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HomeMy WebLinkAbout0124 BETH LANE - Health 124 BETH LANE HYANNIS P A = 272 157 4 r q a " � o s _ . ° vrg APo 3 0 I � too �ft 200 COMMONWEALTH OF MASACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS R . ® DEPARTMENT OF,ENVIRONMENTAL PROTECTION ONE WINTER STREET BOSTON MA 02108(617)292-3500 TRUDY COXE Secretary ' ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor 4 i Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 124 BETH LANE HYANNIS, MA 02601 M272 P157 L30 Name of Owner TITO TEJADA C/O KINLIN GROVER Address of Owner: 698 RT.6A SANDWICH JOHN HUNTER Date of Inspection: 3127/00 Name of Inspector: JOHN GRACI l am a DEP approved system inspector pursuant to SecBon 15.340 of Title 5(310 CMR 15,000) Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02636 Telephone Number: 608464-6813 FAX 608-564-7270 CERTIFICATION STATEMENT , 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 _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: Date:3/27/00N The System Inspector shall su mit 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 inspection is based on criteria defined in.Title V code 310 CMR 15.303.My findings are of how the system is performing at the time-dinspection.My inspection does not imply any'warranty or guarantee of the longevity of the septic system and any of its component's useful life." THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING THE EVERY ONE TO TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. revised 9/2/98 Page 1 of 11 ' ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A' CERTIFICATION(continued) Property Address: 124 BETH LANE HYANNIS, MA 02601 M272 P167 L30 Name of Owner TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3/27/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: X' 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. B. SYSTEM CONDITIONALLY PASSES: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of:the replacement or repair,as approved by the Board of Health,will pass. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. n/a The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank, whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. a n(a 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. n(a 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: 124 BETH LANE HYANNIS, MA 02601 M272 P157 L30 Name of Owner TITO TEJADA CIO KINLIN GROVER Date of Inspection: 3127100 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 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 F , revised 9/2/98 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued)' Property Address: 124 BETH LANE HYANNIS, MA 02601 M272 P157 L30 = Name of Owner TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3/27/00 D. SYSTEM FAILS: " You must indicate either"Yes"or"No"to each of the following: have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. ..Yes No . ^• 4 ', 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 0. _ 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 l of a public well. ' X Any portion of a cesspool or privy is within 50 feet of a private water supply well, , _ X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.If the well has been analyzed.to.be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either"Yes".or"No"to each of the following: The following criteria apply to large systems in addition to the criteria above: The system servesa 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-1WPA)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 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM s PART B . CHECKLIST Property Address: 124 BETH LANE HYANNIS, MA 02601 M272 P157 L30 Name of Owner: TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3/27/00 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 hot been introduced.into the system recently or as part of this inspection. _ X As built plans have been obtained and examined.Note if they are not available with N/A. X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. The site Inspected for signs of breakout. X _ p 9 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)] j� The facility owner(and occupants_,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. E revised 9/2198 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 124 BETH LANE HYANNIS, MA 02601 M272 P157 L30 Name of Owner TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3/27/00 FLOW CONDITIONS . RESIDENTIAL: Design flow: 110 g.p.d./bedroom Number of bedrooms(design).: 3 Number of bedrooms(actual): Total DESIGN flow: 330 gpd Number of current residents:2' Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no): NO Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage): n/a gpd Sump Pump(Yes or no): NO Last date of occupancy: n/a COMMERCIAL] Type of establishment: n/a Design flow: n/a gpd(Based on 15.203) Basis of design flow:n/a, Grease trap present:(yes or no): NO S Industrial Waste Holding Tank present:(yes or no): NO Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available: n/a Last date of occupancy:n/a OTHER: (Describe) nla GENERAL INFORMATION PUMPING RECORDS and source of information: n/a ti ; System pumped as part of inspection:(yes or no):NO f If yes,volume pumped n/a gallons Reason for pumping:n/a r 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/a APPROXIMATE AGE of all components,date installed(if known)and source+of information: 79-794 Sewage odors detected when arriving at the Me,(yes or no) NO revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 124 BETH LANE HYANNIS, MA 02601 M272 P157 L30 Name of Owner TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3/27/00 BUILDING SEWER:X (Locate on site plan) Depth below grade: 18" Material of construction: cast iron X 40 Pvc _ other(explain) Distance from private water supply well or suction line: n/a Diameter: 4" ` Comments: (condition of Joints,venting,evidence of leakage,etc:) THERE IS TOWN WATER' s SEPTIC TANK: X (locate on site plan) Depth below grade: 12" .. Material of construction: X concrete metal_ Fiberglass_ Polyethylene_ other explain: n/a If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 1000G L 8'6"H 6'7"W 4'10 Sludge depth:2" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 6" ` Distance from bottom of scum to bottom of outlet tee or baffle: n/a How 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.) THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING THE SYSTEM EVERY ONE.TO TWO YEARS. GREASE TRAP: _ (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other Explain: n/a Dimensions:n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a Date of last pumping: n/a Comments: - (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) n/a 1 revised 9/2/98 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 124 BETH LANE HYANNIS,.MA 02601,M272 P157 L30 Name of Owner TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3/27/00 TIGHT OR HOLDING TANK: ._ . (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/a Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallons/day Alarm present: NO m Alarm level:N/A, Alarm in working order:NO Date of previous pumping: n/a Comments: (condition of inlet tee,.condition of alarm and float switches,etc.) , n/a a 4 DISTRIBUTION BOX:X (locate on site plan) Depth of liquid level above outlet invert: 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.) THE DISTRIBUTION BOX IS STRUCTURALLY SOUND. PUMP CHAMBER: (locate on site plan) Pumps in working order:(Yes or No): NO Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n/a revised 9/2/98 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL'SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 124 BETH LANE HYANNIS, MA 02601 M272 P157 L36 Name of Owner TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3127100 . 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: n/a Type: •. leaching pits,number:(1)1000 GAL 6 X 6' leaching chambers.'number: (n/a)n/a leaching galleries,number: (n/a)n/a. leaching trenches,number,length: (n/a)n/a leaching fields,number,dimensions: (n/a)n/a overflow cesspool,number: (n/a)n/a Alternative system: n/a Name of Technology: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding;damp soil,condition of vegetation,etc.) THE LEACH PIT IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT HAS NOT BEEN MORE THAN 3/4 FULL. } CESSPOOLS: _ a' (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer.,n/a Dimensions of cesspool n/a Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool,must be pumped as part of inspection)NO Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding;condition of vegetation,etc.)' n/a revised 9/2/96 Page 9 of 11 Y r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 124 BETH LANE HYANNIS, MA 02601 M272 P157 L30 Name of Owner. TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3/27/00 SKETCH OF SEWAGE DISPOSAL SYSTEM: E + include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) W . 23 4H' • o - 4 revised 9/2/98 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 124 BETH LANE HYANNIS; MA 02601 M272 P157 L30 Name of Owner TITO TEJADA C/O KINLIN GROVER Date of Inspection: 3/27/00 NRCS Report name: n/a Soil Type: n/a Typical depth to groundwater: n/a USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate_ Deep SITE EXAM _ Slope _ Surface water Check Cellar _ Shallow wells Estimated Depth to Groundwater 10 Feet n/a 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-10+FEET i revised 9/2/98 Page 11 of 11 -J LOCATION SEWAGE PERMIT 1110. /,� �/ VILLAGE ye4 Al A I N S T A LLER'S NAME & ADDRESS JOH;N A: AALTO BACKHOE SERVICE, 15OValnut Street iWest ,Barnstable, Mass. 02668 .,I UILDE R OR OWNER coed-s W -7/ h i�3 DATE PERMIT ISSUED _,3- ?9 OAT COMPLIANCE ISSUED �t / J / A4 /rJ o ~ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH liration for rrutit - ' ' Anp/icudno is hereby ou6e for u Permit to Construct (Y) or Dcoui" an Individual Sewage Disposal � System a... 72- 111..... .......... ...............................Zi�.�...3.i2...... Installer Address Type ofBuilding Size Lot So feet' Dwelling—No. of B��,00nuu-'-',=~�-------'_--.-]�xyaooivo Attic ( ) Garbage Grinder ( ) Other--Type of Building ............................ No. m6 persons............................ Showers ( ) -- Cafeteria ( ) ~� Other --------------------------------------------------------------------------------------------------------- Design _ per person Septic Tank—Liquid Length...P........ Width...����-- Diameter---------------- DeptSeepage h...3/z----- DisposalPit D�ouou�'-. Depth below inlet-.. Totu ft. M �vu"|�� v , �o m m uu� u � ~~ Percolation Test Results Performed by---.. --. .°0 .................. Date--- Test B6 No. l per inch D�� � �� �� Depth to ground ��' --------- Test P� I�o. 3-��'2....minutes per inch Depth of Test Pit-..--- -------- Depth roground water--'---.-/----- ^w � 0 D�o��u � ... ---''----'---''z��--=-°-=°�=~--'�~-�~-"----�-'��--'---~--------------------------------------- .-.-----__-----__.--.._-------.-.-.--.-----_'------.-_-.-..---_--_----------------.- U Nature of Repairs or Alterations--Answer when applicable----.-----.---------------'.--'--.------ --_---_--------'---'-----._--_----'--'--__-'-_---_----'--''-____-_--.''-_'_----__- A@rneuzcot: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLIT,1E 5 of the State Sanitary Code—The undersigned further agrees not to place He system in � operation. . .^^^'^ . Certificate of Compliance has been -- -'------------ ' Date � Application Approved 8y.......... .� '. ---------.- ---'���'���-�'�����-' o"ie Application Disapproved for the following reasons:................................................................................................................ � � '-'--_--___ Date dL - . Date . ` ' No................ .1':. F>$ ................... THE COMMONWEALTH OF MASSACHUSETTS OAR® O �-ZEAL OF............... ............. r Appliration for Miposal Vqr Towitrurtion Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal S stem app--- f - ------ ..... ........................................... ... ............... .. ,...........; .......... - ...................................... ..-- `1+ es Installer Address ,�' ' Type of Building Size Lot_�'"'.. ..............Sq. feet Dwelling—No. of Bedrooms......... ___________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther s _ ..--•----•---•----•-•----•-•-•-----------------------••-----••-••--• ----•-------•••-•-- ...-- . ._._ W Design Flow____._ ___ ._ gallons per persong�Iiay. Total da} �flow____.___ .__ _________________ s. P4 Septic Tank—Liquid capacity � gallons Length---;.?-------- Width__..=.! __.____ Diameter________________ Depth.... ...... W Disposal Trench No Width.__ x p Vdx___ Total Length............ ,;t Total leaching area_____ sq. ft. - :/ Seepage Pit No-___ --- __ Diameter......�..._.... Depth below inlet________ _________ Total leaching area__ ..____._s . ft. Z Other Distribution box X Dosing tan ( c ,p �t,/}��/,,� /! f(,/ ' Percolation Test Resul s Performed by.................f. ':___.___._.___._.__ _ __ Date__..________.______- a Test Pit No. I__� minutes per inch Depth of Test Pit t__ Depth to ground water __�__��------- Test per inch Depth of Test Pit....................Gzi ' Test Pit �'o. 2________________ P P Depth to ground �water........................ O Description of Soii:,;f!~ _ �r !!t �d� -p•.�� - , •-••••-•--.----•--•-•---- •••-•-- 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 TIT' y g g p y 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been ' su d by the b d health igne .--• -- •:-•- • -• Application Approved BY........... . -------•-- • ------- -•--- / Date Application Disapproved for the following reasons:-------••---------------------••--------------•---•••------•--••--------------------••••-----••---•-----•---•-•- ------------------------ "Date PermitNo............................ ........................ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..., Trrtifirab of Toutphattrr THIS IS TO CIRIMFY, Thatth n' al Sewage Disposal System constructed ( ) or Repaired ( ) ----------------------------------- has been installed in accordance with the provisions of TI 'f j'' e State Sanitary Cod, is fsb,�•Pe j i n the application for Disposal Works Construction Permit No_________________________________________ dated_-..........------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED A A GUARANTEE THAT THE SYSTDATFM.-yWILL •-•�••�C SATISFACTORY. -- ------. Inspector------.....:'=��-� -- ----- 7-------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS w. BOARD OF HEALTH 7�d. ........... tNJti! .....OF... �"""� ,w 5 1 1... ................... No......................... FEE........................ 0 Permission is.hereby granted •-=•---- •-•- :........_._ to Construct or air aId al Sev�ag y sal S sty at No. '( �? ( ) 5 C .4 s�1 ° yr► 'Y l�N1C/1 -------•••-•------• •--•-•.__..._---•-•. •-•-_.... _. .._.•---- ........................................................- Street i t /x- � ( S/. as shown on the application for Disposal Works Construction Per ,'%'iv'rl,L•!i/J / ._.... .. •-•••---------•----•---•----... Board of Healtli DATE........... :.5�_7� r 1 a FORM 1255 HOBBS & WARREN. INC., PUBLISHERS ' F '� uu, c�~ , , TYPICAL SYSTEM PROFILE AREA PLAN FINISH GRADE=5/, CL NOT TO SCALE I FDN TOP FINISH SCALE : I "_ -� � �— FINISH GRADE OVER TANK= �.__r GRADE OVER PIT== / / LOT # 30 B E T Hg S LANE P _ :- r •.rrri /�, VC 0 R C) 0 / �' —� • 1 • • • • • 1 e vv 9 CD • �C. 1. TEES ' e • o • 1 0 ' BSMT /OOC> •. FLR �. GAL. 4 � e • e , • • • o o , o e REINFORCED DIST. BOX 1 1 1 • ' e o o • • o `' 11 TO BE INSTALLED ON , CONCRETE 8 ti , e • e 1 • • • I o 0 1 A LEVEL STABLE BASE • o • • • I • o 0 0 0 1 �' 1 e o • • • i • o a • 0 1 SEPTIC TANK ' TO BE INSTALLED ON A , • • • • • • 1 e C,B• t. OAI. LEVEL STABLE BASE o • ' • • • 1 e I s: tD' 2"-1/8"- 1/2 "WASHED PEASTONE ALL ' ' ' ' • • " ' • • • ' BRICK a MORTAR COURSES AS AROUND FREE OF IRONS, FINES , • • e • • o e o e r REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE 107� LEACHING PIT 24 C.I . MANHOLE COVER a 3/4 TO 1 -112 WASHED CRUSHED FRAME - SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL p IRONS, FINES AND DUST IN // �� t 7h o� 0- IL�— PLACE l �'��-Y D. ) .�... _ _ FOR FIN. GRADE .- 420. Or � � SEE SYSTEM PROFILE � 111� , SOIL AND PERCOLATION j . 14 - DATA Z0i ,moo f - --- --- _ - - -- -- - - /,5 Q�� S�" PERC. RATE : s 2 MIN.�IN. I ; , 6o ' C5IDF� S -- - - -- - - - -- - - - - f!o u�:E W1.224 /4" FOR INV. ELEV SEE TAKEN BY . C. D SPOHR , -- --- INLET o SYSTEM PROFILE � � . , PE'O Dk/Y �� LINE ° o6 �k Ys c-�. �:, ' WITNESSED BY:C3FiE'A1STs��'?lF ¢-°'�. OF NFAc-� © ' 3 ° D OPENINGS W/4 1�8 ��° /-., (107, / `:� 79 «. ._.. - __ ° OUTER DIA. a 1 -3/4 0 DATE : - ` N, L +jl T5:3R ty7INSIDE DIA . ° TEST PIT GND ELEV.F? 336 a ° TOTAL D o AREA c . ,o Do , sys o i l �D .P�s7- LF r f ° • , ° . iv 0 WF3 ',ra 30 , Lew' Y• SfiD]' t. Cs�,r ESN _ 0 D D D 0 0 o �' �' V'� L FROAiT? =5�o ' r�NK Pir (!� _ _ o 0 0 0 o 0 0 o p } � _ II 2 ' 6 '- 6 " D IA. 25 <S lf.�E� �+ . C��'� '`��A� BOT. PERC. HOLE r /C '6IfEFFECT1VE DIA. DOWNn/ � � � , LEACHING PIT SECTIONNo SCALEDESIGN DATA : NOTE. DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM / NO.F BEDROOMS DISPOSAL -LEACHING PIT NOTES: EST. TOTAL DAILY EFFLUENT GALS. I . CONC. TO BE 4000 P.S.I a 28 DAYS . SEPTIC TANK / ��'�' GAL. 2 . REINF W 6 " x 6 " 06 GA- W. W. M. o, 3. 2 'AND 4 ' SECTIONS ARE AVAILABLE FOR GENERAL NOTES Ir/, GREATER DEPTH REQUIREMENTS `1 CCkT/FY THAT TINE PRoPosk3 H005E' I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN .5-HOWA.1OAl THIS P!-F+N C641F0045 TO 77#k' NOTE ' V •Q0'Q� OR LOWER AS ACCORDANCE WITH TITLE5OFTHE STATE SANITARY CODE TOWN OF 64AW57A&E ZoAlIA1� EXCAVATE TO ELE . DATED JULY 111977 a ANY LOCAL RULES APPLICABLE. .E'Ei" REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING � ��, ��-��� 2. ANY CHANGE TO THIS PLAN MUST BE APPR'D. IN MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL WRITING BY MR. CHARLES D. SPOHR• WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, ,0FrQ$ P4.AAI Bot. 27T /---G 8•d COMPACTED IN PLACE. �a.SIDE AREA S. F.��S.F./GAL GALS NOTIFY THE ENGINEER AND BOAROOF HEALTH FOR INSPECTION. = �� °� `�-- OWNERS 4 BUILDER BOTTOM AREA= ! S.F @ ! 0 S. F./GAL ZGALS 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED. TOTAL AREA =�)84E S. F. TOTAL `-%2 GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN F4 y�A/,'tl tJ/Ll.� 'S APPROVAL BY CHARLES D. SPOHR. &y 00" c-Ak A,4 R019/-) LEGEND 6. FOUNDATION INSPECTION REQD. WHEN EXCAVATED. j FAl_A,4007 ;-1` "A�5-5, A ♦ 50.0' EXIST. GROUND ELEV. B _ M. HO T E • 50.0' FINISH GROUND ELEV."UNDERLINED" ,r r 4750 PIPE INVERT. ELEV. REv. DATE DESCRIPTION nor & /).ssu"E-o Ektz`v. t o 0o Q TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM AREA FLAN V(�' F O R 0 o SEPTIC TANK ���� �,( � F"k S'UA-M V PLAA1 ❑ DISTRIBUTION BOX t FLYNN BUILDERS T �j Mq.3� LOT 'O BETH' S LANE : I-or �S Alor IA/ THE FGk C, -e F, ,�ul�L)Ek5' SC,441-1 1 " 30 _ „ 4 C. I . PIPE �` y. I TCHERS WAY) HYANN I S a n�sTA84F FLU ����N ocT '�9 �� c��� � �sc�uv� kV6� �e , ���. ��. e (P } {-1 4"BIT. FIBER PIPE ' TIGHT JOINTS ;o Charles D `. � SPOH►°3 Tom►., 11/>� T � _ __ _ o ' y No. ;4r,a ,r. DESIGNED: C•D.SPOHR DATE:3O OCT -19 DRAWING N0. i'WAV ►v ` ? PROPERTY LINE `'ti `��sTE�` DRAWN: C1.`, . SCALE:AS SHOWN [� MIN. CODE DISTANCE E A`-' 30 C 9 I MAP SEC PCL LOT HOUSE CHECKED: C D. S .