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0022 STUB TOE ROAD - Health
22 STUB COTUIT �I J TOWN OF BARNSTABLE LOCATION ;�a ST U.13 1 © C-. /q 17 SEWAGE#cP4J&- —)3 7 t' VILLAGE COT U 1 T ASSESSOR'S MAP&PARCEL ©LI0 INSTALLER'S NAME&PHONE NO. J1'_0 Ir�/ ' S S �- �� ►C SEPTIC TANK CAPACITY /D O 0 LEACHING FACILITY.(type) S"0 G C ha-Mbers(size) 13 2S NO.OF BEDROOMS 3 PERMIT DATE: COMPLIANCE COMPLIANCE DATE: /J I�l Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 30 1I .3 No. w e� Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitation for Mtspo8al *pstem Construction Permit Application for a Permit to Construct(e.)/Repair(�pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2 ,S'%(/'Z2 rar R<914a Owner's Name,Address,and Tel.No. Assessor's Map/Parcel ®y0— Coj'(//7 .S4� I taller's Name;Address,and Tel.NoSO,?—�,70—9735 Designer's N e,Address,and Tel.,No.S 85-36a 331/ Si �' ors ! 11Y /_=, �e%vic 024'37 " Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) a 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) x"/��j�/� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o!:2�:f Healt Si Date Application Approved by Date f5 A h Application Disapproved by Date for the following reasons Permit No.CWT ` 3 �� Date Issued 5 �. �.... .....�. e., ,.,..;.T,,,,_-. ,a, .-.•.--.r.SF�k.�r F...>„p,w�:;;�.r,.f3.14,...rny4w�s',,.r>.-..`s,�,,..^:ynr`,.••",vavN'Rr,.»'.f.,�,:s ..1.. .- YrK"'tr..-rrT'�,Y...ivs., ^ t � l�O No, �jJ r K -! 3 7 T Fee THE COMMONWEALTH OF MASSACHUSETTS Entered;ncomputer: Yes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS x ltlYlcatlon for IW4,po,SAY 6pstem Construction Permit Application for a Permit to Construct((.)-'Repair(�Up�d^e(') Abandon( ) ❑Complete System ❑Individual Components .s Location Address or Lot No. .5 ft/� !1/.; 4hB� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Q,yO J (f arelyr' Installer's Name,Address,and Tel.Nos-py- ,,20-917.3 8%. Designer's Name,Address,and Tel.No.jld O-116a-,3 11 f "c/u/ich Type-of Building: y Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided �� . gpd Plan Date ;Number of sheets Revision Date Title r Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs orAlteratioZ s(Answer when applicable) _r45ri4/1 T 101w 9 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the.Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt ""r�" Signed Date Application Approved by Dater"j J) Application Disapproved by Date for the following reasons Permit No. /T "" 3 Date Issued " THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(G•r- Upgraded( 4— Abandoned( )by Ve 0v"e-0.$ at 2 2.,S°Tvb f jp40 (/// has been constructed in accordance-, QQ- with the provisions o �0 f Title 5 and the for Disposal System Construction Permit No. 11-l dated 5'�g �[ U Installer j0,5 60 / /�-4�//9 j'/''lJ Designer /0/;V �' c= �Cw,35- /Ali:', #bedrooms Approved design flow , gpd The issuance of this permit shall of b )construed as a guarantee that the system w�function as desig;ed. Date L / ,/�f Inspector - = '- -- - - No. / '" /. 37 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Xkeiposal *pstem Construction permit Permission is hereby granted to Construct( ) Repair((i)" Upgrade(4, )'_ Abandon( ) System located at 2' _ rub ro ,//tVA'1_i L'�TuiTr and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be co pleted within three years of the date of this ermit. Date ? � � �"' Approved by � .. 05/11/2018 02:53PM 17744139468 MEYER AND SONS PAGE 01/01 Town. of Barnstable Regulatory Services z Richard V.Scali, Interim Director tinnt�reslr. Avg Public Health, Division Thomas McKean,Director „ 200 Main Street,Hyannis,MA 02601. Office: 508-862-4644 Fax: 508-790-6304 u Installer&Designer Certification Form Date:55 11 D Sewage Permit# Assessor's Map\Parcel o 113 Designer: mi�yR"f -� Sates Installer: �,ol/I C41 Address: d -1 0' Address: / On was issued a permit,to install a (date) (installer) septic system at U f7 G• 1 nn ,7() based on a desiga'drawn by (address) n f dated (e gi Vr�', , I certify that the s tic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) 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(if wired)was inspected and the soils were found satisfactory. I certify that the system referenced above was construct a ith the terms of the RA approval ledep(if applicable) Ita) er's Signature) No.. 114D (Designer's Signa e) (Affix Designer Here) } PLEASE RETURN TO STABLE PUBLIC HEALTH DIWSIO . CERTIFICATE OF COMPLIANCE M= NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- HEW C Y THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic0esigner Certification Form Rev 8-1413.doc Town of BL--nstable. P# Department of Regtilatory Services _ t • . -' Public wealth I2iVision mace Z ' .6Jy teeKAMM $ , 200 Main Street,Hy#nnis MA 02601 . /!,2 Date Scheduled �/ < Time Fee Pd:' ;c - c P oil Suitability AssegMi ii? foie"S' a'e Disposal t �- PN Performed By. t'` j 'Witnessed By LOCATION & GENERAL INFORMATION [Location Address'.'z� ST ut� '� ��\. Owner's Name B%0.0o Q 5 m �L, y n-rLd 1 I - MA *. " i Address 51Q1A/16� Assessor's Map/P4rcel: 4g6 ) `l3_ '- , I Engineer's Name Mey�4 JYY1 t ✓�C_ NEW CONS' REPAIR Telephone# 36 63311 /Land Use V \ � �" °` �✓ Slopes(4'0) — L Surface Distances from: Open Water Body >2—oD', Possible Wet Area ft Drinking Water Well ft Drainage Way / ft. Property Line �lO ft Other Y ft SKETCH:($treet name,dimensiousV lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) o S _ iLo . 1 • 1, c. r� �r1�El a th tO�BeJroek ` Parent material(gedlogic) CVt'U n Depth Depth to Groundwater. Standing Water in Hole:' Weeping from Pit Face . Estimated Seasonal I'M&Groundwater t - DtTERMIN TION FOR SEAS Oial,SIGN'WATER TALE , Method Used: Jn. Depth C bserved standing;in obs.hole: in. Depth to 5g11 mottles. Depth toiweeping from side of obs.hole in. Giundwater Adjustment fr.' ! _ A .Actor.�._r.� Ad,OrowdwaterLevel.,,.,e, Index Well# Reading Date: Index Well levCl --- dl _. a t PERCOLATION TEST Date..-.--a T4UL Observation Time At 9" Hole# U h _ Time at Depth of Pere -Time(9"-6") start Pre-soak Time.C� ------ End Pre-soak Rate MinAnch t ' Additional Testing Needed(Y/N) Site Suitability Assessment' Site Passed�� Site Failed;•_.— . Original:.Public 1141th Division Observation Hole Data TO Be Completed on Back-- ***If percola�i6n test is to be condiucted within 100' of wetland,you must first notify the Barnstable C4 servation Division at least one(1) week pl<xoi'to beginning. DEEP OBSERVAT ION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel 4 - ' DEEP OBSERVATION HOLE LOG - Hole# . Depth from Soil o' Horizon , Soil Texture Soil Color Soil Other • Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) L)�l—lit► J Q3 ICY4 3�°' U' l Elh 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 Other Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulders. C nsisten ra I Flood Insurance Rate May: Above 500iyear flood boundary No— Yes _ r Within 500 year boundary No Yes Within 100 year flood boundary No!' Yes Depth of Naturallv Occurring Pervious Material Does at least four feet of naturally occurring p v'ous aterial exist.in all areas observed throughout the area proposed for the soil absorption system? vj If not,what is the depth of naturally occurring p rvious material? Certification I certify that on 0 (date)I have passed the soil evaluator examination approved by the Department of Environ ntal Protection and that the above analysis was performed by me consistent with the required tr ' xpertise a d experience des ibed in 3,10 CUR 15.017. Signature Date Q:\.SEPTICV'ERCFORM.DOC Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 22 Stub Toe , Property Address , Meehan Owner's Name ' Barnstable MA ._ 02635 11/16/12 City/Town State Zip Code Date of Inspection 4 Inspection results must be submitted on this form. Inspection forms may.not be altered in any way. _ A. General Information y '' 1. Inspector: Frank Nunes III Name of Inspector } saa Company Name Box 841 f Company Address r tt East Falmouth MA _ .� 02536 Citylrown .State Zip Code 508.272.6433 r 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. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ti ❑ Needs Further Evaluation by the Local Approving Authorityµ , 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. 22 Stub Toe Rd.•03/08 Title W5al dion Fonn:Subsurface Sewage Disposal System•Page 1 of 15 r Commonwealth of Massachusetts _ Title 5 Official Inspection` Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 22 Stub Toe Property Address Meehan ` Owners Name Barnstable MA 02635 11/16/12 Cityrrown 7 State Zip Code Date of Inspection a B. Certification (cont.) Inspection Summary:.Check A,B,C,D4or E I 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: A - ❑ 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 20xyears 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. d *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 yearn 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 + 22 Stub Toe Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 y Commonwealth of Massachusetts Title 5 Official Inspection Form, ° Subsurface Sewage Disposal System Form-Not for Voluntary Assessments wM 22 Stub Toe Property Address f Meehan Owner's Name ., Barnstable MA 02635 11/16/12 CityrTown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.); ❑ 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: F n/a , 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 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 o'r 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: r ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. '❑ The system has a septic tank and SAS and the SAS is within a Zone'1 of a public water supply. ti^ w. ❑' The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 22 Stub Toe Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page-3 of 15 . t- Commonwealth of Massachusetts 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Stub Toe Y Property Address Meehan t, - Owner's Name Barnstable MA 02635 11/16/12 Cityrrown State Zip Code Date of Inspection;e B. Certification (cont.) A C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 PF **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: • . Y • n/a • .•�r e. ; , it • ' D) System Failure Criteria.Applicable to All Systems: You must indicate"Yes"or"No"to each`of the following for'all inspections: Yes No • ❑ ® x Backup of sewage,into facility or system component due to overloaded or clogged SAS or cesspool 0 ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El E. 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 tor available volume is less than '/Z 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. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. r' 22 Stub Toe Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 F Commonwealth of Massachusetts , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. M 22 Stub Toe Property Address , Meehan > Owner's Name s Barnstable MA, 02635 - 11/16/12 Cityrrown 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..) 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 necessarV 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. w 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 R ❑ ❑ the system is within 400 feet of a surface drinking water supply" ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection El', ❑ .,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 w regional office of the Department. 22 Stub Toe Rd.-03/08 y 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 M 22 Stub Toe Property Address Meehan Owner's Name Barnstable MA 02635 .11/16/12 Cityfrown 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: y Yes No ® ❑ + Pumping information was provided by the owner, occupant, or Board of Health ❑ E 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? u . El ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were.not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ 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? ® 11 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 . r 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)] 22 Stub Toe Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 1 Commonwealth of Massachusetts Title 5 Official Inspection Form : Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 22 Stub Toe Property Address i - Meehan '' •. , Owner's Name Barnstable MA 02635 11/16/12 Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions:' n/a • _ '` r 3 per owner Number of bedrooms(design): Number of bedrooms(actual): . DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x 4t of bedrooms): 330 Number of current residents: 0 { 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, Seasonal use? s ❑ Yes,® No Water meter readings, if available(last 2 yea'rs usage(gpd)): : } Sump pump? ❑ Yes ® No Last date of occupancy: July 2012 ` E Date Commercial/Industrial Flow Conditions: = P" Type of Establishment: { Na r� : 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? El Yes ❑ No Water meter readings, if,available: J .Last date of occupancy/use:,` Date r" 6 k Other(describe): n/a f 22 Stub Toe Rd.,03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 3 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form:-Not for Voluntary Assessments , 22 Stub Toe r 'M - Property Address Meehan Owner's Name R : Barnstable ,MA 02635 11/16/12 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) i General Information .. ; Pumping Records: Source of information: . Regular pumping per owner q Was system pumped as part of the inspection? ❑ Yes ® ' No If yes, volume pumped: � gallons � •' F How was quantity pumped determined? r 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) ' El 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. ` 1/18/85 per as built i Were sewage odors detected when arriving at the site? ❑ Yes ® No 22 Stub Toe Rd.•03108 Tide 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, M 22 Stub Toe '• Property Address Meehan Owner's Name Barnstable 'MA 02635 11/16/12 + City(rown State Zip Code Date of Inspection � a D. System Information (cont.) ' Building Sewer(locate on site plan): , Depth below grade: 2; _ 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):. Depth below grade: 18" ' feet Material of construction: ® concrete ❑ metai ❑ fiberglass ❑ polyethylene ; '❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ ' No ------------------------ ------------------------------------------.------------------------------------------------------ - -. 10009 Dimensions 1000g : _ . , a 2" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle ' >12 - Scum thickness. trace. 6 Distance from top of scum to top of outlet tee or baffle`,, t >2 t' >211 Distance from bottom of scu m to bottom of outlet tee or baffle How were dimensions determined? Measured 22 Stub Toe Rd.•03/08 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 k 22 Stub Toe . Property Address Meehan " A. Y� Owners Name Barnstable MA- 02635 11/16/12 Cityrrown _ State Zip Code Date of Inspection F , 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): ti Depth below grade: R r` feet Material of construction: , ❑ concrete.. ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): , n/a ` Dimensions: Scum thickness 1 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle , Date of last pumping: ` Date Comments(on pumping recommendations; inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.):' J R, 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(explai i): n/a 22 Stub Toe Rd.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 22 Stub Toe Property Address Meehan 4 Owner's Name Barnstable MA 02635 11/16/12 Citylrown .State Zip Code ' Date of,lnspection 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 r Level w/the bottom of the pipe a Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or.out of box,etc.): , D-Box 3' below grade and in average condition for its age 7 ` Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes 'ElNo Alarms in working order: ❑ Yes ❑ No , 22 Stub Toe Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 22 Stub Toe _ Property Address Meehan Owner's Name Barnstable MA` 02635 11/16/12 Cityrrown 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 ex lain,wh : Type: ® leaching pits number: ❑ leaching chambers number: El leaching galleries number: ❑ leaching trenches number, length: ❑ leaching.fields,.. number, dimensions: .. µf w ❑ overflow cesspool number ❑ innovative/alternative system' w Type/name of technology- Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): . Leach Pit T below grade, 2' of effluent in it at thisaime,'stain line 18"-below inlet_ invert, sidewalls clean above this, no indication of backup 22 Stub Toe Rd.•03/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System,-Page 12 of 15 • I Commonwealth of Massachusetts {. Title 5 Official Inspectionform' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Stub Toe r M • Property Address , Meehan " Owner's Name Barnstable MA 02635 11/16/12` Cityrrown State Zip Code Date of Inspection, D. System Information (cont.) i 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 y i Dimensions of cesspool Materials of construction Indication of groundwater inflow . a ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): .i..s + Privy(locate on site plan), 4 " Materials of construction: " Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding,•condition of vegetation, etc.): 4 , n1a " K 22 Stub Toe Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 4 . i . Commonwealth of Massachusetts a a Title 5 Official Inspection_ Form '. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4M '< 22 Stub Toe . . - .. Property Address Meehan a Owner's Name Barnstable t , _ MA 02635 11/16/12 Cityrrown State Zip Code , Date of Inspectinrt, x D. System Information (cont.) g Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system inciddingties. to at least two permanent reference landmarks or benchmarks. Locate all wells within.100 feet. Locate where public water supply enters the building. , Y', • (`jam _ `e a - _ , . `C. 4, + " -• 22 Stub Toe Rd.•03/08. i Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 22 Stub Toe Property Address Meehan Owner's Name Barnstable = MA 02635 11/16/12 Cityrrown State Zip Code Date of Inspection' ' 4 M D. System Information (cont.) Site Exam: ' ❑ Check Slope, t ❑ Surface water r ° ❑ Check cellar 'Shallow wells : >12' ` Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground-water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date , ❑ Observed site (abutting property/observation hole within 150 feet of•SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database' explain: . You'must describe how.you established the,high groundwater elevation: ; -GW>12' per elevation of home f ' 22 Stub Toe Rd.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS John Graci DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119 TeaTicket,Ma. (508)564-6813 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 22 STUBTOE RD. COTUIT LOT 45 Name of Owner CHRISTINE GEORGE Address of Owner: SAMEka Date of Inspection: - 3/31/99 Name of Inspector:(Please Print)JOHN GRACIO,t. � I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) '`j� �sr 999 Company Name: John Graci Title V Septic Inspection Mailing Address: P.O.Box 2119 TeaTicket,Ma.02636 Telephone Number: (608)664-6813 Z 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: X Passes The inpection Is based on criteria defined In Title V Conditionally Passes ` code 310 CMR 15.303.My findings are of how the system is _ Needs Further Ev luation By the Local Approving Authority performing at the time of the inspection.My Inspection does _ Fails not imply any warranty or guarantee of the longgevity of the , septic system and any of its components useful life. Inspector's Signature: Date:3/31199 The System Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND✓MOVING TREE NEAR SYSTEM TO PREVENT POSSIBLE ROOT DAMAGE_. RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. revised 9/2/98 Page 1 of 11 a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 22 STUBTOE RD.COTUIT LOT 45 Owner: CHRISTINE GEORGE Date of Inspection:3131/99 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: _ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: System passes Title V inspection B. SYSTEM CONDITIONALLY PASSES: na 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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. na 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 exfiiltration,or tank failure is Imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. na Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed _ distribution box Is levelled or replaced na The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed revised 9/2/98 Page 2 of 11 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) is Property Address: 22 STUBTOE RD.COTUIT LOT 45 Owner: CHRISTINE GEORGE Date of Inspection:3131/99 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 IN ACCORDANCE WITH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE,ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. - 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: , _ The system has 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. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, _ The system has a septic tank and soil absorption system and the SAS is less 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 presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance nhL(approximation not valid). 3) OTHER n1a a revised 9/2198 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) ♦ Property Address: 22 STUBTOE RD.COTUIT LOT 46 Owner: CHRISTINE GEORGE Date of Inspection:3/31/99 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: ` I have determined that one or more of the following failure conditions exist as described 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 into 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 SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below Invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped n(a. 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 I 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 ompounds, ammonia nitrogen and nitrate nitrogen. X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failur'e: E E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: The following criteria apply to large systems in addition to the criteria above: _ 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 upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9/2198 Page 4 of 11 9 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 22 STUBTOE RD.COTUIT LOT 45 Owner: CHRISTINE GEORGE " Date of Inspection:3/31/99 Check if the following have been done:You must indicate either"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 None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection. 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. , X 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.The size and location of the Soil Absorption System on the site has been determined based on: X Existing information,For example,Plan at B4O,H, X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 11 5.302(3)(b)1 X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal Systems. revised 9/2/98 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 22 STUBTOE RD.COTUIT LOT 45. Owner: CHRISTINE GEORGE Date of Inspection:3/31199 FLOW CONDITIONS RES113ENTIAL; Design flow:-M g.p.d./bedroom Number of bedrooms(design): 2 Number of bedrooms(actual):2 Total DESIGN flow: i2 Number of current residents:) . . Garbage grinder(yes or no):DLO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no):JLO Seasonal use(yes or no):M Water meter readings,if available(last two year's usage(gpd): nLa Sump Pump(yes or no): DLO ' Last date of occupancy: nLd _ CO M M ERCIAIJINDUSTRIAL Type of establishment: n1a Design flow: nLa gpd(Based on 15.203) Basis of design flow: nta Grease trap present:(yes or no):DLO Industrial Waste Holding Tank present:(yes or no): NQ Non-sanitary waste discharged to the Title 5 system:(yes or no):11LS2 Water meter readings.if available:n(a Last date of occupancy: nta OTHER: (Describe) ... 1 n(a ` Last date of occupancy: n1a GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection:(yes or no):NO If yes,volume pumped nLa_ gallons Reason for pumping: nLa TYPE OF SYSTEM X Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy - Shared system(yes or no)(if yes.attach previous inspection records,if any) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval r Other: nLa APPROXIMATE AGE of all components,date installed(if known)and source of information: THE SYSTEM WAS INSTALLE DIN 1985 PERMIT#83-2 Sewage odors detected when arriving at the site:(yes or no): NO y revised 9/2/98 Page 6 of 11 4 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 22 STUBTOE RD.COTUIT LOT 45 Owner: CHRISTINE GEORGE Date of Inspection:3/31199 BUILDING SEWER: (Locate on site plan) Depth below grade: 2Z Material of construction:_ cast iron X 40 PVC _ other(explain) Distance from private water supply well or suction line: TOWN Diameter: n1a Comments: (condition of joints,venting,evidence of leakage,etc.) ' nLa SEPTIC TANK: X (locate on site plan) Depth below grade: 1fz Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain) DIA If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): No " nla Dimensions: L 9'6"H 6'7"W 4'10" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: 1Z 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 SYSTEM EVERY TWO YEARS GREASE TRAP: (locate on site plan) Depth below grade: v _ Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) n1a Dimensions: nLa Scum thickness: nLa Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle n(8 Date of last pumping: nLa 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.) nLa • revised 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 22 STUBTOE RD.COTUIT LOT 45 _ Owner: CHRISTINE GEORGE Date of Inspection:3/31/99 TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,Inspection) (locate on site plan) Depth below grade: n/a Material of construction:_ concrete_ metal_ Fiberglass Polyethylene_ other(explain) n& Dimensions: nLa Capacity: nla gallons Design flow: nla gallons/day " Alarm present: NQ Alarm level: n/a Alarm in working order:Yes—No—: NO Date of previous pumping: nLa Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n& 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.) PUMP CHAMBER: MQ (locate on site plan) Pumps in working order:(Yes or No): NQ Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) nLa revised 9/2/98 Page 8 of 11 P I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 22 STUBTOE RD.COTUIT LOT 45 Owner: CHRISTINE GEORGE Date of Inspection:3/31199 b SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) n If not located,explain: k ; nLa Type: leaching pits,number: 1000 GALLON LEACH PIT leaching chambers,number: jiLa leaching galleries,number: -oLa ' leaching trenches,number,length: nLa leaching fields,number,dimensions: nLa overflow cesspool,number: n1a Alternative system: nLa Name of Technology: _n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY PIT HAD 1 5'IN IT AT THE TIME OF THE INSPECTION HAS NOT HAD MORE CESSPOOLS: _ (locate on site plan) , Number and configuration: n1a Depth-top of liquid to in let invert: nLa Depth of solids layer: nLa ,x Depth of scum layer. n(A Dimensions of cesspool: nLa Materials of construction: n& Indication of groundwater: n& inflow(cesspool must be pumped as part of inspection)n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) " n& PRIVY: (locate on site plan) Materials of construction:nLa Dimensions:nLa Depth of solids: n1a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) nta revised 9/2198 Page 9 of 11 i : n SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM t PART C SYSTEM INFORMATION(continued),, Property Address: 22 STUBTOE RD.COTUIT.LOT 46 1- Owner: CHRISTINEGEORGE Date of Inspection:3/31/99 a si SKETCH OF SEWAGE DISPOSAL SYSTEM:' include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' Locate where public water supply comes into house.) f TV k y • ,r• 4.a si •,� � y. t Alv, 11 IT s+ LI v^ , • ,, d •Y" � -� 4 , a a-.:' ! t iM �� yqt ,cam ��A y � 1! �'' ',. Cr ,¢ � Ilk.• �' x: ,+ y 4a �1�'3'"c ., «,; 'Y"rz t, ! Ft s1 i s+ ..r a •., revised 9/2/98 Page 10 of 11 r;. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART C SYSTEM INFORMATION(continued) Property Address: 22 STUBTOE RD.COTUIT LOT 45 Owner: CHRISTINE GEORGE Date of Inspection-3131199 NRCS Report name: n1a ` Soil Type: nLd - Typical depth to groundwater: nLa '4 ,y USGS Date website visited: Wa Observation Wells checked: NIQ Groundwater depth:Shallow _ Moderate _ Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar _ Shallow wells Estimated Depth to Groundwater 12 Feet ` - 9 Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record y X Observed Site(Abutting property,observation hole,basement sump etc.) -a • a as . Determined from local conditions _ Checked with local Board of health _ Checked FEMA Maps _ Checked pumping records _ _ Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET - .. , • •. , is a c revised 9/2/98 Page 11 of 11 "°10 C A ION SEWAGE PE RMIT NO• 7 �69 1LLAGE J INSTA LLER'S NAME i ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED \ DAT E- COMPLIANCE ISSUED O I 30 T9ti1� y � L of y� No...a. )..••••• F�s..��................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town Barnstable .........................................OF.......................................................................................... ' ApplirFation for BhgpaaFal Warkii Tnnitrnrtiun amit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: Lot 45 Stub Toe Road Cotuit, Ma. .......... .. ................•--•• ....---•- ....... ......._......._... ---- .............•----•---- -��--Li......._... - -.........._. Dennis Star Cons ii�feto. 24 Great Pond .t,N.SSOe Ya=oUth, Ma. ......-•.............._.................----•---,................................................ ...._........_...._..---...._....-----.......--------...------------....._..--•-•-_...........---- Owner Address W Installer Address 20,000 d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ _Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ---•-----------------•-------•--_. W Design Flow......................``,?__._.___..______.gallons per person per day. Total daily flow.___._:...__.33...._.__...•-------- ......gallons. WSeptic Tank—Liquid capacity),gQ4._gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No_____________________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) 0-4 Percolation Test Results Performed by Robert,E.._-RayitlOnd-P.E.---_--.•.-•.-••.•_ Date....-11/10 82._._-....•.___. �.a Test Pit No. 1.....2_........minutes per inch Depth of Test Pit------12_�..__... Depth to ground water_none._____.. . Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-------•------------------------------------------------------•------------•---•-------•----........-•----•------•---........------------................... 7. Description of Soil..........0��-36"subsoill--36..�144"--satgl--&--gravel------------ --------•--...----------------•---.......-•------------- x - u ------------------------------------•------------------------------...--------------------------------------------------....-------•------------------------------------------------------------------•- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -------------------------------------------------------•---•------••-------•--••--------------------•-•--------------------------------------•----•••---••-•----•-•-•--••-•--•--.....•-••------...------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT'.; p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss by the bo of health �-� ign -----•--VA ----• --•................ r ate Application Approved By----_----- -- ....F------------- ... .�2.. Date Application Disapproved for a ollowing reasons----------------•-------•------•-----------------------------------------------------------------------..._------ ', Da te Permit No.---._�. ---•---------•-•---•-•-• . Issued........... . ......... ................ 1 Date No.... ...........: ..... Fss.......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ..................... ....................OF.......................................................................................... Applira#ion for Biipooal Vorko Tonitrn.rtion rumit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at Lot 45, Stub Toe Road Cotuit, Ma. ................_........_....................•--•-----•------•-•--........--•-•-•--•--•-------- --•-••----•••-•-••---••-•--._...-•••••--......-•------------•-----•-••--•-----................-•-- Location-Address or Lot No. ---Dennis Star Q9SIS_f Ct7S2�..0O3............................-- .--... ..........24..G Owner Address W Installer Address 20,000 Type of Building Size Lot...........................Sq. feet U Dwelling—No. of Bedrooms................3..........................Expansion Attic ( ) Garbage Grinder ( ) 'k Other—T e of Building No. of persons............................ Showers - Cafeteria dOther fixtures -----------------------•----------•------------------•••--•--•••••••••-•••-•••••-•••••--••••-•••••••••••.._..•••••-••--•••••......-•-•-•...-•-•••••- W Design Flow.................55......................gallons per person per day. Total daily flow............._•330......................gallons. WSeptic Tank—Liquid capacity..1000gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width............_------- Total Length.................... Total leaching area.........._.........sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) / Percolation Test Results Performed by......Robert E. ,RaymondP.E..................... Date........... Test Pit No. 1................minutes per inch Depth of Test Pit...1.............. Depth to ground wate ........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-----------------------------------•---------•---•---------........----------...........-••••--•-•-........................................................ 0 Description of Soil.._..._0"-36" su_b_soil,- 36"-144......sand & gravel...................................................................... x v ------------------•----•--•-------------•-•---------•-•--------------•------------------------------------•------------------------------------------------.---•----------------------------•--•---•--.. W -•-•---------------- --------------------------------------------------------- --------•---.------------------------------------------------------....----•---------------------...................... UNature of Repairs or Alterations—Answer when applicable............................................................................................... ---•-••••••--••-•••••••••••---••-----•••-•--••-••••••••-••••••••••-•••••-••-•--•--•-••.....-•-•••••-•••--•••...••-•••---••-••••••••-•••••••••••--••••••••••••--•••-•••••-••-•••._...-•-...•••-••-•..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'I Tom' p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sgne ...............•-••-••------•--•••-•-•••---•-•-••--.......---•--............••_.... Application Approved By•••-•••••-- : - 5...`...........................•-....-•----.......................... ---•• " ........... Date Application Disapproved for the following reasons: - Date Permit No........ 3. .. Issued l•............................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ..........................................OF..................................................................................... (Intif iratr of Tontpliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by..........."j - _ -_of f..........................................f_.....�............... 1 ^........................................................................................... er ..------••---- has been installed in accordance with the provisions of TITLE j of The State SanitaryLUARANTEE cribed in the application for Disposal Works Construction Permit No...?3.".:2................... dated._ ._.. a'.__.._._........ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........�.._��. .'_ ......................................... Inspector..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town OF Barnstable {� No..f�.....2....... ................ ...... FEE..:f a.............. Disposal Workii Tono#rnrtion rrrmit Dennis Star Construction Co. Permission s hereby.granted--------------------- --•-----------•-----•---I--•-••----•--...._..---••••--••••••-•••••••••••••••---------.............•............... . to Construct ( ) or Repair ( ) 'an Individual Sewage Disposal System at No........I,otr..4S,...Stub..Toe..mad,...Cotuitf..hla........................................................................Z- Street as shown on the application for Disposal Works Construction Permit No................,.._%Dated''........ <............................. 1...............................................' /Board of Health DATE-------------- ...... ........................................... / FORM 1255 HOBBS & WARREN. INC., PUBLISHERS it LOCATION a5 S7-04 roe 4 SEWACmE PERMIT NO. VILLAGE o --ru 1 'f INSTA LLER'S NAME i ADDRESS Qo T174 �i U I L D E R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �� lD "6®f . ., 3 3 :L f_ cx i Ro2.1.1h...za FE$.......... :.. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town Barnstable ............. .....................OF........................................... Appliration for Elisposal Works Tonstrurtinn Prrutit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: .l�riva-----------------------------------•------ .............codaji t4.- s.................................. ------------------- Location-Address or Lot No. ...Theo.CQMt2=j;.,.Qn-.Cn...9...Inc-............................... ............. th,..klg�t Owner Address aamp-••-•••--•-•......-••-•---•.................................... ................................... ... p� Installer � �Address UType of Building Size Lot_20 450............Sq. feet Dwelling—No. of Bedrooms........ ..................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a Other—Type g ---------------------------- P ( ) — Cafeteria ( ) Otherfixtures --------------- --------------•----------------•---•-------------. -----------------••-=-•--•------------.........•------•--....----...........•---- w Design Flow.............55..........................gallons per person per day. Total .daily flow.._...330 gallons. WSeptic Tank—Liquid capacity QN.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area...................sq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by._Robert E..Raymond P..E._______. ..._. Date_._.Sept. 17-, 1982 Test Pit No. 1......3-------minutes per inch Depth of Test Pit - ..... Depth to ground water none G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------=----------------------------------------•------------------------••--------•----•.---......................................................... O Description of Soil.._.0-6" sandy to ng 6"_-36"-.subso l_i 3 "-148" sand x ----- w U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -•------------------------------•--------------------------------------...-----------•--•-------------.......----------=--------------------------------------------------------------------•-••---•••-• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iI':LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by thVboard of health. S' i ed_ ................. ....... .. .. ... ....- Application Approved B ... . _ X ac��/ ------------------------------------------------ Date Application Disa ro for the following reasons:-------•------••-•-------••----------------------•-------•-•--••----------•-----•------._...-----........_._.� --------...-•----- Date PermitNo......................................................... Issued....................................................... Date Fm3............._............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ...............I—........................O F................................_........ ..._........ ._._._............._.._....... Appliration for Bhyasal Works Tonsirurtiun "truth Application is hereby made for a Permit to Construct ( x) or Repair ( ) an Individual Sewage Disposal System at: .......................................... .............. ....................................................... Location-Address or Lot No. 24 Gre .Mgxd Q:-:......................................... I. outh. a. Owner ...Address a .........................4. p........•..... :... � .. � Installer Address UType of Building Size Lot.ZQAN__.__.._._..Sq. feet Dwelling—No. of Bedrooms...._._3..................................Expansion Attic ( ) Garbage Grinder ( ) a'4 Other—T e of Building ............. No. of persons........ Showers YP g --------•----•- P ( ) — Cafeteria ( ) Otherfixtures ------------•-- -•-................................................... ------•-----•--•---•-•----•-------.....-----_...• ---.--•-•- W Design Flow..............55..........................gallons per person per day. Total daily flow........330.............................gallons. WSeptic Tank—Liquid-capacity..lodggallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length....._.............. Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosingtank ( )) tc�.�ert E. R2t P.E. Percolation Test Results Performed by................................ ...__......................... Date..._Sept. _l7, 198.. ,4 Test Pit No. I....... .......minutes per inch Depth of Test pit...1�?.'.4...... Depth to ground water.... ne........__. 04 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•--•--•-•-•----- ------------•-----•-•-•-•---•----•----••-•......••-•-......-••-••----••. O Description of Soil....0-6".sarldy-loan .. V-36" su ° bsoil 36"-148 s� ....................-------------•................. ..-•-•-•--•--•---•--•--------•-•- -----------------------------------------------------•-------••--....------•----••---- W UNature of Repairs or Alterations-Answer when applicable.............................•................................................................ -----•--•------------•------•---•---------------------------------------------------------------------•-••-•-•----------------------......-----------•-•--•-----------------------------........._------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of AITL p of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. f" S ned...................................................................................... ............ `_.... Date Application Approved By. ��u .....................•---------........-•--------------------------.......... ;Date Application Disap roy&Vre following reasons:............................................................................................---•-----•--....... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................ t ...............O F......Barnstable................ (9rdifirtttr of Toutpliatta � THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) `/ Instru�'_ at_. .... ..... ._.. ..A..:......................• ----- ------. ---•--•-------•---•-•-•------- -------- ---- •-•------------ has been installed in accordance with the provisions of TI rr' j of T e State Sanitary Code a de riled in the application for Disposal Works Construction Permit No.... ---•--------•---. dated---=�----:_------- --- -------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIONS TISFACTORY. DATE.............................../.. . .1.''. Inspector................�--------------------------•------.----------.-.--••-----•--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF Barnstable ........... U No......................... FEE........................ 15ispos tl Marko Tuuu#rt ion rrutit Permission is hereby granted-- Sim Construction Co. , Inc.-------------------••----------.------•-------------------•--•••--......••-- to Construct � ) Po Re iir ( .an�pndivaual Sewage Disposal System at No... r ----•- ----- Street as shown on the application for Disposal Works Construction Permit No......, __:; Dat Z .... �. Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS y LEGEND COTUIT PROPOSED CONTOUR ® PROPOSED SPOT GRADE -- 98 -- EXISTING CONTOUR + 96.52 EXISTING SPOT GRADE D LOVELL'S W— EXISTING WATER SERVICE `� POND 0 P� �~ BENCH MARK N TEST PIT 70.0 o m TOP OF UPPER 0 MO� LOCUS FOUNDATION 6 71 .00 1 a� BARNSTABLE GIS DATU 2 1�A3,50"E LOCUS MAP N ; 68.0 LOCUS INFORMATION gyp. PLAN REF: 282/027 68.0 w TITLE REF: 27590/144 i PARCEL ID: MAP 040 PAR. 113 \ FLOOD ZONE: PROPERTY NOT IN FLOOD ZONE \ — _ SEPTIC SYSTEM TP-2 REPAIR PLAN 0 LOCATED AT: \ . \ \�� <<�-A �soo. 22 STUB TOE ROAD v 1 \ o z �' 29$' \ � � ° ° w N COTUIT, MA v` PREPARED FOR C \ ` 5 ft Soil FARO\ oQ/SHAKEEL XIST. 1 000G L.P. removal \\' \ SEPTIC TANK \ MAY 5, 2018 0z \ \ UN O vent 66.o, \ �- - - _ ��C)F' 65,0 = \ ��� OF ass TP-1 \ �'-� D M M t3` + 64.0 1140 G SIE I / O �< ; \ 166.0 r MEYER & SONS, INC. P.O. BOX 981 A, PLAN EAST SANDWICH, MA. 02537 + 63.8 N PH: (508)360-3311 SCALE: 1 in = 20 ft FAX: (774)413-9468 0 20 40 meyerandsonstitle5@gmail.com 0 10 20 40 _SHEET 1 OF 2 J 1894 ELEV. TOP DROP FND. NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS (Existing) BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE FINISHED GRADE (67.0) = 66.0 � F.G.EL: 65.0 F.G.EL: 65.0 F.G. EL- 66.3 VET a I MAINTAIN 290 MIN SLOPE OVER LEACHING AREA a 1 '" F.G.EL 62.50 j 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2" .• . :? STONE OR FILTER FABRIC DOUBLE WASHED STONE " 4" SCH 40 PVC 10" ®®®®• p ®®®® 14 6 0 S= 17 MIN. 1®Is3®®®13®®®®® TEES ARE TO BE INV.60.75 ( ' ) ®®®®®®®®®®® :a 4" SCH 40 PVC 2 EFF. DEPTH ®®®®®®®®®®® INV.61 .25 INV. 60.55 4' 2 X 8.5' 4' EXISTING OUTLET BAF LE PROPOSED DB-3 DISTRIBUTION BOX EFFECTIVE LENGTH = 25' INV. 61 .50 (1-120) INV. ELEV.= 60.25 EXISTING 1,000 GALLON SEPTIC TANK GAS BAFFLE TO BE INSTALLED ON ���� �F ' ss9 OUTLET TEE AS MANUFACTURED BY �`� �y BREAKOUT M.NOTES: ? D R N M ELEV.= 61 .25 1) CONTRACTOR SHALL VERIFY ALL EXISTING TUF-TITE, ZABEL, OR EQUAL m i R TOP CONC. ELEV.= 61 .25 l ,. . PIPE INVERTS PRIOR TO CONSTRUCTION N 1140 INV. ELEV.= 60.25 B® ®® 2) D-BOX SHALL BE SET LEVEL AND TRUE TO ®®®®®®® GRADE ON A MECHANICALLY COMPACTED SIX / ®®®®I�®® INCH CRUSHED STONE BASE,,AS SPECIFIED .INNITAR�p� / BOTTOM EL.= 58.25 ®®®®®®® 310 CMR 15.221(2) l� 3.75' 5 FT. 3.75' 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK WITH 1500 GALLON SEPTIC TANK IF FAILED, EFFECTIVE WIDTH 12.5' DAMAGED OR UNDERSIZED. SEPARATION 5.25 FT. 1-0 4) INSTALL INLET & OUTLET TEES W/ SEPTIC SYSTEM PROFILE SOIL ABSORPTION SYSTEM SECTION GAS BAFFLE AS REQUIRED BOTTOM OF TESTHOLE EL: 53.0 _ ( 5) PLACE SANITARY TEE IN D-BOX (500 GALLON H2O LEACH CHAMBER) GENERAL NOTES: I. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOGS P#: 15665 DESIGN CRITERIA BOARD OF HEALTH AND THE DESIGN ENGINEER. NUMBER OF BEDROOMS: 2 BEDROOM DWELLING/3 BEDROOM DESIGN 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: MAY 4, 2018 OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE SOIL EVALUATOR: DARREN 'MEYER, R.S., CSE #1614 SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/sF) LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: DESIGN PERCOLATION RATE: <2 MIN/IN - 310 CMR 15.405 (1) (B): WITNESS: DON DESMARAIS, BARNSTABLE HEALTH DEPT. DAILY FLOW: 110 G.P.D. X 3 BR = 330 G.P.D. 1) A 2.75 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING GARBAGE GRINDER: NO not designed for garbage render TO BE 5.75 FT (MAX) BELOW GRADE VS REQ'D 3 FT. (H20/VENT PROVIDED) Elev. TP-1 Depth Elev. TP-2 Depth ( 9 9 9 grinder) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 65.00 0" 68.0 0" SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXIST. 1,000 GAL. SEPTIC TANK TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE A LOAMY SAND A LOAMY SAND DESIGN ENGINEER. 1OYR 3/2 IOYR 3/2 " LEACHING AREA REQUIRED: (330)/0.74 445.94 S.F. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 64.00 12 67.0 12 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN B LOAMY SAND B LOAMY SAND USE TWO (2) 500 GALLON H2O PRECAST LEACH CHAMBERS W/ 4' ENGINEER BEFORE CONSTRUCTION CONTINUES. 1OYR 5/8 IOYR 5/8 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 61•92 37" ! 65.08 35" STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF C SANDY C SANDY THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF LOAM LOAM BOTTOM AREA: 25 x 12.5= 312.5 SF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. IOYR 6/6 IOYR 6/6 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 58.50 78" 63.0 60' TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. C2 p I TEST C2 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE MEDIUM O EL 62.0 MEDIUM DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req d A THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING SAND SAND CONSTRUCTION. 2.5Y 6/6 2.5Y 6/6 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. 53.0 144" 57.0 132" 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION i PROPOSED SEPTIC SYSTEM UPGRADE PLAN 4� 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY PERC RATE <2 MIN/IN. (11"C2" HORIZON) 22 STUB TOE ROAD, COTUIT, MA AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY NO GROUNDWATER OBSERVED 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. Prepared for: Faro o Shakeel 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. Design and Site Plan by: SCALE DRAWN DATE 15. ALL PIPING TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPECIFIED) MEYER&SONS,INC. • I, Darren M. Meyer, R.S., CSE, hereby certify that 1 am currently approved by MADEP pursuant to 310 CMR 15.077 N.T.S. DMM 05/05/18 16. REMOVE UNSUITABLE SOIL 5 FT AROUND PROPOSED LEACHING TO TOP OF PO BOX 961 to conduct soil evaluations.and that the above analysis has been performed by me consistent with the SHEET N0. "C2" LAYER AND REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5 REQUIREMENTS. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil.Eval. Exam in October, 1999. EAST SANDWICH,MA 02537 REV DATE CHECKED 508-3622922 DMM 2 of 2 I C�Fa.IE12.A.L N0T�E.S o^ �-T�T 5 uOwv 0 Ae.F MEc.%J s5A LEViEx- _..._ ---- - - _ e�5e n o..I (�.�G G?5 a►r L�*a PL�..ttE PITr-W ALL L•IWES F A t"tIU1MU aF 1/b�� .:x-T I UwtIES� CTNEQ�tSE ALL- ��EG�IED. M SND.LI • . ----- --- �-- A PIPES TO &Wta Id HE T , �� r DE CAST I�r.l Inv-' SC��DvL E AO P�I - A.LL '5EPTIC TA IKS P+ST�+gJTi4.J �k Ar lU nn Lj5Ac ►4.JG PrT SNAL.L 8E DE�IG�.1E� MAIM— ll © " - p-o �..,"C-Ei --� �1 2EM��✓E Au U,JS.J Ta3L� Ma.TEZIta� BE•JE.aTL1 V ! 1 O O C) �G> O m T4 C V E e r E L.E VA-r I O-J S o F L-E t�,C µ 1� P� FO A �Aa�,S of 10 A#30 EjcaL�F+Lt `c.IITN CLs.y F�c� nT O C) 0I SAti1D ��U C�2.ta�/1✓L " T1 1E �PSZtiIST A� !c 8• �.2 D o f p�F�s L FH77 to uST O `�' �J etc fSTIF E� 41NEv TµC S�I�TEr.� lS NEA2 I � I J., � O O I �\ �' '� ® �.J ���E�ETt(�ti1 A..JCJ P�io2 T� pn•UGF�LL1...l6,Zo Z�,_ �� j0" �z'� - l J iJ �i -j v►�� S OTNE2�I SE �soTED, ALA SYSTEM -- a �,A.-1 7 A C. O G O c O �i � AcC. (f W of Tl4 4L�-- 'STATE ' TYPICA _ DISTf?IrJU"i 1GtiJ eyox. I r - } I O 0 O c 0 -- - — 11 LL ►.!OT Tip §GALE TyPicPr` 1lYJ Gay- 5E?TdC.��vt ! A_>ti _1. ASN�r.ICa ---P� _ 06��At VA710A/ R/T5 t'E,uFcP�Ec� g�v-r �..�►c ".y NOT sa SC... � OW 6CIUAL .: TawKS t2S1►aFc�CC-ECr T � GNoiT PF,e fOL A T/,O Al 4A7Z:-' wlru E�.E['TK�- wED�a vt�¢C W+n-# AIOTI�=,6,cGE39 MAI�IHOL�� To 24 - OB3L�.CY•!T/ON5 6�/: .L r� a #� ' 3r' '-' � " 'fz' EM8EC70ED sL Y��s ,�1 gEvrlc rr►�c s•Nn L�c�.r_►+IuG P:,g IbP 6c>Tor�j. Cos,IC, eb 4000 r-.2 TE'ST `0 1SE f%u,LT UP TO 12.E^irF4�S TA '! A OA Z O M- )4—=,4 � aE l c vu F�ti►+y•+ �+r n .�R ToT' Fovrt DAT+ow1 u:v �7 ?,y to p�►TE = ` 1 '` �L - F,r.1l,rk 6c&o4c 1- IAJIstI 4�A,Lx F IIJ154 C-,e^ of cvs� ' /FirJISH G,CasE • d r^ cuEtZ Tr„tK- 7 * GvEe`dma.77 .7 -' >� l�,wcw�.,G vrr• ri�� L o a 20, i "IWL Cf T f' , �� �` `�' • CD Q � � � ' - 12' of �"�,•►'Ii' L1 •• eLL5/1E O 6TorJt r•^ " d --- i - _ _ ee W t occry a�•.1c- DIST V50K Q ® O m e - 0 0 � • _ , SEQTIG TAIJrG ► ELIEV A + . ; TcypIr SEw.sCiE SYaTEM P?U'F1l.L� 8 C ►.jo'T TC)SC1..L� LE-I.CNINC� PIT AT 10 t +1 #3 A._ Y too . 3 T,Tu PROPOSED DV/CLLIt,,G LOCATION %* " DES/GnI (Ze/7ES/•4 70 4%' �e'�OR��ito Gae.�TdU•� �- �'xA PROP05m.0 -$E1dAGm DISPOSAL._ SysTE.t.!( pF 0,60 bM S 3 --- , � 1 PEesON's /ce sx-,plead" jf ' Q P�k'LCXA1Jba� 7� ` &WI-aV-5 vie Tt-IL ✓ o45eo,4 y _ Pr. p �jA,fz�1 ST S�--� GoT'v �"� (VGA sS . 64 c�llV& A.e6 k,CQ ureEo C � ae s�,c s�c,�r a� .l �.>�r>> r�� � C Lx.tes11.vG A.PZt PQoVro&n .Q.PPLICAAIT: �1.1611..l4�12: '!I PROPOSED LEACHING PIT r +Ihi I-I - ),•--1 0 C� �r3� QO6E2'r�tc�{�C2A4+t/M�06.10 �!O D15Pp5A�. l00 % Ex PAKI540N ?f� G�PAT no"o cleivE 39 S'Tf''`1pffe t,J�l.t.11E ' f�� �`.'-- Sd. yA�Mo�TU► MA. E, Fk-4A U�ITI-�, M A % 1/ 377 S I DE\LJA.LL a.( Ek`�(o.ZB)C4)�`J� Z+S, GI P C j, �t� 1-` SCALE: DATE: lHctT BOTTO M AiZEA = Tl' Cg�� 1 ,o) = 5o CAP A tJOT�a SE��P- APPLIC,�.T1 OIJ CIO, �� -" T`�-a� 4Pc st X� ,y Stt�c°' ORAWN �r CHKO !Y; APPO !r: PLAN WO. ►0--�"--- ------{ �LEV-I�$X3 I - GfuJEfz A.L NOTES ALL E L f� 4b Mo1,v o Ae� M E iai,! A SE L.E vE L. usc P►Tc14 ALL LIWE5 A PA1,4. otj of 1/15 v -. „ 'U`', 5 ~I � -- Ti Uw►t,.ES`� o'TN���tsE SPEGiF1ED. LA- P►P 5 ♦e1 T oc <-� �� .�� � H SV`alE►'/� " , 1+ALL �` � r _.--— - TO D ►d- - - � e� u►s-r l aa►� c� sc..+,�o c�� Ao P,/�. 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