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HomeMy WebLinkAbout0257 MITCHELL'S WAY - Health 257`Mitchells Way Hyannis A= e a � A 9 d I a a 1 'a i TOWN OF BARNSTABLE LOCATION ��� � �� JAIM SEWAGE VILLAGE ASSESSOR'S MAP&PARCEL �g®M(ay INSTALLER'S AME&PHONE NO. 4 SEPTIC TANK CAPACITY LEACHING FACILITY: (type - (size) ,®1 �(J-6` NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: 9 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility !*-I 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 an Leaching Facili (If any wetlands exist within 300 feet of le chin cility) �Zb Feet FURNISHED BY 1,S4 5 P .00 � ZY 7777777 ^i"UVT OF$ 1STABL� Inco14 . ilk ' C TAtC CAPACX`ihf Y,.W PA IfUlli 0, '9 AA IV�'��FSICE Bsivreeg Ito D�sxi�war t ;Gk'au ioiti"tlWROMId.Leechtngl acility. Fran saI �fitts6tto� �►Y adta ae 1 a� fa�alltty) Few � ��� >�fi�.�+►Y we�lt�ncl�exist svltl�t��Q R►ec:i�loua� �g ' ` } :' . . r - del: � � t p� � � �, -Y � �, G ^ � Q 1..1 S .: 1 - � -�' � � � � � r V v" a TOWN OF BARNSTABLE LOCATION 3 © V ` `►���� d SEWAGE# QQQ VILLAGE �1,�VVVy V ASSESSOR'S &PARCEL INSTALLER'S NAME&PHONE SEPTIC TANK CAPACITY `©O© C-D,.kG � +� LEACHING FACILITY:(type) (size) 3 k k k NO.OF BEDROOMS a OWNER �e,��4 � lz x PERMIT DATE: '� COMPLIANCE DATE: -7 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility -5 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;5C- 24 ' � . S � W r b c r r w =uo:j� 10 v C) n� 00 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitation for Disposal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade X Abandon( ) Complete System ❑Individual Components Location Address or Lot No. � , Owner's Name,Address,and Tel.No. Assessor's Map/Parcel �( j"[9'-8_' U' , 0&2&d Installer's Name,Address,and Tel.No. Designer's Narre,Address,and Tel.No. ` f Type of Building: y' Dwelling No.of Bedrooms Lot Size a sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.require ) ZZ gpd Design flow provided 3q2A gpd Plan Date Number of sheets Revision Ditto Title e tic Tank Type of S.A.S. Size of; Description of Soil k btliah Nature of Repairs or Alterations(Answer when applicable Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the nvironmental ode and not to place the system in operation until a Certificate of Compliance has been issued by this Boar of H 1 9 �C Signed Date Application Approved by Date !9 Application Disapproved by Date for the following reasons Permit No. V'Q X0" Date Issued - -� ��\ q `+7•. -may w.i.'a.+,E. M"' y Xr r5 ; s "r`"o y .tA. rr.;:,� �"."».3T�.-..:ai ,.ti'ef^�. -'y - p, ,.r,' i ,1 - 1E•'-'f�•.-.'�'�`t,F^T' 71 tk No.', Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION'- TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliCation for.Mis loSal *pstem �OnBtrUCtlOn hermit ..r Application for a Permit to Construct( ) .Repair( ) UpgradeX Abandon( ) Complete System ❑Individual Components Location Address or Lot No.,��� A41' $ ' Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 2+10 0 v y W/u,,; Installer's Name,Address,and Tel No. Designer's Name,Address,and Tel.No. d J y T'P`e of Building: Dwelling No.of Bedrooms '* t Lot Size , _ � sq.ft. Garbage Grinder( ) Other Type of Building. y �b { No of Persons Showers(. ) Cafeteria( ) Other Fixtures �y - i. Design Flow(min.required) O gpd Desi n flow rovided gpd ��4 g p 2_ a Plan Date , / Number of sheets , Revision Date TitleC t v� W291 i# y � ^_ [t Size of Se'tic Tank ;. 1 ttType of S.A.S.' •�,� b Description of Soil l A h4 � ti f Il4. IA Oh A G ,. .kL, •,oNature of Repairs or Alterations(Answer when applicable KitLam#k� "gam t4r� 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 rivironmental Code and not to place the system in operation until a Certificate of r: Compliance has been issued by this Boardrof Hea"lth. Signed . i Date Application Approved by _._ Date ' -fC1 w Application Disapproved by Date for the following.reasons PermifNo. to x0" ,Date Issued ••• 6'"3C, THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO'CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(\/) Aban__doned. by_ f a .. at _ UA jttk , has been constructed in accordance - - MAs _ro— 2'� with the provisiotn�s of Title �'S'and /the for Disposal'System ConstructionPermit No dated Installer kO�� �/1 ayE Ni)�'t. Designer •13 k ". s _ 0 �( d #bedrooms Approved design'Pow gp The issuance of this permits all no be construed as a guarantee that the syste ill f�unctioka les ed Date Inspector .,,. \ No. «tC?�-0 " ���- --- --•-.____�_.-__._._---------,-•----__---------------- -,_-_�_-__=---�--_-__�_.. .Fee s'- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS 30isposat *pstem ConstrUttin Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at tti . , 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 must be completed within three years of the date of this permit. .i""' ('/, Date -F'"f d" Q') Approved by � r To'viltri of BahistAk °p r Regulatory Services nnn�srnnce Richard V.Scali,Intierim.Director MA-v$ , ` Public,Health Eily sign oMmta Thomas M1 cKea.n,Director 200 Main Strect,`1y aunts,MA 02601 01 tire: 508-862-4644 Fax: 508-740,-6304 fustalter&DesipnerCertification form ;Date.• ' SCIV20e.Perinitif Assessor'sMapTarcel Designer: �er � nvt` lt Co"pC,,Ail Address: J'Z ln/, /r1 Address MA til A t Oil . - �v Y1 V-"5-ts�c CO"/CA j was issued a permit to instrall,a elate in taLier Se 6c S stern at c t l l is r p y based on ,design dravrnu by (address) C nr3 t n men� 6 Uo Lts,���" dated 2A l Zc� ` (designer) L'",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 boa,and/or septic tank. Strip out (if required} was inspected°and the soils were found satisfactory. 'I certify that, the septic systein 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 R.Local Regulations. Plan revision or `certified as-built by designer to follow. Strip,out(if required),vas inspected and the soils were:Found satisfactory, jltZ if-y that the system referenced above was constructed in � with the terms 1 app 'alletters(ifapplicable) �µ l . __ �r RED (Insaller's S g-7naturra). rto.3s1as i O , RFt3is,� (:Designer's Sigttatutre) (Affix Design- ere) PLEASE RE RN -ro 'BARNSTAB E PUBLIC FIRALTH DIVISfON CRRTrrICATE OF COMPLIANCE WILL NOT .13E JSSUED UNTIL BOTTt TITS MRM AND As- BL+TUT CARD ARE RE T VEU BY THE BARNS"T'ABLE PUBLIC HEALTH DWISION. THAN Y0U. Q:'Septio>LSe5i9ncr CeTtific&tion porn Rcv 8-14-13'_doc Enginoers note:Tl,�s certification is limited to an as-baltinspecilon of system components as installed prior to bapklIll,The ecgineerdid not supcnnseconstruction of the system.The installerassuines responsibility for all materials,workmanship,backif ling to specified grades vinh proper eumpactlan and setting risersldovors as shown on the design plan. ,r ,,xnp No.. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in c puteb�h r Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftPlitatlon for M18posal *pstrm Const union i3Prmit Application for a Permit to Constr t( ) Repair( ) Upgrade( ) Abandon ❑Complete System ❑Individual Components Location Address or Lot No. 3 3 35- Owner' Name,Address,and Tel.No. Assessor's Map/Parcel a Z�IInstaller's Name,Address,and Tel.No. Designer's Name,Address,and 41o. 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.required) gpd Design flow provided gpd 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) Date last inspected: -l?o't'� 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 E i onmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He tl Date — Application Approved by Date Application Disapproved by Date for the following reasons Permit No _ Date Issued ��r e''kva;+�r�+i.:rw�jK n�.itr x,.rR+•�'ff'!!�ti:` :,;•rr••e e�,7+�°`i"' d'�'-'`uA f'S.,';�•'t.�'khsr+,Kq,' fn, sr�i;r_. � xi,. J *, �<r �Ey, i1M.k.nv� 4r._M. *^R 4."ro$i«..j�.1,...,M+1'Wh.. ,r.� '4:.'?+•'-r�'6r ri,•.',+.k"'..=,nY+rN+«�:""�. No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: .,PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes �4pliratlott for LBtID�'AY pstellY Constructionerlltlt Application for a Permit to Const ct( ) Repair( ) Upgrade.•( ) Abandon El Complete System ❑Individual Components Location Address or Lot No. 35AO�C44. Owner's Name,Address,and.Tel.No. Assessor'sMap/Parcel R30 I ` A e of Installer's Name,Address,and`Fel.No. ;m'"' Designer's Name,Addressvand Tel.1 0. f ; Type of Building: t -a Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) t Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �-;..•, Design Flow(min.required) gpd Design flow provided gpd X Plan Date Number of sheets Revision Date Title " Size,,of Septic Tank V Type of S.A.S. Description of Soil.71 Nature of.Repairs�orAIterations(Answer when.applicable) ;_+ ,'fin. �.�.r v Gw!GA !�/'t. R,wMC n •".. i j p Sw Date last inspected: -Agreement: a The undersign d"agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the ovisions of Title 5 of the E uironmental Code and not to place the system in operation until a Certificate of Compliance has been iss d by:this Board of Health. N i e Date Application Approved_by 41 Date' s1 Application.Disapproved by Date A for the following reasons � � r Permit No. " Date Issued -- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) .Repaired( ) Upgraded( ) Abandoned W by /J!��t/�J Cs I��QA�' y! /- d +r:' -at t Q has been constructed in accordance s _. _ with the provisions of Title 5 and the for Disposal System Constru ion Permit N•- dated ItstaAer1ReVdA E _ Designer #bedrooms Approved design flovA gpd The issuance of this p rmitlshall not be construed as a guarantee that the system 11 cti as desig Date Z Inspector y J •. -' No. .. '^D Fee W THE COMMONWEALTH OF MASSACHUSETTS i PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS E ' Disposal 6pstem Construction Permit Permission is hereby granted to Construct(ter—) ,�gRepair(/_ ) Upgrade( ) Abandon(V V ) System located at `� Q J / 34/1 CAL IV M4 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. r Provided:Constructton must be co, pleted withimthree years of the date of this permit. r. Date Approved.by �n r _ Commonwealth of Massachusetts C�90' 08 1 y, Title 5 Official Inspection Form •h"i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i`=• r . '�1 ,ro 257 Mitchells Way Property Address � Bank Owned (Contact Maiza Eloy @,Today Real Estate 1-800-966-2448) Owner Owner's Name information is T! required for every Hyannis MA 02601 8-10-20 w, . page. City/Town State Zip Code Date of Inspection +. P 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. A. Inspector Information Shawn Mcelroy Name of Inspector Upper Cape Septic Sevices - Company Name P.O. Box 73 Company Address East Falmouth MA 02536 City/Town State Zip Code 508-495-0905 S 13971 Telephone Number License Number B. Certification _ I certify that:l 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: ,y ' ,1: Ej Passes 2. ❑ Conditionally Passes - 3. ❑ Needs,Further,Evaluation by the Local Approving Authority. 4. ® Fails 8-10-20 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 1 Commonwealth'& Massachusetts , �al Title 5 Official Inspection Form i� ws Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town 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: ❑ 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: 2) System Conditionally Passes: El one or more s components as described in the "Conditional Pass" section need to be system 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 (whethe r 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 ON ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 f f ..,: Commonwealth of Massachusetts , 3. Title 5 Official Inspection Form �IQ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town , 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 ON ❑ ND (Explain below): ❑' -obstruction is removed ❑ Y ON ❑ 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 ON ❑ ND (Explain below): ❑ obstruction is removed ❑Y ON ❑ ND (Explain below): 3) Further Evaluation is Required byIthe 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 publid 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.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 i ` Commonwealth of Massachusetts Title 5 Official Inspection Form 01 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is re Hyannis MA 02601 8-10-20 required for ever y Q Y Cit /Town State Zip Code Date of Inspection page. Y P p 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 tark 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 for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 i Commonwealth of Massachusetts a� Title 5 Official Inspection Form C�i Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments + 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town 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 'h 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. ❑ ® 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. ® 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. 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 r Commonwealth of Massachusetts y Title 5 Official Inspection Form _ill Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town 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 Commonwealth of Massachusetts r� IQ I Title 5 Official Inspection Form wM1' 'I Subsurface•Sewage Disposal System Form -Not for Voluntary Assessments _T, ? 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy,@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town State Zip Code Date of Inspection D. System Information ; 1. Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Description: f - Number of current residents 0 Does residence have a garbage,grinder?, , ❑ Yes ® No Does residence have a water treatment unit? w ❑ 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: Unknown ' Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts r� y Title 5 Official Inspection Form it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ?r. 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Tcday Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town 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 Water treatment unit present? ❑ 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: N/A 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 I f Commonwealth of Massachusetts i-i Title 5 Official Inspection Form :%► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448). Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town 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: Pp 9 p _ ( ) 1987 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 24" Depth below grade: feet Material of construction: ® cast iron ' E 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. t5insp.doc•rev..7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c ` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy c@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 18"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 gal Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 6" Scum thickness 3" Distance from top of scum to toa of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 s ` l Commonwealth of Massachusetts r. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town 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: 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 c Commonwealth of Massachusetts ra Title 5 Official Inspection Form -11 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned_ (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page.e. City/Town 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 pumping: 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 0 Comments level note if box is( I and distribution ribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box had signs of back-up with stain lines above outlet invert. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 l Commonwealth of Massachusetts ��. Title 5 Official Inspection Form ri Subsurface Sewage Disposal System,Form.-Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 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: "'W" ❑ 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: Type: ® leaching pits,--, 'number: 1-1000- gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching 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 s Commonwealth of Massachusetts Title 5 Official Inspection Form W�'l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 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.): Leach pit was empty at inspection with obvious stain lines above inlet invert and into riser. 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 fw> Title 5 Official Inspection Form hi Subsurface Sewage Disposal System Form-Not for Voluntary Assessments fr- r . 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @,Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town State Zip Code Date of Inspection D. System Information (cont.j " 13. Privy (locate on site plan): Materials of construction: ' +•� x r Dimensions I Depth of solids ` Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): • i t 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 i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments > 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town 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 r. Lr DO P f -4 r ,3 . r t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 I r Commonwealth of Massachusetts Title 5 Official Inspection .Form i C�G Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @•Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20. page. City/Town 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 ground water 20 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 and town maps show groundwater at 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 c Commonwealth of Massachusetts 3 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 257 Mitchells Way Property Address Bank Owned (Contact Maiza Eloy @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 8-10-20 page. City/Town 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 4 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 4 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION Z � w F IW W TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 257 MITCHELL'S WAY HYANNIS,MA 02601 Owner's Name: HAROLD PETERSON Owner's Address: 66 WEST 94TH ST. NEW YORK NEW YORK APT. 10 A Date of Inspection: 8/23/01 Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 ' CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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: X Passes _ Conditionally Passes _ Needs Furthqr Fvaluation by the Local Approving Authority Fails Inspector's Signature: Date: 8/23/01 The system inspector shall submit a' opy 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. Notes and Comments SYSTEM PASSES TITLE V RECOMMEND-PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S 5 USEFUL LIFE. ****'Phis 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. s � Tith r, lncnartinn Fnrm All S0000 1 Page 2 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE-SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:. 257 MITCHELL'S WAY HYANNIS,MA 02601 Owner: HAROLD PETERSON Date of Inspection: 8/23/01 '. Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes; X 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: SYSTEM PASSES TITLE V RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. 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. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined" please explain. n/a The septic tank is metal and'over20 years old*or theseptic 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. ND explain: n/a n/a 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 obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumping More than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): _broken pipes)are replaced _obstruction is removed ND explain: n/a f I `rfl 4 Page 3 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 257 MITCHELL'S WAY,HYANNIS,MA 02601 Owner: HAROLD PETERSON ` Date of Inspection: 8/23/01 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. I 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(i)(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 6et of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh i� 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 heal#h,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 aseptic tank and SAS and the SAS is within a Zone 1 of. 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 tankaand SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to cetermine distance n/a "This system passes if the'well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of 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: n/a I - Page 4 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE;SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 257 M[TCHELL'S WAY HYANNIS, MA 02601. Owner: HAROLD PETERSON Date of Inspection: 8/23/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for alLinspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground.or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow _ X Required pumping more than 4 times'in.the last year NOT.due to clogged or obstructed pipe(s).Number of times pumped nLa. r _ X Any portion of the SAS,cesspool or privy is below high ground water elevation. _ X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water'supply. X Any portion of a cesspool or,privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool o'r,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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form:] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 A 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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply _ X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—I WPA)or a mapped Zone II of a public water supply well S 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 failodi The owner or operator of any large system co midered a significnl�t 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. d Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM -PART B CHECKLIST Property Address: 257 MITCHELL'S WAY HYANNIS,MA 02601 Owner: HAROLD PETERSON Date of Inspection: 8/23/01 Check if the following have been done.You must indicate "yes" or"no" as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period X Have large volumes of water been introduced to the system recently or as part of this inspection ? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage backup? X Was the site inspected for signs of break out X _ Were all system components,excluding the SAS, located on site'? X _ 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? X _ 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: Yes . no X _ Existing information. For dzample,a plan at the Board of Health. . X _ Determined in the field(if ariy of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] r. ,f Pale 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 257 MITCHELL'S WAY HYANNIS,MA 02601 Owner: HAROLD PETERSON Date of Inspection: 8/23/01 ,l .t� FLOW CONDITIONS RESIDENTIAL 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 Number of current residents: 2 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.20.3): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(.yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use:n/a a OTHER(describe):n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no):NO If yes,volume pumped:n/agallons--How was quantity pumped determined?n/a. Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool - _Privy _Shared system(yes or no)(if yes,attach previous inspection records; if any) Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach a copy of the,DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1987 PERMIT 87492 Were sewage odors detected when arriving at the site(yes or no): NO ' r, f Pale 7 of l 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 257 MITCHELL'S WAY HYANNIS,MA 02601 Owner: HAROLD PETERSON Date of Inspection: 8/23/01 A BUILDING SEWER(locate on site plan) r Depth below grade: 12" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) x Depth below grade: 6" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6" H 5' 7" W 4' 10"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle:32 Scum thickness: 2" ` Distance from top of scum to top of outlet tee-or baffle:6" Distance from bottom of scum to bottom of outlet tee or baffle:n/a How 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 AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.' RECOMMEND PUMPING EVERY, TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. t GREASE TRAP:_(locate on site plan) Depth below grade: n/a s Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to toprof outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related rst: to outlet invert,evidence of leakage,etc.): .n/a' Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 257 MITCHELL'S WAY HYANNIS, MA 02601 Owner: HAROLD PETERSON Date of Inspection: 8/23/01 TIGHT or HOLDING TANK: . (tank,must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or-no):NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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.): DISTRIBUTION BOX APPEARS TO BE STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY. PUMP CHAMBER:_(locate on site,plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a R Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 257 MITCHELL'S WAY HYANNIS,MA'02601 Owner: HAROLD PETERSON Date of Inspection: 8/23/01 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: ` n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number,y length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a t innovative/alternative system Type/name of technology: n/a Comments(note condition of soil, signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): THE LEACH PIT APPEAR TO BE FUNCTIONING PROPERLY.NEVER MORE THAN HALF FULL. BOTTOM IS AT 9 FEET. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a ` Depth—top of liquid to inlet invert: n/a ; Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): n/a 9 Pa,ge 10 of I 1 OFFICIAL INSPECTION FORM-'NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 257 MITCHELL'S WAY HYANNIS,MA 02601 Owner: HAROLD PETERSON Date of Inspection: 8/23/01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. k in Page 11 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 257 MITCHELL'S WAY HYANNIS,MA 02601 Owner: HAROLD PETERSON Date of Inspection: 8/23/01 SITE EXAM ' _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 10+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers (attach documentation) NO Accessed USES database-explain: n/a You must describe how you established the high ground water elevation:. NO WATER ENCOUNTERED AT 10' BY AUGER a tt TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE ISASSESSOR'S MAP & LOTagj> INSTALLER'S NAME & PHONE NO.�'Q,r[ks W' "tr t CS. 7411-,Z83.5 ;SEPTIC TANK CAPACITY �o►� _ ) LEACHING FACILITY:(type) tm&o. �. �: (size) t;X b NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER ;BUILDER OR OWNER irG..ro pe S a DATE PERMIT ISSUED: T DATE C011PLIANCE ISSUED: cl- c6 VARIANCE GRANTED: Yes No � V �� II r I Q 4� -r --I'- 10 % r�l� F�s.......`d`U O THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ----------- ..:...........OF... Appliration for Disposal Works Tnnstrnrtinn Permit Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal SystemLj a Jam.- --------------------------------- ._........... -......... .\a.......... -� ocat n-Address or Lot No. ..Ike,.::................................. y`�.Mv1d.._._.. .............. ..........___ ... 1_ °A._.......:M__... 4 `:5...._.._`�\ Owner \ Address -..... Y'- --•-•-- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons........................ Showers — Cafeteria Q' Other fixtures ............................................................... ---------•----•----•------•----•---------------------'------------ W Design Flow............................................gallons per person per day. Total daily flow_.._................_...._......._..._....__gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter_______---..--_- Depth---------------- Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by........................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-------_............ Depth to ground water......................... (4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--__--_____-____:_..___- •-•--- ------- ---- ---------------------------------------------•---------'----------•'----........................................................ ODescription of Soil........ .......•.................'--------------._...--------------••-•----••......---••-...... U •-•------•--------------•-•-••-----•.....•--•••-••--•'-•----•---------------••••-••••---------------•••----------•••--••----•---••--'-----'-•-•-----•----••--..........---'•-----•..... UW -----•----------------------• -- -------------------------................................................ •-• _ Nature o Repairs or Alterations—Answer when applicable.........`.?- __________ _________b...._...._._.._� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of""TILE p5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has e n isW d by the board of health Signed - a `^ Date Application Approved By............. �-� Date Application Disapproved for the following reasons:-----••-------••----•••-•----•-----••--••-••-'--•-•-------••--•••---------------•----•----•-•----••••'•--...---- ................................-'----....••-----•-------•-•-••'--•--•-•-----------•--••................._...-----'-------•-••••--•-•--••----•-••-•---•--•-----•'•--•------------_...--•-•--•-••-------. Date PermitNo......�__7_....... ................... � Issued_....................................................... 4 Date \o io VI �Ijn ;zt JL zo a Ala J i � { t a j 1! , i j i i j l d .. tjo P 1 10 j urn i a �- f I 1L ¢ ot CY LL j § p p � A r Q C—F _ s l � I i i KC i iiViV � � ip,� _ • GE J 7 r v 4 y ' e ti �. ''>,t�' �'t i;rt"��,Pr,#'�•�. .:�y�,• y`r !r �.3' F r 4.:q'# .iC �'r.�,'S y�\"C fit'" . V44 .� XN� y > S/J ;� ., i.}i� '.1✓ it kv � IT r O PQ I O lam-' Vi OD Y " `jr- o J L- l 40 Al NX J q l � . L g I i i t P CERTIFIED PLOT PLAN LOCATION �!�2!�!s7r9fGE;C (Hlviv!s�, N i SCALE . .�. �:.Z n�. .... .DATE /Vol/,ZSLoo 3 PLAN REFERENCE . 1 CERTIFY THAT THE �ST�IG DW."GL��!G +� SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. DATE /✓o)/ ZZco,3 f, o O REGISTERED LAND SURVEYGh d CIO .( 7o2, -R 00 L OF Mq E A Iq ELLEY -� o. 26100 / � D/ 'fl \ .rf��,�gfCIST E QRE SJ ' L9►�� \ . t /a27-AIL, r GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL l %Py, r� BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTSN� � � ^1 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE �. m LOCAL RULES .AND REGULATIONS. 101,43 , 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 2.5`7MitG,�el�y„ TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 1 PROPOSED S.A.S. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 5—PRECAST LC6 CHAMBERS � ti FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. SURROUNDED W/3.5' STONE 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. y 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE of EXISTING SEPTIC TANK. THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF TO BE REMOVED "~- �• o� � HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. PROPOSED SEPTIC TANK ' 01.0 T 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. THERE ARE NO POTABLE WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS BENCHMARK 0,82:,.:: 100.80 1f 1 all. OUTSIDE COR./BOTT. STEP 100.83 >'. 10 ,82.'" AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE EL.=102.44 0 DIRECTED BY THE APPROVING AUTHORITIES. co LOCUS MAP 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY Ic THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING �Op.� + 101.794 �, U1 —100——EXISTING CONTOUR CONSTRUCTION, ?a`:.,' Crr 101.. tJ �� x 100.98 EXISTING SPOT GRADE 11. WHERE REQUIRED, CONTRACTOR SHALL ;REMOVE ALL UNSUITABLE SOILS '`c�',p♦ 7�•' tJ• �/ EXISTING WATER SERVICE IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND TOE O:_: O ul REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). �'� �' �. 6 �� G EXISTING GAS SERVICE 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE O + 101.60 0,84 3 —�H OVERHEAD WIRES INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. Bm EC 102.4 r' .,:� Cn TEST PIT 13. THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING A TRENCH PERMIT ` :..•. FROM THE LOCAL MUNICIPALITY IN WHICH THE WORK IS BEING PERFORMED. „ ,1 `�'� BENCHMARK 100,8 :`:: .. . o� LEGEND100.3 102.16EX/ST/NGx DRIVEWAY'':' �9 HOUSE(1257) x 97.41 8,66 T.O.F.=102�9t 1.,47 < 100,06 96.94 x +�,17 �0 \� 96,62 \ 99.52 x d N' EXISTING LEACH PlT � \ \ 99.11 \ x DECK z, \ \ 40 1 101.44` TO BE REMOVED \\ LQ1,9 VENT SEE NOTE 11 \ 94`31 \��x SHED TP-2 MANIFOLD TWO P��� OF yASs9� \ —54--- — ^ \ 100 37— TP-1 CHAMBERS 2�� yG ,♦ +'92,51 LOT 14\ o PETER T. ��) x 92,91 13,;� S.F.�� --b�oao3_ McENTEE ___ — —1�a clvlL No. 35109 0 — — + .91,35 1�D�• ,�j0 - - - - -�— 1NL +`95,66 �11 �Fo,-� + 3.55 PARCEL ID: 44-97 s -94 PROPOSED SEPTIC SYSTEM UPGRADE PLAN " edge'..•. � S � Fd weet�5 �f �ofe� \77 �� \` 257 MITCHELL'S WAY, HYANNIS, MA \ + go, 2— — OWNER OF RECORD Prepared for: Quinn's Excavation, 39 Bog River Bend, Mashpee, MA 02649 Poy�� US BANK TRUST, NA TR / ' � C/0 CALIBER HOME LOANS INC Engineering by: SCALE DRAWN JOB. N0. 80 13801 WIRELESS WAY 1"=20' P.T.M. 248-20 WATER SURFACE, EL.=87.8t +,\ g,y� OAKLAHOMA CITY, OK 73134 Engineering Works, Inc. CO—OWNER NAME: 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. LSF10 MASTER PARTICIPATION TRUST (508) 477-5313 8/29/20 P.T.M. 1 Of 2 ALL COVERS SET TO GRADE SHALL BE SECURED NOTE: TO PREVENT BREAKOUT, FINAL GRADE SEPTIC TANK TO PREVENT UNUTHORIZED ACCESS. SHALL NOT BE AT, OR BELOW, EL.=99.0 FOR A DISTANCE OF 15' FROM THE EDGE INSTALL RISER & COVER OVER INLET & OF THE PROPOSED S.A.S. SET TO 6" OF FINISH GRADE PROPOSED D-BOX INSTALL H2O RISER, FRAME & COVER OVER INSTALL H2O RISER, FRAME PROPOSED S.A.S. I OUTLET AND SET TO FINISH GRADE & COVER TO FINISH GRADE INSTALL hH2O RISER, FRAME; & COVER OVER ONE CHAMBER) DECK T.O.F=102.9t AND SET TO FINISH GRADE TO SERVE AS INSPECTION PORT. F.G. EL.=107.Ott F.G. EL.=102.2f F.G. EL.=101.5t F.G. EL.=101.0t CHARCOAL VENT EXISTING\ L 2't HOUSE(#257) L 1% L -71 9' T.O.F.=102.9t® S=1% (MIN.) p S=1% (MIN.) pS= (MIN.)4"SCH40 PVC , 4'SCH40 PVC 4"SCH40 PVC „ , 6' - - 2 LAYF�R OF 1/8' LL'io I E3 O E3 TO 1/2 DOUBLE 14- B" I WASHED STONE INV.=99.35 48" LIQUID OR APPROVED FILTER FABRIC) LEVEL ADD - PROPOSED 3.5' 3' 3.5' „ p INV.-98.87 1/2- GAS B,e,F� INV.=98.70 3/4 -1 3S o� D-BOX EFFECTIVE WIDTH = 10' DOUBLE WASHED INV.=99.10 INV.-98.50 3 OUTLETS — STONE dim H-20 USE 5 LC-6 -LEACHING CHAMBERS IN SERIES h PROPOSED SEPTIC TANK WITH 3.5' OF DOUBLE WASHED STONE-ALL AROUND H-20 CONNECT TO EXISTING SEWER 2' OUTSIDE I PROPOSED S.A.S. INLET TO EXISTING TANK, INV.=99.40t H-20 RATED TOP CONC. ELEV.=99.33 —BREAKOUT_ INV. ELEV.=98.50 E3®®O I=, ELEV.=99.00 NOTES: ®®®®®®® I SEPTIC LAYOUT 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BOTTOM ELEV.=97.50 INVERTS, PRIOR TO INSTALLATION. 3.5' 5 x 6' 30' 3.5' 4' OF NATURALLY OCCURRING 2) SEPTIC TANK & D—BOX SHALL BE SET LEVEL AND TRUE PERVIOUS MATERIAL EFFECTIVE LENGTH = 37' TO GRADE ON A MECHANICALLY COMPACTED STABLE BASE 5' (MIN.) ABOVE G.W. 4' KNOCKOUTS} OR SIX INCH AGGREGATE BASE, AS SPECIFIED IN 310 I O 'EST. HIGH G.W. EL.=92.2 r LEACHING SYSTEM SECTION 20•Dw COVER CMR 15.221(2). � I I ' •3) INSTALL INLET & OUTLET TEES AS REQUIRED. I _ 4) A GAS BAFFLE SHALL BE INSTALLED ON OUTLET TEE a" KNOCKOUT 4' KNOCKOUT ' AS MANUFACTURED BY TUF=TITE, ZABEL OR EQUAL. SEPTIC SYSTEM PROFILE I I I - 4'KNOCKOUT----J i ---------- SOIL LOG r 72" DESIGN CRITERIA DATE: AUGUST 27, 2020 (REF#TPT-20-167) PLAN VIEW SOIL EVALUATOR: PETER McENTEE PE(SE#1542) NUMBER OF BEDROOMS: 3 BEDROOMS WITNESS: DON DESMARAIS, R.S. HEALTH AGENT r------- ------ r— —� SOIL TEXTURAL CLASS: CLASS I ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH ® Ea ® 0 ® ® ® 2" ® 0 A 0" A 0" 12" I ® ® ® ® ® ® ® I I DESIGN PERCOLATION RATE: <2 MIN/IN 1 k 102.0 LOAMY SAND 1021 LOAMY SAND INVERT I I I I DAILY FLOW: 330 G.P.D. 10YR 4/2 10YR 4/2 I I l 101.7 B 4" 11 01.8 B 4" r' 72" —I r 36" l DESIGN FLOW: 330 G.P.D. LOAMY SAND LOAMY SAND SIDE VIEW END VIEW GARBAGE GRINDER: NO-not allowed with design 10YR 5/4 # 10YR 5/4 99.5 30" J99.4 32" LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF C C WIGGIN .LC-6, OR EQUAL, H-20 LOADING .74 GPD/SF PERC LEACHING CHAMBER PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY (H-20) 36"/5!4" PROPOSED D-BOX: 1 INLET, 3 OUTLETS, H-20 RATED -C SAND 6/s i M-C SAND USE 5 LC-6 LEACHING CHAMBERS IN SERIES WITH ` 2.5Y 6/6 PROPOSED SEPTIC SYSTEM UPGRADE PLAN 3.5' OF DOUBLE WASHED STONE—ALL AROUND b 257 MITCHELL'S WAY, HYANNIS, MA 92.2 ADJ. G.W. 52 97.2 ADJ. G.W. — SIDEWALL AREA: (10.0' + 37.0') x 2 x 1' = 94.0 SF Prepared for: Quinn's Excavation, 39 Bog River Bend, Mashpee, MA 02649 91.0 132" 91.10 132" BOTTOM AREA: 10.0' x 37.0' = 370.0• SF Engineering by: SCALE DRAWN JOB. NO. NO GROUNDWATER, PE�RC RATE: <2 MIN./IN. TOTAL AREA:........................................................... 464.0 SF FAWCETS POND WATER SURFACE, EL.87.8 Engineering Works, Inc. N.T.S. P.T.M. 248-20 INDEX WELL MIW-29, WATER I LEVEL=9.0, AUGUST 2020 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.74 GPD/SF(464.0 SF) = 343.4 GPD ZONE "C" ADJUSTMENT=4.4' (EST. HIGH GW=92.2) (508) 477-5313 8/29/20 P.T.M. 2 Of 2 I