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HomeMy WebLinkAbout0312 BRIDGE STREET - Health 312 BRIDGE STREET, OSTERVILLE _ - A= 093 019 1 o :t �1 o a �� o Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ww 312 Bridge Street (REAR SYSTEM ONLY) ,.` Property Address John C. & Mary S. Mechem Owner Owner's Name information is Osterville MA 02655 9-10-08 required for -- —— every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. I eortaf t: out A. General Information forms on the JOHN L. computer,use 1. Inspector: 8 CHU,RRCHILL only the tab key to move your John L. Churchill, Jr., P.E. Nciff41807i cursor-do not use the return Name of Inspector key. JC Engineering, Inc. Company Name VQ2854 Cranberry Highway _ company Address p Y East Wareham MA _ 02538 _ reran CitylTown State Zip Code — 508-273-0377 41807 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000), The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs urther Evaluation by�he Loca1 oving Authority 10-01-08 J[nspr'sgnature Date inspectors submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Official Inspection Form(olde cape builders).doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 312 Bridge Street (REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owners Name information is required for Osterville MA 02655 9-10-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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 Title 5 Official Inspection Form(olde cape builders).doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 312 Bridge Street(REAR SYSTEM ONLY) Property Address John C & Mary S. Mechem Owner Owner's Name information is Osterville MA 02655, 9-10-08 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ® distribution box is leveled or replaced ND Explain: Structural integrity of the distribution box was compromised and shall replaced. However, the pipe in and out of the distribution box appeared to be intact and in proper working condition (i.e, static liquid level was not above the invert out of the distribution box). ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. Title 5 Official Inspection Form(olde cape builders).doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 312 Bridge Street(REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem _ Owner Owner's Name information is Osterville MA 02655 9-10-08 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: "*This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/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. Title 5 Official Inspection Form(olde cape builders).doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 312 Bridge Street(REAR SYSTEM ONLY) Property Address John C. & Mary S Mechem Owner Owner's Name information is Osterville MA 02655 9-10-08 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. I ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, . provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that'one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ the system is within 200 feet of a tributary to a surface drinking water supply El E] Area system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IW PA)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 "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 MR 15.304. The system owner should contact the appropriate regional office of the Department. Title 5 Official Inspection Form(olde cape builders).doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w., 312 Bridge Street (REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owner's Name information is required for Osterville MA 02655 9-10-08 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] Title 5 Official Inspection Form(olde cape builders).doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 312 Bridge Street (REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owner's Name — information is required for Osterville MA 02655 9-10-08 every page. City/Town State Zip Code Date of Inspection _ D. System Information Residential Flow Conditions: y keen opt\ 5 ( OW FOi hse.) Number of bedrooms (design): 3(Re°� 5 5 Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): * see below Number of current residents: 2 Does residence have a garbage grinder? A ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): ***866 gpd Sump pump? ® Yes ❑ No Last date of occupancy: __ • Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title.5 system? ❑ Yes ❑ No Water meter readings, if available: — Last date of occupancy/use: bate Other(describe): 3 3305f4 fot moir system only A A ketom clmit'vedd Qec owciec x I10 = 550 3Q4 Hsf, ftow Title 5 Official Inspection Form(olde cape builders).doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page I of 15 oS4,3e, bnseA a,n \c15r 272- ye�Y5 (inc.lucle5 k►e F',M415 of l�►-y<ound Qook Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 312 Bridge Street (REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owner's Name information is required for Osteryille MA 02655 9-10-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Homeowner; routine pumping in 2004 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: T eofSystem: Yp ® 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: 1000 gallon tank, d-box and leacing field is approximately 18 to 20 years old. Were sewage odors detected when arriving at the site? ❑ Yes ® No Title 5 Official Inspection Form(olde cape builders).doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 312 Bridge Street (REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owner's Name information is required for Osteryille MA 02655 9-10-08 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 1 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): — ,Distance from private water supply well or suction line: N/A feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appeared tight; system vented thou h house vent; no evidence of leakage. Septic Tank (locate on site plan): Depth below grade: 0.5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ® No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 1,000 gallons — Sludge depth: 2 inches Distance from top of sludge to bottom of outlet tee or baffle 34 inches Scum thickness 1 inch Distance from top of scum to top of outlet tee or baffle 7 inches Distance from bottom of scum to bottom of outlet tee or baffle 13 inches _ How were dimensions determined? Field measured I - Title 5 Official Inspection Form(olde cape builders).doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 312 Bridge Street(REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owner's Name information is Osteryille MA 02655 9-10-08 required for every page. CityFrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every two years. Tees appeared to be OK. Liquid level appeared to be at outlet invert._ Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: -- Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Title 5 Official Inspection Form(olde cape builders).doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 312 Bridge Street (REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owner's Name information is required for Osterville MA 02655 9-10-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 inches 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.): Structural integrity of the distribution box was compromised and shall replaced. However, the pipe in and out of the distribution box appeared to be intact and in proper working condition (i.e. static liquid level was not above the invert out of the distribution box). Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Title 5 Official Inspection Form(olde cape builders).doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 312 Bridge Street(IREAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owner's Name — --- information is required for Osterville MA 02655 9-10-08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) locate on site Ian excavation not( required): P If SAS not located,explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: - ❑ leaching trenches number, length: ® leachingfields 1, 15-ft x 30-ft 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.): No evidence of failure present at time of inspection; calculated system capacity=450 gpd (per 1978 Title V)and calculated system capacity=333 (per 1995 Title V) Title 5 Official Inspection Form(olde cape builders).doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 312 Bridge Street (REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem Owner Owner's Name information is required for Osterville MA 02655 9-10-08 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth-top of liquid to inlet invert Depth of solids layer - Depth of scum layer — - Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions — Depth of solids Comments (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.): Title 5 Official Inspection Form(olde cape builders).doc-08/06 Title 5 Official Inspection Form;Subsurface Sewage Disposal System-Page.13 of 15 Commonwealth of Massachusetts _ Title 5 Official Inspection Form A - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 312 Bridge Street REAR SYSTEM ONLY Property Address John_C. & Mary S. Mechem__ Owner Owner's Name information is required for Osterville MA 02655 9-10-08 — — ---- every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. e� �y kor 5y SkLQYI ^y+ 0— BOX He -2 (3) y21:7 t 15. 8 ` h'C`/ DECK yC 2 J O,2.` k9, O , 1, SUN 3 3() (00 ROOM M LP CID J J/CP t Se I `S'fr eel C q. you f� Title 5 Official Inspection Form(olde cape builders).doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 312 Bridge Street (REAR SYSTEM ONLY) Property Address John C. & Mary S. Mechem: Owner Owner's Name information is required for Osterville MA 02655 9-10-08 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells 7 � Estimated depth to ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Conducted a Test Pit front of house during a period of a full moon high tide. Title 5 Official Inspection Form(olde cape builders).doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 TOWN OF BARNSTABLE LOCATION �2jl"lu SEWAGE t20D "-7 VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. -7 V/ SEPTIC TANK CAPACITY 00 12 a 110,01 Se -G LEACHING FACIL=: (type) " (2e) I G x S NO,OF BEDROOMS ' BUILDER OR OWNER PERMITDATE:/L0— (Y —DE C MPLIANCE 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 FFz®N'P, 8F_T i-fUuS E �4CI H U , 9 -276°' 13 -39' C-37' y - q2,I 56®3 --33•5` 6 -7o.q` TOWN OF BARNSTABLE J OCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT 0J3-019 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITX lBC/ X�y�t7Y f LEACHING FACILITY: (type) (size) NO. OF BEDROOMS F' BUILDER OR OWNER /3,Qic 1`l1 i�Gt > l PERMITDATE: COMPLIANCE DATE: t P r J �A Separation Distance Between the: " ' 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) Feet yam, Edge of Wetland and Leaching Facility(If any w.etlapds exist within 300 feet f leaching f ih Feet � =Furnished by — �_'F X ^' � � �� `� 3 �' i j � � 1 �' �' :� � `�, � '• � � 1�'1 /eglf��% ' p � ,.. �}'' / �� A, .. 's +'�- .. .f �i�" � �� - �Ma a �. s No. 200f, y U 7 Fee ISOr THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21ppfication for �Bizpooal *pztem Cott.5truction Vertu Application for a Permit to Construct Repair( ) Upgrade Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. •/_ .� } Owner's me,Address,and Tel.No. 3;2�r 1 a q� s+ (fL.Y 4 ajd ��pa�u2 Assessor's Map/Parcel 3 — 50'r'8,33• gf(R`1 S6F •a73 37' Installer's Name,Address,and Tel.N Designer's Name,Address and Tel.No. K-'• 3ev 1 laC�-C-b n �u� ® n JC fir, i�� Po 0 (v2 ores U 4 2$SyCgr-a46L_r Type of Building: ke,Sr CQ nCQ_ s 3 Dwelling No.of Bedrooms Lot Size 1 510 sq. ft.t.Garbage Grinderf q ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided / ©• gpd Plan Date U U ' � ° Number of sheets Revision Date Title Pro P a fC_ ito Size of Septic Tank S$ O 0 gajldl,) Type of S.A.S. ' X i 1 e Description of Soil IS`X 30' CSC TIC( Nature of Repairs or Alterations(Answer when applicable) Se-'e P-Ae-n Date last inspected: Agreement: The undersigned agrees to ensure the construction, of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the,Envir ental Code an of to place the system in operation until a Certificate of Compliance has been issued by this Board of He . Signed Date / 6 — 6 0 Application Approved by Date 05 — 0& Application Disapproved by: Date for the following reasons Permit No. Z p 0,5- --T D1 to Issued G Ofj 2 dD S —————— ————————————— ——— —-- - - No. .2 �7 U 1 J, � Fee �S I ' ,;THE COMMONWEALTH OF MASSACHUSETTS Entered incomputer: PUBLIC,HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Tippliption for Mtgonl *p.5tem Co t�0truction Permit ' Application for a�Permit to.Construct) Repair(. ) Upgrade j<) Abandon O ❑ Complete'Syste m El Individual Components Location Address or Lot No. I Owner1C 's Npme,Addr-..ss and Tel.,,No. ' 312 0 Assessor's Map/Parcel 3 .r so�' �33 Installer's Name,Address,and Tel.N i Designer's Name,Address and Tel.No. K • Bev I la C�.u-� -o �U Ogq fi 0 h 1G �nq1 oP-er, ('O 30 (028 f-orf5+ C_b_ HA v260 2,sS4Cr:a/1&rr �Iv �a.t_&Ov , A Type of Building: 126 Si&nu� OzS-a Dwelling No.of Bedrooms ? S Lot SizeV/ sq.ft.: Garbage Grinder j Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures —7 Design Flow(min.required) J� SG gpd Design flow provided o / gpd Plan Date 0 ' V Number of sheets Revision Date Title Pt-0 0 fc j LB194t Fyn Size of Septic Tank _�S 4 d 9a./4ol-) Type of S.A.S. _.--vj ' X e(,,C (e_(d an Description of Soil f, P 10—Vl\ P_AM+i+ Is'x 30' IeaCh field +o rc nK Nature of Repairs or,ltgrations(Answer when applicable) /ter` � � -,•.,...,,.,� �_� Date l sVi spected: Agreement: G ThCundersigned agrees to ensure the construction and4i5aintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envi me tal Code an_d not to place the system in operation until a Certificate of Compliance has been issued by this Board/of Health Signed k !/�J" ` -- Date Application Approved by Date Application Disapproved by: Date «.• A for the following reasons Permit No. 2 Q 05 ' 47,C) "Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS '. Certificate of Compliance f THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( {/) Upgraded ( ) Abandoned( )by \A S � at � ,,,+L Cz has been constructed in accordance 4: with the provisions of Title 5 and the for Disposal System Construction Permit No.2 oo ft,— y 0 1 dated Installer 1"� '�/ G G�V+�. G+.� S't , Designer .C . N C,;i tt e 2 NG, #bedrooms S C 3 Jt Z ) ` Approved design flow a K61 "-(K tA ,gpd ` j� The issuan e of fis(vermit shall9not be construed as jag ar to that the system Il fun ton as dest;One• o c if Date � • sector No. 2OU��. ' GI on ----------- . ———— Fee /SSG "'• THE COMMONWEALTH OF MASSACHUSETTS 4. PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Migonl 6p5tem Construction Permit Permission is hereby granted to Construct ) Repair (V ) Upgrade ( ) Abandon ( ) '} System located at 3 1 ,�1Z S 1 (j ST }'t.�/ ( l. 1. �Z and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty ` to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this Date /U / G Approved by own of i5arnstame Regulatory Services i enr 4 'Thomas F.Geller,Director ' 5 W94 Public Health Division �6 . � Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer_& DesigneS,(Certiilleating prsn Date., I© -25-06 Desi&per. �:5 � „�e r�v� , ' WIC Installer.• I? V,.1 ��ULTia o Address: JS5� (-r&AVl erne Jlwy Address: .� E. ivo�c ,a�n HA o z 38 ® re 5 N p26�y on - 0 a $ ! 90 —4eft issued a permit to install a (date) (install septic system at c r d e_ V ee-t _ based on a design drawn,by (�cidress) C rtJ;�lee.rdvl � �:n dated Oc~ cbOU l�too S r . - ^ ,.._��.• I certify that the septic system referenced above was installed,substantially according to the desi�, which may include minor approved changes such as lateral relocation of thy, distribution box and/or septic tank. I certify that th s ptic system referenced above was installed with major changes (i.e. greater than t teral relocation of the SAS or any vertical relocation of any component of the sep4 system) but in accordance with State & Local Regulations, Plan revision o certified -built by designer to follow. r __.. 1rikaller's Signature:) �ti tir�7 (Devi er's i e) (Affi esigner' amp raj IFTT TO U I IFI ATE OF COMPLIANCE MILLNOT BE BUILT1mv'I' �THANK XQU. VISY = C2 HealtivSsptic/Dasigner Cortiflcatian Worm L920 £LZ 809 8N Y Z:133N Y DN38t Wd £0= To 800Z-bZ-130 J LAL f I s CC C-fm- DD�.auB A�'cax HOY. .LOG Note$ �t� sort xa�a+ Qa� ` `8�d1[oaor eou• •. .: OlAer ,Ia►�dO. t,�ltitn� �auoe Man • ��I y 4 � �5 "'✓�it ��� "� . . -. °' ' 1-5 10 i r 51(, _ r bly c-i n 'sa",d - H ma. 5oaw1 .2. 5`S��Y bikk OSRRUMON 1I0I LOG 'Sgs 2 _ (��a Oil NnBaon �iA soft t {aaaoame,Stem 6a . L5 5Yr-I( -- i sly 72-12o C-2 fied. 5a►d - 2. 5Y -7/Y DLICP O&WRVATION KOLE LOG Bob# Gail rmhms UU T"t n "COIN SO � Mold," mum%Sow Bodsm mama _mod,._. r DMWOBMVATZON H=LOG Dote#.�,� eats z+um can dots spu ot�• AbovebODpu*wb&W&ry 1V0 z yes_ r ' WiMeSm�rbaeyeq► No °� ,YQ,:rs, 1P1106 n yeir41nw l�o�. va Dwwi at lent Awr so of netmlly Omni aE parviotu matrd+l eK6t in all erne ciw Yed thraosbout dae • . iaret�rapoGsd oar i6e aoR a6wcptibtt syatean� �„�,,,�,�, It net,vfitt fe tba daptb et A�ptratl oac ,! pavbua tatia�idf 1 -10 Z7�(duo}I btve paand flee BOB WWwtar=99110011 Approved by the De�bneat ot8tn►Iroatswtlai AQtectioa wd that fbe above wtyelr we peKm�by tts ooealeaot with , CD 00 .' the traln� eltpocl#�c deror�tcd 111�l0 C,1d�t l5.017, r • 9i�eotra � n>mr /�e-of-d �- •. i ''d0 A» ^BHRNS`f'NBLE'SOPM OF HEALTH` . W. TOM of Bx=teble p* Depnra in at at 9ftwabq swimqljg t f Public MWth Dfiion Daea 'oo sls�sut s¢lstR tutA alms Dalt ScWt ded C1.. i'R ,n ..� Ttme. �.' Flee N J Soil Sultabilty Assessment far Slcwage D i posarl t armed : yi&OeA elLv nw e-zz C SC yrt .d .jinn a ut s roajia � S . I,t')CAT'IM&GE AL IIVFoRmnON Leeaaan Addms t de�e�k . (?fie rC v i I l'� tawaePaNagns 5:Y.4 r� Aed P.a.&oy 3So, Gz,+ekw k I k, Av wWsMep?P m k g3�Iq �Ineet�asVaata3ohrll. . �htitrz�.�,�U�R-�•� rrewaot rrtuc>7orl UPitIlt lad tlss- Stn�e ^ �exc�er►h�l ,I�,C1aD I- 3 ..»..� �ntlws ok"W fam orawlde SWY 71 b.0 —.t i t9blrWs&Assn >16b n IDdaldRwakar�IFsll,_.,...,„It >!lati��T 7.f�� 1t R+tpenylrN• 7f o sr Opus! g .. ►4I�iTCY�!Me OM&distpulmu ahat cad laddwv of M kdm&pe:s w&tea ft wenu*4 FwM1,r aaw#* See fkCjj oV uros�n 7 Parenl t�ateelat Veala�be) oepxh to 1lat5aek Csalhtt�4man4waMor. 9lssdiealYawbNaln ' wwpdy*am t&iko wadmaW lla ,WAI Er'hbtieasedwa DETERM NATION FOR OASO14AL HIGH WATER TAB MtedsodtSgL, OcreGl pbs�;uu-ltoy� � otttinM9 elaa<w#r aba.hale �� .� la, Dapib tosldi aas�hlt., "— k+► ludelt wall rd Ytapsy kbe olds d�a.Lde: — bb GwAio a A4swat�._ RoMdti�Otdlt lodm►1�St)Ip4el,.,.�..+�... A4,WW M(kQwalllWatdP M. PERCOLATION TFSTBob Time a to • Onagra�on :� � , . >bpq►at>!+ens '�•'^Y� ... � � h'Im>s ac tY' ,.,�..,_ .�_..�,_., ecia or�*oe�tva:s 3;oo T....• 1Yma�"•� :�.,...... �.=...,. . >tna s>Msasai� �•'�° Aaa t+1is,lloat. ` z _ s!'ift>grtq>ailyly�nnme Mtltissea � s>tt�tlod:�,..� Ad�o!'rise6y�r►1sa:Ndr,►M..�N otlatuaa'1 MID MW&Wvlalas t�baarw>tiast Bole Lafyt 1"0 8e Cburpleted oa P�ae --�—-•-- **#If j+trcotauott tW It l o b.conduebd wf"1W st wabody you m=t f of no*the.' Barnof able,CwAsssi v>adon Dtvlsnn,at bad one.(1)wak psl a to bs>Bltaatnp. ► • Q:13�PtiKU'BRt ,D�DC ... _' .. . .. .> . w p -. , j:,5lnes skancl�n' w�1v duec�j es�od d� a Fill .,, �,�. . iS .. lode. *�. Q DATE:V2,4./9"8 ' PROPERTY ADDRESS: -,312 -Bridge Street Osterville,Mass. _ W JUL 0 7 1998 0 2 6 5 5 TOWN OF BARNsTABLE \ HEATLH OEPT. v On the above date I Ins 4 1'p�ected the septic system at the above d a• .dres.s This system consists of the following: 1 . 1 -1000 gallon septic tank. 5 . 1 -precast leaching pit.. 2.• 1 -Distribution box. 6 . 1 -3 'x20 ' leaching trench. 3 . 1 -15°'x30 ' leaching trench. 4 . 2-block cesspools. eased bn my In8rwction, I certify the following conditions: 5 . The system in the rear is a title five septic .system, l 78 Code ) The two .systems in the front are not title five septic systems. They are sewage systems. The cesspools are at least40 years old. They have been added too. The pit is 10-12 years old and the leac hing. trench is .;around the same era. All the systems are in proper working order at the present time. 5IGNATURY7,: Name: J. P.Macomber Jr•, i -------,--------------- Company:_`.P_Macomber & Son- 'Inc Address:_- e-x-66-----=3------- Cente_rvi1l,eLNA_ s__0.2.632 ` Phone:__-50.&_.77.5...3338—____-- i THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPN P. MACOMBER & SON, INC. Tanks-CsuP0 Leachf'aids Pumped Ik Installed Town Sewer Connections P.O. Box 66' Centerville, MA 02632-0066 77-5-3338 775-6412 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 6I7.292.5500 WILLIAM F.WELD TRUDY CC Governor Sccrc ARGEO PAUL CELLUCCI DAVID B.STRL Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissic PART A CERTIFICATION Property Address:31 2 Bridge Street Osterville Address of Owner: Date of Inspection:6/2 4/9 8 Mass. (If different) Name of Inspector:Joseph P.Macomber Jr. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: fJ.P.Macomber & Son INC. Mailing Address: BOX 66 Centerville,Mass, 02632 Telephone Number: 50A-725_3338 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurat and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ,Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails AY Inspector's Signature: 17 j Date: ` The System Inspect shall submit a copy of this in r port to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submi the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system own and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, Or D: AI SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.30: Any failure criteria not evaluated are indicated below. COMMENTS: BI SYSTEM CONDITIONALLY PASSES: NI) One or more system components as described in the `Conditional Pass' section need to be replaced or repaired. The system, up completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined', explain why not. Nl/ The septic tank is metal, unless the owner.or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tar failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Fey• 1 09 10 DEP on the World Wide Web: http:/rwww.magnel.state.ma.us/dep Printed on ReryGed Paper . U SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 312 Bridge Street Ostervill.e,Mass. Owner: Bank Boston Attn: Susan Bykawski Date of Inspection: 6/2 4/9 8 B) SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced. The system required pumping more than (our times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: �12 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is (ailing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS.UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM 15 NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. r 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: jo The system has a septic tank and soil absorption system (IQ and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance _(approximation not valid). 3) OTHER (revised 04/3s/97) Day• 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 312 Bridge Street Osterville,Mass. Owner: Bank Boston Attn; Susan Bykawski Date of Inspection: 6/2 4/9 8 D) SYSTEM FAILS: You must indicate eiv.er "Yes" or"No" as to each of the following: _D I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ;W ,/ Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: _ . The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area • IWPA) or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) P&y• 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 31 2 Bridge Stree Osterville,Mass. Owner: Bank Boston Attn: Susan Bykawski Date of Inspection: 6/2 4/9 8 Check if the following have been done: You must indicate either "Yes" or"No" as to each of the following: Yes No , Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ZAs built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. X1 The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components,excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. —The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) 115.302(3)(b)J (revised 04/25/97) Page 4 of 10 l ' SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 312 Bridge Street Osterville,Mass. Owner: Bank Boston Attn; Susan Bykawski ; Date of Inspection-6/2 4/9 8 BUILDING SEWER: (Locate on site plan) �� Jf Depth below grade:R=1o2�� /8 !? Material of construction: VIcast iron ZQ PVC_other (explain) r!4,V ` Distance fromsrivate water fupffy7well or suction line M't Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) Joints appear tight. No . signs of leakage.- Systems hrough t e house vents SEPTIC TANK:-Let") 'p4�4'v %;4� (locate on site plan) er Depth below grade: (4 Material of construction: Zoncrete metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list a�ge�kA Is age confirmed by Certificate of Compliances&(Yes/No) Dimensions: Sludge depth: !" Distance from top sludge to bottom of outlet tee or baffle:, Scum thickness: Distance from top of scum to top of outlet tee or baffle:zzta. Distance from bottom of scum to bottoymi�f outlet tee r baffler How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Pump tank annually GarhagP d i s=nga 1 i g present inlet & outlet tees are in place T.jauid 1Pvp1 at the ou 1pt 1pypl is 51 innhpq Thp ink is Structurally=sound and, shows aQ signs Q--f leakage. GREASE TRAP:dj1k1e- (locate•on site plan) Depth below grader Material of construction: 14concrete4Ametal4i4Fi berg]assR44 Polyethyleneolaother(explain) AA Dimensions: 14 Scum thickness: .[/ Distance from top of scum to top of outlet tee or baffler_ Distance from bottom of scum to bottom of outlet tee or baffle:�i¢ Date of last pumping: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,-etc.) Grease trap is not present (revised 04/25/97) pigs 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 312 Bridge Street Osterville,Mass. Owner: Bank Boston Attn: Susan Bykawski Date of Inspection:6/2 4/9 8 TIGHT OR HOLDING TAN K:rfW-10,(Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade: AIR Material of construction:4&concrete4metal dAl`iberglasskA Polyethylene,V/,other(explain) A ,vA Dimensions: AA Capacity: AsA gallons Design flow: gallons/day Alarm level: U A Alarm in working order,VA Yes;V4 No Date of previous pumping: A)A Comments: (condition of inlet tee, condition of alarm and float switches, etc.) Tight or holding tanks arp not trPGPnt DISTRIBUTION BOX:-/ (locate on site plan) Depth of liquid level above outlet inven:_ _ Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or\out of box, etc.) Box has one iateral . no evidence of solids carry over; No evidence of leakage into or out of the box_ PUMP CHAMBER: (locate on site plan) Pumps in working order: (Yes or No). �A Alarms in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) Pump chamber is not present. (revised 04/25/97) a496 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 312 Bridge Street Osterville,Mass . Owner: Bank Boston Attn: Susan Bykawski Date of Inspection: 6/24/9 8 SOIL ABSORPTION SYSTEM (SAS):, (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:leaching chambers, number: 6 leaching galleries, number: leaching trenches, number,length: leaching fields, number, dim sions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Loam sand to sand ;fine f pop ing. A vegetation ' no mal CESSPOOLS: (locate on site plan) Number and configuration: Depth-top of liquid to inlet inyert j 611 Depth of solids layer: 66 Depth of scum layer: 3 Dimensions of cesspools i Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Inflow cesspool on hP 1 Pft-sq; ap of hr,LL-e Uza_s pump®d. No slant water l ntrllc, nn r,AG�t, l�^tg �gs•i�e—is dry. No signs of water intrusion. Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Loamy sand to fine sand. No signs of hydraulic ailurP or ponding.. All vegetation is normal. PRIVY: (locate on site plan) Materials of construction:_ d//4 Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Privies are not nrPRPnt (revised 04/15/)7) Fay• 6 of 10 SUBSURFACE SE%'.'AGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propeny Address: 312 Bridge Street Osterville,Mass. Owner: Bank Boston Attn: Susan Bykawski Date of inspection: 6/2 4/9 8 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) ce jf? I ' c` S I D, D�`1 lei . 0- V li•v1••d Ot/IS/771 F•y• 9 o1 10 � dk SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propeny Address: Ohncr: Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 5y5��r 8a,ck v Tv,l1� lcbt) Gcv�er p,P�, Sy�i�rr1 s`t9}�I,s4d,c, 5�<,�-e..m t-Q•��—{,id,� I vbKi- Pvc, IP/i Down 1 Or �'t���5�sPL 1 'dcWrr O�ng� .d ,,n 7� �oJl Cc Do w Y) Cc1 I ge la�mkJ ti�e�t� Cover +o 5m ir— Y?c,Ed C�veX v� n _ -o w In rb Go � nN�-�r-) L-,Zx (o�Y-�o(,a. �.e. 3 x.-L4W4' Zia , ,, � (s•vl••d 0�/JS/f7) Y•y• 9 of 10 w SUBSURFACE SEWAGE DISP. i. SYSTEM INSPECTION FORM ) C SYSTEM INFOI. :ioN (continued) Property Address: 312 Bridge Street Osterville,Mass . Owner: Bank Boston Attn: Susan Bykawski Date of Inspection:6/2 4/9 8 Depth to Groundwater 0_ Feet Please indicate all the methods used to determine High Groundwater EJL a:ion: Obtained from Design Plans on record Oole. ervation of Site (Abuning property observation h ba�emenF sump etc.) Determine it from local conditions Check with local Board of health Check FEMA maps heck pumping records Check local excavators. installers Use USGS Data Describe in your own words how you established the High GroundrwerElevation. Must be completed) Used water contours map. Gahrety & Miller Model 1 2/1 6/94 Pumped cesspool. No signs of water intrusion. lrws�.0 Os/�S/97) Pic. 10�r 10 (,•�t5 T1.-R,•,•..:•r.-..,r-JfR•P„.,.-,..,i.....i.lf•,,,•T,.V.,.,,,Ttr.,A..i,E•.M1f.,,O�T.,CS A'{4 -PTIIii^411TV.TT'Tt!-.,.—,---:-..t,..-•R, 1 TOWN OF Barnstable BOARD OF HEALTH SUIISURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION�� "•TT',�T•'.•::i-T..I T. •�TT1Tif11'tf.ITTITiRT1fPtI1iT1'V.-{Ii UTT- Vr"CrT9iIIiCVif tRIfRTRt'fTti91TTT•TItT.•.•nrI'T'R•1•_J -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 312 Bridge Street Osterville,Mass. ASSESSORS MAP, BLOCK AND PARCEL # 0 / OWNER' s NAME Bank Boston Attn: Susan Bykawski PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber &rSon Inc:"" COMPANY ADDRESS Box 66 Centerville,Mass. 02632 Stre9t Town or City State LIP COMPANY TELEPHONE ( 508 ) 775 _ 3338 FAX ( 508 ) 790 _ 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that t)ie information reported is true , accurate , and complete as of the time of ,inspection . The inspection was performed and any recommendations regarding u pgrade', maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one: Syste6 PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or- the environment as defined in 310 CMR 15 . 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . • System FAILED* The inspection which I h.Ave �tcted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . e M Inspector Signatur. Date One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the 13OARD OF HEALTH. * If the inspection FAILED, the owner or"' ' erator shall u d within o'ne year of the date of the inspection, unless allowed ort required he m otherwise as provided in 3,10 CMR 16 . 305 , partd.doc --4 o»— �� V W Ul � Z7 ti . SSbkv THE COMMONWEALTH OF MA.SSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE S SYSTEM INSPECTOR as provided in 310 CMR 15 .340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. f GL )IInC x, t ))S Acting Dircctc>r of (lie L) Mutt ul Water Pollution Control - - - - --- _ ,,,...-_.�T _ PROVIDE PRECAST CONCRETE EXTENSION FINISH GRADE OVER D-BOX= 9.O'± " - N ERAL NOTES TOP OF FOUNDATION RISER WITH CONCRETE COVER TO WITHIN 3/4"FO 1-1/2 DOUBLE WASHED STONE TO CROWN OF PIPE FINISH GRADE OVER LEACHING FIELD= 8.8 9.4 ' 6"OF FINISH GRADE OVER INLET&OUTLET FINISH GRADE REMOVABLE COVER TO WITHIN " " " SLOPE @ 2% MIN. OVER SYSTEM �--ELEV.= 10.1 ± OVER TANK EL.= 9.6 ± 2 OF 1/8 TO 1/2 DOUBLE WASHED STONE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION 6"OF FINISH GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE @ FND. EL.= VARIES ' PROPOSED INSPECTION PORT VITH ACCESS BOX TO F.G. CODE AND ANY APPLICABLE LOCAL RULES. - --.- - -- - T- - - -- -- 5" DIA. OUTLET(S) (SEE NOTE 21) 20"MIN. ACCESS COVER 9"MIN. ! --- - - -- - 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 36"MAX. - -- - - (TYPICAL FOR 3) ---- } 4"SCHEDULE 40 PVCJIN. SLOPE 1% DESIGN ENGINEER. � PROP. 4"SCH. i " � I i 40 PVC PIPE PROPOSED 4" I 9°,MIN. 4"PVC PEF=ORATED PIPE TOP OF S.A.S. = 7.59' - 7,40' 9"MIN. 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PVC PIPE 36 MAX. END CAP 36"MAX. 6" 3" 2" DROP MIN. - - 1 SLOPE AT f50% SYSTEM UNLESS OTHERWISE NOTED. " " ° 3"DROP MAX. 3 9 ,o _ _ _ 6.90' 4. TO PREVENT BREAKOUT,THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN -8.15'* o PROVIDE WATERTIGHT -^ - ELEVATION =7.59' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. u' T 14" 7,jrj' JOINTS(TYP.) UNLESS A 40 MIL GEOMEMBRAINE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND _ 7.75' T 4" PVC IN FROM THE TOP OF THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. ._ SEPTIC TANK 4" PVC OUT TO o 0 0 0 ► o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 LEACHING FACILITY 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. XIST. SEWER Pl 't i i ` ' o ' 48"LIQUID LEVEL OUTLET TEE 12" 6" 001 6^ 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. - EFFECTIVE 16.0� " 7.3T MIN. 7.20' °° = 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK DEPTH 22 ZABEL FILTER 6" CRUSHED STONE , 7.09' ' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS MODEL#Al801-4x22 OVER MECHANICALLY BOTTOM C'TRENCH TO BE LEVEL EL. = 6•40 i " (GAS BAFFLE ON BOTTOM) COMPACTED BASE i NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH L 6 CRUSHED STONE 38• 4 4 4 AND DESIGN ENGINEER. OVER MECHANICALLY 5 OUTLET DISTRIBUTION BOX r COMPACTED BASE o o TO BE INSTALLED ON A LEVEL STABLE 12� 8. ELEVATIONS BASED ON 1929 N.G.V.D DATUM OF 10.45' ESTABLISHED ON A BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= 1 .37' NAIL SET IN UTILITY POLE#67/34 AS SHOWN ON PLAN. PIPES TO BE LAID LEVEL. { , 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION �- -- - PROPOSED 1500 GALLON CONCRETE SEPTIC TANK 5 MIN. *CONTRACTOR TO REPLUMB LENGTH 10'-6° WIDTH 5'-8" DEPTH 5' 8" i THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW i TYPCAL FIELD PROFILE FIELD END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES EXISTING SEWER PIPING IN _ - C- -r I TO THE DESIGN ENGINEER. DWELLING TO ACHIEVE THIS �F P T I C TANK P I�O F I L _ (DIMENSIONS PER WIGGIN ` 7 +B( N BOX DETAIL _L D DETAILS ELEVATION OR HIGHER. NOT TO SCALE PRECAST CORP., POCASETT, MA) NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE - - -- _._-+-- - ---.- -._ - --- -- ------ --- - - . . .- - - --- - - ---- -- - -- - -- -- _ - -- T STRUCTURES SHALL BE MADE WATERTIGHT. - - - _ - - NOT TO SCALE • • I I �� T N i 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING ENTIRE LOCUS PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS FOR TEST p' �' A REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM POPPONESSET BAY, THREE BAYS, RUSHY MARSH AND CENTERVILLE RIVER. i r �'" APPROPRIATE AUTHORITY. ' � LIVING ROOM INSPECTOR: Donna Morandi 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS BEDROOM CL. ;y.... - - -- µ- ,, ; LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE I! y EVALUATOR: John L. Chirchill, Jr., P.E. • •s* �' _ •''I • Se temba 18 2008 THEY SHALL WITHSTAND H-20 LOADING. r ,.,• // DATE: P BEDROOM t ( • ; ( . 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. NOTE: .. %r •• 1 • • TEST PIT#: 1 r OFFICE CL CL. 1.) MAGNETIC MARKING TAPE SHALL BE �, * • •.� ELEV TOP= 8.70* 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE �� PLACED ALONG THE TOP EDGE OF EACH .�. r i ti , �, t --. • Ar MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. O� BATH SEPTIC SYSTEM COMPONENT. • �' • Jf /¢� 1 ••,' : • # , ELEV WATER= 1.37'* REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, BEDROOM DINING ROOM ( FOYER • `� * ,I � ; • 0 -1 FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). LIVING ROOM � ` '►d • � PERC RATE _ <2 min./inch ,C, • 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN CL. BEDROOM �(�` .1 ,,��` �._..-: ; ;•: ondiA DEPTH OF PERC= 30"-48" 1 SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. 116. PROPOSED PROJECT IS LOCATED WITHIN: �WNE_ : TEXTURAL CLASS: 1 BATH , FOYER t CB/DH "` f LOCUS ASSESSOR'S MAP 93 PARCEL 19 \ / OF / �GYM `� a LIBRARY BATH J202- , Is. �' $ 0. 8 70' OWNER OF RECORD: JOHN C. & MARY S. MECHEM • BOG t Sandy Loam �,` � A 10 Yr 4/4 ADDRESS: P.O. BOX 350 •� 8 8.03 OSTERVILLE, MA 02655 GARAGE �� \ �' �S,S,' i' �i •,_..__ . E Loamy Sarxi FEMA FLOOD ZONE Al(EL. 11) (1 BEDROOM ABOVE) p. i ' " 5 Yr 5/1 , �� / * Q► �:.:: 14 7.53 COMMUNITY PANEL# 250001 0018 D i MAP 93 �,•/ - '.�� ► o tih \ / �".�� �;- Loamy Sand 17. DEED REFERENCE: PARCEL 17 =a Y BOOK 11603, PAGE 43 B 10 Yr 5/6 N/F HYNES / 30" 6 20, 18. PLAN REFERENCE: LOCUS PLAN F irk PLAN BOOK 96, PAGE 37 - _ - - - -- - +► 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. STK/TK SCALE: 1"= 1000' 4R" 4.7u' EXISTING CONDITIONS FLOOR PLAN ���/ Fine-Medium Sand { i 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY SCALE:N:T.S. A��P12(31CTNIA TE LOCATION OF E>CtS Ftl�tf3 t5 x`3t1 `' MAP 93 - FOR SEPTIC SYSTFU UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY LEACHING FIELD (TO REMAIN) PER BOARD OF / GROUNDWATER MONITORING DATA ^ FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. HEALTH AS-BUILT CARD. CALCULATED SYSTEM ,�h PARCEL 19 72 2.70 CAPACITY = 333±GPD (per 1995 Title V)AND 41,450 S.F.± - 121, A 4"PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A CAPACITY =450± GPD (per 1978 T!tie V) / - READING# 1 88" Water 1 3-/ DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A DEPTH OF WATER= W. Water @ 8A" REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. ELEV WATER= 1.20' Medium Sand DATE&TIME= 9-18-08 @ 2:31 P.M. C-2 2.5Y 7/4 ZONING DISTRICT: RF-1 29 ° ��.� O READING# 2 120" -1.30' FRONT YARD = 3O FEET Q Ir - DEPTH OF WATER= 8g^ *SEE GROUNDWATER MONTORING DATA SIDE YARD = 15 FEET MAP 93 EX{STINGR(MOVED AND REPLACED � O I ELEV WATER = 1.28' TEST I REAR YARD = 15 FEET PARCEL 18 PROPOSED 6'x 20' DECK �y j DATE= 9-18-08 @ 3:03 P.M. i E S T PIT DATA �'�` N N/F HYNES to MAP 93 - - PROPVSEVB.�'*x 10'ADDITICIN- I I READING# 3 IN � C `L3 Donna Niorandi +r PARCEL 21-003 INSPECTOR: (coo DEPTH OF WATER= 88" - - ^� - -- EXISTING CONTOUR o co N/F 3EKER EVALUATOR: John L. CFurchill, Jr., P.E. EXISTING CESSPOOL TO BE �. /' M ELEV WATER = 1.37' PUMPED AND FILLED WITH o`5 S' Z DATE= 9-18-08 @ 3:36 P.M. I DATE: Septemb:r 18, 2008 50 PROPOSED CONTOUR CLEAN COARSE SAND (TYP)- p`�' - - - o) ^ -XIS1 ING 1,0(-0 GALLON TEST PIT#: 2 - --W -- -- --- EXISTING WATERLINE 2B - DECK ' ' l SEPTIC TAB_!'' (TOREMAIN) READING# 4 " ELEV TOP= 8.80' EXISTING FENCELINE EXISTING LEACHING PIT TO 8E. S\ ,. � DEPTH OF WATER= gg � -X-X-X-X-X- PUMPED AND REMOVED IN r 1 �� ELEV WATER= 1.28' ELEV WATER= 1.4T ACCORDANCE WITH TITLE V .,( - =�' SUN �' TEST PIT LOCATION r DATE= 9-18-08 @ 4:01 P.M. PERC RATE _ ROOM i O PROPOSED 1,500 GALLON SEPTIC TANK *REMOVE AND REPLACE _� is/�j� - F.)-jST `Y .. i DEPTH OF PERC = _ UNSUITABLE MATERIAL TO p 72 I NOTE: 'C-1"SOIL WITH CLEAN Ol'�i�reFOR I DEPTH OF WATER MEASURED FROM TOP OF EXISTING GRADE TO TOP OF TEXTURAL CLASS: 1 PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE COARSE SAND I = �r 7�/41, Opp STANDING WATER IN TEST PIT#1 DURING THE PERIOD OF A FULL MOON HIGH TIDE. LSA ��` <�\ - --- -- -_ - -- -- - ----- -- -- - PROPOSED 4" PERFORATED SCH. 40 PVC PIPE 4/ '�'0 �" ems_ , - _ DESIGN DATA HC-1 "'� �� �(� �•Yf moo.-9 i 0" Sand Loan 8.80' 0 PROPOSED DISTRIBUTION BOX ,0 7. CB/D 29 CID TP 1 NUMBER OF BEDROOMS(per asbuilt card, assessors, &actual) 5 A 10 Yr 4A \ O, LSA NUMBER OF BEDROOMS(design) 3* (SEE BELOW) 8" 8.13' < a 8.7 ' E Loamy Said `,q ` I DESIGN FLOW 330 GAUDAY/BEDROOM HC-2 PROPOSED INSPECT►ON I't�R. `;�`,g " 5 Yr 5/1 , �n TOTAL DESIGN FLOW 330 GAUDAY 14 7.63 0 0 9' t /(CPS ) SLEEVE PRL USED 4' (6 PR(-)POG' r) 12'a 38, !.EACHING FIELD� 0, LSA � .EWER PIPE AS SHOWN ( DESIGN FLOW X 200 % = 660 GAUDAY Loamy Said 1) - TP 2 �{ USE PROPOSED 1500 GALLON SEPTIC TANK B 10 Yr 5/f O ' POP -OSED t,�'n GALLON SEi'TIC T,�Nr -' 8.80 U SONG 9t?' Wt_PING 8\ !` - PROI- E 30" 6.30, REV.. DATE BY APP'D. DESCRIPTION 5 "5. -:\ t 2� - IEND FOLLOWED BY A C/CTO F c_ __ ^ISTRIBt1TIONBQX / � I INSTALL A 12 x 38 LEACHING FIELD I'erc PROPOSED SITE PLAN 1 LSA / YP FORrY�►CFWFR'P FFS) OP �A I Fine-Medium Sand 4 of M 3 Benchmark SIDEWALL CAPACITY C-1 2.5Y 6/4 i= jQHN �� PREPARED FOR: L ElevNail.= 10.45'UP 67/34 GUYWtRE Dye \� STO�EO,p NO SIDEWALL AREA CREDIT TAKEN ( o FARM N OLD CAPE COMPANIES 4 72" 2.80' N.G.V.D. 1929 \ � �. A Fl�, No. 39690 - o \ BOTTOM CAPACITY R8" Standinc F LOCATED AT i Sn' � (LENGTH X WIDTH)X(0.74 GAUSQ.FT.)= GALLONS/DAYWatt 312 BRIDGE STREETSWING TIES �4o, ,F 2-0;4 CB/DIST. I ( 12 X 38 )X(0.74 GAUSQ.FT.)- 337.4 GALLONS/DAY Medium Said I OSTERVILLE, MA DESCRIPTION HC 1 HC 2 O�cTO sr� ,y� C-2 2.5Y 7/4 �� FFT TOTALS: 121) -1.20' SCALE: 1 INCH = 30 FT. DATE: OCTOBER 1, 2008 SEPTIC TANK(1) 19.4' 27.6' L9 y GF Q 0 15 30 60 120 FEET *AT THE DISCRETION OF THE BOARD OF HEALTH,THE CONTRACTOR MAY O(��. OP � P TOTAL NUMBER OF LINES 2 - - - - i °`" . SEPTIC TANK(2) 23.2' 34.1' CONDUCT AN ADDITIONAL PERC TEST IN THE"B-SOILIN THE LOCATION rP 3 � �('FM� I TOTAL LEACHING AREA 456.0 SQ.FT. RESERVED FOR BOARD OF HEALTH USE joHN L cu` - - OF THE PROPOSED SAS TO DETERMINE IF IT WOULD YIELD A PERC RATE iyl ` o CHURCHILL PREPARED BY: LEACHING CORNER(3) 31.5' 45.2' OF 2 MPI OR LESS, AND THEREFORE AVOID THE REMOVAL AND TOTAL LEACHING CAPACITY 337.4 GALLONS/DAY J . w JC ENGINEERING, INC. REPLACEMENT OF THE UNSUITABLE MATERIAL DOWN TO THE "C-SOIL". I I t 2854 CRANBERRY HIGHWAY LEACHING CORNER(4) 42.1' 56.3' *EXISTING 15'x 30'LEACHING FIELD LOCATED IN THE REAR OF THE EXISTING EAST WAREHAM, MA 02538 HOUSE HAS A CALCULATED SYSTEM CAPACITY OF 333±GPD(per 1995 Title V). LEACHING CORNER(5) 43.6' 78.0' SITE PLAN THE PROPOSED SYSTEM PROVIDES 337.4 GPD RESULTING IN A TOTAL OF 670.4 LEACHING CORNER(6) 33.5' 70.4' GPD(i.e.333+337.4),WHICH IS GREATER THAN THE REQUIRED DESIGN FLOW 508.273.0377 SCALE: 1"=30' OF 550 GPD FOR A FIVE(5)BEDROOM HOUSE,THEREFORE OK. Drawn By- BSM Designed By-MCP Checked By:JLC JOB No.1481