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HomeMy WebLinkAbout0083 WHITMAR ROAD - Health R r ?Gall d 056 064 �t r I <S4 0 �2 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION 6-6 — MAP O S lv -.R...;7 PARCEL I Q� 4 TITLE 5 LOT Z3 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address- ® Owner's Name: ✓ G , o FFe.1 Owner's Address- o - Tnw ZQ 3 z' G.rr�r NOF O Date of Inspection: 6� /l�/t O�tG6� yF�< N p As�g6 T �F Name of Inspector. (please print) Company Name: Mailing Address: Po eax Telephone Number. CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below' true,accurate and complete as of the time of the inspection.The inspection was training and experience in the proper function and maintenance of an site sewage disposal armed based on my approved system inspector pursuant to Section 15340 of Title S 310 ry�� I am a DEP / ( CMR 15.000� The system: 1,�/Passes - Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: � — Date: The system inspector shall submit a copy of this inspection report to the DEP)within 30 days of completing this' sy °1 rng Authority(Board of Health or gpd or er,the' inspem ection.shall the stem is a shared system or has a design flow of 10,000 DEP.'Ihhe original should be sent to the system wn re and copies set the at O the buyer, �ft to the appropriate �and the approving of the authority. Notes and Comments ""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 w>71 perform in the future under the same or different conditions of use. f Page 2oflt OFFICIAL INSPECTION FORINI— NOT FOR VOLUNTARY ASSESS SUBSURFACE SEWAGE DISPOSAL, SYSTEM INSPECTION FORM TS PART A CERTIFICATION (continued) Property Address: Owner- Date of Iaspecti a: Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D 271ve Passes: not found any information which indicates that 15.303 or in 310 CUR 15.304 ex Any failure criteria not e anv of valuated arc lure criteria described in 310 CIv1R are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the'Conditional p��� repaired-The system,upon completion of the replacement or rove don need to be replaced or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)is the for the folkowin e`rplain g statements.If"not determined'please The septic tank is metal and over 20 years old"or the unsound,e�chrbits substantial infiltration or a diitration or t: tic tank(whether metal or not)is structurally existing tank is replaced with a complyingfailure is imminent.System will pass inspection if the •A metal septic tank will septic tank as approved by the Board of Health. indicating that the tank is less than 20 Yection r it is is available. sound,not leaking and if a Certificate of Compliance Years old is available. ND cxplain: Observation of sewage backup or break out or high static water love! in the dis�ibutioa box due to Obstructed pipe(s)or due to a broken,settled or uneven dis�ibuton box System will broken or approval of Board of Health): Puss inspection if(with broken pipe(s)are replaced obstruction is removed distribution box is leveled or repL.,ced ND explain: The system required Pumpingmore than 4 times a year Pass inspection if with ) Y due to broken or obstructed ( approval of the Board of Health): Pipc(s).The system will broken pipe(s)are replaced Obstruction i II s removed I ND explain: Page 3 of l 1 OFFICLAL INSPECTION FOR��I - NOT FOR Y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM[N(ENTS PART A CERTIFICATION(continued) Property Address: �� � �/„� � Owner. 20Gjr_ S Date of Insp on: C. Further Evaluation is Required by the Board of Health: Conditions e:dst which require fiuther evaluation the Board is failing to protect public health safety or the environment of Health inorder to determine if the system 1- System will pass unless Board of Health determines in accordance with 310 Cb the LR 1S.303(1)(b) that 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 [ail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis.performed at a DEp certified laborsto bacteria and volatile organic compounds indicates that the well is face from ry.for coliform the presence of ammonia nitrogen and nitrate nitrogen is Pollution from that facility and failure criteria are triggered A copy of the analysis must equal lroo or c=than 51�pt°n�that no other this form 3• Other. Page 4 of l 1 OFFICIAL INSPECTION FORINI— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM L fSPECTION FORM PART A CERTIFICATION (continued) Property Address• U 49 Owner, p S Date of Inspecti a: ,2_p D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No, _ f�v/ �ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent f to the surface of the ground or surface waters clogged SAS or cesspool due to an overloaded or tatic liquid level in the distribution boe above outlet inv esspool ert due to an overloaded or clogged SAS or Limed depth ut cesspool is less than 6"below invert or available volume is less than Vz day flow Required pumping more than 4 times in the last year NOT due to clog Of times pumped ged or obstructed pipe(:).Number .,,.�Any portion of the SAS,cesspool or privy is below hi y portion of cesspool or �mound water elevation. privy is within 100 feet of a surface water supply or tributary to a surface'` water supply. _/Any portion of a cesspool or privy is within a Zone 1 of a public well. �/ 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 grater than SO 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammoni nitrogen and nitrate nitrogen is equal to or less than S ppm,provided that no othenal a r failure criteria are triggered.A copy of the analysis must be attached to this form,] (Yes/Na)The system fails 1 have determined that one or mote of the above failure crita as described in 310 CNM 15.303,therefore the system fails.The system owner should ontactt 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 iS,000 gpd- You must indicate either'yet"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes no the system is within 400 feet of a surface drinbng water supply the system is within 200 feet of a tributary to a surface ddnldng water supply the system is located in a nitrogen sensitive area(Interim Zone I1 of a public water supply well Wellhead protection Area—IWPA)or a mapped If you have answered"yes"to any question in Section E the "Yes" in Section D above the large system is considered a significant threat,or answered g system has faded 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 o1Sce of the Department. f Page 5ofll OFFICIAL INSPECTION FORM(_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B J CHECKLIST Property Address: �> �i /0i ram t�7C/ N f Owner. Date of Inspection: Check if the following have been done.You must indicate'ves"or"no"as to each of the followin : Yo Pumping information was provided by the owner,occu pant,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 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 zZ Was the site inspected for signs of break out Were all system components,excluding the SAS, tocated on site Were the septic tank manholes uncovered,opened and the interior of the im of the es oe tees,material of construction,dimensions,depth of liquid depth of sludgeanms acted for the condition depth of scum _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal system e size and location of the Soil Absorption System(SAS)on the site has been determined based on: Y n Edsting information.For example,a plan at the Board of Health _ Determined in the field(if any of the failure criteria related to Put C is at issue is unacceptable)(310 CNN 15.302(3)(b)] approximation of distance r Pagc 6 of t i OFFICIAL INSPECTION FORINI—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C /SYSTEM IlYFORUNTATION Property Address- (,✓Gl, /-c!1'l0� o 63SOwner. w o� Date of Inspection: FLOW CONDMONS RESID ENT]AL Number of bedrooms(design): `7" Number of bedrooms(actual): DESIGN flow based on 3 IO CMR 15.203 (for example: 110 Wd x#of bedrooms): T Number of current residents: Does residence have a gage grinder(yes or no): Is laundry on a separate sewage system(yes or no)✓L_�7 [if yeas separate inspection required] Laundry system uuTected(yes or no):LG^J Seasonal use:(yes or no):Al'V Water meter readings,if available(last 2 years usage(gpd)): Sump Pump(Yes or no):4-V Last date of occupancy: _ COMMERCLiUINDUSTRLA.L Type of establishment: Design flow(based on 310 CNM 15.2037 gpd Basis of design flow(seats/persoas/sgfl,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):—. Water meter=dings,if available: Last date of occupancy/use: OTHER(describe): Pumping Records GENERAL INFORMATION Source of information: (O od - o�. -, ✓ Was system pumped as pars of the' on(yes or no):,�v ! If yes,volume Pumped-----93llons—How was quantity Pumped determined? Reason,for pumping TC,t2nk, SYSTEM distribution bOX,soil absorption system ---Single cesspool ___-Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records.if any) _Lnnovative/Altertwive technology.Attach a copy of the eumt operation and maintenance obtained from system owner) contract(to be _Tight tank _Attach a copy of the DEP approval Other(describe): Appro.,dmate age of all components,date installed(if mow and and source of information: / —0Z /- Were"age odors detected when arriving at the site(yes of no):�/Q Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORNI PART C SY//ST/EIv1 INFORMATION(continued) Property Address- In/Gti y'v'7Gii Owner-.C� of Date of Insp oo- l -O � BUELDING SEWER(locate on site plan) Depth below grade:Materials of construction cast iron _ C_other(explain):from private water ( � ): pri supply well or suction line: Comments(on condition of joints,venting,evidence of leaicige, etc.); SEPTIC TANY, (locate on site Lan Depth below grade: Material of construction: concrete_metal_fiberglass----Polyethylene other(ccpL•un) If tank is metal list age:_ Is age confirmed by a Certificate of certificate) Compliance(yes or no):_(attar a copy of Dimensions: 6� Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle:�_ Scum thickness: (�_ Distance from top of scum to top of outlet tee or baffle: O Distance from bosom of scum to botto�j 0 outlet tee ox�baffie: D How were dimensions determined: f 0e f C� 771v Comments(on pumping recommendations,inlet and outlet tee or bafn conddition,structural integrity,as,,g laced to outlet invert, dens of le:ilcage, / liquid levels 0 0� , GREASE TRAP:0ocate on site plan) Depth below grade:_ Material of construction:_concrete_•metal_fiberglass_. mlYethylau o f (e`cpLzirt): I Diace:isions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or ba c Date of List pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, as related to outlet inve evidence of leakage,etc.): °' ctum! ��'.liquid levels rt, .3 pages ofli OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SE WAGE WA GE DISPOSAL SYSTENt IlYSPECTION FORM PART C SYSTEM INFORNI[ATION(continued) Property Addrw: r✓`?Gr Owner. U a �vZG 3S Date of Insp oa• —�oZ-off TIGHT or HOLDING TANK//(tank must be pumped at time of'tnsTet'rion)(locate on site plan) Depth below grade: Material of construction: contzete meta! fiberglass_polyethylene other(eeplain): Dimensions: Capacity: 9211ons Design Flow: tllons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and goat switches,etc.): DISTRIBUTION BOAC.Z(if sent must be opeaed)(locate an site plan) Depth of liquid level above outlet invert: ✓gyp/v�-1�, / Comments(note if box is level and distribu on outlets outle 1 e i or out of bo:c, ): ecItial,any evidence of solids carryover,any evidence of 0 Ott/r G G PUMP CHAMBER Py(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appraLe:rartces,etc.): I i v Page 9 of l t OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTENI E TOMIATION (continued) Property Addrew: Owner. Date of Wpecti n: SOQ.ABSORPTION SYSTEM(SAS): pocate on site plan,excavation not required) If SAS not located explain why: Type Idir- • c mbehing pits,number._ •� leaching chambers,number. leaching galleries,number leaching trenches,number,length: w leaching fields,number,dimensions: overflow cesspool,number innovative/alternative system Typefname of technology: Comments(note condition of soil,signs of hydraulic faflure,level of n etc.): lj Po fig,damp soil,condition of vegetation, CESSPOOLS:Z(ceSSPOOl must be pumped as of'part utspectuon)(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 inIIow(yes or no): Comments(note condition of soil,signs of hydraulic Eadute,level of ponding,condition of vegetation,etc.): 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.): I Page 10 of t t OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address- Owner. moo, Date of Inspection: — -�-C, SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system includin tzes to at least two benchmarks.Locate all wells within 100 feet.Locate where public water supply Permanent nters the building. or Fro 4-1 t 131 o C -- /Soo Ta n�✓ I . 3 Soo y Page 1 l of l 1 f' OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM[ IIYFORMATION(continued) Property Address- i Owner. Date of Inspectio : 7 SATE EXAM Slope Surface water Check cellar Shallow wells ` Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design rved site(abutting property/observation hole wi 150 feet of SAS) reviewed eckcd with local Board of Health-,=pbm_ GI Checked with local excavators,installers.(attach documentation) Accessed USGS database-ccplain: You must scn how you established the hi h 114 lW a 9 g ga^ound water elevation / Zone --12 bill 0 OF -� v a. cle rya,l v for - I ell-� P ell ,7 14 wag - zo-7-e - OZ------------- 1. F 4 # YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate)! You must first obtaim the necessary signatures on this form at 200 Main St.,.Hyannis. Take the completed form to the Town Clerk's Office, Vt FI:, 367 Main St., Hyannis, MA 02601(Town Hall) and get„the Business Certificate that is required bylaw. t DATE Fill in please: _f APPLICANT'S., YOUR NAME/CORPORATE NAM1=E_C/k I -yt F{7�CC'e_ `FrV 4C A BUSINESS TYPE: BUSINESS YOUR HOME ADDRESS:.. (,,,1, i'_t jneAf 367 ,St2 TELEPHONE. .#J° Home Tele .hone Number: ��/L'C NAME OF NEW BUSINESS GvrGt'SCtL ()Q cy^X `e5i9ln Have you been givemapproval from.the building division? YES NO - ADDRESS OF BUSINESS T3 C) i —1 Y o-y- `;� 1p�� r MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need: You MUST GO TO 200 Main St. -(corner'. (corner of Yarmouth Rd. &-Main Street) to make sure'you have the appropriate permits and licenses required to legally, operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. N. Authorized Signature**. COMMENTS. 2. BOARD OF HEALTH . . n ;A This individual has b n inf f ermit requirements that pertai to this type of business. qe l/ . - MUST DAMPLY WITH ALL Authorized Signature** HAZARDOUS MATERIALS REGULATIONS COMMENTS: 3.,CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual 4afi been informed of the lic using requirements that pertain to this type of business: Authorized Signature** , COMMENTS: TOWN OF BARNSTABLE Date: /Z/ 20/ I f TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: R-,m X A La`PdSCa,,` _1 i24� rj-)e!5jQj3 BUSINESS LOCATION:,E�3 w 13IM&Lr / D C0T(i%T mf 0263S INVENTORY MAILING ADDRESS: ,�a TOTAL AMOUNT- TELEPHONE TELEPHONE NUMBER: 1-5vc-367­ �Zq 2- CONTACT PERSON: Rich" R()bt ,be-e EMERGENCY CONTACT TELEPHONE NUMBER: 1 So6-367- 76 3 "3 MSDS ON SITE? TYPE OF BUSINESS: L�<ecc p� lip INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt&roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) /7•47 a_jr�V rh/,� T P.r'I a.L5' Thy w i t Spot removers &cleaning fluids (dry cleaners) —R0I;Qh� �S wed:d � �^r- Other cleaning solvents �I Bug and tar removers 1)(19113 Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Plicant's Signature Staff's Initials 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 PAULCELLUCCI DAVID B.STRUHS Govemor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION ii Property Address: 83 WHITMAR LANE COUTUIT OSCO O(S`-` Name of Owner KEVIN HEALY Address of Owner: SAME Date of Inspection: 8/18/99 Name of Inspector:(Please Print)JOHN GRACI tSF �1 1 le am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) A Z le lob 0 Company Name: nla y OF �99 Mailing Address: nla d ,Yp�ONTI `� Telephone Number: n/a 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 Furtheibmit ' n 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:8118/99 The System Inspector shallopy 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 PUMPING THE SYSTEM EVERY TWO YEARS. revised 9/2/98 Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:8/18/99 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: nLa 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. nLa The seotic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. nLa Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due`o 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 nLa 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 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:8/18/99 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 16.303(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 a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, The system has a septic tank and soil absorption system and the SAS is less 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 n/a-(approximation not valid). 3) OTHER n!a revised 912198 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:818/99 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 ta. 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 Failure. 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 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:8/18/99 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) [1 5.302(3)(b)] 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: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:8/18/99 FLOW CONDITIONS RESIDENTIAL: Design flow:940 g.p.d./bedroom Number of bedrooms(design): 4 Number of bedrooms(actual):4 Total DESIGN flow: 4411 Number of current residents:4 Garbage grinder(yes or no):NQ Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no):JM Seasonal use(yes or no):M Water meter readings,if available(last two year's usage(gpd): nLa Sump Pump(yes or no): NO Last date of occupancy: n& COM M ERCIAL/INDUSTRIAL Type of establishment: Wit Design flow: nLa gpd(Based on 15.203) Basis of design flow: n(a Grease trap present:(yes or no):�LQ Industrial Waste Holding Tank present:(yes or no): NQ Non-sanitary waste discharged to the Title 5 system:(yes or no):NQ Water meter readings.if available:n& Last date of occupancy: n& OTHER: (Describe) IILa Last date of occupancy: nLa GENERAL INFORMATION PUMPING RECORDS and source of information: n1a System pumped as part of inspection:(yes or no):�LQ If yes,volume pumped nt& gallons Reason for pumping: n& 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 Other: n& APPROXIMATE AGE of all components,date installed(if known)and source of information: 1997 Sewage odors detected when arriving at the site:(yes or no): I1LQ revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 83 WHITMAR LANE COUTUIT r Owner: KEVIN HEALY Date of Inspection:8/18/99 BUILDING SEWER: (Locate on site plan) Depth below grade: 14" Material of construction:_ cast iron X 40 PVC _ other(explain) Distance from private water supply well or suction line: TOWN Diameter: nta Comments: (condition of joints,venting,evidence of leakage,etc.) nLa SEPTIC TANK: X (locate on site plan) Depth below grade: K Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain) nLa If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NQ nLa Dimensions: L 10'6"H 6'7"W 6'8" Sludge depth: L" Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle:6 Distance from bottom of scum to bottom of outlet tee or baffle: 17"" 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 EVERY TWO YEARS GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) n1A Dimensions: Wa Scum thickness: n& Distance from top of scum to top of outlet tee or baffle:ji& Distance from bottom of scum to bottom of outlet tee or baffle n& Date of last pumping: n& Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) n& revised 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:8/18/99 TIGHT OR HOLDING TANK: NQ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: nLa Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain) nla Dimensions: n& Capacity: nLa gallons Design flow: nLa gallons/day Alarm present: NQ Alarm level:jiLa- Alarm in working order:Yes_No_ NQ Date of previous pumping: nta Comments: (condition of inlet tee,condition of alarm and float switches,etc.) nLa DISTRIBUTION BOX: X (locate on site plan) Depth of liquid level above outlet invert:LIQIUD LEVEL WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) DISTRIBUTION BOX IS STRUCTURALLY SOUND PUMP CHAMBER: NQ (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.) Wit revised 9/2198 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:8/18/99 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: nLa Type: leaching pits,number: Wa leaching chambers,number: 3 CULTEC CHAMBERS leaching galleries,number: _nLa leaching trenches,number,length: nLa leaching fields,number,dimensions: nLa overflow cesspool,number: nLa Alternative system: Wa Name of Technology: .n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE SAS IS FUNCTIONING PROPERLY. CESSPOOLS: _ (locate on site plan) Number and configuration: nta Depth-top of liquid to inlet invert: n& Depth of solids layer: -n& Depth of scum layer. nLa Dimensions of cesspool: n& 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.) Wa PRIVY: _ (locate on site plan) Materials of construction:nfa Dimensions:n& Depth of solids: n& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Wa revised 9/2/98 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:8/18/99 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) n/a 1A FJZCA� Peach A q a I� CI GA �U �� 37 aC q3 revised 9/2198 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 83 WHITMAR LANE COUTUIT Owner: KEVIN HEALY Date of Inspection:8/18/99 NRCS Report name: n(a Soil Type: Wa Typical depth to groundwater: n& USGS Date website visited: n& Observation Wells checked: UQ Groundwater depth:Shallow _ Moderate _ Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record _ Observed Site(Abutting property,observation hole,basement sump etc.) _ Determined from local conditions _ Checked with local Board of health _ 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 revised 912198 Page 11 of 11 l THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) Im ^�C� C DATA TOWN OF BARNSTABLE WTYON v � � SEWAGE # AGE ASSESSO S Xi & T---�L—Z--�T � INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY B t5 v LEACHING FACILITY: (ty w t �si e�j �S NO.OF BEDROOMS BUILDER OR OWNER u in PERMTTDATE: COMPLIANCE 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 J �>. A- O o �6 IA g 84 �{o No. 9`l 4D 7 O Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Digooar *pgtem Construction Permit Application for a Permit to Construct(✓)Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. c� Owner's Name,Address and Tel.No. VV �-}��1�19"It V AV-,1�A)Assessor's Map/Parce��' �, 13 dG V w� Tv� a�- 383a Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 1:e S"Vvey G,5 -7 7/-g3g9' i�o .,bo Ra,D �oSS ►Mu,r��o�us rt t�lc �J�f3 Type of Building: Dwelling No.of Bedrooms Lot Size '15j 09&sq.ft. Garbage Grinder(09 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Y(S" gallons per day. Calculated daily flow © 6- gallons. Plan Date I I Q--ci w Number of sheets oZ Revision Date Title S I I?- tS-f wu Size of Septic Tank I S 4 uaI IoAJ Type of S.A.S. 3 S005ct, �"� c-�"eO � '`' � w 1_�n tj 'CS S< <S t ENJK Description of Soil 5�e-e ,�Irk �✓ ZV7 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued o of J Signed Date G �' Application Approved by t ate ���� P� Application Disapproved for the following reasons ti c� I Permit No. 67 Date Issued 96 No. (n '(D / O Fee < v D THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -'TOWN OF BARNSTABLES MASSACHUSETTS 01ppfication for Miopogal *pgtem Conotruction Permit Application for a Permit to Construct:(✓)Repair( )Upgrade( ).Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �—�—�,L Owneerr's Name,Address and Tel.No. Assessor's Map/Parceig (p (o !, �/ 13 (2JcJ (f 1�.S. L (V 6: (o tt✓S�U✓1 X� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. nl �c S,.vyey C�nS�t�d9tVC� �7�j77/�g3q� Lj�.�g, yam, s Reap r^u-�s'tnNS r+�i Ic y��-Doss Type of Building: Dwelling No.of Bedrooms Lot Size 15109 6 sq.ft. Garbage Grinder(NP Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures 4 _ Design Flow gallons per day. Calculated daily flow '`<� 1/-0 6- gallons. Plan Date Q-9 Number of sheets Revision Date itle 5 l wa- 12 1 r4 IV Size of Septic Tank l' S D u R 1 OA! Type of S.A.S. 3 SOO tj u- vr, C Ant°C 11 A- `'tr(S -SirN Description of Soil . I Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue o Yof Signed Date APPlication'Approved by Date -7 '' f�.-9 - Application Disapproved for the following reasons i Permit No. 9 Date Issued 0 Q6 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ! Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(­ j Repaired ( ) Upgraded( ) Abandoned( )by at Ltd ` I WH !7-M A K O 06f 1 as been constructed in accordance with the provisions of Title 5 and the for Di s osal System Construction Permit No. 4Lg dated /.? -/U`S6 Installer_ /!5-0/L Designer The issuance"of this permit shall not be construed as a guarantee that the system will function as designed. Date 1 l 1 q Inspector ——— — /—�-/-- — ----- ---- ---- — ----- No. � (O`7� —.— — -- — -- --Fee (//UU THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE, MASSACHUSETTS ! wi!5po.5ar 6pgtem Construction Permit 1 Permission is hereby granted to Construct(Y Repair( )Up rade( )90A band n( ) System located at tol- 'V/ W 4 17 �I� 1_ 1 t and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: Approved by _T"OWN OF BARNSTABLE "G y SEWAGE # / !J VILLAGE >� ASSESSOR'S MAP & LOT,S - INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER ti . P BUILDER OR OWNER B�L je' �l DATE PERMIT ISSUED: (p - T 7 DATE COMPLIANCE ISSUED: 7 VARIANCE GRANTED: Yes No �i" t , ,. F' H THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) mP�CC DATA TOWN OF BARNSTABLE 111 C-ATION G�J �� G�/mil SEWAGE # .F��`.� � VILLAGE eg' .S" ASSESSOR'S MAP 6i LO lco INSTALLER'S NAME & PHONE NO. A & B CANCO 775-6264 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ®�'' (size) NO. OF BEDROOMS �Z PRIVATE WELL 0P,- LIC WA DER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: �t VARIANCE GRANTED: Yes No 01 .1 �71 M C�� � : r r ���� I I MILL M. d, � O ti A. 57 LOT 115 POD � O�j? 104 '� � I 90 92 94 96 98 � 100 102 , I w l j / I PRINCE COVE �106 I o S86 5119'E I 290, 81' 105. 61 �� L T°P DRIVE 24.0' n2 o A. M. 56/64 \ ��` \ GAR LOCUS MAP 1 AREA = 45, 096 S. F f \ ,I 16 4. 5 6,0' W y y I ASSESSORS MAP 56 LOT 64 j PLAN REF L C. 39614 B S EET 3 ' \ I is RES. ZONE,- 'RF" FLOOD ZONE: "C K - ���\ I 241 1 TP , BENCHI 151. 6' l ° l0 10 MARK 1 !; 4 1° - CATCH �aa ���L �G�` 6� �. >u c �. ,I4.0' lo' �c BASINS � WILMI0M G. N URPHY No 3anm EL=1031 5,3' \ 1 ,,'off ` � � l PROJECT LOCH TION 24"E / / `�\ ASSESSORS MAP 56 LOT 64 WHITMAR ROAD,- COTIJIT, MA. APPLICANT.- 1--)E VA UGHN STy i YANKEE SUR VE-Y CONSUL TAN TS P. O. BOX 265 UNIT 5, 403 INDUSTRY ROAD 8 \ �\ l MA. 02648 i MARS TONS M/L L S, l - PH.(508)428-0055 — FAX(508)420-5553 88 I - SCALE. . 1 » 30-- FT DA-TE. - 11/1719 f 90. 92 4 _ -- 96 98 100 102 T � - ! _ _ , y^ 3 rG y v.� i _ 2 - i _l.rrt .'mow..t� Y ,�4:'^ V♦ �i���- --'G4 7, -�°. .� ......_.. :+, .. -.. _... .., s. _ :�. .. _ .. ... � ...:,&k . .. .s .-v,.. ... .-. ^sue-'�... .w�+ '..:�. ,.. -�.._ < � _,�•.. .`�- .a.�..:. - �:.�,.,s. -,.:3>z.� ,. __._. ,: _. �. .._- -..-� .. .. ,. _ ,ti:. >_ _ x v.- _. «_._. >__. r,�.a �_ ,fi it ..•^a-:, t. .�a-r�s.,..M'z. a ... ..• >•- -_ -.- ,. .... n n.... �. -.......w ... ..:-a�+y .-. ... ,s..-._ ..'::4. _-{:4.. .1 � 4_'. dl'-Nz,n .H, r`.'1. Ca1'.i - _ +�.">a _ , ._ �,-�. .°�• - _ ,�-" - ,as. -�� ,o- ^... _ _ - .,_ :_ ' '�• _.. .....<. N', . . .. v.'"x _ .. .. ,. . ... z .r-, .•, o-r ,< :. _ ..,.�a .L� ,r� _ .. t ''+ ,. ,,...'x' .. x.- .. _ _..1._,,..: w-1, aK ... 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G. �- �-'._ .- .« ..�-: '$'.A ,Y' -. m. ..w'a"'�-.Y ,,�C-.. .,,,,,,;fit ,� � _.,. _ - ,. +.,, .. 4'?^:�'� <: -=.��'. +)?- r - . .. _.- w.. z... .. �. ,... Y -. > � � �t;^'x'�_ .,._._ .. �. � - �`�.. �_ w. mow. .._ .. .. _-•£r:"':aa'�-. .. - ,.., ��. -"•� - -&!... -�.. .. - �-...ham- ,. .�. ...s._ _ . ? _`"'' ma`s . 's€' e".r .5:+s• .'RS. )7 ����sy,,,, -/� .,:_ _ .,._ ,,.a. ...-,>: ...r.. __ ,_ e _... ... .. ... ..._. ...s.�€:ew .. .- �"k. -. _s"" F;.. •,d.F ...., ,.•:^- `��C', ".�,._.:. �s,..r9.r• "w _ _ _ •-s. -... �'"'�"� _ n..,� EL. = 103' TOP OF FOUNDATION 00' MIN, 10' MIN. CONCRETE COVERS 4" SCHEDULE 40 P. VC MIN. PITCH 1/8 PER FT 2"LAYER OF EL= 100 118"-112" CONCRETE COVER WASHED STONE EL,=103 4" CAST IRON PIPE ' (OR EQUAL) MINIMUM PITCH 1/4 ' PER FT CLEAN SAND 9 FLOW LINE 10' MIN. 10' EL=100 INVERT i%N 14" _ _ o 0 20' o 00 = _ _ _ _ _ = o 0 0 0 EL.= 101' INVERT SUM LEVEL 0 0 0 0 = _ _ _ = _ = o o 00 o --- INVERT BAFFLE EL.—100.25' INVERT INVERT o EL.= 97.5 EL.= 100.5' EL.= 100' — EL,= 9_9. 75 IN 4 0 4 (TO BE PLACED ON FIRM BASE) DISTRIBUTION EL.= 99.5_ MECHANICALLY COMPACTED OR 6" OF STONE ' BOX __l50_12__GALLONS TO BE WATER TESTED SEPTIC TANK 35.5' TRENCH FORMATION IF MORE THAN ONE OUTLET i� PLACE ON 6" STONE 3/4" TO 1-1/0" SOIL ABSORPTION L1, PROFILE OF WASHED STONE S YSTL' M (SAS) SEWAGE DISPOSAL SYSTEM BOTTOM OF TEST HOLE OR USES PROBABLE WATER TABLE ELEV. =_9_2___ NOT TO SCALE NO OBSERVED WATER TABLE (11112196) ELEV. =_92 OBSERVATION HOLE I ELEV.= 104.0 PERCOLATION RATE �5 _ MINI INCH AT _4�ff INCHES OBSERVATION HOLE 2 ELEV.=_ 104_ :. DEPTH HORIZ TEXTURE COLOR MOTT. OTHER DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 4 0-6" A SANDY LOAM IOYR4-4 0-6" A SANDY LOAM 10YR4-4 ! 6"-36" B LOAMY SAND I0YR6-8 6"-36" B LOAMY SAND IOYR6-8 �'- 36"-138 Cl MED. SAND I0YR7-3 PERK. 36"-144 ' Cl MED. SAND 10YR7-3 GENERAL NO TES E F 1) ALL WORKMANSHIP AND MA TERIALS SHALL CONFORM TO D.E.P, TITLE 5 AND THE TOWN OF �A_RNSTAB�E=___ RULES AND NO WATER NO WATER REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO - SOIL TEST E WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST 11112196 SOIL TEST DONE BY BRUCE MURPHY , R.S. 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITNESSED B;Y: ED BARRY WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE p # 8809 DESIGN CAL CULA TIONS.' USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4) ANY MASONARY UNITS USED TO .BRING COVERS TO GRADE SHALL NUMBER OF BEDROOMS . . . . . . 4 BE MORTERE'1J IN PLACE. _ INSTALL THREE (3) ACME_ GARBAGE DISPOSAL . NO 5) NO DETERMINATION-HAS BEEN MADE AS TO COMPLIANCE-.WITH 500 GALLON LEACHING_ TOTAL ESTIMATED FLOW I CHAMBERS. WITH FOUR .FEET _ DEEDED OR ZONING REGULATIONS- OWNER/APPLICANT_I,5�:TO = - - ( _440-_GAL/BR./DA Y x _4_ BR.) GAL/DA Y 4 STONE SIDES AND ENDS_ - }} OBTAIN SUCH DETERMINATION FROM APPROPRIATE- AUTHORITY SPACED ONE' FOOT APART. REQUIRED SEPTIC TANK CAPACITY 150Q GAL. = 6 UTILITIES SHO W1V.ARE APPROXIMATE ONLY :EXCA VATION<:CONTRACTOR_ - _ - _ - - - - — .-av SOIL CLASSIFICATION 1 - IS TO: CALL_- DIG.. SAFE__;>AT 1-800-322 4844 AT LEAST- 7,2y HOURS: ' y _ = -_. — =� Y DES'IGN,=:PERCOLATION=RATE'._ <° 5 MIN'.- - _ : - , _. �. - _: >.r -. w. ,. R_ TO_ COMMENCING WOR - _ _ .�, �_. «-, .x � �,. 4�ax --:�. _�... 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