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Home My WebLink About0022 WASHINGTON AVE EXT. - Health 22 WASHINGTON AVE. EXT., HYANNIS A= j TOWN OF BARNSTABLE LOCATION a oL W AS tf!VC-600 AVC EYT SEWAGE#_ ;L6157 " (309 CZVILLAGE HYAUVIS ASSESSOR'S MAP&PARCEL: a.? ®3` INSTALLER'S NAME&PHONE NO.CA PEtvi AE Con'-Pa1.45cS .S02-07-A77 SEPTIC TANK CAPACITY (Goo Gh",oti S. LEACHING FACILITY.(type)p) Stay 4AL Cho"(size) I?,f')La5l NO.OF BEDROOMS 3 OWNER RAQ F, RosajA 110 w4z- PERMIT DATE: ` '' 't COMPLIANCE DATE: 3_ I(a- 1 5 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 1�O�, 05_1,8V00 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) NIA Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) A Feet FURNISHED BY CA PF 11b 9 �U 17R I��S L�•�'. � 4 , A_i A•2 "34-V 6-1 - 21 , A-3 ;42 A' k4 d39e1` Q-4 =3( .2` A-5 =41.1` la-S 00 c� i = i q D� No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppliLation for Disposal 6pstpm Construction Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. 9a MJAS(l&X--7W Auk AE)Cr Owner's Name,Address,and Tel.No. H j WA Q NAwAx s 17o umA tVf OA L Assessor'sMap/Parcel 3a- /3-1 as WA6.4(0L AU'E 49 YA0PI Installer's Name,Address,and Tel.No. ,�l -�7I- $'77 Designer's Name,Address,and Tel.No.561j�-a73 -03-7-7 C,4PE�c2�� Pier (,(L ;Tc zSJc 1S3 GU +�2�i C. ST C_7 4e.+4�04 Type of Building: # Dwelling No.of Bedrooms 3 Lot Size ice(: Z sq.ft. Garbage Grinder( ) Other Type of Building jaF=-SL b&-j ( L, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) JCS gpd Design flow provided �� . gpd Plan ._-Date I 'S A01 15 Number of sheets ' Revision Date Title ;ja w,4,;AAiA9�TD&) Avg &K-Z Size of Septic Tank 1,5 m p 6d44-c,®f j Type of S.A.S(X) [p G41 L6XJ Description of Soil 6d,4z5R a /-5ee Nature of Repairs or Alterations(Answer when applicable) 1U51E;7 6-')C.(grLL)6�7- 1 SOD7 LPA) $StglV. -K JLL 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. I , t Signed Date ( '' `�- and S Application Approved by Yk f- Date Application Disapproved by Date for the following reasons Permit No. �6 -OMI Date Issued +- No. — ` ` Fee 00 THE COMMONWEAN OF MASSACHUSETTS Entered in computer: Y es PUBLIC HEALTH DIVISION - TOWN-OF BARNSTABLE, MASSACHUSETTS Application for ;Disposal 146pstem ConstCuctiori jermit Application for a Permit to Construct( ) Repair(X Upgrade( j Abandon( ) DqComplete System ❑Individual Components Location Address or Lot No. as PJA5t4ls_Q- J r UE: iiyc7- Owner's Name,Address,and Tel.No. H- NA Q NA wAx t?cmmA NA WA z Assessor's Map/Parcel 7jo1 as WM u ; Y,40)J1 Installer's Name,Address,and Tel.No. 5_09477_8 9?-1 Designer's Name,Address,and Tel.No..5,)!; 73.03.7-7 d,4PEwcb-4_::- t�'*l7 acP4t�5�S c.c c. -7L zvc J53 57` MASNP%GG- E. 4 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building R t.C(L�' (d-(_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 C7 gpd Design flow provided , c� gpd Plan Date 15 Number of sheets ( Revision Date Title ;x uj A sA wG_a ),u AUK_ 4sxT N o c 2. Size of Septic Tank l(So D 64L4otj Type of S.A.S(.1.) 5frE3 4 j 42X j !�1144"QeC Description of Soil 0 7A ss '5 4d cgs kQ I(S kir ?4A&j Nature of Repairs or Alterations(Answer when applicable) I S aD [ 4 l �D e D- Rg �� SC?o C �..l l fL(�2C6 t L—I ` a v 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 pr"ovisions 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. ,t Signed y � �t Date "f Application Approved by Lth-44Date j q _( Cj Application Disapproved by Date for the following reasons Permit No. ^/ Date Issued . --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certifirate of Compliance THIS IS TO�C-EtRTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(x) Upgraded Abandoned( )by ( �l✓l>Jl� �11J7`GI�Q( �,�.� at a 0'1. W A1;JA 1 NlGMpj,) , Lk= �YT UYA 00l S has been constructed in accordance With the provisions of Title,5 and the for Disposal System Construction Permit No. � / ated - Installer (3 ,c)l Dr— �Q ZE09 4er Designer_uc Ex mic #bedrooms Approved design flow in / gpd i The issuance of this permit shall not be construed as a guarantee that the system w'I.1`function as designed. Date � X Inspector ;f!' ,�� \\ ---------------------------------------.-------------------------------------------------------------------- No. Cho( Fee _4 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposat *pStem Construction Permit Permission is hereby granted to Construct( ) Repair(A) Upgrade(. ) Abandon( ) System located at A 02 WA5'14a)& A U e GeT t4Y1 lAl/C 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:Constructioon'must be completed within three years of the date of this permit. I,, C Date I-� �y Approved by i i3(bu r. Vu I/vv 1 �03/17/2015 20:02 5082730367 Town of Barnstable Regulatory Services Thomas F.Geiler,Director BAVRWN VILC� • Public Health 'Division P Thomas McKean,Director Deb„jai 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790.6304 Date: 3"i 8 Sewage Permit# ad15'609 Assessor's Map/Parcel 32 7 /33 Installer &Designer Certification Form Designer: S(- ��1ai,t�eexi��• TAG Installer: Ca(��w;d� �nterPciszS� �t-G Address: Address: l 53 C-Om "e,cccul 54fee:+ East WOce.hQm HR c253$ NaatnQee., On Cge_Wide.- Er►te'rpases was issued a permit to install a (date) (installer) septic system at 22 W05hi61.5�d,n A-lie" EX4 , based on a design drawn by (address) _5C Coe.�;n eeti!1 I T+nc,, dated (designer) V 1 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. Stripout (if required.) was inspected and the soils were found satisfactory. 1 certify that the septic.system referenced above was installed with major changes (i.e. greater than I W 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. Stripout(if req ' nspected and the soils were found satisfactory. OF "�1p CMUNCI(ILL s , JR. CRIL (installer's Sig e) No 41307 esigner s Signatur (Afti)oWesig e s 2Kmp Here) PLEASE REJUJOO BA STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BF ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. I'ulli..ihnnsldcn�ncrccnilkuiiun fionwdoc �Vif Tovvli>ta of Barnstable >P# Department of Regulatory Services ./. HA VISTA IA r Public Health Division Date MAB3. �p 1639., 200 Main Street,Hyannis MA 02601 Date Scheduled— ...� Time Fee Pd. rSa ' uitabilit_y AssesSmentfor Ste .DI p l Performed By: d(C 6APA f qri echl i r k I t G S L Witnessed By: LOCATION& GE,NERAL INFORMATION Location Address Owner's Name t"£RC)IbI04 NA W-tz a �Ja�S�ra �l AEUE 6 M 14YAPPIS Address .Z']-&JAS't4eAJC-,.-MW AVE G Assessor's Map/Parcel: ' �'' /o3 Engineer's Name peep t..—C— ,t NEW CONSTRUCTION REPAIR Telephone# 0�5-47� �--r. �G Et►5firleetilt� Land Use SineT e--- — � ;U8-273-0-W7Slo Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line 7 1 O ft Other _ ft SIMETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands(n proximity to holes) See- n k a&flQcl P1�r► Parent material(geologic) QUkW `` Depth to Sedroc.k Depth to Groundwater. Standing Water in Hole: Weeping 15•oln Pit Face t t Estimated Seasonal High Groundwater 7 13 2 b js DETERMINATION FOR SEASt`3.NAL HIGH WATER TABLE Method Used: Diferk &selUn Ftorl Depth Observed standing in obs.hole: 71 3.2 In. Depth to soil mottles: in. Depth to weeping from side of obs.hole: ``_____ in, Groundwater Adjuxtment f[. Index Welt# — Reading Date: Index Well levol Adf,f±ctbr- ;r q�,dlnutldwater level PERCOLATION T.E+ST Date L s-1 s Uwe I I AM Observation �.__. Hole# Tinto at 4" 4 U Depth of Perc 41- - (oc) Time at 6" Start Pre-soak Time @ '6 2 an- Time(9"-6") _ End Pre-soak i'_13 ww Rate Min./Inch {2 Site Suitability Assessment: Site Passed _ 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:1S EPTIC\PERCFO RM.DOC . i i DLLP-OBSERVATION MOLL LOG Dole# 2. Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones',Boulders. X .s onsistency.%Gravel) 30- LS j0ir 5/s ~. 2 C. G 5 2,.51 "/16 % staYz� DEEP OBSERVATION]BOLE LOG Dole# Dept from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsisten %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,%O e DEEP OBSERVATION DOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other . Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, I+lood 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? '(ES If not,what is the depth of naturally occurring pervious material? Celctiffcation I certify that on ��'27"?`? (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 ex p fence described in 10 CMR 15.017. Signat ure Date Q:4S HPTIC\PERCPORM.DOC COMMONWEALTH OF MASSACHUSETTS EXECUTIVE-OFFICE OF ENVIRONMENTAL AFFAIRS r DEPARTMENT OF ENVIRONMENTAL PROTECTION y V 4 TITLE 5 OFFICIAL INSPECTION FORM-NOT`FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:. a o a , Owner's Name: L1�� Owner's Address• RECE'VED Date of Inspection: Za l APR 2 4 2001 Name of Inspector: (please print)Qn J�/,)AD)0�1 T�wNOFBAR Company Name: Pam% H�ALTl t Dsp-r Mailing Address:, ,0 . �F o�Xye . Telephone Number: — 3 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.onmy training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to ection 15.340 of Title 5(310 CMR 15.00.0). The system: Passes Conditionally Passes . sTurther Evaluation by the Local Approving Authority.2/ . F ils Inspector's Signature Dater 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 10,00.0. 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 ****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. Title 5 Inspection Form 6/15/2000 page I Page 2`of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address; C Owner: Date of Inspection: [tiL -01 Inspection Summary: Check A;B,C,D or E I ALWAYS complete all cif Section D. Thave em Passes: not found anyinformatio;,which indicates that any of the failure criteria.described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments- B. ,t 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•ezfiltration 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 bo' System will pass:inspection if(with approval,of Board of He alth): ealth): broken pipe(s)are.replaced obstruction is removed 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: 2 Page 3 of 1'l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART.'A CERTIFICATION(continued). Property Address: 02 I Owner: Date of Inspection.: 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 31.0 CMR 15.303(l)(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. 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 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: 3 Page 4 of 11 OFFICIAL.INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM' PART A CERTIFICATION(continued) Property Address: JQ _awl Owners Date of Inspection: y/ice/pJ A System Failure Criteria applicable to all systems: You.:must indicate"yes"or"no"to each of the-following for all inspections: Yes N 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 '/z 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 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 160: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.] I "v '(Yes/No)The system fails. I have determined that one or Imore 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 1000: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 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 it 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 3.10 CMR 15.304..The system owner should contact the appropriate regional office of the Department. 4 { Page 5 of 1 I r OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION'FORM PART B CHECKLIST Property Address: Owner: , ILE: Date of Inspection: !V./s-f p J 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 ; L_'W ere any of the system components pumped out in the previous two weeks? . normal flows in the previous two week period? I/_ Has the system receivedp _ 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: Yes no f_ 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(3)(b)] 5 Page 6 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY-ASSESSMENTS - SUBSURFACE SEWAGE;DISPOSAL SYSTEM INSPECTION FORM PART C ` SYSTEM INFORMATION Property Address: ,4 Owner: Date of Inspection:. FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):- Number of bedrooms(actual):.3 DESIGN'flow based on 310 CMR 15.203(for example: 11.0 gpd x#of bedrooms):3 Number of current residents:. 02 Does residence have a garbage grinder(yes-or no) ZO Is laundry on a separate sewage system(yes or no [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no):� . . Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no): z1— Last date of occupancyl "".V COMMERCIAL/INDUSTRIAV/II Type of establishment:. Design flow(based on 310 CMR 15.203): gpd Basis of design.flow(seats/persons/sgft,etc,): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pimping Records Source of information: Was:system.pumped as Part of the inspecti n(yes e no If yes,volume pumped: gallons--How Was quasi !ty pumped determined? Reason'for pumping: - TYPE F SYSTEM eptic 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 DEP approval _.Other(describe):' Anproximate age of all components,date installed(if known)and source of information: Were_sewage odors detected when arriving at the site(yes or no): (?'! 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued). Property Address: A Owner: (' C J,i, 42C Date of Inspection:_ BUILDING SEWER(locate on site plan)_/k_?� Depth below grade: Materials of construction: cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: r/(locate on site plan) Depth below grade:1� Material of construction: oncrete_metal_fiberglass polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a.copy of certificate) i Dimensions: /(� `X t!o' ?C Sludge depth:l� Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: if Distance from top of scum to top of outlet tee or baffle: Distance from bottpm of scum to bottom of outlet tee or baffle: How were dimensions determined: Comments(on pumping recommen ationsf inlet and outlet tee or baffle condition,structural integrity,liquid levels s related to outlet invert,evidence of leakage,etc.): 14 /5`00 �i C� c i, t�, Gar-ae�E' GREASE TRAP• locate on.site plan). Depth below grade:_ 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY,ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM JNSPECTION FORM :.PART C SYSTEM INFORMATION(continued) Property Address: X l Owner. f� Date of Inspection: 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/day Alarm present(yes or no): .Alarm level: . Alarm in..working order(yes or no): Date of last pumping: Comments(condition of alarm and:float_switches,etc.): DISTRIBUTION BOX: L1 (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: / 16A 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.): t PUMP CHAMB_(locate on site plan) Pumps.in.workin�order.(yes or no): Alarms in working order(yes or no) t Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM'INFORMATION(continued) Property Address: 41 Owner: Date of Inspection: �c4/, /g/ SOIL ABSORPTION SYSTEM (SAS):.�_4ocate on site plan,excavation not required) If SAS not located explain why: Type leaching.pits,number: eaching chambers,number: ►/ leaching galleries,number: leaching trenches,number, length: leaching fields,number, dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil;condition of vegetation, etc): 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 solidsaayer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or 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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: p�o� ,•, T C� . Owner: 61 Date of Inspection: y —llol ` 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. nj • ` i t.�P t 10 II Page I I of I I OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C . SYSTEM INFORMATION(continued) Property Address: ° A Owner: ? Date of Inspection: c�Z-z2w SITE EXAM. Slope . Surface water Check cellar. Shallow wells Estimated depth to ground water feet Please indicate(check).all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: 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: rl; / 11 TO OF BARNSTABLE LOCATION �. S ex SEWAGE # ('6 VILLAGE /e ASSESSOR'S MAP & LOTZE Z"6 5 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /S' LEACHING FACILITY: (type) A. 7'-� (size), NO.OF BEDROOMS J� BUELDER OR OWNER Y4;1 PERMIT DATE:'/d 3"'9 1 COMPLIANCE DATE: ;/ -'7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching cility Feet Private Water Supply Well and Leaching Facility (If any we ' exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands xist , within 300 feet of leaching facility) Feet Furnished by f � ('� ♦ . �� . �� `l\l 1 �� it i` �'�, .a w � � lM t I. /� -� i� 2i No. �" Fee $50 . 00 THE COMMONWEALTH OF MASSACHUSETT Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIPPlication for Zigpool 6pmem Cow6truction Permit Application for a Permit to Construct( )Repair(x)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2 2 Washington S t EX t Owner's Name,Address and Tel.No. 171 —81 3 orman erritt Assessor's Map/Parcel Hyannis, MA PO Box 55 87 Garden Ln >0 Hyannis Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6 Designer's Name,Address and Tel.No. Wm E Robinson Sr Septic Service PO Box 1089, Centerville, MA 02632 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(nc) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) Title 5 Septic System consisting of 1500g tank, D—Box, and three stonepacked infiltrators Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued.by this BDard prHealth. Signed ga Date Application Approved by 9 / Date fa'^' Application Disapproved for the following reasons Permit No. '® Date Issued A No. Fee 5O THE COMMONWEALTH OF MASSACHUSETT Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 01ppiication for Migaal *rgtem (Construction Vermit Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) O Complete System El Individual Components Location Address;;o`r Lot No. Owner's Name,Address and Tel.No. 22 Washington St Ext ial-m lti3Aerritt Assessor's Map/Parcel Hyannis,-'AMA PO Box 55 87 Garden Ln 227 o Hyannis, MA 02601 Installer's Name,Address,and Tel.No. 7 7 5-8 7 7 6 Designer's Name,Address and Tel.No. Wm E Robinson Sr Septic Service PO Box 1089, Centerville, MA 02632 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(nc) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures #i Design Flow gallons per day. Calculated dail '' 0- gallons. Plan Date Number of sheets Revision Date Title I Size of Septic Tank Type of S.A.S. Description of Soil sand ltr Nature of Repairs or Alterations(Answer when applicable) Title 5 Septic System consisting of 1500g tank, D-Box, and three stonepacked infiltrators Date last inspected: , Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system i in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued y this °ard ealth. Signed b r-lY ` Date AU`�` ��.. Application Approved by # Date Application Disapproved for the following reasons. Permit No. iv, ,00 Date Issued � --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS Merritt BARNSTABLE, MASSACHUSETTS (tertificate of QCompliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System,Constructed( )Repaired(XX)Upgraded( ) Abandonned( )by Wm E Robinson Sr Sept Sry r.� 2 at Washing on St Ext, hyannis has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. , dated1/� d�� Installer Wm E Robinson Sr Sept Sry Designer The issuance of this permit shall t be construed as a guarantee that the s e 1 function as d n . ' Date Inspect _ ___ __ _____ THE COMMONWEALTH OF MASSACHUSETTS Merritt PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 'Wi.5pogal *pMem Construction Vermit Permission is hereby granted to Construct( )Repair(X:K)Upgrade( )Abandon( ) ~ System located at 22 Washington St Ext Hyannis, MA- a Installer: Wm E Robinson Sr Sept Sry and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this it. Date: /��'''� ^� � Approved by NOTICE: This form is to be used for the repair of failed septic systems only CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS). I,William E. Robinson, Sr.,hereby certify that the application for disposal works construction permit signed by me dated &-j 9 `� , concerning the property located at 22 Washington St Ext, Hva�, MA meets all of the following criteria: * There are no wetlands within 300 feet of the proposed septic system. * There are no private wells within 150 feet of the proposed septic system. * The obseved groundwater table is 14 feet or greater below the bottom of the leaching facility. * There is no increase in flow and/or change in use proposed. * There are no variances requested or needed. SIGNED: 1 C0 l DATE LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 60 (Attach a sketch plan of the proposed system. Also if the licensed installer proposes a certification plot plan,this plan should be submitted). I I 1 �J I� c .� r - � � , � ✓ � � �� € � 0 ?" �� 7�-�, L � � 1 t P �..v �� 1 1 i AS COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617-292-5°5'00 y r V T 2 4 1997 TRU Y COXE W1L1:lAM F.WELD � Governor 1'AINOFBARhISTABLE r Secretary , ARGEO PAUL CELLUCCI HEALTH DEFT. DAVPID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION F RM8 Commissioner PART A L 9 CERTIFICATION Norman & Lorraine Merritt Property Address: 22 ''Washington Ave Ext, HyanniAjdress of Owner: No Box 55, Hyannis,MMA erritt Date of Inspection: //0°"C '-97 (If different) 02601 Name of Inspector: Wm E Robinson Sr 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Wm E Robinson Septic Service �- Mailing Address: PO Box 1 089 Centtzryi 1 1 ,- , MA 02632 Telephone Numbers 5 0 8 , 7 7 5_R 7 7 6 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: !J Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: ) a t Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 Department of Environmental Protection. -The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: A I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] YSTEM 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. Indi to yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. _ The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:/hvww.magnet.state.ma.us/dep f'J Printed on Recyded Paper r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 221 Washington Ave Ext, Hyannis Owner: Merritt Date of Inspection: A:: y B) SYSTEM CONDITIONALLY PASSE$ (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 C) FU HER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) STEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT T E SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE E VIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/25/97) Page 2 of 10 ti SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 22' Washington Ave Ext, Hyannis Owner: Merritt Date of Inspection: -7 D] SYSTEM FAILS: You. ust indicate ei;,.er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct he failure. Yes o Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or p'onding 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 1/2 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 Soil Absorption System, cesspool or privy is below the high groundwater, elevation. Any portion of a 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 I of a public well. _ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia rnitrogen and nitrate nitrogen. E] LA E SYSTEM FAILS: You ust indicate either "Yes" or "No" as to each of the following: The-following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area- IWPA) or a mapped Zone 11 of a public water supply well) The o ner.or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requir ments of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST i Property Address: 22' Was,hingtOnAve Ext, Hyannis Owner: Merritt Date of Inspection: I G Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes / No Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or / as part of this inspection. f/ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. 4 _ The site was inspected for signs of breakout. All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. _ Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)] (revised 04/15/97) Page 4 of 10 i� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 22 ) Washington Ave Ext, Hyannis f Owner: Merritt Date of Inspection: /d FLOW CONDITIONS RESIDENTIAL: Design flow: 6 t5 p.d./bedroom for S.A.S. Number of bedrooms:,/ Number of current residents: �L, Garbage grinder (yes or no):ZD Laundry connected to system (yes or no)�j Seasonal use (yes or no):/I.,-01 1 /9 5 — 1 1 /9 6 — 8, 600 cu f t Water meter readings, if available (last two (2)year usage (gpd): Sump Pump (yes or no):A---0 ( 6 4, 5 0 0 g a l s) 11 /96 — 9/97 — 6 , 800 cu ft Last date of occupancy:6-0-G,o 'f ( 51 , 0 0 0 ga l s ) C O MERCIALJINDUSTRIAL: Type establishment: Design ow:_gallons/day Grease t p present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanit waste discharged to the Title 5 system: (yes or no)_ Water met r readings, if available: Last date f occupancy: OTHER: escribe) Last date upancy: GENERAL INFORMATION PUMPING RECORDS and source urce of information: t System pumped as part of inspection: (yes or no)�/�-,s If yes, volume pumped: Qallons Reason for pumping: &;'64j a TYPE OF STEM 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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no)/d (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 22 . Washington Ave Ext, Hyannis ' t Owner: Merritt Date of Inspection: da •-�— BUILDING SEWER: (Locate on site plan) Depth low grade: Material of construction: _cast iron _40 PVC_other (explain) Distan from private water supply well or suction line Diam er Comm ts: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:"L" (locate on site plan) Depth below grader Material of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: 1 Sludge depth:_ ' Distance from top of sludge to bottom of outlet tee or baffler_ Scum thickness: 0 r ' Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: / J- • How dimensions were determined: ,1&6 CA/ Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of I uidd lev I in relation to outlet invert, structural integrity, evidence of leakage, etc.) //Z�Lc/ rr '�" GREAS TRAP: (locate o site plan) Depth belo grade: Material of onstruction: _concrete _metal _Fiberglass _Polyethylene other(explain) Dimension Scum this ess: Distance om top of scum to top of outlet tee or baffle: Distance rom bottom of scum to bottom of outlet tee or baffle: Date of st pumping: Comments: (recommen ation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, a Bence of leakage, etc.) (revised 04/25/97) Page 6 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 22'i`Washington Ave Ext, Hyannis Owner: Merritt Date of Inspection: /,0A-4-q 17 TI T OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (locate n site plan) Depth low grade: Material f construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimen 'ons: Capaci gallons Design f1 w: gallons/day Alarm lev I: Alarm in working order _Yes; _ No Date of p vious pumping: Comment (conditio of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_✓ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if I el a d distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) �✓�t'"C/ o 10 PUMP AMBER: (locate on site plan) Pumps in orking order: (Yes or No) Alarms i working order (Yes or No) Comme s: (note c ition of pump chamber, condition of pumps and appurtenances, etc.) 16 (revised 04/25/97) Page 7 of 10 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 22 , Washington Ave Ext, Hyannis Owner: Merritt Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:_ leaching chambers, number:J leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ondin condition of ve tation, etc.) �!G/�a�� 1+��f CESSPOOLS: _ (locate on site plan) ' Number and configuration: �Y Depth-top of liquid to inlet invert'• P P q Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Comme ts: (note co ition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate site plan) Materials of onstruction: Dimensions: Depth of sol ds: Comments: (note condit' n of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Fags 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 22;�i Washington Ave Ext, Hyannis Owner: Merritt Date of Inspection: /p�� q 7 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (locate where public water supply comes into house) vL;, v°f %6a-t, i A tL 4 -X j j �0 �. ) W I 1 (revised 04/25/97) Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 22> Washington Ave Ext, Hyannis Owner: Merritt Date of Inspection: /Q !, —aj h' Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) (revised 04/25/97) Pago 10 of 10 1. LOiCAT ION �G ® � E AG E PERMIT NO.. VILLAGE INS Dih LL,ER' A & ADDR SS Le B UI'LDE R OR OWNER p ? Uzym an, � - DATE P ERM.IT ISSUED � f 6 ..,", (n t / DATE COMPLIANCE ISSUED -- `' .. ,, - J e � � � \� d �� _ - y a THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............OF..... ..�✓t 19' Appliratinn -for UiBpuiittl Works Cnnnitxnrtinn Vrruiit Application is hereby'made for a Permit to Construct ( ) or Repair (4_Xa dividual Sewage Disposal System t: 1 -- -- ----- --------------------------------- o on-Address or Lot No. l wne ......Address... - ler4 Address UType of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 1-1 A4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P4Other fixtures ----------------------------------------------------------------------------------------- --------------------------------------------------------- d W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------ ..gallons Length................ Width ..........._.. Diameter---------------- Depth.--------------- xDisposal 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water...----._--_-.-._-.----- �14 Test Pit No. 2________________minutes per inch Depth of Test Pit----------_--------- Depth to ground water------------------------ ------------------------................................................................................................................................. ODescription of Soil------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------- x x ---------------------------------------------------------------------=-----------------.................... - - ----- -- ------ = U Nat re of Repairs or Alt atdon Answer when ap i ble._ . _ �...._____________________ _ ..: �a�� rea.t�--------------------------_--.. ----------�/. -------------------------- reemertt: �� The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has issued y the boars oWet j Date Application Approved BY 6 ,. d�------------ ....... ------- -------------- � ' Daet Application Disapproved for the following reasons------------------------••--•----• --------------------------------------------- -----•---•--------------- ----••---•..............•---....-•--•--•--••-•--•-------------.•-----....--•••--•-••----••......•---•---•-----------........--_.._..------------•----.----•---•---------------------------------------- Date Permit-No.......................................................... Issued........................................................ Date is , No..--- �•--.. Ftnic.....S7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............OF.... . ............................ Ap,p gyration -fur Diiqvviial lVarkii Towstrurtion Prruid Application is hereby'made for a Permit to Construct ( ) or Repair (4-�ndividual Sewage Disposal System t: if .._. - ��JLocation-Address or Lot No. �s- ) l ---------•-----------•------------•----•-•-•---------------------•---------••......-•-----•-•---- � Owne Address I Iler Address d Type of Building Size Lot............................Sq. feet U H Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )p, Other—Type of Building ._......................... No. of persons.........------------------- Showers ( ) — Cafeteria ( ) dOther 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 ( ) aPercolation Test Results Performed by.......................................................................... Date-----:........-------------------------- Test Pit No. 1--------------__minutes per inch Depth of "rest Pit-_---.-----_-._.__.. Depth to ground water....--.._..---..-_.____. t14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-..-.---__-._------- P4 ----------------------_-- --------------------•-- •------------.......................................................................................... 0 Description of Soil----------------------------------------------------------------------------------------------------------------------------------------------------------------------- x r , U I ;ire of Repairs or Alt anon —Answer when ap i ble.. _-aJ _ _____ /Q./J __ fVk__.._.....__-..--.--_._... Ge.- �r.`._. -----------------------------------------v------------------------------------ reement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has J)eft issued by the boar of ee . Signe �• ..•...... :- E!`1�`� -. ---------------------- Date Application Approved By---- Date Application Disapproved for the following reasons:------------------•--------------------•---------------------•----------------..---------------------------•--•- -•----•..-•----------------•---•----.-•----.------------------------•...---------------.-••-•-----•--.••... Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD ZO ,—H-EAILTH .. Vdlrl 1...............OF........ ........................................... �rrttftratr /f f��mpliaurr THIS'- T C VFY,,TI the n idual wage Disposal System constructed ( ) or Repaired stal I ---- ...... -- '--=1 �a � •-^ ��•F .....------------------- a been installed in accordance with the provisions of : _ 1 XIZoTl�eSa�fe Sanitary �jode as descr' in the application for Disposal Works Construction Permit N ..._.._ - .._. dated_.. ............................ ............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ -•--- ------- ...... Inspector------ ----- x-�--=- ----------------------•----- THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALT `� .......'OF... . . �... � . ....6.4 No......t ................ FEE..- --••.............. Permission is her grant __ ______ __ _�f/r'�- !_.._.1; _� Ft, .. . .. to Construct a )�rRepair ( n In ivi al S _ age.L2js osal ys m � Street as shown on the application for Disposal Works Construction Permit No..._ _':'�� ed___ _��.'__lf1'_7_C,...... v .. DATE. _ ................................. Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS FINISH GRADE OVER D-BOX= 39.2'+ T.O.F. EL.= 39.8�± FINISH GRADE OVER CHAMBERS= 39.0' - 39.2 GENERAL NOTES 3/4"TO 1-1/2"DOUBLE WASHED f PROVIDE EXTENSION RISER REMOVABLE WATER-TIGHT COVER OVER SLOPE @ 2/° MIN. OVER SYSTEM STONE TO CROWN OF PIPE WITH COVER OVER INLET& RISER TO WITHIN 6"OF FINISHED GRADE 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS OUTLET TO WITHIN 6"OF F.G. METF,�ODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE , F.G. OVER TANK EL. = 39.3�± 5" DIA. OUTLET(S) MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2"OF 1/8"TO 1/2"DOUBLE WASHED CODE AND ANY APPLICA� LOCAL RULES. @ FND. EL.= 39.5 STONE OR GEOTEXTILE FILTER FABRIC --! -"" - - -- --------- ---- ---- --- - - 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE TOP OF SAS= 3f5.33� PLACE RISERS ON ALL DESIGN ENGINEER. PROPOSED 4" 6"MIN. 9„MIN CHAMBERS WITH 3. 4"SCHEDUL�40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL EXiS i dNG 4" SCH.40 PVC 36 MAX. 35.50' 36"MAX. � INLET PIPES TO 6"OF SEWER PIPE SEWER PIPE BREAKOUT EL= 36.00 FINISHED GRADE SYSTEI UNLESS OTHERWISE NOTED. " " 3" DROP MAX - ' 4. TO PREVENT B&KOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 6 3 2" DROP MIN 3" 9 MIN.SLOPE 01% L 19 ± PROVIDE WATERTIGHT ELEVATICI�= 36.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 10" 4" PVC IN FROM JOINTS(TYP.) o �cb- ► 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 14" *36,7'-#- SEPTIC TANK 4"PVC OUT TO 0 O 0 0 0 0 0 � � O 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 0o p CONTRACTOR TO PROVIDE O LEACHING FACILITY o0 0 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. SPECIFIED DROP BETWEEN ' " " po INLET AND OUTLET CONTRACTOR .. CONTRACTOR SHALL ' I 6 ' 2, po °0°0 op ppo 6: THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48 VERIFY CONDITION OF OUTLET TEE 35.90 MIN. 35.73 00 0 o LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE o 0 o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS tw OVER MECHANICALLY oo °° _ p o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE I AND DESIGN ENGINEER. 5 4.0' 8.5' (TYP) 4.0 4.0' 4.0' OUTLET DISTRIBUTION BOXZ NP) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 40.00' TO BE INSTALLED ON A LEVEL STABLE 25.0' ( ESTABLISHED ON TOP OF STOOP CORNER AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 28.1 O� PIPES TO BE LAID LEVEL. 33.50 12.83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1 ,500 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON CHAMBERS 5'MIN. CHAMBER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES SEPTIC TANK PROFILE DISTRi6lT{ON BOX DETA{L TYPICAL CHAMBER PROFILE CHAMBER TAILS TO THE DESIGN ENGINEER. *CONTRACTOR TO VERIFY EXISTING CHAMBER ELEVATION PRIOR TO ANY WORK& 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE - 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING u TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM ` - PERC NO. 14611 APPROPRIATE AUTHORITY. MAP 327 S ,0 INSPECTOR: Donna Miorandi, RS 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOT 32 " �4 +� EVALUATOR: Michael Pimentel, E.I.T. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE • THEY SHALL WITHSTAND H-20 LOADING. C.S.E.APPROVAL DATE: Oct. 1999 �I � + �Q 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. �X� ► DATE: January 5, 2015 + 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE + TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. APPROXIMATE LOCATION OF EXISTING N77 ZONE 2 0 ELEV TOP= 39.10' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, SAS (i.e. 3 H-20 INFILTRATORS PER ELEV WATER <28.10'J X X�" FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 0_00��o4g�p5"E X X X � X r�r� /r = AS-BUILT CARD)TO BE ABANDONED - X 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN X� 8" = PERC RATE _ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. X�X�X_XI 38x9 8" 0 / 39x2' y ;' M • DEPTH OF PERC= 42"-60" 16. PROPOSED PROJECT IS LOCATED WITHIN: 12" / 12" \ O < t TEXTURAL CLASS: 1 0) z >- ! ASSESSOR'S MAP 327 LOT 33 38x6' TP 1 x a z . �! _ OWNER OF RECORD: HAQ NAWAX& ROBINA NAWAZ X .. � = w LOCUS , r h 6 39x1' 3) . ' PROPOSED 2 - 500 GALLON LEACHING Cd Q j 0" 39.10' ADDRESS: 22 WASHINGTON AVE. EXT. 0 11. CHAMBERS WITH AGGREGATE ° < OP 6.dm HYANNIS, MA 02601 cu/ X Fill \ / (2 \ + He FEMA FLOOD ZONE X x X 36.60'F #`!! 30" COMMUNITY PANEL# 25001CO568J \ 39 S Loamy Sand n 38x6' O B 10 17. DEED REFERENCE: BOOK 13873, PAGE 299 .� PR. "D-BOX" i P ; 42�� 35.60' 18. PLAN REFERENCES: 1.)PLAN BOOK 134, PAGE 93(WASHINGTON AVE. EXT. LAYOUT) Perc 2.)PLAN BOOK 10, PAGE 101 \ MAP 327 / �' � \ >c _ 9x1 0 x PROPOSED INSPECTION PORT ..1 60" 34.10' 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. \ LOT 33 3 O 1 10,176±S.F. ( - / 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY LL ' 38x9' FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY __ x Coarse Sand FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. 38x7' 6.. x C 2.5Y 6/6 >c TREE (TYP) N 1 . ''� 0 21. A 4" PERFORATED SCH.40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A (4 X o (5-10/o gravel) DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A X 1 ZG) 39x2' xo REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. m O ; 12" ' 21 aw m LOCUS PLAN - Z X I 7 --EXISTING 1,500 GALLON SEPTIC TANK SCALE: 1"= 1000' p � ; HC J I \ TO BE UTILIZED IN THIS DESIGN 132"1 128.10' m L ; No Mottling, Standing or Weeping Observed x O DESIGN DATA TEST PIT DATA LEGEND 39x5'o 38x6 PERC NO. 14611 o \ STOOP 0 \ >x INSPECTOR: Donna Miorandi, RS 50xO' EXISTING SPOT GRADE m NUMBER OF BEDROOMS (DESIGN) 3 #22 _ X EVALUATOR: Michael Pimentel, E.I.T. -- - - 50 - - -- EXISTING CONTOUR wQ EXISTING GC �\ DESIGN FLOW 110 GAUDAY/BEDROOM U.P. C.S.E. APPROVAL DATE: Oct. 1999 PROPOSED CONTOUR 3-BEDROOM � a x r1 DWELLING FLAGSTONE y MAP 327 TOTAL DESIGN FLOW 330 GAUDAY DATE: January 5, 2015 SAS TOF=39.8'± PATIO ° = 660 50 PROPOSED SPOT GRADE 39x2' y LOT 27 DESIGN FLOW x 200 /o GAUDAY TEST PIT#: 2 Benchmark USE EXISTING 1,500 GALLON SEPTIC TANK ELEV TOP= 39.10' GAS - EXISTING GAS LINE '28.10 Stoop Comer \ EXIST. x ELEV WATER= < ❑/H/y,/ - EXISTING OVERHEAD UTILITIES f Elev. =40.00' GARAGE _ Approx. M.S.L. '� PERC RATEx W W--- EXISTING WATER LINE C) i INSTALL 2 - 500 GAL. CHAMBERS W/ AGGREGATE DEPTH OF PERC= x TEST PIT LOCATION SIDEWALL CAPACITY TEXTURAL CLASS: 1 4So (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY O O O EXISTING 1,500 GALLON SEPTIC TANK 39- � 11' �X�X 25.0'+ 12.83' 2 2' 0.74 GPD/S.F. = 11 GAUDAY 41�1� X \ `"X ( )( ) ( ) ( ) 2 0 0" 39.10' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE X-t BOTTOM CAPACITY X " Fill ❑ PROPOSED DISTRIBUTION BOX BIT OR,vE '1 X- 1477'4905 E (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY d d`� 97 6 (25.0'x 12.83') (0.74 GPD/S.F.) = 237.4 GAUDAY 30• 36.60' �p PROPOSED 500 GALLON LEACHING CHAMBER �39 / B Loamy 10Yr 5/8 d / TOTALS: 42" 35.60' REV DATE BY APP'D. DESCRIPTION TOTAL NUMBER OF CHAMBERS 2 -- _. -- TOTAL LEACHING AREA 472.2 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE TOTAL LEACHING CAPACITY 349.4 GALJDAY PREPARED FOR: MAP 327 LOT 34 Coarse Sand CAPEWIDE ENTERPRISES C 2.5Y 6/6 (5-10%gravel) LOCATED AT SWING-TIES 22 WASHINGTON AVE. EXT. NOTES: HYANNIS, MA 02601 DESCRIPTION HC GC 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF 132„ SCALE: 1 INCH = 10 FT. DATE: JANUARY 8, 2015 CORNER OF STONE(1) 28.1' 35.6' 28.10 0 5 10 20 40 FEET EACH SEPTIC SYSTEM COMPONENT. No Mottling, Standing or Weeping Observed ; I"of MgSSAC CORNER OF STONE (2) 40.9' 57.8' 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF �o L PREPARED BY: THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST CORNER OF STONE (3) 50.5' 54.5' RESERVED FOR BOARD OF HEALTH USE CHU HILL JC ENGINEERING, INC. PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL IVIL 2854 CRANBERRY HIGHWAY BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. CORNER OF STONE (4) 40.8' 30.0' .41 EAST WAREHAM, MA 02538 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED ZONE 2 SITE PLAN 508.273.0_3_7_7___ _ OR THE ESTUARINE WATERSHEDS. SCALE: 1" = 10' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.2976