Loading...
HomeMy WebLinkAbout1420 SANTUIT-NEWTOWN ROAD - Health -- -ti LOT 3 NEWTOWN RD., COTUIT A=025.011 TOWN OF BARNSTABLE %`' �S 11—°Z r LOCATI^,-N O SEWAGE # VILLAGE rD7il/ 7- ASSESSOR'S MAP & LOT-rrnp azrs INSTALLER'S NAME&PHONE NOrt��4y&-5 Al- 61041;V 77.5'-8f2Z SEPTIC TANK CAPACITY ISD y / LEACHING FACILITY: (type)�z*e, Cf4.4r-n,6��5 (size) -'tea d NO.OF BEDROOMS 113 BUILDER OR OWNER PERMIT DATE: ����f 98 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 leaching fa ility) Feet Furnished by R �O cr s a a V O Pivs q 57VgE AiU vWle TOWN OF B STABLE LOCATION l � SEWAGE # VII.LAGE_��y�`� ASSESSOR'S MAP & LO INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS �} BUILDER OR OWNER PERMITDATE: 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 leaching facility) Feet Furnished by LL 9 '' oq AA 333 liq � 56 J Q SC $1� ag cA . cB (off e cC ,j Commonwealth of Massachusetts' Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for.Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 317/14 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. A. General Information 1. Inspector. I� Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 City/Town State Zip Code 508.272.6433' Telephone Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes`'y' ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 3/7/14 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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under . the same or different conditions.of use. 1420 Santuit Newtown Rd•03108 Idle 5 Official Inspection F u .Sewage Disposal System• e 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 City/Town state Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E 1 always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Pumping suggested every 3 yrs to prolong the life of the system B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements.if"not determined,".please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as' approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally,sound,.not leaking,and if a Certificate of Compliance indicating that the tank is less than 20 years old is.available. ND Explain: n/a ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced ❑ obstruction is removed 1420 Santuit Newtown Rd•03108 Tide 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts 6 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ' 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cunt.): ❑ distribution box is leveled or replaced ND Explain: n/a ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ ,broken pipe(s)are replaced ❑ obstruction is removed ND Explain: , n/a C) Further Evaluation is Required by the Board of Health: 0 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is.failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ 'Cesspool or privy is within 50 feet of a bordering vegetated wetland'or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier,N any) determines that the system is functioning in a manner that protects the public health, safety and.environment: ❑ - ',The system has aseptic 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. El 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. 1420 Sentuit Newtown Rd•03/08 Tide 5 Official inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ya� 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 Cityrrown State Zip Code .Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (co,nt.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less.than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: n/a D) System Failure Criteria Applicable to All Systems: You must indicate`,`Yes"or"No"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters ® ,due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded ® or clogged SAS or cesspool ® Liquid depth in cesspool is less than 6".below invert or available volume is less than '/day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water`elevation. ® t: Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 1420 Santult Newtown Rd•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposed System-Page 4 of 15. Commonwealth of Massachusetts v W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M . 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 CityFown State Zip Code Date of Inspection' B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1,of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.'[This 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.] The system is a cesspool serving a facility with-a design flow of 2000gpd-" 10,000gpd. The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be " necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes. No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply El the system is located in a nitrogen sensitive area (Interim Wellhead Protection EJ' Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 1420 Santuit Newtown Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or,Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® 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? ED ❑ Were as built plans of the system obtained and examined?(if they were not, available note as N/A) Z ❑, Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs.of break out? ® ❑ -Were all system components, excluding the SAS, located on site? ® ` ❑ 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? ® 0 Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and,location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ 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)] 1420 Santuit Newtown Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design):.. 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No 9 Seasonal use?. ® Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ❑ Yes No Last date of occupancy: seasonal Date Commercial/industrial Flow Conditions: Type of Establishment: n/a 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 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): n/a 1420 Santuit Newtown Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 �. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1420 Santuit Newtown Rd - Property Address Colton Owners Name Cotuit MA 02635 3/7/14 City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: No history given Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ 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: 1998 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ® No 1420 Santuit Newtown Rd•03l08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): , Depth below grade: 3' feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): >10' Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage,etc.): Septic Tank(locate on site plan): 2'6., Depth below grade: . feet Material of construction: ® concrete ❑ metal, . ❑ fiberglass ❑ polyethylene ❑ other(explain) Covers raised to 6'`of grade If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No ------------ ----------------- -------------------------- Dimensions: 1500g Sludge depth: Distance_from top of sludge to bottom of outlet tee or baffle >1211 Scum thickness 1/2" >211 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle ,2, How were dimensions determined? Measured. . 1420 Santuit Newtown Rd•03108' Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1420 Santuit Newtown Rd . Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3 yrs to prolong.the life of the system Grease Trap(locate on site plan): Depth below grade: feet Material of construction: . ❑lconcrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): n/a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle ' i 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.): n/a Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ' ❑ concrete ❑metal ❑ fiberglass ❑ polyethylene ❑ other(explain): n/a 1420 Santuit Newtown Rd•03/08 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3M14 City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No. Date of last pumping: Date Comments(condition of alarm and float switches, etc.): n/a 'Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): 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.): D-box in very good condition, cover raised to 3"of grade Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes: ❑ No y Alarms in working order: ❑ Yes ❑ No 1420 Santuit Newtown Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a Soil Absorption System (SAS) (locate on site plan, excavation.not required): If SAS not located, explain why: Type ❑ leaching pits number: ® leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): : . Chambers were video inspected and are dry at this time,.no indication of past backup 1420 Santuit Newtown Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 Cityrrown State Zip Code Date of Inspection, D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No. Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): F Privy(locate on site plan):' Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): n/a 1420 Santuit Newtown Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 II Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3%7/14 City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties .to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. )A 1420 Santuit Newtown Rd-03/08 Title 5'Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 a , Commonwealth of Massachusetts Title 5 Official Inspection Formr Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1420 Santuit Newtown Rd Property Address Colton Owner's Name Cotuit MA 02635 3/7/14 - City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water k ❑ Check cellar Shallow wells Estimated depth to high ground water: >20' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date El 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: per elevation of home 1420 Santuit Newtown Rd•03/08 Title 5 Official Inspection Form'Subsurface Sewage Disposal System•Page 15 of 15 L No. 78'-3G ,1 THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH Yl OF Sri1-.1 APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (I's Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components Location ner's Name P�i►r OF 2.s- /// �y�® �}Sa�►.,,1 Maffar ,I#g Address V Lot# / Tcle Installer's N Design�N e ti Ff'C Q dGS /u /'4(D/e//y fit,N� Address Address 3 ao �3Ert✓s�s Gr/ �,� '3 L Telephone# Telephone# Type of Building: -'--e s tee-- Lot Size y7 �', Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) 3 3 gpd Calculated design flow 33 ,0gpd Design flow provided gpd Plan: Date Z Number of sheets L Revision Date Title 5/77,; / e k✓,l4-� O�<►�G o/ L--0r 3 Sy�S?��� .crF.,ii:�,�✓a.r ` , Description of Soil(s) t --- Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation J 7 } DESCRIPTION OF REPAIRS OR ALTERATIONS The under i ned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and fu r agrees not to place the sy min operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date -inspee —zS= FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 � 8 L s * i r V� n � R � TOWN OF BARNSTABLE LOCATION A/&W 41gV ?e,47:9( SEWAGE # VILLAGE CO ,I AqorN%2SS-oi/ ASSESSOR'S MAP & LOT;rrnp�etio_i�_r INSTALLER'S NAME&PHONE NOr✓ 01,63 At /77,0e ,-V 7775-MZZ SEPTIC TANK CAPACITY /SD LEACHING FACII.IT'Y: (type),!�ZA[Li C�A/�'1,G�•2S (size) a-SAD NO.OF BEDROOMS BUILDER OR OWNERS Srsf!'N PERMTTDATE: a�1 9�F COMPLIANCE DATE:��r� (?,_, 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 leaching faa ility) �� Feet Furnished by No. 9�'3�r THE COMMONWEALTH'OF-MASSACHUSETTS FEE I �» BOARD OF HEALTH t APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Peri it to Construct Repair ( ) Upgrade ( ) Abandon ( ) - Complete System ❑Individual Components t .3 ��kf✓To..�.•° 2'� Cf%i7t/� T ( ��` C ya�S � v.r-. � / . ' P hLocation �me Map/Par I# Address Lot# / Telc ones# �-- Installers jV i Designer's'N��ne Address / Address 3 A� '�E/'}✓`SEtS !mil/ N�v�C! G 2 - y1'`7 —7 Telephone# s— la Telephone# Type of Building: Lot Size f Sq.feet f Dwelling—No.of Bedrooms _3 Garbage Grinder ( ) w Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow min.required) 3310 • d Calculated design flow 3 d Design flow provided 3 d g ( q ) gP g gP g P --/ . Plan: Date /IV Number of sheets Revision Date Al 14 Title Ta, t •✓<14e- yL AW 7- 7 Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator /4. Date of Evaluation % - f' DESCRIPTION OF REPAIRS OR ALTERATIONS The under, ed agrees to'install the'above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and fu r agrees not to'place the sy min operation unril a Certificate of Compliance has been issued by the Board of Health. e .✓� Signed Date FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. O ' Y✓ THE COMMONWEALTH OF MASSACHUSETTS FEE ley'. �r Y` l�R.•�nSar��bl� BOARD OF HEALTH CERTIFICATE OF-COMPLIANCE Description of Work: ❑ Individual Component(s) XComplete System 4 t The undersigned hereby certify that the Sewage Disposal System;Constructed "� g y y g p y ( );Repaired( ),Upgraded( ),Abandoned( ) at ZO 3 has-been-installed.in-accordance with the provisions of 310 CMR 15.00 (Title 5)sand the approved'designplans/as-built plans relating to application No. dated �' 9� Approved Design Flow . (gpd) Installer Designer: Inspector l \ Date )` ?, �'�' The issuance of this certificate shall not be construed as,a guarant erhat the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 ' No. / "' THE COMMONWEALTH OF MASSACHUSETTS FEE Gw*'�"yJ ,�✓ BOARD OF H E A LT H DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at /-o v�-— 1,J /z/ Z c) � as described in the application for Disposal System Construction Permit No. 9d dated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met. -Date G�2 r/' Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 w i i TM FORM 1255 (REV 5/96) H&W HOBBS&WARREN PUBLISHERS- BOSTON 4i 4, COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION y J� TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 Owner's Name: SUE RUSSEL'L Owner's Address: 1420 NEWTOWN RD COTUIT,MA 02635 Date of Inspection: 4/2/01 RECEIVED Name of Inspector: (please print) JOHN GRACI { Company Name: SEPTIC INSPECTIONS ' Mailing Address: P.O. BOX 2119 TEATICKET,MA.02536 APR 17 2001 Telephone Number: 508-564-6813 FAX 508-564-7270 TOWN OF BARNSTABLE f ;r: HEALTH DEPT. CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is M1 f true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and a F experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: " Y X Passes" zyf� _ Conditionally Passes _.Needs Furt` valuation by the Local Approving Authority ' Fails r' Inspector's Signature: _ . Date: 4/2/01 . The system inspector shall submitA copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be �4 sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. # n • is j3 Notes and Comments VERY TWO YEARS TO THE SYSTEM PASSES TITLE V INPECTION. RECOMMEND PUMPING Sl STEM E r.�pA PROLONG THE SYSTEM'S USEFULL LIFE. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This 4 i. inspection does not address how the system will perform in the future under the same or different conditions of use, t A; f#y e !':.t ' r r /,/1 rl'i 111 ill Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A a CERTIFICATION (continued) t ' ' Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 Owner: SUE RUSSELL `' Date of Inspection: 4/2/01 Inspection Summary: Check A,B;C,D or E/ALWAYS complete all of Section D A. System Passes: _ X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 i CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. t t B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, i upon completion of the replacement or repair,as approved by the Board of Health,will-pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. .,t n/a The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced h .t 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. t' ND explain: n/a n/a Observation of sewage backup or break out or high static'water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of _• Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ; ND explain: n/a n 1 n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced ' r x'r.:i.f l ,c _obstruction is removed ' ' ND explain: n/a , ;` Page 3 of 11 ' { OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM >a E { PART A } CERTIFICATION(continued)' Property ert Address: 1420 NEWTOWN RD COTUIT, MA 02635 Owner: SUE RUSSELL Date of Inspection: 4/2/01 C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is ,A not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is wtthi'n 50 feet of a surface water _ Cesspool or privy is within?50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: i _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water t .f supply or tributary to a surface water supply. T _ The system has a septic tank and SAS and the SAS is within a Zone'1 of a public water supply. ry _ 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 4. supply well**.Method used to determine distance n/a ,3 ao . **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia t k§ nitrogen and nitrate nitrogeny,is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy r : of the analysis must be attached to this form.; 3. Other: n/a> Wk a Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A y CERTIFICATION(continued) j, Property Address: 1420 NEWT,OWN RD COTUIT,MA 02635 l x. Owner: SUE RUSSELL Date of Inspection: 4/2/01 D. System Failure Criteria applicable to all systems: ' You must indicate"yes"or"no','to each of the following for all-inspections: 14. Yes No X Backup of sewage into facility or stem component due to overloaded or clogged SAS or cesspool - P g tY Y P gg X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool k" X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ;h X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/s day flow X Required pumping more than 4 times in the last year NnT due to clogged or obstructed pipe(s).Number of times . pumped nLa. _ X Any portion of the SAS,cesspool or privy is below high ground water elevation. : X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. w= X X Any portion of a cesspool or privy is within a Zone 1 of a public well. = L X Any portion of a cesspool or privy is within 50 feet of a private water supply well. t } " X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP a certified laboratory,for coliform bacteria and volatile.organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be _ attached to this form:]' (Yes/No)The system faiLz have determined that one or more of the above failure criteria exist as described in 310 �$ CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure.:: t . t E. Large Systems: ,r To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. .«g You must indicate either yes or no to each of the following. .i (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply r� 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 < If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the largesstem has failed.The owner or operator of any large system considered 0 significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate ional office of the Department. regional n Page 5 of 11 .7,; a} OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 Owner: SUE RUSSELL a¢ Date of Inspection: 4/2/01 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: { Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? i X Have large volumes of water been introduced to the system recently or as part of this inspection? r r _ X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? aura, X _ Was the site inspected for signs of break out X _ Were all system components,excluding the SAS,located on site? X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? , X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance y of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no X Existing information. For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is Y unacceptable)[310 CMR 15.302(3)(b)] ' l ;t �t Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 Owner: SUE RUSSELL Date of Inspection: 4/2/01 FLOW CONDITIONS x . RESIDENTIAL y Number of bedrooms(design):3 = Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR`15:203 (for example: 110 gpd x#of bedrooms):330 Number of current residents:3f ' Does residence have a garbage grinder(yes or no): NO ' Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO , Water meter readings,if available(last 2 years usage(gpd)):n/a Sump pump(yes or no): NO x { ' Last date of occupancy: n/a r ' f s , COMMERCIALANDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd �. Basis of design flow(seats/persons/sqft,etc.): n/a Grease trap present(yes or no): NO iF Industrial waste holding tank present(yes or no): NO . y Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a s ,.GENERAL INFORMATION Pumping Records # Source of information: n/a �°',. Was system pumped as part of the inspection(yes or no): NO y If yes,volume pumped: n/agallons--;How was quantity pumped determined? n/a s , Reason for pumping: n/a b TYPE OF SYSTEM E y X Septic tank,distribution box,soil absorption system Single cesspool R _Overflow cesspool k _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 ,aaintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information, t 1998 PER OWNER 1 $C.. Were sewage odors detected when,arriving at the site(yes or no):NO P' .! ..- f _ . •. ,¢#y ! r. � ` ,� a r.. '. i�r�� Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 Owner: SUE RUSSELL Date of Inspection: 4/2/01 BUILDING SEWER(locate on site plan) Depth below grade:30" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade:24" T :. Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age,confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) ` s Dimensions: 1000 GALLON L 8' 6" H 5' 7" W 4"' "' t Sludge depth: I" Distance from top of sludge to bottom of outlet tee or baffle:33" »; Scum thickness: I" Distance from top of scum to top...,of outlet tee or baffle:6" ; Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.RECOMMEND MAINTAINING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. y GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene other(explain): n/a Dimensions: n/a t Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to;bottom of outlet tee or baffle: n/a Date of last pumping: n/a ; Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a ' h " - Al Z�i t Page 8 of 11 i. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACEf SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 Owner: SUE RUSSELL Date of Inspection: 4/2/01 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a I . Material of construction:_concrete_metal_fiberglass_polyethylene other(explain): n/a Dimensions:n/a Capacity: n/a gallons i3 # Design Flow: n/a gallons/day Alarm present(yes or no): N/A t Alarm level: N/A Alarm in working order(yes or no): NO : Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): STRUCTURALLY SOUND PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no):NO Alarms in working order(yes or no):NO _ Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):, n/a ?1s� 1 �F R Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 {' Owner: SUE RUSSELL Date of Inspection: 4/2/01 + �' r `,i• SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) ? ,. If SAS not located explain why:,, Y n/a Type f n/a leaching pits, number: Wei FLOW DIFFUSERS leaching chambers, number: 2 n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): ' THE LEACH FIELD APPEARS TO BE FUNCTIONING PROPERLY-THE SYSTEM SHOWS NO SIGNS OF FAILURE.BOTTOM AT T RECOMMEND RAISING COVER-5'DEEP CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) . ` 4 i Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a } Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no):NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 3' n/a Sri � ,t . Q I Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 ; Owner: SUE RUSSELL Date of Inspection: 4/2/01 ' SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. x Locate all wells within 100 feet.Locate where public water supply enters the building. ,r >;q j x. 0 AA BA Iby 1_ c � 8 0 a co �68 ` cc ,4 i n Page I l of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1420 NEWTOWN RD COTUIT,MA 02635 Owner: SUE RUSSELL Date of Inspection: 4/2/01 SITE EXAM _Slope _Surface water _Check cellar 1 Shallow wells Estimated depth to ground water 10+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-if checked,date of design plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) YES Accessed USGS database-explain: n/a y You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS- 10+FEET n ® . 7<1 lo- e D 5 Vie_ ti _ ACCESS COVER TO WITHIN 6" OF FIN, GRADE 2% SLOPE REQUIRED OVER SYSTEM T,O,F. AT EL. 65.0' ACCESS COVER (WATERTIGHT) TO TEST HOLE LOGS / WITHIN 6" OF FIN. GRADE 2 DOUBLE WASHED PEASTONE ,,, MINIMUM 7 I 64 6 3 5 N UM 5' OF COVER _VER PRECAST - RICHARD LEARNED __ _ _ ----f--- -� - ENGINEER: I RUN PIPE LEVEL � � / ''FOR FIRST 2' - I 61.5' WITNESS: J. DUNNING ? QOr► PROPOSED 11500 - � r DATE 4/17/97 � 62.0' __ - coIL� � � � oaa GALLON SEPTIC t_61 -�r I - l'' 7- _ 60,67' , CJ (� a C� C� C7 C� C� Cn a n slaEs , F' _>r('. RATE < MIN PER ,JVcH �- E�.75' TANK (H- 10 �►---- -�1� -- LC> SELL S POND F BAFFLE F'1.0 / $8 60.83' --- C� C� L o•�ov I g" - R g C7 l� a C� C� C7 a C7 a a 58,67' CL,aSS _ �_ SOILS Pik ,$9 Z "� Y L go -1- b •/ 6 CRUSHED STONE OR MECHANICAL � ` � / 5.0?' ^ d ( SLOPE) " 3/4" TO 1 1 /2" DOUBLE WASHED STONE y✓ DEPTH OF FLOW = 4' COMPACTION !15 221 [21) TH2 53.6 EDGE OF WETLANDS TEE SIZES: 1 sI_oPE) �� PLAN BOOK 532 PAGE Lz 7 t INLET DEPTH = 101, i \ 63 r ELEV. OUTLET DEPTH - __ _— � �' 66 '? LEACHING \` ' t FOUNDATION-- 13' -- SEPTIC TANK 37' - — D' BOX --- --- — �. A LOCATION MAP SCALE 1" - w?� FACIUT'r �• / LS 10YR 4 3 \ 12 / SEPTIC~ PROFILE � r �\ B ASSESSORS MAP 25 PARCEL 11 (NOT 10 aCALEI \ � ZONING DISTRICT: RF 50 \ \ LS YARD SETBACKS: 1#' 52 \ �'�\ 36" 10YR 5/6 63.6' FRONT = 30' 54 I 96'Cirr 40 SIDE = 15' 56 _ REAR = 15' } 1 ` 42 IVIS PLAN REF, BOOK 532 PAGE 63 2.5Y 7/4 FLOOD ZONE: C VERIFY ZONING REQUIREMENTS WITH TOWN \ OFFICIALS PRIOR TO CONSTRUCTION 1 -62 ELEV. �46 I iI —63 \ � � --- I PROP- -� A DWELL BENCHMARK - CTi OF CATCH 6, � A A TO 8„� 1 YP. 156" '3 6 NOTES: I E3ASii`J EL = n? 85 (ASSMD �,, 6; •'63_ � \ T F - 62 � •$ .6 �-•�Lq,ti,� g NO WATER ENCOUNTERED 65.0' S BARN. G.I.S ) 1 . DATUM IS ASSUMED 2. MUNICIPAL WATER IS AVAILABLE F' �0 10YP 5 iE 64 5' 3. MINIMUM PIPE PITCH TO BE 1/8" PER F001. � SILT FENCE BACKED B'> --�` 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 STAKED HAY BALES C 5. PIPE JOINTS TO BE MADE WATERTIGHT. (WORK LIMIT LINE) 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. "'6`�- MS ENVIRONMENTAL CODE TITLE V. 7, THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE 2.5Y 6/8 USED FOR LOT LINE STAKING. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. W 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT '66- '~ INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED ---_- FROM BOARD OF HEALTH. ✓Er` I 1 . CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE Q 0 LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR � o TO COMMENCEMENT OF WORK. ------67 ,�� �"�, iZ - NO WATER ENCOUNTERED 1 TEST SEPTIC DESIGN: (No DISPOSER ) 517E AND SEWAGE PLAN 68 --- / 3 110 330 1 / / HOLES; DESIGN FLOW: __ BEDROOMS ( GPD) = GPD OF USE A330 GPD DESIGN FLOW LOT- 3 SANTUIT NEWTOWN ROAD W SEPTIC TANK: 440 GPD (2 ) = 660 IN THE TOWN OF: / J �� USE A 1500 GALLON SEPTIC TANK (COTUIT) BARNSTABLE J LOT 3 �•�' LEAGHING� 25 + 1-.83) 2 (.74) el �ri S MORIN 112 PREPARED FOR: oo 47,605 s.f. \\ �. SIDES. �----- ry - / (1.09t ac� YO 25 x 12.83 (:74) = 237 LEGEND D BOTTOM: 30 0 30 60 90 TOTAL: 472 S.F. 349 GPD PROPOSED SPOT ELEVATION USE (2) 500 GAL. LEACHING CHAMBERS WITH 4' b ' ALL AROUND SCALE: - DATE: JUNE 24, 1998 } 100x0 EXISTING SPOT ELEVATION 1 10n0 PROPOSED CONTOUR a 5W-•362-4541 4 Fox 508 362-OW \ - - 100 - - EXISTING CONTOUR down cape engineering, inc. CIVIL ENGINEERS BOARD OF HEALTH LAND SURVEYORS r I MA Y CD APPROVED DATE >,. 939 main. st. yarmouth, ma 92675VA T-9 , 7 ,Y r a r ^ •7 a 'S r. �r .,ri.•.r.,:.c.. yw, iY' b . . ^ .. >r. . . J.�p+ a:.t .A': :% ...,Y..K,. ,.o:r.• ,.M..:.,a i°r �i , � ..- : .: c�.�r ... :,., ,.w a .:.� .,,. .L. :.., ,.f..- ..r < .,. H ,.. ... .,,, '°?:-; ..t' ,. cam' .. ;....� ;,..:. .... , �' .. ... ca �: .. ?k_... n ",,.�' _ .. .. ,; :. .,. ., Ye... +.. .1: „ n :,,. .. ✓ .,.... ...,.- Y...... ..:t. i. ,....A.. .. �. ... k... .+.,t, .e. A.w.r,... .. .., r ♦ .Y.N. ._