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HomeMy WebLinkAbout0040 GEORGE STREET - Health rA4WGliorge Street, Hyannis, �. =- i I1 l� e II, I. 1 II �I� o - O C II . . TOWN OF BARNSTABLE . LOCATION l(Q 6(fon.e S�- SEWAGE# ?_ooq'36g VILLAGE LhAnn i4 ASSESSOR'S MAP&PARCEL 29 t 18 -t INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I a o � F LEACHING FACILITY:(type) . S 10 oe I esS 'rolt.✓t c).'1 (size) '39 x Z.9 Z- NO.OF BEDROOMS.. OWNER IN M�`t S PERMIT DATE: t 12 0 COMPLIANCE DATE: g' c 5 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom.of Leaching Facility 10' u 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 FURNISHEDBY Ct,;V&41 ���c�Or•�Z �`� Cl Ic, � W V O - r No. V� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpliration for Bisposal 6pstem Construction-Verrnit Application for a Permit to Construct( ) Repair) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. yp "r[,q Sz'd?pe i Owner's Name,Address,and Tel.No. rA;Ca-«►AP Ph„1,e 5 Assessor's Map/Parcel 20( $'Z �`'t'A'�^ils (Zpt 5 t ' ftvAtbwe l f-4A 0 Installer's Name,Address,and Tel.No.�n�,,; -E�j�rrPnSes Designer's Name,Address,and Tel.No.Tc.E„g,,0—lh PO 30x-763 2$fH co , til- Type of Building: Dwelling No.of Bedrooms Lot Size 13 G(o® 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 ( 1 I y 1200j Number of sheets Revision Date Title SE Size of Septic Tank 15nc� Type of S.A.S AAltC 3 io N49,�5gg Description of Soil Nature of Repairs or Alterations(Answer when applicable) �Q,r,�� 1 jG0 4,C 1A--to `,Z� S & �. L 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 Signed Date till �� Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued ,., �.,,., mx �iFw�:�r:,+�++,+��-�-.,.f,:9:w-vw -..,..rr.•.�.,.... ..»....,,.-..... -�-_.�----.�--�-- n .,;_. — - r..,..anw�.�+�-w--•^-.�:a�•w-..,� V....M ..•.,. tea,=....•«c-a Fee .( V y THE COMMONWEALTH OF MASSACHUSETTS . Entered in computer: Yew PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS a, application for,Misposar, *pstem Construction Permit t . Application for a Permit to Construct( ) RepIr-) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. %40 Ge_�,r e !sr�d a e4i Owner's Name,Address,and Tel.No. ►'h �nt pie,ogp.�'P ST Assessor's Map/Parcel Z�( �Z n;_� t�'tA-(btet^+aA•c� 14(p o��s Installer's Name,Address,and Tel.No.(���ew r.[e 6;,)4j0,5 e) Designer's Name,Address,and Tel.No.rc.E"s Po $ox-76 Type of Building: Dwelling No.of Bedrooms 3 Lot Size 13 6�o Q sq.ft. Garbage Grinder( ) Other Type of Building ,btu"n A v No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date ( (I ( � 2oar, Number of sheets Revision Daie Title DLO G SQ I Size of Septic Tank 1-ISM Type of S.A.S Z) A 2C 36 H(- Description of Soil ,Nature of Repairs or Alterations(Answer when applicable) �f ) l j©O 1A 1.. "I y i y —3zi-1 Date last inspected: Agreement: ' F 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�Healt Signed Date 1 _2,0oq Application Approved by I Date Application Disapproved by We for the following reasons Permit No. p� f�'� — p _ Date Issued Z- ' r-__-.._.._ .--,--_•_---.-------------------------.--------------.-----•-_---_._-_-•_---_•-----•_�____________________�--- .i_�-_--_-_-_--_ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded( ) Abandoned( )by la JLe.��, i�A- eL,L •e at 4•0 Ge has been constructed in accordance I with the provisions of Title 5 andI the for Disposal System Construction Permit No. dated 1 r s !it 'y Installer ,7 LL( Designers :L. #bedrooms 3 Approved design flow A 3 Z D gpd The issuance of this permit hall not be construed as a guarantee that the system wil fine ion as fdes'igne 1. Date It) Inspector lnr---------------- ----- Noa\��/� / d - ----- -- - -- - - - r- - - o U-I'�{(�p Fee 1 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair ) Upgrade( I) Abandon( ) System located at (� 20f 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:rConstruction must be completed within three years of the date of this permit. Date `� ���d� Approved by �� -�� S Town of Isarnstame Regulawry Services r ot Thomas F. Ceiler, Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office: 508-862.4644 17ax; 508-790-6304 Installer Desi Culmeation arm Date' /0 Designer: -"rc:- � heec< Tin c Installer: C:c: ew,&, 6&ec' res� Adciressc 2.6.5 k Cc�,ntverr tlr hw�' Address: —� -----_----_-_- -,. Wore,�n6m Hr4 6253 fi C- t1`�� ✓IM1(� 0r, l l l2. Zvi di3 �Lco� i a permit toy install a (xnstalle `¢S _-" was issued septic system at �y ��e c ; 4 5 t ¢¢. based on a design, drawn by (address) i;tee�,c•c ve be�_...—__.r.&0..._.._._ ?.�-.L dated N� A(n , y ZCo y (designer) ^� •_Z I.certify that the septic system referenced above was installed substa ntially to the design, which may include minor:approved changes such as lateral relocation ofgthe distribution box and/or septic tank, 1 certify that the septic system-l-eferenced 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, JOHN L. taller'S Si' attlTl1_ --- a CHUF2;,ril�. ,� J 'IVIL • a�f177 t .—. (Designai s Si e) `---- _ WE estgner' t►mp Here) P "TU TO ST LE Y3 ON C T C T . OF CCE L B T C BY THE �• H U, I' ON. (�: Heplth/Septic/t)esigper Ceilif;catioh Foam T 0 -d L9£0 £LZ 809 ON I N33N I8N33r WU OZ: T T O T 0Z-t�0-NUr e , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name. information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: t/ A. General Information When filling out � forms on the —✓ computer,use 1. Inspector: only the tab key to move your robert Paolini ' cursor=do not use the return Name of Inspector key. Capewide Enterprises,LLC. Company Name r� P:O.Box 763 Company Address centerville Ma. 02632 City/Town State Zip Code (508)428-4028 S14454 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and.that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 1."40 of. Title 5(310 CMR 15.000). The system: E ❑ Passes ❑ Conditionally Passes ® Fails' ❑ Needs Further Evaluation by the Local Approving Authority En C; 10/01/2009 r- Inspector's Signature Date CD 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. t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Dispo I Sol Page 1 of 17 e Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name a information is required for Hyannis Ma. 02601 10/01/2009 every page.. ' City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/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 3'10 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5'Ofricial Inspection Forth:Subsurface Sewage Disposal System-Page 2 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface-Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name information is required for y H annis Ma. 02601 10/01/2009 , every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): f ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑'Y ❑ N ❑ ND (Explain,below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 pipes)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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: El Cesspool or privy is within 50 feet of a surface water El Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•04/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Amm Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M Michael Miles Property Address 40 George St. Owner _ Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection .B. Certification (cont.) 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: ❑ 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 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: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded El ® or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. El ® 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. El ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within'200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered `yes"to any question in Section E the system is considered a significant threat, or answered `yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ 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? i ® ❑ 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? ® ❑ Was the.facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has , been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name information is Hyannis Ma. 02601 10/01/2009 required for y every page. City/Town State Zip Code Date of Inspection D. System Information Description: The septic system consists of two cesspools and one leaching pit. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes n No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date 2009 . Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ,❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): t General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool ® Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)' ❑ Innovative/Alternative technology..Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the PEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address . 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: _ Leaching pit installed 1988 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1' Depth below grade: feet Material of construction: ❑ cast iron ❑40 PVC ® other(explain): Orangeberg pipe Distance from private water supply well or suction line: 10'+ feet Comments (on condition of joints,venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑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 Dimensions, Sludge depth: - t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) 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 Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: 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 baffle Date of last pumping: Date t5ins•09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: - ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): 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.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 x Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. ` 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): f Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): l Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts. Title 5 Official Inspection Form, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy soil.Leaching pit was full at time of inspection. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 main and 1 overflow Depth—top of liquid to inlet invert 1' Depth of solids layer Depth of scum layer 511 Dimensions of cesspool 2/6'x6' Materials of construction Concrete block Indication of groundwater inflow ❑ Yes ® No. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Main cesspool was full at time of inspection.Overflow was-dry but stain line was observed at top of ` cesspool showing it has been full at one time. ij f Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): - - i t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 117 Map Page T of 2 Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size ® Zoom Out ,In O O ! r . f{ Imo` •; I , 6 �� T ,. ::. ; ... 2 ::.Feet: < e .._........a........_.._.............. ....................................................................................................... .....• Set Scale 1" = 20 I Aerial Photos 4 APDISCLAIMER _ ._._......._ - f ' r`n ,,inhf 9MF_,)onQ Tn... of P.—O.H. NAA All rinhfc roconn httn-//www.town.ha.rn-,ta.hl e.ma..ns/a.rci ms/anngehann/man.agnx?nronertvTT)=291 OR2&ma.n... 10/3/9.009 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Michael Miles Property Address 40 George St. Owner Owner's Name information is required for Hyannis Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ; ® Check cellar ® Shallow wells Estimated depth to high ground water: Bottom of LP 22' 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 ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments Michael Miles ' Property Address 40 George St. Owner Owner's Name information is required for Hyannis. Ma. 02601 10/01/2009 every page. City/Town State Zip Code Date of inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ®Inspection Summary D(System Failure Criteria Applicable to All,Systems)completed ®. System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 IA 7 'Comft)onweafth `MOSSOC M'Of- Lzatts ,a— John Grad ExecuNe Office-ofEr-MroMmental-Affdrs D.E-P I Title V Septic-Inspector.P.O. Box 2119 0 t iftt-ft t- 6A pie,R 1' -0 Teaticket,MA92536 hyaronmental Pr tection M8)5-0::6$13 let A. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION loor Property Address: 40 George St HyannisAddress of Owner: Date of Inspection:9126196 Mrs.Wafters(if different) Name of Inspector:John Greta Company Name,Address and Telephone Number: 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 coffipfet&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 Furthej�Evaluation By the Local Approving Authority Falls Inspector's Signature: Date: 9126196 V The System.Inspector shall.submit a copy of this inspection report to the Approving Authority,within thirty(30)days of completing this inspections. If the system is a shared system or has design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B.C,or 0: A] SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CIVIR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair, passes inspection. Indicate yes,no,or not determined(Y,N_or ND). Describe basis of determination in all instances. If "not determined",explain why not.) The septic tank is metal, cracked,structurally unsound. shows Substantial infiltration or exfittration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 11115195) One Winter Street • BosWn,Massachusetts 02108 • FAX(61T)556-1049 *.Teleph6ne(617)-292-5500 r-s.e'f ,,. i t a''�, < s... v., ..ae `.s s{� - w• lk ,}K' '7 i .y.9 at", h {r •!' �e19•.•'V ¢ .`*aA di; .3 "' t i t' �.'" ', "`+�',�?' •§,may 1 ''�_�:� 'T"r +. '9^''r f' _ •'.'4't.2.4, ` �" }� a?3'.0 w. ter' •�. � hr;' � '�` .�' r �-. 'Yw,-FS� � � t <� •�_�r"c --..tea..-,_.�.a.•ar�.�„�•..C.�. � - _�- � _ "qf�#,-•'�j- }--�11f'`''�'C.-'�-r•r •%, �- —..�--fir �.-s��''r``..�'��5� .�-e c ""�:�..,-t-t^'sa .,.�.>— ''•�i'sn.� � �c• -�.�...."�"��'--x.".^�-_ �,-s-a`•z+��.�:��as-�12�"•�+�-- ��"'r,-•x+.�,.�..;.-.-��.._ QP _ -ice.--,�„r�-'� �:a-.•- 1.-�. -, _ r.:,�:_ _.w�. .. 1-. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 40 George St Hyannis- Owner:. Mrs.Watters Date of Inspection: 6196. Sewage,backup•of-breakout_orbighs tic.water_level observed in the distribution box is due to a broken, ;settwd ol'm-�;ve7i-distribntton-tex:�he�-sysfenrwiit-pass-inspection-if(with-approval.of-the..Board,of Health)_ broken•pipe(s)are replaced obstruction is removed - distribution box is leveled or replaced _ _The system required pumping snore than four times a year due to broken or obstructed pipe(s). The - - system will pass inspection it(with approval of the Board of Health): - - brokempipe(s)are replaced obstruction is removed 1 Cl FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: _ _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT.THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria volatile organic compounds indicates that the well is free from pollution for that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm. 3) OTHER D] SYSTEM FAILS: _ I have determined that the system violates one or more of the following failure criteria as defined in y 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. Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged cesspool. SAS is in hydraulic failure. (revised 11115195) 2 - x .t'e?�'- .• LF-7�4.» � Tc. �+,t�•��.`+'�j"-c :+n 4�F'.^te:, '�� "�i: _.;""t � J .�.F- _ �,r: _ +z "•{. ct '�i�'A.P •r � F .•�•'traf �} 4 4' � SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART A -CERTIFICATION (continued) ' . Property Address: 40 George St Hyannis- _ r Owner: Mrs.Watters Date of inspection:,9126196 _ E�IIFAILS-(bdhtrnuadX'_' Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6°below invert or available volume is less than 1/2 day flow. r Required pumping more than-4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped - _ Any portion of the Soil Absorption System, cesspool or privy is,below the high groundwater elevation. - Any portion of a cesspool or privyis-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 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. 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: The following criteria apply to large systems in addition to the criteria: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water.suppty 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 Area (IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 11115/95) 3 , t s't i�i'� X+i.A a. � ♦ r� �r...w...�..,. `.• .'N� .,.r i-�. ,�� .„�.j Sys., Kc� �Y � t z L`:: tr '/`tl I •r - �.,y # L� _� \,.,y{}2',y-,�f ti,y s.: .� t � . •awt� •.•" � A.� � fit" .a j.';y j!. X.s' b,.li, a- 4£'`' W S —StJ$St}RFAGE SEWAGE DISPOSA -SYSTEM INSPECTION FORM s - -L T,B> s s - _ ---1_..,:,_�^-•��^cr-•.�`.w r. `" �.s's !_.�•„�,.�--_=S-F#E'L'LLST+- ..--=-=^�- -`.w�'-'T-,p-..:_�= 4+«;W^r`•...--.r-'� '-�_:.a�-�--��..._��,,,�•.-:� Property Address__40 George St_Hyannfs ' Owner: - - - -.Mrs Wafters UdLtl Check if the following have been done: 'x Pumping information was requested of the owner,occupant,-and Board of Health. X None of the system components have been pumped for at least two weeks and the and the system has been receiving normal flow rates during that period. Large volumes of.Water have not been introduced into the system recently or as part of this - inspection. nlaAs 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. X The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods, x The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 1111115195) 4 ,� • P i t0 •c.: :s.?'yC+ * 4r1A�"(�°'.:rs ,} '., ty�,.-.� Y �-." t ct.: i*Yes rl,�•. � � [ VV -SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM T ,. PART-C - ��� .,`SYSTEM INFORMATION - f�~---�..�.: �,�..�`�.:-��.�" ;w.-�3. �:�-.-...--'ice-Y..�._„-s'"i.�,—•,.��._LY��, Y- - .'_=�_y_,-.•.-y=.r-^R� ;,�a'�r.,.,.. L ...L :.- > �--,.. -,..____ -.i _ -.•w��,-.yrs....+-- .F' w:X fir-�.•s s:Sw w-.ti-- 5=••a•sc+-=`�a•-4 y Ets..•:... _ u._r. _. �_Property-Ad-dress-,-4QCeorgtStFiyannis - -� - -• - — - - I owner= _Yt Mrs.watters— ,, . -3• ;-�' __- . Dafe.of-Ins pectron_ 9126/9 _ FLOW CONDITIONS - E�ESTD5tFIIAL .� Design flow: a -- gallons Number of bedrooms: 3 - - Number of current residents: Garbage grinder(yes or,no)` ao - - Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No _ Water meter readings,if available: Na - Last date of occupancy: COMMERCIAL/INDUSTRIAL: ✓ Type of.establishment: Na Design flow:a gallons/day Grease trap present:(yes or no) No Industrial Waste Holding Tank present::(yes or no) No Non-sanitary waste discharged to the Title 5 system: (yes or no) No Water meter readings, if available: 'n/a Last date of occupancy: rda' OTHER: (Describe) Na Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System has not been pumped in the last two years. System pumped as part of inspection:(yes or no)Yes If yes,volume pumped: 1000 Qallons Reason for pumping: maintenance. TYPE OF SYSTEM Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) ( if yes, attach previous inspection records,if any)' Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source information: Main 30 years Leach pit 8 years. Sewage odors detected when arriving at the site:(yes or no) (revised 11115195) �� s�a� � l�k�'. � j � �,_�` Z{}-��Y,�`f�:F `��'>;4t�.a� t'�i4�4�i�.y.Trs''�. :�Y F�� Tix�^ �. 3i�. 'c�'i ''t t�jt•. a: .. ,. ;�v.>�"', -^:^r� '��-�..�.,-;fir•.,„ _y�A`*'�3`"�-_.='�`������_ __ �s�-� :a:=..- _y, -�r'.--�''�•``-'��'t.`-�..��+--.a, `-='a��• ''SUBSURFACE SEWAGE DISPOSAL SYSTEM_INSPECTION FORM ' r _ PART C _ SYSTEM INFORMATION(continued) .P_ropertij Address•"'4fl George St HyanNs - - - - Ownei: _ PMrs.Watteis' Date of lnspectlon_4t28I96 _ oc t —_— _ .,Depth-below grade: rda Material of construction:x concreate- metal_FRP_other(explain)r Dimensions: Na Sludge depth:Ma - - Distance from top of sludge to bottom of outlet tee or baffle: n1a Scum thickness.Na Distance from top of scum to top of outlet tee or baffle:nta _ Distance form bottom of scum to bottom of outlet tee or baffle:n1a _ Comments: -(recommendation for pumping,condition of iniet'and outlet tees or baffles,depth of liquid level in relation to outlet invert,.structural-integrity,--- - evidence of leakage,etc.) Na GREASE TRAP:_ a (locate on site plan) Depth below grade:a Material of construction: _concrete_metal_FRP_other(explain) Dimensions: nla Scum thickness:n1a Distance from top of scum to top of outlet tee or baffle:n1a Distance from bottom of scum to bottom of outlet tee or baffle: 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.) Na `3 s I t (revised 11115195) 6 f�}-4i♦ L��'SSr ,,.,t, .,sK��"•x"��.a.� �•Fr:-.-- "� -~=� �`4,'F•--.�.•,..,.asss•• s„1'�"-. :.x'"-�,�^.s_.,,,, '+ ^.�-.�.�:-`�---�...4 r'"`c---��- -'rn�s:4�»:t'. ...w�.,.r-; � �"+-�Y �°.A,��-��'• "` ,, �..��� .,,,.�t'- •,.�w�a"gam"-c�':ic..- `�"Y.a. "c+-� '�. ah•..... "�,t-•��.^•.•.. :n_.'�``•3.w.-., "'xa_ d`"v._rT �.+`j'r''°_—t ` ..2'-"'a-r .x.�.e u'.. z .. .. �'SS".. .'r"Y"'"•,Z' '-.�• -._-is*7. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C _ ... _uc_ _ " SYSTEM INFORMATION(continued) .r • Property Address: 40.George SLHyannls - �- - -Owner _ ? ;Mrs Wafters t _ - '- Date of lnspectiori'912619 4 vY.r. ?w �- - --» :� f,• -?--- - ._ --- TIGHT OR HOLDING TANK:` (locate on site plan) Depth below grade:n1a - - -Material of construction:_concrete_metal_FRP_other(explain) Dimensions: nla _ - Capacity: n(a gallons Design flow: nla gallons/day - - - Alarm level: n1a - Comments: (condition of inlet tee, condition of alarm and float switches, etc.) n1a DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: nia Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box etc.) nla PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no)_ Comments: (note condition of pump chamber;condition of pumps and appurtenances,etc,) n/a (revised 11115195) 7 • Y ti.."' • '„Sr •8'F ^. f�„ �" 1 y ,� ,� fMMUI S �j�P "S - s14�J ""'•'- M'.e.•e s f „�-' ,}. .a cam} ,t WA, ,• + r°!'.i 1-4 �=.�-_�> '�.:a�"` -'' «�.�'r.� _-..c7G+sfie'. - ..a,►a+.�-rr. - _- - _ ;;-' •rr- .--tom._ a'�, :•�•�.. +i"..r ^- "+"r-+�,L € SCE .ems_ +: `_'a - --�, 'sue�i y; a 3 - ���5--,.'',,.�..���.+_�W�"-"�-n�:�-- e ... 'n-�p.'7' s-��-��5�"�-��•�.' ,rc ,.�.•atw. .u..� t-- ,.a+,,•r �s.i.. -.`: -"�`�o•i."-4T-i'��J�.�.+`—�X"'�Sf+ •ss"'a� ,K�r�+•Tier+ e�-al"' � '7-'.�'^�s" �'"�''1""�i+• 'r•�+n"..�1G"� "R✓" � �3y5�laJ•,,w --� „�r� �*��r;.�,.. _ �, ?�.,�._ �. Y ..ti* rid-trr- �� '��T y�.`� �•^r•,a,,„� .,ri '�' .i '�'�,u'- F..`. •"''_" tw. �"x i.. ,c-�+- t x.. S �-�:*� �^. T�'y>�.�y'��tr T•„F •�y -..z....tr6'W",.'�'Sr�'�K14F -.:.- -�v y y...� t4,v _ ! ± F� h�'1.s.,`� yW �s.y *+.,.,4.'". '' 't',... ^"V a`'•d-`..u'_"�Y-'y�'•'.-Ta � �� �.` '_'..••.. _� 4;. P 1 y- t +c� �7;.:? �r� i-i .,y�. SCI8,5 AeSETl,Ge—POSALS(STEMINSPECTIONFORNI; a 'z""" .w-� ..+,•...a.. �A �. '��"r.+_.'�Kja•'•i�..a.;.�` tir «.+ �..a,.. �.«>•t��.� -:""'}'.-"�,."''�� ..R�}P'R t7 t.••t,E's„�'�il",,.�_�k�.n.�.�'',Y.-.- .;-�s��+?4�r•"'�a .`� 1,�� t��.T=-s> . '� r .- .••-y+...-.�-Yam"''' �"� ....t'T" 11 'i•cF� '*r,.•t�i-$ac.-�.w:?nr.�' r .s .�. ,-, .^ �y".'+,T' "�"�F}a`:: -'-'-.^��^ri'".. �...-":�.'""'.'"'".`' y '"� _ - t�L+`�„T.�-F-;�.--.+rt •r. .-,,,..,,,_.,_ t-"'-__" �i,,�, ""'�..,� T - -?.. .,.. �-+,..-.,._:?a-- 'sr• -:•..-.F-r'.`--�a��?:�t.s�••-ss�,,,�._. '-5'� ..- ��.• a '"-....- -ti•.t,'_ fa.Tc- '!� -"r'sti t .S-kv �., _ - - -.: ,.wa ..•e. roeaR}�Address 4�George :. '-..-,- .is•••,:r,i•CiiJ:::WY'Sa-rr.-«.� .•.re.:... ..... �-.f: =-'w'1-_ '": e' h'-'a'-- Mrs.Wattecs: ; _ t tdate.at Tnspectfon:9128 fr, ~,SOIL ABSORPTION SYSTEM (SAS).X - (locate on site plan,if possible; excavation not required,but-may be approximated by non-intrusive.methods). If not determined to be present, explain: Na - _Type: _ leaching pits, number: 1,000 gallon leach ptt _ leaching chambers,number:nia leaching galleries, number: Na leaching trenches,number, length: Na ' leaching fields,number,dimensions:nla overflow cesspool, number:n/a Comments:(note condition of-soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) --The leach pit is structurally sound and functioning property. _ n CESSPOOL$:x (locate on site plan) Number and configuration: none A. Depth-top of liquid to inlet invert: V Depth of solids layer: 6" Depth of scum layer: 1. Dimensions of cesspool: 6x6 Materials of construction: BLOCK Indication of groundwater: NONE _ inflow(cesspool must be pumped as part of inspection) Na Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Main cesspool is structurally sound and functioning property.Recommend pumping system every year for maintenance. PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: Na Depth of solids: Na Comments:(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) PrivyComments (revised 11115195) ~ •f' -,y .sJ' } 'yw-'T �++`lea�L�Fl�i �� h. T'..S•� � +Y} �.'.y� N1 ww: a+. � r :n ry' MIN SUBSURFACE SEWAGE-DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued). 7. Property Address: 40 George St Hyannis Owner: Mrs.Wafters Date of Inspection:9126198 - SKETCH OF SEWAGE_DISPOSAL-SYSTEM: -' include ties to at least two permanent references landmarks or benchmarks locate all wells within-1,00' _ Dee .� ��. co DEPTH TO GROUNDWATER Depth to groundwater:12 feet method of determination or approximation: USGS Maps and Charts (revised 11115195) 9 TOWN.OF BARNSTABLE LOCATIONS C�a� �� SEWAGE # VILLAGE n C ASSESSOR'S MAP & LOT ', INSTALLER'S NAME & PHONE NO. ; SEPTIC TANK`CAPACITY LEACHING FACILITYAtype) (size) NO. OF BEDROOMS PRIVATE WELL OR PU (LIC "WATHR iBUILDER OR OWNER ;DATE PERMIT ISSUED: DATE ..COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No � . . . - � f� 1 • ��. ., a� rj f �,0�. .... _ � �. � c r A � '��. _ ti � � ® L f c. _ . II :. 0 ,. TOWN OF BARNSTABLE LOCATION SEWAGE# FY- 3/6 ' VILLAGE ASSESSOR'S MAP Cz LOT g/v 4 INSTALLER'S NAME & PHONE NO.-A & B C ANC,'O 775-6264 k SEPTIC TANK CAPACITY , o_v v / �s LEACHING FACILITY:(type) (size) i,oov sue_ .NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER �,bEs �.✓�%tip DATE PERMIT ISSUED: f DATE COMPLIANCE ISSUED: lo�i/ w VARIANCE GRANTED: Yes No /� W 1 - 1 f � .�• i . C i ' _ _ - - -� ��. � �: � -� ' . _ � � ` v �° t . ' �' �� o ,� \ r, .' r .r -, ,: -. ASSESSORS MAP NO: -------------------- PARCEL NO: Fia.....o20 ........... THE COMMONWEALTH OF MASSACHUSETTS BOAR® O1F1 I HEALTH own .......................OFR1R1e............ ,� lir i�an for Uhip sa1 Works Tontitrurtiun Virmit Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at: .....q�...�e• ..._.r *........ G7�la14...................... .................................................................................................. 11 l�ocation-Address or t No. ,... . r�anl -•.....................•--.....- Owner Add ss a 4 .�'�r!;o...................................................................... ..............................................6W.1te&MOlf' ................ Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a+ Other fixtures ................................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity...----.....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 ( ) PercolationTest Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water...--............... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x ;.:... 0 Description of oil......................................... U ---•--------•-----..---•-----------------•--•---------------------------•----------------------------------------.................................. . ------------------------- ----- --------------------------------------------------•--------------------- ...--------------------------- ------------------. --- - ------------ U Nature of Repairs or Alterations—Answer when applicable- r I .. ..--.1000-� -� .�t .1y��4' it+........... os-r .. Agreeme The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issue_d by the board of health. Signed / -. / ------------------------------------------ ... '.• .'. / Date Application Approved By---)9v_ n4LVL ------ •-----. -------••--•-----• -•--•-•--•--------..Da--------------•-- Date Application Disapproved for the following reasons---------------------------••-----------------------------------------------------------------------.........._. --....---•----------•--------•--------------•------------------------•---•-------•-----------------------•------•-------••-•----------------------------------------•----------------•--------•-•--•-••-- Date PermitNo.......D.--O-.-.....3 ----.................. Issued........................................................ Date .0 No.... .o. ..�3 Fss.............:.. .........._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 OF. r^ Appliration for Uioponl Works Tonotrnrtion thrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: L 1 Location-Address � , 1 or Lot No. ! rkJ _ I ...................................... ..'•--r-Y...... ........:5:... .. ' ... :....._...................._..._..... ...................... —Owner.... _G Address r ri Installer Address 1 UType of Building Size Lot............................Sq. feet ,.. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures ............................... .. W Design Flow.........................................• . per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity......_.....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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ a+' ---•-------•-------------------------•--....------------------................................-•----......................................................... 0 Description of Soil......................................................................................................................................................................... x V ---------------•---------------•-----........•--•--.....------------•--.._.......---......--•---------------------------------------•------------------------------••-------------------------•--------- W •----- . ---••-----------------------------------------------------------------------------`........................--..-•ln-•--- •----------------------------------••-- VNature of Repairs or Alterations—Answer when applicable.=......................... . Y Y . Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITT-2 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. Signed..:...: ., f r. -- �� /� ( .. .�Jj/J Date y [�.!1.� : . """".��.......-------•-------• ----------------------------•-•-----.... Application Approved B Date Application Disapproved for the following reasons:------•--------------------•----------------------------------...---------------------------------------------- I ..................•----•--....----•----•-•---•----•--•--•-------------••--•-•----•---------••--------------•--------------------------------------------------------------..........------...-••-•....._ ... 3/ / Date Permit No.......t.t .................. Issued_........................ Date THE COMMONWEALTH OF MASSACHUSETTS RS ( BOARD OF HEALTH .........!.........'......................OF..... `.:,....!.......'....t...;....................................................... (9ntifiratr of TontpliFanr THIS IS 0 C TI Y Th the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by....................A' ----� 0-__.-----..------_.-•--- ------- ---------.-.------•-•-----•----•-----------.--•-•-•-•---------------------------..-------•------- 46 ---•---•........................... has been installed in accordance with the provisions of TITLE 5 of T e State Sanitary Coe as db 'sc d in the application for Disposal Works Construction Permit No._ ...__...._. dat(d._. .. .V................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE.CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SAc�TrISSFACTORY. DATE......................�-.. ..�''..�f. _-.----....--•--•--•--•---•--. Inspector............................. ------------•----•---------------.--- THE COMMONWEALTH OF MASSACHUSETTS !/ BOARD OF HEALTH '._ r ...........!.:.....?......................OF....... :......................_. ................................................... FEE.. ................. io oo Works Ton tr ton ermit Permission is hereby granted A)7 to Const�r}�c ( ) or Repair (V-) an Individ al Sewage Street isposal System (1 ....... as shown on the application for Disposal Works Construction e it No��sV/ ,)ate�.....(Q . . .. .. ............ �........ . ---- .-------/ -•---- ... •-- ............. / �n i Board of Health DATE.../!,".- 0 ---------------------------------------'.... FORM 1255/HOBBS & WARREN. INC.. PUBLISHERS VENT WITH CHARCOAL FILTER TO GENERAL NOTES TOP OF FOUNDATION = 44.1'± INISH GRADE OVER D-BOX= 42.8'± BE PLACED AT EDGE OF BRUSH FINISHED GRADE OVER BIODIFFUSERS= 42.5' - 42•83' PROVIDE CONC. RISER WITH 4"SCHEDULE 40 PVC MIN. SLOPE 1% SLOPE 2% MIN. 1, COVER OVER INLET&OUTLET FINISH GRADE O\oER TANK EL.= REMOVABLE WATER-TIGHT COVER OVER °O UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISHED GRADE TO WITHIN 6"OF F.G. 4Z.8'+ RISER TO WITHIN 6"OF FINISHED GRADE INSPECTION PORT WITH ACCESS BOX TO METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FOUNDATION = 43.3'± 5"DIA. OUTLET(S) WITHIN 3"OF F.G. (ONE PER TRENCH) CODE N ANY APPLICABLE LOCAL RULES. _ _ _ ____ _ ______.___ _------- _.__...__.._.� _ -_------_--_._-- 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 20"MIN.ACCESS 36"MAX. _ __ I DESIGN ENGINEER. COVER(3 TYP.) 9"MIN. - i 9" IN. 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL EXIST. SEWER PIPE 36"MAX. SEE NOTE 21 48"MAX. TOP OF SAS/B.O. = 38•83' SYSTEM UNLESS OTHERWISE NOTED. 2"DROP MIN. WATERTIGHT 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN MIN.SIOPE�196 6" 3" 3" g" __ L=79' PROVIDE - 3"DROP MAX. - JOINTS (TYP.) ELEVATION =38.83' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A PROP. PVC 10" = 4"PVC IN FROM 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF SEWER PIPE 14" 39 5� SEPTIC TANK • 4"PVC OUT TO 1.33' n10.1"TYP 6"TYP THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. /*40.U± LEACHING FACILITY 0 90, MH (NP') 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. VI n 39.75' 12" 6" i I 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 48" OUTLETTEE 3$.67' MIN. 38.5' 38.4 37.5' (LAID FLAT) 2.875'(34.5")--+- 5.75'� 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK 6"CRUSHED STONE 5 0' (TYP.) FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS ? 22"ZABEI FILTER OVER MECHANICALLY NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 18.0'TO FND MODEL#A1801-4x22 COMPACTED BASE (TYP.) 5'MIN. 11.50' AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX 30.0'(TYP FOR BOTH TRENCHES) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 43.9' ESTABLISHED 6"CRUSHED STONE TO BE INSTALLED ON A LEVEL STABLE ON A NAIL SET IN A TREE AS SHOWN ON PLAN. OVER MECHANICALLY BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV= < 31.87' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION COMPACTED BASE PIPES TO BE LAID LEVEL. PROPOSED 1500 GALLON CONCRETE SEPTIC TANK THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW BIODIFFUSER (PROFILE) BIODIFFUSER (END VIEW) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES 'INVERT IN CESSPOOL, (;0N r RHc i u� LENGTH 10' 6' WIDTH `8" DEPTH 6$' ryry �+ p v � G - ARC 36HC #361 �BD BIODIFFUSERS H-20 TO THE DESIGN ENGINEER. TO VERIFY ELEVATION & REPORT TO SEPTIC TANK PROFILE (Dimensions per Wiggin DISTRIBUTION BOX DETAIL 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. ENGINE--R IF DIFFERENT NOT TO SCALE PrecastCorp., Pocasset,MA) NOT TO SCALE NOT TO SCALE _ _ 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM ( * • PERC NO. 12754 APPROPRIATE AUTHORITY. INSPECTOR: David W. Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS EVALUATOR: Michael Pimentel, E.I.T. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. i •H. C.S.E.APPROVAL DATE. Oct. 1999 I s DATE: Nov. 2, 2009 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. ELEV TOP= 42.7' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, • • s r� ELEV WATER= <31.87' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). PRDPOSED r • ,Q► 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 15CO-GALLON " -- PERC RATE _ <2 min./inch w SEPTIC TANK * 4 SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. MAP 291 •�� DEPTH OF PERC= 30"-48" MAP 291 LOCATIONS OF 16. PROPOSED PROJECT IS LOCATED WITHIN: = APPRoxfMATE o PARCEL 78 PARCEL 77 EXISTING CESSPOOLS TO BE PUMPED • TEXTURAL CLASS: 1 ASSESSOR'S MAP 291 PARCEL 82 AND FILLED WITH CLEAN SAND ••ZONE I _ OWNER OF RECORD: MICHAEL V. MILES a _ - - _ _ _ PROPOSED Q ADDRESS: 69 PLEASANT STREET - - - CLEANOUT 0" 42.T Fill MARBLEHEAD MA 01945 0 4" 42.37' ! I Loamy Sand 109.68' v / �� I �~ LOCUS A 10YR 3/1 8 42.03 FEMA FLOOD ZONE C B Loamy Sand COMMUNITY PANEL# 250001 0005 C x 22.0' P MAP 291 10YR 5/6 17. DEED REFERENCE: LAND COURT CERTIFICATE 142662 O O O ! 30' 40.2' V PARCEL 82 Perc 18. PLAN REFERENCE: LAND COURT PLAN 14034-H (SHEET 1) x � o -43- 13,660 S.F.t 48" - 38.7' 19, ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. X 14" °r° I DECK x' 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY w CONC. �� FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY PATIO �` FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. x ' M-C Sand �% -X-X-X-� #40 � t� C 2.5Y 6/6 21. IN ACCORDANCE WITH 310 CMR 15.401 - 15.405, THE FOLLOWING LOCAL UPGRADE APPROVAL EXISTING IS REQUESTED FROM 310 CMR 15.221(7): b 3-BEDROOM zo (1.) A 1.0'WAIVER(4.0'-3.0') FROM THE DEPTH OF COVER OVER THE LEACHING FACILITY. MAP 291 GARAGE , NMAP 291 o N DWELLING : 91 LOCUS PLAN PARCEL 81 N TOF=44.1 t co N PARCEL 83 o � o SCALE: 1"= 1000' 130" 31.87' PORCH s No Mottling, Standing or Weeping Observed / TEST PIT DATA PAVED \ DESIGN DATALEGEND / a I DRIVE o PERC NO. 12754 ' I / 12 TP 1 �43 INSPECTOR: David W.Stanton, R.S. - 50xO EXISTING SPOT GRADE 43 42xZ 25 6. NUMBER OF BEDROOMS (DESIGN) 3 EVALUATOR: Michael Pimentel, E.I.T. - 50 - - EXISTING CONTOUR 4 `� DESIGN FLOW 110 GAUDAY/BEDROOM Oct. 1999 ^ ' 2) 1 C.S.E.APPROVAL DATE: 20.5' TP 2 ) TOTAL DESIGN FLOW 330 GAUDAY 2DOg 50 PROPOSED CONTOUR 42x7 s �� DATE: Nov. 2, 14" O j DESIGN FLOW X 200 % = 660 GAUDAY TEST PIT#: 2 ❑/H/W EXISTING OVERHEAD UTILITIES 0.01 o USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV TOP 42.7 --WW--- EXISTING WATER LINE I = - L=12 0.0 0' PC 1 ELEV WATER= <31.87' R=17 61 .15' i i 1 TEST PIT LOCATION _ HC I PERC RATE1111-7-177-111111111 _ V,eo A11,,1 PROP. VENT WITH CHARCOAL FILTER TO CONNECT m EDGE OF PAVEMENT INSTALL 12 - ARC 36HC (#3616BD) BIODIFFUSERS (H-20) DEPTH OF PERC= O O O PROPOSED 1,500 GALLON SEPTIC TANK TO TOP INSPECTION PORT ON EACH TRENCH Benchmark o TEXTURAL CLASS: 1 Nail Set in Tree ? SYSTEM CAPACITY PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE PROP. TOTAL 12 ARC 36HC BIODIFFUSERS (H-20) GEORCE STREET Elev. =43.9' (6 BIODIFFUSERS EACH TRENCH) (40'WIDE LAYOUT) Approx. M.S.L. (TOTAL L.F.OF BIODIFFUSERS)(7.8 SF/LF)(0.74 GPD/SQ.FT.)= GPD ❑ PROPOSED DISTRIBUTION BOX G`1 PROPOSED INSPECTION PORT WITH (60.0')(7.8 SF/LF)(0.74 GAUSQ.FT.)= 346.3 GAL. LEACHING/DAY 0" 42.7' ACCESS BOX TO GRADE (TYP OF 2) , Fill PROPOSED ARC 36HC(#3616BD)BIODIFFUSER(H-20) tJ d k vjt 4" San42.37 HC 3 HC 4 TOTALS: A Loamy 10YR 311 d 8" 42.03' TOTAL NUMBER OF BIODIFFUSERS: 12 B Loamy Said TOTAL NUMBER OF COUPLINGS: 0 10YR 5/6 TOTAL LEACHING AREA: 468.0 SQ.FT. 30" 40.2' REV. DATE BY APP'D. DESCRIPTION (3)-, 4) TOTAL LEACHING CAPACITY: 346.3 GAL./DAY - --- - - ------- - --- - --- -.-- PROPOSED SEPTIC SYSTEM UPGRADE PREPARED FOR: NOTE: CAPEWIDE ENTERPRISES s 5) EFFECTIVE LEACHING AREA OF 7.80 SF/LF OBTAINED FROM THE C -C Sand DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER 6/6 LOCATED AT SWING TIE MEASUREMENTS "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO SCALE: 1" = 20' ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003(LAST 40 GEORGE STREET NOTE: MODIFIED JUNE 30, 2009). TRANSMITTAL NUMBER=W000052. DESCRIPTION PC 1 HC 2 HC 3 HC 4 HYAN N IS, MA 02601 __ _ __---- - -------------_ SEPTIC COVER IN (1) 19.3' 22.4' 130" 31.87' SCALE: 1 INCH = 20 FT. DATE: NOVEMBER 4,2009 MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE o �o Zo 4o so FEET 1. SEPTIC COVER OUT(2) 25.6' 20.9' ; No Mottling, Standing or Weeping Observed TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. tN�FM ��`� �0 PREPARED BY: ti -------__- BIODIFFUSER CORNER(3) 25.1 41.9 CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE RESERVED FOR BOARD OF HEALTH USE u JOFiN L � JC ENGINEERING, INC. 2. BIODIFFUSER CORNER(4) 36.9' 24.9' 1 o CNURCHILL J 2854 CRANBERRY HIGHWAY LOCATION OF THE PROPOSED LEACHING FACILITY TO ENSURE BIODIFFUSER CORNER(5) 45.4' 36.7' N 41807 CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. EAST WAREHAM, MA 02538 REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS SITE PLAN BIODIFFUSER CORNER(6) 36.5' 49.5' _ _508.273 0377 Designed By: ARE NOT CONSISTENT WITH TEST PIT DATA. SCALE: 1"=20' ( Drawn By: BMB BMB Checked By:JLC JOB No.1719