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Home My WebLink About0409 PITCHER'S WAY - Health 409 r i4c ier' vVay Hyannis A= 269— 163 TOWN OF BARNSTABLE LOCATION 'J D9 P;-Ichcrs wchw, SEWAGE #QQ2 90.5- VILLAGE PWmn n p S . ASSESSOR'S MAP & LOT-P13 - G 3 INSTALLER'S NAME&PHONE NO. i3 s3 £xcAVA-r=or.� y7`7- OG S"3 SEPTIC TANK CAPACITY IDOO�3c%.J - /000 qQ-1 �? /r".P C-Aczm 'Cr- !� LEACHING FACILITY: (type) 54 6nc -�'�clo� (size) JS x 30 x 1 NO.OF BEDROOMS .3 BUILDER OR OWNER Er,n ci /r?e Ur;c1c PERMIT DATE: :7-2 2 - O 9 - COMPLIANCE DATE: R- G -0 9' 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 Al-16 le 3i 2—} AZ: . BZ IS►�Z Reap .�Wc Ilina► A3" ` 3 ► Ay- e� z 1By -.S4 — — — — AS -29': . V No. C7EC Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLt, MASSACHUSETTS Yes ZIPPYicatiou for 3Digpo!6o1 *pgtem Cow6tructiou Permit Application for a Permit to Construct( ) Repair(� Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. H 0 9 17 L (S W C1 \f Owner's Name,Address,and Tel.No. ��a nnls f-e.nq �1L34 ncle_. Sog 95�_zzy 9 - Assessor'sMap/Parcel -Ph r 116-3 ''109 �I I nn(.S Installer's Name,Address,and Tel.No. 509-LA17_Q 65 2) igner's Name,Address and Tel.No. -50 i -3 6 4541 B Ex�QV Gt } [D r cep n``'`1-�9 G ,n-e e r c rL-9 r-t Type of Building: f Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3� gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title 71 1� -6 i+-eC Size of Septic Tank - 1 0OC) ex 16+l R-9- Type of S.A.S. Description of Soil 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 Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si ned Date 7I21 D el Application Approved bysAtt Date 7 )a,/ Application Disapproved by: Date for the following reasons Permit No. pc-y-[ '-9-z� Date Issued a— A, kkv ' d' cam./`'' -I L' Fee No } Entered in computer: ��THE COMMONWEALTH OF MASSACHUZETTTi�S- Yes PUBLIC HEALT,,,HMJVISION { TOWN-OF BARNSTABLE, MASSACHUSETTS 01ppYication for Mi4po5al A&p5tem*Construction Permit Application for a Permit to Construct( ) Repair(� Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Compo It Location Address or Lot No. ')Q j L I ( � \J Owner's Name,Address,and Tel.No. ��.t�c, 1�i��;IcLe..., . 5U� `► 57."'? z �� Assessor's Map/Parcel IS Z 6 t. i b-5 r Installe((r'ss Name,Address,and Tel.No. 5CA. Ll 17 C �5 "7� 'Designer's Name,Address and Tel.No. I \j C r,t ! I r 1, c W _x,L ILV /t,t Type of Building: 1 Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ff�� Design Flow(min.required) V gpd Design flow provided gpd Plan Date 7 1 1 5 10 9 Number of sheets Revision Date Title +IP f 1j1 C.t rL_ Size of Septic Tank i 00 C-X I S l Q ''1 Type of S.A.S. Description of Soil I � „ Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: t 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. ff Si ned U Q Date 712,1 1 6%cl Application Approved by �--`"""""'—'L''"` - Date Application Disapproved by: Date for the following reasons { '} Permit No. Date Issued 2AO -' 0 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 C fI�1_rA 1 6 C) at H(� "1 _ \ !° \1 ('I (`7 has been constructed in accordance / with the provisions of Title 5 and the for DisposalSystem Construction Permit No. datedLP071 Installer 7R(,)k PA , (I a i Designer /I ) A f r, _p v t' r r� #bedrooms Approved desrign-how , gpd The issuance of this 1 permit shall not be construed as a guarantee that the system will functtiio as designed. s Date �{ p�() Inspector -,5 _ 4-__. .tom a- ^1.-.R;a .: .. � --- --. '1{ f / •r • No r."T,',.:J', ""-�-�� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS Th9pogal 6pgtem Construction Permit Permission is hereby granted to Construct ( ) Repair Upgrade ( ) Abandon ( ) System located at PI I/'1 to i 1 I and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditio�. . Provided: Construction in st be c mpleted within three years of the dated this p it. Date Y Z�? " Approved by FROM :down cape engineering inc FAX NO. :15083629880 Aug. 07 2009 08:15AM P1 i Town of Barnstable 'Regulatory Services 1 $ Thomas F. Ceiler,Director MAN. Public Health Division o ` Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & .Designer Certification Form Date: 0 6 Q Sewage Permit#0 d��— a Assessor's Map\Parccl Designer: a0or 2. `�/1Q�r), Installer: _ CG{ ✓GZ. Ow Address: 9�39 .Q,t V Address: oa�� On was issued a permit to install a O (date) (installer) J septic system.at � 1 C�,J W C based.on a design drawn by (address) _.� dated _..._• (designer.) T 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. _ 1 certify that the septic system. referenced above was installed with major changes (i.e. greater than 1.0' 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. OF 'SS9p io DANIE A. s OJAI (installer's Signature (;IVIL 'o No.46502 �. 0)esigner's Signature) (Affix Designer's Stamp Here) PLEASE' WETURN TO FiARNSTABLE PUBLIC HEALTH DIVISION, CEO RTI ICATE OF CONTLIANC'F WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARM RL;CEIVFD BY THE BARNSTABi.,E PUBLIC HEAL 11 DIVISION. THANK YOU. Q,1-Icalth/Scpiic:McMgner Certification Form 3-26-0.doc Town of Barnstable P,1 3 0 Department of Regulatory Services Public Health Division Date �A 1639. `6� 200 Main Street,Hyannis MA 02601 Date Scheduled 0 0 (/ I Time Fee Pd. ��I Soil Suitability !Assessment for Sewage isposal Performed By: Witnessed By: Vt P LOCATION & GENERAL INFORMATION Location Address Owner's Name &-now ALB f)eJ f '4 �1 Imo► 4�ck�e,(S C-l�G►-y n n I S p Address `l a q _P,+Gbm Ways Ny Assessor's Map/Parcel: C 1 I�0 3 Engineer's Name Down to p_t NEW CONSTRUCTION REPAIR �' Telephone# .50$— —45 Land Use .4 444A -� Slopes(90) Q — S A t _---- Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well `—eft Drain Way ""90 / t property Line —� �_ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) m / � Parent material(geologic) �^�l�� ( I(g o rc J g ) lli t� Depth t4 Bedrock ��J i Depth to Groundwater Standing Water in Hole: t Weeping from Pit Face —� Estimated Seasonal High Groundwater DETERNIINA ION FOR SEASONAL HIGH WATER TABLE Method Used: A l#I Depth Observed standing in obs.hole: —in. Depth to soil mottles: in, Depth to weeping from side of obs.hole: In, Groundwater Adjustment ft. Index Well# Reading Date: Index Well]eye[ Adj,factor— Adj.Graundwater Level Observation PERCOLATION TEST bate Time Hole# Tit-no at 9" Depth of Perc 6 Time at 6" Start-Pre-soak Time @ Time(9"-6") — End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed T Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:\S EPTIC�PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil Other Surface(ia.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% ravel O s� `'1 Pam-- 62 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon SoiliTexture Soil Color Soil Other ' Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% ravel V-- lo to 2 2 - - -�- z yC.9 y7 17 r� N Z(-J @ �z - 1)Ct. A DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, 1 Flood Insurance Rate'Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? 1--Q4 If not,what is the depth of naturally occurring pervious material? Certification C, J I certify that on f�/ (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience ascribed in 310 CMR 15.017. Signature Date Q:ISBPTIC�PERCFORKDOC Commonwealth of Massachusetts ®� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments is 409 Pitchers Way Property Address M3 Y Erna McBride, Parma Heights, Ohio Owner Owner's Name information is required for every Hyannis MA 02664 August 8, 2016 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. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not David B. Mason use the return Name of Inspector key. David Mason �y Company Name 4 Glacier Path Company Address East Sandwich MA 02537 Cityrrown State Zip Code 508-367-1617 S1287 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 U&AA �/ August 8, 2016 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 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 �e I d VS l� Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y g page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E!always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system passes on the bases of the observations of the system on August 8, 2016 and does not represent or guarantee the operation of the system from that date into the future. 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 409 Pitchers Way Property Address Erna McBride, Parma Heights Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every Y —� page. City/Town 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 W Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 Au required for every Y gust 8, 2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS Is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine'distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for 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: 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 '/day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y 9 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 II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts N Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �^M 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is required for every Hyannis MA 02664 August 8, 2016 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 back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design):, 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is g required for every Hyannis annis MA 02664 August 8, 2016 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes n No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d Yes 9 ( Y 9 (gp ))� Detail: 2014; 44,000 gallons and 2015;49,000 gallons Sump pump? ❑ Yes ® No Last date of occupancy: current 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 w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y g page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Board of Health Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): Pump chamber 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 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8 2016 required for every y 9 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: installed on August 6, 2009 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line 10+: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2 inches 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 Typical Sludge depth: 8" 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 409 Pitchers Way M Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y g page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 36" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Scour Stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Effluent level with outlet invert. Tank is 2 inches below grade. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 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 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y g page. Cityrrown 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-3/13 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 41M ; 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y —g 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 Level with outlet inverts 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.): There are no flow levelers in dbox, but effluent was at equal levels with the three outlet pipes. No evidence of solids carryover. 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.): Pump chamber appeared to be in working condition. * 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: SAS is a leaching field without an inspection port. Probed the leaching area which indicated dry stone. (Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 i Commonwealth of Massachusetts F Title 5 official Inspection Fora m Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y g page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 1; 15'x30' ❑ 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.): No signs of hydraulic failure by probing and there is no surface break out observed. surrounding soil is dry. No excessive vegetation growth. 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 Commonwealth of Massachusetts F Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y g page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y 9 page. City/Town 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every y g page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 10'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: Groundwater Contour Map ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater Contour Map Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride, Parma Heights, Ohio Owner Owner's Name information is Hyannis MA 02664 August 8, 2016 required for every Y _ g page. Cityfrown 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 G TOWN OF BARNSTABLE LOCATION *9 �iic{,ers t.)r,�� SEWAGE#at79 a�S r VII.LAGE ASSESSOR'S MAP&LOT a6 9=/G 3 INSTALLER'S NAME&PHONE NO. B$9 ExCAt/A-r20n] /77- OG g SEPTIC TANK CAPACITY /_OOD 9o.1 — 1000 can 1 J?Vfn;e �om�rr LEACHING FACILITY:(type)s•lonr- (siu) /S x 30 x i NO.OF BEDROOMS 3 ' BUILDER OR OWNER Er,na_ ?e-ar;dr PERMITDATE: '7-2 2-O 9 COMPLIANCE DATE: S-G-t7 9 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 Wedand and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by A 016 8Z-28 Rcar DWoltinc1 A3' z/ B3-47AL s fr t oscht [i Aq- �1�' Z B http://www.townofbamstable.us/Assessing/14Mdisplay.asp?mappar=269163&seq=2 8/5/2016 � TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date _ ( Time: In Out C �I Owner dam'^"' Tenant Address r0 ' ' Address Complia,pce Remarks or Regulation# Yes VNO Recommendations 2. Kitchen Facilities 3. Bathroom FacilitiesApmvem 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use - 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal -�--� 17. Temporary Housing 18. Driveway Width 5(L— (—�D N f 1,d 70 19. Number of Tenants Observed PART II r If ` 6 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Rio Number of Bedrooms 2-- Number of Vehicles Allowed (max) Number of Persons Allowed (max) r Person(s) Interviewed Inspector i If Public Building such as Store or Hotel/Motel specify here y LOCATION SEWAGE PERMIT NO. ,2 9 �� - �a VILLAGE A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED y r 1 `V Q r k `h zs � a . � $ 15.00 lt?o � ..... Fxs............................_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -•---............. ..ToWn........OF...........-.Barnstabl e .................................................... Appliration for Bhipooal Workii Tontrnrtion ranfit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 409 Pitcher's Wary Hyannis, MA 02601 .... ...._ .......................... ................ .....---••---....--------•-•-•-----••----•-••.._......._.....--•-----••-• Location-Address or t No. Erna McBride 409 Pitcher's Way, yannis, MA 02601 .......... ........-- -... .. •---.....-•----.........._................_......--•---...---.....-- ............ ......... W A & B Cesspool Service 128 Bishops Terrace, yannis, NA 02601 .-....-..---•-•----•-------- ----------------•--- -----------------------------------•..........-----------•---------............... --•-.-- Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.........3................................Expansion lic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ----------------------------•--• W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---_--------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ µ, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •---------------------------•-•----------------••----------•--•.....------------•----.....---•-•••-•......................................................... ODescription of Soil...........Sand................................................................................................................................................... x U ' ------------- -------------------------------------------------- ---- -------�G..C�- U Nature of Repairs or Alterations—Answer when applicable...inst allat i on of a ___ n_I...pze _-atgne..-jAckacl__leach__pit---�overflow�--using..EXTRA STONE, Agreement: The undersigned agrees to install the aforedescribed' Individual Sewage Di posal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersi d fu grees not to pla the system in operation until a Certificate of Compliance is'su by the ealt . ----- ---------------- ------•....................................... 5/11/84 ,... _... ;. t Application Approved B •-- • . ..... ............ ................. 7 /8---•-•. -------•----�......----•------•----------•-------------•--- Date Application Disapproved for e f owing reaso"ns:--------•-----------------------------------------• ............................................................ ---------------------------------------------------------------------------------•-----•---•-------------------•---------------------------------•-------------------------•---••-------------•---.-••-- Date Permit No............A....................................... Issued-........5...11! Date Nod!-........._.....- Fxs......... ._15.00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ----------------- - - Town.........OF.............Ba=.tah`1.e--......------------------------------------------ Appliration for Uiipniial Works Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: .409..Pitcher's tjay.,..-Hya s� Ii Q Era .cBrieLocation-Address Y.eor Lot No __ -------------•--------••••......--------------- .....92601-----•---- Owner Address .. & .. Cess..00l...... ce .......................................... 128 Fish ops Terx 4.....Q2�Q1...:. Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms........3.................................Expansion Attic ( ) Garbage Grinder ( ) Other—T3'P e of Building ------------------ P.......... No. of.persons Cafeteria ..._..._.__Z............. Showers — d a ( ( )Other fixtures ---------------------------- -------------- ------------------------------------------------------}------- - ----------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter.-...-_.___.___- Depth................ x Disposal Trench—No. ................. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ �4 14 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GXI Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •---•--------------------------------------------------------------------------------------------------------•---.........--•-----------• ---- •--------- O Description of Soil..........Sand.................................................................................................................................................. W U --------•-----••-----•----------------•------------------------•-------------------•-----------•-•--------•-----•••-------------•--••-----------•-----•-------------------......---•-------------•--•••- W UNature of Repairs or Alterations—Answer when applicable..insl-allatton"-":C..a._.60LO..ga,llcu,-..pze.-mean .,.. st9w---I.c-ked-.leach-pit--knyerflow-)--usixW,.EXTRA...ST.ONK.---------•---------------------•------------------------------••--•-------- 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 furtfyer grees not to pl e the system in operation until a Certificate of Compliance-, een i si Xdy the Xl fealt , . Sign ------------------- ?l ed .. ................ C � �'�t C- .5/11 .__..... /Date ApplicationApproved By.......................................................................� ......-----..........11/84-------- Date Application Disapproved for the following reasons-------------------------------••----•----------------------------.............................................. ---------•...........................•--••---------------•--•-----------...------......---------...-----------•-•••---------•-••-----•-------------.................................................... Date Permit No.......... `...... Issued. ..................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................TQWn..........OF........13 xi5.tab1e.............................---.................. CIntifiratr of Toutpliancr THIS IS TO CERTIFY, That the Individual Sewage Disposal S-stem constructed ( ) or Repaired ) by A .. .. C.... of Service,__.128.Bishops..Terracet Hyann s� P;A 02C01 I taller a409 Pitcher's Way, Hyannis, M4 02601 . --rna McBride --------•--------•-------------------•--•---•--------------........-----------•--•- has been installed in accordance with the provisions of ' TLB 5 of The State Sanitary Cod�j as described in the application for Disposal Works Construction Permit No .---------------------------------- dated-��(.1�/-��............................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. C�• ) d pp DATE............................................s?.. . ......l.Y---••...... Inspector.............. ........................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable No........................ FJ 15.00 ....................... 'Dispoll t nr� ��an rnr ilan eratti � \ A & B Cess ool Service Permission is hereby granted................ c ................................... to Co struct ( )) or,,Re&Pairy( ) an Individual Sewagge Disposal System at No�2 Pitcher's_way, Hyannis, VIA 02.601 - Erna YC_Bride Street as shown on the application for Disposal Works Construction Permit No.-`"...... ..... Dated51111 ...................... .......... -- .......................................................... ��)n �(� Board of Health DATE.-----•--------------(-t--- --------•----•----........--•-------------._..... FORM 1255 A. M. SULKIN, INC., BOSTON SECTIONSENDER: COMPLETE THIS .MPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. ' natu / item 4 if Restricted Delivery is desired. ��y Agent ■ Print your name and address on the reverse rr Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. (<< � i.(> D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No I IAYA 3. Service Type 2F Certified Mail ❑Express Mail ❑Registered 0 Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number ` 7007 �p71O OOO'S t 5820 17502 `; I (Transfer from service labeo F —' PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540' UNITED STATEg-1 9T-XL J�E12 fti1='' 7 ostae$�Fees P + �`�i�efUt1�4ix XJ 3�t2•;''cyi • Sender: Please print your name, address, and,IZIP+4 Jr his box • I cm„ > z Town of Barnstable cr; e Health Division IV 200 Main Street c—n Hyannis,MA 02601 �m I t-��«} '7FFi°aF)?1.+J1.?.Itsi?fei1 ?le?t +?.fl?iddll?�ji?f?11.?,dtl?i OF SHE Tp� Town of Barnstable Barnstable Regulatory Services Department cac ftv I: fARNWABLE, M^ Public Health Division m i639• �� rfD MAt A' 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO January 2, 2008 Erna McBride 409 Pitcher's Way Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 409 Pitcher's Way Hyannis MA was inspected on July 2, 2007 by David Coughanowr, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system FAILED under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: Any portion of the SAS, cesspool or privy is below high ground water elevation. You are ordered to repair or replace the septic system within One (1) year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PEgQRDE HE B OF HEALTH 7007 0710 0005 5820 7502 omas McKean, R.S., CHO / Agent of the Board of Health 7007 0710 0005 5820 7502 7007 0710 0005 5820 7502 Q:\SEPTIC\Letters Septic Inspection Failures\409 Pitcher's Way.doc rR 8 m� o am CL e y;Om ro on o �m 3n 3� 9 �': m_ m� ---- --_ -- - --r ----- �� ` 1 � G �� t � ��' � �� S \U � _r Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 409 Pitchers Way I L)o Property Address Erna McBride q . l L2-3 Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer, use 1. Inspector: only the tab key to move your David D. Coughanowr cursor-do not Name of Inspector use the return key. Eco-Tech Environmental Company Name Q 43 Triangle Circle Company Address Sandwich MA 02563 City/Town State Zip Code 8 364-0894 Pending td C0 T ephone Number License Number CID B. C;Ottification I certifyahat I,have personally inspected the sewage disposal system at this address and that the - ' informat n reported below is true, accurate and complete as of the time of the inspection. The inspection was polrformed 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 t:h--Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes [Al—Fair ❑ Needs Further Evaluation by the Local Approving Authority L40� L July 2, 2007 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 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. t5-2675.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 i �J Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is required for y H annis MA 02601 July 2 2007 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Inspector's Note==> A septic system is deemed to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed below. The septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. 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. ❑ 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. ND Explain: ❑ 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 t5-2675.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: 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 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. t5-2675.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %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. t5-2675.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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 II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5-2675.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 1 1 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is required for Hyannis MA 02601 July 2, 2007 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 back up? ® ❑ Was the site inspected for signs of break out? SAS also inspected ® ❑ Were all system components, excluding the SAS, located on site? Outlet only ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5-2675.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments „ 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): n1a Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): n/a—no plan Number of current residents: 1 Does residence have a garbage grinder? Removal of grinder is recommended ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 111 gpd 9 ( y 9 (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: currentDate 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: Last date of occupancy/use: Date Other(describe): t5-2675.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is required for Hyannis MA 02601 July 2, 2007 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, d+s#rit-tiers bex, 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): Approximate age of all components, date installed (if known) and source of information: Age: 17+years. Certificate of Compliance for repair issued 5111184 (Board of Health permit#84-406). Were sewage odors detected when arriving at the site? ❑ Yes ® No t5-2675.doc•08106 Title 5 Official Inspeclion Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 2 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.): Sewer appears structurally sound with no evidence of backup or leakage into dwelling 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: n.d. Sludge depth: n.d. Distance from top of sludge to bottom of outlet tee or baffle n.d. Scum thickness n.d. Distance from top of scum to top of outlet tee or baffle n.d. Distance from bottom of scum to bottom of outlet tee or baffle n.d. How were dimensions determined? n.d. t5-2675.doc•18106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 1 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 July 2 2007 required for Y , every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic tank not evaluated. Tank should be pumped dry at time of system repair and examined for structural integrity if it is to be reused. 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.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): j Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): t5-2675.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 t Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No t5-2675.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 t Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �^M 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 ❑ leaching chambers number: ® leaching galleries number: 1 ❑ 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.): Soils above both components appeared unsaturated. No evidence of surface ponding, breakout, lush vegetation, or other evidence of hydraulic failure was observed. Both components were found to intercept the adjusted high groundwater table. See page 15 t5-2675.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Y Hyannis MA 02601 Jul 2 2007 required for Y , every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): 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.): t5-2675.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 I Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection D. m Syste Information ormation (cont.) 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. LOCATIONS LEACH O� PIT A B z� 1 22.5 f't 26.5 f't FLOW 2 26.0 f t 34 f t DIFFUSSER °M SEPTIC o TANK A B EXISTING DWELLING # 4ZJ LEACH PIT FLOW z ADJ DIFFUSSER J EL = 26.91 — GW_V — — — — — — — — — — — — — w OBS EL = 25.41 F- EL = 24.11 g-Glv+ — — — — — — — — — — EL = 24.06 3ILEACHING CATCH BASIN PITCHERS WAY I NOT TO SCALE t5-2675.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 ., .: c\� r' '� �� . _ _ r _`---- 1 1, Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'GSM 409 Pitchers Way Property Address Erna McBride Owner Owner's Name information is Hyannis MA 02601 Jul 2 2007 required for y y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ® Shallow wells Estimated depth to ground water: 8feet 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: A survey instrument was used to determine the elevations of the lip of a nearby leaching catch basin in which groundwater was observed, and the elevations of the ground surface above the leach pit and the flow diffuser. The distance to the bottom of the leach pit was measured and the distance to the top of the flow diffuser was determined by means of a probe, and the depth to the bottom was calculated. Existing groundwater was determined to be at elevation 24.11. Applying a groundwater adjustment of 2.8 feet(Index well M1 W-29 June 2007 reading= 7.4)gives adjusted high groundwater at 26.91. The bottom of the leach pit is at elevetion 24.08 and the bottom of the flow diffusser is at elevation 25.41, both of which are below the adjusted high groundwater level. t5-2675.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 Town of Barnstable o Regulatory Services * w Thomas F. Geiler,Director BARNSfABM 9w �•�A Public Health Division ArFD MA'S Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 REGARDING SEPTIC INSPECTIONS BY PRIVATE CONTRACTORS DISCLAIMER A septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town .of Barnstable Health Division received the original or copy of the report;. this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observations and interpretations contained within this report. In addition, by receiving the report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual.number of bedrooms approved at a particular property would be listed on the Disposal Works Construction Permit. QASEPTIMisclaimer Private Septic Inspections.DOC SYSTEM PROFILE ALL 'SYSTEM COMPONENTS SHALL BE NOTES MARKED - MARKED WITH MAGNETIC TAPE OR �o (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. PROVIDE MIN 20" DIAM. WATERTIGHT 1. DATUM IS APPROX. NGVD (GIS SPOT EL.) ACCESS COVERS TO WITHIN 6" OF FIN. GRADE \ TOP FOUND. EL. 34.3' PROVIDE INSPECTION PORT TO WITHIN 3" OF FINAL GRADE 2. MUNICIPAL WATER IS EXISTING a o � 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. I o MINIMUM J5' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER YSTEM 30.5' I a a . PROP. TEE 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS TO BE AASHO H-M Q Hyo. E PRECAST H-10 O Q RISERS (TYP) O; 4"OSCH40 PVC .5 t �'s 4' CO PIPES LEVEL 1ST 2' 2" PEASTONE OR GEOTEXTILE 5. PIPE JOINTS TO BE MADE WATERTIGHT. Jac ' FILTER FABRIC OVER STONE O Z r " " _ 29.75 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE Mitchells 10 EXISTING 14 (� TEE 1000 GAL H-10 TEE WITH .. 28.1' a ° ° ° ° 6" MIN. SUMP o00000000000000 000000000 000000 310CMR 15.000 (TITLE V.) SEPTIC TANK ° 0000000000000 ° ° ° ° oo ° ° o000000 ** j o°°°o°000°°° 12" MIN. TNT. DIAM. 29.25' o°o°o°o°o°0°0000000° ° °000°0°0°0°0°000000000000000 °0°0°0°0°0°0°0°0 000°0°00000°0° o 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � (RE USE) °°°°°°°°°°°°°°°°°°°° °°°°°°°°°°°°°°°°°°°°°°°O°O °°O°O°000000000° O °° 28.6 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND a ..... , , ° ° o o ° ° ° o o ° o ° ° o 0 0 ° ° ° o ° ° o o ° o ° o ° m ".. - L 29.45 29.28 NOT TO BE USED FOR LOT LINE STAKING OR ANY Main OTHER PURPOSE 4" PVC SET AT 005'/' SLOPE West Main• St. St. ON 6" DOUBLE WASHED 3/4" - 1 1/2" STONE a ` GAS BAFFLE & C 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 1 o� cJ ae TUF-TITE EF-4 ( % SLOPE) o S 30' x 15' x 0.5' DEEP LEACH FIELD Pie• EFFLUENT FILTER 6" CRUSHED STONE OR MECHANICAL ( 1 % SLOPE) 5.0' 9. COMPONENTS NOT TO BE BACKFILLED OR (OR EQUAL) COMPACTION. (15.221 [2]) CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD FOUNDATION EXIST. SEPTIC TANK 17' PUMP LEACHING of HEALTH. 14' D' BOX 5' FACILITY CHAMBER 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL USE ADJ. G-W ELEV. 23.6' CALLING DIGSAFE (1-888-344-7233) AND VV /"� UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT VERIFYING THE LOCATION OF ALL UNDERGROUND & NOT TO SCALE PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE. WORK. 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 269 PARCEL 163 SHALL BE REMOVED 5' BENEATH AND AROUND THE ALARM AND CONTROL PANEL 20" MIN WATERTIGHT ACCESS COVER TO FIN. GRADE PROPOSED LEACHING FACILITY. LOCUS IS WITHIN WP DISTRICT TO BE INSTALLED INSIDE / b SEPTIC UPGRADE ONLY (NO CONSTRUCTION PROP.) BUILDING. ALARM TO BE ON r 12. EXISTING LEACHING FACILITIES SHALL BE SEPARATE CIRCUIT FROM PUMP �� PUMPED AND REMOVED OR PUMPED AND FILLED INV. IN 27.93' \ / \ / I � WITH CLEAN SAND. 1000 GAL H-10 S 2" PRESSURE LINE PROVIDE APPROX. 107' OF 40 MIL LINER AT LIMIT OF VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY BE 500 GAL+ SLOPE TO DRAIN BACK TO PC REMOVAL, SURROUNDING PERIMETER OF SAS. TOP AT EL. IMMEDIATELY GRANTED BY THE BOARD OF HEALTH AGENT OR ALARM ON RESERVE 0.25"'WEEP HOLE 29.75', BOTTOM AT EL. 25.75'. ENGINEER TO CERTIFY BY HEALTH INSPECTOR FLOAT SWITCH INSTALLATION. fig' SETTINGS: PUMP ON CHECK VALVE PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED 4" WORKING RANGE $ "MYERS SRM 4 5' REMOVAL OF UNSUITABLE SOIL REQUIRED 594.35 BY THE BOARD OF HEALTH REVISED DURING A PUBLIC 4" SUBMERSIBLE 4/10 HP PUMP AROUND PERIMETER OF LEACHING FACILITY, 4 HEARING HELD ON MARCH 10, 2009 PUMP OFF 12" SYSTEM (OR EQUAL) DOWN TO SUITABLE SOIL LAYER. REPLACE // I 2) FAILED SYSTEMS ONLY: SEPTIC SYSTEM COMPONENT TO 23.43' ��oo WITH CLEAN MED. SAND, TO MEET o CD �� SPECIFICATIONS OF 310 CMR 15.255(3) FOUNDATION SETBACK, IF AN IMPERVIOUS LINER IS DESIGNED 6" CRUSHED STONE OR MECHANICAL PUMP CHAMBER BENCHMARK: USE / I 4' AND INSTALLED. COMPACTION. (15.221 [21) (NOT TO SCALE) CONC. BOUND AT 15 0 / I VARIANCE REQ. MFC 15.405 1b: REDUCTION IN SETBACK TO FNDN EL. 28.5' x W /\��`' I (20' TO 16') - LINER PROVIDED SYSTEM DESIGN: J x �8 83, �N / .� I m , LEACH FIELD DETAIL 1000 GAL. H-10 ST FLOATS WHEN /' °�'� -_ ..GARBAGE .DISPOSER IS__NOT. ALLOWED G-W IS WITHIN 1' OF INVERT (BUOYANCY OK) 2g �Q I 1" - 20, _ , GROUNDWATER ADJ. DATA: p � / N WELL: MIW 29 1 X 32.45 33.87 I DESIGN FLOW: 3 `BEDROOMS ® 110 GPD = 330 GPD ZONE: BORDER C/D o' S x .06 USE A 330 GPD DESIGN FLOW ADJ: 2.8'/3.5' (AVG. 3.1') - 27 H 16' 03. x 30 W 3 3 �r>-W' �o X 3 SEPTIC TANK: 330 GPD (2) = 660 TEST HOLE LOGS25 gg �' EXIST. DWELL. II **RE-USE EXISTING 1000 GAL. SEPTIC TANK 2 TOP FNDN = I LEGEND ADD 1000 GAL. H-10 PUMP CHAMBER ARNE H. OJALA, PE, SE EL. 34.3' i 32.84 99 _ ENGINEER: EXISTING CONTOUR DAVID W. STANTON, RS CD x 99 1 LEACHING: WITNESS: PROP. VENT WITH CHARCOAL FILTER �-� � EXIST. SPOT ELEV. JULY 13, 2009 AND BUGSCREEN (FINAL PLACEMEN BY \ ��\ DECK C I 99 SIDES: N/A DATE: CONTRACTOR WITH HOMEOWNER � 2 g I �- PROPOSED CONTOUR BOTTOM 30 x 15 (.74) = 333 GPD < 2 MIN/INCH CONSULTATION) 9 �� , X 32.88 I PERC. RATE _ �� X 7 I 3 9 I (� 99 PROPOSED SPOT EL. TOTAL: 450 S.F. 333 GPD x 25. 4 X 28.16 CLASS I SOILS P# 12630 jv ' TH1 USE 30' x 15' x 0.5' DEEP LEACH FIELD WITH (3) 4" C x 26 X 28 37 4 x 32.76 x 13 .08 ,A TEST HOLE PERF. PVC IN DOUBLE WASHED, STONE. SEE DETAIL ELEV. ELEV. 32.4 I 1 2 / 32.3 I x 26.33 27 12 KS , MA p" 30.2' p" 30.4' c, 4 32 27.1 2 v F 53 I APPROVED DATE BOARD OF HEALTH 12" FILL 1 p» FILL OT 79 �' � w 6, I 13, 08f S.F. �� o � o � 31.87 " % sM$ 4.99 X 25.50 �, 27..A C) 7 A ��•1.69 TITLE 5 SITE PLAN G 21�7�1 30.4 31.56 OF 14" 10YR 2/2 12" 10YR 2/1 / p B B X 5 (027. ° �9 0.56 097 ®7 409 PITCHERS WAY _ _� LS LS co X 26.50 2 g Z° HYANNIS 28_2-0 \ - - - " 2.5Y 6/4 „ 2.5Y 6/4 N 36 27.2 36 27.4 �9.39 _ - - PREPARED FOR _x w 15 14.7' B&B/McBRIDE Z A C C D 6.19 AD PERC PERC /36 RRY RO 10 JULY 15, 2009 �C� �� ' Q a ER �,� MCS MS CN yy �j�OFssq �y��oF,y o off 508-362-4541 DANIELA. 'y DANIIEL cyG� 5 fax 508-362-9880 ' OJALA A. -4 downcope.com 116 OBS. G-W 20 5 1 " OBS. G-W 20.5' `' CIVIL ' OJALA down cope eagiaeefill iac. No.46502 No.409110 ° �' .� � '�. 25 50 75 100 2.5Y 7/4 2.5Y 7/4 °� G, T °Ps �O CAPACITY - GPM civil engineers Scale: 1"= 20' rONA6 �� ,� �. PUMP CURVE FOR MYERS SRM4 4/10 HP PUMP land Surveyors 120" 20.2' 120" 20.4' -7- !9- 939 Main Street ( Rte 6A) 09- 153 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOU THPOR T MA 02675 09-153.DWG(SBO)