HomeMy WebLinkAbout0169 LONGVIEW DRIVE - Health 69—' View Drive
Hyannis
A=251-085
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i
TOWN OF BARNSTABLE
LOCATION Dif(I//5 SEWAGE#
VILLAGE }{ dqt-�y�/S ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.S �y2U-9738✓05�!%Gr �t /3i¢��yS
SEPTIC TANK CAPACITY 1000
LEACHING FACILITY.(type) ('size) 3 X 2 S5
NO.OF BEDROOMS j /-
OWNER
PERMIT DATE: 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) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY
Q :IN $
Q � �
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L.4
Commonwealth of Massachusetts ar�- D8S
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
rri
M 169 LONGVIEW DRIVE
Property Address
DUNBAR �
Owner
Owner's Name t,e
information is required for HYANNIS f MA 02601 7-24-18
every page. City/Town State Zip Code Date of Inspection 1 '
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 A. General Information
forms on the
computer,use 1. Inspector:
only the tab key
to move your DOUGLAS A BROWN
cursor-do not Name of Inspector
use the return
key. D.A.BROWN INC
Company Name
P.O. BOX 145
Company Address
CENTERVILLE MA 02632
Gaon Cityrrown State Zip Code
508-420-4534 S14297
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 15.340 of
Title 5(310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
6�v
n 7-24-18
ctor' gnature 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24A8
every page. Cityrrown 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:
® 1 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:
LEACHING SYSTEM IS ONLY A LITTLE OVER 2 YRS OLD AND IS IN GOOD WORKING ORDER.
THIS REPORT CAN NOT PREDICT THE FUTURE PERFORMANCE UNDER THE SAME OR
INCREASED USAGE. THIS REPORT IS NOT TO BE USED FOR BEDROOM COUNT
DETERMINATION.WE ARE USING INFORMATION AVAILABLE TO US FROM THE BOARD OF
HEALTH AT TIME OF INSPECTION.
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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. Citylrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes (cont.):
❑ 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):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17' ,
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. Cityrrown 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 aseptic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and 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.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
1
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
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•3113 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
wM ,. 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS .MA 02601 7-24-18
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.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. 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 11 of a public water supply well
If you have answered "yes"to an question in Section E the system is considered a significant threat
Y Y Y4 Y 9 ,
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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
1q1-L IN Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
,M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. City/Town 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 backup?
® ❑ 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: 4
® ❑ 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
I t5ins-3/13 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
M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA' 02601 7-24-18
every page. City(rown State Zip Code Date of Inspection
D. System Information
Description:
ACCORDING TO AS-BUILT CARD THIS SYSTEM CONSISTS OF A 1000 GALLON TANK AND 2
500 GALLON LEACH CHAMBERS WITH STONE.
Number of current residents: '
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonaluse? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d SEE BELOW
9 ( years 9 (9P ))�
Detail:
2016-----337 2017--409
Sump pump? ❑ Yes ® No
Last date of occupancy: CURRENTLY
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•3/13 Title 5 Official 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
169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. City(rown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: CURRENTLY OCCUPIED
Date
Other(describe below):
General Information
Pumping Records:
Source of information: 6-OF 2016 DEBARROS SEPTIC
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
NEW INSTALL
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.
e ❑ Other(describe):
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
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:
pp g p ( )
TANK APPEARS TO BE ORIGINAL S.A.S 6-2016
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: feet
Material of construction:
❑ cast iron ❑40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 2
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: 1000 GALLON
Sludge depth: MODERATE
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
°M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. Citylrown 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 LIGHT
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.):
I RECOMMEND PUMPING AT TIME OF TRANSFER AND AT LEAST EVERY 3 YRS THERE
AFTER FOR MAINTENANCE.
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
J
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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
9 P Y rY
M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. Citylrown 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-3113 . 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
�M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
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 011
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.):
BOX WAS FUNCTION ING,PROPERLY AT TIME OF TRANSFER.
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.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -,Not for Voluntary Assessments
5 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. CityrTown 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:
❑ 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.):
ONE CHAMBER WAS OPENED ANF HAD ABOUT 2 INCHES OF WATER IN THE BOTTOM WITH
NO SIGNS OF FAILURE OR STAINING.
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
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
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.):
C
_ t5ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
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
1
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
every page. CityrTown 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: GREATER THAN 5 FT
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: 7-2018
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:
DESIGN PLAN
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3113 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
,M 169 LONGVIEW DRIVE
Property Address
DUNBAR
Owner Owner's Name
information is required for HYANNIS MA 02601 7-24-18
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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17
Assessing As-Built Cards Page 1 of 2
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http://www.townofbarnstable.us/Assessing/HMdisplay.asp?mappar=251085&seq=2 7/24/2018
No. U p v S� t Fee h U '
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pplitation for Disposal �6pstrm Construction Permit
Application for a Permit to Construct(4_)---1;Ce_pair(e4-Up�a ed ( ) Abandon( ) ❑Complete System RIndiidual Components
Location Address or Lot No./(v!�/ ®s�Jl�(/j(�(,�/ ®�'(V!� Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel . -��1_d y' s 10614
In taller's Name,Address,and Tel.No. ®$- 98'0-175'2 Designer's Name,Address,and Tel.No.sle
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.re u d) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date _ -T,4V f /
Title
Size of Septic Tank Uo 0 Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) / 6/I /U
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed LC Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. ?O// — o�— Date Issued
No t Fee __-
THE COMMONWEALTH;,OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTARL�E, MASSACHUSETTS Yes
01ppfitation for Disposal 6pstem Construttion 3permit
Application for a Permit to Construct(4�Repair(G}-- grade( ) Abandon( ) ❑Complete System 21ndividual Components
Location Address or Lot No.16 9 Z_,o4q Vljl W �/(t//� Owner's Name,Address,and Tel.No.
Assessor'sMap/Parcel -�5�-48y5 'Ovl642
In taller's Name,Address,and Tel.No.SOg-2$O-�77f� Designer's Name Address,and Tel.No.SG9 -�GU
�ascp/-, o.�Q,¢��s ter_-y��� s zny //
/ G/4 Ys7CJ�9 /I/ j� S�s�H� ,(r,
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.re//q__ui/rid) / gpd . Design flow provided / gpd
Plan Date w/ 7�l jp Number of sheets Revision Date -"j /(�
.,... Title
Size of Septic Tank Uo o Type of S.A.S. 1� , I e
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Srf� /4 C UY /s'19' /U 01417
Date last inspected:
• Agreement:
i
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 thEnvironmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed ,� /- Date
Applicatiod pproved-by' Date
Application Disapproved by Date
for the following reasons
Permit No. ?U 1/ - 2 a)7- Date Issued ( � (�� j
-----------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,/that the On-site Sewage Disposal system Constructed Repaired Upgraded( )
Abandoned( )`by b 141nd'O S
at % 5&1 (/� has been constructed in accordance /
with the provisions/of Title 5 and the for Disposal S stem Construction Permit No. /( bated (r /
Installer,/Qt/jGj [/.f9 a//'m S Designer �7
#bedrooms Approved design flow/ _ '0 gpd
The issuance of this permit shall not be construed as a guarantee that the system wAffunc�c,Jas designed.
Date { a' I Inspector /
---------------------------------------------------------------------------------------------------------------------------------------
No. D d -2 a Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS
Disposal 6pstetn Construction jhrmit
Permission is hereby granted to Construct( ) Repair( G) Upgrade( nn) Abandon( )
System located at Lon a 1//r� ,t/�'/ V1,5
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. .A
Provided:Construct must be completed within three years of the date of this permit.i n ` Q
Date f/� Approved by01
Ail
From: 06/27/2016 08:52 0085 P.001/001
Town of Barnstable,
Regulatory Services
Richard V. Scali,Interim Director
Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis, KA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer&Designer Certification Form
Date: bl Sewage Permit# /� eaessor's MaplParcel Z-S Jo -
Designer: {1`"`'� ��-( , c ✓�^S Installer: �dY/
Address: 0 ' Z / Address: �� ���
_ 1
On toli i � be u, was issued a permit to install a
J(date) (ins alter)
septic system at Lt)N i �"� g-* C\t"N+5 based on a design drawn by
(address)
AP ., S 6 �- dated 7 I L
(designer)
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and,'or septic tank. Strip_ out (if required) was inspected and the soils
were found satisfactory.
t
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 1 Of-lateral relocation of the SAS or any vertical relocation of any component
of the septic system)but in accordance with State& Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required)was inspected and the soils
were found satisfactory.
I certify that the system referenced above was construct e with the terms
of the RA approval letters(if applicable)
QA
MEYER
( staller's Signaturey 1140
l�e�cgner's�igi}atur, CABLE
(.Affix Designer amp Here)
TO BARN PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT.CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
QASeptic\Designer Certification Form Rev 8-14-13.doe
I
Town of BArns'table P#
Department of Regulatory Services
Public Health Division Bate
2-5 icy
� �ARNBr'ABCBv •
16sy �s 200 Main Street,Hyannis MA'02G01
Date Scheduled Time
— J � Fee Pd. 1� p' 'y
� ' .
oil Suitability Assessr� eizt fog- Se age �p.osal: ..,
Performed By: l° Witnessed By: e
LOCATION_ &"GENERAL TNFORIYI�TION -
a-
Location Address I Ownee&Namel.DU'N�
- Address RoG N1 r
• �Iy�N.I s .w� �,y
Assessor's Map/P4rcel: O rye ` . ,' Engineer's Name M"e-r 4 �yyt f
NEW CON51RUd'I ION REPAIR '` { Telephone# 360-330
Land Use 11)��'rl k i Slopers vy"') ' 't Surface Stones
' k
Distances from: Open Water Body � �"'b ft Possible Wee Area ft Drinking Water Well �ft
+ � ft --
Drainage Way ` ft Prop�rtyLine 7 'Other
SKETCH:(Street name,dimcnsioos'of lot,exact locations of test holes&perc tests,'Ibcate wetlands in proximity to holes)
C
Depth to Bedrock r
Parent material(geologic C'" '
Depth to Groundwater. Standing Water in Hole:II i Weeping from Pit Face.r -�
Estimated Seasonal T-Iigh Groundwater -
D TION FOR SEASONAL HIGH WATER TAALE y
Method Used
ln. t ln•
Depth Cibsrxved standing in obs.hole Deh to Sall mottles:
P; -;
Depth toiweeping from side of obs.hole ! in. Groundwater AtlJuetment 1t-
! _ :.factor,.,._4- Adj.(7roundwaterl evel.,,,,fl,
Index Well# Reading Date: Index Well level - A dI,
PERCOLATION TES_T Date , Thue
Observation .._.-
14ole#
Time --
Depth of Pere v
D
Start Pre-soak Time.@
End Pre-soak
Rate MinAnch
Site Suitability Assessment: Site Passed _ Site Failed:
Additional Testing Needed(Y/N)
Original:.Public I-e'�Ith Division J Observation Hole Dafa To Be Completed on`Back----=—
***If percolafiion test is to be conducted within 100' of wetland,you must first notify the
Barnstable C61iservation 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,Stone,Boulders.
onsistenc o Gravel
'1_ 7 ' S Y
1...:j V
t:.
13 to
.,h.: • w
33`- tV' C Mep e 1
DEEP OBSERVATION HOLE LOG Hole#
, .
Depth from Soil Honzon Soil Texture Soil Color Soil' Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistenc %Gravel)
Olt
(�It anti Q 31
DEEP OBSERVATION HOLE LOG Hole#
Depth from' Soil Horizon Soil Texture Soil Color Soil Other.
Surface(in.) (USDA) (Muns`ell) -Mottling (Structure,Stones,Boulders.
Consistenc %Gravel
N r
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
C nsisten na I
F
ti
1
Flood Insurance Rate Map:
Above 500 year flood boundary No._ Yes
Within 500 year boundary No L 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? -- -----
If not,what is the depth of naturally occurring pe viof us material?
Certification
I certify that on 0 (date)I have passed the soil evaluator examination approved by tte
Department of Enviro mental Protection and that the above analysis was performed by me consistent with
the requir rain' g,expertise and explerience described in 3:10 CMR 15.0 7.
Signature v Date l
Q:\SEPTICU'ERCFORM.DOC
No. ... Z.:.y��1N� r Nss.. ...J...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
70. ......................0F..&/.. ✓s; f...:C. ............................------------
�� Appl ration for Disposal Iforks Toustrnrtuan Vrrmit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at: ��- R " '� e
.... o T ........�.ni�fir : . i S
.......___ -- -- ------- ----------•-----•-..............._..............._.
o tion-A dress ---or Lot No.
.....-•..................•-•-......._... --•-•--------------------•----•-------. ...... ...................................
Owner Address
W
M Installer Address
Type of Building ize Lot M... ...........Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic (✓ Garbage Grinder
Other—Type of Building �p-, yp g _.�.G....---.--•--._...... No. of persons............................ Showers ( ) — Cafeteria ( )
dOther 0Aures .-----------•-••••--•------------------•---...--------.-----................-------•-------------..__........
W Design Flow.....................................gallons per person per day. Total dail}� flow......._.�__�_.d....---......._..........gallons.
WSeptic Tank—Liquid'capacit .___.gallons Length . ..... Width.�l�� r_.___. Diameter________________ Depth---------
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft.
Seepage Pit NoA& ..... Diameter...../P........ Depth below inlet.....6............ Total leaching area, ft.
z Other Distribution box Dosing )
'-' Percolation Test Results Performed by.,�Y, --- ---.----•----------------- Date. Zl. � ..............
a
a Test Pit No. 1................minutes per inch Depth of Test Pit.l?_�......_. Depth to ground water...ZV vA........_..
LT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
C4 -----_. ---------------- •-----•-•----•-••----••••------•-----•---•--•••••---•-----•-•••----•-•-•••---•••---......•--•-••-•---••----......----•----
0 Description of Soil.........................................................................................................................................................................
x
w •-----------------------------------------------
----•------------------------------------------------------------------•--------------•-•------------------------------------------....-•----------........._._...............................-•-•-....
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
..............................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TIli U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be su d by th bmvd8,ealth,
,
Signed ......... •..... _..... �
D/Ae;
Application Approved By---- • .�. . •....................... ......................................... -------•--- �L �---•--
D
Application Disapproved for the following reasons:.................................•---.....--------............-----------------......-------•---...-------•----.
.........................••-••....-•----•••••.........------....-•---•------•••••----•--........••--•----.----•---....._..-----------------•------........---------------------------------.......-•-•---
47—
Permit No.-�7CS------------------
Date
-...... Issued- ......... ................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.................:. ... ... ......OF... .. "� !?ds °t`�F .....................................
Appliration for Disposal Works Tontrudion jkrmif
Application is hereby made for a Permit to Construct ( : or Repair ( ) an Individual Sewage Disposal
System at:
-•----------•-----•--•--•----•. ..........................................
f-
� n--Address or Lot No.
lT, l lio ar }....._..---•.............................• ................................................. ..._...----------------••_____
Owner Address
W
Installer Address
Type of Building ize Lot-!" ::_.:__.` ..........Sq. feet
Dwelling—No. of Bedrooms. _._..Expansion Attic ( Garbage Grinder 40
`4 Other—Type of Building / No. of persons____________________________ Showers — Cafeteria
P4Other fixtures .................................•.....................................................................................................................
W Design Flow......�. .............................gallons per person per day. Total dail,Y flow.-__._:n �_��__________. _......_.___gallons.
WSeptic Tank—Liquid capacit� _____gallons Length_!__ ..... Width__/-:�:_.... Diameter________________ Depth_____.._-.
x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area____________. sq. ft.
Seepage Pit NoA-1-1�=�...... Diameter.___.Z42_....... Depth below inlet.....4............ Total leaching ar q. ft.
z Other Distribution box ( Dosing tank )
Percolation Test Results Performed by._. _l ............................................... Date r :...::.r__ ___.......__-.
a Test Pit No. I...... minutes per inch Depth of Test Pit. __ .............. Depth to ground water----:'!�.:__.___..-
fi Test Pit No. 2...............__minutes per inch Depth of Test Pit.................... Depth to ground water........................
-------------------
-.......
•--•---•------------........
...
-...........
------ ------•----•-----------
0 Description of Soil........................................................................................................................................................................
x
w
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•---•------
U Nature of Repairs or Alterations—Answer when applicable...............................................................................................
... .........................................................•---•
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 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..::.................................................................................. .........................-
j� Date
Application Approved By.. •........................•--•--•----•-•------- ......... r / _....
'r DaEe
Application Disapproved for the following reasons:..............................................................................................................
-
---------------•----....-•-•••---....----•--•-•-...•-•-•-----------------••-•-....-------•••-•-•-...--------•-----•-----•----------•----------•------••••-----------------•••--...---------•--.._......
Date
Permit No... 15
-••••-•---_... Issued........................................................
te
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................OF.... ....................................
Tatif irate of 'Tomplianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( u or Repaired ( )
by------------------•----------------•-----------••--•--•----------••-•----------------•--•---------- ----------_-----._---_----------------------------------------_--.--•-•------------•----------•-
^� rbnstalles•---
R
"r �:--=---••------ °fit`•'--�- -----�'� ,� - �- r.�.. x..
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No-----cF _________________ dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE......................,(.-.... .. . ............................. Inspector.--••-----�___)Lj--------------•-----------•--------------_---_-_.---_-
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF� HEALTH
N
............... ..-......OF..... ? ��'�t!:�iL��_ ...
No...__�_ .'....1�..... FEE..71.....
Disposal Works Tonotr ion Fermi#
Permission is hereby granted. .............................................
to Construct, (N,/ or Repair ( ) an Individual Sewage Disposal System
at No....=1� ,. E> 1-t 3L_f C:t_�? T•.._:..a� ft
Street 7�^-�
as shown on the applicatidfi for Disposal Works Construction Permit No..<.....!'_.____...'Dated..........................................
-----..._..-•---•............................•----------------------.......------•..........--••--.._.._
Board of Health
DATE................................................................................
FORM 1255 A. M. SULKIN, INC.. BOSTON
LOCATION 36 NO. s �"
VILLAGE Canoh _ )� I l=L DATE
APPLICANT n iC L I''}'1 aAal rQ.S FEE
ADDRESS _ 11�1 - • I f�_ TELEPHONE N0. (Non-refundable
:ENGINEER _ 4 ,Q_s _TELEPHONE NO. '
DATE SCHEDULED /,ob Arh
(Applicant' s signature
. . . • O . • • • . • . • • • : • . . . . . . . O • . . O . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . ... .
ASSESSOR'S MAP & LOT NO. SOIL -LOG
SUB-DIVISION NAME DATE JiC 2.01 1 n�� S TIME
EXPANSION AREA: YES NO ENGINEER
TQWN WATER �4_. PRIVATE WELL BOARD OF HEALTE
EXCAVATOR
SKETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and
'`percolation tests, locate wetlands in proximity to test holes )
NOTES :
lee
o
r ,,o O •
!A6
PERCOLATION RATE: ZV-4, LL,A
TEST HOLE NO: "'� ELEVATION: TEST HOLE NO: I} Z ELEVATIO
� 3
2 2
z 3
3 3 l u
ti 4 4
5 IAA c� 7 TO T- �ti a E 5 5A�
7 *r�Wtl:. GaB�I Isr kA)FY
6 S Mdtl—C; l cow
g 9
10 10
� 11 11 „_, 1 � •
12 12
\Z
13 13
14 � \ ' /
a 1,0� Z, 14
15 15
16 16
SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD�LEACHING PITS
LEACHING TRENCHES.
UNSUITABLE FOR SUBSURFACE SEWAGE. REASONS :--
NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION
ORIGINAL: COMPLETED IN ENTIRETY BY P . E , AND RETURNED TO BOARD OF HEALTH
COPY: RETAINED BY APPLICANT
.....................
n1d dl
. ..... ... ...........
Isla A
an niq
..........
v N.':l
G a l4lknd �
Pt
f i . ..... L4-
..........
...........
150,
'
rV
Al
<
oa-
Vf
tit
t ba
........... .........-
110
V,011 R\l
fj
441
POP
Ilk
X,
-A fit
tp
POtn'
Shirley wis
Mend/
Nyes
shalldj� p4nd u
Stoney em.
76/
ip Pt
I vn� 'Al Doseber*
-RAt
ij
Ong
Litt / at IM
-A k
t'�..........
Ar
K 4k
-W'�5/
- x ".
•
Fire
'A 4
WE
r w j
c 5
P'
a
. LEGEND HYANNIS
PRO ET
PROPOSED CONTOUR
8 POSED SPOT GRADE WEQUAQU
LAKE o
v —— 98 —— EXISTING CONTOUR
+ 96.52 EXISTING SPOT GRADE W
BENCH.. MARK
W= EXISTING WATER SERVICE
I PAINT SPOT ON . TEST PIT O
BULKHEAD CORNER 74 _ LOCUS J
" 20'
BARNSTABLE GIS DATU
LOT
,-�/ A E= 12356sf+— o Z RTE 28
. � LAND COURT PLAN`28749—
, — ASSR MAP251 PCL 85 �' °� 0 LOCUS MAP
75 _ vL L PLAN REF: 28749—B
\ �� / TITLE REF: C200434.
G \ z PARCEL ID: MAP 251 LOT 085
EXIST. 1,000G EXIST. 1 000c
LEACH PIT
b `SEPTI TANK \� ;
(APPROX.) 'note 17)
i \ SEPTIC SYSTEM
It w WATER
�yo ` 0 �r ', GATE REPAIR PLAN
LOCATED AT: -
n \ ; �Z C) �.69 LONGVIEW DRIVE
L. `
• , I
I c
-HYANNI MA
o ` _ PREPARED FOR
y DUNBAR
a - o o y ! JUNE 7, 2016 REV: JUNE 13, 2016
TP—z \C b !
74
,. / o� ARl EN M. y�
/ N. 14
O
�6
,
,
- � •.,..� .` . ` T SCALE-- 1 in = 20 ft
w , r o 20 y MEYER & SONS, INC.
40
P.O. BOX 981
0 10 20 40 r EAST SANDWICH, MA. 02537
PH: (508)360-3311
FAX: (774)413-9468
T meyerandsonsinc®gmail.com
Y SHEET 1 OF 2 J 1787,
NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GENERAL NOTES:
TOF SEPTIC TANK i GRADE SHALL NOT BE < EL:72.30 FOR A DISTANCE
15' AROUND THE PERIMETER OF THE S.A.S.
EL.=76.75t INSTALL RISERS & COVERS OVER INLET & �
PROPOSED D-BOX 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
OUTLET AND SET TO 6" OF FINISH GRADE
INSTALL LOCKING COVERS IF AT FINISH GRADE INSTALL RISER & COVER PROPOSED S.A.S. BOARD OF HEALTH AND THE DESIGN ENGINEER.
_ SET TO 6" OF GRADE INSTALL A RISER OVER' ONE CHAMBER (MIIN) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
AND SET TO 3" OF F.G. OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
F.G. EL=75.20t F.G. EL.=75.20t F.G. EL: 74.80± LOCAL RULES AND REGULATIONS.
F.G. EL: 74.80 MAX. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
( ) TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
DESIGN ENGINEER.
'" 9" MIN COVER/
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
36" MAX COVER L = 40' L = 40'(MAX) I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
® S=1% (MIN.) EL.=73.71t 0 S=1% (MIN.) ® S=1% (MIN.) ENGINEER BEFORE CONSTRUCTION CONTINUES.
4"SCH40 PVC _ 2" OF 3 8" DOUBLE WASHED
4"SCH40 PVC 4"SCH40 PVC / 3/4" - 1-1/2" 5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
/ STONE OR FILTER FABRIC DOUBLE WASHED STONE
t0' g 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
\INV,=72.65 14 HEALTH FOR CPROPER NSPR OR ECT1ONS DURING CO TO NOTIFY THE NSTRUCCAL BTIION.OARD OF
48"uouio kNV.=72.40 ®®®®• p ®®®®
LEVEL7. DWELLING IS SERVICED BY MUNICIPAL WATER.
GAS BAFFLE PROPOSED ®®®®EMEREM ®
®E3 E3®E3 E3 EM E3 EM E3 E3 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED
D-BOX INV.=71.80T ®®®®®®®®®®® TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.
" INV.=72.00 DB-5 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE
> , LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO STARTING WORK.
EXISTING 1.000 GALLON SEPTIC TANK 4 Z X $,5 4 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5.
EXIST. SEWER OUTLET EFFECTIVE LENGTH = 25.0' 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY
INV. ELEV.= 71 .30 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
13. NO KNOWN PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING
BREAKOUT 14. ALL PIPING TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPEC. )
NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING TOP CONC. ELEV.= 72.30 EL. 72.30 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW
PIPE INVERTS PRIOR TO CONSTRUCTION FOR THE USE OF A GARBAGE GRINDER.
INV. ELEV.= 71.30 ®® 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING
2) 0-BOX SHALL BE SET LEVEL AND TRUE TO ®la®a®®® 17. ACCESS PORTS TO BE CUT INTO DECK TO ALLOW ACCESS TO
GRADE ON A MECHANICALLY COMPACTED SIX ®®®®®®®
<" INCH CRUSHED _STONE BASE, AS SPECIFIED,.IN BOTTOM EL.= 69.30 '+ ®®®®®®® SEPTIC TANK UNDER DECK, THERE ARE NO'SONO-TUBES ON TANK.
310 CMR 15.221(2) 4 5 FT. 4
3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK EFFECTIVE WIDTH = 13'
' WITH 1500 GALLON SEPTIC TANK IF FAILED, SEPARATION 5.80 FT..
DAMAGED, NOT H2O LOADING, OR UNDERSIZED. SOIL ABSORPTION SYSTEM (SECTION)
4) INSTALL INLET & OUTLET TEES W/ SEPTIC SYSTEM PROFILE BOTTOM OF TESTHOLE EL: 63.+507 (500 GALLON LEACH CHAMBER)
GAS BAFFLE AS REQUIRED
N.T.S.
DESIGN CRITERIA SOIL LOGS P#:15031
NUMBER OF BEDROOMS: EXISTING 3 BEDROOOM
SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) DATE: MAY 5, 2016
DESIGN PERCOLATION RATE: <2 MIN/IN SOIL EVALUATOR: DARREN M. MEYER, IRS, CSE
WITNESS: DAVE STANTON, BARNSTABLE HEALTH �� MgsS
DAILY FLOW: 110 G.P.D. X 3 BR DESIGN FLOW: 330 G.P.D.
GARBAGE GRINDER: NO (not designed for garbage grinder) Elev. TP-1 Depth Elev. TP-2 Depth DA E
ip
SEPTIC TANK: 330 d 200% = 880 pd USE EXIST. 1,000G SEPTIC TANK 74.50 A LOAMY SAND i 74.50 A 0" 0
gp x g 1OYR 3/Z LOAMY SAND
LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. 74.00 6" 10YR 3/2
74.00 6"
USE TWO (2) 500 GALLON PRECAST LEACH CHAMBERS6/8
71.75 B LOAMY SAND 33". B LOO SAND NCI TAR
> C 1 71.75 33"
W/. 4 STONE ON ENDS AND 4 ON SIDES: 25 L x 13 W x 2 C 1,D MEDIUM MEDIUM
SAND SAND
t� PERC TEST 2.5Y 7/4 2.5Y 7/4
r: BOTTOM AREA: 25 x 13 = 325 SF ® 70.2
-; SIDE AREA: (25 + 13) X 2. X 2 .= 152 SF -
"TOTAL SQUARE FEET PROVIDED = 477 vs. 445.94 REQ'D PROPOSED SEPTIC SYSTEM UPGRADE PLAN
DESIGN FLOW PROVIDED: 0.74(477 S.F.) = 352.98 G.P.D. vs. 330 G.P:D. req'd 63.50 132" 63.50 132"
PERC RATE <2 MIN/IN. ("Cl" HORIZON) 169 LONGVIEW DRIVE, HYANNIS, MA
NO GROUNDWATER OBSERVED Prepared for: Dunbar
System Design and Topography Plan by: SCALE DRAWN DATE
MEYER&SONS,INC. N.T.S. DMM 06/07/16
• 1, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX 981
to conduct soil evaluations and that the above analysis has been performed by me consistent with the F�4STSANDMCH,MA02537 REV DATE CHECKED SHEET NO.
requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October, 1999.
50e•362-2922 06/13/16 DMM 2 Of 2
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