of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) r• revised 9/2/98 Page 7orll " III .. . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) JyopertyAddresS:243 Sandlewood. Dr . , Cotuit Owner: Benjamin Lim Date of Inspection. TIG T OR HOLDING TANK: (Tank must be pumped prior to, or at time of, inspection) (local on site plan) Depth below grade:_ Materi if of construction:_concrete metal_Fiberglass_Polyethylene_other(explain) Dime ions: Capa ity: gallons Desi n flow: gallons/day Ala present Alar level: Alarm in working order: Yes_ No— Dot'e f previous pumping: Com ents: (co ition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: (/ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, ence of solids carryover, evidence of leakage into or out of box, etc.) - PUMP HAMBER:_ (locate n site plan) Pump in working order: (Yes or No) Alar in working order(Yes or No) Com ents: (not condition of pump chamber, condition of pumps and appurtenances, etc.) 'l revised 9/2/98 Page 8of11 SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 'rop"Address: 243" Sand.lewood. Dr. C.otuit Owner: Benjamin Lim Date of Inspection ! 3 --g 5 / SOIL ABSORPTION SYSTEM(SAS):_✓ (locate on site plan, if possible;excavation not required,location may be approximated by non-intrusive methods) If not located, explain: r. Type: leaching pits, number: leaching chambers,number:_ leaching galleries, number:_ leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number. Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure,-level of ponding, damp soil, condition of vegetation, etc.) lS� .Q C ,b/ e ; f C POOLS: (local on site plan) Number and configuration: Depth-t of liquid to inlet invert: Depth of olids layer: )epth of cum layer: r Dimensio s of cesspool. Materials f construction: Indication f groundwater. i flow (cesspool must be pumped as part of inspection) Comment x (note con ition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRI (locate n site plan) + Material of construction: Dimensions: Depth o solids: Comm is: (note ndition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) x revise: 9/2;7C Page of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) '3,roperty Address:2 43 S and.le wo o d. Dr . , C o t u it )wrier: Benjamin Lim Jate of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) I 1 5 V e . revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) rowty Address:243 Sand.lewood. Dr . , ` Cotuit owner: Benjamin Lim Date of Inspection: NRCS Re port name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope ,, x Surface water Check Cellar Shallow wells Estimated Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans'on record Observed Site (Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health r 4 Checked FEMA Maps Checked pumping records Checked local excavators, installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed)- lab td �p � m,nps 1 � S revises 9/2/96 Page IIor]I 4 E S 3 &E ACM REsf Rv . L O? 11 7a.t 41#1- . 785T V . sRrvk Assn, o j b 3&`` StC? L {;cJl TN- � ' ''� rryrfall�l tip v N } i C L fi Y 4 co 4 ` FQpntII j \ 50 T' r_.. LEJ . 30•� r 5 o,f G1E[Z • �$ . �. ExiST ExtST lrr�LL 0� © GJELL . �U/LD/ivG 5�7-L3,GC,�..:,P• � CJ�;� �ti1?�' - 5 GA L� .' . J O . . f �i2Q moo.SFI7 , SEPTIC 5y5T� CONST2E�GT/DN SNA L G GONFOIzM TO MASS DES/G fir, FL O GV _ GAL�DA Y E N!i/Q oniMEn/-T�,�,- Coves Ti r� IT Y. C'EVi E '7->- 7.7� LGAC W` .,e-A. -4 � � MIN �//t/G� . �. �, �/EALTiN ,4; ._ �'�`A, LEAGM. .��'�� �330)�*��= r3� TOP OF ro20�0 S a �.E.aC.�-1 .�, so.0 2 " OP Paq 57-ONE'' MAAlANOLE`#CO✓E,0 70-: lD Tp -IAJOE�2V/OUS C'a.✓E,rz 71O p2E VE.A/T _ W17s,4/A/ /' QF /F/N15/-r�5n0 0.0AD �20M /rVF/LTi2AT/�t/6 2.4'Co�/ , SrorvE 2 j 15 COvAZ 4 N, o q �� �,.Box I 2/"W/M- o L)�� 0 — D1Q ; ` //Pir�A/ M.iv /4'/FOOT �O'�MiN ZOO %4.'/FOo7 , eta - Mrn[ r'r.car �. P/T .DiA. -Y_ Mral_ /�."Door n 200p �'VA5HE0 T / STD NE G.Q.4--`.O i /Al-r/E,er /NVE�T CA PA c-t I TY A 11 ROUNO 3`9. 8 c�rrcz�.► of CW�[TTz`T/G:�/7" pi 7- TE L OG�t T1O/V UM S TABLE jr .. GES //1J Tom/ f� Jiv 'TA^v.er 01-,5, e�BvTioAl 80X oZ OU L ET-S� AA-fZ> L.E.eFG�,//.VG p/T FO,tc? no • 3E,; OFEi�/ 0,2CED COA/G.2ET� COA/C.2E7E5 �T.�'E.VG - 3000 Psi M; /A/. t � � a4 20000 13y ? ''/ H'/O LOAD/rvG D,2/VF-ti AY !./QT -rc BL LOC,4TED OVF2 5Y5TE�I :untLEsS !-/- 00 DES/GAr L OA Z>/Ar`G /S !lSED: ♦.y D ,R,eoV,4L- LEGEND - N --98-- EXISTING CONTOUR x 100.98 EXISTING SPOT GRADE ® o° o °O H.-W- OVERHEAD WIRES a°\ fO SPwOoa —W— EXISTING WATER SVC. LOCUS ° TEST PIT e BENCHMARK ,O o 0°• 3 ' P9 �2 w 8k PO 5 9K 2 �fm o� Ploy • o " Route 28 LOCUS MAP NOT TO SCALE 76 73.5,5� x 75.10 -�_ x �f� ^^S 26-19.46" W � 125.00' t x A,75 I I• x 70.915 \ `I EXISTING LEACH PIT h 9�o x 73.59 I /I TO BE PUMPED, FILLED WITH 1 SAND AND ABANDONED- 1 . FTC\ x 70,95 \TP-2 \ \ O 71 \ \ 77,98 x \S :;j �09 - �OI REMAIN-SENG E NOTE NOTET�4 K �\ I E7.60 x 77.02 _ �-' �\ TOP OF TANK Et.=76.20t \ IN V-(OU 1)=74.87E 0•\ \ 76,90 \ v �- v' 18.53 0 BENCHMARK " 8. j or./Conc.Bulkhead w f 78.35 78.9 DE K \x 77.80 L,=79.91 o I 79A8 \� i M , Z I /EXISTING HOUSE(#243) x 78)0\ o 0 T.O.F,=79.0± o X 78.20 I <:, 78.70 I 8.63 x 79.45 CTI 7M I : 78;s 3 LOT` 11 i MBLU 025 033 1 .: .Q x 78,35 .; 78, 1 20,000S.F. i x x 78.15^4'� x 78.38 \�-x 78.02 x 7 ----x- 78,06 76.51 ' 76,06 0.00 N 26.19'46 E UP 74,49 74,60 74.66 edge of pavement 75.07 75.45 • ��P��� OF Mgss9��G o PETER T. . SANDAL WOOD DRIVE o Mc CIVILEE N No. 35109 USZERS� £S ECG\ tQ1L � 11%� OWNER OF RECORD LIM, BENJAMIN W 119 GREEN POND-,ROAD PLAN REFERENCE: PLAN BK 284 - PG 42 (LOT 11) EAST FALMOUTH, MA 02536 Engineering by: SCALE DRAWN J06. No. PROPOSED -SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. 1"=20' P.T.M. 243-13 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 243 SANDALWOOD DRIVE COTUIT MA (508) 477-5313 10/16/13 P.T.M. 1 Of 2 Prepared for: Benjamin Lim, 119 Green Pond Rd, East Falmouth, MA 02536 i e •f✓ NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL-74.0 SEPTIC TANK FOR A DISTANCE OF 15' AROUND THE INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S.A.S. AND SET TO 6" OF FINISH GRADE. PROPOSED S.A.S. PROVIDE ACCESS TO GRADE 'OVER OUTLET COVER PROPOSED D-BOX INSTALL WATERTIGHT RISER & PROVIDE TWO ACCESS MANHOLES TO WITHIN 3" T.O.F.=79.9 t COVER SET TO 6" GRADE OF FINISH GRADE FOR 'INSPECTION PURPOSES F.G. EL=79.0t F.G. EL.=78.3t F.G. EL=76.5f F.G. EL=77.0t, � MAINTAIN 2% GRADE (MIN.) OVER S.A.S. e. 27L(, L = 41' = 13'(MAX.) ® S=1% (MIN.) S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC ee0"t. 66aa9BB 14" - aaaaa9a EXISTING 48" LIQUID aaMMaaa LEVEL ADD 4. 5.2' 4' GAS BAFFLE INV.=73.87 PROPOSED INV.--73.70 INV.=74.87f D-BOX EFFECTIVE WIDTH =; 13.2' + EXISTING W/INLET TEE INV.=73.50 EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN H-10 RATED TOP CONC. ELEV.=74.3f - BREAKOUT ELEV.=74,0 BY INV. ELEV.=73.50 a as NOTES: MMMaa a0a1M 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE Maas aaaaa BOTTOM ELEV.=71.50 INVERTS, PRIOR TO INSTALLATION. 4' 1. 3 X 8.5'=17.0' 4' 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' ON A MECHANICALLY COMPACTED SIX INCH CRUSHED PERVIOUS MATERIAL STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN. SEPARATION TO G.W. LEACHING SYSTEM SECTION 3) INSTALL INLET & OUTLET TEES AS REQUIRED. NO G.W., TP-2, EL.=65.2 _ 4) CONTRACTOR SHALL INSTALL AN APPROVED GAS 3/4" TO 1-1/2" DOUBLE BAFFLE ON THE OUTLET TEE. WASHED sTONE SEPTIC SYSTEM PROFILE 3" LAYER OF WASHED STONE DOUBLE WASHHED STE E N.T.S. (OR APPROVED FILTER FABRIC) GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOG BOARD OF HEALTH AND THE DESIGN ENGINEER. J VV 2= ALL WORK AND MATERIALS'SHALL CONFORM -TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE DATE: OCTOBER 10, 2013 (REF. P#14,153) LOCAL RULES AND REGULATIONS. SOIL EVALUATOR: PETER McENTEE PE, (SE#1542) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACK FILLED .PRIOR WITNESS: DAVID STANTON R.S. TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE HEALTH AGENT DESIGN ENGINEER. ELEV. TP- q I DEPTH ELEV. TP-2 DEPTH 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING - . FROM THOSE SHOWN. HEREON SHALL-BE-REPORTED THE DESIGN -- - --- - - -- - =mot 76.9- .A - - --0:_75.7 A-- _ _.. __0Y ENGINEER BEFORE CONSTRUCTION CONTINUES. SANDY LOAM SANDY LOAM 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 76.6 10YR 4 2 4" 75.4 10YR 4 2 4" 6. THE DESIGN ENGINEER! IS NOT RESPONSIBLE FOR THE FAILURE OF g B THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF SANDY LOAM SANDY LOAM HEALTH.FOR PROPER INSPECTIONS DURING CONSTRUCTION. 10YR 5/8 10YR 5/8 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 74.4 C 30" 73.2 C 30" 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION"SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. MED. SAND MED., SAND 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 2.5Y 6/6 2.5Y 6/6 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 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). 66.4 138" 65.2 138" 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE NO GROUNDWATER INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. PERC RATE: <2 MINIJIN. (OF FILE 4/6/77) 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND SANDY SOILS ARE CONSISTENT WITH PERC IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. 14. USE OF EXISTING TANK IS CONTINGENT ON AN ACCEPTABLE INSPECTION. NO DECK FOOTINGS SHALL BE ALLOWED TO REST OVER SEPTIC TANK. • r DESIGN CRITERIA NUMBER OF BEDROOMS: 3 SOIL TEXTURAL CLASS CLASS I w ®®®®®®®®�®� DESIGN PERCOLATION RATE: <2 MIN/IN N z ®k®FE ®®® (0.74 GPD/SF LOADING RATE) - DAILY FLOW: 330 GPD .DESIGN FLOW: 330 GPD 102" GARBAGE GRINDER: NO LEACHING AREA REQUIRED: !(330 GPD) = 445.9 SF 4" KNOCKOUT .74 GPD/SF 20" DIA. COVER EXISTING SEPTIC TANK 1000 GALLON CAPACITY PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS 4" KNOCKOUT 0 / 4" KNOCKOUT 62" USE 2-500 GALLON LEACHING CHAMBERS 1N SERIES SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES SIDEWALL AREA: 2(13.2' + 25.0') X 2 = 152.8 S.F. 4" KNOCKOUT BOTTOM AREA: 13.2' x 25.0' = 330.0 S.F. TOTAL AREA:..............................................................482-8 S.F. 500 GALLON CAPACITY, H-20 LOADING DESIGN FLOW PROVIDED: 0.74 GPD/SF(482.8 SF) = 357.3 GPD, CHAMBERS Engineering by: SCALE DRAWN JOB NO. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. N.T.S. P.T.M. 243-13 12 West Crossfield Road, Forestdole, MA 026" DATE CHECKED SHEET NO. 243 SANDALWOOD DRIVE COTUIT MA (508) 477-5313 10/16/13 P.T.M. 2 of 2 'Prepared for: Benjamin Lim, 119 Green Pond Rd, East Falmouth, MA 02536