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HomeMy WebLinkAbout0614 BUMPS RIVER ROAD - Health (2) 614 Bumps River Road, Osterville A=144-006 o ` 0 TOWN OF BARNSTABLE LOCATION SEWAGE # 5 VILLAGE ©sty UI l Cc ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. CI c.,Ot Weds ri, fr 5'dir '9-0c2Y SEPTIC TANK CAPACITY /9-00 qdJ LEACHING FACILITY: (type) . P,p. s to (size) o?V X 3C NO.OF BEDROOMS y BUILDER OR OWNER TXo^cs 6.-L( F�"wr PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 9• Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) y0 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by A A2 a �- y A S �d3•/ r A 6Y•� f 4 32 3O'a F la 4D•�o -T g Bq 314•9 C� 85 , 39•0 9 $Lo .�y•� r39 38.9 No. aoo Fee /00 THE CO M&NWE LTH 0 ASSACHUSE$STS � Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 91pprication for ;h5pozar Opttem Cottgtruction Permit Application for a Permit to Construct( )Repair Xupgrade( )Abandon( ) O Complete System individual Components Location Address or Lot No. Lk Z uy �,s Owner's Name,Address and Tel.No ��u►�l� ,ate ��� �Q, � Assessor's Map/Parcel 4 poCo Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 4 Q a 539 - +9 Q(e Type of Building: Dwelling No.of Bedrooms 4 _ Lot Size-41 aj5Z ft. Garbage Grinder(ri//k- Other Type of Building W®f)e No.of Persons Showers( ) Cafeteria( ) Other Fixtures c Design.Flow A,L)&� gallons per day. Cal ulated daily flow gallons. Plan Date a� N OS Number of sheets Revision Date r—� TitleN�o�ec� �SvsLe�z Size of Septic Tank 2_z(tS•t— 163.16 20,QA ' cesk Type of S.A.S. cR®ac '6b Aory,ihjr V-tLZ-L Description of Soil Nature of Repairs or Alterations(Answer when applicable) C� O ID Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. oo Date Issued �-0 No. a Fee (00 — TKE 00, MONWEAiLTH OF ASSACHUSE-VVS- . Entered in computer. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTSIlk ZIPPfication for 3b. igpoo'af-*potem Co*5truction Permit Applicationfo a Permit to Construct( . )RepairxUpgrade( )Abandon(y ) ❑Complete System individual Components Location Address or Lot No#(v iy 1�j u/m� �y�`�p� Owner's Name,Address and elf.Npp,,, v�k�. /�1 S T'1 Y1,•\. 1 • q.II�'�I�� �V y "•'R�\t �4� ^n,.,,I ;. Assessor's Map/Parcel fw4 I n 4 o0(, e M E Installer's Name,Address,and Tel.No.?4.\ Designer's Name,Address and Tel.No. +. t r �" • ' F�)PEWtQLe� Er3t. 0.:C !{AY �"JV.SvcS• }. ^►.e ��% 4d�-ywae 539 - Type of Building: Dwelling No.of Bedrooms 4 Lot Size r' sq.ft. Garbage Grinder . ;�..• Other Type of Buildin No.of-Per fk0 n sons Showers( Cafeteria( ) Other Fixtures __- t)41:1i1qY \En1 kN Uau(,< ` t Design.Flow gallons per day. Cal ulated daily flow �r gallons. Plan, Date �� Num be of sheets Revision Date Title QG Se c. 'So 1SvbCCGR ` ,1G50\ Size of Septic Tank `-7�(5 T- t S`06 C,-mA -T C-,jK Type of S.A.S. Leas N i h)( Gt CLD Description of Soil acts pLC� Nature of Repairs or Alterations Answer when applicable) aC0 P ( .�Y Date last inspected:' Agreement: - The undersigned igrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with,the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signe > Date 4' "2-L o,,3 Application Approved by / tin,• �. Date Application Disapproved for the following reasons Permit No. .200 m?L/7 Date Issued 6 -.7 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance e)yom� THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired Upgraded( ) Abandoned( )by t"'I 1444-) J ��l�f Q✓I)- .> C-� (— at 6 ti ��05 2 l x� 2�A 05 My \1 e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.BOO dated Installer � uJi�� Designer. The issuance of this permit shay not be construed as a guarantee that t 4system ill funotio_ as fiesigned. Date 6 ZfZ5a Inspecto No. o o ' LI- Fee 06 — s THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS �Digo$af *p$tem Con.5truction Permit Permission is hereby granted to Construct( )Repair( 1Q,Upgrade( )Abandon( ) System located at Gt-f &­Is ye.".re k, U a d aS)t1"`\t and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Con truct•on must be completed'within three years of the date ofc ifh p rmit. Date:_ (o L� Approved by _ j ! V 9116/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems. Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I,Z_o,�� - hereby certify that the engi neered plan signed by me dated \3�\ ,concerning the property located at' meets all of the following criteria: •- This failed system is connected to a residential dwelling only. There.are,no.commercial or business uses associated with the.dwelling. • The.soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or.may conduct deep test holes and percolation tests at-the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will-be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the. Frimptor method when applicable] Please complete the following: M CA C �_kk- L\ 0.Ci ' A) Top of Ground Surface Elevation(using GIS information) 00 B) G.W. Elevation \ +adjustment for high G.W. ©� DIFFERENCE BETWEEN A and B 1�, SIGNFD : DATE: - O NOTICE Based upon the above information;a repair permit will be issued for bedrooms maximum.. No additional bedrooms are authorized in the future without engineered septic system plans. gASepdc\percexemp.doc Town of Barnstable OptHE Tpy, Regulatory Services tia ; Thomas F. Geiler, Director BARNSTABLE. 9� MASS. ��� Public Health Division �En�AO'�A Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 6/8/05 Designer: Shay Environmental Services, Inc. Installer: Capewide Enterprises Address: P.O. Box 627 East Falmouth Address: P.O. Box 763 MA 02536 Marstons Mills, MA 02632 On 6/03/05 Ca ewide Enterprises was issued a permit to install a (date) (installer) septic system at 614 Bumps River Road, Osterville, MA_based on a design drawn by (address) a. Shay Environmental Services, Inc. dated 06/02/05 (designer) XX I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF- CAR E I taller's Si ure o E. SHAY No. 1181 9 p STER� S CP RDM4A esigner's ignature (Affix Des! Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form , C TOWN OF BARNSTABLE rANIN � SEWAGE #/55 fed' /f/� /ASSESSOR'S MAP &LOT ly ` INSTALLER'S NAME&PHONE NO. d� �F � SEPTIC TANK CAPACITY LEACHING FACILITY: (type)1vl"&'M�ort Ly� (size) 1,0Xre,x,2 NO.OF BEDROOMS J BUILDER O �WN' PERMIT DATE: �`� 7 COMPLIANCE DATE: Separation Distance Between the: a -r 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) /�114 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) - Feet Furnished by gra l' . . 00 �1 No. ! ` Fee J'V.. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Digogaf *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade(IO)Abandon( ) /Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel o. Assessor's Map/Parcel 119,5 � 1 114a4IA25 n&P/// Installer's Name,Address,and Tel.No. ` Designer's Name,Address and Tel.No. geiw/o/// Co���7 `g3Q9 Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder(/� Other Type of Building l ,>o✓lGP No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 33&1 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. lil' 9?.�l�� Description of Soil Nature of Repairs or Alterations(Answer when applicable) 20-)I`le Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issuedb this Bo Health. / Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued Z /� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0(ppYication for Xigpozar *raem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(/Abandon( ) Vcomplete System O Individual Components Location Address or Lot No Owner's Name,Address -and Tel. o. ./ Assessor's Map/Parcel C�y j4� � rel*, Installer's Name,Address,and Tel.No. Designer's Name,A dress and Tel.No. qw Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder(� Other Type of Building ve4e No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /S�42Z Type of S.A.S. �'lQ,i•'j/y,�/,�f�s/ S Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b this BoW 9f Health. Signed Date Application Approved by Date 2 Application Disapproved for the following reasons Permit No. _ / 7-1D Date Issued THE COMMONWEALTH OF MASSACHUSETTS" + BARNSTABLE, MASSACHUSETTS (tertificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( ' )Upgraded(C_ } Abandoned( )b D at _ has been constructed in accordance with the provisions of Tiffe 5 and the for Disposal System Construction Permit No. 9 1-/®Z dated 2 Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date_ ` , - J 4!� Inspector i No. ------------------------- ! ��^ ©�� Fee �i THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS !6poml *pgtem Con-5truction hermit Permission is hereby granted to Construct( )Re.air( )Upgrade �/f Abandon( ) System located at `/Z Ll�l � //./f�� and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: 2 /� 9 Approved by - �2►,2 ` IOl9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT _ ENGINEERED PLANS) Adel I `o hereby,certify that the application for disposal works construction permit signed b me dated �-6�g � concerning the cons p g y , I property located at r Dl meets all of the . rr following criteria: V here are no wetlands located within 100 feet of the proposed leaching facility Yere are no private wells within 140 feet of the proposed septic system - There is no increase in flow and/or change in use proposed - ere are no variances requested or needed. If the proposed leachine facility will 'e located within =50 teat of any wetlands, the honor of:he Ql�e located !ass than :ourteen (1 11 feet above the maximum adiusted proposed leaching facility will p groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) B)Observed Groundwater Table Elevation(according to Health Division weil map) SIGNED: DATE: ` h LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER { [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, k d $ this plan should be submitted]. V i IF enttb folder:oat . fi 1 ON c�ESL li✓lL 0 00 . 4 �b !c f Lt ;A- - l� 11" ` v TOE OF BARN: GB# o SEW A . &LOT fy LpCpfiION 6 e ASSESSOR'S MAP 77� GE ✓�/" !// S` A . . L. VII. IER'S.NAME&PHONE NO. Il`1STAL:.. c L s'xa g CAPACITY 1Sda (size) SEPTIC:;TAN LEAC G FACU TTY: (type) 3 •' NO: OE::BEDROOMS C� BUTI,DER O"l COMPLIANCE DATE ATE Feet PENT DP► ce Between the: of Leaching Facility Sepai�auon Distan Feet pd'usted Groundwater Table and Bocto� any Wells exist Maw 1 Well and Leaching Facility vale Water Supp Y facility) Feet P'` `` within 20o feet of leaching wetlands exist onaite or d Leaching Facility(B any Edge of Wetland an facility) _ - :'.within 300 feet of leaching —_ Furni shed by I 00 b� _ ��Ir SINE Town of Barnstable Department of Health, Safety, and Environmental Services s�xer�ere. ; Public Health Division � ' ASIL 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 - Thomas A. McKean, RS, CHO FAX: 508-790-6304 Director of Public Health Mr.Thomas Criffin,Jn. January 6,1998 614 Bumps River Rd., - Osterville,MA 02655 ORDER TO COMPLY WITH 310 CMR 15.00,THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at 614 Bumps River Road,Osterville was inspected on June 30, 1997,by Robert Bortolotti a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00)due to the following: • %`Back up of sewage into facility or system component due to an overloaded or clogged cesspools. • Cesspool was full at the time of inspection. You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office(Town Hall, 367 Main Street, Hyannis)that will bring the septic system into compliance with 310 CMR 15.00,The State Environmental Code,Title 5 within(14)fourteen days of receipt of this notice. You are also directed to bring the septic system into compliance within thirty(30)days of receipt of this order letter. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings,onto the surface of the ground,or in to surface waters: Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH (McKean,R.S., C.H.O. Agent of the Board of Health q\health\dbfiles\title5i.doc i i [Installer letter TO: JP (Date) oz O!Ss- ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned b you located at (D) l�u S ��W -- /�a�►as �`11Q� p Y Y inspected on-(Tu,re =,i94? by Pz+' &4olo'16' a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 5 (310 CMR 15.00) due to the following: TI E n e_ A C3^ 0r Cth -GupaDf e w2_ nP l5 r, You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within (14) fourteen days of receipt of this notice. You are also directed to bring the septic system into compliance within thirty (30) days of receipt of this order letter. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health Town of Barnstable TOWN OF BARNSTABLE LOCATION �I .tea SEWAGE # VILLAGE ASSESSOR MAP & LOT INS . NAME&PHONFNO. SEPTIC TANK CAPACITY a S� LEACHING FACILITY: (type) (size) NO.OF BEDROOMS S BUILDER R OWNER PERMTTDATE: COMPLIANCE DATE: 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 Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) ,. Feet Furnished by �" �� ��' �� �y� S� r �1� r �`�� DDT 8 ryf BORTOLOTTI CONSTRUCTION,INC. 765 WAKEBY ROAD,MARSTONS MILLS,MA 02648 Tp 508-771-9399 508-428-8926 FAX: 508-428-9399 �- "Op e, 1,9,g, _ , TXrryFPT . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM';A, PART A � CERTIFICATION Property Address: Date of Inspection: O Inspec N me: er's Name and Address: - CERTIFICATION STATEMENT* I certify that I have personally inspected the sewage disposal system at this,address and that the informa- tion reported below is true,accurate and complete as of the time of inspection.The inspection was per- formed 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 Evalu n By t at Aproving Authority Fails Inspector's Signature: Date: The System Inspector shall submit a copy of this inspection report to the Approving authority within thir- ty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. P�AM/� ��L? INSPECTION SUMMARY: ��St/� ©�•��.d� A)SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system,upon comple- tion of the replacement or repair,passes inspection. " Indicate yes,nor,or not determined(Y,N,OR ND): Describe basis of determination in all instances. If not determined",explain why not. The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing sep- tic tank is replaced with a conforming septic tank as approved by The Board of Health. Sewage backkup 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): SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A a CERTIFICATION (continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System-required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of The Board of Health): Broken pipe(§)are replaced Obstruction is removed 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 the public health, safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF;HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 Feet of a surface water Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh. 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and 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 is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and i" within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and 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 the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less '—than"5 ppm. D)S TEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 15.303. The basis for this determination is identified below. The Board of Health shoul be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. . Discharge or ponding of efluent 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 clog- ged 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 -2- . d n SUBSURFACE SEWAGUDISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued). 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: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 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: 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 Il 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. d groundwater treatment program requirements of 314 CMR 5.00 and G 00. .Please consult the local regional office of the Department for further information. a n _ SU SURFA SE AG, E DISPOSAL SYSTEM T` EM INSPECTION F RM k PART B . s CHECKLIST ; Check if the following have been done: =i, y Pumping information was requested of the owner,occupant,and Board of Health. 7None of the system components have been pumped for atleast 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. As-built plans have been obtained and examined. Note if they are not available with N/A The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow: _%LThe site\was inspected for signs of breakout. r :zt 1-All system components,excluding the Soil Absorption System, have been located on site., _ The`septie.tank manholes were uncovered,opened,and the interior of the septic tank was in.: ` spected for condition of baffles or tees, material of construction;dimensions,depth of liquid, a: depth of sludge,depth of scum. # The size and location of the Soil Absorption System on the site has been determined based on :existing information or approximated by non-intrusive methods. 3 # k S . ti r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) t/ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C F —SYSTEM INFORMATION / FLOW CONDITIONS RVISEDYNTIALe / Design Flow: gallons Number of Bedrooms: 'b Number of Current Residents: Garbage Grinder: IUV Laundry Connected To System:( / Seasonal Use: Water"Meter Readings,if ilable: O Last Date'of Occupancy: AA CO MERCIATANDUSTRIAL: 106 Type of Establishment: ' Design Flow: nallonstday Grease Trap Present: (yes or no) Industrial Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings,If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENE INFORMATION ol PUMPING RECORDS and source of information: ` System Pumped as part of inspection:?W If yes, volume pumped: gallons. Reason for!pumping: TYPtOF SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If)es,Mach previous inspection reco if any) Oth r(explain):( a4& AP X1WL t GE of all components,date installed(if known)and source of information: CR Sewage odors deteco when arriving at the site: U -4- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: AV 6 Depth below grade: Material of Construction: 'concrete metal FRP Other (explain) — Dimisions: Sludge Depth: Scum Thickness: Distance from top of sludge to bottom of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: 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: Depth Below Grade: Material of Construction: concrete metal FRP Other. (explain) — — — — ; Dimensions: Scum Thickness: Distance from top of scum to top of outlet tee or baffle: 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.) TIGHT OR HOLDING TANK: Depth Below Grade: Material of Construction: . concrete_metal_FRP_Other(explain) Dimensions: Capacity: gallons,Design Flow'. gallons/day Alarm Level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER:A�— Pump is in working order: Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SOIL ABSORPTION SYSTEM(SAS): V" (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: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions:. Overflow cesspool,number: Comments: (note condi ' n of soil, signs of hydraulic failure level of ponding,condition of vegetation, etc a.Ax ,11 ef CESSPOOLS: Number and confi ration: -gu p_�Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of Cesspool:&•d xS � Materials of construction: " et fthIndication of groundwater: Inflow(cesspool must be pumped as part of inspection) Comments: (note condition of 'lk, signs hydraulic failure, level of ponding,condition of vegetation, et PRIVY Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) -6 - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (conlinued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include des to atleast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. `1 rb 5y �3 h s DEPTH TO GROUNDWATER i Depth to groundwater: /�' Feet " Method of Determination or Ap roxi don: 1t1�f'/ 1� r✓ �1 �l i 5 �� .. - 6 _7 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF NVIRONMENTAL PROTECTION E ONE WINTER STREET,BOSTON MA 02108 (617)292-5500 1 R - D EC WILLIAM F.WELD TRUDY COXE Governor ` secretary ARGEO PAUL CELLUCCI fEttT DAV1D B.STRUHS Lt. Governor Commissioner - - - - - - - SUBSURFACE-SEWAGE-DISPOSAL SYSTEM INSPECTION FORM - — --- - --- --- PART A CERTIFICATION Property Address: � t��v � osZ,r ��� Address of Owner: V\1a.q�.� i�. ►��wac L Date of Inspection: 12.\%b\q (If different) `kVj wv�., Name of Inspector: Q,,\� ��jp�\� �cr w��S� uqv}, 0Zt.3$ Company Name, Address and Telephone Number: VN\A ►.Stz.1� S-MIJ �? t Mrs. CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes _ Conditionally Passes _ Needs Further Eval y Local Approving Authority Fails Inspector's Signature: Date: I Q, 1 v to The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner.shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 11/03/95) ��Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 6%'1 %�zws f% Qa,rftuL Owner: Date of Inspection: B] SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout or high static water level observed 'n 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): broken pipe(s) are replaced obstruction is removed distribution box is levelled or replace The system required pumping more than four times a ear 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 4 obstruction is removed C] FURTHER EVALUATION IS REQUIRED BY THE BOARD HEALTH: Conditions exist which require further evaluation b the Board of Health in order to determine if the system is failing to protect the . public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEA H DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEAL T AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 fee of a surface water Cesspool or privy is within 50 fe t of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOA OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A NNER THAT PROTECTS THE PUBLIC HEALTH.AND SAFETY AND THE ENVIRONMENT: The system has a septic to and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. _ The system has a septic nk and soil absorption system and is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The system has a septi tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a ell water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution f m that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm• 3) OTHER (revised 11/03/95) 2 .r l SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: D] SYSTEM FAILS: I have determined that the system violates one or more of the follow' g failure'criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health sho Id be contacted to determine what will be necessary to correct --the failure.---- - - - - - -- -_. - -- - -- Backup of sewage into facility or system component d to an overloaded or clogged SAS or cesspool. Discharge.or ponding of effluent to the surface of th ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above o tlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below ' vert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the ast year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption Syste , cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is w'hin 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is ithin a Zone I of a public well. Any portion of a cesspool or privy s within 50 feet of a private water supply well. Any portion of a cesspool or pri is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analy�s. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile org nic compounds, ammonia nitrogen and.nitrate nitrogen. E] LARGE SYSTEM FAILS: The following criteria apply to la r a systems in addition to the criteria above: The system serves a facility wit a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and t e environment because one or more of the following conditions exist: the system is withi 400 feet of a surface drinking water supply the system is wit in 200 feet of a tributary to a surface drinking water supply the system is to ted in a nitrogen sensitive area(Interim Wellhead Protection Area (IWPA) or a mapped Zone Il of a public water s pply well) The owner or operator of any s h system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 nd 6.00. Please consult the local regional office of the Department for further information. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: (.u{ r6o,,,ps Q„/c,%P__ Owner: N Fez ` Date of Inspection: Check if the following have been done:--- ,Pumping information was requested of the owner, occupant, and 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. i As built plans have been obtained and examined. Note if they are riot available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. 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. AThe size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner(and occupants, if different from owner) were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspection: FLOW CONDITIONS RESIDENTIAL: — SF.a.nae4 syE sZ ,,,� l..g�.0 Design flow:SSo gallons Number of bedrooms: Number,of current residents: b�j Garbage grinder.(yes or no): w-xp�_ Laundry connected to system (yes or no):_!.%�S Seasonal use (yes or no):_hLg . Water meter readings, if available: Last date of occupancy:_QALEgk&5 COMMERCIAUI N DUSTRIAL• Type of establishment: Design flow:_gallons/day 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: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)j,�,p If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) -i. Other(explain) S.aN.,.Jt., - ( „� Ira - APPROXIMATE AGE of all components, date installed (if known) and source of information: �S Sewage odors detected when arriving at the site: (yes or no)_E�p (revised 11/03/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of Inspection: SEPTIC TANK:_ (locate on site plan) Depth below grade: Material of construction:_concrete-_metal _FRP_other(explain) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 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: Comments: (recommendation for pumping, condition of inlet and outl tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) GREASE TRAP:_ (locate on site plan) Depth below grade: Material of construction: _concrete _meta FRP—other(explain) Dimensions: Scum thickness: Distance from top of scum to/.bom tee or baffle: Distance from bottom of scumf outlet tee or baffle: Comments: (recommendation for pumpingof inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, i r' (revised 11/03/95) 6 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: _. Owner: Date of Inspection: TIGHT OR HOLDING TANK:_ (locate on site plan) Depth below grade: Material of construction: concrete metal FRP other(explain) Dimensions: Capacity: gallons Design flow: eallons/day Alarm level: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX:_ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of lids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER:_. (locate on site plan) Pumps in working order:(yes or n/onditfion Comments: (note condition of pump chamber pumps and appurtenances, etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: b14_3j2>_w, ?5 Lv.c v2,r Owner: {JUNC."z' Date of Inspection:�-Ik' 6 SOIL ABSORPTION SYSTEM (SAS): S (locate on site plan, if possible; excava on not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:,�t,xQ� i Sxe�l+�3 leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of nding, condition of vegetation,etc.) 14 Nc.)Q.uvN"Q_ CESSPOOLS: MS (locate on site pan) nn Number and configuration: QU Ndl Depth-top of liquid to inlet invert: to�� Depth of solids layer: 1Z" Depth of scum layer: Dimensions of cesspool: 9, Materials of construction: e'CncA A-y_ i3loe K Indication of groundwater: 1.� inflow (cesspool must be pumped as part of inspection) Lkps Comments: (note condition of soil, signs of hydraulic failure, level of pon 'ng, ondition of ve etation, 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.) (revised 11/03/95) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Qay.O-'L— Owner: � Z Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' A DEPTH TO GROUNDWATER Depth to groundwater: [11 feet method of determination or approximation: kk fir, C0011FA vV\ o� Z' a9,ao�e c�2� Qz (revised 11/03/95) 9 Failed 12/7/98 _.... Pass/Assesso Parcel number Address Village . Inspect date Repair Date Permit# F 310 139 20 Baxter Road Hyannis 10/10/97 F 028 081 113 Audreys Lane Marstons Mills 8/16/96 F 172 086 82 Ashley Drive Centerville 3/13/97 } Page 2 PERCOLATION TEST T'Y'PiCAL 1500 GALLON H- 10 SEPTIC TANK Y T M Dote of Percolation Test MAY 25. 2005 NOT TO SCALE P EAN 0 E SEPTIC S i � I E \ Test Performed By Carmen E. Shay, R.S., C.jE. DAM By WAIVER (per BARNSTABLE B.O.H 3-24' AM ACCESS MANHOLES EXCAVATOR: CAPEWIDE ENTERPRISES. LLC - 10' -a' SEPTIC TANK SHALL BE FACTORY CONSTRUCTED OF SOUND \ Percolation Rate: 2 MPI O 114* DURABLE WATERTIGHT MATERIAL AS PER TITLE V CODE 15.226. ° i �- `�..-,.. �p `I ` soCENTER ACCESS COVER OF SEPTIC TANK TO BE RAISED WITH THE APPROPRIATE RISER TO WITHIN Q \ n 6" OF THE EXISTING GRADE AS PER TITLE V �R \ Test Hole Test Hole �`� 0u THE ACCESS COVERS FOR THE SEPTIC TANK,\ No. 1 NO. 2 DISTRIBUTION BOX AND LEACHING COMPONENT SET DEEPER THAN 1 FOOT BELOW FINISHED L; GRADE SHALL BE RAISED TO WITHIN 12" OF C� P. \ DEPTH SOILS ELEV. DEPTH SOILS ELEV. " Y, � µ ,•_m,,,i �; FINISHED GRADE. U `` ,_ r 0 98.50 0 98.50 4' INSTALL TUF-TITE GAS BAFFLES OR EQUALS c �L ��9 \ FEEL REINFORCED PRECAST CONCRETE ON ALL OUTLET TEE ENDS T O \ FILL FILL PLAN VIEW \ 0'-36" 5.50 0"-30" 5.00 / I Sandy Loam Sandy Loom �� ^ / 10 YR 3/2 10 YR 3/2 3-24' REMOVIABLE COVERS 36"-48' A, 94.50 36•-54" A, 94.00 j loam Loam iB _afn�:Jr'-rnln�rhlVe to outlet s. I ^� Sandy y I 3' '' i �- 10 YR 3/6 10 YR 5/8 I t c'h.n l GI OUTLET �, I l \ \ O�, / 4e"-72" a 92.50 54'-72" - ' u '°`" 9 0 Sandy Loam Sandy Loam \ E$ + ', 4'-0' -1, I. 7 '' 1 o.�.w. Liquid depth \ 2.SY )/4 2.SY7/4 11G � b><\ C R f�`� - - �- -- � I/ / 72'- 114" C 89.00 72'- 110' C 89.33 �\ - CONCRETE EDGE O� F-ORMER - --"� - 2Med Sand Mod Sand 2.a .R 7/2 2.3 YR 7/2t0'-0'114'- 168" C 86.50114"- 168" C 86.50 ' CROSS SECTION END-SECTION ALL OUTLET PIPES FROM THE _ / / ^ ! I �U ', rnsTRIBUTION Box SHALL BE -- - - - - - -- 96 /'' SET LEVEL FOR AT LEAST 2 RI- 2" -' X COVER KNOCKOUTS�T .\ 15.5• OUTLET t2• iNLET 1 - - - - - - - - - - - / 98 Perc #1 �/� t \ / Depth to Perc: 114" to 132" (Test Hole #1) <_ e \ / / Perc Rate= Less Than 2 MPI 6 MIW29/ZONE C - INDEX = 6.4 for 4/05 4' - SCH 40 Tee- ADJUSTMENT ,9 V ADJUSTMENT = 0.9 FEET -LAN SECTION CROSS-SECTION } _ \ / / OD OBSERVED H2O Elev. = 150" or 12.5' below Grade n 8 ADJUSTED H2O Elev. = 11.6' below Grade per Frlmpter 7 / 3 HOLE DISTRIBUTION BOX - H-10 ' OADING ` L O T#F I / / / / / / // i NOT TO SCALE 1 41,280 Square Feet vt� Design Calculations Number of Bedrooms: 4 Equivalent to 440 Gal./Gay Garbage Grinder: No C 1 I / CULL Leaching Capacity Required: 440 Gal./Day Minimum ( Title V ) Septic Tank - 2 x 440 Gal./Day = 880 USE EXIST. 1500 GAL. Septic Toni.,. EXIST. \ � � i I SOIL ABSORPTION AREA: Using percolation rote of < 2 min./inch fLa I Proposed Leaching Field Dimensions: ® 20' Wide by 30' Long. / SAS ' , LOT 2 el�rl�'i`n Bottom Area: 0.74 gal/sq. ft. x 600 sq. ft. = 444 gclions # Sidewall Area: Not Utilized j I \ Providing = 444 gallons L 0 T# - l `,' O O ' FROM O NOTE: �' L' --- ---------- j EDGE \ \ O No t. �. RE PROPERTv _ :1 L T c 1 5 STRIP AROUND _JEST HOLE #2 40 POLYETH'1'LENE LINER FROM - - - - ( I 1 92.50 to 95.50 AND TO EXTEND 0 BEYOND 3A -- II I SHED / JJJIDJPDXIr96\ 1 I I 1 Ft REMOVE & REPLACE A. B & C-1 SOIL LAYER ✓�� \ I I I I--� - ,30,__�y �1 ` i �I HIV I �� - '•� _ _ _-_`; _ _`V __ 1-_ _ iNLf�I�S f1f!! i TO ELEVATION 89.00 OR MED. SAND LAYER IF VARIABLE _ . (REFER TO PROFtLE VIEW NOTES) TEST C E #' r I _ELE'. = 98.50 ��• ` t I I I � i O �0� Exist. Septi� \ I I aJ i Tank PROJECT BENCH MARK a � j 1500 GAL. ` �/ I TOP OF THRESHOLD FOR BACK DOOR ELEV. = 100.00 (Assumed) I 4 i EXSTNv ASSESSORS MAP - 144 oc,=-= - 006 8�td�►1-��+ � 3:�giW'E _ ? 4 BEDROOM v '' / ''dam te'pa"r HOSE NERAL lTF C � i_ /i ' _ - - / i T Contractor is responsible for Di sofe notificatior. DENC ES PROPOSED p g \ - -✓ 88X� end protection of oil underground utilities and pipes. SPOT GRADE 2. The septic„tank enq distribution box shall be set ever on 6 of 3/4 -1 1/¢2" stone. 104X46 =�C�ES EXISTING 3. Bockfill should be clean sand or gravel with no A yRgDE stones over 3" in Sze. 4 This system is s.:bfect to inspection during ;nsta!lot;on by CARMEN E. SHAY - Environmental PL _ _..;\�� `.. The COrtraCtCr gh.atl r+S2al, th�S System OCCJ ,J^'.'2' NO. DATE: DEF'NiT10% ,vith rtle , of the Massachusetts state ._de, t 'e ac-, ,e. r' \ - - I � S1.00 \ Add Second Perc Test -ocet: 9 7 -- _ _ __. Y ^a Loco peg icc;t� g. re Ele/,,, trlc)nj* Der 9/-- _ 1 vise , ^�,o'~'s 'or S Vr_- _.. a,-. c .-. e - - �"ro7E. ALL P;PES APE 'C SF d SfifE��_` 4f 'T CT ' :ITC ..-'_� _'' _�UA S r�". ....� _�-�� E,V�S. � f�� �'- � I I� �. ��,'.. ALA �CF-' GAS � TEE EACH FIEL CPQS'- ��� - I 1+--`0� Thin, f,orir--►i ��'� "ram TANK _ 3504 4" on center � W-0" on center 6'-.0" on center 4" on center i 10 ser t'.0 tank ; Provide Risen 4 necNsc f "-so. cover --S* ;e ,-. I e" C I v l- L to branq Septic conk colors to within i with n 6' of rn;snod 9,ode of the +In shoe q aae V I c �\ D*ado D-3a Q 9E.SC _ 0 J I � � V J R . sr Crode Over LeoM �e+d - 98.SD 2"-1j8"-i/2" l } I -T r-(- i r..� I r-� I i �- Washed Stone , OSTERVILLE, M ~' I 2" s 1 . 614 BUMPS R�'ER . ROAD jPREPARED BY: �« 3/4"-1/2 Washed Stone 6• Min. roar 3' Maalrr urn S=.DDF -- O S T E R I !E M a S Love far 2 r f0 , 0 2 6 5 5 Nt, o7Pt r- 10' s_1/8' oer root -a' Perraotec PVC. - 2"-',8" ; ;2' Washed Stone A4 r w,p. r� >a..T -- -- 5_ D.005 foot CA RM.�'N '. SHAY X L, EXIST. 1500 GAL 12•' Invert E7ev.m 96.50 20 1 4" So& 40 25 SEPTIC TAW 10' 3/4'-1y,' washed Stone b Fa,NOATIor+ el s' Soh 40 PYL� N 'Bottom each Facility Elev.=ss.00 RY'ICG , o N �'Ni�IRONMENTAL S�' S INC n e T Sch. 40 - 4' perforated P.V.C. pipe c l You { [� _ 9.1' PROVIDED N P.O. BOX 627 z 6' OF 3/4'-11/2" STONE ° F bl REMOVE & REPLACE TO o/sTE� EAST FALMOUTH, MA 02536 BOTTOM OF C- 1 LAYER Adjusted Groundwater = Elev. 86.00 A SYSTEM PROFILE II Observed Groundwater = Elev. 86.00 NITARtP� compacted stone 'c Bottom of Test Hole Elev.l 4�1 TEL/FAX 508-539-7966 Not to Scale H-10 a HOU m DST eox Note: Remove soil down to el. 89.DO & replace with SCALE: 1 =20' DRAWN BY: CES DATE: MAY 27, 2005 clean coarse sand w/pert. rate less than or or equal to 2 min./in. before & after placement PROJECT#SD-751 FILENAME: SD751 PP•DWG SHEET 1 OF 1