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HomeMy WebLinkAbout0109 LONGVIEW DRIVE - Health 109 Lon-qview Drive;LIe Hyannis A= 091, u ' n ° a a t , rY „ .� .it t' -, ti✓. „ � O , u R n \, 0 c 41.. z: If Rme oldmOlm • v � a .> n z ti c u c. is i J , n, V a o � IY n o y°.. � L '�I•'a�� +,by � .r. , ,g N;. � `� - ,. � N,L x .�, iN - ,� _ ., II ,. �; w u .: '� t ' o` 1531/3 RED 10% P4 s y I� 11i//��� �111...� '```,� I� III 4 TOWN OF BARNSTABLE Q' LOCATION 109 tong EW SEWAGE# n201(9 VILLAGE G N1 t g ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �f�cnyca9l� - nwcr(O�f'�- SLj�-9'753 SEPTIC TANK CAPACITY t SeV C E x1S+-(N5 LEACHING FACILITY.(type) A -( 36 Oa^Vo (size) 31. 6 x D•G4r NO.OF BEDROOMS OWNERtN� PERMIT DATE: COMPLIANCE DATE: I�. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) A✓/A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) W A Feet FURNISHED BY � r- cs Q c � 0 2a � � w Dpp c ^1 O QD w N u a o a u N ►� N ' LP, CIO p (� W f Commonwealth of Massachusetts , 091 �n Title. 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine I~� Owner Owner's Name ;3 information is required for every Centervijre H4"jj�S Ma. 02632 October 23, 2020 page. Cityrrowrf State. Zip Code Date of Inspection r .t 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:When filling out forms A. Inspector Information Sl# /L4 941 on the computer, use only the tab Thomas Roux key to move your Name of Inspector cursor-do not use the return Company Name key. 89 Mayflower Lane Co „b Company Address East Wareham Ma. 02538 City/Town State Zip Code 774-678-9066 S14531 Telephone Number License Number B. Certification I certify that:) am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);I have personally inspected the sewage disposal system at theproperty address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 0clo tr-- '�02(0 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23, 2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments v 109.Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23 2020 page. cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 pipe(s)are replaced ❑Y ❑N ❑ ND(Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts rP Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 4 � 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information Centerville Ma. 02632 October 23 2020 required for every page. Citylrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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 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 must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following foe 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5. Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23 2020 page. City/Town 3 State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 Y2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times,pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. El ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. 0 ® The system fails. 1 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. 5) 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 CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma 02632 October 23 2020 page. Cityrrown : State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: 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? ® ❑ 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? ® ❑ Wasthe 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 r c� Commonwealth of Massachusetts Title 5 Official Inspection Form l Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23, 2020 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 4 DESIGN flowbased on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 332 gpd Description: 4 bedroom house was designed for 3'bedrooms. Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) 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: current Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form �' M1 Subsurface Sewage Disposal System form.-Not for Voluntary Assessments Y 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma.. 02632 October 23 2020 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Wa ter treatment unit present. El Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/28/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23 2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components date installed (if known)and source of information: septic tank is 49 years old, d-box and SAS are 8 years old. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 3.33' feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: +10' feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c Commonwealth of Massachusetts ,e Title 5 Official Inspection Form la Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 109 Longview Dr. Property Address Elizabeth Sunshine ` Owner Owner's Name information is Centerville Ma. 02632 October 23 2020 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 2.33' 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: 8'L x 5.2'W x 53H Sludge depth: <111 Distance from top of sludge to bottom of outlet tee or baffle 33" Scum thickness <111 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 15" How were dimensions determined? measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The septic tank does not need to be pumped out at this time. t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5. Official Inspection Form ` Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23 2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: i Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name. information is required for every Centerville. Ma. 02632 October 23 2020 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last um in : p p g Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 01. 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.): Would recommend cutting down the Maple tree that is very close to the D-Box, due to root infiltration. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Ownees.Name information is required for every Centerville Ma. 02632 October 23 2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Since the septic tank and D-Box are both functioning correctly,the SAS is draining properly. Type: ❑ leaching pits number: ® leaching chambers number: 18 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ Teaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23 2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): No evidence of hydraulic failure. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23, 2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23, 2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately See C" 6 s �- � L) t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 I 10/23/2020 ShowAsbuilt(1700x2800) TOWN OF BARNSTABLE LOCATION 10i LoAuio/ SEWAGE# O19-a7CL VILLAGE. J�kfA t$ ASSESSOOR-S MAP&PARCEL 251` c{I .. INSTALLER'S NAME!PHONE NO.�nan�a �t._�c..�.r(mI+ aVi4-1775 SEMC TANK CAPACITY ITOV (ex'stlM9) LFACHNO PACU=(type) AE($6 CNaaW)CHaaW) c > 31•6 X 9.6 NO.OFHEDROOMS 3 OWNER K PERMrrDATE COMPLfANCE DATE: I' . .. S�Hm Diemnw Between the: . . - Ma�Adjmmd(homdweoc Tebkmtbe Batmen ofLmehiog PapLty Z'1' Fret . Pmm;Wa Supply WeB mdLcwhmg PacWty(Ifmy welb cant sim w witltm 200 feet ofleeching fecUlty) N/A Fea Edge ofWellmd=d[aachmtg Facflay(Ifaoywalmds curt wilhm 300fhetofkachmg Fea 1 PURNLgfRtDHY �WW►�ti�� Q1S P}-20 CV - agow l y A Y. i�3L4' 2a36.o ® 4 <3 s 5 -3S:8 Can vtnr � 2 3p.t 3, 3p.t t G wsc 4 44.5 https:/fitsgldb.town.bamstable.ma.us:8431/Home%ShowAsbuilt?mp=251091&sq=2 1/1 c Commonwealth of Massachusetts �e Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23, 2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam:. ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high round water: below 11' p 9 9 fe et 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: 8/24/12 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: From the design plan on file. Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Dr. Property Address Elizabeth Sunshine Owner Owner's Name information is required for every Centerville Ma. 02632 October 23, 2020 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist)completed ® D. System information: For 8:Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included P p 9 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 E,P/l 7/2012/MCN 09:24 AM SandwichTownOff ices FAX No, 1 5C8 833 OC18 P. 001/031 Town of Barnstable Regnlatory Services r Thomas F.Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,INLA 0:60I Office: 508-362-46 Fax: 503-750-6304 Installer& Desi , er CertAilcatiata orri Date: Sewage Permit# Assessor's Map\Parcel / Designer: Installer: r%c i Address: Address: i(14-V (n't�� On — '-' .�i1 'K °��2-WaS issued a permit to install a (date) (installer) septic system at iuyf Q l V 6 based on a design drawn by (address) �V1 ated-717,91241-1/ 7- (desi�.ner) I certify that the septic system referenced above was installed substantially accordirg to the design. which many include minor approved chances such as 1&teral relocatioa o:the distribution box and/or septic tack. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component Of the septic system) but in accordance with State & Local Regulations. ?tan revision or certified as-built by designer to follow. DAR EN M. ��r✓,, M (Installers Signature) No. } 4 r QNIWtO (]Designer's Signature (Af�is Designer's Stamp Here) PLEASE RETIJRJN TO BARNSTABLE PUBLIC HEALTH DIVISION. CEtiI IICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS I0M'YI AND AS-BUILT CARD ARE RECEIVED BY THE g kRNS"IABL1E PUI3LIC IiEALTH DIVISION. TI1 A`iK-y Q:Htmith/Seprie/Desi3rer Certificadc)n Form 3=26-a.doc 'Town of BaI nstabie P# • � .Deportment of Itegtilatory Services eet>a Public Health Division Bate G/ l ass $ 1639. 20D Main Street;Hyannis MA 02601 - Fee Pd. Date Scheduled 1 © Time �L , `oil ,suitability Assessment fop S`ewgge Disposal Performed B �VQ` iN M t x ' Witnessed By: LO CATION"& GENERAL WORM A.T70N Location Address' Q = Owner's Name FAIMPI 82O i \lam?ve_S 8 eC-N T Vim. Address Assessor's Map/P4rcel: w I Engineer's Name, 'rye \ M e.q t!` NEW COTISIRU� (ION REPAIR X 1 i. Telephone# S73 &o ` ,S 3 1 ©� /0 Land Use t �S Slopes('Yo) "S u dace Stones '�� i Water Well �ft 1/ ft' Drinking Wa Distances from: Open Water Body ft� Possible Wet Area . Drainage Way `3 ft. Prop .rty Line + ? u. ft` Other ft SKETCH:(Street name,dimensiods'of lot,exact locations of test hotel&pert tests,locate wetlands in proximity to holes) _ GEE,G • r .. .. . - 'PPa1/145 116.87' _ GGa. W y" rG —2939 _ < #109 '10F 50 O O I! ,• I8 3 / "0 LLB �I I1 - GARAGE • FSPI L1 DRIVEWAY IN 25, y \OOOG` r Parent material(gc0log1 ). � `�sa'i Depth to$edrock Depth to Groundwater. Standing Water in Hole:` Weeping from Pit Face ' Estimated Seasonal High Groundwater DI�° ATION FOR SEASONAL HIGH;VVAT T L , Method Used• /�'i in. Depth td Spll mvt[I�s: ln• ` Depth Cibserved standing;in obs.hole: in, Depth twnter male ment Depth toiweeping from side of obs.hole: Adj.Oroundwater i evel.,,,,o. f Index Well# Reading Date: Index Well 1eve1 - i PERCOLATION TEST Observation I i Time at 91, ------- Hole# Depth of Pere Z —IGt► r Time at 6" -�- ® 3_ Time(9"-6") — Start Pre-soak Time.@ _--s End Pre-soak Rite MinJInch x Site Failed: — Additional Testing Needed(Y/N) Site Suiiability Assessment Site Passed r Original:.Public`r,-e$ith Division Obse'vation Hole Data To'B eCompleted'on Back— ` o must first notify the ***If percolatyion testis to be condlacted within 1.00 of wetland,y,u Barnstable Conservation.Division at least one (1)week prior to beginning. DEEP OBSERVATION HOLE LOG Hole#�_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulders. Consistenc %Gravel 011-- 'r ITF 3 " 4A DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) n Md d 2_5 DEEP OBSERVATION HOLE LOG Hole# N Depth from Soil Horizon SoilTexture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel f i I i 1 DEEP OBSERVATION HOLE LOG Hole# N A Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consistency. Gravel) Flood Insurance Rate Mat): Above 500 year flood boundary No— Yes __ Within 500 year boundary No✓ Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the area proposed for the soil absorption system? yes If not,what is the depth of naturally occurring pervious material? Certification I certify that on cd (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required t ' ing xpertise and experience described in 3,10 CMR 15.017. Signature e Date Q:4SEPTIC\PERCFORM.DOC Q • Town of Barn'stable Barnstablee Regulatory Services DepartmentA*AmeficaCily �;. ISA MASS. A LE, public Health Division MASS. 1639, `gym rF0 MAt A 200 Main Street, Hyannis MA-02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7011 0470 0001 4525 6690 v April 17, 2012 Federal Home Loan Mtg Corp 8200 Jones Branch Drive MS 202 Mclean, VA 2210273110 r ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,Title 5. The.septic system located at 109 Longview Drive, Centerville,MA, was last inspected on 4/03/2012 by Michael Kellett, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Fails"under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the-following: • System is in Hydraulic Failure You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system with in the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH omas McKean, R.S. CHO Agent of.the Board of Health QASEPTIC\Letters Septic Inspection Failures or Future Evahl09 Longview Dr.,cent..doc Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 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:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael Kellett use the return Name of Inspector key. Aardvark Environmental InspectionsVQ , Company Name PO box 896 Company Address East Dennis MA 02641 City/Town State Zip Code 508-385-7608 SI 3742 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. l am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system:. ❑ Passes ❑ Conditionally Passes. ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 04/07/12 Inspectorls Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-11/10 - Tide 5 Official Inspection'Form:Subsurface Se i posai System-Page 1 of Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-'Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is required for Centerville MA 02632 04/03/12, page. Cityrrown state Zip Code Date of Inspection B. Certification (cont.) " Inspection Summary:Check A,B,C,D or E I always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310.CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora 9 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12' page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.):. ❑ Observation of sewage backup or breakout 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 o.f'Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ U ❑' 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): El broken pipe(s) are replaced . ❑'Y . ❑ N ❑ ND(Explain below): ❑., obstruction is removed ❑ Y ❑ U ❑ ND (Explain below): r C) Further Evaluation is Required by the Board of Health: ` ❑ .;Conditions exist which require furlher 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 r 15.303(1)(b)that the system is not functioning"in a mannerwhich will protect public health, safety and the environment: ❑ Cesspool'or privy is within 50 feet of a surface water a ❑ Cesspool or privy is within 50 feet of a bordering,vegetated wetland or a salt marsh t5i is=t il1G Title 50iiciai InspecUon Farm:Subsuiiace Sewage Cispasai System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is Centerville MA 02632 04/03/12 required for every page. Cityrrown State- - Zip Code Date of Inspection B. Certification (cont.) q 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 tarok 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 fecal col form 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_ P , 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 R ® El clogged, of sewage into facility or system component due to overloaded or p SAS or cesspool ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ®, Liquid depth in cesspool is less than 6"below invert or available volume is less than Y2 day flow' t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposaf'System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No E] ' ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ 0 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. ❑ Z Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy ispless than.1.00 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,,perforated 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 otherfailure 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 1'0,000gpd. ® ❑ The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner shouldcontact 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 1.0,000 gpd to 15,000 gpd'. For large systems,you must indicate either"yes"or"no`ta 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 ❑ y ❑ 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-. F t5ins•11/10 - 'Title 5Offcial Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address_ Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 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? ® El available as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling:inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components,excluding the SAS,located on site? ® ❑ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction, dimensions,depth of liquid,.depth of sludge and depth of scum? ® ❑ 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 ofdistance 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•11/10 Title 5 Cfficial Inspection form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 page. City/Town State Zip Code Date of Inspection D. System Information Description:: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? _ ❑ Yes ® No 09/11 Last date of occupancy: Date 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?y ❑' Yes ❑ No Water meter readings,if available: t5ins•'11/10 Title-5Official Inspection Form: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 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.), Last date of occupancy/use: Date Other(describe below): General Information, Pumping Records: F 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: ' - r Type of System: . ® Septic tank, distribution box, soil absorption system ❑ Single cesspool= ❑ Overttow cesspoob ❑ Privy ` ❑ Shared system (yes or no)'(if yes.;attach previous inspection records,if any) ' ❑ Innovative/Altemative 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 l/A system by system,operator under contract Tight tank.Attach a copy of the'DEP approval. , . `Other(describe): t5ins•11/10 Title Official Inspection Form:.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 109 Longview Drive Property Address Federal Home Mortgage Corp ' Owner Owner's Name information is required for every Centerville MA 02632 04/03/12: page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed.(if known)and source of information.: 06/30/99 per BOH: Were sewage odors detected when arriving at the site? F ❑ Yes ® No Building'Sewer(locate on site plan): Depth below grade: 2.4 q feet . Material of construction: ❑ cast iron N 40 PVC ❑ other(explain): Distance from private water supply well or suction line' feet Comments(on condition of joints,venting,evidence of leakage,etc.):: ,a Septic Tank(locate on site plan): Depth below grade: 1.5 feet Material of construction:. " e ❑ concrete ❑ metal ❑ fiberglass;; polyethylene ❑ other(explain) r.. .. If tank is metal,list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gat r , Sludge depths {t5ins•11/10 - - - Title 5Official Inspection Farm:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 109 Longview Drive Property Address a. Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 page. City/Town State Zip Code Date of inspection D. System Information (cons.)_ Septic.Tank(cont.) Distance from top of sludge to bottom ofouflettee or baffle 27" 8" r 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 baffler 16" . a How were dimensions determined? measured Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): The tank was sound and tight with tees in place and liquid at outlet invert.The tank showed signs of backup/scum residue on top of tee and pipe. ¢d_ Grease Trap(locate on site plan):. Depth below grade: Meet Material of construction: k' ❑ concrete ❑.metal ❑fiberglass ❑polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum:to top of outlet tee or baffle,a Distance from bottom of scum to bottom of outlet tee or baffle' Date of last pumping: ' Date t5ins•11/10 - Me 5 Official inspection Form::Subsurface Sewage.Disposal[System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 page. Cityrrown State Zip Code Date of Inspection. D. System Information (coat.) Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outletinvert,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: r. 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•11110 Title 5 Official inspection Form:.Subsurface Sewage Disposal)System•Page 11 of 17 ,. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is Centerville MA 02632 04/03/12, required for every ' page. Cityfrown State Zip Code Date of Inspection D. System Information (coot.) Distribution Box(if present must be opened)(locate on site plan)- Depth of liquid level above outlet invert even. 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.): The box was flooded. h . 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.): Soil Absorption System(SAS)(locate on site plan,,exca:vation not required): 'if SAS not located,explain why: a t5ins-11/10 Title 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 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is Centerville MA 02632 04/03/12' required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching,trenches number,.length:. ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ inn ovative/a Item ative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil, condition of vegetation,etc.): This system has 2 500 gallon drywelis in a 25'x13'stone field.There was staining and ponding above the leaching. Cesspools'(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction .. 9 Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Me 5 Official Inspection Form:Subsurfac&Sewage�Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is Centerville MA 02632 04/03/12 required for 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.): 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.): t5ins-11/10 TdJe.5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts I Title 6 Official lspectl ' Farm Subsurface Sewage Disposal System Form Not for Voluntary Asse ments 109 Longview Drive a Property Address Federal Home Mortgage Corp ! Owner Owner's Name information is Centerville MA 02632 04/03/12 required for every page Cityrrovan State Zip Code Date of Inspection D. System Information (cont.) . Sketch Of Sewage Disposal System:Provide a view of the sewage iisposal system,including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building.Check one of the boxes below: ® hand-sketch in the area below " - ❑ drawing attached separately 1fbr1 r • i F:ss .ly. IV j t51ns•11/10 - • Tille 5 official inspeC190n Foi n:SubsufFam Sewage Disposal System•Page 15 of V Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface.Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address 4 - Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 page. Cityrrown 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: 20.0 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: USGS maps show an elevation of over20.0 feet. Before filing.this Inspection.Report,please see Report Completeness Checklist on next page. t5ins•11/10 ' Trde 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts ugTitle 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Longview Drive Property Address Federal Home Mortgage Corp Owner Owner's Name information is required for every Centerville MA 02632 04/03/12 page. Cityrrown 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 ® 9 P Y P 9 p to e t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage:Disposal System-Page 17 of 17 TOWN OF BA.RNSTABLE ` \LOCATION /O �o�� �r4V SEWAGE # VILLAGE ASSESSOR'S MAP & v INSTALLER'S NAME&PHONE NO. 77-0 3 Y9 , gS--- Li SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 7 3 NO.OF BEDROOMS 3 BUILDER OR OWNERS PERMITDATE: 4/, Z 9 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist j 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 fac9ilij) _. Feet Furnished by s cA s Ze • N� � J No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z[pprication for Migpogat *pgtem Construction Permit \1 y� Application for a Permit to Construct(pair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No./DQ i y r�° j^1 V15 Owner's Name Address and Tel.No. Assessor's Map/Parcel Cropervf/// ���/ O le—Orr ? d Qi seta g' /057 Installer's Name,Address,and Tel.No. e17'7—0✓'l 1f 57 Designer's 4.e,Address and Tel.No. Lg-/- Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil 5 to sr� Nature of Repairs or Alterations(Answer when applicable) t"I'll f;X/.ST/�4✓ C'i=�5f�d011 rl�iT Cls �9 P1514 .- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this J3oard of Health. Signed Date Pr Application Approved by 441,4 Date Application Disapproved for the following reasons -6L Permit No. Date Issued Noy = $,.Fee t THE COMMONWEALTH OF MASSACHUSETTS- -- Entered in computer: ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSA,CHUSE.. S Yes X, 01ppYicatfon for w ogal*pgtem Construction Per it Application for a Permit to Construct(pair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./07 4aor /� 0-1 Owner's Name Address and Tel.No. Assessor's Map/Parcel Ja, Installer's Name,Address,and Tel.No; y Jul—O��� Designer's ame,Address and Tel.No. ✓a eW4 .fit /3,4rr'as c/as Cf'!� G'c f3��rds oww rSTotis mil,ks --Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) X/ � O/s tr/ C i H / oe Si gh . S1'*// 1300 lv../, 2 - sda 6*1, i=%/s r--4 v 'st��/: Q9rovHca/. ",psk .Srati e Date last inspected: Agreement: 1 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 inoperation until a Certifi- cate of Compliance has been issued by this Board of Health., Signed Date G - 29- P9 Application Approved by 1 Date Application Disapproved for the following reasons r P Permit No. _ -- —- Date Issued iA —————— ——————T--——————————————————————— THE COMMONWEALTH OF MASSACHUSETTS ti BARNSTABLE, MASSACHUSETTS Certificate of (Compliance '�:-.T.HIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(repaired ( )Upgraded( ) Abandoned( )by ./as z,�ao -e- at /O Q `r di^/ .,i V.%l r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer 41 ge,4 0t Rar,v y s' , Designer e 0. 12, ZY wo-,-6 s)(., n t, The issuance of this permit s all fnot be construed as a guarantee that the sys a will function as designed/ Dater 1 �' Inspectors'�i i•`1 ., +1 1/t i �>`/�f f'i .?`!Y` / - J — ----- ------ No._ Fee 111 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS Migpozar 6potem Construction Permit Permission is hereby granted to Construct(e,#Irepair( )Upgrade( )Abandon( ) System located at ro S Lo"e �'d!17:-r 'Vi and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructio ust b co leted within three years of the date oft t. ` Date: Approved by _ �'�`�•�l� � �i!;''J� 116/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) L czs!"� /,,r /fe?e k-'V S hereby certify that the application for disposal works construction permit signed by me dated t- — ,�Q- q 9 concerning the property located at /p���a <<w Qr ��hTi=�"di�l� meets all of the following criteria: The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. &�--T_he soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system ere are no private wells within 150 feet of the proposed septic system _There is no increase in flow and/or change in use proposed �re are no variances requested or needed The bottom of the proposed leaching facility will not be located less than five feet above the ma.�dmum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the ma<imum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surfac Elevation(using GIS information) B) G.W. Elevatio +the MAX. High G.W. Adjustment DIFFERENCE BETWEEN A and B SIGNED : DATE.- (Sketch proposed plan of system on back]. q:health folder.cent -/o 07yii `'wIP7 ^� O 'l t O • 0 ,�Ol � No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in cWYes PUBLIC HEALTH DIVISION - TOWN OF.BARNSTABLE, MASSACHUSETTS ftpYitation for Misposal *ppstrm Constru>rtion permit Application for a Permit to Construct( ) Repair( ) Upgrade,O Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. J D 1 L o A5 V 1 4 W �� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Z 5-1 / 9/ .t I S 0t4 j^V I A S 7 74— 1 S31 Installer's Name,Address,and Tel.No. S-08 Z 74-f 7 S3 Designer's Name,Address,and Tel.No. r��n�e er► tom.,. l2 SON T ,/ht �� ���� 361Z-Z11r_ Type of Building: �� ��'i i.tl1 lZ c( i' AtiO� ��-�� it 7po welling No.of Bedrooms -3 Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 gpd Design flow provided 3 3 2 gpd Plan Date 61 241(2- Number of sheets 2- Revision Date Title Size of Septic Tank trio Type of S.A.S. A Z� 3(o Co ,A, % gE 2S Description of Soil Nature of Repairs or Alterations(Answer when applicable)Re 10 1;fit✓► S (�/1�h �V[ W 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 b 's Board of Hee Ith. ( ign ,J Q Date S Application Approved by Date Application Disapproved by Date for the following reasons Permit No. - Date Issued YL No. Fee / 0 �:A THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: .� Ye PUBLIC HEALTH DIVISION - TOWN-OF- BARNSTABLE,MASSACHUSETTS application for Bisposal *pstrm Construction P—a twit Application for a Permit to Construct( ) Repair( ) Upgrade(I Abandon(, ) El Complete System ;0 Individual Components`'. Location Address or Lot No. O q L o A5 V!e W ®� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 2 s/ / 9/ N lv S o a 7 7`7'- q/4 15-11 Installer's Name,Address,and Tel.No. ,S'otf 2 74- 17 S3 Designer's Name,Address,and Tel.No. r,en �e cn it ���Gf R (ONST /h{. 1/C ( i� Co Z- Z-, z Type of Building: 4 (4 c,,/) I? /HO✓ 7U o e`cs�Dwellin No.of Bedrooms )A/0 g 3 Lot Size � sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Y Other Fixtures Design Flow(min.required) 330 gpd Design flow provided 3 >Z gpd Plan Date 2 q/ 2 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Q 2 L 3!� �#A,- 3E IZS r Description of Soil Nature of Repairs or Alterations(Answer when applicable) /2-In ( 4 r )(1 y t w) S� S Iv I�► lvf tv ( ()A I dl l/�I H � l ! � A IG( 34, 6 A Pr M b-"f f *f } Date last inspected: a 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 b ;h s Board of H'e�lth. 10 igned R! / Date y S Application Approved by / /' 1 ( Date Application Disapproved by Date for the following reasons s Permit No. Date Issued ------------- ---- ----•-- ------•------Z ----- ----•----------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Complianir THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by } at ( t.kJT� M �u has been cons cted' ac o with the provisions of Title 5 anti- e for Disposal System Const ction Permit No _A ed Installer � � 'yern Q-r Designer I; #bedrooms j Approved design flow j gpd The issuance of this permit shall not be onstrued as a guarantee that the system wif funct'o a igned. Date Inspecto( �-- --------- _ -- - - - - ------ -------------- ----•--------------------------------------- ------- o. Fee ---- --- N - � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS j/ Disposal 6pstent-Construction Permit Permission is hereby granted to Construct( ) Repair( )^� Upgrade/( ) Abandon( ) System located at ()q 6 0A a1 V I 1 C tnl ►/ `? -n,n 1 S ,ate A and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction nxwt e o leted within three years of the date of this permit. Date Approved by ( r J ' TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE_ ��-,,-�-�y.j;�- ASSESSOR'S MAP& LO "D INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY SJO LEACHING FACILITY: (hype) NO. OF BEDROOMS I size) X / 3 , BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE:Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Edge of Wedand and Leaching FacilityFeet within 300 feet of leachi g facihty (�any wetlands exist Furnished by Feet Gr"i(r y, ' HYANNIS LEGEND PROPOSED CONTOUR > ® _PROPOSED SPOT GRADE PARCEL ID: --k —— 98 —_ EXISTING CONTOUR 251/145 + 96.52 EXISTING SPOT GRADE r 'PaJ�� LOCUS J W— EXISTING WATER SERVICE 1�T a ® TEST PIT ,. 1 V 116.870 O p rn TBM: 74.5 d- COR. CHIMNEY x 00 L=75.0 74.1 \ 2a TE N 0O 74.7 I X ! -'' o ..�. c W LOCUS MAP W - �P� ' LOCUS INFORMATION J PARCEL ID: i i ! PLAN REF: LCP 28749B SH.2 251/104-H00 r �_ f TITLE REF: CTF# 192346 . 29. 39• !. PARCEL ID: MAP 251 PAR. 91 ZONING: "RC-1" #1 O9 I i / ` O �r FLOOD ZONE: "C" COMMUNITY PANEL: 250001-0005-C DATED:08/19/85 TOF=75.0 " SEPTIC SYSTEM A ii INV.=72.87 o — ^� REPAIR PLAN TOP=72.68 LOCATED AT: 109 • LONGVIEW DRIVE 16 MAP c9 �� t HYANNIS, MA. PARCEL ID. �......� s. ASP �' - __ 0 1 PREPARED FOR 1 0 1 25 9 L _ r . . T _ 0 - - AREA-11,737t S.F. --_ _ % R�►� �� w NELSON J E N K I N S GENERAL NOTES: 74_. - wAY . ��'� --- ----------------- - _ N 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL "--_y!� BOARD OF HEALTH AND THE DESIGN ENGINEER. i' _ i CD AUGUST 24, 2012 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. 73.8 .�'�J y 0 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 117.8g, X OF SS TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING i� 1 D�13R R FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. I N' 1 40 "' 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. PARCEL ID: FEX15T. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 251/090 I ,000G HEALTHE TH FOR CONTRACTOR INSPECTIONS DURING COR TO NOTIFY THE NSTRUCAL CTION. OF SEPTIC TANK o N►TA��a`' Q / 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 0 �.V✓ 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED + ! TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. MEYER & SONS, INC. 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. { REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5. �/ 11. 48 HOUR NOTICE FOR p ENGINEER CERTIFICATION f.0. B 0 X 981 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY ' I 13. NO PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING " EAST SANDWICH, M A. 02537 14. ALL PIPING 15. THE DESIGN TOFB HIS" SCH S STEMODOES/NOT ALLOW(UNLESS SPEC. OTHERWISE)` (5 0 8)3 6 2—2 9 2 2 FOR THE USE OF A GARBAGE GRINDER , 16. NO WETLANDS WITHIN 100-FT. OF PROPOSED LEACHING SCALE 1" = 20' SHEET 1 OF 2 J J 1462 f + NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE <-EL:71.26 FOR A DISTANCE OF 15' AROUND THE 'y 'SEPTIC TANK PROPOSED D-BOX PROPOSED S A S PERIMETER OF THE S.A:S. " T.O.F. EL.=75.00 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER 14" 'OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF .GRADE ONE CHAMBER (MIN.) AND SET TO 3 INSTALLED OF- F.G. �ENcn� F.G. EL.=74.00t F.G. EL.=74.0t F.G. EL:74.0t F.G. EL: 74.00(MAX.) OF M9Sf 9.4s" DA E y L 17't 9" MIN COVER/ j •' L 15' L = 10' MAX ® S=1 X (MIN.) 36" MAX COVER ® S=1% (MIN.) ® S=1%((MIN) INSTALL TWO INSPECTION PORTS (MIN.) 12 37" O. 1140 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC 10" '�fC/SiEO ]Eli INV.= 71.50 14" 6 10:75" TO `�4NITA0 48"uoui0 IN INV.=71.25 ��(VV " LEVEL. - " PROPOSED INV.= 70.83 � COUPLER DETAIL GAS BAFFLE D-BOX 3 ROWS OF 6 UNITS ® 5'/UNIT + 1 COUPLERS 01.16'/UNIT = 31.16'/ROW INV.=71.10. DB-3 H-2o) INV.=7o.93 SOIL ABSORPTION SYSTEM . (,PROFILE) EXISTING 1,000 GALLON SEPTIC TANK RESTORE VEGETATIVE COVER EXISTING OUTLET COMPACT SOILS UP TO 18" ABOVE LEACHING TO PROVIDE H2O FOR VEHICLES BACKFILL WITH CLEAN PERC SAND NOTES: 1) CONTRACTOR SHALL VERIFY ALL,EXISTING TO TOP OF CHAMBERS 60'- PIPE INVERTS PRIOR TO CONSTRUCTION 2) D-BOX SHALL.BE SET LEVEL AND TRUE TO BREAKOUT=TOP ELEV.=71.26 GRADE ON A MECHANICALL COMPACTED SIX INV. ELEV.=70.80 INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.= 69.93 310 CMR 15.221(2) EXISTING SUITABLE , 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK - MATERIALWITH 1500 GALLON SEPTIC TANK IF FAILED, 'S' MIN. ABOVE BOTTOM OF DAMAGED, NOT H2O LOADING, OR UNDERSIZED. T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 3 x 2.88' = 8.64' , (6.63' PROVIDED) / 4) INSTALL INLET & OUTLET TEES W USE 3 ROWS OF 6-ADS ARC 36HC GAS BAFFLE AS REQUIRED . BOTTOM OF TESTHOLE EL=63.30 = (H20) UNITS F NO STONE W/ 1 COUPLERS _ IN EACH ROW• SEPTIC SYSTEM PROFILE TYPICAL SECTION N.T.S. N.ra 16' P#: 13718 SOIL LOG DESIGN CRITERIA DATE: AUGUST 16, 2012 SECTION fo.7s" NUMBER OF BEDROOMS: 3 BR DESIGN SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE. #1614 INVERT SOIL TEXTURAL CLASS: CLASS I WITNESS: DONALD DESMARAIS, BARNSTABLE BOH HEIGHT END CAP DESIGN PERCOLATION RATE: <2 MIN/IN Elev. TP-1 Depth Elev. TP-2 Depth ADS - ARC 36HC CHAMBER (H20 LOAD) DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 330 G.P.D. 74.30 A 0" 74.30 A 0" LOAMY SAND MODEL ARC 36HC GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 1oYR 3/z LOAMY SAND 1oYR 3/2 LENGTH 63" SEPTIC TANK: 330 d x 200% = 660 NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT gp gpd USE EXIST. 1,000 GALLON SEPTIC TANK 73.63 B 8 73.63 B 8° EFFECTIVE LENGTH 60" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY SANDY LOAM r SANDY LOAM DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. 1OYR 6/8 1OYR.6/8 SIDE WALL HEIGHT ---To- 0.75" DISTRIBUTION BOX: 3 OUTLETS (MINIMUM)(H20 LOADING) 71.38 C 35, 71.38 C 35" OVERALL HEIGHT 16' , OVERALL. WIDTH 34.5' 4640 TRUEMAN BLVD PRIMARY S.A.S. MEDIUM SAND MEDIUM SAND HILLIARD, OHIO 43026 USE 3 ROWS OF 6 - ADS ARCHC 3616 H2O UNITS-NO STONE 2.5Y 6/4 I. 2.5Y 6/4 10.7 CF CAPACITY AND EXTENDED' 1.16' W/ COUPLER IN EACH ROW f (80.0 GAL) ADVANCED DRAINAGE SYSTEMS, INC. s BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF CHAMBER) ;PERC ® . ; PROPOSED SEPTIC SYSTEM SITE PLAN . • (CHAMBERS: 6/ROW)18 UNITS x 5.0 LF x 4.80 SF/LF = 432.00 SF EL. 69.30 132" 132 (COUPLER: 1/ROW) . 3 UNITS x 1.16 LF x 4.80 SF/LF = 16.70 SF 63.30 63.30 - 109 LO N GVI EW -DRIVE, HYAN N I S, MA TOTAL AREA ='448.70 SF PERC RATE <2 MIN/IN. ("C3" HORIZON) PER SIEVE SAMPLE Prepared for: Jenkins DESIGN FLOW PROVIDED: 0.74GPD/SF(448.70SF) = 332.03 GPD > 330 GPD req'd- NO GROUNDWATER OBSERVED' :.,' P i Engineering by: Surveying by: SCALE DRAWN MEYER&SONS,INC. dlacDouBall Survey NTS D.M.M. 1, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approvedlby MADEP pursuant to 310 CMR 15.017 PO BOX96f (508) 419-1086 DATE: CHECKED to conduct soil evaluations and that the above analysis has been performed by me consistent with the requirements of 310 CMR 15.017. 1 further certify that I!have passed the Soil Evol. Exam in October, 1999. EAST SANDW/CH,MA 02537 SHEET N0. 506-3622922 08/24/12 D.M*. 2 OF 2