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HomeMy WebLinkAbout0160 ACORN DRIVE - Health PF 160 ACORN DRIVE OSTERVI LLE A= 144-015 TOWN OF BARNSTABLE LOCATION /�(,D CO!^l/l Q/'I V % SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. ,f0�'_y2o -%138 CtSCdO`j /��r'r'y� SEPTIC TANK CAPACITY DO LEACHING FACILITY:(type)3 Aeaul J_ftDIFI'dS�(size) NO.OF BEDROOMS OWNER�ifl�il F l!4 fl97�� l� PERMIT DATE: — /%—I2 COMPLIANCE DATE:Separation Distance 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 .a c ov r� Dr(V/ j i,3AC k ,t . �jp, 37G 26,9•, 04 I I =N sarc rlah o�r'S V Na Fee M► �Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for Disposal *pstrm (Construction Permit Application for a Permit to Construct(4.��Repair(grade( ) Abandon( ) ❑Complete System ❑Individual Components , Location Address or Lot No.160 #j GOY!? Q/y j/_ Owner's Name,Address,and Tel.No. D�r,Friii�/_ Assessor's Map/Parcel / _ ,,P 1460.,OW Installer's Name,Address,and Tel.No.5*&O8-4ef f-99ez Designer's Name,Address,and Tel.No.&Pg-X-2-Qg22 - 60/, h% erVtis . /s r- s 4 ."46 Type of Building: 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) 3:5 O gpd Design flow provided 3�� gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank X/000 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) -re5r4111 1040a6mlk bed jZ!' /I, &_gg 41e1i�s 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. S'Le, Date -7Z Application Approved by + Date 4 Zo 1 Z Application Disapproved b Date for the following reasons Permit No. _Zo i'? -- 7 2_-L Date Issued ' I INo Fee f Vv � THE COMMONWEALTH OF MASSACHUSETTS +, Entered in computer: PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE, MASSACHUSETTS Yes implication for Disposal *pstrm Construction Permit { Application for a Permit to Construct Repair(-)—Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No./6 D /46 tf/_= Owner's Name,Address,and Tel.No. (' f�5T/ `!/////=_ /-��vsy is(�1 /Ja,7✓rc /C r Assessor's Map/Parcel /y _ - c/ /C D �+�U�!' U�'/1/i'� C;'$T: /�/•�i:f Installer's Name,Address,and Tel.No. 'J� �?af �✓��a Designer's Name,Address,and Tel.No.�/1G'Z�2-�y`L'2 el.` (O e Type of Building: Dwelling No.of Bedrooms _� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 gpd Design flow provided 3 33 gpd Plan. Date Number of sheets Revision Date Title " Size of Septic Tank >(/0007 Type of S.A.S. 1 i Description of Soil j i Nature of Repairs or Alterations(Answer when applicable) 2a�Sj // iC DU(� � ✓`1�,� Gi /�Lj/�/=6� i `/� , /_)0a"., // l O S- 9/e)Ur all tG, 7S' 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 f•`' Compliance has been issued by this Board of Health. i S' ned Date 7 o�2 Application Approved by ; Date `1 Z.,Z Application Disapproved b i. ? _,� "-< r Date - r for the following reasons Permit No. 2 01 Z — 7 Z 2 1 Date Issued - . . --.-_----. :_ -_ __ -.- - - - -- - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate, of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired Upgraded ( ) Abandoned( )by at /Gd f`/:%�� /il �// 1//= l'S%r:=.vl�/.I//, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No..Zo IZ- 2 Z dated / �// ZO Z Installer Jo. r_✓r L).e.%��at�U ' ` Designer //,.i,Yy/_--r #bedrooms -Z Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system;will function as designed. / Q Date 25 Inspector V No.2 O IZ 22 Fee ' �UUD au THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction Permit Permission is hereby granted to Construct(`) Repair Upgrade( ) Abandon( ) System located at 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:qonstVuction must be completed within three years of the date of this permit. Date T 9 Z-° Approved by �— d — Town of Barnstable 'WE Regulatory Services » Thomas F. Geiler, Director ""S& Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,CIA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: l 11 Sewage Permit# 26219 - 2 Assessor's Ma \Parcel Designer rn v v` installer: J/_,5el_�� Address: I l/ �Vlk � _ . Address: _Y/e!! ���'�—�� e kt`t>�nl &n CAJ 1A/U� �sfio.V 5_/0 On �—/q /2 Jfeid Z- 1-5;a9,02-0.f was issued a permit to install a (date) (Installer) septic system at based on a design drawn by (address) �— t/�_ dated �+% " (designer) 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 o �th;. distribution box andj'or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any; vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF. -,y4,s9� o DA EN Y ( st l�ler's Signature) N t SANITA��I'� (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTAB PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUEU UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU Q: Heal th/SepticTesigner Certification Form 3-26-4.)doc I Town of Bdi stable r# Department of Regulatory,Services • ' - Public Health Division Bate— S uexarenr� .200 Main Street Hyannis MX02601A. -Fee Pd. Date Scheduled Time ` �1!_ `oil Suitability Assessi7ient fop Sewage Disposal r Performed By. )C, 1" { / Witnessed By'1 �✓1Ci((/� �M` —5 F ' .� LOCATION & GENERAL INFORMATION Location Address Owner's Name P19 N,�LA kalAddress nnD'�, Assessor's Map/P rcel: �, `I. Engineer'srwName f�� +t'`v_If P Y �( Tele hone# NEW CONSIRU�TION REPAIR '\ P Land Use Slopes(5'0) `' t Surface Stones Distances from: Open Water Body 7 ft Possible Wee Area 7 ft Drinking Water Well7� ft -7"� L ft Property Line �ft Other a•ft Drainage Way ' SKETCH:(Street name,dimensioos'of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) y I ..'TO P. hllk S� . „ Parent material(geglOgic) Depth to Bedrock Depth to Groundwa�dr. Standing Water in Hole: & i- Weeping from Pit Face y Estimated Seasonalltigh Groundwater DtTERMINATION'FOR SEASONAL HIGII WATER TA L Method Used: I e obs.hole: Depth to Soll mottles: Depth abevd stndingin Iti Orouttdwttter Adjustment' Depth[oweeping from side of obs.hole: i A ;faetor Adj,Groundwater level.N3�t� Index Well# Reading D te: Index Well level • "—f"'" I . . PL+RCOLATIOlr17,EST Doti x'4W Observation. J Tiine at 9" r _ -:---- Hole# : Time at&' Depth of Pere Time&'-61') —_ Start Pre-soak Time-0 G= ` End Pre-soak RateMinJInch Site Suitability Assessment: Site Passed Site Failed:_— Additional Testing Needed(Y/N) Original:"Public he'�lth Division Observation Hole Data To Be Completed on Back= ***If percolation test is to be condFacted within 100' of wetland,;you must first notify the Barnstable C44servatien Division at least one (1)wedk prior to beginning. DEEP OBSERVATION HOLE LOG 'Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel A �i DEEP OBSERVATION HOLE LOG Hole# ?/ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel) 6 �aa>7,► S� 1�2�g 71 DEEP OBSERVATION HOLE LOG Hole# N Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon SoiI Texture Soil Color Soil Other Surface(in.) DA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, ra I I� Flood Insurance Rate Map: ` Above 500 year flood boundary No Yes Within 500 year boundary No V/ Yes Within 100 year flood boundary No V Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervi us material exist.in all areas observed throughout the area proposed for the soil absorption system? If not,what is the de947 lly occurring pe vious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Envirotection and that the above analysis was performed by me consistent with the require rain eience described in 310 CMR 15.017. Signature Date Q:\.SEPTIC\PERCFORM.DOC J , COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION r i 1 yvsy TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 160 ACORN DRIVE OSTERVIL,LE Owners Name: SUSAN BULLOCK Owner's Address: Date of Inspection:6/27/05 Name of Inspector: (please print) Douglas A.Brown i = Company Name: Douglas A.Brown Septic Inspections Mailing Address:P.O Box 145 CID Centerville,MA 02632 • - Telephone Number: 508-4204534 ' CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a'DEP _ approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: X Passes y Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature:A�a Date: 6/27/05 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. 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 1 Revised on 10/31/2000 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 160 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection: 6/27/05 inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information winch indicates that any of the failure criteria described in 3 10 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: i B. System Conditionally Passes: one or more system components as described in the"Conditional Pase'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 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 distribution box is leveled or replaced 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 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 160 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection: 6/27/05 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 CNM 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 I 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: I i Page 4 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 160 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection:6/27/05 D. System Failure Criteria applicable to all systems: You must indicate"yes or no to each of the following for all inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number — of times pumped X 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. X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Arry 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 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.] NO (Yes/No)The system falls.I have determined that one or more of the above failure criteria exist as described in 3 10 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure, E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or no to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant'-threat,or answered ye$'m 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 Page 5 of 1 t OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 160 ACORN DRIVE OSTERVILLE Owner: SUSAN BULLOCK Date of Inspection: 6/27/05 - Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No X Pumping information was provided by the owner, occupant, or Board of Health X Were any of the system components pumped out in the previous two weeks ? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X Were all system components,excluding,the SAS,located on site? X _ Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition of t he baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _ X Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? s The size and location of the Soil Absorption System(SAS)on the site has been determined based'on: Yes no X _ Existing information.For example,a plan at the Board of Health. X 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 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 160 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection. 6/27/05 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN How based on 3 10 CMR 15.203 (for example: 110 gpd x# of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NA Seasonal use: (yes or no): NO X •®G, 0&1 Water meter readings,if available(last 2 years usage(gpd)): 1?q OWS 6-1 Sump pump(yes or no): Last date of occupancy: COMMERCIAL/INDUSTRIAL: 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 Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): NO If yes, volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system.(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system awner) Tight tank _Attach a copy of the DEP approval Other,(describe): Approximate age of all components,date installed(if known)and source of information: 1987 BORTOLOTTI CONST Were sewage odors detectedwhen arriving at the site (yes or no)? NO Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 160 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection: 6/27/05 BUILDING SEWER(locate on site plan) 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: (locate on site plan) Depth below grade: 2° Material of construction: X concrete_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) Dimensions: 1000 gal Sludge depth: TRACE Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: TRACE Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.)- 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.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 166 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection: 6/27/05 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: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 0 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.): r PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no):. Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps andappurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 160 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection: 6/27/05 r SOIL ABSORPTION SYSTEM(SAS):_(locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: X leaching chambers,number: 3 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.): OPENED ONE CHAMBER 8"LIQUID AT THIS TIME 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 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.): J Page 10 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 160 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection: 6/27/05 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. 1 .4 Li � 1 + I 3 Page 11 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM ] INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 160 ACORN DRIVE OSTERVILLE Owner's Name: SUSAN BULLOCK Owner's Address: Date of Inspection:6/27/05 SITE EXAM Slope: Surface water: Check cellar: Shallow wells Estimated depth to ground water 7 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: OFF AS BUILT #87-755 TOWN OF BARNSTABLE v LO A iU l6 U�Cpr/1 Lri re-, SEWAGE # V�,L•AE �S�C�"✓./lL. G ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. yU�'L45 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS —3 BUILDER OR OWNER sttsct rt u L L O C,�' PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by P::ge 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(coatinued) Property Address: 160 ACORN DRIVE Owner's Name: SUSANBULLOCK Owner's Address: Date of Iuspectlon:6/27105 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permaneout refemnce landmark o. benchmadcs.Locate all wells within 100 feet Locate when:public water supply enters the buildiug. L4.elc 04- 1Gr 1.4 ` A z 92/ V Q I-z�• L 0 1 Z i L No.......... ......... Fss.A ..00. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF' 1 EALTH ........ ............Ton......OF...Barnstable Appliratiun for Disposal Works Ton,strnrtiun Prruti# Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 160-Acorn Drive ................_- -•• .............................................. .................................................... ....................------•---•-•----...... Susan Bulloc k Location-Address O s to rvi lle or Lot No. Owner Address w Macomber & Son Inc . Centerville ,._ _ , • . . . . . . . •--....----/••-•------...••••••......................... Installer Address Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms.................................. .Expansion Attic ( ) Garbage Grinder ( ) �+ Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures .................................. w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No . ...._._..... Width..... ........ Total Length....._....... Total leaching area..' A._.......sq. ft. -- Pit Noa:_pioa :Diameter.................... Depth below inlet................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ R+.. ....................... ............................................--------------------------------- --- ................................................. 0'. Description of Soil....2Y&......san.d...&..,Gx_avC I.................. 4.._ .-----......•-------------------•----------------------...•--------------------------...........------•-- `---- ?- ................._._ -f.............................................................. t ---------------------------------------------------------------------------------------------------------- -x-f- `vt ........................ }... 111-41-LIe � �U Nature of Repairs or Alterations—Answer when applicable..___-da.f f_U.S-OrS.._._��._. ._. -----------------------------------•-----------------------------------.........._........---•-------------------.....,;;K--------------------------------------•-•-------=-----------................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be 's ed by the bo d of I Sig d. D to p Application Approved By------ ��...r...............•• ••--- 27--7 _ Date Application Disapproved for the following reasons--------------------------------------------------------------------------------•------------------•---------- ---------------------•---•••----..........--------------------------------------........---------------••--------------........_.....----------------------------------------------------------....-•--- Date PermitNo......................................................... Issued �._^ .......... ............................. Date No ---•-•- J•' FE$ �..... f..4 ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................... ... Appliration ,for Disposal Works Tonstnirtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair O an Individual Sewage.Disposal System at ... ..... . vo -----_ ...... ............................................... ..•----_... .... ---- -•- •••. •-------- -----_.... ...... Location• Address or Lot No. W04, Bullock .... - __. ...----- •..............•--------......_............ .........• _ .. .......--•--... ..............-------••-----------................._.. Owner Address .--------•....................... .................. Installer Address UType of Building Size Lot.......................:....Sq. feet Dwelling—No. of Bedrooms...............................................Expansion Attic ( ) Garbage Grinder ( ) a aOther—Type of Building ____________________________ No. of persons............................. Showers ( ) — Cafeteria- ( . ) Otherfixtures . .................................----------------------------------------------------------------------------- -------- WDesign 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.................... 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.................... 44 Test Pit No. 2................minutes per,inch Depth of Test Pit.................... Depth to ground water........................... a' -- -• - --=----------••-------------•-.._._.: --------------------------------------------------------- Description of Soil_..: OHM_A.. $.._______________________________ x -- - --•.....................••------------...••-----_----- V ...............••-•-•---...---.._..._..-••----------•---------------------..__...._--------------- •---••---•-------- W - ---•- U Nature of Repairs or Alterations—Answer when applicable-"tw __________________________ ..................-.......................................................................................... -------- ---•-----. Agreement: The undersigned agrees to install.the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT: 5 of the-State Sanitary,Code—The undersigned further agrees not to place the system in operation until a Certificate of:Compliance has be s ed by the b9ard of i . Sign _� . ....- .... :............ Application-A roved B ✓ Date Date Application Disapproved for the following reasons......................................................------•---------------•--•-----------------•-------••••-- --._......-•-•---.......-•----•--•----------------------------•--.._..------------•---••--------•-•-----------------•--------....--------•------------------------------------ ...................... Dat& Permit No.............................. --•---------------------- Issued_........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TC1tl • role ........................... ......... .OF....................................................... ................... &r. firate of TompliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired Q ) by... C1 -- ?..�a��t...��►Q-+------------ at .. "" 0 � 1 � oftery Installer % ._._ ..-•---- ----------------••--•------------•-------------•- ___.._-----....._...---•------------•--•---•-----•---•-----•---•-•-•-••----------•-----•------- has been installed in accordance with the"provisions of TI 7 5 of The State Sanitary C�e as described in the application for Disposal Works Construction Per No._._ �.�, ............. dated....... .._T�,____.- . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................................................ Inspector �� , 4u_..�.rs:pC�3:��, -+�yi1'SetA•6rw.c3�N viuf3._.,iwa _ � - .. ..., THE COMMONWEALTH OF MASSACHUSETTS - BOARD OF HEALTH ✓ ...............................:. .....OF..... ._._.... ................._.........._.__.._....__.._..._._.._......_.. $ 00 No......... .'.. FEE ..................... Ri11ttttus 1 r Permission i hereby ?" . ��� �� `�''�'i► se eby .--- ------- •--..._....••,••-•--•--.-- -----------------•----... _......... ._.. to Con t ct (` fir_R,eg iVf a)daii j�i �Sev�age Disposal SystemBaloek atNo................................................................................................................................................................................................ Street as shown on the application for Disposal Works Construction Per . No___ ___ _ ____ __ Dated___..6 ......... DATE....'''.,�-A--7-.,�•--._...-•-----------••-------•------...... Board of Healt X FORM 1255 HOBBS & WARREN, INC., PUBLISHERS J. TOWN OF BARNSTABLE g7�'� +CA ON /T-,&-G&U .MI 1�F Y SEWAGE # �- VILLAGE QS%Qtl/L.4 ASSESSOR'S MAP & LOT /e/Y—15-ow a j INSTALLER'S NAME & PHONE NO.064FIZT" SddMc. W y}�=- SEPTIC TANK CAPACITY ®oo O z„ LEACHING FACILITY:(type) -r-ZO Q/:-�uS.ScrRs (size) j afcY NO. OF BEDROOMS PRIVATE WELL O BLIC WAT1E_ BUILDER OR OWNER Sc�Str! �C1C�GC'� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No X i �y CJJE7rk V&SF2UEO YmB......... ... ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... ........ .........­0F.........../VOL.f ---------- /Y ............... Appliration for Dhipatial lVarkii Tomitrurtivit ramit 0 Application is hereby made for a-Permit to Construct or Repair (XI an Individual Sewage Disposal System at: lWL yu '0 ...........D� /2/ .... . ............................... ................. .................................................................................................. on-Address or Lot No. Owner 0 ............J..* ............................................... ........... ....... kddress ..... ..... ....................... ......................... .. ........... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............. ..........................Expansion Attic Garbage Grinder P4 Other—Type of Building ............................. No. of persons...........:a:�----------- Showers ( j — Cafeteria Otherfixtures ...................................................................................................................................................... Design Flow...............// .................gallons per person per day. Total daily flow............02 ...................gallons. Liquid capacity/4.14�..gallons Length...... Width.....<....... Diameter________________.. Depth..<511_./9 Septic Tank .`.... t Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area_------------------sq. f t. Seepage Pit No...................... Diameter.................... Depth below inlet......_.._.._._..... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Per-formed by..------ i- ------------**......................................... Date........................................ -----------Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water____-------__-_----_---. Gz., Test, Pit No. 2........:.......minutes per inch Depth of Test Pit..._........._..._.. Depth.to ground water--______--_-_-_-----_-_- ix ------------------------------------------------------------------------------------------------------------------------"---------------*----------------------- 0 Description of Soil................5;51N D.......:;r . ................................................................................................. U ........................................................................................................................................................................................................ ........................................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable..._.... ._. ..ME 0if-D.........011�-- ..... ........4C. ....................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'L_111';LE 5 or the State Sanitary Code"--The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been e by the bo -- d oj-hvalth. Signed-------- ..................... . .... . .............................. ..... ........... t'-7:? Application Approved By........ .................... -------_-------------------- --------------I-17-te a Application Disapproved for the following reasons:.............................................................................................................. ........................................................................................................................................................................................................ . Date Permit No......................................................... IssuedL............U.... . je 7 late . ......................... No.....WSJ.... FEs.--� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ -- .....­1.. ....OF............... .tJ</ts/ .-.........-------------------------------------------------- Appliratiou for Uhipmal Workii Tuttfitrurtiutt 1hrutit Application is hereby made for a Permit to Construct ( ) or Repair X) an Individual Sewage Disposal System at: ....1� ............................... ..........................................��?. ...�------------------------------------- ---....---------------------........_..--- r t S-ncation-Address r/ or t . _,.. •_Q: %:�.( C E U l: r.... .%. t f..... ..__....__. .c '...................................... ............................................................................. (zl L✓ _,OCner, .Address ' �7_ 6 , , G ( St , - r � � % U Ei1//1 Installer Address QType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms______________�.......................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons............. .............. Showers ( ) — Cafeteria ( ) W Other fixtures ...................................................... W Design Flow.............. _.!...................gallons per person per day. Total daily flow........... =:: ______._____.________gallons. P4 Septic Tank—Liquid capacityf_' .__gallons Length.....%__....... Width___C_____.__.. Diameter______________- Depth__ ........ 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........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water_-___---.___________,.-- (Tq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x ..-----------------------•. .......-----....---._..._..--------------------------------.............................................................. O Description of Soil-•-------•--- a.J .........` t ' f! ----------------•-------------•-------------------------....-•----.. x W -----------------------------------------------•--.....----------------------..------------------------------�•-------•-•-------•-----••••--••------••----••••---•••-----•......---------•----•-- Ux Nature of Repairs or Alterations—Answer when applicable.__.__._( & V�-__-_.�,G.D•__•----_©- -::! `c' '� P _ - ----------------------------•---. - L'-� i'£/fit"L bu/714 r� 1: 01 Agreement: The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with the provisions of i? i E j of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issuri by the b7rd of-health. Signed `? rt/ -..�'�Uc.-C`.. �------ �!= ` ?,�_..._:'.. _ D to Application Approved B _.. _, -� . .` " Date Application Disapproved for the following reasons--------------------------------•------------------------------•-----------------•-----......................... -•-•-•••-•-••---•---------•-•••-•-•---------•----•---------------•---•--------•-----••-...._........-••---•--------------------••-•----•-••••••••--------------•------•----------------••--•......•---- ��. Data Permit No. = ' .....__...-•-•-------------••--•--••_. Issued.------.---1- _ :: Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... aJ, ....0. .....,""�.�1�� ..........:....................................................L ...... Tntifiratr of Tautpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) JL-- '" stakler ii _ at 4-- -----Co..=�= .C�1rrl us J, .,�C. has been installed in accordance with the provisions of ii" ,r j of The State Sanitary Codeps described in the z ..L`%...`application for Disposal Works Construction Permit �'o_______ _______________ _••-' ----' dated-.. �_ THE ISSUANCE OF THIS CERTIFICATE SIiALI. NOT BE nRUE S A GUARANT THAT "tHE SYSTEM W1 l. UNC ON SATISFACTORY. C _____________�� DATE......---•-- ..�...........-•-•--•--------•--------._.. Inspector_ ...._.r THE COMMONWEALTH OF MASSACHUSETTS .- --•.- _�'._';- ��"_��. . BOARD OF HEALTHtj _ — �i���a��l urk� Cnu��#rt�tiutt; .eruti� Permission is hereby granted -' '-.................... "'." ra= t I--� ..' __... to Constr}i�ct (� ) oyNRepair ( ) an I dividual Sewage Disposal System at No. 1. '_ C`� `. l C" -----•-- ................................................................................................ •..... 1---.-._� --.•-------------••----------------- ---------.._........... Street as shown on the application for Disposal Works Construction Permit Nos�......... �'Dated_____�%� �. �____________________ ..r .i,,. �..............,...._.....,,....m.. } Board of Health DATE..............L f.__ .rr '__!______.._____._.______........... FORM 1255 HOBBS & WA�,REN. INC., PUBLISHERS 57 � J L-OC ''AT10N SEWAGE PERMIT CIO. VULAGE L"L' I N S T d LLER'S NAME Oe_ ADDRESS R U I E R OR OWN ER ------------- DATE PERMIT ISSUED DAT E COINPLIANCE ISSUED elf , o a r� o r ELEV. TOPS NOTE: MAGNETIC TAPE TO,BE PLACED OVER ALL.COVERS PROPOSED TANK PUMP CHAMBER D-80X FOUNDATION INSTALL RISERS W/IN 6" OF FINISH GRADE INSTALL RISERS to FINISH GRADE INSTALL RISERS';WAN 6" OF FINISH GRADE (Existing) FINISH GRADE=25.10 = 23.28 EL.21.75f EL.21.75t EL.23.0f' EL.23.0t F.G. EL: 25.0 MIN. COVER OVER S.A.S. _ 9" MAINTAIN 2% MIN SLOPE OVER LEACHING AREA MAX. COVER OVER S.A.S. = 36" U SPEED INSTALL TWO INSPECTION PORTS(MIN.) :i SANITARY NEE L -10'(MAX) p.IC 4" SCH 40 PVC 4" SCH 40 2 SCN TWA e. e ® S= 1% (MIN.) 6.35" TO. CELLAR FLOORIN� 10 14 o so iR (MIN.) 1a FORCE INVERT__- a' • TEE's ARE To BE D=BOX INV.=24.05 "• 4'SCH 40 PVC 16" INV.= 24.25 :J INV.- 20.59 3 ROWS OF 5.UNITS AT 6.25'/UNIT + 0.75' WEDGE = 32.0'/ROW rASTEE SHALL NOT EXTEND PUMP OFF 4" BELOW FLOW LINE INV.ELEV.=23.93 w FILTER INV.=2o.5G USE,DB-S SOIL ABSORPTION SYSTEM (PROFILE) Exist. Invert 12" ( ) EXISTING 1,000 GALLON SEPTIC TANK Im__ INV.=20.75 INV.=20.84 GAS BAFFLE TO BE INSTSALLEO ON S I, OUTLET TEE AS MANUFACTURED BY RESTORE VEGETATIVE COVER TUF-TITE, ZABEL, OR EQUAL BACKFILL WITH CLEAN PERC SAND NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING 4) GAS BAFFLE W/ FILTER TO BE INSTALLED ON OUTLET TEE TO TOP OF CHAMBERS PIPE INVERTS PRIOR TO CONSTRUCTION. AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 2) PUMP CHAMBER AND 0-BOX SHALL BE SET 5) INSTALL SANITARY TEE IN D-BOX LEVEL AND TRUE TO GRADE ON A MECHANICALLY. 6) REPLACE EXISTING 1,000 GALLON SEPTIC TANK WITH BREAKOUT=TOP ELEV.-2-4.32 COMPACTED SIX INCH CRUSHED STONE BASE AS SPECIFIED IN 310 CMR 15.221(2). 1500 GALLON SEPTIC TANK IF FAILED, DAMAGED, OR INV. ELEV.= 23.93 LESS THAN 1,000G IN CAPACITY. BOTTOM ELEV= 2340 3) INSTALL INLET & OUTLET TEES AS REQUIRED. . . EXISTING SUITABLE SEPTIC -SYSTEM PROFILE 2.83' MATERIAL 5' MIN. ABOVE BOTTOM OF N.T.S. T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 3 x 2.83',= 8.49' (5.05 PROVIDED) USE 3 ROWS OF 5-ADS 11008D PROVIDE WATERTIGHT CONCRETE RISER AJD. GROUNDWATER EL.=18.35 INSTALL 1' PVC CONDUIT TO HOUSE FOR WIRING =• BIOOIFFUSER UNITS-NO STONE WITH WATERTIGHT JOINTS. WARE HIGH WATER ALARM WITH SECURED COVER TO GRADE FLOAT TO GP 2000 HIGH WATER ALARM PANAL ON CIRCUIT SEPARATE FROM CIRCUIT TO THE PUMP. NEMA 4 JUNCTION BOX CORROSION RESISTANT TYPICAL SECTION & LIQUID-TIGHT CABLE CONNECTORS SUPPORTED JOINTS TO BE MADE BY 1-1 4" PVC CONDUIT. , HOISTING CABLE 7xt9 STAINLESS STEEL / • , 1/8" DIAMETER. / 1,760 LB. STRENGTH. WATERTIGHT 2"BALL VALVE w/ UNIONS SCH. 80 PVC PC INV.(IN)=20.50 GEORGE-FISHER CO. MODEL NO. 560 OR EQUAL 2"SCH. 40 DISCHARGE TO D-BOX SOIL LOGS ALARM ON EL: 19.15 CLEAN-OUT 40 TEE w CLEA OUT CAP , / { PUMP ON EL: 17.83 PROVIDE 1/4' WEEP HOLE IN DISCHARGE - le�. TH 1 Eler. TH-2 E h_ D t Depth .PIPE FOR SELF-DRAINING FORCE MAIN ° PUMP OFF EL: 17.50 J?" 16. DATE: SEPTEMBER 4, 2009 21.56 A . 0" 21.40 A 0' l 1`2 2" BALL CHECK VALVE SCH. 80 Pk SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614 LOAMY SAND LOAMY SAND 100 P.S.I. FLOWMA71C MODEL No. 208S 10YR 3/1 1aYR 3/1 WITNESS: DONALD DESMARAIS, BARNS. BOH 2os1 s 6• - 20.73 e" a PROVIDE 2- WADE ANGLE FLOATS: 2" SCH. 40 PVC DISCHARGE PIPE LOAMY SAND FLOAT NOA: PUMP ON/OFF (BARNES 073618 OR EQUAL) LOAMY SAND FLOAT NO.2: ALARM ACTIVATION (BARNES 073612 OR EQUAL) BARNES SEV412 PUMP .5 H.P. 115 V I JOYR 5/8 . tOYR 5/8 2" DISCHARGE PASSING 2" SOLIDS OR EQUAL . PUMP CHAMBER, PUMP & ACCESSORIES AVAILABLE AS A UNIT GROUNDWATER OBSERVED AT 82" EL 14.75 18.58 38".• 18.48 C _ 35" THROUGH WIGGEN PRECAST CORP., BOURNE MA. (800) 564-6774 INDEX WELL MIW-29 ZONE: C PUMP & ACCESSORIES AVAILABLE THROUGH WILLIAMSON ELECTRIC (781) 444-6800 LEVEL 8.4 ADJUSTMENT: 3.8 ft. PERC • 17.25 I ADJUSTED HIGH GROUNDWATER AT EL 18.35 MEDIUM f�IDUM ' PUMP DETAIL I SA 2.5Y 7/3 2.5Y 7/3 N.T.S. BUOYANCY CALCULATIONS DOSING & STORAGE REQUIREMENTS ���, of '�qs 13.58 - 96" 13.57 s4• J' PERC RATE <2 MIN/IN. ("C" HORIZON) Septic Tank - EXISTING DAILY FLOW: 330 GPD y Pump Chamber DOSING REQUIRED: 4 CYCLES/DAY (SAND) o DA R PROPOSED SEPTIC SYSTEM UPGRADE PLAN BOTTOM OF PUMPa n CHAMBER: to 330 _ 4 = 82.5 GALLLONS/CYCLE M H"GROUNDWATER: EL: teas DISTANCE REQUIRED BETWEEN PUMP 1140 BUOYANCY FORM M I=OF�: 160 ACORN DRIVE, OSTERVILLE, MA e.4e'x 8.29'x 1.0'X 62.4 f/au. ft. 2A24.4 flm/k ON AND PUMP OFF FLOATS: ..�co MA)aMUM DISPucomrr. 18.35-1e.17 . LIS' 82.5 GAL/CYCLE = 250 GAL/FT = 0.33 FT/CYCLE . (4"') '�G/$Tt�`- - - Prepared for: Pamela Patrick - - MAXIMUM UPLIFT P - 2.18' x 2.e24.4 @t/fl - 6.157.19 1bL www of EMFRr Pump cHmem -e00D Ibt NITAR�1`� �l Engineering by: Surveying by: SCALE DRAWN JOB. N0. WEx1HT ov FILL(COVER)OVER PUMP CHAMBER: STORAGE REQUIRED ABOVE WORKING LEVEL: 310 GALLONS IJ DARRENM.MEYER,R.S. 5.46' x 8.29'x I& (am)x 110 Ibt/ou. R. - 4.97e Bit/R STORAGE PROVIDED: � � � � Eco-Tech �viroame�ta! N.T.S. DMM TOTAL COUNTER WEx7fT-e.0�mt + 4.978 Ibt- 12.978 an _ PO BOX 981 INV.(IN) EL:20.50 - PUMP ON EL:17.83 =2.67' EAST SM01MICH,MA0253T (508) 364-0894 DATE CHECKED SHEET NO. IZ978 The > e157.19 The : buoymwy enteke ok STORAGE PROVIDED = 2.67' X 250 GAL FT = 667.50 GALLONS - / s�sz-zsz2 10/12/09 DMM 2 Of 2 - i SURVEY REFERENCE: Q LEGEND OSTERVILLE PLAN OF LAND BY CHARLES N. SAVERY, PLS. !C, DATED: AUGUST 10, 1964J,\\ , PROPOSED CONTOUR ROUTE 28 rZ \,S's, t ® PROPOSED SPOT GRADE o 5 ft. Soil Removala LOCUS EXISTING CONTOUR OF (see note 1 3) O�\., 160 ACORN DR. Mgss9 %� �• + 96.52 EXISTING SPOT GRADE AR EXISTING WATER SERVICE `" cn ME F`�-� Existing 1,000G TEST PIT ? No. 1140 "' poi" F,. - Existing Leaching O�-i� Po septic tank - O is in area of construction w - \ P BUMPS RI NITAR\pN (see Note 10) / 0 �• 6' �. s, ER ROAD. _ 3 LOCUS MAP LOCUS MAP N.T.S. GENERAL NOTES: • ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 0 o - BOARD OF HEALTH AND THE DESIGN ENGINEER. 22 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS \\ COO `9�. TH-1 � \ OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE \, LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: r \ 1N � � . • � ��\� ��. � - 310 CMR 15.405 (i) (B): 1) A 3.7 FT. VARIANCE FROM 310 CMR 15.211 TO ALLOW LEACHING TO BE ®� 16.3 FT FROM DWELLING VS REWD 20 FT. (LINER PROVIDED) G ' 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR \�• c' F� \9p \ TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE I 23 .s DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING i FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 0. X LOT 3 / > ENGINEER BEFORE CONSTRUCTION CONTINUES. / \ 5. ALL ELEVATIONS. BASED ON ASSUMED'DATUM. �� AREA = 1209g/sf +- \ Z 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF BENCH MARK �� THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD -OF PAINT SPOT ON STEP !� ��� �� If /�! /��� _ HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. ELEVATION = 22. 2S 2i�,� �� ��� \� 9� " \ % �� 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED BARNSTABLE GIS DATUM TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9 \ X' 23 i��F 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE / THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING �'��•.� �\ \\ \ O �\ Z� ; . �z of \ \ CONSTRUCTION. \ \ !!• ��\\ O \ ' o o� v�11 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND REMOVED FROM AREA �� \\ S;G \���.I��,-oo� �i��p </�\ OF CONSTRUCTION PER TITLE V, REPLACE WITH CLEAN MEDIUM SAND DESIGN CRITERIA �� I \ \ c� i 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES-ONLY DESIGN CRITERIA: 3 BEDROOM \� \\ \\\ / \�- C O AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY SOIL TEXTURAL CLASS: CLASS I I� \ ! ��. y-� 13. REMOVE ALL UNSUITABLE SOILS 5 .FEET AROUND LEACHING TO ° 21 \ \ EL. 18.48 OR TOP OF C LAYER AND REPLACE WITH DESIGN PERCOLATION RATE: <2 MIN/IN �•.� \ �c� O �. CLEAN MEDIUM SAND PER TITLE V. DAILY FLOW: 110 G.P.D./BR \ \ Off, i ! I 14, NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING DESIGN FLOW: 38R x 110 GPD/BR = 330 gpd (MIN REQ'D) �•.� \\ ! �J� c-1 < 15. NO WETLANDS WITHIN 100 FT. OF PROPOSED .LEACHING GARBAGE GRINDER: NO \ . \ ! �i 0" O 16. PLACE 40 ml POLY BARRIER AROUND LEACHING ON ALL SIDES AT EDGE PROPOSED SEPTIC TANK: 330 gpd x 200% = 660 gpd FUSE EXIST. 1,000G TANK y OF SOIL REMOVAL FROM EL. 24.32-20.32 TO PREVENT BREAKOUT PROPOSED PUMP CHAMBER: 1000 GALLON 22C� �� 17. ALL PIPING TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPECIFIED) LEACHING AREA REQUIRED: (330) = 445.94 S.F. • PRIMARY S.A.S. •74 P PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 3 ROWS OF 5 - 11" ADS BIODIFFUSER H-20 UNITS-NO STONE } 160 ACORN DRIVE OSTERVILLE, MA - AND EXTENDED 0.75' W/ CONTOURED WEDGES `'� ' BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.70 SF/LF OF BIOD_UFUSER) Prepared for: Pamela Patrick (BIODIFFUSERS) 15 UNITS -x 6.25 LF x 4.70 SF/LF = 440.63 SF MAP: 144 Engineering by: Surveying by: SCALE DRAWN (CONTOURED WEDGE) 3 ROWS x 0.75' x 4.70 SF/LF = 10.58 SF LOT., 015 DARRENM.MEYER,R.S. Eco-Tech M2pironmenW 1"=20' DMM PO BOX 961 g 508 364 OS 4 DEED BOOK. 19998 ( )TOTAL AREA = 451.21 SF � EIISTSANDWICH,MA02537 DATE CHECKED SHEET N0. DESIGN FLOW PROVIDED: 0.74GPD SF 451.21 SF = 333.89 GPD > 330 GPD re 'd DEED PAGE 168 / ( ) q a 5oase2-2sn 10/12/09 DMM 1 Of 2 ,E