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0640 SANTUIT ROAD - Health
640 Santui#Road A = 006 - 029 Cotuit 1 TOWN OF BARNSTABLE L`JCATION SIyO_ra �� Po14e,/ SEWAGE# 20/�/ y3 VILLAGE�p r6l T ASSESSOR'S MAP&PARCEL(�� INSTALLER'S NAME&PHONE NO.�/JS"�/�OP9�3 �� ���,�yp0- SEPTIC TANK CAPACITY /�00 LEACHING FACILITY: (type) �,�j_ f /_�/"s' (size) 2.S_x 1 NO.OF BEDROOMS OWNER X2 el PERMIT DATE: COMPLIANCE DATE: 1f —/7 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 eachin l facility) Feet FURNISHED BY ��— /I z 3? s A3 -------------- i r TOWNYO/F�FsARNSTABLE LOCATION �/0 s h d T d 1 =x� '-r:.r SEWAGE# VILLAGE roriit " ASSESSOR'S MAP & LOT 0aG r 04 f INSTALLER'S NAME&PHONE NO. 97!7- o3.44 Jas eiR6 7, agrrgs SEPTIC TANK CAPACITY `. 04�(On1. LEACHING FACILITY: (type)2�So1J NO.OF BEDROOMS 3 //�� BUILDEROR OWNER /�vpoW 1`!S /&,W s PERMUDATE: l— 17'27 COMPLIANCE DATE: Separation.Distance Between the: . Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility)., " Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leac 'ng facility) Feet Furnished by 4r , IA ix IN L�, No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS applijc4ien for Disposal 6pstem Construction J)rrmIt Application for a Permit to Construct( e a' pgrade Abandon( ) ❑Complete System El Individual Components Location Address or Lot No.w/ Kowa Owner's Name, dress,and Tel.No. �ro�/�4rr�y�,- Assessor's Map/Parcel00� —d,� �otv! Is r! /- Installer's Dame,Address,and Tel.No. Designer's Name, ddress,and Tel.No;�oB—3�d— E ,cYpNC- �i -. V,q a' Type of Building: Dwelling No.of Bedrooms ,� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow(min.required) _ gpd Design flow provided ® gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank = Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) d l<7 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 b is Board of Health. n d Date Application Approved by Date Application Disapproved b 41 Date for the following reasons A on Permit No.If, Date Issued No. ' / Fee THE COMMO-hONEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitatlon for ]Disposal *pstem Construction Permit Application for a Permit to Construct ft pgrade�Aband-on( ) ElComplete System ❑Individual Components Location Address or Lot No,,/�Q� /Qom Owner's Name,Address,an�el.No. Cotal T is olllns^r .Ti Assessor's Map/Parcel0O� -a,,-V c7 In taller's Name,Address,and Tel,NoSUt//20-975 3 Designer's Name,,Address,and Tel.No SlCG4�1 �Tl!!2�'a` .�sfo�s !�/� �/s !=, �•�r�✓wrc� ors�r Type of Building: f w Dwelling No.of.Bedrooms, 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( i Other Fixtures ,__ Design Flow(min.required) N gpd Design flow provided ® gpd Plan Date Number of sheets , Revision Date ' Title ' z Size of Septic Tank Type of S.A.S. Description of Soil Y Nature of Repairs or Alterations(Answer when applicable) Sy��y Date last inspected: i 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 byAls Board of Health. bn C-) Date Application Approved by ft Date ✓ ,_ ` Application Disapproved b F`Date for the following reasons s� Permit No. Date Issued _F___________•________________________________________________________._______________________ _______---------______.__.________________ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance .1k THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(4�i) Upgraded( �" Abandoned( )by , y ©,S� 'J� � l�fl��'U at ,�`/0 '�r d ! CO T//l, has been con a with the provisions of Title 5 and the for Disposal System Construction Permit No an Installer JOS RdXe"-U S Designer yx_:Y J_ #bedrooms _ Approved design flow 3S 6 gpd The issuance of this permit shall not be const wed as a guarantee that the syste will func o igned. Date 7 Inspecto�rl_ -----------`------------- ---'---- --- -----------------------------=----------------------------------------------------- No. f - Fee / THE COMMONWEALTH OF MASSACHUSETTS PDX() uj PUWC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS PO 1C,• (�- misposal *pstem Construction Permit ermission is hereby granted to Construct( ) Repair(v) Upgrade( y- andon( ) System located at 5'O l�IrJ C/j T 10,/4W 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:Cons tion us a completed within three years of the date of this permit. Date Approved by Town of Barnstable Regulatory Services Richard V. Scali, Interim Director. &UMSTABLE ' 9 MASS. Public Health Division` '��Nu►+° Thomas McKean,Director , 200 Main Street,Hyannis,MA 02601 r Office: 508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: 14 0 Sewage Permit# - Assessor's Map\Parcel d� Designer: T Installer: s ;�S���j � i9/���S Address: �b Address: �� �. / / On �/lJSG�� �151YI;,I"DS was issued a permit to install a (date) // (installer) septic system at l� � ��� based on a design drawn by (address). dated / P (designer) �C tr��, I certify that�e tics stem.referenced above was installed substantial) according to fY p Y Y g the design, which may include minor approved changes such as lateral relocation of the distribution box and/or' septic tank. Strip out (if required) was inspected and the soils were found satisfactory. . I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component - of the'septic system) but in accordance with State & Local Regulations.. Plan�revision or certified as-built by designer to follow. Strip out (iflrequired)was inspected and the soils were found satisfactory. I certify that the system referenced above was construct e with the terms of the 1\A approval letters(if applicable) M. nstaller's Signature) °` 99 frr, W. Designer's Signature) (Affix Designer amp,Here) PLEASE RETURN TO B STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-1.3.doc - Town of B --nstable. P# Department oiRelgttl-story Services .�� y�' • � II q Public Healh Division Date S l D � .- ts� tee$ 200 Main Stieet.Hyannis MA 02�601Al ` �. - L �. r Fee Pd. J 0 sw G ' Date Scheduleda i Tttne _- e Disposar r1q ► o1'S ztab essr e il' Asst, Y Se '.� Performed SyyV` l e'er �-''` 'Witnissed AV- . LOCATION&GENERAL INFORMATION Location Address �t ' "Fal r `+u/ owners Name ',E-n T /' t { •A,�^ ' Address` 7(���ne� Assessor's Map/P�rcel: 'G� .�'rV Engineer's Name VvreyQ„r a�• �f/✓li 'NY4 v ry NBW CONSTR ! Teleptoae0 3311 y Land Use - Slopes(%) d Surface Stories • 'T , . y . ft Drinking Watery I , Distances from: t)pen Water Body _tt 'Possible Wet Area i g Drainage Way > f U y_ft` Property Lin' ft Other ft - — ', a v r '- •i + i�... '• - .� ,-.. . i '. ,� v SKETCH:($trees name,dimcnsiods%f lot,exact locations of test holes&perd tests,locate wetlands in proximity to holes)' , 3 i y . .. c�V I Depth to e ^ _.._r k ` Parent material(geglogic) — I Bedrock , Depth to Groundwakdr: Standing Water in HoI Weeping from Pit Pace Estimated Seasonal High Groundwater i. D T ,RMIN TION FOR SEASONAL HIGH WATER TABLE Method Used: y Depth C1bperved stendingiin obs.hole: In. Depth to Sol]Mottles: in. Depth,toiweeping from side of obs.hole: I in, (ji;undwatet Adjustment f< - ' ' � A !factor..._-� Adj.Groundwater Level..,._, Index Well#, Reading Date: index Well level • PERCOLATION Taff : .note 't'l Observation I 71Me at 9" ` Hole# Depth of Pere 'Time at O ) Start Pre-soak Time.@ t Tim "-G' - ` End Pre-soak Rate MinAnch F ' i Additional Testing Needed(YIN) Site Suitability ASSO-smenC Site Passed ,_ Site Failed: ` Ongiaah.Public He4ith Division Observation Hole DataTo Be Completed on Back **If percolatipntestis to be conducted within 100' of wetland,you must first;notify the Barnstable C40servation Division at least one(1)wedk prior to beginning. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil ther .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsistenc %Gravel 2' 7/ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling, (Structure.Stones,Boulders. ns's enc %G OIL if, �1 t� Ito u1i . z- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil they Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. n isten Flood Insurance Rate Maw Above 500 year flood boundary No----'- Yes X_ Within 500 year boundary No� Yes Within 100 year flood boundary No- Yes } Depth of Naturally Occurrine Pervious Material . Does at least four feet of.naturally occurring p v' Iterial exist.in all-areas-observed throughout the area proposed for the soil absorption system. If not,what is the depth of naturally occurring pe vi6us material? Certification I certify that on V (date)I have passed th soil evaluator examination approved by the Department of Envir n ntal rotection and that the a ove analysis was performed by me consistent with the requir tra g expertise d exp 'ence describe in 310 CMR 15.01 . Signature Date Q.\SEFTICIPERCFORM.DOC Z 203 498 866 US Postal Service Receipt for Certified Mail No insurance Coverage Provided. Do not usejW International Mail See revers Sent to St ber Po te,&AF Code � Postage Certified Fee Special Delivery Fee Restricted Delivery Fee LO Return Receipt Showing to Whom&Date Delivered a Return Receipt Showing to Whom, Q Date,&Addressee's Address 0000 TOTAL Postage&Fees $ r th Postmark or Date € /0%d= �7 L rn a Stick postage stamps to article to cover First-Class postage,certified mail fee,and charges for any selected optional services(See front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached, and present the article at a post office service window or hand it to your rural carrier(no extra charge). ai 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the Q) return address of the article,date,detach,and retain the receipt,and mail the article. 3. If you want a return receipt,write the certified mail number and your name and address 0) on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article a RETURN RECEIPT REQUESTED adjacent to the number. Q d 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee,endorse RESTRICTED DELIVERY on the front of the article. M 5. Enter fees for the services requested in the appropriate spaces on the front of this E receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811.1 ri I 6. Save this receipt and present it if you make an inquiry, 102595-97-B-0145 a i Tow_n of Barnstable • Department of Health, Safety, and Environmental Services BAMSTAMom. Public Health Division i63q. � ,�rFD A 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health October 1, 1997 Donald Erwin 640 Santuit Road . Cotuit, MA 02635 ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at 640 Santuit Road, Cotuit was inspected on September 23, 1997 by John Graci, a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • The leaching pit was full of wastewater effluent and solids, above the effective depth level for leading. You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within (60) sixty days of receipt of this notice. You are also directed to bring the septic system into compliance within ninety (90) days of receipt of this order letter by installing a replacement leaching facility. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. Za RDER OF THE OARD OF HEALTH s A. McKean, R.S., C.H.O. Agent of the Board of Health qV-1tMr,1au,t1u,.&, •.�I"E Town of Barnstable • Department of Health, Safety, and Environmental Services • BARNSTABM r MA9s. Public Health Division i63� ArF°�A 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health TO: ZkA I�tOIn 0 DATE: 3�, 7 -m-fv, ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at CP�lD -�+vJ ��, 6�0-was inspected on 23r V) by Gear, , a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within (44)-€ouft n days of receipt of this notice. (�J ' `'WJ You are also directed to bring the septic system into compliance within t�hifty-(M days of receipt of this order letter. 1(2(�kC(n _) cf, , You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health gWalthWb t1altitle5i.doc l Conunonvwealth of Massachusetts Executive Office of Envirolunental Affairs ' Dept. of Environmental Protection ,�olu1 Grad One winter Street, Boston,Ma. 02108 D.E.P. Title V Septic Inspector P.O. Box 2119 Teaticket,MA 02536 WILLIAM F.WELD Governor ARGEO PAUL CELLUCCI Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ORT A ScFp CERTIFICATION �O 9 Toly�'OF 199? Property Address: 640 Sentuit Rd. Cotuit Address of Owner: /ygq(9qq, a� Date of Inspection:9/22197 (If different) �EAl'�(f Name of Inspector:John Graci Donald Erwin I am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000) C' Company Name,Address and Telephone Number: 9 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: Passes This inspection is based on criteria defined in Title V ConXubmit ly P sses code 310 CMR 15.303.My findings are of how the system is _ Neeh Evaluation B the Local Approving Authority performing at the time ofthe inspection.My inspection does Y PP 9 tY not Imply any warranty or guarantee of the longevity of the X Fell septic system and any of its components useful life. Inspector's Signature: Q/ Date: 9/23197 The System Inspector shalla copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. 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 the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B.C, or D: A] SYSTEM PASSES: _ I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below.- COMMENTS: B] SYSTEM CONDITIONALLY PASSES: _One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair, passes inspection. Indicate yes,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 conforming septic tank as approved by the Board of Health. (revised 04127197) One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500 r` ♦ 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 640 Santuit Rd. Cotuit Owner: Donald Ervin Date of Inspection:9122197 — Sew.aae backup or.breakout.or hiah.static water level obser.ved.in.the distribution box is due to a broken. or obstructed pipe(s)or due to broken, settled or uneven distribution box.The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled 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 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 the public health,.safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES 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 a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: — The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. — The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupply well. — The system has a septic tank and soil absorption system and 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 than 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 presense of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid) . 3)Other D] SYSTEM FAILS: You must Indicate either"Yes"or"No"as to each of the following: x I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No _X__ Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged cesspool. x_ SAS is in hydraulic failure. (revised 04/27/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 640 Santuit Rd. CotuR Owner: Donald Erwin Date of Inspection:922/97 D] SYSTEM FAILS(continued) Yes No x Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. x Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped X Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. —X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. . _X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. 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] LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria: The 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 X the system is within 400 feet of a surface drinking water supply x the system is within 200 feet of a tributary to a surface drinking water supply _ X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further Information. (revised 04127/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 640 Santud Rd. Cotuit Owner: Donald Erwin Date of Inspection:9n2/97 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: _ Pumping information was requested of the owner,occupant, and Board of Health. X None of the system components have been pumped for at least two weeks and the 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. _ x As built plans have been obtained and examined. Note if they are not available with N/A. X _ The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout._ X All system components,excluding the Soil Absorption System,have been located on the site. X 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. X The size and location of the Soil Absorption System on the site has been determined based on The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal Systens. x Existing information. Ex. Plan at B.O.H' Determined in the field(if any failure criteria related to Part C is at issue,approximation of distance.is X — unacceptable)[15.302(3)(b)J (revised 0407/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 640 Santuit Rd. Cotud Owner: Donald Erwin Date of Inspection:9/2W7 s , FLOW CONDITIONS RESIDENTIAL: Design flow: 220 g•p d./bedroom for S.A.S. Number of bedrooms: 2 Number of current residents: 0 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings,if available:(last two(2)year usage(gpd): n!a Sump Pump(yes or no): No Last date of occupancy: 2 months ago COMMERCIAL/INDUSTRIAL: Type of establishment: n!a Design flow:0 gallons/day Grease trap present:(yes or no) No Industrial Waste Holding Tank present: (yes or no) No Non-sanitary waste discharged to the Title 5 system: (yes or no) No Water meter readings, if available: n/a Last gate of occupancy: n<a OTHER: (Describe) n1a Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System has not been pumped in the lest year. System pumped as part of inspection: (yes or no)No If yes,volume pumped: 0 gallons Reason for pumping: n/a TYPE OF SYSTEM x Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) ( if yes, attach previous inspection records,if any) I/A Technology etc. Copy of up to date contract? Other. APPROXIMATE AGE of all components,date installed(if known)and source information: Approximately 10+years - Sewage odors detected when arriving at the site: (yes or no) No (revised 04127/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 640 Santuit Rd. Cotuit Owner: Donald Erwin Date of Inspection:922/97 SEPTIC TANK: X (locate on site plan) Depth below grade: 16' Material of construction:X concreate metal FRP Polyethylene_other(explain) If tank is metal, list age o . Is age confirmed_by Certificate of Compliance No (Yes/No) Dimensions: L 8'6'H 5'7'W 4'10' Sludge depth:5" Distance from top of sludge to bottom of outlet tee or baffle: 22" Scum thickness:7" Distance from top of scum to top of outlet tee or baffle:6" Distance form bottom of scum to bottom of outlet tee or baffle: 11" How dimensions were determined: Measured 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.) Septic tank and all components are structurally sound.Recommend pumping septic system every two years for maintenance. GREASE TRAP:_ (locate on site plan) Depth below grade: n/a Material of construction: _concrete_metal_FRP_Polyethylene—other(explain) Dimensions: n/a Scum thickness:n/a Distance from top of scum to top of outlet tee or baffle:n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping,ia 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.) n/a BUILDING SEWER: (Locate on site plan) Depth below grade: 2' Material of construction: cast iron X 40 PVC_other(explain) Distance from private water supply well or suction lin0o- Diameter: 4• in/amments:(conditions of joints,venting, evidence of leakage,etc.) (revised 0427/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ` Property Address: 640,santuitRd. Cotuit Owner: Donald Envin i Date of Inspection:922/97 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: n/a Material of construction:—concrete—metal FRP_Polyethylene_other(explain) Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallons/day Alarm level:—n/a Alarm in working order?_Yes_No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc:) rJa DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: n/a Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box etc.) n/a r PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no)No Alarms in working order(yes or no)_Yes Comments: (note condition of pump chamber,condition of pumps and appurtenances, etc.) n/a a i (revised 0427/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 640 Santuit Rd. Cotuit Owner: Donald Erwin Date of Inspection:9122/97 SOIL ABSORPTION SYSTEM (SAS):X (locate on site plan,if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Na Type: leaching pits,number: 1,000 gallon leach pit leaching chambers,number:n/a leaching galleries. number: n/a leaching trenches,number, length: We leaching fields, number, dimensions:n/a overflow cesspool,number:Na Alternate system: n/a Name of Technology:_n/a Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) The leach pit is past the effective depth of leaching.The sas is in hydraulic failure.Pit was full.Solids were in the pit. CESSPOOLS:_ (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection) Na r Comments:(note condition of soil, signs of hydraulic failure. level of ponding, condition of vegetation, etc.) Na PRIVY:_ (locate on site plan) Materials of construction: Na Dimensions: n/a Depth of solids: Na Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Na (revised 04/27/97) ..SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C .. SYSTEM INFORMATION(continued) F .. 640 Santuit Rd. Cotuit Donald Erwin 922/97 ETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references, landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) f �o I� $ Ib yb , F 104/27l97) Page of 10 .0 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 640 Santuit Rd. Cotuit Donald Erwin 9122/97 Depth of groundwater 12+ Please indicate all the methods used to determine High Groundwater Elevation.- Obtained from design plans on record. Observation of Site(Abutting property, observation hole, basement sump etc.) r. Determine it from local conditions Check with local Board of Health Check FEMA Maps Check pumping records Check local excavators, installers x Use USGS Data Describe in your own words how you established the High Groundwater Elevation.(MUST be completed) USGS Maps and Charts c - (revised 04127/97.) lay 10 of 10 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Print your name, address, and ZIP Code in this box• Public Health Division sown of Barnstable P.O.Box 534 Hyannis,Massachusetts 0260; IIIIIIfJIIIIIIIIlr its Irll1:1111 dill1.111'1 oil IL11 If if fill 11111 d SENDER: p ■Complete items 1 and/or 2 for additional services. I also 7$h to recelve ti 0 ■Complete items 3,4a,and 4b. followi gser,)nces,(for,an ty ■Print your name and address on the reverse of this form so that we can return this " a extra fee): / card to you. ■mama i this form to the front of the mailpieoe,or on the bads if space does not 1. ®`Addressee's Address Z ■Write'Retum Receipt Requested'on the mailpieoe below the article number. 2. ❑ Restricted Delivery N ■The Return Receipt will show to whom the article was delivered and the date .. C delivered. Consult postmaster for fee. ° 3.Arti Addressed to: 4a.Article Number g �V'e��'� � Op c E 4b.Service Type c°� ❑ Registered g1 Certified rn !� ❑ Expr Mai ❑ Insured WIx ❑ Re ��r a se ❑ COD 7.Da , i elive z �t } 5.Received By:(Print Name) 8.Add fi'see' res (Only if requested c W and p idL- ° 6.Sign ure:( ddresse ° =! -- rn PS Form 3811, December 1994 102595-97-13-0179 Domestic Return Receipt No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: v Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zippricatton for �Digogar *pgtem Con6truction Permit Application for a Permit to Construct(Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 6,Z/O Rd Owner's Name,Address and Tel.No. y2 6�' 5-97S Corvi i Assessor's Map/Parcel L Gar ,T Installer's Name,Address,and Tel.No. 4,117— 03 t/q Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) iX/.1r,(11fi <.= �/iu�o /i�iah s h� T,a.�ns6/ 2 - �rof� G Aa L,�,��4, �Z �,1/.:� avZ rl, `_7",Za..,: 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 Certifi- cate of Compliance has been issued by this Board of Health. Signed - Date /7-9'7 Application Approved b '"� > Date /--f 7- E7 Application Disapproved for the following reasons Permit No. Date Issued r 06 No. � . � � �Fee f.- Entered in computer: THE COMMONWEALTH'OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplic t on for Migogaf 6potem Construction Permit Application for a Permit to Construct(f..�"Repair( )Upgrade( )Abandon( ) 0 Complete System ❑Individual Components Location Address or Lot No, Owner's Name,Address and Tel.No. 'f2 9'" 87 ,(-a T Assessor's Map/Parcel 0416 d 2 4v H u -,E.C/ a fvi T Installer's Name,Address,and Tel.No. �✓'1`l" O'3 S`9 Designer's Name,Address and Tel.No. J,9,s,e V4 8/ � Type of Building: r- Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil - :y Nature of Repairs orA)terations(Answer when applicable) F;/� 1'.l1,577"rZ Lr-_X0e- IAOa A/r W., r1 odat &_ rdti Date last inspected: Agreement: The undersigr_ed 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 Certifi- cate of Compliance has been issued by this Board of Health. Signed - Date //— /7 -97 Application Approved by -= Date //-/7- f'7 Application Disapproved for the following reasons Permit No. — Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( y'2epaired ( ) Upgraded Abandoned( )by 0,, /.3 4P1,-a at yo 5,tO-d6lrylvi A has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.97, "__-7 dated 202"- Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date _ C► __ 7 Inspector —� // No. big 3 -------------------------- —Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lid opal 6potem Construction Permit Permission is hereby granted to Construct( ,epair( ) pgrade( )Abandon( ) System located at G 410 .SNHwrvl'r and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty,--to comply with Title 5 and the-following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this t. Date: Approved 41::�v M 10/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH /aND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) I, ✓ � ! /�� /3,�w,,,a , hereby certify that the application for disposal works construction permit signed by me dated 11._ /7—?7 , concerning the . property located at L q4 meets all of the following criteria; There are no wetlands located within 100 feet of the proposed leaching facility 6-IThere are no private wells within 150 feet of the proposed septic system mere is no increase in flow and/or change in use proposed There are no variances requested or needed. • If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will net be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) B)Observed Groundwater Table Elevation(according to Health Division well map) . 1 SIGNED: DATE: !/—,! — s LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER _y [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. q:health folder:cert is • � Fxrsr�hy L,f? Apo G,vl s A d TOWN OF BARNSTABLE LOCATION 1, D S r� r SEWAGE # 97-Gl 3 :�., VELLAGE La r&L ASSESSOR'S/MAP& LOT d e e INSTALLER'S NAME&PHONE NO._Y21= 03 y9 Ios L'boy �„ r?dHr� c SEPTIC TANK CAPACITY LEACHING FACII.TTY: (type) "jvo " NO;.OF BEDROOMS �? i I. BUILDER OR OWNER ! N �•y PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maumum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge..:.of Wetland and Leaching Facility(If any wetlands exist 'within 300 feet of leac ng facility) Feet ! Furiushed by J1 O LOT 76 �� LEGEND COTUIT P AREA = 46200 sf+— I O PROPOSED CONTOUR 1 �G PLAN eocr 1 9 PAGE 1 43 + ® PROPOSED SROT GFEADE � ASSR MAP 6 PCL 29 ��Q` �O LOCUS —— 98 —— EXISTING CONTOUR �p� P h ' + 96.52 EXISTING SPOT GRADE I 0 Sp 34 a W EXISTING WATER SERVICE ry�A TEST PIT L19� 3 SCALE: 1"=30' �� ir Z < � O-p e' N \ ' , ' �y} 32 � / 30 G Q �+ LOCUS MAP -28. f LOCUS INFORMATION PLAN REF: 019/143 TITLE REF: 29083/100 PARCEL ID: MAP 006 PAR.. 029 ZONING: "RF" FLOOD ZONE: "X" COMMUNITY PANEL: 25001C0752J DATED:07/16/14 m 34 � /�� �/ //' � �24 4; � SEPTIC SYSTEM 82 RE-PAIR PLAN LOCATED AT: C 640 SANTUIT ROAD. ' P COTUIT, MA EXISTING LEACHING � PREPARED FOR TP y LEONARD PETIT i o EXIST. 1,000G SEPTIC TANK 11 JULY 17, 2017 11 in - sz o Z-z .\ \ r � OF I + 1 WATER LItJ[ 1 G 24 - - si _1 ii, v i 11 'QNITA?0 Y m I PAVED DRIVEWA 26 I • �8 MEYER & SONS, INC. 1 P.O. BOX 981 EAST SANDWICH, M'. 02537 3O ' BENCH MARK PH: (508)360-3311 } * FAX: (774)413--9468 ' PAINT SPOT ON meyerandsonstitle5�gmail:com PATIO CORNER �. 24.64 BARNSTABLE CIS DATUM SHEET 1 .OF 2 J 1930 ELEV. TOP FOUNDATION NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS 8RING ALL COVERS TO WITHIN 3" OF FINISH GRADE (Existing) FINISHED GRADE (25.0) 30.76 F G.EL: 27.0 F.G.EL: 26.65 F.G. EL: 25.0 VENT a MAINTAIN 2% MIN SLOPE OVER LEACHING AREA EL: 25.49 2" OF 3/8" DOUBLE WASHED STONE OR FILTER FABRIC 3/4" - -1/2" DOUBLE WASHED STONE :a 6„ 4" SCH 40 PVC 1o"I MIN. ®®®® p ®®®® 14 e © S= 1% ®®®®®®®®®®® ' TEE'S ARE TO BE INV.23.00 ( ' ) ®®®®®®®®®®® 4" SCH 40 PVC 2 EFF. DEPTH ®®®®®®®®®®® INV.24.15 1 INV.22.80 ' 2 X 8.5' 4' GAS PROPOSED DB-3 4 EXISTING OUTLET BAFFLE _ DISTRIBUTION BOX EFFECTIVE LENGTH 25' INV. 24.40 (H20) INV. ELEV.= 22.50 EXISTING 1 ,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON �� OF MAss9 BREAKOUT OUTLET TEE AS MANUFACTURED BY TUF-TITE, ZABEL, .OR EQUAL ? D R E TOP CONC. ELEV.= 23.50 ELEV.= 23.50 NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING 1140 "' INV. ELEV.= 22.50 VMVM=IME3 ®®® PIPE INVERTS PRIOR TO CONSTRUCTION a ®®®®®®® 2) D-BOX SHALL BE SET LEVEL AND TRUE TO fit;/ ®®®®®®® GRADE ON A MECHANICALLY COMPACTED SIX' NITAR��'� l BOTTOM EL.= 20.50 NwE3E3E3E3IE3IE3E33M INCH CRUSHED`STONE BASE, AS SPECIFIED IN 3.75 5 FT. 3.15' 310 CMR 15.221(2) 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK l 1� SEPARATION '7.61_ FT. EFFECTIVE WIDTH = 12.5' WITH 1500 GALLON ,SEPTIC. TANK IF FAILED, DAMAGED, NOT H2O LOADING,'OR UNDERSIZED. SEPTIC SYSTEM PROFILE' soli ABSORPTION SYSTEM SECTION) 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL: ' 12.89 _ ( GAS BAFFLE AS REQUIRED (500 GALLON LEACH CHAMBER) GENERAL NOTES: ` w SOIL LOGS P#:15358 _ DESIGN CRITERIA 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL NUMBER OF BEDROOMS: 3 BEDROOOM DESIGN BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: MAY 18, 2017 SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) OF THE STATE ENVIRONMENTAL,CODE, TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN/IN LOCAL RULES AND REGULATIONS. SOIL EVALUATOR: DARREN MEYER, R.S., 'CSE #1614 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR WITNESS: DON DESMARAIS, BARNSTABLE HEALTH DAILY FLOW: 110 G.P.D. X 3 BR = DESIGN FLOW: 330 G.P.D. TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE GARBAGE GRINDER: NO (not designed for gorboge grinder) DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING SEPTIC TANK: FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN Elev. TP-1 Depth Elev. TP-2 Depth 330 gpd x 200% = 660 gpd, USE EXISTING 1,000 GAL. SEPTIC TANK ENGINEER BEFORE CONSTRUCTION CONTINUES. 25.09 0" 2.3.89 0" _ 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. FILL FILL LEACHING AREA REQUIRED: (330) = 445.94 S.F. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 24.09 12" 22,89 12" .74 i1 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF A LOAMY SAND A LOAMY SAND HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. tOYR 4/1 . 1OYR 4/.l USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS W/ 4 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 23.51' 19" 22.31 }9" B LOAMY SAND B LOAMY SAND STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2°D 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 10YR 6/6 10YR 6/6 80TTOM AREA: 25 x 12.5= 312.5 SF ClTO A•CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 21.59 42' 20.39 42" 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE Cl SIDE AREA: 25 + 12.5 X 2 X 2 = 150 SF THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING LOAMY FINE LOAMY FINE ( ) CONSTRUCTION. SAND SAND TOTAL SQUARE FEET PROVIDED = 462 'vs. 445.94 REQ'D 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND'REMOVED PER TITLE 5. 10YR 6/6 10YR 6/6 REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5. PERC ® 19.09 C2 72" a 17.89 C2 72" MEDSD�SE MEDACOARSE DESIGN FLOW PROVIDED: 0.74(462 S.F.) 342.25 G.P.D. vs. 330"G.P.D. req'd 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION EL 18.7 AANN 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 2.6Y 7/3 { 2.5Y7/3 PROPOSED SEPTIC SYSTEM UPGRADE PLAN AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 14.09 132" 12.89 132" 13. NO PRIVATE WEDS WITHIN 150' OF PROPOSED LEACHING. <2MIIN/INCH IN •C2` SOILS 640 SANTUIT . ROAD, COTUIT, MA 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. NO GROUNDWATER OBSERVED Prepared for: Petit 15. ALL-PIPING-TO-BE-4--SCH-40-0-1-/8!/FT-(UNLE-SS-SPECIE[ED) Engineering and Survey by: SCALE DRAWN 16 REMOVE ALL UNSUITABLE SOILS 5 FT AROUND LEACHING TO� MEYER&SONS,INC. CN•T,ELEV. 19.09 OR TOP OF 'C2' LAYER AND REPLACE-WITH-CLEAN 1. Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 S• DMM L to conduct soil evaluations and that the above analysis has been perforiiied by Me consistent with the PO BOX98f MEDIUM SAND PER TITLE 5. DATE CHECKED. SHEET N0. requirements of 31U CMR 15.017. 1 further certify that I have passed the Sal Eval. Exam in October, 1999. EAST SANDWICH,MA fY1537 , `��-" 50"2-2922 07/17/17 DMM 2 of 2