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HomeMy WebLinkAbout0275 BRIDGE STREET - Health 275 BRIDGE STREET, OSTERVILLE A= lip v Sullivan Engineering Inc. 7 Parker Road.. Box 659 Osterville MA 02655 Peter Sullivan PE Mass Registration No. 29733 e-mail PSullPE@aol.com phone 508-428-3344 fax 508-428-3115 MEMO TRANSMITTAL SHEET May 11, 2001 To: Steve Swain Fr: Sullivan Engineering Inc. RE: Todd Wetzel/275 Bridge-St., Osterville At the request of Todd Wetzel we are sending you copies.of the Septic Calculations that are needed by the Board of Health for the additional 2 bedrooms that are being proposed at the referenced property: If you have any questions, please contact our office. Thank you. Cc: Todd Wetzel �� LZ i Sullivan Engineering Inc. 7 Parker Road.-Box 659,Osterville MA 02655 508428-3344 e-mail: psullpe*—aol.com fax 508428-3115 May 10, 2001 Board of Health Town of Barnstable 367 Main Street Hyannis, MA 02601 RE: Septic System at 275 Bridge Street Osterville, MA Dear Board of Health, Please find attached a completed Septic Inspection Form, a Septic System Evaluation of Existing Flow Capacity, and a copy of the Plan Showing The Design Of A Proposed Subsurface Septic Disposal System for the above referenced property. The Septic Inspection shows'that the existing system passed inspection. The Septic System Evaluation of Existing Flow Capacity shows that the existing system has the capacity to handle the additional two bedrooms that the Wetzels are proposing. According to 310 CMR 15.301-2 `upgrade of the system is not required if the system was designed to accept design flows resulting from the change in use or expansion of use". Therefore there is no requirement to upgrade the existing system. I trust this meets your present needs. If you have any questions, please feel free to contact me. Ve truly yours, Peter Sullivan P.E. Sullivan Engineering Inc. �= . 'iL1._iyjf,.'I `�;i 2-57..3 Cc: Todd Wetzel 6y0 ✓t Members of The American society of Civil Engineers and The Boston Society of Civil Engineers SEPTIC SYSTEM EVALUATION.OF EXISTING FLOW CAPACITY AT 275 BRIDGE STREET OTSERVILLE, MA FOR TODD WETZEL BY SULLIVAN ENGINEERING OSTERVILLE, MA DATED: MAY 10, 2001 Design Flow Single Family , Existing Bedrooms 4 Proposed 2 Total Bedrooms 6 Total F (no grinder) 660 gpd Septic Tank 6 200% daily flov 1320 gpd Existing 1500 Gallon Tank Complies Leching System ( 5 Galleys with 3' stone 10'x26'x3.3' See Note Below) Sidewall 236 SF x 2.5 = 590 GPD Bottom 260 SF x 1.0 = 260 GPD Totals -496 SF = 850 GPD Existing System Complies Note: Geometry for Leaching System from the original Design Criteria which can be found on: Plan Showing The Design Of A Proposed Subsurface Septic Disposal System Lot 7, Bridge Steet, Bamstable Ma. Dated Feb 28, 1995, Stamped &Sealed 3/6/95. OF FAR �G SLI.LIVAI'l 1�0 r's_ 7"s3�' CIVIL. ` • I SULLIVAN ENGINEERING INC. OS Uql 2001 ri0:44 FAX 561 22-5 2830 Bennis Sanidas UQ 2 cOmMONT,WEALTH OF MASSACHI_TSEqTS ( EXECUTIVE OFFICE CF ENVIR.oNmENTAL.r' Y'FAIRS DEPARTMENT OF ENVIRON-KENTAL PROTECTION TITLE 5 OFFICIATE INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART:A CERTYFICATION Property Address- R Owner's Nam .. Owner's Piddress: -7-5z &�5- . Date of Inspection: )JJ O Name of Inspector: (please print) _ r , Company Name: 1 � Mailing Address:�PD Telephone Number: "So - yc� • . �f� 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 timi of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposa!systems. I am a DEP approved system inspector pursuant 7passes ction 15,340 of Title.5(310 CMR 15.000). The system: Conditionally Passes eeds urth r Evaluation by the Local Approving Authority ails Inspector's Signature: Date: The system inspector sh 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 grtater,the inspector and the system owner shall submit the report to the appropriate regional office of the rDEP.The . al should be se*'r to the system owr:pr and copies sent to the buyer;if applicable,and the approving 1116 V1151L1 SS VLL�a.'.V4 �/. . authority. Notes and Comments ***This report only describes conditions at the tirne of inspection and under the conditions of use at that time. This inspection does not address how the system will perforw in the future under the same or different conditions of use. i>e111215 ci5�u5/2uci1 1�i:4i Fri 561 _3 :.53U Sanloas . Page 2 of l l OFFICIAL VVI SPECTION FORM--NOT FOR VOLUN NARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORMM PART A CERTIFICATION (continued) Property Address: 2zeml . A Owner. Date of Inspection: inspection Summary; Check A,B,C,D or E/:ALWAYS complete all of Section D A. System Passea: I have not found any information which indicates,that any of the failure c iteria described in 310 CMR 15.303 orin',;0 CivIR 15.304 ekist_Aby failure criteria"not evaluated are.utdicated belov:. Comments- B. System Conditionally passes: one or more system coin-ponents as described in the"Conditional Pass"'section need to be replaced or repaired.The system,upon completion of the replacer-ent 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 olds`or the septic iank(whether metal or not)is structurally unsound,exhibits substantial infiltration or enfiltration cr tank failure is im-ninent Systcm 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: - .._... 4 servation of sev�age oaa:up or Urear:out or bigh,stat►c water level in tli disrrit+tifion box due to fi roken or " obstructed pipe(s)or due to a broken,s_ttled or uneven distribution boa. System will pass inspection if(with approval of Board of Health): I . broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain:. The system required pumping more tltan•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: 0511105112001 10:dd F_•.X 561 225 2830 Dermis Sariidas Page 3 of 11 . OFFICIAL INNSPECTION FORRI NOT FOR V0L1JTNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORIM PART A CERTIFICATION(continued) Property Address: - Owne Date of Inspection: C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of 1-leakh in order to determine if the system is failing to protect public health,safety or Lie environment. = 1. "System evil)pass unless Board o`fAeaitb aeteraiinesin a �or`darice w;ib 310 i�.Itn iAyi;hd: ,e— system is not functioning in a manner which +Fill protect public health,safety and the environment: _ Cesspool or privy is within 50:eet 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, is any)determines that the system is functioning in a manner that protects the public health,safety acid environment: _. The system has a septic tank and soil absorption systeni(SAS)and&,e SAS is within 100 feet of a surface water supply or tributary to a surface%vater 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 frorn 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 13z -bHc'eria'Y1iad,vo.y��l~Ci�3I11C:GZ�C.GiluS,li:livlt��_u wi the1:C11:5^'�r'Tl:-pb iCri�i 0tn':lH2t'fiC:lIL1-'73 —-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:, 0.5 0;5.,2Ui;1 11):-48 F.�1 561 z;15 _2830 LNllllj.S Sanit.las Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL. SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property-Address: Owne Date of inspection: ���jf;'�/n L D. System Failure Criteria applicable to all systems: You must indicate'�es"or"no"to each of the following for all in,pections: Yes No -• _✓ ackup ofsewage"into'faciiitybr system component dice to:overloaded br clogged SAS or cesspool ischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or . logged 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 Icss than-b"below invert or available volume is less than�A_day flow • Required pumping more than 4 times in.the last year NOT due to clogged or obstructed pipe(s).Number 72 of times pumped ortion of the SAS,cesspool or privy is below high Bound water elevation. Any p 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 I of a public well. _ Any portion o;a cesspool or privy is within 50 feet of a priti•ate wa_er sipply well. Any portion of a cesspool or privy is less than 1.00 feet but greater than 50 feet from s 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 s ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) (Yes,'No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CW. 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 msidered 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 ad ditiort 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 Welihcad 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 symern is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Sectiar,E or failed under Section D shall upgrade the system in accordance with 310 CNIR 15.304.The system owner should contact tha appropriate regional office of the Department. US=05•,2001 10:45 F-A-:: 561 [:.'S ::�'JU Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSIMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEMINSPECIIQN FORM PART B CHECKLIST Property*Address: Owner. f Date of Inspection: _ Check if the following have been done-You must indicate"ves"or"no"as to each of the fol loving: - .e., Leo'--~- ------ ------• -. _.. .� _.. _ .— .- -- -- t/ pumpin+information was provided,by the owner,occupant,or Board of Health Were any of the systern components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? . V11-14ave large vo;umes 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 ) +Z _ Was the site inspected for signs of break out? -� Were all system components, excluding the SAS,Iocated on site _ Were the septic tank manholes uncovered,opened,and the interior oft tan}; inspected for the condition 07 e baffles or tees,material of construction,dimensions,depth of liquid,depth of sludae and depth of scum? Was the facility owner(and occupants if different from owner)provided v6th information on the proper m menance of subsurface sewage disposal systems? The size and lacatian of the Soil Absorption 5ystern(SA.S)an itie;;ite nas'osea de,ertnirieu u:;ed'ou: Yes no _ ✓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 15.307(3)(b)J 212^ I)enills Sanidas Ov-(t5.2,001 10:-1�J FAT 561 ,._o Y8a0 _ _ • Page 6 of I 1 OFFICIAL.INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS .S.UBSURF_ACE SEWAGE DISPOSAL S1'S EM INSPECTION FORNZ PART C SYSTEM.INFORIVIATI ON Property Address: .9 Owne Date of Inspection: O FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):4— Number of bedroom(actual): DESIGN flow based on 310 CMR 15 203 (for example: 110 gpd x a of bedroom,):_ '`lumber of current residents: Does residence have a.garb2lge grinder(yes or no):_. Is laundry on a•sdparate sewage system(yes or no)� gEif yes separate inspection required] Lawndry system inspected(yea or no) dT Seasonal use:(yes or no): " Water meter reading;;, if available(Last.,?years usage(gpd)): Sump pump(yes or Last date of occupancy: COM MERCIA LANDUSTRIAL/Xe)— Type of establishment: Design flow(based on 310 Ckv, 15.203): °pd Basis of design flow(5eatrlpersons/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 p the inspection(}es or n if yes,volume pumped: gallons—How was quanttry peed det`rrtlned?— Reason.for-Oumping; TXP OF SYSTEM _Septic tank,distribution box,soil-absorption system Single cesspool Overflow cesspool Shared system(yes or no)(if yes,attach przv,ous inspection records,if an Innovative/Alternative technology.Attack+a copy of the current operation,anal rnainterance contract(to be ooWned from system owner) - _Tight tank Attach,a copy:of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of infomiation: Were sewage odors detected when arriving at the site(yes or no): =T"'" 05%65.2001 10:46 F_k! 561 225 2830 DennIS Sanidas Page 7 of 11 r T - '' AT�Y ASSESSMENTS OFFICIAL INSPECTION FORM—NOT FOR V OLUh t SUBSURFACE SEWAGE DISPOSAL SYSTEM P+�SPEC.TIOIV FORMPAIL SYSTEM INFORN ATION(continued) Property Address' Owne . ' Date o nspecdon: -� BUILDING SEWER(locate on site plan) Depth below grade: 14ateri2ls 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 lcaicage;etc.): f SEPTIC TANK:­L111,0cate.on site plan) Depth below grade: _ Material of construction:�oncrete_metal fiberglass_polyethylene _ fir other(explain) nog (attach co v of . Iftank is metal list ap: is age conmed by"a Cenif;_att of Complia_ncc(yes or /N• p� certificate) Dimensions: /�r Y o - Sludge depth: " Distance from top of slud-ge to bottom of cutlet tee or baffle: 30 Scum thickness: `'_ /i Distance from top of scum to cop of outlet tee or baffle. i Distance t;om bottom of scum to bottom of outlet tee or bafhe How were dirntrisions determined: uons; e�and tlet tee or baffle condition,structural integrity,li.quid levels Comments Con pumping recommend as related to outlet invert,evidence of leakage,etc.)- r ' GREASE T ocate on site plan) Depth below..grade:_ Material of construction:_concrete____m polyethylene mother, (explain): _-------- r-- 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: liquid levels .Comments(on pumping recommendations inlet and outlet tee or baffle condition,structural integrity as related to outlet invert,evidence of leakage,etc.): 05%Oa!2001 10: Page 8 of 11 OFFICIAL.INSPECTION FORINI—NOT FOR VOLUNTARY ASSESSMENTS SUBS LTRFACE'SEWACE DISPOSAL SYSTEM INSI']ECTIOP1 FORM PART C SYSTEM INFORMATION(continued) Property Address _ %�/�+ Owner. . Date of Inspection: T�;3,�0 TIGHT or HOLDING TANk'/ a-nk must be pumped at time of inspection)(tocate on site plan), Depth below grade: Material of construction:' concrete metal fiberglass_polyethylene o2her(explain): Dimensions: Capacity: gallons Design Flow.- gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(),es or no}; Date of last pumping: Comments(condition of alarm and float switches,etQ. _J DISTRIBUTION BOX: ifpresent must be opened)(locate on site plan). Depth of liquid level above outlet invert:.1G� :�</.r �.Y� i Comments(note if box is level and distribution to outlets equal; any evidence of solids+=a'�)'Q`�er,any evidence of leakage mto.or out of box,etcwzl,)' - er - i PUMP CHAMBER f eate'on site plan) i I , Pumps in working order(yes of no): Alarms in working order.(yes or no): ` Corhineuts(note coiiclition of pump chamber,condition of putrips and appiL-tenances,etc.): k U5;'Ua�••2UU1 JU;46 FAX 561 2.25 ::630 Dennis Sanidas page 9 of 11 OFFICIAL INSPECTION )FORM—NOT FOR YOLuNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOIUM PART C SYSTEM INFORMATION(continued) Property Address: 9 Owner:2 - Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why Type leaching pits,number:_ leacbing chambers,number: ✓leaching galleries,number- leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number. _ innovativeialternative system . T,y e!name of technology: Comments(note condition of soil,signs ofb draulic failure,level of ponding; damp soil, condition of e•ec�tation, etc. : CESSPOOL cesspool must be pumped as part of inspection)(locate on si.e plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of setup layer: Dimensions of cesspool: Materials of conswuction: Indica6onofgroundwater•irflow.(vesor-no):.—.�.. .. = Continents(note condition of soil,signs of hydraulic.failure,level of ponding,condition afwegecation,etc: pgIVY�yTL&--6Vcate on site plan) Materials of construction: — Dimensions: - - Depth of solids: Continents(note condition of soil,signs of hvdraulic failure,level of ponding,condition of vegetation, etc.): 2UU1 li`.. 50 F,A-1 561 'ZS page 10 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOI,L�iti'TAR� ASSESSMENTS FORM STIBSURFACE.SEW.AGE DISPOSAL, SYSTEM i?�•�FE+C'CI PART C SYSTEM INFORMATION(continued) Property Address: 40 \4..` Ow•n e' Date of Inspection: Ali a/� .SKETCH OF SEWAGE DISPOSAL SYSTEM provide a sketch of the sewage disposal system including ties to at least t- o permanent reference landmark;or benchmarks. Locate all�, ells within 100 feet.Locate where public .vaier,uppiy enters the building. i� • l �� qq l . �j 05-`Q5;2001 10:47 F•LT 561 225 2430 Dennis Sanidas Diu'; Page 11 of I 1 OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORMM PART C SYSTEM INFORMATION(continued) Propem Address: 1 v Owne �O Date of Inspection: -:7// =k M 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 propertylobservation hole within 150 feet of SAS) Checked with local Board of Health-explain: Ehecked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high around water elevation: ry COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF.ENVIRONMENTAL AFFAIRS c DEPARTMENT OF ENVIRONMENTAL PROTECTION" " TITLE 5 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION r RE.CEIVED Property Address: _ Owner's Nam . " FEB 26 2001 Owner's Address: TOWN OF BARNSTABLE Date of Inspection: c// Ail U", HEALTH DEPT. Name of Inspector: (please print) Company Name: p � Mailing Address: SO g alb Telephone Number: CERTIFICATION STATEMENT ` I certify that I have personally inspected the sewage disposal system at this address and that the inform at ion.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. La m a DEP approved system inspector pursuant to ction 15.340 of Title 5.(310 CMR 15.000). The system: Passes Conditionally Passes. eedsjFurther Evaluation'by"the Local Approving Authority ails f Inspector's Signature: Dater The system inspector shal 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 Page 2 of.]I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address:�s Owner. �. Date of'Inspection: _ Q Inspection Summary: Check A B,C;D or E/ALWAYS eomplete all of'Section D A. System Passes: I_have-not found any information which indicates that any of the failure criteria described in 310 CMR '1 0 ford310,CMR.15.304 exist.Any failure criteria not evaluated are indicated below. Comments:d B. System Conditionally Passes: One or more system components as described in the'"Conditional Pass section need to be replaced or repaired.The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N;ND)in the for the following statements. If"not determined"please explain. The septic.tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound;exhibits substantial`infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with`a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven`distribution box. System will pass-,inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed 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 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owne Date of Inspection: e� �® 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,publichealth,safety or the environment. 1. System will pass unless Board of.Health determines in accordance with 310 CMR`15.303(1)(b)that the system is not functioning in a manner which.will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water y . --........... Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh i 1 2. System will fail unless the Board of Health.(and'Public Water Supplier,if any)determines that the . system.is functioning in a manner that protects the public health,safety and environment: _ The system has aseptic tank and soil absorption system(SAS)and,the SAS.,is,within 100 feet of a,, . . surface water supply or tributary to a.surface water supply. _.The sy.stem.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: la- 3 ;. r Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: Owne Date of Inspection:4141,A��,� D. System Failure Criteria applicable to all systems: You must.-indicate"yes"or"no"to each of the following for all inspections: Yes No ackup of sewage into facility or system component due to overloaded or.clogged SAS or cesspool Discharge or pond ing 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•ofa cesspool or privy.is within a Zone I of a publics 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 that! 100 feet but greater than 50 feet from a private water. supply well with no acceptable water quality analysis: [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution'.from'that facility and the-presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided:that no other failure criteria are triggered.A copy.of'the analysis must be attached to this form.] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 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: � y 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 ofa surface drinking water supply the system is within 200 feet of a tributary to a surface..drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat.under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page.5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:. Az Owner. i eC. Date of Inspection: Check if the following have been done. You must.indicate."yes"or"no"as to each of the following: Yes No ►off_ Pumping information was..provided by the owner,occupant,or Board of Health 1/Were any of the system.components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note,as N/A)' Was the facility or,dwelling inspected for signs of sewage back up? Y 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 SoilAbsorption System(SAS)on the site has been determined based on:. Yes no ✓Existing information.For example,a plan at the Board of Health. o% 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 r .o Page 6 of 11 OFFICIAL INSPECTION'FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIONFORM PART C SYSTEM INFORMATION Property Address: Owned Date of Inspection: f FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design); Number of bedrooms(actual): . DESIGN flow:based on 310 CMR 15.203(for example- 110`gpd z#of bedrooms): Number of current residents:—� Does residence have a garbage grinder(yes or no):— Is laundry on a.separate sewage system(yes or no) y.[if yes separate inspection required] Laundry system inspected(,es or no): L,�' Seasonal use: (yes or no Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): " Last date.of occupancy: (Z Lam' COMMERCIAL/INDUSTRIAL/Xel' Type of establishment:. . Design flow(based on 310 CMR 15.203): god Basis of design flow(se ats/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 pa o the inspection( es or n If.yes, volume pumped: gallons How was quantity p' ump'e"d determined" '' -- - - - Reason-for pumping: TYPJ&OF SYSTEM Lf Septic tank,distribution box;soil absorption system. Single cesspool Overflow cesspool _.Privy _Shared system(yes or no)(if yes,attach previous inspection records;if any) _Innovative/Alternative technology..Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach a copy'of the DEP approval Other(describe): Approximate 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 •i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued). Property Address: Q-1 .— c� � Owner Date of Inspection: BUILDING SEWER(locate on site plan)Azip— Depth below grade: Materials of construction:_cast iron _40 PVC_other,(explain). r Distance from private water supply well.or suction line: s. Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_ locate on site plan) g/ Depth below grade: 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) _ Dimensions: 15 Y �X g Sludge depth: `�� Distance from top of sludge to bottom of outlet tee or baffle: 30: Scum thickness: Distance from top of scum to top of outlet tee or baffle: 3 S Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Comments(on pumping recommendkions, nlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.))' r / P GREASE TRA� ocate 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 _ . . ,_w Page 8 of 17 OFFICIAL INSPECTION FORM=NOT FOR:VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address-co Owner. 5 ' Date of Inspection: TIGHT or HOLDING TANK ank must be pumped at time of inspect-ion)(locate on site plan) Depth below grade: Material of construction: _concrete- metal fiberglass • polyethylene - otlter(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.): DISTRIBU TION BOX: 06iT present must be opened)(locate on site plan) Depth of liquid level above outlet invert: , . Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover;any evidence of leakage into or out of box, etc.)• ®i. al- PUMP CHAMBER� cate on site plan) Pumps.in working.order(yes or no):. Alarrns:ill working Order(yes or no)x Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): 8 , I f Page 9 of 1.1 OFFICIAL INSPECTION FORM-NOT.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 7S" G Owner. Date of Inspection: :�)44 SOIL ABSORPTION SYSTEM(SAS): /(locate on site plan,,excavation not required) If SAS not located explain why: Type __._.._.._.. leaching pits,number:_ leaching chambers,number: t"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. U� , Ap�zP P e CESSPOOLSe2U"(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.): r, PRI LY/ locaie'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.): I , Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFO RMATION(continued) Property Address: C P Owne Date of Inspection: 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: �Aoq� Ub till, 10 B ' 1 Page I 1 of 11 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner Date of Inspection: 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: I hecked with local excavators, installers-(attach documentation) Accessed USGS database-explain: g !I You must describe how Y g you established the high round water elevation-.n: r Xlow zzeoz ep r . '•_ -3- - _ .. .. Ali TOWN OF BARNSTABLE LOCATION _ SEWAGE# ' `f-d y I> VILLAGE. ��°� f�IGGY _ ASSESSOR'S MAP&LOT6911— 0'V I INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) y�y L NO.OF BEDROOMS BUILDER O PERMITDATE: { `' COMPLIANCE DATE: •" Separation Distance Between the: J Maximum Adjusted Groundwater Table and 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) �U`"''� � Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by TIJ i A Y o- ?3_oq1 No.. v-.. F>ss....../..(�1.. ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _- _oF...... Appliration for Bi_qpniittl Workii C omitrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal _$ystem at: ' .- - Loc tion A ess ' or Lot No. - ...... .�1�.0 .:... 1 ►G 2 � t .......M-. .l�l - �-- Owner ddress --- -------------- --------- ----- Installer Address J UType of Building Ll Size Lot7 .... .....Sq. feet Dwelling—No. of Bedrooms--------------------------------------______Expansion Attic ( ) Garbage Grinder (�V Other—Type of Building a YP g --------•-----•-----------•- No. of persons............................ Showers ( ) — .Cafeteria ( ) Other fix ur Design Flow............ ... ............ .... lions per person of Total y�......!r7�.�v-_---:---..----___..__on.. WSeptic Ta k— i 'd capacrit . 41tons LePgth� '' Width _ Diameter-----_.--.___-- Depth. �'Q x Disposal � t.To. c?� Width 1 Q Total Length.. Total leaching area- sq. ft. Seepage Pit No----------_--------- Diameter.................... Depth below inlet_..I��. Total leaching are�. ._..sq. ft. t Z Other Distribution box ( ) Dosing tank ( - ) '~ Percolation Test Results Performed b 4.d .............. Date......................._ 7 �1 Test Pit No. 1.... "IZI. minutes per in Depth of Test Pit:___l.�__.......... Depth to ground water... 0 -------- Test s/ fz, Pit No. 2....... ...nllnutes per inch Depth of Itst > .I.0. ..... Depth to ground water... ...... - oDescription > ----- ' ,�L----------------•-.•----------------------------. Descri tion o Soil---•- It � ..1i-. - - - - - -------------------------•----------------. -------------•----•----- x �--•---------•--- ................................................. W .........-. -- I ..... _-- UNature of Repairs or Alterations—Answer when applicable.------------------------------------------------------------------------------------•-.-------. -•---------•----------------------••----------•-------------------------------------................-•-•••••••----••--------•----•-•-•-••••--••-•------••---•••--••-•-••-••••-•-••-•--•-•------•----•-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —P e unde i edlWrther agrees not to place the system in operation until a Certificate of Compliance as be i ed b o of health. Signed - -.. ..._ .... � Application Approved By .... ... ._....... .. ..... . . .... .. ................ Application Disapproved for the following reaso __--- ------------------------------------------------ -> ----------- ..- -------------------------- .... .. ...ate .............. Date Permit No. :....- '� - .. Issued -------- -0 � No.. ........��/.�. FEs........ ( .... THE COMMONWEALTH OF MASSACHUSETTS' BOARD OF HEALTH ----. - c of . ......... .............. Applirativit for Ditipwial Workii Towitrnrtion Putu t Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ........................--......................................--................................ Location-Address or Lot No. ......................_.......................................................................... -••-•"--•----------•--...---..............-•--------•----•••---•••............................._.. Owner Address Installer Address ' � Type of Building Size Lot__ _..�,<. ...__._.._4 ..... feet ., Dwelling—No. of-Bedrooms.----- ------------------------------Expansion Attic ( ) Garbage Grinder WO WOther—.Type of Building ....................... ..... No. of persons........................ Showers ( ) — Cafeteria ( ) `Other fixtures --------- �' W Design Flow..........._ i .;` wl,_. lions per person e� ,d �� Total W ----_° :._... on R: Septic Tank—,} u.d capacity �_(�; ions Le�gth✓ _'°�`G _ Width :,`Diameter.-. .. ._.-_-_ Depth_ ' W Disposal O ---•_:-_-- Width,.-/_.0......... Total Length...---- y;;�Total leaching area -�-- sq. ft. 3 Seepage Pit No....................."Diameter-------------- Depth below inlet_.._�:+�...:._ . Total leaching areal: v...sq. ft. Z Other Distribution box ( . ) Dosing tank ( ) a Percolation Test Result Performed bY...---------------------------------- "--------------------------- Date................... --- ' Test Pit No. I..... '"_---minutes per inch Depth of Test Pit ......____.. Depth to ground water I' e G4,'rt Test Pit No. 2.....r..L minutes per inch epth of((kk st it , a t epth to ground water ; - Descri Description of.Soil- .--7,4c � �d" s �;� . '_............................................ h -- -----•-•-•...............•-.•--'- fa-� a 4 .w' of5 y, ,......_.___ _.... ._•____'___..'_____"` _'___�.ea .......................XL y3 _%__:/-S✓°_'�.-___.'_.__"' ____•__""'.............'....._.........__._._'.. U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ----------------------------•------------------------------•------------------------•--------------•----•------------------------------------------•------------------------------------.._.........---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 71 the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed J q ....... ............/-//�/f/A.�.y .......---^---..--.------.---.--------(('1..... A lication Approved B � % ./� -. s..o..lir..,..-_ �, V- - ,_. ., Application Disapproved for the following reaso --------------------------------------------- -------.-......---------------------.------ -------------------- ---------------- -------- �. .... .----- ---------------------------------- ----------- .-- ....... " e Permit No. ----- = g .. Issued .......... - - � Dace THE COMMONWEALTH OF MASSACHUSETTS00 - BOARD OF 'EA TH P4 311k ---- --- ............--------------------------- OF Ertifirate of crap inure I / THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed O or Repaired n......- ------------------------- ------- - � Installer at ............ � ( .......����J........_r�h ��✓�--4 C F ... . ...... .. . ..................... ............. has been installed in accordance with the provisions of TITLE 5fb,fX Skate nvironmental Code as described in the application for Disposal Works Construction Permit No. ..... .:...--..... ----------.- dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B CONSTRU D AS A GUARANTEE THAT THE y SYSTEM WILL FUNCTION SATISFACTORY. D --.. <........�....` __-------- ..9 . e � """"""""""""" Ins ecto THE COMMONWEALTH OF MASSACHUSETTS AR OF SEA TH �.• v v ... ...0 F. � ................................. No... .. . .......���...� FEE.. ......0.. �tntt1 n TP-litnrtilan rrntit �, --Permission i hereb anted---------l -•".....� il°,f-/ to Construct or�Ijtepait ( ) an�Iddual S ge D spl�yst - f � Street � as shown on the application for Disposal Works Construction Permit No. . _...._ __ ated.......................................... ...--••-----------------•--•-•----•-----.. ............................................................ Board of Health DATE............................................................................... Form 1255 H&W HOBBS&WARREN TM Publishers �. ZG � � +� y a � _, ".� -� � \ t,�+ � '�� �� i .ter' �- H'1 � .l i`.Aj- TE`T PIT Oti TA GENERAL NOTES "� ' T.P. -i T.P. -2 1i 71 i J. THIS PLAN IS FOR THE DESIGN AND INVERT ELEVA TIONS.' CONSTRUCTION OF THE SEWAGE DISPOSAL �"_L �i•d y-7 LAND. ELEV. _- Opu%lD. ELEV. FACILITY OX K INVERT AT BUILDING 1.O G. W. ELEV. O.W. ELEV. ALL CONSTRUCTION METE/DOS At AND INVERT IN AT SEPTIC TANK 12 L -c r>>' y� 2. A �o4,a0�L MAINTENANCE FOR THE SEPTIC SYSTEM SHALL INVERT OUT A T SEPTIC TANK I O.Sit ��`' ACCESS COVERS RUST t�'E W1111IN 12' OF FINISH GRADE. ' CONFORM TO MASS. D.E. 0.E. TI TL E 5 AND L OCAL — ?7�- a u 7 L �_—_y l:/,�`—""�-- �� ,��.�:. :.: U 1 .�'. .��`t' INCJrCA TES 'r��� BOARD OF HEAL TH REGULA TIONS. INVERT IN AT DIST. BOX q Q 1_ -- t , �. 4.-j .•a-+1 PERC. TEST - --- �' INVERT OUT A T DIST. BOX - T ` H 3. ALL SEPTIC SYSTEM COMPONENTS SUBJECT TO ��-- , ,� _ c� VEHICLE LOADING (I.E. UNDER DRIVEWAYS, ETC.) INVERT IN AT j { j - MIN. 2' OF r.. , .p SHALL BE DESIGNED TO WITHSTAND H-20 LOADING. 1_. `—` �•f _;., 1/B'-1/2' DIA. CD BOTTOM OFt',� 1�G r2Y , � 4 MIN. _ `'- WASHED STONE INDICATES , -�5 4. ALL SEWER PIPE SHALL BE SCHEDULE 40 OR OBSERVED GROUNDWATER �• y o DEPT 10-b I , y OBSERVED APPROVED EQUAL. rJo L ► �RaUND,✓A TEA ADJUSTED GROUNOWA TER Z � �`� '!� DI T. 3/4 -1 1/2 DIA. p• i 5 0 0 GAL 8�T 1' W p WASHED STONE - , _ ,, , 5. BEFORE STARTING CONSTRUCTION CAL L DIG SAFE ' u N p� ,,�•� �,Z, .� , ; ,_ + 7 '1�� L 0 1-800-322-4844 FOR LOCATION OF SEPTIC TANK �� 9 5 INDICr, Tt J --,_ __- UNDERGROUND UTIL I TIES. Ste-d f� _�``��``' c' / `' ' 1 r-- 10 TES r PIT ct .O.0C7 6. DA TUM IS N G V77 7. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE �� _ (�! 10 WITH DEED RESTRICTIONS OR ZONING REGULATIONS. -•----- - --_____ _____ _ IT SHALL REMAIN rHE 0I✓NER'S RESPONSIBILITY TO OBTAIN ALL REOUIRED PERMITS, SPECIAL PERMITS, DA TE.• -- VARIANCES, ETC. FOR THIS PROJECT. BRIDGE STRL�EI 6 A Z�C-�'S•' TEST dY. Ck-I '.'v � �~-• + ?�..� w�'" ��', B. IT SHALL REMAIN THE OWNER'S RESPONSIBILITY TO HAVE THE PROPOSED DWELLING FOUNDA TION WITAESS E'D fI Y.• 6 A4 y DESIGNED TO ACCOUNr FOR THE EXISTING GRADE R -,2t?3. •T? AND SOIL CONDI TIONS A T THE LOCA TION OF THE _---___-0 93 __ _ I PROPOSED DWELLING. ---= -- - -- _- L ECZ-ND 9 ,CD ! 5 1.00A`fFAD �,U A P G gj�>VA)bW.G '��o••�'EGT1©,� ov�Rt,�4v n�5� � T' o ---- -- _--. _50----- _ EXISTING CONTOUR ; r, U0� PFIOPOSEO CONTOUR j P�20POSP t? POOL -ro )3g D� r,. '0'JL PK � t _._. _ DESIGN FLOW BED 0 r '` 1 C`J-0�= PROPOSED SPOT GRAOE °' BEDROOM Diy'cL L I iVG d 110 G, 1_/D,ti'Y PER BEDROOM p; DIRECTION OF STORAIWA TER cOUAL5 a_ _ GALS. Y PER ODA`Y. - ,rV RUNOFF 7 4 W SEPTIC TANK REOUIRED. GPV X 150,3' C"yG GAL. L UCL�S RAP TA/✓K PROVID,,�.7 _ �' `c:�<".;:� GAL. .SCA!F 1 = 208.'7' + SIZE OF LEACHING FACILITY REOUIRED c7 r rv, ....J.• rl dlCJl L MPGNa . RN!E /Iiilrc ., 44,Qu ,d' �; Litt GALLONS PER DAY SIZE OF L E ACHING FACILITY PROVIDED.' Landm b �yslt, -G .�.1 LL t : ;✓ITS✓ -- ' STONE � irl ,rs SIDEWALL 5'.r-. X •�.. - .. GPD + , . pon SOTTO,+� �=�o.C�, S.r. ,1 d .C� _ , 0 GPD �A t we r f(� t ..o t , ; ROGER I� �• �'- f j ll : `� �r T TO .S.F. Er GPD G\lr1 v „ 7h ]iRA�ND ISLI,ND w �0°9CIk ify°f" G1r��b J o l /iVQ �� .�� BREAKOUT CrILCULArIONS: + /,'r (�•�� E. 1111 �+ �• a �ItiB'9f.. � � L t A t` . C, I JLOPL / it 1~JV ' = 9•.Y a'ti �p Tidal 11500 G`1t-\L p \ �r pall t L/ ., 1 ii SEA VIf `U. •n � 1 �l�C. Y Ia�.i Cll Ve/. Ii'r r { I•'• deck __ p• i) ♦.- —�- E3 e a h �*:. ` c � i r".�. GA TC AL ENGINEER PROFESSION �`'��` XJT VIL A DA TE 7X1 POO PAUL 4-7. R. o RYLL y x N0.32448 a PLAN SHOWING THE DESIGN OF A PROPOSED SUBSURFACE SEPTIC DISPOSAL SYSTEM , n LOT 7, BRIDGE STREET, BAPNST L s�A FEBRUARY 28, 1995 SCALE 1 = '30 , "ROFESSIG��.AL LAND SUR✓EYOR LOT 7 t-. S.F. EAGLE SURVEYING �' E�^aGINE'=RIND, 45929� `� 441 ROUTE -130, SAIVUV..1 CH,, A A DATE 9X�---9-- 123. 61 -- 9X4 PROJECT NUMBER 95-01 llflt::.YMii.WIIWM'i1.MM141`.WYIWfY,+.A>IWNti4..'a. ..:.d.u.A...;. WPuw:::V9Lh:iRibiaMwY+.W aWMMYII YIiIW.niYMI1gYllle.Mr..u::.,..,..w.r-ne..,,.+.wn.WWsu-YW1ru-..:.,.-........ ..:VYr..wY/8w.a.urrAMwri.YuiisiWW'.M.+u..:1..+....awauYw.MiiW�O .