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0008 EAST BAY ROAD - Health
so 8 East Bay ltoad, 01terville A-141-105 p 4c�,�sn ��tp a('e,^1�1, i �4 I fl d o i e� Q�11 y t s".v�Q, a"�.�-.s _'o+a - m ., _. ._,- _ .., � o s ..,.� .-- ,,_n.. .;�.,e A .... „ �f.�"° . oe,. o•.tea. .,�..m... _.a . . .. _ p o y x e'Gm.e 1 01 {` U ��( l�od Fee No. , THE COMMONWEALTH OF MAS ACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftPriration f Disposal *pstem CConstrurtfou Permit Application for a Permit to Construct( Repair( ) Upgrade( Bandon( ) plete System ❑Individual Components Location Address or Lot No. Jr � 6, f Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Y G (.,Arell Z.L Installer,s/Name,Address,and Tel.No. Designer' N d ess,and Tel.No. od�J )r� �sdL t ,4,r,k/'0 Type of Building: / „n��►Jig. Sd d 5� cSs�� Dwelling No.of Bedrooms Lot Size G 0/d47 0 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets o2 Revision Date / % 2.3 Title Size of Septic Tank SQ`) ���, Type of S.A.S. S -it LAJ- �/S lJ�i s' !/r? l�l� Description of Soil SA 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 Certificate of Compliance has been issued by this Board S e C/W'� %t� �� 'lj Date ✓of Application Approved by Date Application Disapproved b Date for the following reasons Permit No. d f �_(� Date Issued lo4 .L 04 o Uri { No D V ° .f f'(� t� Fee pp THE COMMONWEALTH OF MAS ACHUSETTS Entered in computer: ' PUBLIC HEALTH DIVISION - TOWN'OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Mispo°saY� Epstein Construction Permit Application for a Permit to Construct(Repair Upgrade( ) bandon( ) (mplete System ❑Individual Components Location Address or Lot No. f/' /<, �� L Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's N e,Ad ess,and Tel.No. — �, �as�� � �4��„�l ,.-/. < yr Type of Building: / Dwelling No.of Bedrooms [' Lot Size sq.ft. Garbage Gfiner( ) Other Type of Building All No.of Persons Showers'(.� ) Cafeteria( ) Other Fixtures Design Flow(min.required) 6 Q gpd Design flow provided , gpd Plan. Date Number of sheets Revision Date y • U 3 Title Size of Septic Tank , Type of S.A.S. Description of Soil Nature of,Repai"r's or Alterations(Answer when applicable) 1z�> Date last inspected: - Agreement: r'' The undersigned agrees to ensure the construction and ma%htenance 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>oper"atiori until a Certificate of _:o Compliance has been issued by this Board of Health. /�� / p f S e �°/ C/� CUM r Date f o� /" /F.)w T Application Approved by e r Application Disapproved b 15ate for the following reasons t Permit No. /�/� GI rc Date Issued d r --------------- - - ---------------- �HE`ZOMMONWEALTH OF MASSACHUSETTS 7 BARNSTABLE,MASSACHUSETTS Certificate of Compliance > THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed Repaired( ) Upgraded( ) `� Abandoned( )by c U,r At ,( has been constructed in accordance :i , with the provisions of Ti le 5 and the for Disposal System Construction Permit No. ) a( J_ cj dated Installer Designer #bedrooms ( _ d z P o/ r?I Approved design flow j ; gpd —40 The issuance of this permit sh 11 not Ve ccoo�nstrued as a guarantee that the systenfwil� t* f esign d. Date L/ /"j Inspecto No. a Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS � x Misposal 6pstem Construction Permit t Permission is hereby granted to Construct Repair( ) Upgrade( ) Abandon( ) System located at.. � and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction ust be completed within three years of the date of this permit. Date _ I,� �� �- /� Approved by u/? ►U)4 ' Pees® , � Ie,f �� � c�- �3 / _... _ Town of Barnstable . Inspectional Services % easrrsTaat.s. Public Health Division i639. Thomas McKean,Director oa 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 6/11/19 Sewage Permit# 2018-398 Assessor's Map\Parcel 141\105 Designer: Sean M.Riley,Coastal Engineering Co.,Inc. Installer: Robert B.Our Co.,Inc. Address: 260 Cranberry Highway Address: 24 Great Western Road,P.O.Box 1539 Orleans,MA 02653 Harwich,MA 02645 On 12/28/18 Robert B.Our Co.,Inc. was issued a permit to install a (date) (installer) septic system at 8 East Bay Road,Osterville based on a design drawn by (address) Coastal Engineering Co.,Inc. dated 10/17/17 (designer) x 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. Strip out (if required) was inspected and the soils were found satisfactory. 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. Strip out(if required) was inspected and the soils were found satisfactory. x Partify that the system'referenced above was constructed in liance with the to rms of /=a oval letters(if applicable) %%A of A,% q SEAN o RILEY (Ins er s Signature) CIVIL N 4 No. 46715 2 A STEA�O��� �sslONAL ENG\ (Designer's Signature) (Affix DeirWs Stamp 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. Woa\deptAHEALTMEWER connecASEPTIMesigner Certification Form Rev 8.14-13.DOC COASTAL t engineering co. April 9, 2018 Project No. C18614.00 Board of Health Attn: Thomas McKean, Health Director 200 Main Street Hyannis, MA 02601 Board of Health Variance ApplicationFiline Package - Assembly Required LLC 8 East Bay Road "Captain's House" Osterville, MA Dear Mr. McKean: The Standard Conditions for PERC-RITE Drip Dispersal System Certified for General Use, last revised and issued on November 23,2016 by the.Massachusetts Department of Environmental Protection (MassDEP), require the Designer to,certify that the system has been designed in accordance with the Approval, any Company design guidance, and 310 CMR 15.000. This letter will serve to certify that the design shown on the submitted design plans for the above referenced properties., prepared by Coastal Engineering Co., Inc,, issue date December 1, 2017, conforms to the General Use Certification Approval issued to American Manufacturing Company, Inc. by MA-DEP, to the design guidance, and 310 CMR ' 15.000, If you have any questions or comments please contact me at your convenience.- Very truly yours, 3, ` COASTAL ENGINEERING CO., INC. Sean M. Riley, P.E. CFM ` SMR cc: Matt Kaufmann - KVA D:IDOCIC786001186141PermittingTOH Captain's House(8 East Bay)12018-03-08-Design Cert.doc' Orleans I Sandwich I Nantucket W = ' . 'i TOWN OF BARNSTABLE LOCATION �_ - SEWAGE# ( ' VILLAGE �'��'���/ ASS SOR'S/MAP&PARCEL T� ��-6s INSTALLER'S NAME&PHONE NO. // 7`" ��� X169fi3 SEPTIC TANK CAPACITY dA S T dZ)!! � ,? f/ G�a� l✓ LEACHING FACILITY:(type) &1 - lle— / (size) 40 NO.OF BEDROOMS — Led OWNER �'SS .WI�I 9^G tJIO � a-1.tJ PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility lJ 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 s. cr C� r 7�r� gL�7 21� Ae- EXERPT FROM THE BOARD OF HEALTH MEETING.MINUTES.'APRIL 24, 2018: _ A. Sean Riley, Coastal Engineering, representing Ms. Samiljan, Trustee - Assembly Required LLC, owner— 8'East Bay,Road; Osterville,.Map/Parcel 141-105, 1.59 acre parcel; repairing a failed septic system, multiple; variances requested. John,Schnaible, Coastal Engineering, presented the plan. Upon a motion duly made'and seconded, the Board voted to grant the septic plan with the following conditions:. 1) with have a PercRite system, 2) at the Barnstable County. Registry of Deeds, they will record a.six'(6) bedroom deed restriction and must record on the deed that an I/A secondary alternative system is installed and required monitoring and mwntenance,Aand 3) an official copy will be supplied,to the Health Division. (Unanimously, voted in favor.) y Hof t tp� Town of Barnstable Barnstable �� "� Board of:Health` 1 j hARNSTABLE; Mi y ASS. �' 200 Main Street, Hyannis MA 02601 999■■■ �Ar 1639- 2007 fD MA p otlice:-5,08.862-4644. Pawl Canhift D M;D. FAX: 50ST790-6304 j6h.i hl Sa%�'ayanagi. inn aId Cu idagnoli;:Tv4.I?,, June 14`,.20.18 Mr. Sean M. Riley, P.E. Coastal Engineering`Co: 260 Cranberry Highway Orleans, MA 02653 RE: 8 East Bay Road, OstenriRee� A =�1`41-1G5- Dear Mr. Riley, You are granted a conditional Variance on behalf of your client-,. Assembly Required L.L.C. c/o Nancy B. Samiljan, to construct an,onsite sewage disposal system incorporating drip dispersal at 8 East Ray Road, Ostervil e. The: variances granted areas follows: Section 360-1 of the Town:bf Barnstable Code: To insta'll,a 1eaching'f6cil.ity`75. feet away from a coastal bank; in lieuof the.rninirrium 10046et separation distance required. Section 360A of the Town of.Barnstable Code: To install a septic tank 59 feet away from a coastal bank, in lieu of`them inimum 100 feet%separation distance required:. Section 360A of the Town of Barnstable Code: To install a septic tank 95 feet away from a wetland, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the.Towmof Barnstable Code: To install a-pump chamber 95 feet away.from a wetland, in lieu of the minimum 100.feet separation distance required'. Q:\WPFICES\Riley8EastBayRoadVariances2018:docx; Section 360-1 of the Town of Barnstable Code: To install a pump chamber>61 feet away from a.,coastal bank, in. lieu of the_ rninimum IQ0 feet separation distance required. Section 360-1 of the Town'of Barnstable Code: To install the. pump chamber' 88.5 feet away from a pond, ,in.lieu of°the minimum 10.0 feet. separation distance required. Section 360-1 of the Town of Barnstable Code: To install the distribution box 99 feet away from a pond, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code; To install a soil absorption system 64.4 feet awayfrom a pond; in.1ieu of the minimum 100 feet separation distance required. These variances are granted with the following conditions; (1) No more than six (6) bedrooms are authorized at this property. Dens., study rooms; offices, finished attics, sleeping lofts, and similar-type rooms are considered 'bedrooms" according to the MA. Department of Environmental Protection, (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to isix bedrooms maximum. A copy of the recorded deed restriction shall be: submitted to the Health Agent prior to obtaining a disposal works construction permit, (3) The engineering plan shall' be revised .to provide the following: provide. design calculations fora two compartment tank, show minimum of five feet separation to adjusted high groundwater table, show '/2°' piping (not '/2 provide original. wet stamp plan', provide a note to verify soils at time 9f installation, correct the dates of test holes #3 and #4 which' 'were evaluated or°'March '20, 2018 (nof March' 5, 2Q18),-and provide-,a note ensuring fence posts will be installed before, drip tube(s). are _installed in the, area of the.leachn.g facility, (4) All.conditions contained within the DEP approval letter for the'PERC-RITE Drip Dispersal.System entitled `Certification for General Use' dated March 15, 2007 revisedMvember`23, 2016, shall be strictly adhered to. (5) The septic system. shall be installed in strict accordance with the revised engineering plans. (6) The designing engineer shall supervise "the construction of the onsite sewage disposal system and shaLL certify in writing to the Board of Health Q:\W PFILH\Riley8EastBayftadVariances2018Aux that the system was 'installed in substantial compliance. with the revised engineering plans. These variances are granted. because the proposed plan°appears to meet the maximum feasible design standards contained within the State Environmental Code, Title 5 and local Health'- Regulations: 'The erigineer designed the septic system attempting to maximize.setbacks to the coastal .bank and wetlands while: providing:greater separation to the estimated high groundwater.by utilizing apes- rite drip dispersal system. The wastewater effluerit will.be spread thoughout,the leaching area and will be placed within-6 inches of grade, to provide .maximum. aeration, nitrogen uptake, and-filtering through the soil horizons, Sincerely yours; I(v uI ,. Can ': D. M:D: Chairman Q:\WPFI,LB\Riley8East gay RoadVariances2018.dock f E1 Y 1 Y 178 ^7 C 6 r-t 12-218-20-113 a 12 ® fig.=8r3 3 i ' r DEED RESTRICTION Y WHEREAS, Assembly Required LLC, a Delaware limited liability company, c/o MMP Management LLC, with.a mailing address c/o Paul McCoy Family Office,3'1 St. James Ave., s Suite 740,Boston MA 02116,acting by and through its duly authorized agent Mary Plum ("Grantor") is the owner of the property known as and numbered 8 East Bay Road, Osterville, Barnstable County, Massachusetts,as is more particularly described in a deed dated August 23, 2017, recorded in the Barnstable County Registry of Deeds in Book 30,724, Page 1.02, and also shown as Lot B on a plan of land entitled "Plan of Land in Barnstable,MA.prepared for Ann M. Williams et al, Scale V =30' Dater September 6,2000" by Down Cape Engineering, Inc., Civil Engineers,Land Suiveyors, 939 Main Street, Yarmouth, MA 02675, which plan is recorded in the Barnstable County Registry of Deeds in Book 563,Page 44 (the"Property"); WHEREAS,by Decision.of the Barnstable Board of Health.("Board")dated June 14, 2018 ("Decision"), the Board approved certain conditional variances to construct an onsite sewage disposal system incorporating innovative/alternative"drip dispersal"technology("the System")to serve the six(6) bedroom, residential dwelling on the Property shown on the Floor Plans prepared by Shope Reno Wharton LLC, entitled"Captain's House"with an Issued for Permit Date of August 28, 2017 and an Issued for Construction Date of September 28; 2017 ("the Plans"), which Plans are on file with the Board; WHEREAS, as a condition of its approval;the Board required the Grantor to agree-to . limit the number of bedrooms on the Property to.six (6)bedrooms for as long:as said Property is served by the System; WHEREAS, as a condition of said approval by the Barnstable Board of Health, and as a pre-condition to granting a disposal works construction permit for the-System in compliance with 310 CMR 15.200, State Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage,the Board is requiring that the agreement for the restriction on the number of bedrooms be put on record with the Barnstable County Registry, of Deeds by recording this document; NOW, THEREFORE,the Grantors do hereby place the following restriction on the Property,which restriction shall run with the land and be binding upon successors in title: l. The dwellings constructed on the Property pursuant to the Decision shall be limited to a maximum of six(6) bedrooms for as'long as said Property is served by the System. Grantors agree that this deed restriction affects the land more particularly described in the deed dated August 23,2017, recorded in the Barnstable County Registry of Deeds in Book 30,724,Page 102, and also shown, as Lot B on a plan of land entitled."Plan of Land in Barnstable; MA prepared for Ann M. Williams et al; Scale I" =30' Date: September 6, 2000"by Down Cape Engineering, Inc., Civil Engineers,Land Surveyors, 939 Main Street,Yarmouth, MA 02675,which plan is recorded in the Barnstable County Registry of Deeds in Book 563,Page 44. Executed as a seal instrument this�—.V,day of:December,2018. Mary`Plum " COMMONWEALTH OF MASSACHUSETTS ss; 2' _ �>2018 On this T7, day of UL ,2018, before me,the undersigned notary public, personally appeared Mary Plum,and proved to me through satisfactory evidence of identification,which was pri,vE5 c k _,to li ; `e person whose name is signed on the preceding or attached document,and 161C.. � `"d recl to.tie, hat-she signed it voluntarily for its stated purpose. Notary P�,.b ic. My Co.m'mi , on;expires: J . 10 431,5215.2 "I,`•1t,«<,uiueurq,r�rr' Pb K •G�,�,6E T,S,'oi'•: Y r •' r . qr4MrSSACNUSE��� �` BARNSTABIE REGISTRY OF DEEDS . -2' John F. Meade, Register B k 31754 Ps l7Z� "�644-69 1 2-29-201 3 & 1 2 % 48p) DEED RESTRICTION WHEREAS,Assembly Required LLC, a Delaware limited Iiability company,c/o MMP Management LLC,with a mailing address c/o Paul McCoy Family Office,31 St.James Ave., Suite 740,Boston MA 02116,acting by and through its duly authorized agent Mary Plum ("Grantor") is the owner of the property known as and numbered 8 East Bay Road,Osterville, Barnstable County,Massachusetts,as is more particularly described in a deed dated August.23, ` 2017,recorded in the Barnstable County Registry of Deeds in Book 30,724,Page 102, and also shown as Lot B on a plan of land entitled "Plan of Land in Barnstable,MA prepared for Ann M. Williams et al, Scale V=30'Date: September 6,2000"by Down Cape Engineering, Inc.,Civil Engineers,Land Surveyors, 939 Main Street, Yarmouth,MA 02675,which plan is recorded in O the Barnstable County Registry of Deeds in Book 563,Page 44 (the"Property"); WHEREAS,by Decision of the Barnstable Board of Health (`Board") dated June 14, 2018("Decision"),the Board approved certain conditional variances to construct an onsite sewage disposal system incorporating innovative/alternative"drip dispersal"technology("the 0 System")to serve the six(6)bedroom,residential dwelling on the Property shown on the Floor Plans prepared by Shope Reno Wharton LLC, entitled"Captain's House"with an Issued for Permit Date of August 28,2017 and an Issued for Construction Date of September 28,2017 ("the Plans"), which Plans are on file with the Board; WHEREAS,as a condition of its approval,the Board required the Grantor to agree to A limit the number of bedrooms on the Property to six(6)bedrooms for as long as said Property is (� served by the System; WHEREAS,as a condition of said approval by the Barnstable Board of Health,and as a pre-condition to granting a disposal works construction permit for the System in compliance with 310 CMR 15.200, State Environmental Code, Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage,the Board is requiring that the agreement for the restriction on the number of bedrooms be put on record with the Barnstable County Registry of Deeds by recording this document; NOW,THEREFORE,the Grantors do hereby place the following restriction on the Property,which restriction shall run with the land and be binding upon successors'in title: ' Bk 31754 P9179 #64469 1. The dwellings constructed on the Property pursuant to the Decision shall be limited to a maximum of six(6)bedrooms for as long as said Property is served by the System. Grantors agree that this deed restriction affects the land more particularly described in the deed dated August 23,2017,recorded in the Barnstable County Registry of Deeds in Book 30,724,Page 102,and also shown as Lot B on a plan of land entitled "Plan of Land in Barnstable,MA prepared for Ann M. Williams et al, Scale I"=30'Date: September 6,2000"by Down Cape Engineering, Inc.,Civil Engineers,Land Surveyors,939 Main Street,Yarmouth, MA 02675,which plan is recorded in the Barnstable County Registry of Deeds in Book 563,Page 44. �� Executed as a seal instrument this day of December,2018. Mary Plum COMMONWEALTH OF MASSACHUSETTS 95S C x , ss. 121 71 ,2018 On this TZ, day of DtL ,2018, before me,the undersigned notary public, personally appeared Mary Plum,and proved to me through satisfactory evidence of identification,which was pyjy f,,CS W to b e person whose name is signed on the preceding or attached document,and ackno� ed to a at she signed it voluntarily for its stated purpose. Notary Pub is My Commi 'on expires: 11, 2'1 102q L 4315215.2 y ,'i MpMyEp6tN � hM,�35AOHt156p.` BARNSTABLE REGISTRY OF DEEDS -2- John F. Meade, Reo ter • T ..^', '�',.et "# "s'-` w �d a # :� f..a.ar+�� �[ff��," yr .� i*" -SF=—,i�.:,•��� * .�. � I _ • a r, pp _ , �� q;�YJf�� �a^1 •. �+. ck� i' '. - ' mod. •1 '•e .�. Y*'M+ !� - r l� - . r 1 E • fV•`dd 1, - fir- .jR J Mrs f �� �,y � a ,, ���J � � �' �,d..�[�,. •. c �L `-!.' _. r.0 ii,,�� '"" i�� .{. t«�,�' < �+F r.�. 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': w s; 1/ ,.`a .•` '1.,,,r. a - ��A`._ � � a t i � �... � rR 'ti:` "'f"� y,� � ' • `�3J,. -h• •_ , F .te'SA , I , dTa *��: »... x � 1. - '.� 'ti^ :"!S �s �,F �*t � `•'M.�� �q,, �E tCj 7 s y�,` "w`Y'+ S a ,a;.� ,,',,[« � •,^ + .ter �`' , `,,�yS, ' ( r f "'�:.[ '," � 'll +` JV � +1 / i �•4y�k:`4 _ + i mil^'y �� � � 1� I �� .I � � � - � �r � /'.i �a a"'�"r.'.^ y`���tlw•. E� � ' �;� .ire f �'.. ,, � ��, 4. y n• ' •t% Town of Barnstable P# �S(� OFIHE Department of Regulatory Services Public Health Division Date r�I v� 16 .aM.39 ' ,�$ 200 Main Street,Hyannis MA 02601 y �fp►M`liA f Ix Date Scheduled ✓ e� Time Tee Pd. ;,� Soil Suitability Assessment for Sewage Disposal P Performed By: o ��a+� �$ Witnessed By: LOCATION &rGENERAL INFORMATION .,......, _, A Location Address B,�� Owner's Name 1 G ". Address 13 G %I Assessor's Map/Parcel: Engineer's Name NEW CONSTRUCTION REPAIR' Telephone#--�a8'. Z��•_�,�y( _ -"`" -"_ Land Use �F,r�`l RL Slopes(%) Surface Stones Distances from. Open Water Body 00 T ft Possible Wet Area _ft Drinking Water Well Z,0 0 T ft 1 i Drainage Way /00--� ft Property Line `� -� ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) ^ a 3 a< ze �� pie ,,p ( S , r ��/ � ?,. � oQa `�,•' ' �o oQa ,.:. I `,,� ��a t� 0�4,� ,_�M� 000 ''L •�t18 I� a/ � �(, s a / y _ J _ MWIe r G 0 P• �` •� BAR dP \ ' 6a err eP6�y�`a�05 Ey'SA\N POr zfi v 'v04 i oRB• , pJHpi+gq� % z \�.rop c��' 1. ; if• '675 F '�, j y.` .s ,,I/\1� \ \8 q8 Parent material(geologic) 0 ALA 0AL, d���P�'�\ Depth to Bedrock /, 'r° Depth to Groundwater:-Standing Water in Hole: N 615 Weeping from Pit Face \ ". Estimated Seasonal High Groundwater 1-2 DETERMINATION FOR'SE SONAL HIGH WATERTABLE Method Used. S �0 _l ro�Z o 11 Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level N� PERGOLA>TION:TEST' Time . Observation Hole# Time at 9" Depth of Perc Time at 6" r Y Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./inch LZ m Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division 'Observation.Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. . Q:\SEPTIC\P ERCFORM.DOC'._. BAy ;DEEP_OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistence %Gravel) 1 S� -.-`y 1 DEEP OBSERVATION;HOLE LOG„ ., Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders: Consistency,%Gravel) s _ DEEP'OBSERVATION HOLE LOG Hole# : . . r. � Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) r DEEP OBSERVATION HOLE LOG Hole'# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency %Gravel) Flood Insurance Rate Mau: Above 500 year flood boundary No Yes' X. Within 500 year boundary No X Yes Within 100 year flood boundary No Ix Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Y�� If not,what is the depth of naturally occurring pervious material? Certification �pQ I certify that on I� ' u, I�� J ( I have p e e s '1 evaluator examination approved by the Depai t of Environmental Prot ction nd tha e a ve nalysis was performed by me,consistent with the requir fining,a ertis and pease ce de be 310 CMR 15.017. Signature Date Q:\SEPTIC\PERCFORM.DOC ASSEMBLY REQUIRED LLC c/o Mary Plum Paul McCoy Family Office Services 31 St.James Avenue; Suite 740 Boston MA 02116 April 26,2018 By In Hand Delivery Thomas McKean,Director Health Department Town of Barnstable 267 Main Street Hyannis, Massachusetts 02601 Re: 8 East Bay Road, Osterville,Massachusetts; PERC-RITE Drip Dispersal System Owner Certification Dear Mr. McKean: Pursuant to the Vote of the Barnstable Board of Health at its meeting on April 24, 2018, and pursuant to Section II, Design and Installation Requirements, Paragraph 24(c) of the Massachusetts Department of Environmental Protection's Certification for General Use of the PERC-RITE Drip Dispersal System, issued on March 15, 2007, revised November 23, 2016 ("Approval"), as Duly Authorized Agent of the Owner of Record of the above-referenced property, I hereby certify that the Owner: i) has been provided a copy of the Approval, the Owner's Manual, and the Operation and Maintenance Manual for the above-referenced System, all of which are attached hereto as Exhibits A, B, and C, respectively, and the Owner agrees to comply with all terms and conditions contained therein; ii) has been informed of all the Owner's estimated costs associated with the operation, including, when applicable: power, consumption, maintenance, recordkeeping,reporting, and equipment replacement; iii) understands the requirement for a service contract; As Owner of Record,the Owner intends to ensure compliance by hiring duly qualified design engineers, installers and operators who will be retained for the specific purpose of ensuring compliance with these provisions. Mr. Thomas McKean April 26, 2018 Page 2 iv) agrees to fulfill its responsibilities to record a Deed Notice as required by the Approval and 310 CMR 15.287(10)2; v) agrees to fulfill its responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5)3; vi) understands that garbage grinders may only be installed if the design plan has been sized to include a grinder; vii) understands that, whether or not covered by a warranty, the Owner must repair, replace,modify or take any other action as required by the Department of Environmental Protection or the local Approving Authority, if the Department or the local Approving Authority determines the System to be failing to protect public health and safety and the environment,as defined in 310 CMR 15.303. Very truly yours, Mary Plum Duly Authorized Agent Assembly Required LLC cc: Mr. David Stanton, Barnstable Health Inspector 3845724.1 2 310 CMR 15.287(10)states:"Prior to obtaining.a Certificate of Compliance for installation of a new or upgraded system,the system owner shall record in the chain of title for the property served by the alternative system in the Registry of Deeds or Land Registration Office,as applicable,a Notice disclosing both the existence of the alternative on-site system and the Department's approval of the system. The system owner shall also provide evidence of such recording to the local Approving Authority." 3 310 CMR 15.287(5)states:"Prior to the transfer of any ownership interest in an alternative system,or of any right or responsibility to operate an alternative system,the owner or operator shall provide written notice to the proposed new owner or operator that the system is an alternative system. Such notice shall include notice of the general conditions and any special conditions applicable to the system and its owner.In addition,the owner shall include either a copy in full or a reference to the notice of the alternative system described in 310 CMR 15.287(10), and the recording information for.that notice, in the instrument of transfer of any such ownership interest.In the event of the transfer of any such right or.responsibility without a transfer of ownership interest,the owner or operator shall include a copy in full or a reference to the notice of the alternative system described in 310 CMR 15.287(10),and the recording information for that notice,in the agreement transferring such right or responsibility." + Notice of Alternative Sewage Disposal System M.G.L. c. 21A, §. 13 and 310 CMR 15.0287(10) This Notice to be recorded and/or filed for registration in the chain of title of the Property served by an Alternative ewage Disposal System("Alternative System").] + NAME(S) OF OWNER OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: Ass<<iiil�h ltciluirr�tl 1,1,t�', � l�el:�����ia-C holitr4l�1i,il�ilit�� vt�riili.�itti�< �i�ill! �i.iti�iiliii�; :i�lrlr���� of 0o Naillcy li. satttiljsiit. 4011 lllaillik, A' iiriC, lisislon, N.1A 112 t W.. itch! Chi Diik 1ti f urittld �gj:, t rt li,c�,liiel]i►c +llie(:t►�, III'Pwil .NIJ; Err '1 1111ik Office ,tj,e:ice,,; 1 14t. .la�i�ic� ,1�'�r��1e+ :+�rit� %llt, !#,�:le►tt N1'A 021,1it. ADDRESS OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: 8 East Bay Road, Osterville,Massachusetts TITLE REFERENCE FOR PROPERTY SERVED BY ALTERNATIVE SYSTEM [check and complete each that applies]: Deed recorded with the BARNSTABLE REGISTRY in Book 30,724,Page 102 ' Certificate of Title No. 2138W3 issued by the Land Registration Office of the 41111 w uil,ly Registry District _Source of title other than by deed [If Alternative System Owner(s)is other than Property Owner(s),complete the following:] Alternative System Owner Name: Assembly Required LLC Alternative System Owner Address: c/o Nancy B. Samiljan, 400 Atlantic Avenue,Boston,MA- 02110, alid el i Mih Aiillwri/,aril t-,cool M.cir% 'Hiiiii, ri 1'aulVIVC'i�N Fliii,'s.i} ivw� J t. luriaa.ti k�'rilua: ta+atilr 74l, 11��,traii li ! 02'I16. WHEREAS, Section 15.280 of Title 5 of the State Environmental Code ("Approval of Alternative Systems"), provides for the Massachusetts Department of Environmental Protection (the "Department")to approve or certify, as appropriate, all proposals to construct,upgrade or replace on-site sewage disposal systems using alternative systems; WHEREAS, owners and/or operators of approved or certified alternative systems are subject to general conditions,as specified in Section 15.287 of Title 5 of the State Environmental Code, 310 CMR 15.287, and may be subject to special conditions,as specified in the Department's approvals or certifications; such general and special conditions potentially including, without limitation, requirements relating to the use of trained operators,periodic inspections,maintenance, sampling,reporting and/or recordkeeping; WHEREAS, Section 15.287(10)of Title 5 of the State Environmental Code, 310 CMR 15.287(10),requires that"prior to obtaining a Certificate of Compliance for installation of anew or. upgraded system,the system owner shall record in the chain of title for the property served by the alternative system in the Registry of Deeds and/or Land Registration Office, as applicable, a Notice disclosing both the existence of the alternative on-site system and the Department's approval of the system. The system owner shall also provide evidence of such recording to the local Approving Authority [J"and WHEREAS,the Property is served by an alternative sewage disposal system. NOW,THEREFORE,Notice of an alternative sewage disposal system is hereby given for the above-referenced Property, as follows: Pagel of 2 ' 1 t 1. Existence. An alternative system has been installed as a new or upgraded alternative sewage disposal system, on or adjacent to the Property, and serves the Property. The trade name and model number(s)of the alternative system are as follows: Trade name of technology: Pere-Rite Drip Dispersal System ! Manufacturer Name: American Manufacturing Company Model number(s): ASD 15 2. Approval/Certification. On 11/23/16, the Department,pursuant to its authority under the section of Title 5 as specified below; approved or certified the technology used in the above-referenced alternative system,under MassDEP Transmittal Number X250379. [Check one of the following,as applicable:] Approved for remedial use under 310 CMR 15.284 _Approved for piloting under 310 CMR 15.285 Provisionally approved under 310 CMR 15.286 Certified for general use under 310 CMR 15.288 A copy of the Department's Approval/Certification is available from the Department in person or on- line at the Department's website: http://www.mass.gov/dep. = i WITNESS the execution hereof under seal this Z� day of April,2018, made by the above-named i Alternative System Owner(s). � ` I Assembly Required LLC c/o Nlnr� 1'111eti i'tt rl :1k do Vaillih (Mica tit�r�'itcr ; 1 St. 311mv., efific: 1 i(dte 7411 COMMONWEALTH OF MASSACHUSETTS ✓u��.�, ss On this day of : q , 20 V, before me,the undersigned notary public, personally appeared Mary Plum,proved t6 me through satisfactory evidence of identification,which were 1>4 ntie- ,to be the person whose name is signed on the preceding or attached 1 document, and ackn wledged to me that she signed it voluntarily for its stated purpose. PATRICIA,'CUIRK ,: NoOjN i ubllc`., official signature and seal of notary) 38468.., COMMONWEALTH Of MAs9ACNU5ER8 ( My Oommiselon Expires September 30. 2022. Page 2 of 2 4ARN CAM REGISTRY OF DEEDS i 10110 F, Molde, Register 260 cranberry Highway AUTHORIZATION FOR Orleans,MA 02653 TECHNICAL C ^ASTA L 508.255.6511 P 508,255.6700 F (�J} Orleans I Sandwich I Nantucket SERVICES engineering co. coastalenginearingcompany.com To: Assembly Required LLC Date: 03/21/2018 Project No. P032118.xx Madison Chavez, Property Manager Project: Perc-Rite.Drip Disposal Operation& 110 East Bay Road Maintenance ' Osterville, MA 02655 T: 774-836-8266 Location: 8 East Bay Road Osterville MA Coastal Engineering Company, Inc. (CEC)will perform the Assessor's Map: 141 Parcel: 105 following professional services relating to the referenced Fixed Fee`. See Attachment 2 project. Contract Duration: Ongoing SCOPE OF SERVICES: Coastal Engineering Co., Inc. (CEC)will perform the services outlined in Attachment 1 regarding the.Operation and Maintenance of the Perc-Rite Drip Disposal Systems at 8 East Bay Road, Osterville MA CAS/mmw SUBJECT TO TERMS AND CONDITIONS ON REVERSE_ AUTHORIZED FOR COASTAL ENGINEERING: SIDE ❑ We are proceeding with service(s) noted as per your By: direction. Immediate notification in writing is required if you wish to alter this authorization. Chad A. Si mons, WTPO March 21,2018 ® Please execute this agreement authorizing us to proceed. No services will be performed until you return this agreement with authorization in writing. AUTHORIZED BY CLIENT: ® This document will become our original agreement, Acceptance of this agreement by signature authorizes Signature n Date COASTAL ENGINEERING to proceed as described,This �A, ( C�tr+�• ��c�y }�Sw�� 12e< , ,el Cat_ proposal expires in 90 days if not signed by both parties. Printed arrie and Title PLEASE SIGN AND RETURN ONE COPY D:IPROPOSALSIIHOLDIWastewaterATS12018►Assembly Required LLC ATS 201812103.doc f COASTALTANDARDNGAGEMENT TEONDITIONS FOR CHN CAL SERVICE CONTRACT C -- eng ineeringco. FIXED FEE PROPOSAL January 1, 2016 COMPENSATION FOR SERVICE CONTRACT: Coastal Engineering Co., Inc. from CEC that the stakes or other markers were set for the intended purpose (CEC)bases Its compensation for services on this project on the fee given for and are in place to the accuracy appropriate for the intended use. the project. CLIENTs are advised that Additional Services requested beyond the Scope covered by the fee proposal or change orders attached thereto will ELECTRONIC FILES: Electronic files are transmitted for informational be based upon the time input according to our current hourly fee rate schedule. purposes only and at the request of the CLIENT or CLIENT's agent. CEC's Fee proposals for services are prepared to the best of our ability based on facts official product is limited to its signed and sealed hard copy of plans, available at the time of submission. specifications, and/or studies. The CLIENT agrees to hold CEC harmless for any damages from inappropriate or illegal uses by others from any electronic TRANSPORTATION:Time and travel expenses incurred,when travel is in the transfer of information that was requested by the CLIENT or CLIENT's agent. interest of the project,will be charged for in accordance with our fee schedule. INDEMNIFICATION AND LIMITATION OF LIABILITY: CEC agrees to SUBCONTRACT SERVICES: CEC may engage subcontractors and/or other indemnify and hold CLIENT harmless against damages and liability resulting professionals to perform required services such as soil borings, drilling, from the negligent acts, errors, or omissions of CEC. The CLIENT agrees to construction, etc. That subcontractor's charge plus a service charge will be limit CEC's liability, resulting from errors and/or omissions in services furnished added to our fee. to the CLIENT directly by CEC to an amount not to exceed our fee. The CLIENT agrees to require a like limitation from any contractor engaged to REIMBURSABLE EXPENSES: Reimbursable expenses will be billed at our perform work for which we have provided reports, plans, and/or specifications. cost plus a service charge. Examples of reimbursable expenses ordinarily The CLIENT shall further indemnify and hold CEC harmless from any liability charged are replacement equipment, plumbing and hardware supplies, and resulting from the acts,errors,or omissions of the CLIENT or CLIENT's agents, chemical supplements for process control. contractors, or assigns. Such indemnification shall include the cost of defense arising in any way with claims connected with any such liability excepting only PAYMENT: Invoices will be rendered monthly or as work progresses. Invoices such liability as may arise out of CEC's sole negligence in performance of are due and payable upon receipt.Amounts over 30 days past due are subject services. CLIENT agrees that any and all damages arising from negligent act, to a service charge of 1.5%per month(18%annually).The CLIENT agrees to error, or omission shall be made against CEC directly and shall not be made pay reasonable attorney's fees and any collection fees incurred in the collection personally against any of its directors,officers,agents,or employees. of any amount owed hereunder and not paid when due. CONSEQUENTIAL DAMAGES: Notwithstanding any other provision hereof, CHANGE OF SCOPE: If, during the performance of services under this CEC shall not be liable to the CLIENT for any incidental, indirect, or Agreement,there is a change in the Scope of Services requested on the basis consequential damages arising out of or connected in any way to the services of an oral or written order by the CLIENT, or as required by circumstances to rendered hereunder,including,but not limited to,loss of use,loss of profit,loss address contingencies,or to revise plans upon the request of the CLIENT,CEC of business,loss of income,or loss of reputation. will perform these services in accordance with our fee schedule.CEC reserves the right, at our discretion, to issue a Change Order to this Agreement, NO WARRANTIES: CEC .makes no warranties, express or othermse, in However,a Change Order is not required prior to rendering such services and connection with GEC's services except for those which may be specifically the CLI ENT agrees to pay for such additional services. stated in the Operation and Maintenance Scope of Services, SUSPENSION OF SERVICES:If the CLIENT fails to make payment of invoices Men due, CEC may suspend performance of services under this Agreement.. In the event of a suspension of services, CEC shall have no liability to the t CLIENT for delay or damage caused by such suspension of services. TERMINATION PROVISION: This Agreement may be terminated by either party upon five(5)days written notice in the event of failure of performance of terms and conditions of this Agreement by the other party through no fault of the terminating party. CEC shall be compensated for services performed up to the time of termination. INSURANCE: CEC is covered by Worker's Compensation Insurance and Public and Professional Liability Insurance. We will furnish certification upon request. - RIGHT OF ENTRY: Unless otherwise agreed, the CLIENT furnishes right-of- entry on the land for CEC to make measurements,soil tests,or other required explorations. CEC will take reasonable precautions to minimize damage to the land from the use of equipment,but we have not included in our fee the cost of restoration from damage that may result from our operations.If we are required to restore the land to its former conditions,the cost of doing so will be added to our fee. OWNERSHIP OF DOCUMENTS: All documents, including original drawings, estimates, specifications, field notes, and data, are and shall remain the sole and exclusive property of CEC as instruments of service.The CLIENT may, at his/her expense,obtain record prints of drawings,in consideration of which the CLIENT will use them solely in connection with the above described project and not for the purpose of making subsequent extensions or enlargements thereto. USE OF DOCUMENTS:Services performed and documents prepared by CEC under this agreement shall be for the benefit of CLIENT only and may not be relied upon by any third party(ies) unless specifically agreed to in advance by CEC and CLIENT. USE OF STAKES:CLIENT,CLIENT's contractor,or any third party may not use , stakes or other markers set at the site by CEC before obtaining verification f Assembly Required LLC March 21,2018 ATTACHMENT 1 OPERATION AND MAINTENANCE SCOPE OF SERVICES The following is a summary of the scope of services to be provided by Coastal Engineering Co., Inc., Technical Services Division for the benefit of the Perc-Rite Disposal System owner: The treatment system shall be operated by a Certified Wastewater,Plant Operator in accordance with the requirements of 257 CMR 2.00 and the Board of Certification of Operators of Wastewater Treatment Plants. The treatment system shall also be operated in accordance with the conditions established by the Massachusetts Department of Environmental Protection (DEP) under 310 CMR 15.000 Title 5 of the Massachusetts Environmental Code for the permitted use and with the local Board of Health. EQUIPMENT MAINTENANCE 1. Within design capacity and capability of the equipment, maintain the Pere-Rite System for the benefit of the Client. 2. Certify and document all maintenance for the System's Maintenance reports will be provided on an annual basis or by request of the Client. 3. Certify and document all repairs to the equipment. 4. Perform other services that are incidental to the services specified here including facilitating emergency repairs in the` most expeditious and cost-effective manner at an additional cost as requested by Client. 5, Pump maintenance to be performed in accordance with manufacturers specifications by subcontractor and invoiced by them directly to the client. PERC-RITE DRIP DISPOSAL SYSTEM MAINTENANCE In accordance with the Perc-Rite Drip Disposal System operation and maintenance (O&M) requirements, conduct O&M inspections using the Perc-Rite technology checklist to document the findings of each inspection. Perc-Rite Inspections to include: 1. Standard maintenance as follows: a. Inspect the disposal field for visible wet spots b. Check the control panel for proper operation c. Check the liquid level of the pump chamber to confirm proper switch operation d. Check the pump and valves for proper zone operation e. Examine the hydraulic unit • Clean filters as needed • Check all hydraulic components for leaks • Determine and record flow f. Check the zone dosing rates g. Examine tanks and pumps and clean effluent screens,filters and floats, as needed 2. Maintenance frequency: Conduct semi-annual operation and maintenance services to perform standard Pere-Rite system maintenance, REPORTING: Prepare summary report following each inspection and file reports with the Department of Environmental Protection,Barnstable County and the local Board of Health ,i Assembly Required LLC March 21, 2018 NOTES: 1. Coastal Engineering will perform no procedures requiring confined space entry. 2. Services under this contract specifically do not include or cover any responsibility for system malfunction attributed to process design,equipment specified and/or installations as provided by others. 3. Client must provide access to all System components at time of O&M visit. 4. This service contract assumes seasonal occupancy of the dwelling or facility. The Owner shall notify TSD if F occupancy becomes year-round. 5. TSD will notify the appropriate authority of any event of electrical or mechanical failure within the treatment system,or of any event which may adversely affect the performance of the treatment system. 6. In the event that the system alarm Is activated and the system fails,the OWNER shall notify TSD who shall notify the DEP and Board of Health within 24 hours. Corrective action shall be taken immediately. Y f Assembly Required LLC March 21, 2018 ATTACHMENT 2 COST OF SERVICES 1. Yearly fixed fee costs for the services outlined in Attachment 1: ...,______,,._.$400 Billed at$200.00 semi-annually 2. Barnstable County Database Management Fee'........................................... 3. Services performed in addition to those noted, including responding to alarms, will be invoiced at $100.00 per hour Monday thru Friday 7am to 5pm.After regular business hours and holidays will be billed out at$125.00 per hour. 4. The cost for replacement equipment,supplies and process control chemicals will be invoiced at our cost plus surcharge in accordance with our Standard Conditions for Engagement(copy attached). 5. Additional sampling and testing,if required,will be invoiced at time and expense,in accordance with our standard rates. ; In the event that state or local regulatory bodies change sampling requirements and/or Operation and Maintenance requirements,the cost estimate will be revised to reflect these changes. * Barnstable County assesses an annual database management fee of$50.00 for each wastewater treatment management system in Barnstable County. Each July the County sends an assessment notice to Coastal Engineering Company,Inc.,for the systems operated by Coastal. Coastal Engineering pays the fee for the system owner and includes a $50.00 charge per system,this fee will be on your next invoice as a reimbursable expense. 3831036.1 Il i Town of Barnstable- . Barnstable AI-AIn�._ Board of Health y 939. B"M'� `Fg 200 Main Street;Hyannis NLA 02601 I I ��fp 2007 Office: 508-862-4644 Paul Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald Guadagnoli,M.D. June 14, 2018 Mr. Sean M. Riley, P.E. Coastal Engineering Co. 260 Cranberry Highway - Orleans, MA 02653 RE: 8 East Bay Road, Osterville A = 141-105 Dear Mr. Riley, You are granted a conditional variance on behalf of your client, Assembly Required L.L.C. c/o Nancy B. Samiljan, to construct an onsite sewage disposal system incorporating drip dispersal at 8 East . Bay Road, Osterville. The variances granted are as follows: Section 360-1 of the Town of Barnstable Code: To install a leaching facility 75 feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install aseptic tank 59 feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a septic tank 95 feet away from a wetland, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a pump chamber 95 feet away from a wetland, in lieu of the minimum 100 feet separation distance required. Q:\WPFILES\Riley8East8ayRoadVariances2018.docx u l Section 360-1 of the Town of Barnstable Code: To install a pump chamber 61 feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install the pump chamber 88.5 feet away from a pond, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install the distribution box 99 feet away from a pond, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a soil absorption system 64.4 feet away from a pond, in lieu of the minimum 100 feet separation distance required. These variances are granted with the following conditions: (1) No more than six (6) bedrooms are authorized at this property. Dens, -study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to six bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The engineering plan shall be revised to provide the following: provide design calculations for.a two compartment tank, show minimum of five feet separation to adjusted-High grdundwater-tab le;-show-1/z"-piping (not 1/2-'),—- — -- - - -- provide original wet stamp plan, provide a note to verify soils at time of installation, correct the dates of test holes #3 and #4 which were evaluated on March 20, 2018 (not March 5, 2018), and provide a note ensuring fence posts will be installed before drip tube(s) are installed in the area of the leaching facility. (4) All conditions contained within the DEP approval letter for the PERC-RITE Drip Dispersal System entitled 'Certification for General Use' dated March 15, 2007 revised'November 23, 2016, shall be strictly adhered to. (5) The septic system shall be installed_ in strict accordance with the revised engineering plans. - - __"-_.__- (6)------The designing--engineer shall supervise-the construction of the •onsite sewage disposal system and shall certify in writing to the Board of Health Q:\WPFILES\Riley8EastBayRoadVariances2Ol8.docx I tom. that the system was installed in substantial compliance with 'the revised engineering plans. These variances are granted because the proposed plan appears to meet the maximum feasible design standards contained within the State Environmental Code, Title 5 and local Health Regulations. The engineer designed the septic system attempting to maximize setbacks to the coastal bank and wetlands while providing greater separation to the estimated high groundwater by utilizing a per- rite drip dispersal system. The.wastewater effluent will be spread thoughout the leaching area and will be placed within 6 inches of grade to provide maximum aeration, nitrogen uptake, and filtering through the soil horizons. . Sincerely yours, ul J. Can D. M.D. Chairman Q:\WPFILES\Riley8EastBayRoadVariances2018.docx I EXERPT FROM THE BOARD OF HEALTH MEETING MINUTES APRIL 24, 2018: A. Sean Riley, Coastal Engineering, representing Ms. Samiljan, Trustee - Assembly Required LLC, owner- 8 East Bay Road, Osterville, Map/Parcel 141-105, 1.59 acre parcel, repairing a failed septic system, multiple variances requested. F John Schnaible, Coastal Engineering, presented the plan. Upon a motion duly made and seconded, the Board voted to grant the septic plan with the following conditions: 1) with have a PercRite system, 2) at the Barnstable County Registry of Deeds, they will record a six(6) bedroom deed restriction and must record on the deed that an I/A secondary alternative system is installed and required monitoring and maintenance, and 3) an official copy will be supplied to the Health Division. (Unanimously, voted in favor.) 1 h g 4/9/18 ` Op THE DATE: P FEE: $95.00 M f • CC • BARNSTABLE, 9 MASS. �p i639• �� h^^ } REC.BY (r ?� . rFp MA'1 A t�`Q Town of Barnstable SMED.DATE: Board of Health 1c3i 200 Main Street, Hyannis MA 02601 ' Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 JunichiSawayanagi Donald A.Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION ' Property Address: 8 East Bay Road, Osterville Assessor's Map and Parcel Number: 141-105 Size of Lot: 1.59 acres Wetlands Within 300 Ft. Yes x Business Name: No Subdivision Name: APPLICANT'S NAME: Assembly Required LLC Phone Did the owner of the property authorize you to represent him or her? Yes x No PROPERTY OWNER'S NAME CONTACT PERSON Name: Assembly Required LLC Name: Sean M. Riley, Coastal Engineering Co., Inc. Address: c/o Nancy B. Samilian, 400 Atlantic Ave. Address: 260 Cranberry Highway, Orleans, MA 02653 Boston, MA 02110 Phone: Phone: 508-255-6511 EMAIL: sriley@coastalengineeringcompany.com VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) See Attached See Attached NATURE OF WORK: House Addition House Renovation LJ Repair of Failed Septic System x Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in S separate,collated packets. Five(5)copies of the completed variance request form Five(5)copies of engineered plan submitted(e.g.septic system plans) Five(5)copies of MA DEP approval letter for UA septic systems only. _ Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian _ Signed letter stating that the property or business owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). _ $95.00 variance request application fee collected (No fee for lifeguard modification •renewals , grease trap variance renewals [same owner/lessee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) _ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A.Guadagnoli,M.D. C:\Users\Decollik\AppData\Local\Microsoft\windows\Temporary Internet I Files\Content.Outlook\BMQD49H2\VARIREQ Rev APR2017.DOC I , i ZEIP-11L,��j zeal)- " RE: Board of Health Meeting April 24, 2018 v 3t 8 EAST BAY RD, OSTERVILLE -SAMIJIAN/ASSEMBLY REQUIRED LLC Engineer: Sean Riley, Coastal Engineering Inspector's notes(DS) upon review of plans for 8 East Bay Rd, Osterville • Need original wet stamp • Note on soils @ time of installation, but already did perc • Test hole#3 &4—actually done 3/20/18 (not 3/5) • Need deed notice • Basement?—unfinished? `— • Design calc's in 2 compartment tank; diagram sho Cssingle tan • Pg 2—Should be 5' min.to highwater • Fence on A�pin' posts should be put in before drip tube to ensure not punctured. COASTAL engineering co. Project#C18614.00, April 9, 2018 Board of Health ` Attn: Thomas McKean, Health Director 200 Main Street Hyannis, MA 02601 Re: Board of Health Variance Request Proposed Sewage Disposal System Upgrade Assembly Required LLC 8 East Bay Road Osterville, MA Map 141 Parcel 105 Dear Board Members: On behalf of our client, Assembly Required LLC, we are requesting a variance from'the Barnstable Board of Health Regulations to install a Sewage Disposal System Upgrade to replace an existing system.at the above referenced property. The requested variance is from Regulation 360-1, setback requirements. Due to the proximity of the wetland/top of coastal bank, the configuration of the lot and estimated high groundwater, the horizontal distances between the components and the wetland/top of coastal bank cannot be met. The greater degree of environmental protection can be met by locating the sewage disposal system components farther from the . resource area than the existing, providing greater separation to estimated high groundwater and by utilizing a perc-rite drip dispersal system. The effluent will be spread throughout ,the leaching area and will be placed within 6 inches of grade to provide maximum aeration, nitrogen uptake, and filtering through the soil horizons. The vertical separation between adjusted high groundwater and the bottom of the drip irrigation system is 8.8 feet (the present soil absorption is only 3 feet above groundwater). The variances requested are as follows: - TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS 360-1 SETBACK REQUIREMENTS -SEPTIC TANK LESS THAN 100'TO DEP COASTAL BANK (41'VARIANCE REQUESTED) -SEPTIC TANK LESS THAN 100'TO EDGE OF WETLAND . (5'VARIANCE REQUESTED) -PUMP CHAMBER LESS THAN 100'TO EDGE OF WETLAND (5'VARIANCE REQUESTED) -PUMP CHAMBER LESS THAN 100'TO DEP COASTAL BANK (39'VARIANCE REQUESTED) x -LEACHING FACILITY LESS THAN 100'TO DEP COASTAL BANK (25'VARIANCE REQUESTED) , Coastal Engineering Co., Inc. respectfully requests that the Board of Health approve the requested variances. A representative will be at the public hearing on April 24th to present the plan and address any questions you may have. Orleans I Sandwich I Nantucket - . Please schedule this request for your April 24, 2018 public hearing. If you have any questions or require additional information, please contact our office. Very truly yours, COASTAL ENGINEERING CO., INC. Sean M. Riley SMR/sgc Enclosures cc: Assembly Required LLC AbutterReport http://maps.townofbamstable.us/arcims/appgeoapp/AbutterReport.a... Adjacent (Please choose abutter list type) Abutter List for Map & Parcel(s): '141105' Default buffer of parcels adjacent to the selected parcel Total Count: 4 1 Close Map &Parcel Owners Owner2 Addressl Address 2 Mailing Country Deed C ityStatez ip 141104001 ASSEMBLY REQUIRED C/O NANCY B 400 ATLANTIC BOSTON,MA 30724/97 LLC SAMIUAN AVENUE 02110 141105 ASSEMBLY REQUIRED C/O NANCY B 400 ATLANTIC BOSTON,MA 30724/102 LLC SAMIUAN AVENUE 02110 141105001 ASSEMBLY REQUIRED C/O NANCY B 400 ATLANTIC BOSTON,MA 30724/97 LLC SAMIUAN AVENUE 02110 141106 BARNSTABLE LAND p 0 BOX 224 COTUIT,MA 10242/259 TRUSTINC 02635 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required, contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 2/2 812 0 1 8. t 1 1 of 1 2/28/2018,2:00 PM Abutter Map (BOH) 8 East Bay, Osterville a ®Map X 'maps townofbamstable us/aiams/appgeoapp/nap aspx prbpertylD 141 OS 0 �}�-�Q Su ch _ III\ m _ ._ _... ! y Most:Y dad G Gmail L'F Simpleln/Out, New F Id r N T b (!(j)Wetlands&Watershe...'(�FM DEP NOI Numb Compress PDF Town of Barnstable Geographic Information System H—S.—I, I home I Nelp Parcel Vlesvei 'Csistom'MeD 1 6'utf �E slza 8® Zoam Out ®�®�®�®®in . ..',lawamt 9lseo'a91ae roPo � 1 `wfmam]r L'o �'Aki yi 1, ,•�I D `eae. '�It ...�.IinecjN e]] ael] "• �}��, �' ' �4] • . - � latm d�'T 1T6t tu�I .. 11i ei6 ,.:1 41emoa oo] t�Ps,� 1 : I�� r14 ' '" 19,�rADI; 1911W •„! ! 4R109D�0 ( , I u. ',• 19fOW001 .y 1911�09006. ;'�d1 I 1 I _ • 191106 � T r]9 8 ee ar' 1 I 9m I ro] A" � nQ bea� x N rtt k� fl ,•o. ..�.:I. 1910P) I::♦q B eq IA B V C 1 i ,,,� l9uoe wup9w9 yid l f 141e09 rw I10e. as 0� � 1 P •, � ��i, g 1911a) IIIIYA01 .(. Y 0 18 erg . rtos r°e i . { P.djacent'(Pleasechease abutter list type) C,pYlgh1100a.]010 Taws ar —d.bl..MA All rlahtr—d.S9 dOar.11dnr e,—.1110 GIs c G � Owner's Manual AMERICAN ,PERC-RITE° " WASTEWATER DRIP SYSTEMS Z ZONE or 4 ZONE SIMPLEX or DUPLEX- PATENT #'s: 5,200,065 5,984,574B 6,261,452131 ZONE 2 9PCF ZONE 1 �V CENTRAL UNIT(CU) Q SUPPLY O TO CU SEPTIC TANK PUMP TANK OWNER'S NAME HEALTH DEPT. ID NO. LOCATION NAME STREET NAME CITY, STATE ZIP Table of Contents American Manufacturing Limited Warranty 2 Introduction 2 Safety Precautions and Warnings 2 Owner's Responsibility 3 , Overview of American Perc-Rite® Drip 3 System Parameters of American Septic Drip 5 r Data Registers & Component Specifications & Details 6 Startup Log 8 r. MANUFACTURED BY: AMERICAN MANUFACTURING COMPANY INC. 5517 WELLINGTON ROAD, GAINESVILLE, VA. 20155 1-800-345-3132 ©American Manufacturing Company, Inc., 2006 - 1 - www.americanonsite.com AMERICAN MANUFACTURING LIMITED WARRANTY For one year (12 months) after the date of purchase, American Manufacturing Company, Inc. will repair or replace any product or portion thereof which proves to be defective due to materials or workmanship of American Manufacturing. We reserve the right to repair or replace defective materials at our discretion. This warranty does not cover the following conditions: 1. Defects or problems caused by improper installation or maintenance of materials. 2. Abuse, neglect or accidental damage of products. 3. Normal maintenance or upkeep of products. 4. Lighting, war, floods, or other acts beyond our control. 5. Misapplication of our products for their designed purpose, or misapplication according to local, state or national codes when in effect. 6. American Manufacturing Company or its representatives are not responsible for the labor for the replacement of defective parts. Defective or warranted materials must be returned to us or a place designated by American Manufacturing. All returns must be accompanied by a return authorization number supplied by American Manufacturing. American Manufacturing will in no way be responsible for any losses or damages incurred by failure of equipment, parts or service. NOTE: Some states do not allow exclusion of damages so this may not apply to you. There are no other warranties written or implied. INTRODUCTION Congratulations! You are now the owner of a state of the art wastewater treatment and recycling system by American Manufacturing Company, Inc. We have been in business for over 20 years and are considered one of the leaders in the On-Site Wastewater industry. With a staff having over 100 years collective experience in providing solutions to new sites and sites in need of repair, we are able to deliver an ecological, economical, easy to install and off-the-shelf Perc-Rite°Drip to owners like yourself. When and How to use manual This owner's manual should be read cover to cover initially, and then as needed to answer any questions or assist the owner in fulfilling their maintenance and inspection responsibilities. When and Where to call for assistance or get additional information If at any time you have a question about the Perc-Rite°Drip or observe any alarm or unusual condition, you should call your qualified service representative or installing contractor as soon as possible. The owner should record in the back of this manual, the contact name and telephone number of the qualified service representative and installing contractor. If further assistance is needed, call American Manufacturing Company, Inc. at 800-345-3132, or visit us at www.americanonsite.com. Overview of Manual The manual is organized to cover safety precautions and warnings, an overview of the Perc-Rite°Drip components, and the owner's responsibility. A startup log and limited warranty are in the back of this manual. SAFETY PRECAUTIONS AND WARNINGS The owner or operator of the Perc-Rite®Drip should take precautions consistent with operators working with sewage and/or electricity while working with, or around any of the system components. Electrical Hazards The Perc-Rite°Drip incorporates pump(s), float switches, relays and many electrical components that use 230 volts, 120 volts or 24 volts AC. Improper use of equipment can cause an electrical shock and may lead to serious injury or death. Sewage Hazards Proper attention should be given to cleanup when working in and around the septic and pump tanks and wastewater handling equipment to insure that disease causing bacteria are not transmitted to persons or contact surfaces. The septic and pump tanks can allow for a toxic buildup of poisonous gasses that can lead to serious injury or-death if inhaled. Heavy Lifting Hazards The owner and/or operator should exercise proper caution when lifting heavy system components, such as pump tank lids. Improper lifting of heavy components can lead to loss of limb and/or mobility. © American Manufacturing Company, Inc., 2006 - 2 - www.americanonsite.com OWNER'S RESPONSIBILITY Preventative Maintenance The drip field area should receive only the most passive type yard uses. No use is recommended when conditions are wet. Under no conditions are any autos or heavy machinery to be allowed on the site. In order to prevent erosion, the site should be established and maintained as a healthy lawn, or if wooded, mulched and stabilized. Erosion of the site and the adjacent areas should be controlled and eliminated. Surface waters should be diverted away from all components. Scheduled Inspections Within a month of operation the owner should contact the installer to have the system inspected for-proper startup. After three months of operation the drip field should be walked and the system inspected. Symptoms to look for on the field walk inspection are patches of wetness. If symptoms are identified, notify your service provider immediately. The drip field should be walked &inspected at least annually. A trained professional service provider, your American Dealer, should inspect the septic tank and pump chambers at least once a year. The septic tank should be pumped when the sludge level reaches 25% or approximately 12 inches, or when the scum layer on top is excessive. The flow meter reading in the hydraulic unit should be recorded with the date on a quarterly basis. Alarms- Notifying Service Provider of alarm events The system controller is equipped with an audiovisual alarm-to-alarm high water level condition. The high level alarm- may be silenced by pressing the "silence" button on the side of the control. Since a high water level condition can be caused by pump failure, excessive infiltration, or an unusually large peak water use, the owner should call the service provider to determine the cause of the alarm prior to requesting service. If at any time there are any indications of failure, such as the flow meter not moving during a dose or wetness in the area of the drip field, notify your service provider immediately. Monitor & Regulate waste input to septic tanks Since all processes in this sewage disposal system use biological activity to treat the wastewater, only typical biodegradable household wastes are to be disposed of in drains leading to the septic tank. Never dispose of pesticides, oil or grease based products, or non-fecal solids (especially feminine hygiene products) into the system. Minimize disposal of high strength over-the-counter type products such as bleach, and do not use colored toilet tissue. OVERVIEW OF PERC-RITE DRIP SYSTEM The Perc-Rite° Drip System is a unique fluid handling system for dispersal of effluent wastewater in soil systems. The system incorporates filtration, time and level controlled application and ultra low rate drip distribution. In conditions where aerobic dispersal, such as "Low Pressure Distribution", of septic effluent is required or where land application with the use of conventional soil absorption fields are not acceptable, this system offers a unique method for subsurface distribution of the waste water effluent. The Perc-Rite° Drip System will accommodate virtually any type of pretreatment process, whether septic tank (anaerobic), aerobic, lagoon, or any type of treatment facility. Only primary treatment (the removal of large settleable solids) of sewage is necessary for the operation of the system. Local soil and site conditions may require additional treatment for excessive organics, oil and grease or other contaminants. Since the installation of the field distribution lines causes very little soil disturbance and effluent discharge volume from each emitter hole is insignificant, the installation of the system has very little site impact even in established lawns or park areas. After installation there are virtually no visible indications that the installation site is being used for disposal purposes. This system is especially suited for landscaped or wooded areas near buildings, trailer parks, apartment complexes or residential subdivisions. The Perc-Rite° Drip System is operated via a "state of the art" controller, which is activated by level sensing devices (standard mechanical differential float switches) located in a dosing tank downstream from the pretreatment process or processes (typically a septic tank). When activated by the rising level of effluent in the dosing tank, the controller will enable the disposal cycle, and as dictated by the time clock, pump the effluent through a.115-micron disc filter and then to final drip dispersal. Drip Tubing The drip field supply line conveys the effluent to the drip absorption zone that is being dosed where it is discharged below the soil surface through a patented chemical-resisting pressure compensating self cleaning "drip" poly-tubing emitter. The emitters or "drippers" are located every two feet in the tubing and emit 0.65 gallons per hour per emitter. The dripper lines are automatically scoured (forward flushed) every 25 dosing cycles. This function is activated by the controller, which opens the field flush valve, thus allowing the flushed effluent to be returned to the pretreatment tank. The duration of this cycle is approximately three minutes. The flushing cycle produces a high ©American Manufacturing Company, Inc., 2006 3 - www.americanonsite.com f velocity cleansing/scouring action by the effluent along the inside walls of the dripper tubing and P.V.C. Manifolds. The tubing emitters are self-cleaning and require no maintenance. The construction of the drip tubing is unique in that the internal diaphragm and labyrinth provide for an exact amount of effluent to be discharged from each of its emitters, which are spaced at two-foot intervals along the entire length of the drip tubing. Each emitter maintains a constant flow over pressure ranges of 7 to 70 psi. Because the effluent is distributed at an ultra low rate, large quantities of effluent may be economically distributed over large areas during controlled periods of time without saturating the surrounding soil. Air Release Valves The drip field return line conveys the effluent from the drip absorption zone (used to"flush"or clean the tubing) back to the pretreatment device. Each zone will have an air release valve housed in a small valve box at the highest point of the return manifold pipe. This valve will close when the water pressure arrives at the valve during each dose. The air release valve allows air to reenter the tubing after each dose to allow the tubing to drain. This also_prevents the uphill tubing from draining water into the downhill tubing and overloading downhill tubing. In the event of damage to the air release valve, effluent may leak from the system. This condition should be fixed immediately by replacing damaged parts. Air release valves should not be covered with soil or other material and should always be accessible to the service personnel. Seauence of Operation: PERC-RITES DRIP SYSTEM The pump control panel is equipped with four float switches to control the timed doses to be discharged. The four float switches, "Redundant Off', "Standard Dose Enable", Peak Dose Enable" (optional), and "High Level" function as follows: Redundant Off-The water level must be high enough to overcome the "Redundant Off' (first&bottom) float in order for the pump to be permitted to run. Standard Dose Enable - When the water level rises high enough to overcome the "Standard Dose Enable" (second) float and the time clock has timed out the preset time delay of 180 minutes (rest between dosing cycles for two zone designs) the pump will activate and the lead zone is dosed. The pump will continue to run for the length of time as adjusted on the pump run timer and then shut off. The pump will remain off until the internal time clock again times out the preset time delay (180 minutes) after which the pump will activate (as long as the "Standard Dose Enable" float is still up) and will run until the pump run timer finishes timing out.. This process will repeat until the water level drops below the "Standard Dose Enable" float and the pump run timer has timed out. The rest time automatically varies with the number of Zones. Peak Dose Enable -The control system will be equipped with a "Peak Dose Enable" circuit to manage peak flows and excess water use. If the rising water level activates the "Peak Dose Enable" (third) float, the "Pump - Off- Pump & Alarm" switch is set to "Pump", and the preset time delay has exceeded 108 minutes ("Peak Dose Enable" rest between cycles for two zone designs), the lead zone will be dosed. When the peak circuit has been deactivated the normal pumping cycle will resume. If the rising water level activates the "Peak Dose Enable" (third) float, the "Pump. Off- Pump&Alarm" switch is set to "Pump&Alarm", and the preset time delay has exceeded 108 minutes ("Peak Dose Enable" rest between cycles for two zone designs), the lead zone will be dosed and the "Peak Dose Enable" '- alarm will be activated. The audio portion of the alarm may be silenced by pressing the Test-Normal-Silence switch to the silence position. When the "Peak Dose Enable" float has returned to the down position the alarm will be deactivated and the normal pumping cycle will resume. The rest time automatically varies with the number of Zones. High Level - If the water level rises enough to overcome the "High Level" (fourth) float, the audiovisual alarm will activate. The audio portion of the alarm may be silenced by pressing the Test-Normal-Silence switch (located on the outside of the control panel) to the silence position. The alarm circuit will auto reset when the "High Level"float returns to its normal (down) position. The high-level alarm float is a wide-angle float in order to latch the alarm signal. CONTROLLER The "state of the art" controller is enclosed in an outdoor electrical control box located near and connected to the hydraulic unit. The control panel uses 115 or 230 volt power and the microprocessor has 120V and 24V AC inputs and relay outputs for automatic operation of the Perc-Rite°Drip System. When in the"Hand"or"Off'position, the manual switches (Hand-Off-Auto) on the door of the control panel completely bypass the microprocessor. The"Hand" position will allow manual operation of the component in the event of a microprocessor failure. NOTE: ` THE HOMEOWNER ASSUMES FULL RESPONSIBILITY FOR CONDITIONS OR MALFUNCTIONS DUE TO CHANGES IN PUMP RUN TIME BY ANYONE OTHER THAN A QUALIFIED SERVICE REPRESENTATIVE. LEAVING THE PUMP CONTROL IN THE "HAND" POSITION WILL FORCE THE PUMP TO RUN CONTINUOUSLY AND MAY RESULT IN PUMP FAILURE. ©American Manufacturing Company, Inc., 2006 -4- www.americanonsite.com r i Normally Open Flow'neter Supply Valves Disc Filters Normally Closed Field Flush Valve Normally Closed Zone Valves 3ackflush Valves j. Supply From l Puma 3ar,k Sep t....... Return Too Tar-k Hydraulic Unit The submersible pump delivers unfiltered effluent through each filter. The filter backflushing schedule is triggered at the beginning of each dose cycle. The backflushing sequence is as follows. One filter valve closes, thus blocking the flow of unfiltered effluent to that filter. After a short delay, the other flushing valve opens, thereby backflushing the unused filter. The accumulated impurities discharge back into the pretreatment unit. The closing and opening procedure of the filter and back flush valves causes a change of flow within the unit to provide effluent from one filter to backflush the other filter. The backflush procedure lasts approximately fifteen seconds then the back flushing valve closes. Only after the first filter has completed its backflushing cycle, will the second filter begin its cycle of backflushing in the same manner as the first. Effluent will then be pumped through clean disc filters, then through the flow meter and finally through the zone valves to the drip field supply line. During extended dose times the disc filters are re-backwashed to assure optimum operation. System Parameters Simplex System w/ 1 or 2 Zones & 2 Disc Filters a. System Fail indicated by high level alarm or unusual wetness in the field. b. Standard Rest time between doses = 180 minutes, 4 doses per day per zone. c. Peak Rest time between doses = 108 minutes, 6.6 doses per day per zone. d. Flow meter on hydraulic unit (record periodically to monitor activity). e. To remove pump or zone from service place its'control switch to"off". System Parameters Simplex & Duplex System w/ 4 Zones &2 Disc Filters a. System Fail indicated by high level alarm or unusual wetness in the field. b. Standard Rest time, 4 doses per day per zone; • 4 zones in use doses = 90 minutes, • 3 zones in use doses = 120 minutes, • 2 zones in use doses = 180 minutes, c. Peak Rest time between doses • 4 zones in use doses = 54 minutes, • 3 zones in use doses = 72 minutes, • 2 zones in use doses = 108 minutes, d. Flow meter on hydraulic unit (record periodically to monitor activity). e. To remove pump or zone from service place its'control switch to"off'. ©American Manufacturing Company, Inc., 2006 - 5 - www.americanonsite.com AMERICAN "PERC-RITE°" WASTEWATER DRIP SYSTEMS 2 ZONE or 4 ZONE SIMPLEX or DUPLEX CONTROLLER SIEMENS MICROPROCESSOR - INPUTS AND OUTPUTS The Siemens microprocessor has inputs on the bottom and outputs on top. The two zone units have 8 inputs (0-7) and 6 outputs (0-5). The three and four zone has the following; Output QO .0 1 .1 1 .2 1 .3 1 .4 1 .5 1 .6 1 .7 Q1 1 .0 1 .0 Input IO .0 .1 1 .2 1 .3 1 .4 1 .5 1 .6 1 .7 I1 1 .0 1 .1 .2 .3 .4 .5 MICROPROCESSOR - INPUTS AND OUTPUTS R R R R R R ' E E E E E E F F F F F F A B C A B C Input Input Input Description Output Output Output Description + IO IO IO QO QO QO .0 .0 .0 DOSE CUTOUT .0 .0 .0 IPUMP 1 .1 .1 .1 OFF LEVEL FLOAT .1 .1 .1 ZONE RETURN .2 .2 .2 DOSE ENABLE FLOAT .2 .2 .2 FILTER 1 .3 .3 .3 PEAK ENABLE FLOAT .3 .3 .3 FILTER 2 .4 .4 .4 RESET/CYCLE START .4 .4 .4 FIELD 1 .5 .5 .5 PUMP 1 .5 .5 .5 IFIELD 2 r .6 .6 .6 ZONE 1 VALVE .6 .6 FIELD 3 .7 .7 .7 ZONE 2 VALVE .7 .7 FIELD 4 .0 .0 ZONE 3 VALVE .0 .0 PUMP 2 Input Input Input rni� put Output Output I1 I1 I1 1 1 .1 .1 ZONE 4 VALVE .1 .1 ZONE MASTER .2 .2 PUMP 2 .3 .3 CURRENT SENSOR .4 .4 HIGH LEVEL (OPTION) .5 .5 JAUX. INPUT 1 References:"REF A " is Two Zone Simplex System "REF B " is Four Zone Simplex System "REF C " is Four Zone Duplex System ©American Manufacturing Company, Inc., 2006 - 6- www.americanonsite.com M Output Ligfits %0000000m000 itIL o O -ii OCIO 1Tt tT O O aaa aaas ��+-� 1 1 1L A P aw.wamwiwTit 00 000000000 NSV/tPh/60Hz 175V 1Ph $DH PILOT CIRCUIT ALARM CIRCUIT Input Lights O O PUMP #1 SUPPLY PUMP #1 FEED 0 O O PEAK RESET/ FILTER BACKFLUSH ZONE MASTEfl LEVEL CYCLESTART �2 Kan&o.Aim O O ® O O �M., i�A1 0 o A;' ® ® e O i A?' (�A 11 R. %. 0� 0n 01 `0n 0n PUMP2 PUMPI REZONE ZONE1 ZONE ZONE3 ZONE4 TURO O HSAQFAub ft'do.NIb Ha161M&b Wn60WNib KvAIOMh Hvd-0, M141.RNM 4?b �M� OR _ 0 12OVAC� 24VAC-jf-120VAC-, BTt 8T2 [TB3 i�� INS I`n '� a- i PC OFF TE PE i 1_ AC 1 2 7 2 Z4ZRz4-DRAG HI H2 A2 P2 Al PI I DVC (DIRECT VOLTAGE t CUTOUT) OFF I t I 1 (Blower Fail Option J I ! 115V STANDARD) o\ I TIMER ENABLE F1 Z ' I GO F2 Z1 Z3 ZR 1 I I �—` I PEAK ENABLE I ANTI—I PILOT NEUTRAL FREEZE ALARM NEUTRAL SOLENOID VALVES IHEATERI F1 FILTER #1 1 1 (MAY BE UUMPCD TOGETHER d F2 = FILTER 2 I I F SEPARATE SUPPLIES � L___J ARE NOT REQUIRED) HIGH LEVEL t Z1 = ZONE #1 120V/50OW Z2 = ZONE#2 MAX 23 = ZONE #3 O Z4 =ZONE #4 DRY ALARM CONTACTS ZM = ZONE MASTER (OPTIONAL REMOTE ZR = ZONE RETURN LOCATION ALARM) 1) Leave switches in "Auto" or "Off" - Never leave switches in "Hand" or "On" position. The Off position will take component out of service. 2) To Silence Alarm - On outside of control push "Test-Off-Silence" switch to "Silence" and release. 3) Leave power "on" - There is a strip heater in the hydraulic unit which is powered by the control panel. Power must be left on to protect unit from freezing. 4) To start automatic cycle - Push and hold "Reset" button for over 5 - seconds until an automatic cycle starts. Then release button. 5) Manual Operation - Place "H-O-A" (hand-off-auto) switch to "Hand". This position is like an "ion switch" and should operate the individual component regardless of other conditions. ©American Manufacturing Company, Inc., 2006 - 7 - www.americanonsite.com Name: Dater Owners'Address: „ American Perc-Rite° Drip Startup Log USER LOG Line As-Built Description Number of Zones:_ Date Date Date Date No. Value 1 BEDROOMS 2 GALLONS PER DAY 3 TEXTURE GROUP 4 GPD/FT2 DESIGN SOIL LOADING,RATE 5 TOTAL LINEAR FEET TUBING 6 GPD/LF FT DESIGN TUBING LOADING RATE 7 METER READING 8 ZONE 1 LINEAR FEET OF TUBING 9 ZONE 1 NUMBER OF FIELD FLUSH CONNECTIONS 10 ZONE 1 GPM DOSING FLOW RATE 11 ZONE 1 GPM TOTAL FLUSHING FLOW RATE ° 12 ZONE 1 RUN TIME 13 ZONE 2 LINEAR FEET OF TUBING 14 ZONE 2 NUMBER OF FIELD FLUSH CONNECTIONS ^- 15 ZONE 2 GPM DOSING FLOW RATE 16 ZONE 2 GPM TOTAL FLUSHING FLOW RATE 17 ZONE 2 RUN TIME 18 ZONE 3 LINEAR FEET OF TUBING 19 ZONE 3 NUMBER OF FIELD FLUSH CONNECTIONS 20 ZONE 3 GPM DOSING FLOW RATE 21 ZONE 3 GPM TOTAL FLUSHING FLOW 22 ZONE 3 RUN TIME 23 ZONE 4 LINEAR FEET OF TUBING 24 ZONE 4 NUMBER OF FIELD FLUSH CONNECTIONS 25 ZONE 4 GPM DOSING FLOW RATE . 26 ZONE 4 GPM TOTAL FLUSHING FLOW 27 ZONE 4 RUN TIME 28 PEAK ENABLE CYCLE COUNTER 29 HIGH LEVEL CYCLE COUNTER. 30 CONTRACTOR STARTUP REPRESENTATIVE:. -- STARTUP DATE: CONTRACTORS NAME & PHONE; Note to Owner: Any changes to pump run timer should be recorded in manual on.this page. AMERICAN MANUFACTURING COMPANY, INC. P.O. BOX 97, ELKWOOD, VA 22718-0097, 1-800-345-3132 ©American Manufacturing Company, Inc., 2006 - 8 - www,americanonsite.com a.a"ate - _ YOUR DRIP DISPERSAL EXPERT IN NEW ENGLAND P„ ROUTINE OPERATION AND MAINTENANCE PROCEDURE FOR PERC-RITE® DRIP DISPERSAL SYSTEM MODELS: ASD, QM, WD A. Field Conditions and Preparation 1. Obtain records from previous visit/start-'up 2. Walk the field to determine if wet areas are present 3. Open hydraulic unit and document flow meter reading 4. Calculate and document daily water usage 5. Open pump chamber and check liquid level/floats 6. Trigger alarm float 7. Open valve box and inspect air release valves B. Control Lights and Switch Positions 1. Open the control panel 2. Make sure all HOA switches are in the automatic position _ 3. Microprocessor: confirm power and run lights are on 4. Verify float LED display corresponds with float positions in pump chamber C. Pump and Valve Operation ' 1. Turn all HOA switches in control panel to ""OFF"; 2. Inspect (and clean if necessary) disc filter(s) 3. Manipulate each HOA switch to test solenoid and valve operation. The flow meter should only turn when a zone valve. is open and pump is on 6 Sargent St.,Gloucester,MA 01930 (978)282-1322 www.oakson.com info@oakson.com July 2017 11 P a g e & OAKS N YOUR DRIP DISPERSAL EXPERT IN NEW ENGLAND n 4. Place all HOA switches in the "AUTO" position. Hold in the "RESET/CYCLE START" button (approx. 5. seconds) until you hear a click , a. At the hydraulic unit, you should witness a complete system cycle b. After pressurization time, document the flow , rate(s) by reading the flow meter for a timed minute c. Compare design flow to timed flow (10% tolerance) d. Flow variation is most common sign of system issue e. Inspect air release valves for normal operation D. Septic and/or Pre-treatment Tanks (if incorporated into O&M contract) 1. Examine and clean effluent filters 2. Document sludge/scum levels in tank 3. Recommend pumping if necessary 4. Service pre.-treatment system E. Finishing Up ' 1. All HOA switches in control panel should be in ""AUTO"' position 2. Close and secure all tanks, hydraulic 'unit, control panel, and air release valves 3. Fill out operator checklist. Provide copies to homeowner, local BOH, and Oakson within 60 days 6 Sargent St.,Gloucester,MA 01930 (978)282-1322 www.oakson.com info@oakson.com July2017 2 Page YOU.lIP DISPERSAL EXPERT INNEW[NGIANC ROUTINE OPERATION AND MAINTENANCE CHECKLIST FOR PERC-RITE® DRIP DISPERSAL SYSTEM MODELS: ASD, QM, WD Property Address: Date: Time: Air Temperature: Weather Conditions: FIELD CONDITIONS A. Drip dispersal field: visible wet spots YES NO objectionable odor YES NO Comments: B. Air release valves: functioning properly YES NO Comments: FLOAT OPERATION . A. Floats: register on PLC YES NO Comments: B. Alarm float: audible/visual YES NO Comments: CONTROL PANEL A. HOA Switches: functioning properly YES NO Comments: B. PLC (microprocessor): power/run lights on YES NO Comments: I Ilk e . 6 Sargent St.,Gloucester,MA 01930 '118,111-1311 www.oakson.com 4 info@oakson.com July 2017 1 P a g e & OAKS N YOUR DRIP DISPERSAL EXPERT IN NEW ENGLAND HYDRAULIC UNIT A. Disc Filter(s): cleaning required YES NO Comments: B. Valves: opening/closing YES NO Comments: A C. Condition: signs of erosion/infiltration YES NO settling/movement YES NO Comments: SEPTIC and/or PRE-TREATMENT TANKS (if included in contract) A. Effluent Filter: cleaning required YES NO N/A Comments: B. Septic tank: pumped since last visit YES NO pumping recommended YES NO 1. Sludge depth: 2. Scum depth: j Comments: C. Service pre-treatment system' YES NO N/A Comments: _ Operator signature License No. Company Phone No. Comments/Observations: . r Flow Meter Reading: Dose Rate(s): Flush Rate(s): 6 Sargent St.,Gloucester,MA 01930 (978)282-1322 www.oakson.com If info@oakson.com July2017 21 Page r x- COASTAL engineering co. Project#C18614.00 April 9,2018 A- ABUTTER NOTIFICATION Re: Board of Health Variance Request Proposed Sewage Disposal System Upgrade Assembly Required LLC 8 East Bay Road Osterville, MA Map 141 Parcel 105 Dear Abutter: On behalf of our client, Assembly Required LLC, we are requesting a variance from the Barnstable Board of Health Regulations to install a Sewage Disposal System Upgrade to replace an existing system at the above referenced property. The requested variance is from Regulation 360-1, setback requirements. Due to the proximity of the wetland/top of coastal bank, the configuration of the lot and estimated high groundwater, the horizontal distances between the components and the wetland/top of coastal bank cannot be met. The greater degree of environmental protection can be met by locating the sewage disposal system components farther from the resource area than the existing, providing greater separation to estimated high groundwater and by utilizing a perc-rite drip dispersal system, The effluent will be spread throughout the leaching area and will be placed within 6 inches of grade to provide maximum aeration, nitrogen uptake, and filtering through the soil horizons. The vertical separation between adjusted high groundwater and the bottom. of the drip irrigation system is 8.8 feet (the present soil absorption is only 3 feet above groundwater). The variances requested are as follows: TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS 360-1 SETBACK REQUIREMENTS: + -SEPTIC TANK LESS THAN 100'TO DEP COASTAL BANK , (41'VARIANCE REQUESTED) -SEPTIC TANK LESS THAN 100'TO EDGE OF WETLAND (5'VARIANCE REQUESTED) -PUMP CHAMBER LESS THAN 100'TO EDGE OF WETLAND (5'VARIANCE REQUESTED) -PUMP CHAMBER LESS THAN 100'TO DEP COASTAL BANK (39'VARIANCE REQUESTED) " -LEACHING FACILITY LESS THAN 100'TO DEP COASTAL BANK (25'VARIANCE REQUESTED) The application and plans are available for review at the Barnstable Board of Health Office located within the Barnstable Town Hall, 200 Main Street, Hyannis, MA. Information may also be obtained by contacting our office. This hearing is currently scheduled April 24, 2018 beginning approximately 3p.m. at the Barnstable Town Hall. Orleans I Sandwich I Nantucket. " ' Very truly yours, COASTAL ENGINEERING CO., INC. Sarah Cole cc: Barnstable Board of Health Assembly Required LLC Sean M. Riley, Project Manager D:1DOC\C18600\18614\Permitting\BOH Captain's House(8 East Bay)\Abutter Note.doc n Town of Barnstable P# __113 alldo Department of Regulatory Services - : gpRNgrpgLE, + Public Health Division Date r 9 MASS. 1639. 200 Main Street,Hyannis MA 02601 f ArFD MA't A � ✓°� Date Scheduled �/ �� �A/� ✓ Time 16 Fee Pd. I yu Soil uitability Assessment for Se%agefisposal Performed By: U G � DG d"S' Witnessed By: `�J LOCATION &.GENERAL INFORMATION Location Address Owner's Name Or �) a �►4-c��vs:�� Gass f ,��1 6�e Address K_,,K P U rA VV ; Assessor's Map/Parcel: ' , Engineer's Name C>P,!5-Tk . N NEW CONSTRUCTION REPAIR Telephone# e�� (;C) Land Use KgcJ« Slopes(%) 0 —j Surface Stones Distances from: Open Water Body I y 0 4 ft Possible Wet Area 'v 0 k ft Drinking Water Well 260_ ft 5 Drainage Way 06 T ft Property Line 0 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&rpefctests,.locate wetlands in proximity to holes) r _ 177 �i ry�J t � � NZ I, +-+, ��in 7-,,- "\1 gig _;�N Parent material(geologic) V K0_ U41,/ w PQ h�t� Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face J4- 1 Estimated Seasonal High Groundwater IJlavo DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: (L Depth Observed standing in obs.hole: C in. Deptli to soil mottles: in. Depth to weeping from side of obs.hole: 0 ._in. Groundwater Adjustment 0 ft. � � J -7 Index Well#(,u -_M Reading Date• uW IoVI Index Well level j'' Adj.factor_ Adj.Groundwater Level l�gvo PERCOLATION TEST Date Time: Q� - Observation Hole# Time at?" Depth of Pere Time at 6" Start Pre-soak Time @ ti° Time(9"-6") End Pre-soak f/G Rate Min./Inch L: Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q ASEPTIC\PERCFORM.DOC € DEEP OBSERVATION HOLE LOG Hole;# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) o f A OYD 6 DEEP OBSERVATION HOLE LOG Hole'# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel l oa _._........ ............................. ...... .. .. . ........... ...... ... _.. ................. ..... ............. . .. .. ........... ............. ............. .... .. ....... DEEP OBSERVATION:HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole#' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Mau: Above 500 year flood boundary No_ Yes Within 500 year boundary N Yes Within 100 year flood boundary No Yes' Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perviolas material exist in all areas observed throughout the area proposed for the soil absorption system? _ If not,what is the depth of naturally occurring pervious material? Certification pp� I certify that on W�- r Vd (date)I havelpassed the soil evaluator examination approved by the Department of Environmental Protection-ad_ ;at the above analysis was performed by me consistent with the required train experti e and experience escr'ed in 310 CMR 15.017. E` Signature -" Date zo t Q:\SEPTIC\PERCFORM.DOC R g Co'r nll;otlweelth of Massachusetts Exccubvo Office of Energy &Env'ror��r=(�r-ita4 Affairs t Department of Environmental Protection ()nc..! Winter e St l. (^?t F.,I+oszon, mA C jc`)fft a rt 1 7-^,92 r 500 Charles D.Baker Matthew A.Beaton Governor Secretary Karyn E.Polito Martin Suuberg Lieutenant Governor Commissioner CERTIFICATION FOR GENERAL USE Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: American Manufacturing Company, Inc. 22011 Greenhouse Road, PO Box 97 Elkwood, VA 22718 Trade name of technology and model: PERC-RITE Drip Dispersal System,Models QM(WD), ASD-15, ASD-25 &ASD-40 (hereinafter called the "System"). A schematic drawing of a typical System, a Design Manual, an Installation Manual, and an inspection checklist are part of this Approval. Transmittal Number: X250379 Date of Issuance: March 15, 2007, revised November 23, 2016 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000 ("Title 5"or"the Code"), the Department of Environmental Protection hereby issues this Certification for General Use to: American Manufacturing Company, Inc., PO Box 97, Elkwood, VA 22718 (Hereinafter "the Company"), for the System described herein. Sale and use of the System are conditioned on and subject to compliance by the Company,the Designer, the Installer,the Service Contractor, and the System Owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000. November 23, 2016 David Ferris, Director Date Wastewater Management Program Bureau of Water Resources This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617.292-5751.TTY#MassRelay Service 1-800-439-2370 MassDEP Website:www.mass.gov/dep Printed on Recycled Paper Certification for General Use Page 2 of 15 PERC-RITE Drip Dispersal System—March 20,2015 I. Purpose 1. Department approved Drip Dispersal Systems provide alternatives to a conventional leaching system and alternatives to some of the other design requirements of Title 5. 2. This Certification is for the installation of a System to serve a facility for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the Approving Authority and the site meets the siting requirements for new construction.. 3. This Certification shall not be used for the installation of a System to upgrade or replace an existing failed or nonconforming system, unless the facility meets the siting requirements for new construction, including a reserve area. All other proposed upgrades utilizing this System shall be in conformance with the Remedial Use Approval issued by the Department for this System. 4. With the other applicable permits or approvals that may be required by Title 5,the Certification for General Use authorizes the installation and use of the System in Massachusetts. All the provisions of Title 5, including the General Conditions for Alternative Systems (310 CMR 15.287), apply to the sale, design, installation, and use of the System, except those provisions that specifically have been varied by this Approval. 5. Provided that the local approving authority approves the System in conformance with the Department's General Use Certification for the System, Department review and approval of the site-specific System design and installation is not required unless the Department determines on a case-by-case basis, pursuant to its authority at 310 CMR 15.003(2)(e), that the proposed System requires Department review and approval. 6. The Department has determined that the System is equivalent to a pressure distribution system designed in accordance with the Department's Pressure Distribution Guidance. Il. Design and Installation Requirements 1. The Drip Dispersal System may only be used for disposal of wastewater effluent from a Title 5 septic tank meeting the most current standards for new construction or from a secondary treatment unit Certified for General Use by the Department. In addition to the requirements of this Approval,when a secondary treatment unit precedes the Drip Dispersal System,the Designer,the Installer,the Service Contractor, and System Owner shall be responsible for compliance with the requirements of the Department's secondary treatment unit Certification. 2. The System is a pressure distributed subsurface wastewater drip dispersal (disposal) system that replaces a conventional soil absorption system (SAS). The System is designed to distribute septic tank or secondary effluent and pressure discharge it at a depth of at least 6 inches below finished grade. The System includes a pump, control panel, a filter module/hydraulic unit and drip dispersal zone(s) with drip tubing incorporating discharge emitters. The dispersal zone(s) include small diameter flexible Certification for General Use Page 3 of 15 PERC-RITE Drip Dispersal System—March 20,2015 polyethylene tubing with pressure compensating emitters. The emitters operate on a pressure differential across the emitter, with wastewater discharged in small doses. Dispersal field dosing is timed and controlled electronically to provide pre-programmed volumes of effluent for discharge to each dispersal zone(s). The System allows periodic backwashing of the filtration system and forward-flushing of the dispersal tubing with the flush/backwash effluent conveyed by return line to the septic tank.The System may include single (the QM/WD model) or two-stage (the ASD models) automatic backwashing disc filters within the filter module and air vents in each dispersal.zone. Each zone shall have air release valves at the high points of manifolds and check valves on each return manifold in multi-zone systems. The System shall be equipped with a totalizing flow meter. 3. The System shall include the following: a) Pumps capable of providing pressure of 10-60 psi throughout the dispersal zone(s). Each drip dispersal zone shall be dosed a minimum of four times per day, or as recommended by the Company. Duplex pumping shall be provided for facilities with design flows of 2,000 gpd or greater. The pump chamber, combined with available storage in the pretreatment units, shall provide at least one-day storage, as required by Title 5. b Timed dosingfor the drip system with a time r controller capable of operating the p Y p p g system during peak flow events without high-level alarms. c) Automatically backwashed filter(s) capable of screening particles larger than 115 microns prior to discharge of the effluent to the drip tubing. Filter(s)backwash shall be conveyed back to a separate settling tank or to the septic tank. d) Air vents in a zone shall be placed at a higher elevation than the drip tubing in that zone but below the ground surface. Air vents shall be accessible from finished grade and insulated to prevent freezing. e) Drip tubing lines installed as level as possible on contour and a minimum of 6 inches below finished grade. Drip line spacing is typically 24 inches with drip tubing emitters spaced 24 inches on center. The drip dispersal tubing shall be automatically forward flushed after a pre-programmed number of dosing cycles as determined by the Company. Flushing velocity shall be at least 2 feet per second at the distal end(s) of each drip dispersal lateral within a zone. All drip line flushwater shall be conveyed back to the pump tank, a separate settling tank or to septic tank. fl The dispersal area shall not be installed under a paved surface, or in areas of routine traffic, parking or storage of heavy equipment. In addition no planting or soil excavation shall be done in or within 5 feet of the drip disposal area after its installation. The system may be designed to,allow for installation of drip tubing up to five feet from a building cellar wall. g) No change in existing surface slope over the dispersal field is required.. 4. The System may be installed in soils with a percolation rate of up to 60 minutes per inch (MPI) in Class I, II, lIl, or IV soils, subject to the restrictions of the Approval. The Certification for General Use Page 4 of 15 PERC-RITE Drip Dispersal System—March 20,2015 System shall only be installed in Class IV soils, as defined in 310 CMR 15.243, when the design has been reviewed and certified by the Company(see Paragraph V.3). 5. The System may be installed in the A, B or C soil horizon or in fill material meeting the current Title 5 specifications, at a depth of at least 6 inches below,but not more than 24 inches below the finished grade. The use of the A horizon(or fill material) shall not be included in the determination of the required minimum of 4 feet of naturally occurring pervious material. For proposed installations in the A or B soil horizon, a soil evaluation shall be performed to determine whether or not these soils are the most restrictive layer and the appropriate loading rate for the design of the Drip Dispersal System. The soil evaluation of the A and B horizon must be acceptable to the local approving authority and may include,but not necessarily be limited to,a sieve analysis or a modified shallow percolation test. 6. The minimum effective dispersal area provided for the System shall be`based on the soil loading rate(gpd/sq.ft.)derived from the Company's Design Guidance or the limitations imposed by this Approval,whichever is more stringent. 7. The effective dispersal area shall be calculated as the bottom area of the drip tubing system. No sidewall effective dispersal area,credit shall be given for Drip Dispersal Systems. 8. The effective dispersal area provided by each emitter shall not overlap with the effective dispersal area provided by an adjacent emitter. 9. The effective dispersal area shall be a maximum of 4 square feet per emitter (2 feet by 2 feet), provided that adjacent lines of the tubing are spaced at least 2 feet apart and the emitters are at least 2 feet apart along the length of the tubing. 10. The minimum spacing between lines of drip tubing shall be 12 inches. The total number of emitters in the effective dispersal area shall not exceed one emitter per. 1 square foot of the effective dispersal area. 11. The System may have a layout which is different than a conventional system in terms of shape. Accordingly, a reserve area must be provided that meets the dimensional requirements of a conventional soil absorption system using either standard or pressure distribution loading rates. 12. Prior to using Pere-Rite Drip Dispersal for new construction, the record drawings submitted to the Approving Authority shall demonstrate that both a primary and reserve area for a conventional SAS can be designed for this the property, including both a primary and a reserve area. Once it has been determined that a conventional system can be constructed the record drawings can then depict the location of a primary Perc-Rite Drip Dispersal system, sized per this Approval,which would be constructed. No additional Perc-Rite Drip Dispersal reserve area need be depicted. The System Owner shall not construct any permanent buildings or structures or disturb the site in any manner(except for installation of drip tubing) on the approved conventional reserve area in a manner that would prohibit installation, if needed, of a full-sized conventional SAS. Certification for General Use Page 5 of 15 PERC-RITE Drip Dispersal System—March 20,2015 13. If additional drip tubing is installed in the future,the effective dispersal area for each existing and new emitter must be recalculated based on the new separation distances and the requirements above. 14. Residential Systems less than 2000 gpd, Alternative Design Standard to 310 CMR 15.242(1)(a)Effluent Loading Rates—For residential Systems with design flows less than 2000 gpd, the required effective dispersal area may be reduced up to 50 percent when using the loading rates for gravity systems of 310 CMR 15.242(1)(a), provided that the Drip Dispersal System is preceded by a secondary treatment unit with General Use Certification that allows for a 50%reduction in effective leaching area. Any reduction in effective leaching area shall be in accordance with the requirements and limitations of the secondary treatment unit General Use Certification and this Certification. No reduction is allowed in addition to the reduction allowed under the secondary treatment unit General Use Certification. For residential design flows of 2000 gpd or greater and for all nonresidential systems, no reduction in the effective dispersal area is allowed. The record drawings must indicate an area for a full-sized conventional primary SAS and the area for a full-sizedpurpose conventional reserve SAS are for the sole of upgrading the on-site sewage disposal system in the future, if necessary, without any increase in flow. (The effluent loading rates provided in 310 CMR 15.242(1)(b) for pressure distribution may be utilized, but no reduction in the effective leaching area may be taken when using these loading rates, as stated in the regulation.) 15. The supply lines, drip tubing manifolds, and headers shall be sloped to allow effluent to drain back to the effluent pump (dosing) chamber by gravity to prevent freezing or installed at a depth of least four feet. The drip tubing and shallow manifolds shall be designed to drain into the soil upon completion of the pump cycle. 16. For Systems with a design flow of 2,000 GPD or greater, the System shall be equipped with a flow meter and automatic remote telemetric notification to the Service Contractor. 17. Except for septic tank covers which are not required to be at grade, the frames and covers of all other access manholes and ports of the System components shall be watertight, made of durable material, and shall be installed and maintained at grade,to allow for necessary inspection, operation, sampling and maintenance access. Manholes brought to final grade shall be secured to prevent unauthorized access. No structures which could interfere with performance, access, inspection, pumping, or repair shall be located directly upon or above the access locations. 18. The System shall be equipped with sensors and high-level alarms to provide notification to the System Owner and Service Contractor of a high water situation due to pump failure, pump control failure, loss of power or system freeze up. The control panel including alarms and controls shall be mounted in a location always accessible to the Service Contractor. Certification for General Use Page 6 of 15 PERC-RITE Drip Dispersal System—March 20,2015 19. The System does not require a five foot over dig as indicated at 310 CMR 15.255(5). 20. All System control units,valve boxes, drip dispersal lines,conveyance lines and other System appurtenances shall be designed and installed to prevent freezing per the Company's recommendations. 21. System unit malfunction and high water alarms shall be connected to circuits separate from the circuits to the operating equipment and pumps. 22. Any System structures with exterior piping connections located within 12 inches or below the Estimated Seasonal High Groundwater elevation shall have the-connections made watertight with neoprene seals or equivalent. 23. Installation of inspection ports as described in 310 CMR 15.240(13) is not required for this System. 24...Upon submission of an application for a Disposal System Construction Permit (DSCP),the Designer shall provide to the local Approving Authority: a) for any proposed non-residential System, any System to be installed in Class IV soils, or any residential System with a design flow 2,000 GPD or greater, certification by the Company as specified in Paragraph V.3. b): certification by the DesiRner:'thiit the design conforms to the Approval,the Company Design Guidance, and the-.Code;'and c) a certification, signed bythe Owner of record for the property'to be served by the Technology, stating hat the.property Owner: i) has been;provded a copy:of the Approval;:,the Owner's Manual and the 'Operation and Maintenance Manual and th-e Owner'agreds to conlply with all term s.and conditions ii) has been informed of all the Owner's.estimated costs,associated mith the operation including,.-wl en applicable power-consumption, maintenance, recordkeeping;,reporting; and`,equipment replacement; iii) understands the requirement for a service contract;: iv) agrees to".fulfill his responsibilities:to provide a Deed Nofic 'as"required by _ .. the Approval;, v) agrees to`fulfill his,responsihilities to provide written notification of the . Approvaito any;`new-Owner,as requtred by"310 CMR 15.287(5); v) if the design does not-prOide.:for the use'of garbage grinders;the"restriction is understood and accepted,, and vii) whether or not covered by a warranty, the'System Owner understands the requirement to repair;"replace,modify or,take-any:;other action as required.,by the Department or the local Approving Authority;-if the Department or the local Approving Authority determines the:System to be failing to protect public health.and safety and the environment, as defined in 310 CMR 15.303. Certification for General Use Page 7 of 15 PERC-RITE Drip Dispersal System-March 20,2015 25. The System Owner and the Designer shall not submit to the local Approving Authority a DSCP application for the use of a Technology under this Certification if the Certification has been revised, reissued, suspended, or revoked by the Department prior to the date of application. The Certification continues in effect until the Department revises, reissues, suspends, or revokes the Certification. 26.The System Owner shall not authorize or allow the installation of the System other than by a person certified by the Company to install the System. 27. Prior to the commencement of construction, the System Installer must certify in writing to the Designer, the local Approving Authority, and the System Owner that (s)he is a locally approved System Installer and has been certified by the Company as qualified to install the System. 28. Except where the Approval specifically states otherwise, the Alternative System shall be installed in a manner which does not intrude on, replace, or adversely affect the operation of any other component of the subsurface sewage disposal system. 29. Drip tubing may be installed with a vibratory plow,a static plow, a narrow trencher(<6" width),by hand trenching, or by scarifying the surface and bedding the drip tubing in clean sand meeting the current requirements for fill material in Title 5 with cover consisting of sand and topsoil meeting the 6 inch minimum depth requirement. Vegetative cover must be replaced for installations where it is removed or buried during installation. 30. Drip tubing shall not be installed when soils are frozen or saturated. 31. The Installer shall maintain on-site,at all times during construction, a copy of the approved plans, the Owner's manual, the O&M manual, and a copy of the Approval. 32. Prior to the issuance of a Certificate of Compliance for the System, the Company or its designee shall submit to the local approving authority and the System Owner a signed certification that the Alternative System has been installed in accordance with the Company's requirements, the approved plan, and the Approval. This certification in no way changes the Title 5 requirements for the Designer and Installer certifications. 33. Prior to the issuance of a Certificate of Compliance by the local Approving Authority, the System Installer and Designer must provide, in addition to the certifications required by Title 5, certifications in writing to the local Approving Authority that the System has been constructed in compliance with the terms of the Approval. 34. The Department has not determined that the performance of the System will provide a ` level of protection to public health and safety and the environment that is at least equivalent to that of a sanitary sewer system. a) If it is feasible to connect a new or existing facility to the sewer, the Designer shall not propose an Alternative System to serve the facility and the facility Owner shall not install or use an Alternative System; and Certification for General Use Page 8 of 15 PERC-RITE Drip Dispersal System—March 20,2015 b) when a sanitary sewer connection becomes feasible after an Alternative System has been installed,the System Owner shall connect the facility served by the System to the sewer within 60 days of such feasibility and the System shall be abandoned in compliance with current Code requirements, unless a later time is allowed in writing by the Department or the local Approving Authority. III. Operation and Maintenance 1. To ensure proper operation and maintenance(O&M) of the System,the System Owner shall enter into an O&M Agreement with a qualified Service Contractor . whose name appears on the Company's current list of Service Contractors.. Prior to commencement of construction of the System,the System Owner shall provide to the local Approving Authority a copy of a signed O&-M Agreement. 2. From start up and thereafter, the System Owner and Service Contractor shall be responsible for the proper operation and maintenance of the System in accordance with this Certification, the Designer's O&M requirements,the Company's O&M requirements and the requirements of the local Approving Authority. The System Owner and Service Contractor shall be responsible for compliance with all monitoring and inspection requirements. All inspection, operation,maintenance, and monitoring requirements remain in effect until the conditions are modified, terminated, or superseded by a new Approval. 3. Prior to issuance of the Certificate of Compliance,a clean water test of the System shall be performed in the presence of a Company representative and the Service Contractor to check for leaks and for the proper distribution of effluent and to ascertain and verify system design flush and dose rates. The local approving authority shall be given adequate notification and opportunity to witness the clean water test, or at their discretion, may accept a letter from the Company representative certifying that the System operated properly during the clean water test. 4. For design flow rates of less than 2,000 gpd,the Service Contractor shall inspect and service the System at least annually, in accordance with Company requirements and checklist. 5. For actual or design flow rates of 2,000 gpd or greater, the System shall be inspected and serviced at least quarterly, consistent with the pressure distribution inspection requirements of 310 CMR 15.254(2)(d) and in accordance with Company requirements and checklist. 6. At a minimum, the Service Contractor shall clean the effluent tee filter according to 310 CMR 15.227(7), inspect pumps, controllers, air relief valves, and other system filters, and provide service, as necessary. . - Certification for General Use Page 9 of 15 PERC-RITE Drip Dispersal System—March 20,2015 7. Each time an Alternative System is visited by a Service Contractor the following shall be recorded, at a minimum: a) date, time, air temperature, and weather conditions; b) observations for objectionable odors; c) observations for signs of breakout of sanitary sewage in the vicinity of the Alternative System; d) identification of any apparent violations of the Approval; e) since the last inspection,whether the system had been pumped with date(s) and volume(s) pumped; f) sludge depth and scum layer thickness, if measured; g) when responding to alarm events,the cause of the alarm and any steps taken to address the alarm and to prevent or reduce the likelihood of future similar alarm events; h) any cleaning and lubrication performed; i) any adjustments of control settings, as recommended or deemed necessary; j) any testing of pumps, switches, alarms, as recommended or deemed necessary; k) identification of any equipment failure or components not functioning as designed; 1) parts replacements and reason for replacement, whether routine or for repair; and m) further corrective actions recommended, if any. 8. Unless directed by the local Approving Authority to take other action, the System Owner shall immediately cease discharges or have wastewater hauled off-site, if at any time during the operation of the Alternative System the system is in failure as described in 310 CMR 15.303(1)(a)1 or 2, backing up into facilities or breaking out to the surface. IV. Additional System Owner and Service Contractor Requirements 1. Prior to comm enceramt.of construction of the,System-and after recording and/or registering the Deed N.otice,iequired by 31.O CMR,:15.287(10) the System:Owner shall provide to the local,Approving Authority a copy of: a) a certified.Registry;copy of theDeed Notice.,bearingahe book'and page/or document.nunber;;and b) if the property.is unregistered land d-copyof th&.System,Owner's deed to the property as-recorded;at the Registry, bearing a marginal reference.on the System Owner's deed to the property.: The Notice to be recorded-shall be:in the form of the:Notice provided:by the Department: 2. Prior to signing any agreement to transfer any or all interest in the property served by the System, or any portion of the property, including any possessory interest,the System Owner shall provide written notice, as required by 310 CMR 15.287(5) of all Certification for General Use Page 10 of 15 PERC-RITE Drip Dispersal System—March 20,2015 conditions contained in the Approval to the transferee(s). Any and all instruments of transfer and any leases or rental agreements shall include as an exhibit attached thereto and made a part of thereof a copy of the Approval for the System. The System Owner shall send a copy of such written notification(s)to the local Approving Authority within 10 days of giving such notice to the transferee(s). 3. The System Owner shall provide access to the site for the Service Contractor to perform inspections, maintenance, repairs, and responding to alarm events, as may be required by the Approval. 4. The System Owner and the Service Contractor shall maintain an O&M Agreement at all times. The duration of the O &M Agreement shall be at least one year and shall include the following provisions: a) The name of a Service Contractor,who meets the qualifications specified in the Approval, shall be included; b) The Service Contractor's responsibilities for inspection, operation, maintenance, monitoring, recordkeeping and reporting, as required by this Approval shall be included; c) In the case of a System which is determined to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303, an equipment failure, alarm event, components not functioning as designed, or violations of the Approval, procedures and responsibilities of the Service Contractor and System Owner shall be clearly defined, including corrective measures to be taken immediately. The System Owner and the Service Contractor shall maintain on-site, at all times, a copy of the O&M Agreement,the approved design plans, the Owner's Manual, and the O&M Manual. 5. The Service Contractor shall submit to the System Owner the O&M report and inspection checklist within 60 days of any site visit. 6. The System Owner and the Service Contractor shall maintain copies of the Service Contractor's O&M reports, inspection checklists, and all reports and notifications to the local Approving Authority for a minimum of three years. 7. Upon determining that the System is in violation of the Approval or the System is failing to protect public health and safety and the environment, as defined in 310 CMR 15.303, the Service Contractor shall notify the System Owner immediately. 8. Upon determining that the System is failing to protect public health and safety and the environment, as defined in 310 CMR 15.303, the System Owner and the Service Contractor shall be responsible for the notification of the local Approving Authority within 24 hours of such determination. 9. In the case of a System that has been determined to be failing to protect public health and safety and the environment, an equipment failure, alarm event, components not functioning as designed, components not functioning in accordance with Certification for General Use Page 11 of 15 PERC-RITE Drip Dispersal System—March 20,2015 manufacturers' specifications, or violations of the Approval, the Service Contractor shall provide written notification within five days, describing corrective measures to the System Owner,the local board of health, and the Company and may only propose or take corrective measures provided that: a) all emergency repairs, including pumping, shall be in accordance with the limitations and permitting requirements of 310 CMR 15.353; b) the design of any repairs or upgrades are consistent with the System Approval; c) the design of any repairs or upgrades requiring a DSCP shall be performed by a Designer who is a Massachusetts Registered Professional Engineer or a Massachusetts Registered Sanitarian, provided that such Sanitarian shall not design a system with a discharge greater than 2,000 gallons per day. d) the installation shall be done by an Installer with a currently valid Disposal System Installers Permit and the Installer shall be certified by the Company as qualified to install the System . The System Owner shall also be responsible for ensuring written notification is provided within five days to the local board of health. 10. The System Owner and the Service Contractor shall provide written notification to the local Approving Authority within seven days of any cancellation, expiration or other change in the terms and/or conditions of a required O&M Agreement with a Service Contractor. The Service Contractor shall provide written notification to the Company within seven days of any cancellation, expiration or other change in the terms and/or conditions of a required O&M Agreement. 11. By February 15th of each year, the System Owner and the.Service Contractor shall be responsible for submitting to the local Approving Authority all O&M reports and inspection checklists completed by the Service Contractor during the previous 12 months. 12. By February 15th of each year,the Service Contractor shall be responsible for submitting to the Company copies of alLO&M reports including alarm event responses, violations of the Approval, inspection checklists completed by the Service Contractor, notifications of system failures, and reports of equipment replacements with reasons during the previous 12 months. 13. The Service Contractor shall notify the System Owner of any changes to the terms and conditions of the Approval within 30 days of any changes. _ 14. Within one year of any changes to the terms and conditions of the Approval, the System Owner shall amend, as necessary, the O&M Agreement required by Paragraph III.1 to reflect the changes to the terms and conditions of the Approval. 15. To determine whether cause exists for modifying, revoking, or suspending the Approval or to determine whether the conditions of the Approval have been met, the System Owner shall furnish the Department any information that the Department requests regarding the System, within 21 days of the date of receipt of that request. Certification for General Use Page 12 of 15 PERC-RITE Drip Dispersal System—March 20,2015 16. The Approval shall be binding on the System Owner and on its agents, contractors, successors, and assigns, including but not limited to the Designer, Installer, and Service Contractor. Violation of the terms and conditions of the Approval by any of the foregoing persons or entities, respectively;shall constitute violation of the Approval by the System Owner unless the Department determines otherwise. V. Company Requirements 1. The Approval shall only apply to model units with the same model designations- specified in the System Approval and meet the same specifications, operating requirements, and plans, as provided by the Company or its authorized agent at the time of the application. Any proposed modifications of the units, installation requirements, or operating requirements shall be subject to the review of the Department for inclusion under a modification of the Approval. The Designer shall be responsible for the selection of the appropriate model unit except, for systems of 2,000 gpd or more,the Company or its authorized agent shall be responsible for verification of the appropriate model unit as part of the review of proposed installations under a General Use Approval. { 2. Prior to submission of an application for a DSCP,the Company or its authorized agent shall provide to the Designer and the System Owner: a) All design and installation specifications and requirements; b) An operation and maintenance manual, including: i) an inspection checklist; ii) recommended inspection and maintenance schedule; iii) monitoring(i.e. water use); iv) alarm response procedures and troubleshooting procedures; c) An owner's manual, including alarm response procedures; d) Estimates of the Owner's costs associated with the operation including, when applicable: power consumption, maintenance, recordkeeping, reporting, and- equipment replacement; e) A copy of the Company's warranty; and . f) Lists of certified Installers and trained Service Contractors. 3. Prior to the submission of an application for a DSCP, for all nonresidential Systems, all Systems to be installed in Class IV soils, and all Systems with design flows of 2,000 gpd or greater, the Company or its authorized agent shall submit to the Designer and the System Owner, a certification by the Company or its authorized agent that the design conforms to the Approval and all Company requirements and that the proposed use of the System is consistent with the System's capabilities. The authorized agent of the Company responsible for the design review shall have received technical training in the Company's products. 4. The Company must maintain programs of training and continuing education for Service Contractors. Training shall be provided at least annually. If the Company ' B Certification for General Use Page 13 of 15 PERC-RITE Drip Dispersal System—March 20,2015 requires trained Designers and Installers, the Company or its authorized agent shall institute programs of training and continuing education that is separate from or combined with the training for Service Contractors. The Company or its authorized agent shall maintain, annually update, and make available by February 15`h ofeach year, lists of trained Service Contractors, certified Installers and, if training is provided, trained Designers. The Company or its authorized agent shall certify that the Service Contractors and, if training is provided, Designers and Installers on the lists have taken the appropriate training and passed the Company's training qualifications. The Company or its authorized agent shall further certify that the Service Contractors on the list have submitted to the Company all the reports required by Paragraphs IV.9, 10, and 12. 5. The Company or its authorized agent shall not re-certify a Service Contractor if the Service Contractor has not complied with the reporting requirements for the previous year. 6. The Company or its authorized agent shall not sell the System to an Installer unless the Installer is certified to install the System by the Company or its authorized agent. The Company or its authorized agent shall require, by contract,that distributors and resellers of the Technology shall not sell the System to an Installer unless the Installer is certified to install the System by the Company. 7. As part of any training programs for Service Contractors, Installers, or Designers, the Company or its authorized agent shall provide each trainee with a copy of this Approval with the design, installation, O&M, and owner's manuals that were submitted as part of the Approval. 8. The Company shall provide, in printed or electronic format, the System design, installation, O&M, and Owner's manuals, and any updates associated with this System Approval, to the System Owners,Designers, Installers, Service Contractors, vendors, resellers, and distributors of the System. Prior to publication or distribution in Massachusetts, the Company shall submit to the Department for review a copy of any proposed changes to the manual(s) with reasons for each change, at least 30 days prior to issuance. The Company shall request Department approval for any substantive changes which may require a modification of the Approval. 9. Prior to its sale of any System that may be used in Massachusetts, the Company shall provide the purchaser with a copy of this Approval with the System design, installation, O&M, and Owner's manuals. In any contract for distribution or sale of the System,the Company shall require the distributor or seller to provide the purchaser of a System for use in Massachusetts with copies of these documents, prior to any sale of the System. 10.To determine whether cause exists for modifying, revoking, or suspending the Approval or to determine whether the conditions of the Approval have been met, the Company shall furnish the Department any information that the Department requests regarding the Technology within 21 days of the date of receipt of that request. Certification for General Use Page 14 of 15 PERC-RITE Drip Dispersal System—March 20,2015 11. Within 60 days of issuance by the Department of a revised Approval, the Company shall provide written notification of changes to the Approval to all Service Contractors servicing existing installations of the System and all distributors and resellers of the System. 12. The Company shall provide written notification to the Department's Director of the Wastewater Management Program at least 30 days in advance of the proposed transfer of ownership of the System. Said notification shall include the name and address of the proposed owner containing a specific date of transfer of ownership, responsibility, coverage and liability between them. All provisions of this Approval applicable to the Company shall be applicable to successors and assigns of the Company, unless the Department determines otherwise. 13. The Company shall maintain copies of: a) the Approval; b) the installation manual specifically detailing procedures for installation of its System; c) an owner's manual, including alarm response procedures; d) an operation and maintenance manual, including: i) an inspection checklist; ii) recommended inspection and maintenance schedule; iii) monitoring requirements, if any(including water use and power consumption when required); iv) alarm response procedures and troubleshooting procedures. . e) estimates of the operating costs provided to the Owner, including,when applicable: power consumption, maintenance,recordkeeping,reporting, and equipment replacement; f) a copy of the Company's warranty; and g) lists of trained Designers (if any), certified Installers, and trained Service Contractors. 14. The Company shall maintain the following additional information for the Systems installed in Massachusetts and make it available to the Department within 30 days of a request by the Department: a) the address of each facility where the System was installed,the Owner's name and mailing address (if different), the type of use(e.g. residential, commercial, institutional, etc.), the design flow,the model installed; b) the installation date, start-up date, current operational status; c) the name of the Service Contractor, noting any cancellations or changes to any Service Contracts; and d) copies by of all Service Contractor records submitted to the Company, including all O&M reports with alarm event responses, all monitoring results, inspection f Certification for General Use Page 15 of 15 PERC-RITE Drip Dispersal System—March 20,2015 checklists completed by the Service Contractor, notifications of system failures, and reports of equipment replacements with reasons. 15. The Approval shall be binding on the Company and its officers, employees, agents, contractors, successors, and assigns, including but not limited to dealers, distributors, and resellers. Violation of the terms and conditions of the Approval by any of the foregoing persons or entities, respectively, shall constitute violation of the Approval by the Company unless the Department determines otherwise. VI. General Requirements 1. Any System for which a complete Disposal System Construction Permit("DSCP") Application is submitted while the Approval is in effect, may be permitted, installed, and used in accordance with the Approval,unless and until: a) the Department issues modifications or amendments to the Approval which specifically affect the installation or use of a System installed under the Approval for the System; or b) the Department, the local approval authority, or a court requires the System to be modified or removed or requires discharges to the System to cease.' 2. All notices and documents required to be submitted to the Department by the Approval shall be submitted to: Director Wastewater Management Program Department of Environmental Protection One Winter Street- 5th floor. Boston, Massachusetts 02108 3. The Department may suspend, modify or revoke the Approval for cause, including, but not limited to, non-compliance with the terms of the Approval, for obtaining the Approval by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Approval, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to the Approval and/or the System against the Company, a System Owner,a Designer, an Installer, and/or Service Contractor. Commonwealth of Massachusetts Title 5 Official Inspection Fora, Subsurface Sewage Disposal System Form- Not for Voluntary Assessments , 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is Osterville MA 02655 "June 25, 2010 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. Please see completeness checklist at the end of the,form. Important` A. General Information When filling out forms on the computer,use 1. Inspector: 1 / only the tab key to move your Patrick T. Sullivan (� J cursor-do not Name of Inspector use the return key. Ready Rooter, Inc. Company Name P.O. Box 371 Company Address Sandwich MA 02563 City/Town State Zip Code 508-888-6055 S1 12843 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 Further Evaluation by the Local Approving Authority June 29, 2010, Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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:Subsurface Sewage Dis osa stem•Pa e 1�61 V t5ins•09/OB P 9 P Y f Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is Osterville MA 02655 June 25, 2010 required for , every page. Cityrrown 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 t e"Conditional Pass" section need to be replaced or repaired. The system, upon completi of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years of -or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infi ration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is re laced with a complying septic tank as approved by the- Board of Health. *A metal septic tank will pass inspecti n if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank i less than 20 years old is available. ❑ Y ❑ N ❑ N (Explain below): l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 2 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25, 2010 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or dVoardHea 'settled or uneven distribution box. System will pass inspection if(with approval of ): ❑ broken pipe(s) are replace Y, ❑ N ❑ ND (Explain below): obstruction is removed Y ❑ N ❑ ND (Explain below): distribution box is leveled o Y ❑ N ❑ ND (Explain below): ❑ The system required mping more than 4 times a year due to broken or obstructed pipe(s). The system will pass ins ection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Bo d of Health: ❑ Conditions exist which require further eval ation by the Board of Health in order to determine if the system is failing to protect public hea safety or the environment. 1. System will pass unless Board o Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not unctioning in a manner which will protect public health, safety and the environment: El Cesspool or privy is withi 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 3 Commonwealth of Massachusetts Title 5 Official Inspection Form. Subsurface Sewage Disposal"System Form Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25, 2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 a sorption system (SAS) and the SAS is within 100 feet of a surface water supply or tri,butary 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 an0AS and the SAS is within 50 feet of a private water supply well. i ❑ 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 we *. Method used to determine distanc . **This system passes if the well w ter 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 n 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 El ® 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 I ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25 2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: '❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 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" "no"to each of the following, in addition to the questions in Section D. Yes No 1 ❑ ❑ the system is within 00 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 cated in a nitrogen sensitive area (Interim Wellhead Protection Area— IWP or a mapped Zone II of a public water supply well If you have answered "yes"to a y question in Section E the system is considered a significant threat, or answered "yes" in Section above the large system has failed. The owner or operator of any large system considered a signific nt threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25, 2010 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? . 0 ❑ 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 8 Number of bedrooms (actual): 8 DESIGN flow based on 310 CMR 15.203 (for example: 110,gpd x#of bedrooms): 880 GPD t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 6 I� l Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage,(gpd)): 2008= 578 GPD2009=430 GPD Detail: Cottage fed by same meter at 633 Main street. Irrigation on meter. Sump pump? ❑ Yes ® No Current 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 itle 5 system? ❑ Yes ❑ No Water meter readings, if available- t5ins•09/08 ( Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 7 of 7 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25 2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Ready Rooter records: Pumped 2005 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons, How was quantity pumped determined? 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) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 pf 8 i-_ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25, 2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: System installed Feb. 20, 1998. As-built and Certificate of Compliance on file at Board of Health. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 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.): Septic Tank(locate on site plan): Depth below grade: #1= 21" #2= 14" 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= 8'X4.5'X5' #2=11'X5'X4.5' Sludge depth: #1= 3" #2=2" t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 9 1 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .'' 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance.from top of sludge to bottom of outlet tee or baffle #1= 34" #2= 37" Scum thickness #1= 1" #2= 1/2" Distance from top of scum to top of outlet tee or baffle 6" on both - Distance from bottom of scum to bottom of outlet tee or baffle #1= 13" #2=15" How were dimensions determined? Tape measure and dip tube. Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): All PVC tees in place on inlets and outlets of tanks. Liquid level at outlet inverts. Risers bringall covers within 6" of grade. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑/erglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum t/bottom or baffle Distance from bottom of scuutlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 10 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is Osterville MA 02655 June 25, 2010 required for State Zip Code Date of Inspection every page. City/Town 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.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fibergl ss ❑ polyethylene ❑ other(explain): Dimensions: Capacity: l� gallons Design Flow: gallons per day Alarm present: I El Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarrn/and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Title 5 ofricial9nspection Form:Subsurface Sewage Disposal System-Page 11 of 11 t5ins•09108 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25, 2010 every.page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on bite plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Poly D-Box. One inlet, two outlets with equal flow. No solids carryover. No sign of high water staining over outlet inverts. Riser brings concrete cover within 6"of grade. Pump Chamber(locate on site plan): ' Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump Zbetion of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Cisterville MA 02655 June 25 2010 every page. City/Town State• Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 8-Maxis w/4'of stone. ❑ leaching galleries a number.' ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ . innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): SAS located and inspected with camera. Base of chambers damp, but stone visible. No sign of past hydraulic failure. Infiltrator Maxis are top loaded. Cesspools (cesspool must be pumped as part of inspec'on) (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 15ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 13 L Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 0 8 East Bay Ro ad Property Address Jonathan Slone Owner Owner's Name information is required for Osterville. MA 02655 June 25, 2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of etc.): ponding, condition of vegetation, Privy(locate on site plan):. Materials of construction: Dimensions Depth of solids Comments (note condition of soil, Sig s of hydraulic failure, level of ponding; condition of vegetation, etc.): 3 . t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 14 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is Osterville MA '02655 June 25, 2010 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately l Ili LU � 1 , I I . I o i AL t Yr;3 to t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is OStervllle MA 02655 required for June 25 2010 9 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) ` Site Exam: ❑ Check Slope ❑ :Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: >4 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: 1995• 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: ma.water.usgs.gov terraserver-usa.com You must describe how you established the highground water elevation: x No ground water encountered during test hole to 10' (1995). Base of SAS 4.5' below grade. Accessed local ground water contours and topo mapping. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 16 i Commonwealth of Massachusetts = Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 8 East Bay Road Property Address Jonathan Slone Owner Owner's Name information is required for Osterville MA 02655 June 25 2010 every page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ` ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file ,. I t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in comp r: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppliLatlon for Disposal 6pstem ConstCuttlon permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ❑Complete System El individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. i Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address,an .d Te No. / ` Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.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 Certificate of Compliance has been issued by this Board of . i e Date q 7 i"7 Application Approved by ® , Date Application Disapproved by Date for the following reasons Permit No. i Date Issued <, ^'.--.rid'. .. . � -• ,.£ .'.. ,,:,k�.. .. � i -1 afr�7C Fee Ab No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION'- TOWN OF BARNSTABLE, MASSACHUSETTS application for Disposal *pstem Construction Permit Application for a"Peimit to Construct( ) Repair( ) Upgrade( ) Abandon V ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel r%o . Installer's Name,Address,and Tel.No. ! Designer's Name,Address,and Tel No. ,t Type of Building: •J Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ). Other Fixtures Design Flow(min.required) gpd Design flow provided !. gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: 1 The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea ) i ne rC%I �? "" J Date �i'7)/-7 Application Approved by m , Date l' Application Disapproved by J Date 9 for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned^) y O_�(` — at / has been constructed in aac°cordanc with the provisions of Title 5 and the for Disposal System Construction Permit No-r °,/ rd�d �J'�- / Installer Designer #bedrooms Approved design_flo ,, gpd The issuance of this permit shall not be construed as a guarantee that the system`will fun tionVas d signed. .----- Date �c?—//W172 Inspector - - - ------------ -------------- No. - - ---- - ------ - -- -,-- L---- -- -- - - � ! �.� Fee �. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS / ]Disposal *pstem Construction Permit Permission is hereby granted to Construct( Repair( ) U grade Abandon( _ System located at J /�/j- V and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must a ccompleteiti within three years of the date of this permit. Date /n-/ Approved by COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS I DEPARTMENT OF ENVIRONMENTAL PROTECTION 5 " TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION . Property Address: 8 East Bay Road Osterville Owner's Name: Jonathan Sloane Owner's Address: P.O.Box 351 Weston,MA Date of Inspection: 8/15/2007 Name of Inspector: (please print) Patrick T.Sullivan Company Name: Ready Rooter Mailing Address: P.O. Box 371 Sandwich,MA 02563 Telephone Number: (508)888-6055 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 off Title 5(310 CMR 15.000). The System: v Passes Conditionally Passes. Needs Further Evaluation by the Local Authority Fails Inspector's Signature: ' Date: G� a The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of:.t0,000 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 pa proving authority. 1 . ; C-0 c Notes and Comments CJ .:'tom• {f) ****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. Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: _8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: 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. r Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pas "section need to be replaced or repaired.The system,upon completion of-the replacement or repair,as app oved by the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND)in the for the foll wing statements. If"not determined"please explain. The septic tank is metal and over 20 years old* or the sep c tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank ilure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as appr ved by the Board of Health. *A metal septic tank will pass inspection if it is structurally ound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is availab . ND explain: Observation of sewage backup or break ouVr 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): br en pipe(s)are replaced struction is removed istribution box is leveled or replaced ND explain: The system required pumpin more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval o the Board of Health): broken pipe(s)are replaced . obstruction is removed ND explain: 1 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 8 East Bay Road _ Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 C. Further Evaluation is R/eh by the Board Health: Conditions exist whicfurther ev ation by the Board of Health in order to determine if the system is failing to protect public hey or the nvironment. 1. System will pass unld of ealth determines in accordance with 310 CMR 15.303(1)(b)that the system is not functio nner which will protect public health,safety and the environment: _Cesspool or privy50 feet of a surface water Cesspool or privy 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 pudic health,safety and environment: _The system has a septic tank and soil absotion 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 SA$and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and dAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank hd SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". M hod used to determine distance "This system passes if the 11 water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic co pounds indicates that the well is free from pollution from that facility and the presence of ammonia nitro en and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. copy of the analysis must be attached to this form. 3. Other: i" Page 4 of 11 ' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A . CERTIFICATION(continued) Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 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 and overloaded or clogged SAS or cesspool _ _✓ Liquid depth in cesspool is less than 6"below inverfor available volume is less than 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 — P P �'Y et of a surface wa ter supply' or tr ibutary to a s water supply. ary surface — _ Any portion of a cesspool or privy is within a Zone 1 of a public well. — Any portion of a cesspool or privy is 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. [This system passes if the well water analysis, performed at a DEP certified laboratory,.for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one or more of the above 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 fa ' ty with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the foll ing:. (The following criteria apply to large systems in additio to the criteria above) yes no _ —the system is within 400 feet of a surfac drinking water supply — —the system is within 200 feet of a tri tary to a surface drinking water supply — _the system is located in a nitroge sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped' Zone II of a public water supp well If you have answered"yes"to any q stion in Section E the system is considered a significant threat,or answered "yes"in Section D above the large yytem has failed.The owner or operator of any large system considered a significant threat under Section E r failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner sho d contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 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 than owner)provided with information on the proper maintenance of subsurface sewage disposal systems.? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No Existing information.For example,a plan at the Board of Health. _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C .SYSTEM INFORMATION Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no):X�_S Is laundry on a separate sewage system(yes or no):�2�if yes separate inspection required]. Laundry system inspected(yes or no): Seasonal use: (yes or no): Water meter readings, if available(last 2 years usage(gpd)):` r �Ci ^ ta IAI�A V 6 c Sump Pump(yes or no): Q'z� Last date of occupancy: COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR .203).. gpd Basis of design flow(seats/pers s/sq. ft. etc.): Grease trap present(yes or no . Industrial waste holding t present(yes or no):_ Non-sanitary waste disch ged to the Title 5,system(yes or no): Water meter readings, i vailable: Last date of occupanc use: OTHER(describ GENERAL INFORMATION Pumping Records Source of information: - s ,_14- S, Was system pumped as part of the inspection(yes or no):— If yes,volume pumped: _gallons--How was quantity pumped.determined? ' Reason for pumping: . TYPE OF SYSTEM Septic tanks 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 nstalled(if known)and source of information*C Were sewage odors detected when arriving at the site(yes or no): C� I_ ( Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 BUILDING SEWER(locate on site plan) Depth below grade: 3Q Materials of construction:_cast iron 40 PVC other explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of lea age,etc.): SEPTIC TANK: . (locate on site plan) Depth below grade: Material of construction: concrete metal_fiberglass polyethylene '9 _other(explain) . If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: g Sludge depth: Distance from the top of sludge to bottom of outlet tee or baffle: 3( 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 baffler How were dimensions determined. -,,p w„ 4&c,rG p 't�, p �c��.AQ— Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Nen GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outle tee or baffle: Distance from bottom of scum to botto of outlet tee or baffle: Date of last pumping: Comments(on pumping recommend ions, in and outlet tee or,baffle condition,structural integrity,liquid levels as related to outlet invert,evidence f leakage,etc.): Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron A0 PVC_other(ex lain): ; Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leak he,etc.): SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction: oncrete metal fiberglass__polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: %/ x Sludge depth: (" Distance from the top of sludge to bottom of outlet tee or baffle: 3 Scum thickness: ( " Distance from top of scum to top of outlet tee or baffle: g Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: �,,,o w„�.4sc',_ �s.p cT�i��. Comments(on pumping recommendations inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 'n �v-c.�-,5 to;�v.,'.w 6w'y es� �,•.d��2, GREASE TRAP:—(locate on site plan) Depth below grade:— Material of construction: concrete metal. , f erglass polyethylene_other (explain): — — — _ Dimensions: Scum thickness: Distance from top of scum to.top of ou/age, ffle: Distance from bottom of scum to bottoee or baffle: Date of last pumping: Comments(on pumping recommendatid outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert, evidence of l ): l Page 8 of 11 O OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION,(continued) Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 TIGHT or HOLDING TANK: (tank must be p ped at time of inspection)(locate on site plan) Depth below grade: Material of construction:_concrete metal fiberglass_polyethylene_other(explain): Dimensions: Capacity: gallo Design Flow: jAlarnmn ga ns/day Alarm present(yes or Alarm level: orking order(yes or no): Date of last pumping: Comments(condition d float switches,etc.): DISTRIBUTION BOX:—Zif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(not if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: (locate on site plan Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump ch er,condition of pumps and appurtenances,etc.): j Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: eaching trenches,number,length: leaching fields,number, dimensions: ",.vim o n, c overflow cesspool,number: innovative/alternative system Type/name of technology: ` Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,, etc.): CESSPOOLS: (cesspool must be umped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet inve Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of constructio . Indication of ground w ter inflow(yes or no): Comments(note co dition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): fl PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs hydraulic failure, level of ponding,condition of vegetation,etc.): l Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 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. I I I cx,p—S-c r - - -I C Li 3 " L Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued)' Property Address: 8 East Bay Road Osterville Owner: Jonathan Sloane Date of Inspection: 8/15/2007 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet r Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record—If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the local Board of Health-explain: hecked with local excavators, installers-(attach documentation) Accessed USGS database-explain: s S , �o You must describe how you established the high ground water elevation: .. .moo �•�{i,-., �..-bc�w�-Q <,�o��s..T' ��Y.�/1 `, .�. ��.5 i• �a`� -• l=tce,S''. - V:Z4CG 2 S � L � 1�x c u'l'I V k; (:)►�I'I( 'I' (>1' I�,\�\ lll(.7N1tI��;'I'.�11., .-�1') :111tti Dj,,,PARTAIEN'I' OrENVIRONMENT AL PROTECTION Oh"hI('I.AL INSPECTION FORM -I NOT FOR V t , SUBSURFACE SEWAGE DISPOSAL SYSTEM FO A(ENTS PART A CERTIFICATION Property :ld(jress: 5 � RECEIVED 0%vner's Name: 0"ner's Address: MAY 15 2001 Date of Inspection: TOWN OFB ARNSTABLE HEALTH DEPT. Name of Inspector: please print) / S Company Name: Mailing Address: Telephone Number: Y CERTIFICATION STATEMENT I certify that 1 have personally inspected the sewage disposal system at this address and that the information r below is true, accurate and complete as of the time of the inspection. The inspection was training and experience in the proper function and maintenance of on site sewage disposal reported performed based on my approved system inspector pursuant to Sec ' n 15.340 of Title 5(310 CMR e disp s The system: p systems. 1 am a DEP Passes � ' Conditionally Passes _ Needs 1-uriher f ValUalion by the Local Approrutg Authority' Inspector's Signature: Date: 6 e o The system inspector shall submit a co DEP) within 30 days of completing s i of this spection report to the Approving Authority(Board of Health or P b this inspection. If the system is a shared system or has a design flow of 10,000 , DE or greater, the inspector and the system owner shall submit the report to the appropriate regional office of th DEP. "I-he oriefinal should be sent to the system p I authority stem owner and copies sent to the buyer, if a r pp.rcable, and rile approving Notes and (:onuncnts f " I hrs r e1,I)c only describes conditions at the time of inspection and under the conditions of use at thatr u. o"" Thiti u1,11crrrllrl dues not address ho" the sysicnl �ti ill perform in (Ili fu(urr unut'; file anli or different Y N conditions of use. r- cnt r 3 grill ("1'i 2000 zz t i. (4-TACIAL INSPECTION FORM — NOT FOR VOLUNT.-kRV ASSESSMENTS -'01?SURFACF SEWAGE DI-SPO-SAL SYSTEM INSPECTION FORM PA R,1' A CERTIF]CATION ( ' Propert.N Address: qV 0�i Date of 4spccl ion: 0 Inspectitln Summary: Check A,B, D or E A LNVI jz�"'S complete all Of Section D A SYS rj-j-Passes: 11;1\'U 1101 found an-Nj informal ion which ind F5 ictes that any of cia 30-, ol In 3 10 CM R 1-5,304 exist Any fallUl C criteraia not eval'uatedtil ae r fa e 11ilure1jiCaleridter belodescribed inCMR Comments: B. SYS(ern Conditionally Passes: One or more system components as described in the "Conditional Pass"section need to be replaced o repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, willr pass. Ans 'er yes, no or not determined (Y,N,ND) in the expl in. for the following statements. 117"not determined"please The septic tank- is metal and over 20 years old* or the septic tank- (whether metal or not) is structurally un.so d, exhibits substantial infiltration or exfiltTation or tank- failure is imminent. System will pass inspection if the ex1s1lI L, lank is replaced with a complying septic tank as approved by the Board of Health. *A im fal septic tank will pass inspection if it is structurally sound, not leakin g and if a Certificate Ot-Compliance indica ing that the tank is less than 20 years old is available: ND c, plain: Observation of sewage bac up or break out or high static water level it, the distribution box due to broken or di obst cted Pipe(s)or due to a brok n, settled or uneven stribut appr al of Board of Health): 1011 box. System will pass inspection if(withbroken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The systemrequired Pump Ig more than 4 times a near due to broken or obstructed pipe(s). The system will pass inspection If(with approval 0 the Board of Health): )FOkell pipe(s)are replaced obstruction is removed NJ) cxpj,jjjj, OVFI(IAL INSPECTION FORM - NOT FOR VOLUNTARY ASSF.SSMF;NTS Sti[ISURFACE SEW;kCF I)ISPOSAL SYSTEM INSPECTION FORM P A rrr A �(' ('I'IZfII'ICATION tcontinuecil Propcn\ Address: a.- Dale of In.lt cc•Ircrn: C. Ful-Owi E*valuation is Required b.v the Board of Health: Condilions exist which require further evaluation by the Board of Health in order to determine if the system is 13ilm-g to protect public health, safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the s •stem 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 sYsten 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 sui face water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. File system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a pr Fate water supple well". Method used to determine distance ' This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform b cteria and volatile organic compounds indicates that the well is free from pollution from that facility and th presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other fa'lure criteria are triggered. A copy of the analysis must be attached to this form. r t 3. Othcr: 1 f 1 t 6 3 c)F F►c ►:�'tiPl- -.1 ION FORM — N(!'V FO!2 VOLUNTARY ASSESSMENTti U.[ ►'UtiAL SYSTEM INSPE(_TION FORM P A WV A C'IIl'I IFI�':� [ ION (continued) Propert� :�cfclress: � -- � t ✓a I � �/ . 17 S --- ------ - -- f Date of tspectron:� D• System Failure �i���PhSwe to all systems: You must indicate "yes" or •no" to each of the following fir all inspections: Yes No �- rckul� of-sewage into facility or system component due to overloaded or clogeed SAS or cesspool .� Dl1 :rr,1 or ponding of effluent to the surface of the ground or surface waters due to an overloaded or o `c SAS or cesspool a c Ir Ird level in the distribution box above outlet invert due to art overloaded or clogl4ed SAS or ss of i depth in cesspool is less than 6" below invert or available volume is less than 1/2day flow un-0 pumping more than 4 times in the last year NOT due to clogged or obstructed III es pu pipe(s). Number f mped A rtion of the SAS• cesspool or privy is below high ground water elevation. y )onion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface ter supply. fly 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 supple well with no acceptable water quality analysis. [This system passes if the well water analysis, perfor•nted at a DEP certified laboratory,, for coliform bacteria and volatile organic compounds Indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria J/ are triggered. A copy of the analysis must be attached to this forma �� (1'ed scrci) The system tails. I have determined that one or more of the above failure criteria exist as described in )0 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to deterrnrrte what will be necessary to correct the failure. E. L rge Systerns: To be onsidered a large system the system must serve a facility with a design flog+•of 10,000 gpd to 15,000 gP Y u m st indicate either"yes" or "no" to each of the following: ( le f flowing criteria apply to large systems in addition to the criteria above) ys o the systern is within 400 feet of a surface drinking water suppiv the system is within 200 feet of a tributary to a surface drinking water supp % " l t the systern is located in a nitrogen sensitive e area (l.nterim Wellhead Protection Area - I WPA) or a map ed Zone !I of r, public water supply well _: P 11 ou h ve ans»crcd "�,es to anv question in Section I the systent is consicicrcu :I ,r niticant threat, or anti�,crru y "v"s" in l5ectrun I) above the IarLc system has failed. l he owner or oper;uor of any lar,;e •:vstcnt considered a 15. ificant threat: i:ndcr Section !- or failed under .tic coon I) sha!I upr,tr;rdc the .acnr rr: .:ccurdani:e with ;I(1 t_MR 15.3U1 the ti�;r, nr c,uyt,�r should �.nnt:u i r!rc :tp rrn�ri;!1c rc��ic�; • <. I l c,!iicc of OFFICIAL INSPECTION FORM --NOT FOR VOL UNTARY ASSESSMLA I'S SUBSURFACE SEWAGE DISPOSAL. SYSTEM INSPECTION FORM P.A RT 13 CHECKLIST Check if the following have been done. You must indicate "yes" or-no" as to each of the following: Ys o P nipor", information was provided by the owner, occupant, or Board of Health' Were anv of the system components pumped out in the previous two weeks ? the s stem received normal flows in the previous tw w° — Y p o week period . Have large volumes of water been introduced to the system recently or as pan of this inspection ? 11 ere as built plans of the system obtained and examined? If the were not available note /Y ( y oeasNA) as the facility or dwelling inspected for signs of sewage back up ? Was the site inspected for signs of break out ? \k'ere all system components, excluding the SAS, located on site ? septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition tSf 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 c and location of the Soil Absorption System (SAS) on the site has been determined based on: Y s o Existing information. For example, a plan at the Board of Health. . _ Determined in the field (it-any of the failure criteria related to Pan C is at issue approximation of distance is unacceptable)13 10 CMR 15.3)02(3)(b)J i L 01`11('fAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS a Sl!(3�UIlFA(:'E SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SN"STEM INFORMAT10N (hvncr: r r Datc of 4cclioll: FLOW CONDITIONS IZI:SIDE\I�IAL- Numhcr o; bedrooms(design): Number of bedrooms (actual): d�2— D1-SIGN floe- haled on 3 10 CMR 15.203 (for example: 1 10 gpd x # of bedrooms): 3 v Number c�(cun-ent residents: _� Does residence have a garbage grinder(yes or no): Is laundr- on a separate sewage system (ycs or no): if yes separate inspection required) Laundr system inspected (yes o to): _ Seasonal use: (yes or no): Water meter readings. if 91b le (last 2 years usage(gpd)): Ko O D a Sump pump (yes or no): > f0E7 Last date of occupancy: COMMERCIAL/INDUST I AL Type of establishment.- Design flog+•(based on 310 C 15.203): d Basis of design flow (seats/pers ns/sgft,etc.): Grease trap present (_yes or no): Industrial wasw holding tank pr sent (yes or no): Non-sanitar\ waste discharged o the Title 5 system (yes or no): Water meter readings, if availa le: — Last date of occupancv/use: OTHER(describe): �.Pumping Records GENERAL INFORMATION •� Source of information: Was system pumped as-pari Of tile inspechon'(yerbr—no).:.__ If yes. olume purnpcd: _.gallons -- How was quantity pumped determined.) Reason for pumping: TYPE I`S1'S"r EM epnc tank, distribution box, soil absorption system — Single cesspool ____ Overflow cesspool _ Privy — Shared s"stertt (yes 01 no) Of yes, attach previous inspection records, if any) — hu�ovati lternative technology. Attach a copy of the current operation and maintenance contract (to be obtained front s%,;Iejlt owner) — Tight tank ___ Attach a copy of the DEP approval — Other(describe) Apprc virr; r „l ;,il c unponcnt date installed (if-known) ,tnd source of information Were �,e•��.:r.;.c r..;,�r•, ,iriccicd \thcn arrivirtz�. ;t; the site Ives or no): ------ Oh l I< I.�1. INSPi�;( "I ION FORM — NOT I"OR > OI INTARY ASSLSSMI-_N I S S[ IISI IlF`AC'E SENVAGE DISPOSAL SYSTFM INSPECTION FORNI PART C SYSTFM INFORMATION „,,nuinre,il Propert\ ;lddress: ice Ualc of nspccliun: BUILDING SE'WE R (locate on site plan) Depth helo�k i mdc Materials Ofconstnict)oil: _cast iron _40 PVC other (explain): Distance from private water supply well or suction line: Continents (on condition of joints, venting, evidence of leakage, etc.): SEPTIC TANK: _(locate on site plan) Depth below grade: Material of-construction: _concrete_metal _fiberglass_polyethylene —other(explain) If tank is metal list age: _ Is age confirmed by a Certificate of Compliance (yes or,no): _ (attach a copy of certificate) Dimensions: � O O Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: __A�P, _ -- Distance from top of scum to top of qutlet tee or baffle: &affl?�e: Distance from bottomof'scum to bottom of outlet tee or How were dimensions determined: aP 9V= rc m Comments (on pumping recommendations inlet and outlet tee or Me condition, structural integrity, liquid levels as related to outlet invert. evidence of leakage, etc.): - --- --- - --- - ----- —... n ---r Viz----- GREASE TRAP: (locate on site plan) Depth below grade: Material of constru ion: _concrete _metal _fiberglass__polyethylene other (explain): — Dimensions: - -- ----- Scum thickness:- ------ Distance from top f'scum to top of outlet tee or baffle: _ Distance from host nt ol'scum to bottom of outlet tee or baffle-- - Date of last pumpir g: ----- Comments(on pun ping recommendations, inlet and outlet tee or baffle condition. structural integrity, liquid levels as related to outlet nvert, evidence of leakage, etc.): t I':fL!C \ l)I I I . O(�F►C1AL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMEI-, I.S DISPOSAL SYSTFNI (NSPI,;CI'ION FORNq PART (_' SYSTEM INFORM.A 1 RYN I'ropertc Address: C—I-- - - a Owner. r ,-- --------- Date of Ir sf l,�ction � �--- TIGHT or HOLDING TANK: (tank must be pumped at time 01-inspection)(locate on site plan) Depth belo- ordde: Material of construction: --__concrete metal fiberglass - --, ----polyethylene other(explain): Dimensions: --_— - Capacit\- _ — Desi, gallo s n Flow g rs/day Alarm present(yes or no): Alarm level: Alann in \v rkin order Date of last pumping: g (yes orno): Comments(condition of alaml grid float switches, etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert` Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leaka,c inti, of, out of box, etc.): r r PUMP CHAMBER: (locate on site plan) Pumps ii) %korking order(yes or no Alarms in working order(yes or n ) Comments (note condition of pump cha r, condition of um , p ps and appurtenances, etc.): OFFICIAL INSPECTION FORM - .NOT FOR VOL[�NI :�Ill` ASSE.;SS,1lE:N1�S ► SUBSURFACE- SEWAGE DISPOSAL SYSTE11 INSPECTION FORM PART C SYSTEM INFORMATION tcontirmai f'ropert� :�ddress: � e fi f C1 , � -- Dare of Inspection: ` r— d 0 l SOIL A13S0RPTI0IN SYSTEM (SAS): (locate on site plan, excavation not required) II SAS not located explain why. Type __ I',chins pits. number leaching chambers, number: leaching galleries, number: leaching trenches, number, length: leaching fields, number,dimensions: overflow cesspool, number: innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): CESSPOOLS: (cesspool must be pumped as pan of inspection)(locate on site plan) Number and confi uration: Depth — top of JiqL id to inlet invert: Depth of solids laNcr: Depth 01 scum lav r: Dimensions of ces pool: Materials of const ction: Indication of grou dwater inflow(yes or no): Comments (note c edition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): PRIVY: (locate on site plan) Materials of c mstnrction: Ditncrtsions Depth of soli s ---- _ Comments ( to condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): e P'wc 10 kit I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS a SUBSURFACE SE«'AGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (cantinucdl Property Address: ___ �uC( Owner:4 Dale of Inspeclion: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmark benchmarks. Locates or all wells with in 10 0 feet. Locate where public water supply enters the building,. 0 15 4Cz � z OFFICIAL INSPECTION FORM - NOT FOR vOl,l- N"F :+It} AS�E:StintEN F`.ti SIII3SIIRFACE S1"WAC,E UISPOS.A L SYSTEM INSPEC"i'ION FORM IPA R T C SYSTF:t\1 INFORMATION rronimue i! , Propert\ Address: 9 6�,d I I C: 7 I)atc tit I tspection: 51 fl: k:\:,:,1 5/11:5 Slope Surface water Check cellar Shallow wells Estimated depth to ground wa feet Please indicate (check) all methods used to determine the high ground water elevation: _ Obtained from system design plans on record - If checked, date of design plan reviewed: Observed site abuttin r ( g p operty/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 9stablished the hi P ground water elevation: 12-17-1997 11:48AM CENT DST FIREDEPT 5087902385 P.02 n 09—avvis-a-1a lV tuuat rl(C LJC}Jd1`UnenL Fire Department retains original application and issues duplicate as Permit. •�%ha�'t~ir�r,�n'r,�o��i�xe C/�cea.— ✓c�aa�a��iixe ✓_�,ayL t r,:.�t�•~�::ti?`'j APPLICATION and PERMIT Fee:_10.00 for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 146, Section 38A, 527 CMR 9.00, application is hereby made by: Tank Owner Name(please print) Williams X • ayneture ecr roryormry Address 8 East Bav Road Osterville, MA 02655 street Cry state Tip Enviro-Safe Company Name Per I Co.or Individual g��"o'e S 1CP ` 4/e'a F.O. Box 8I0, E. Sandwich � Pear Address Address —5 Penn �t Signature(if applying for permit) Signatur if ap ying fcr rmR) IFCI Certified Other Z IFCI Certified = LSP# Other Tank Location 8 East Bay Road, Osterville, MA Steer AMrOSS Gy Tank Capacity(gallons) 1,000 Substance Last Stored Oil Fuel Oil Tank Dimensions(diameter x length) Remarks: rr . . _n . Firm transporting waste F.riviro-Safe State Lic.# MA-329 Hazardous waste mantles T E.P.A. # MAM5269323 Approved tank disposal yard Turner Salvage Tank yard # 002 Type of Inert gas Tank yard address 235 Street,_T.. MA City or Town Centerville FDID# 01920 Permit# Date of issue December 17, 1997 Date of expiration December 31, 1997 Dig safe approval number. 974900642 Dig Safe Toll Free Tel. Number-300-322-Q44 Signature/litle of Officer granting permit W After removal(s)send Form -290R signed by Local Fire Dept.to UST Regulatory Compliance Unit, One Ashburton Place, Room 1310, Boston. MA 02108.161S. FP•292(revised 9/96) r� 0 No....A.: � F��v..................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiuu for Biu uml Workii Tomitrurtiu Permit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal S stem at, R ..... ...........�_ast..... .............. .... /L.. .. n�.... 4 or Lot No. er t Address .....-�,E',0ZV-?--5--------------------------------- ..........Q n-�------...-- ------....--------------................--- Installer Address Type of Building Size Lot............................Sq. feet ►. Dwelling—No. of Bedrooms._ ______________________________._Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.......____gallons Length................ Width-----.---------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No--------_----------- Diameter------------------.. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 14 Percolation Test Results Performed by.......................................................................... Date........................................ a ,a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water............_........... a -----------------------------------------•--•-----•----- .................................................................................................... 0 Description of Soil........................................................................................................................................................................ -------------------------------------------------------------------------------------------------------------�,-- . -------- -----� -------(� U P PP /f � ... 9-�. Nature of Repairs or Alterations—Answer when applicable Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compll , ha e b he board of ealth. Signed ...... ....... �� .................... ------------- Application.Approved BY y "-`-�...... -�._..:—...�............._ ---------------------................-... :3.....� D......... Application Disapproved for the following reasons: .:. _---------------------------------------------------------------------------------------------------------------------------- ------------------------------------------...__......__...._....................--...............------------------------------....-..............----------.....------------- ------------ ........................................ Dare Permit No. ........... .e.: ............ Issued - --- -� - . Dare --- -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Binpwial Wvrkt5 TomitruA�FnIndividual rrmit Application is hereby made for a Permit to Construct ( ) or Repair ( Sewage Disposal System at* ""^''°���, �' A, .............................;.................... ....�R)............... ............... ................................................... -- L cati n Ss��Addrr" or Lot No. ---------------------- Address � Address UType of Building Size Lot............................Sq. feet ., Dwelling—No. of Bedrooms---- ----------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building -------- ------ No. of ersons-_-.---------.---_-_.------- Showers a g ------------- p ( ) — Cafeteria ( ) Otherfixtures .-------•--------------------------------------•-•------------.-.....--------•- ------ .............................................................. W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width--..-..--------. Diameter---------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length..._.-..-- _--.---- Total leaching area.....................sq. ft. 3 Seepage Pit No...................... Diameter.-------.....__----. Depth below inlet_._._._............. Total leaching area..........r).:sq. ft. z Other Distribution box ( ) Dosing tank ( ) _r' ,) Percolation Test Results Performed by.......................................................................... Date.........==' Test Pit No. l................minutes per inch Depth of Test Pit......------_----_- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................-... P4 ....--•----•----------------•...•--•-•--•---•-------------•------•••--------•-•-•-•---------•................................................................ 0 Description of Soil........................................................................................................................................................................ x U Nature of Repairs or Alterations—Answer when applicable..._ r �._-_--.. .....11. � -- _..... Agreement: I -----------•------------ --. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance1with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance`has bee �r�ssled bhe board of'realth. Signed r .r �r�lsr, � 0", " Application.Approved By ..... � '- -�� `'�.z ..�_;a A .......................................... ` ....a . % ..—...1 s Application Disapproved for-the following reasonr.• . ..... ........ ........ ._. ._........--........... ..... =............................................... .................. ................`.-.--.-...--------------------------------------.-..-..---------------- ----.-. -------------------....---.......................----... ........................................ Permit No. _ Issued �.......... —7 . . Date THE COMMONWEALTH OF MASSACHUSETTS • BOARD OF HEALTH TOWN OF BARNSTABLE Ter tifi ate of Cforaplianre THIS119TO CERTIT That the Individual Sewage Disposal System constructe`3}(x �i) or Repaired ( ) by ...... .. ............ - ....................... at .......-.. _ .... *` i .- .. 1 has been installed in accordance with the provislons off TITLE 5 of The State Eovironmental Code as described in �� "-. ? , ? .. the application for Disposal Works Construction Permit No. t. .. J---- d ated .' ._...-_. ....' _-_-.._.--_----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE- ..... '...'....- - �-..�--------------------------- Inspector --.... - ----------_ _----------------------------------.....-..-.-..--------- ----•---------_•-•---- ---------- - --,_-----.� _�� Y. ?' -_em_ '`�_`-�'- THE COMMONWEALTH OF 'MASSACHUSETTS c J BOARD OF HEALTH 06 _ TOWN OF BARNSTABLE0 FEE. �i��n��tl �rk� �nra��tr�stuan �leruttt I ,� Permission is hereby granted__ ... .. •,, y to Construct ( ) or Repair (�} Individual Sewage Disposal System ! '`..._. A-.....� �-Street4 1 �. as shown on the application for Disposal bt/oks Construction Permit No. �?_.:: 7-._ Dated_.__, ?�..c�''.:..��_ •...............•-------•-......---��`.. --- 1 ......................... DATE.......... ' �r .............................. _ Board of Health FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS (�J/ 0a I'A'1 a to� � � o THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Diinpwial Murkg Tvastrurtign runfit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System©©at: " r -A..............F........ f BC.; 'Rd. .............0.-0,T(0 L) -- Q" ..... ................................................................... �1 L c do lddtess or Lot No. .. - ....�.�L_JI- 1---��---- ---------------------*---------- --------------------------------------------------•--•-----------•--------...----•------------•--- r o.vner t � Address a ���c�. ------------------------------ ----------------------0---S.. ustaller Address UType of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms._1________________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------- - - W Design Flow--------------------------------------------gallons per person per day. Total daily flow.-------------------------------------------gallons. WSeptic Tank—Liquid capacity............gallons Length---------------- Width---------------- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. 3 Seepage Pit No_____________________ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ Test Pit No. I----------------minutes per inch Depth of, Test Pit-........:........ Depth to ground water........................ G14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P4 -------------------------------•---•-----------------------•---•-•-•------------•-------------------......................................................... 0 Description of Soil......................................................................................................................... .............................................. x U ---•-------------------------------•------------------------••---•----•••----------------------.....-------------------------------•--------..._-- ----------------------------------------------- W ------------------- ----- -- ------- --------- UNature of Repairs or Alterations—Answer when applicable______ _ ____ ____ __ ________ ... ................................................................................................................................................................................_. ........................._ -.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli e d e board of he th. Signed ---- ------- - - - - - .... .--- ..... . -- ---------------- .� ------------ Application.Approved By ---- P ^� --�----------- ----------------..........:............ .............. �.�- �:.-../�'S.—.. Application Disapproved for the following reasons- -------------------------------------------------------------------------------------------- ..................................................._...............------------------------- ........_..................... __... .................. ....._._....... .. --------------------- --......... LJ......-��. ..� ......................................................... to Permit No- -------------- ........... Issued _ Date No-1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Bi-tipuittl Wor1w Tomitrnrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: f` - ...... . ...Y ............. .• _ . ! L c do _lddtess or Lot No. t ... .9:_...-•--�.��,-- ......I- ---- ------ -•-----------------------•----------...------------------....----•-------..............--•-•------ W ® j owner �3 Address 1nstaller Address d Type of Building Size Lot............................Sq. feet a a Dwelling No. of Bedrooms._j----------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------- ----------------------------------------------------------- ---•-----•-•••------------••••---------•••......-•••-------•. W Design Flow--------------------------------------------gallons per person per day. Total daily flow-.------------------------------------------gallons. WSeptic Tank—Liquid capacity------------gallons Length________________ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No. ................... Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No..-__.-__--___._... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY------- ........----...................................................... Date........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit-------------------- Depth tD ground water-_-.--.-------_-_----_- ; fi Test Pit No. 2.....:.........minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 04 --------------------------------------------------------------------------------•-------------------------- .------------------------ •------------------- ..... 0 Description of Soil........................................................................................................................................................................ V ....•-•••••--------•---••-•-----••••••-•-•-•---•••-••-•----•----•-••-•--•--•-•------•-••••-•-------•---•-•-••---------- ------------- -------- x Nature of Repairs or Alterations—Answer when applicable._. ----------------- U P � �'�------ ..-- --•-----•:---•--•------•-••-•-••-----•--------•..._.....--•-••-•-------------•---•-•--•-••••••------•-•---------�----•-.. . w Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System-in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance •.as-bee?ssved by -Re board of he Ith000.... Signed . V:Y.. - " ....:u � -- -. .. . I f � 5101, Application Approved B -.-. ..... - ` '�-: APPlication'Dis_approved for the.following reasons: .--------------------------------------_`---------...----.......----------------------------- '----------- 1 -� ''" `, i*y ---------- ---------------------------- �� r 1,,0 i t- - -- ............... ..."r.,. -- .... ......... ._.Dace "------ Permit No. .-� .. -�?jI.`57 5. �...� --- - � Issued ---- -- ------------ •i p'(` $.� �. ""#� Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Te>r#ifi atP a`C'Jamplia"itcE THIS IS 50,�, �7F , tT( hat e Ind v-dual/Sewage Disposal,System constructed,,( ) or Repaired rr by 4s�+t�,. . x .... --- ----................... . .. has been installed in accordance with the pr sions of TITLE 5 pf The State Environmental Code as described in the application for Disposal Works Construe on Permit No. --_��J...z..3!�� ...-.- dated .... 2�.-.-.- ,., V.- .-. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUMAS A GUARANI if: SYSTEM WILL FUNCTION SATISFACTORY. f -r DATE - -.................. ...:------ - ' ;-...' ....... Inspector _----------------------.-`:.. -.... "�,r\ ------------ r...-...... THE COMMONWEALTH,MOF MASSACHUSETTS. '+' L/ r '5 BQ� RD OF HEALTH . R TOWN OF;BARNSTABLE'=. �i��uuttl ur� ��unufrnrtilan �prmit Permission is hereby granted---- - , to Construct ( ) o Repair (6 )n Individual Sew>age Disposal System at No.------ ...... � .F ................. as shown on the application for Disposal Works ConstryEtion Permit No _1_��e_ Dated-_-_�..-.�>.-��_........... _ Board of Health DATE................... `--•----- ------ FORM 36508 HOBBS Q WARREN.INC.,PUBLISHERS No. Fee ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppfication for Miopaaf *p5tem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. .7 Lt AS( BAY RD• (� Owner's Name,Address and Tel.No. Assessor's Map/Parcel r r O 71 V 0, �O hNH�I�A+� GQ IgLIJ Sn 8- N20 ^OU�"Z Installer's Name,Address,and Tel.No. n Designer's Name,Address and Tel.No. R FA DV' (ZWTey\- I U zJ L (00 GO>t 3-71 6AAWIC19 MA Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) RtyPLACrr -ym/;Pd L,60Zr From ('Asr LnAW r?.'a ®LT TO 5 EPfic -FA41L. 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 V Date "d S 3 Application Approved by Date 2 0 Application Disapproved for the following reasons Permit No. '2�j Z Date Issued No.2VV> Z f 2' U Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Zipplicattou for Mtgooal *pztem Cougtructiou Permit ; Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components J Location Address or Lot No. g r A S( 8 AV f K m 1 Owner's Name,Address and Tel.No. Assessor's Map/Parcel r I b�� V SO hrvA4t AnI S LQ A1<t J Installer's Name,Address,and Tel.No. n Designer's Name,Address and Tel.No. 2 ruApy- awTlyl , LPL a a, a 00 GQY 3?i gAW4)wiC14 MA Type of Building: k Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) s Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures w Design Flow gallons per day. Calculated daily flow gallons. Plan Date OU Number of sheets Revision Date Title ¢' Size of Septic Tank Type of S.A.S. Description of Soil } � A Nature of Repairs or Alterations(Answer when applicable) .� ' RI'N.ACtj' (ylPN-) om (,AIT' LnAW t0.11? T TO =•- P T-Ay-)1L s Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health Signed Date_ 6 'd 33 3 Application Approved by Date to2 u Application Disapproved for the following reasons x f Permit No. 0 —?-q 2 Date Issued � 03 l THE COMMONWEALTH OF MASSACHUSETTS ���� BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal.System Constructed( ) Repaired ( )Upgraded( ) Abandoned( )by at a s has beenconstructe in acc rdance e1Dwith the provisions of Title 5 and the for Di posal System Construction Permit No. _? -2,12 dated 2 a 3 Installer Designer The issuance of this p rmit shal not be construed as a guarantee that the system wil nc ' as n Date 2 D 3 Inspector Fee ✓U . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS xigpool 6potem Construction Permit Permission is hereby granted ttg Construct,( )Repai �)Upgraded �)Abandon( ) System located at c G S� t'7 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: Construct i n must a completed within three years of the date of this permit. Date:_ 2 Q 3 Approved by TOWN OF BARNSTABLE LOCATION ��ap�� SEWAGE# �S- 3®- VSLLAGE�5y'�ry��\-ems ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. l r SEPTIC TANK CAPACITY = OOC-) 2,& , LEACHING FACILITY:(typej—Z, KJ. r (size) NO.OF BEDROOMS ®P OWNER PERMIT DATE: ��T/�/9 $' COMPLIANCE DATE: O �i Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) / Feet FURNISHED BY ui- L 7 i G c CO � n 4 4 TOWN OF BARNSTABLE 1',OCATION SEWAGE 30-7 `rvVILLAGE ® �ru \��? ASSESSOR'S MAP&PARCEL /Yj- -/O S' -INSTALLERS NAME&PHONE NO. Lzcy `M,Ac SEPTIC TANK CAPACITY V®OQ LEACHING FACILITY:(type)'3.,� r e��,*s (size) NO.OF BEDROOMS OWNER �.oA��.vcaw \®V�� PERMIT DATE:�3/� @ s- COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ? ► S C � Ile A� �, 9 obi -fig „ 27 r >0 fF 1 I . �- T111WN OF BgNSTABLE LOCATION rasroav VULAGE � ' C ASSESSOR'S INSTALLER'S NAME&PHONE NO. J 4ek' '' SEPTIC TANK CAPACITY D LEACHING FACILITY: (type) © (si ) z t4 NO.OF BEDROOMS BUILDER OR OWNER PERMUDATE: COMPLIANCE DATE: r �U Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 206 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by >A CMJ I t AsBuilt ` Page 1 of 2 TOWN OF BARNSTABLE LOCATION SEWAGE# S J C� VILLAGE�S�'C ry V`V,_ ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. l SEPTIC TANK CAPACITY' I = i OCX� k$C=K:D LEACHING FACILITY(type��.gt—� r Maw,,s (size)- q j NO.OF BEDROOMS OWNER PERMIT DATE:y� ,�Tg s: COMPLIANCE DATE: O Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility *> `f 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 I 2 �a I . i 1 � � cy � `t C I http://issgl2/intranet/propdata/prebuilt.aspx?mappar=141105&seq=2 9/29/2017 . 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N ri i i CAPTAIN'S HOUSE . v'-z�• I y'3�• e1 L _ --- _ --- M r _ -- _ .. 1—d fur cm,F—lml m7.09.28 . ez In '�, 3-0• 9e.y�• 2-14'v x'O I` Issued fo,Bullding Permit .13.Q8.28 � sly.,I•. � _ _ s'-s• v's• Irw• � m'-r a`s1' z ir-+• - s'-s�. I BASEMENT;FOUNDATION ELOOIL PLAN Basement Plan AREA DIAGRAM r 1609 SF . . 663 SF DEEP OBSERVATION HOLE LOGS - PJ15431 & P115616 ESTIMATE HIGH(USS FRO TER TERMET CA CULATION ON-SITE DRAINAGE NOTE: ARCHITECT NOTE: SITE & LANDSCAPE NOTE OOC SE 3-5474 _ ALL ROOF RUN OFF SHALL BE COLLECTED BY GUTTERS AND FOR MORE INFORMATION REGARDING SEE SITE & LANDSCAPE CONTRACTORS To USE THE LATEST HAWK DESIGN APPROVED BY BARNSTABLE CONSERVATION �" DATE OF DOH 1 & 2 TESTS: JULY 26, 2017 - P#15431 DATE OF DOH 3 & 4 TESTS: MARCH 20, 2018 - P#15616 INDEX WELL: # MW-29 ZONE: B DOWNSPOUTS AND REROUTED TO LEACHING RECHARGE BASINS (LRBIs) LATEST SHOPE RHENO WHARTON PLANS LANDSCAPE PLANS FOR ALL DETAILED GRADING AND REFER TO THE COMMISSION UNDER MASS DEP FILE NO. / %ice PERCOLATION RATE LESS THAN 2 MINUTES PER INCH DROP IN WITNESSED BY : JOHN G. SCHNAIBLE, CEC, R.S. DATE OF READING: JULY 2017 VIA 6" DIA. SDR 35 COLLECTOR PIPE (S=2% MIN.). CONTRACTOR TO ISSUED FOR CONSTRUCTION. ARCHITECTURAL/STRUCTURAL DRAWINGS FOR ELEVATIONS RELATING TO TOP SE#3-5474. FOR MORE INFORMATION SEE THE C HORIZON IN DOH # 1 DONALD DESMARAIS, TOWN OF BARN. BOH, R.S. CONFIRM LOCATION OF LRB'S/COLLECTOR PIPES WITH ENGINEER PRIOR OF FOUNDATION & FINISHED FLOOR ELEVATIONS. REFER TO LANDSCAPE PLANS PROPOSED SITE PLAN BY COASTAL ENGINEERING ��5� COASTAL DEPTH TO GROUNDWATER: 7.7 TO INSTALLATION AND NOTIFY ENGINEER OF ANY DISCREPANCIES. /WITNESSED BY : JOHN G. SCHNAIBLE, CEC, R.S. NO GROUNDWATER ENCOUNTERED FOR YARD DRAIN DETAILS LOCATIONS AND RIM FINAL RIM ELEVATIONS. COMPANY TITLED "C2.1.1 PLAN SHOWING �,P DONALD DESMARAIS, TOWN OF BARN. BOH, R.S. GROUNDWATER LEVEL ADJUSTMENT: 2.0 PROPOSED SITE IMPROVEMENTS" DATED APRIL 19, S ,% / engineering co. GROUNDWATER ENCOUNTERED ACTUAL GROUNDWATER LEVEL® SITE: EL= 4.7 2017 & REVISED FEBRUARY 5, 2018. /-- / 260 Cranberry Hwy.Orleans,MA 02653 ESTIMATED (MAX.) HIGH GROUNDWATER LEVEL EL= 6.7 } // \ I 508.255.65U P 508.255.6700 F DEEP OBSERVATION HOLE 1 - P#15431 EL 13.8f NO SCALE LOCUS EAST BAY l DEPTH FROM SOIL COLOR I I 1 r ti ESOILHORIZON SOIL TEXTURE SOIL MOTTLING OTHER LOT 4 ;J SURFACE (MUNSELL) - MAIN STREET ''r r r / 1. '6,, \ I \ a a� o 0" - 48" FILL l r° ,r `s / �\ / /APPROX. LOCATION OF EXISTING t i off, ' / • 1 �:r ' W. WATER SERVICE. WATER SERVICE TO f ` . !� - PERC AT 48 (EL.=9.8f) "'v. ! f q 48" - 132" SAND 10 YR 7i4 No FINE TO MEDIUM DRAINAGE & SEPTIC DETAILS. t '`, / ;^� `fi�, *`, F, �1'BE CUT, CAPPED & ABANDONED ' / V, '�,rjl, NNQ q m /� SAND, LOOSE GROUNDWATER ENCOUNTERED AT 1P _._. ..--..' IL- 11 O j ,/ j X �� � A DEPTH OF 109" (EL.=4.7t) SEE SHEET C2.5.5 FOR PROPOSED SEWAGE DISPOSAL SYSTEM DETAILS, (V j f rr f Q I DRAINAGE DETAILS, ELEVATIONS AND ADDITIONAL INFORMATION. REFER r / CONTRACTOR TO INSTALL 4 W DEEP OBSERVATION HOLE 2 - P 15431 EL = 12.6t NO SCALE TO SCHEMATIC PROFILE VIEW FOR PROPOSED SEWAGE DISPOSAL SYSTEM ,Q�. - � � ` ' FENCE POSTS PRIOR TO '" `�o OSTERVLLLE, MA �` INSTALLING DRIP TUBING. SIZES, INVERT ELEVATIONS AND ADDITIONAL INFORMATION. fib �3 >° ,�o- �� f / r "`, 1 cs�, W DEPTH FROM SOIL COLOR ( i o �° f ,> �. KEY MAP w SOIL HORIZON SOIL TEXTURE SOIL MOTTLING OTHER � � ! ° o ` `� / ./ ` 1' PROPOSED 909t S.F. N", ��✓ x SURFACE (MUNSELL) - o/o �r _ .� NO SCALE T*Q 'J � Z :, / �" �� t i. -\-_ __=PERC-RITE DRIP DISPERSAL 1y W a O" - 20" FILL - � 3 0 '� \. 1 SYSTEM (SEE SHEET C2.5.5) d Cn •" s o, % W PROPOSED /1*3 `�W 1 PROPOSED ,� �} v\ 20� W � w 20" - 34" B LOAMY SAND 10 YR 5/8 - QQ CATCH BASIN ', " `4 - -/- , ,d BLUESTONE{ _ 'i. „= .11 �`' REFERENCES• Q T- 4 RIM EL.=12.20 �.": N J r , STEPPERS \ \ q p " .: 05 U Q ASSESSORS MAP 141 PARCEL 1 " - " 1O YR 7 4 FINE TO MEDIUM GROUNDWATER ENCOUNTERED AT j / v ,. '`` ',; o .� a z 34 132 C SAND / NO Ili # ��� elN' DEED BOOK 29648, PAGE SAND, LOOSE A DEPTH OF 102" EL.=4.1 t t�'` PROPOSED j a i -. Z \ PLAN BOOK 563, PAGE 44 x °�3 0 WATER SERVICE 3 rr u s r t, I c ,. ; ti PROPOSED I = O C� � Q Q' �, 1 PROPOSED Z ::: 0 :,: LOT 4 SHOWN ON PLAN OF LAND TITLED r1. ..;�� -_ -•; ,, p ,.;c; .a g4�� 1,500 GALLON "PEA - F 04 vl C BBLESTONE , Q' ? w 77 fr --- �`� ;- 'J t ?. .* :` SEPTIC TANK 1 1O0' FROM ' N SHOWING PROPOSED RE DIVISION 0 W r� Ca DEEP OBSERVATION HOLE 3 - P#15616 EL = 17.6t NO SCALE SITE BENCHMARK: w ,'-' ;/ _.- APRON w `` !�F DEP TOP OF LOTS SHOWN ON P.B. 507, PG. 2 & P.B. Q W Q SOIL SOIL COLOR TOP OF MAG NAIL SET COO ` `i " E �, rt, =- 4. x` r �� r..=1 , 4.1 x - > I' COASTAL 563, PG. 44" PREPARED FOR SAMILJAN & �W' q O DEPTH FROM SOIL SOIL OTHER _ J 5.4g 55 '`, o N «.,. 6 ,. 4 , - I :d' BANK L w � a S `` •.. P , Op r•.,,. ,, ;.r; -'•�'T A �> SHAH, PREPARED BY COASTAL ENGINEERING SURFACE HORIZON TEXTURE MUNSELL MOTTLING ELEV.=11.24 (NAVD 1988) O g �� � ., I --¢ 4 O 96- �` � P 1` 1 _ COMPANY AND DATED JULY 31, 2017. '' a t P• FILL - - NONE (C.E.C. TO TRANSFER `` w \ - �`; .-. Z i A a, 0 42 �` GE t �s• ti /, 1 BENCHMARK PRIOR TO PROPOSED LEACHING } _._.._ " . _ ���. sED caRA ,` -, , , < w -1 _ rv\-. , , , , y,-, m; FLOOD NOTE. RECHARGE BASIN _ - 1� ,.,.. , , , , ~ " " C , FINE SAND NONE LOOSE START OF CONSTRUCTION) „ _. _ _ 84.� pe E; " w, .;`=1: r t�;;;•,�A.:Fc ,. - ? Q 42 - 156 10 YR 6/6 1 4 ;- ; ; 1, 1 0 f pR 8 ` :. S1 FLOOD ZONE AE (EL 12) AS SHOWN ON �� I.�w;'.�.`� ,. 1 _ FEMA FIRM PANEL #25001CO544J PROPOSED y, "; .V r� 4 ' 0'\ ":t _ A C UNITS 5 .,..,k„ y.t "1: PROPOSED RET. WALL '7 / 1 1 EFFECTIVE DATE JULY 16 2014. 13.57 t PROPOSED 2� / N' ` 'r ;' r G 5 U, , DEEP OBSERVATION HOLE 4 - P#15616 EL = 17.3t NO SCALE & BLUEsroNE srEPs ,-s �UH_7 �'1 "' __ ,, �,, s \ z DEPTH FROM SOIL SOIL SOIL COLOR SOIL lo.- \ `. LOT 4 �x .� �i �� oumooR g e y ��, �' DATUM NOTE. SURFACE HORIZON TEXTURE MUNSELL MOTTLING OTHER �,� op � ' �^ , RINSE AREA \ ' F a ,'1„ p EXISTING TREES rn /" ---° - - 1 F, '° _ \ ELEVATIONS SHOWN HEREON ARE BASED u 15.9 ��' �� 1 \� ON THE NORTH AMERICAN VERTICAL CONSTRUCTION NOTES TO REMAIN f 0 f - 0" - 18" FILL - - NONE (SEE HAWK PLAN FOR '`�J 5�t1 I,� SED a DATUM 1988 (NAND 1988) �' 4.. \ . . �� ,,-1 1� � EpROPo 16.44 � 1. INSTALLER TO ARRANGE A PRECONSTRUCTION CONFERENCE WITH ENGINEER PRIOR TO MORE INFORMATION) - - 1�1 ��,, 16.75 pA�o ..• '-1 ` 5 l PROPOSED 2,000 GALLON °�° °�° w B LOAMY SAND 10 YR 6 6 NONE �;, 16.75'° , ��� PUMP'CHA�BER w/ r., o� to �o H 18" - 42" / CONSTRUCTION. c� '� HYDRAULIC UNIT *** ZONING N o �" `y Q 2. ENGINEER SHALL INSPECT WHEN THE COMPONENTS OF THE SYSTEM HAVE BEEN \ �' �� : sl v rt N ' 42" - 138 C FINE SAND 10 YR 6 6 NONE LOOSE INSTALLED. s I /T ' \ R^\\� Y' � 0 0 0 0 / 3. INSTALLER TO PERFORM A WATERTIGHT TEST ON ALL CHAMBERS AND TANKS. TEST TO EXISTING SEPTIC TANK `� � �k PB 1 � � � ' w ,' ZONE: RF-1 I ; � ,� p. 5, . PROPOSED 100' FROM !, ,_i i k a� - ✓! �� � N / I BE WITNESSED BY ENGINEER AND PERFORMED AS FOLLOWS: (TO BE REMOVED) 1'" �✓t �� . 'a \\1 „ FENCE W/ - FILL TANKS WITH WATER AND PRESOAK FOR 24 HOURS. DEP TOP OF -= o (MIN) p t / i LOT AREA MIN 43,560 S.F.* DESIGN CALCULATIONS (CONTACT ENGINEER AT START OF PRESOAK) ` COASTAL `- i '1 li l \ \ �l I1` / GATE_A(TYP) ,r FRONTAGE (MIN) 20 FT. ct c� cv - Z -ENGINEER To MEASURE WATER LEVEL AFTER PRESOAK IS COMPLETE a BANK\ ! f ---,i 0 i ,\ to 1` g. `� LOT WIDTH (MIN) 125 FT. o N t ✓ `} pSED �� O. \\\ \'' ; I l _-._ -- FRONT SETBACK 30 FT. SEAL - ENGINEER TO RE-MEASURE WATER LEVEL 24 HOURS AFTER PRESOAK P N PROPOSED LRB '�,� pROP DESIGN FLOW: EXISTING 6 BEDROOMS AT 110 GAL. PER DAY PER BEDROOM = 660 GPD ` " � E 0 �� \` '� �-.I PROPOSED -- - ENGINEER TO RE-MEASURE WATER LEVEL 48 HOURS AFTER PRESOAK Cr o p B• EENE SIDE SETBACK 15 FL a' 65 \ 14' DIA. X WD I 0 �, SCR a .� YARD DRAIN / " 4. INSTALLER TO PERFORM A CLEARWATER TEST PRIOR TO SYSTEM BEING PLACED INTO I E 1 - 1 poRCN aUi RIM=16.40 _ - ! ;, ® REAR SETBACK 15 FT. SEPTIC TANK: 660 GPD X 200% = 1,320 GAL - USE 1,500 GAL SEPTIC TANK SERVICE TO DEMONSTRATE OPERATION OF SYSTEM. TEST TO BE WITNESSED BY -- v 901't ,-s--, %�,.�== _ - - , % l _ - 1 1 Lxv OVERLAY DISTRICTS: " '�,c ENGINEER AND BOARD OF HEALTH. EXISTING 6 BEDROOM / i - ! \ - �� � ; : PROPOSED LRB _ SOIL ABSORPTION A = 50.5 x 18 W. PERC-RITE DRIP DISPERSAL FIELD CAN LEACH: SOIL ABSORPTION SYSTEM �` , .> 1 1. ! -- `"^' D „ +r 14 DIA. X 6'D - r -' AQUIFER PROTECTION OVERLAY DISTRICT - ,� ,{ . SYSTEM: Vt = 50.5 x 18.0 x .74 = 673 GPD > 660 GPD REQUIRED Ei 1' 16.75 opoSE 1 --'/\i cn m ""' t - RESOURCE PROTECT1ON OVERLAY DISTRICT * ( ) (TO BE REMOVED) ' 16.36 PR p „ - i _' ; tR1! a 14.41. , NON p Npo - E RE SE o p B� \ i+ � / * +i l PUMP CHAMBER. 1 DAY ABOVE ALARM = 660 GAL. - POWER, CONTROLS AND ALARMS 1 DOSE = 623 GAL. E ? " „,_.---- 16.16 - CAS FS1g•00 r H F E - RPOD LOT AREA (MIN) 87,120 S.F. dr+. 6Z S 11 SUMP = 623 GAL __, l8iPROPOSED BRICK WALK _ ) \. �� 1 R� �21 \ s :J TOTAL = 1,906 GAL. - USE 2,000 GAL PUMP CHAMBER 1. CONTRACTOR SHALL PROVIDE ALL REQUIRED ELECTRICAL EQUIPMENT, CONDUIT, AND WIRING --^-. \ 1 1 �\„ _ - -=,-1 ---` gP �t�aNA FOR A COMPLETE AND OPERATIONAL SIMPLEX PUMP SYSTEM IN ACCORDANCE WITH THE W/ BLUE STONE STEPS -- 13.83 1 \� 1 __ ���,, 1 r LOCO PE PERC-RITE: REQ. LENGTH OF TUBING = 909 S.F. / 2 = 455 FT 12.1 i , PROPOSED DEp Zs�� NATIONAL ELECTRIC CODE. LEGEND MATCH EX. p p B 1 i 1 � �V; ,,,..._ , PATIO W/ �, FOOD 10 RUNS X 50.5 FT = 505 FT > 455 FT (MIN.) 2. POWER AND ALARM WIRING SHALL BE PLACED IN CONDUIT AND RUN UNDERGROUND TO ALL 16 _ ., �- - 1 EL.=11.0 r eli., --r , > , . `.... FIRE PIT EXI TING USE SINGLE ZONE, SIDE FEED PERC-RITE SYSTEM WITH 1 LATERAL AND 10 RUNS EQUIPMENT: , 3. ALL MANUFACTURER SUPPLIED CONTROL AND ALARM PANELS SHALL BE WALL MOUNTED AT 1 I,,/rm T \ 1, `'I ` • -- 1 ■ BOUND INSTALL: ONE ( 1 ) - A = 50.5'L.'x 18'W PERC-RITE DRIP DISPERSAL FIELD THE BUILDING. LOCATION MUST BE APPROVED BY OWNER ` / 'e - OP 8 - ( ) / �- y T�� r F UAtxN ONE ( - 1,500 GAL. SEPTIC TANK, MINIMUM ALLOWED .. .. \ 4 �,._.. .._" , _,._. /,z• W W y y . .� y / -" - 'CATCH BASIN W 4. ALL WORK SHALL BE PERFORMED BY LICENSED ELECTRICIANS. 15 . ONE ( 1 ) - 2,000 GAL PUMP CHAMBER W/ HYDRAULIC UNIT *** f ` -- �. W- - - 11 - .w �"+• .- O DRAIN MANHOLE l /W. '� W W W .�� PROPOSED EDGE W y J yW"""-w...�.- - W_ y.- W W. - ,. O <..< ,.. _ SEWER MANHOLE ___ _ .__ \ ��ll OF LAWN (TYP.) S ' PROPOSED W_ W y y:: y PROPOSED m y -W W , W. / y W W W - y y _--W y , Q TELEPHONE MANHOLE GENERAL NOTESI'll , �``� / " y; V A/C UNITS W - W _y W w INSPECTION NOTE GAS SERVICE ,, _,,..__� - - w � , - y W_ � f �: TOCB c _. W '�- -� �y y DEP W.< W.l' W W W , 4: y W y y W *: - w� y y, so f 19� kf MANHOLE Cn APPROVED '� W n1 i 1) GARBAGE GRINDERS ARE NOT ALLOWED WITH THIS DESIGN. "" 0 9 y -".' /W W � W W W W W W W +G �✓I. :�/+'W W W �W' W W O T 1 TALLER IS RESPONSIBLE FOR ASSURING THAT COMPONENTS OF THE SEWAGE DISPOSAL SYSTEM THE STATE ENVIRONMENTAL CODE TITLE 5 REQUIRES INSPECTIONS rn LIMIT OF WORK/ Y- �_ y a W W W '"W W W W y W W W W W W W W W '" \�„, + WF-39 « MONITORING WELL �M� FL0 APPROXIMATE LOCATION OF �F� y y W W W W W y„ _. WF-40 Q 2) HE INSTALLER O 0 SEDIMENTATION BARRIER � _.ZOrVE / EXISTING SEPTIC SYSTEM y "''� lP�`� 1 y W i' W V ARE DESIGNED WITH SUFFICIENT STRENGTH TO SUSTAIN ALL LOADS TO BE IMPOSED ON THEM. ANY OF THE SEWAGE DISPOSAL SYSTEM BY THE DESIGN ENGINEER. m G7 �QO `,Y S W, W W D ZONE W/W W W y W W,/ y y y W--y 24 M GAS VALVE ^ COMPONENT OF THE SYSTEM SUBJECT TO VEHICULAR TRAFFIC MUST COMPLY WITH A MINIMUM U) o (OOC SE#3-5474) D ZONE rA i/� y (TO BE REMOVED) FLOOy •. 0'J W' W y y y y y ~� WF-41 .^ 4 WATER VALVE " �'"`.1 v R'1 E W W W W--%v W W W W * '�W A' W W y W W y W W W W W W 1 V' I� I:. STANDARD of A.A.s.H.T.o. H-20 WHEEL LOADS. INSTALLATION CONTRACTOR MUST NOTIFY THE DESIGN ENGINEER � - ;,-.v '�� W W Tff W ,1y W W W W W W/y y W W y y y W WF-42 'f 3) PRIOR TO SETTING ANY SEWAGE DISPOSAL SYSTEM COMPONENT INSTALLER SHALL VERIFY EXISTING PRIOR TO THE START OF INSTALLATION FOR DISCUSSION ON PROPOSED / U HYDRANT ..t., y W W W W fV v� .,I✓ -,. y . W W W W W EDGE OF ,� �.r CONDITIONS, INCLUDING ELEVATIONS OF EXIT INVERTS, AND REPORT ANY DISCREPANCIES TO THE � m EDGE OF LAWN/ " ` y . W y W y y y . y W W'W �� �' PROPOSED W; y . W/- r- O- DESIGN ENGINEER. REQUIRED INSPECTIONS. MITIGATION :`•'/W �P��C?.� y y W y W �'. -W RESTORATION AREA 'y W a'' �` FLAGGED rn% Z ELECTRIC METER 2 \ OF F W ,„-.y-,�. . W y. y W y- W ty ,Y I W y W 4W WETLAND .� 4) ALL GRAVITY SEWER PIPE SHALL BE 4" DIA. SCH 40 PVC UNLESS OTHERWISE NOTED. THE MINIMUM PERC-RITE SYSTEM SHALL BE INSPECTED ONCE PER YEAR -4 PLANTINGS GF, - - SEE WILKINSON ;. W : f�WF-43 M� PULL BOX SLOPE OF 4" DIA. SCH 40 PVC SHALL BE 0.01 FT/FT. (PERPETUAL MAINTENANCE AGREEMENT REQUIRED) � i END OF DEP y y y w . - �, 6 ECOLOGICAL PLANS) y y LOT B ry CABLE TV BOX ...� O 44 5) NO PART OF THIS DESIGN SHALL BE ALTERED WITHOUT PRIOR APPROVAL FROM THE DESIGN ENGINEER OD �, a1. y`w " COASTAL BANK W y W -"Wry y' J y W W y y y . y r,,- ' AND THE AGENT of THE LOCAL BOARD of HEALTH. ALL REQUESTS FOR CHANGES SHALL BE MADE IN r I l ^, � vo--W- W W W y W " y y -W wy y y W-y W yr y 69,165t S.F. TEL TELEPHONE BOX r� � p y _ .-, w . WF-44 V. WRITING PRIOR TO CONSTRUCTION. �+ �: ,. ;W . W W W_ ^"•�' .- . y W W --, W, W W y W W ,1� 1 1 OO' (�. (y �, W y W W . f+"'y . W . ~�W `W W,.✓W' y / y j 6) THE USE OF ALTERNATE MANUFACTURERS FOR SYSTEM COMPONENTS SHALL NOT BE APPROVED IF THE NQTE; `J ` w y y ;' y -w ' y y y y y y W--� y W �,w y y y y W y W y W y y y y y/W� W y W y W y 59f ) • T (1 AC. LIGHTPOST USE of THEIR EQUIPMENT REQUIRES CHANGES IN DESIGN. FROM / •W cl�- THE INFORMATION HEREON HAS BEEN PREPARED ACCORDING TO THE � �'�. W y,W W � W W {J �W W � �y-' W •Y W W W y W W y w W W y # � --�- MISC. SIGN `J � 7) THE INSTALLER SHALL ASCERTAIN THE LOCATION OF EXISTING UNDERGROUND UTILITIES PRIOR TO EDGE OF W 'y y .s `'W y s y .i .W y W W W W W .. . . y ExcavAlloN, AND SHALL PROTECT uTIu11Es wITHw THE WORK AREA DURING CONSTRUCTION. REQUIREMENTS OF TITLE 5 OF THE STATE ENVIRONMENTAL CODE FOR SUBSURFACE wETLAND .. y y y y, W y ,_W W y " - ---•� y - - y W - - y y i- W y y - © POST 8 THE EXISTING SEWAGE DISPOSAL SYSTEM SHALL BE PUMPED AND REMOVED WITH SURROUNDING DISPOSAL OF SANITARY SEWAGE AND LOCAL BOARD OF HEALTH REGULATIONS. y y y �%y W 'J y FROM yl .y y W 4- 1 W y y y y y y y' - y W� WF-45 6g•g4 �I LAND SUBJECT` y y y y y 'y W W ` '� ` 2" E UTILITY POLE CONTAMINATED SOILS AND BACKFlLLED WITH CLEAN COARSE SAND. SIEVE PERCENT . W . y W �'ry y EDGE OF ,W y W y y W y W y W W y y W W W W W W - S 66.380 , 9) ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING TAPE OR A COMPARABLE y W y y/ WETLAND f y y W y W! y TO COASTAL W�� I� � ,1` -0 GUY POLE MEANS IN ORDER TO LOCATE THEM ONCE BURIED. SIZE PASSINGCn ` y y W y '` y y y y y -STORM FLOWAGE �� �•-�" y W I O IF APPLICABLE: # 4 100% ' yyyWyyyy( \yyy\y Yyy � yyyyyy�� ,..-•„yy yy y WF-46 GUY WIRE O y y y � l 10) FILL MATERIAL FOR SYSTEMS CONSTRUCTED IN FILL SHALL BE CLEAN GRANULAR SAND, FREE OF PLAN \\ ` y - y`y y y y w`y W y`�y' �_�y-- y y y y y y y y y y y y W y y y y VARI ANCES } # 50 10%-100% _._..__ ._ . ORGANIC MATTER AND OTHER DELETERIOUS MATERIALS. THE SAND SHALL BE GRADED SUCH THAT NOT �L W\ _ m �"`� # 1DD D%-2D% O �� •� W ly W W y�� W - y •Y'`y y y y y y y W W y W y W y y y y - -- _,.,,_ TpWN OF gARNS1ABLE TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS • SEE r'�1 MORE THAN 45% OF THE SAMPLE, BY WEIGHT, SHALL BE RETAINED ON THE SIEVE. THE FILL SHALL S• •� y __.a y WF-47 AGE EASEMENT # 200 0%-5% 20 10 0 20 60 ems- J y W \W y . . l.W W.., y` y W-3 WETLAND FLAG May NOT CONTAIN ANY MATERIAL LARGER THAN 2 INCHES. THE MATERIAL THAT PASSES THE #4 SIEVE ,! y y �__.l^* `y y" y y y DRAIN SHALL MEET THE FOLLOWING GRADATION REQUIREMENTS: Z. W W W W y y �, _, _y.-•- --W" W' W y W W y_ y 360-1 SETBACK REQUIREMENTS: y W y W W \,V W y y6 W W y y W y W W y � HYDRAULIC UNIT IN W W W T. I y W y y y . - SEPTIC TANK LESS THAN 100' TO DEP COASTAL BANK � I I � EDGE OF WETLAND w k,Y W y t •4 y W W W '�...-....•. (SEE THIS SHEET AND SHEET C2.5.5 FOR DETAILS) y1 y y y y - (41' VARIANCE REQUESTED) W Qi W y W t y W W *** CONTRACTOR MUST CONFIRM FINAL LOCATION WITH ENGINEER PRIOR TO _ y y y y'; W W .\ W . y,� y . y . W � y W W W y y �WF-48 �_ - SEPTIC TANK LESS THAN 100' TO EDGE OF WETLAND FENCE 1 1 inch = 20 ft. . . . W. . y W W r-4 INSTALLATION. INSTALL UNIT AND PIPING IN ACCORDANCE WITH y ~y, y \, . W W, y W y y y y W . y y y y -'� (5' VARIANCE REQUESTED r^ ^ THIS AREA IS SERVED BY TOWN WATER \''�.- y` y y y y y W, y y y y y . y y ' - PUMP CHAMBER LESS THAN 100' TO EDGE OF WETLAND OVERHEAD UTILITY LINE V Q a, PROPOSED CA MANUFACTURER'S REQUIREMENTS REFER TO COLD CLIMATE NOTES. ( ) y y 1.5" DIA: SCH 40 PVC W y t y 'W y y' y y (5' VARIANCE REQUESTED) CAPTAINS HOUSE "FLUSH RETURN PIPE ' CONTOUR O TOP OF FIN. FLOOR EL:=19.00 FROM HYDRAULIC UNIT RAISE COVERS TO WITHIN 6" ZABEL FILTER - PUMP CHAMBER LESS THAN 100 TO DEP COASTAL BANK 04 (SEE ARCH. FOR T.O.F. & F.F.E) OF FINISH GRADE A1800 SERIES (39' VARIANCE REQUESTED) DEP TOCE3 TOP of COASTAL BANK (0.5% MIN. SLOPE) - LEACHING FACILITY LESS THAN 100' TO DEP COASTAL BANK AS DEFINED BY MA DEP >" w MODEL 4X22 RAISE COVER TO WITHIN 30" CAST IRON COVER Q Fyn B - POLICY 92-1 h o, 6" OF FINISH GRADE TO FINISH GRADE (25' VARIANCE REQUESTED) [- = p h FINISH GRADE=VARIES (SEE PLAN) FINISH GRADE=16.5t FINISH GRADE=16.7t F.G.=16.8t MAX. TO 16.4t MIN. (25% > SLOPE > 10%) U H r DOH #1 ti V) W 9" MIN. 6" MIN. AND S�PPLY CEC TEST HOLE LOCATION O Q w 1' 4" DIA SCH 40 PVC PIPE 3' MAX. 3' MAX. 2 MIN. ' MAX. (SEE SOIL REMOVAL NOTE) (SEE SOIL LOGS) a oWo Un N OR AS REQUIRED BY MASS .. .•• FLOW C" MIN. LAYER OF RETURN 0 5' 4'• - '• '' _` •:• LINE " • . W LEAN SAN RELEASE 5 ' SCALE a PLUMBING CODE 4 DIA SCH 40 ¢ DROP:2 min. : : • , . , e. :.. VALVES - o� 3" max. • PVC PIPE :.i " ,. --- -------- --- - --- -- --- - - --- -- ----- ------- .--- - ------ ---- -- - --� ---- - ------ - . 3 1 5 0 15.50 PROPOSEDTOUR DRAWING FILE AS NOTED V . .. . . .. lib llz� RETURN PIPE _ ______-.----1 .-____-----=---- ----- -=.-_---_ ___�__--- -==-- =-=--------___-___ __ . ------- - ---- -------- ---- - 10 C18614-DRIP.dw a. 10" SEE .. SEE PERC RITE DRIP % g % - - --- - - -- ------- ----- ----�--=--=...-=--=---- ------ - ---------- -- --- ''. --. ... -. - ------- --- L. DATE A 14.40 .•• BELOW EL 13.8 MIN. DISPERSAL FIELD LAYOUT PERC-RITE - - - - - 20.6t SPOT GRADE 13.70 13.45 {THIS SHEET) ALONG FIELD DIMENSIONS: , _ LIMIT OF WORK/ 3 n L ( .rZ 1 r . . :. . _ . . z 4-1 WITH SHEET C2.5.5 - ---�--.:.::: . ... -----------------------=-------- --1.*:, =--=---_____,_----7'---------_-------- ---- ------ --- --- THE MINIMUM SLOPE FOR : 1,500 GALLON H-20 13.35 50.5 L x 18 W DEPTH To ESTIMATED HIGH SEDIMENTATION BARRIER DRAWN BY H " LIQUID DEPTH ) 1. . ..: ..`, a 4 DIA SCH 40 PVC PIPE •' SEPTIC TANK .i GROUNDWATER= 8.8't --- -- --- ----- ----- . - ' ----'------ "--- -- - -- --- ----- - - -- - - - --- - -- ------ -: .. -- - . �; - W - WATER SERVICE MJB/PMJ v IS 1/8" PER FT t SEE SHEET C2.5.5 .. - . . . .. .. . . .. • :. . ..... W/SANITARY TEES ,' FOR TYPICAL PUMP TANK AND ALARM AND �_ -_____�____-__- r__•_- ___ ----_-d___:_____,-_-_--�_,________'-__ - --- ------ -- - - -- -# -----�;----_ ----- -- CHECKED BY COMPACTED BASE `; HYDRAULIC UNIT DETAIL " LAG PUMP "ON" SZ ESTIMATED HIGH = GAS SERVICE 6 : .. .: : . --- W 6" LAYER OF LEAD PUMP "ON" - GROUNDWATER - - --- --_-. .. `--- - -_ -------------- ---- -- ------ ----- --- ---- ------- - --- - E - ELECTRIC SERVICE o0 v / .. ::. _. " EL.=6.7t .. LS'SPACING (TYP) oCRUSHED STONE :.:'. . ;•••. - •.. . • 6 " n - - _- -----=--- --- -- --- -- --------- ------- -- ----- -- ------ ---- -1. ----- - --- - - - - INTER CONNECTIVE ROUTE (KVC) � . • A .M . PUMPS OFF .. . . ... . " PERC-RITE DRIP DISPERS F _ _ _-__________-�.. _____,_,_______I..__,__ _�w-_�,_ _-_�. �---- w�---- -- ---- 1. ------ -- DRAINAGE PIPE 0 20 AL IELD U. ------ -. •::. I -------- 6.0 =2% MIN.) '. SUMP - - -_- --------=- --- - - -- - ----- -- -.--- -- --- ------ - --- ------ --- ----- ---- - --------- ----- COMPACTED BASE ,. . :% :; '. • . • "••' •':...• •-.. : . �.y. •.:• . . NOT TO SCALE _ �, SDR 35 S �o L=35't W/ 6" LAYER OF • 1' " r YD YARD DRAIN CRUSHED STONE �.:, _ ° (SEE HAWK PLAN) o PERPETUAL MAINTENANCE AGREEMENT � C2o3*5 o L=SfN. coMPACTED BASE REQUIRED WITH PERC-RITE SYSTEM PERC-RITE DRIP DISPERSAL FIELD LAYOUT 9 LIQUID DEPTH OUTLET TEE DEPTH 2,000 GALLON EFFLUENT DOSING CHAMBER (H-20) CAPTAIN'S HOUSE 00 BELOW FLOW LINE (INSIDE TANK DIMENSIONS: 10'L x 5'W) w/ 6" LAYER OF SEE SHEET C2.5.5 FOR MORE INFORMATION u NOTE: 4 FT 14 INCHES CRUSHED STONE •� ° ALL WATER FIXTURES TO BE WATER TESTED BY 5 FT 19 INCHES /� /� PERC-RITE SYSTEM MUST BE INSTALLED BY A r 5 CONTRACTOR TO VERIFY ALL SEWER EXIT LOCATIONS PRIOR 6 FT 24 INCHES SCHEMATIC FLOW PROFILE i OF 2 SHEETS V) TO INSTALLATION OF ANY SYSTEM COMPONENTS. 7 FT 29 INCHES CERTIFIED INSTALLER APPROVED BY ENGINEER. RE-ISSUED FOR REGULATORY REVIEW 04-23-2018 ,a A ALL INSTALLATIONS MUST CONFORM TO THE MINIMUM REQUIREMENTS OF TITLE 5 � PROJECT NO. w v 1 C 18614.00 Xf�' a�' --- 26" DIA. CAST IRON FRAME AND "SEAL-TITE" COVERS TO FINISH GRADE (H-20) PRECAST CONC. RISERS W/ SEALED JOINTS AIR RELEASE VALVES WITH 1/2" SUPPLY&RETURN MANIFOLD PLACED ON EVERY LEACHING CHAMBER UNIT WITH A"PIPE IN." COVERS TO GRADE LOCATED ABOVE DRIP TUBING TO DRIP TUBING COVER SHALL GENERAL PERC-RITE DISPERSAL SYSTEM CONSTRUCTION NOTES: (HIDE IN PLANT BED) CONSIST 2" MIN - 6" MAX FINISH GRADE _ FINISH GRADE ALLOW MANIFOLDS TO DRAIN _- 2" LAYER OF 1/8"TO 1/2" 1. THE SYSTEM SHALL NOT BE INSTALLED IN WET OR FROZEN SOILS. �,ly VERTICAL SUPPLY& CLEAN SAND COVERED BY 6" li _ - - -i 2. DO NOT PARK, DRIVE LARGE EQUIPMENT, OR STORE MATERIALS ON THE DISPERSAL AREA. NO ACTIVITY SHOULD OCCUR ON THE DISPERSAL RETURN LINES LOAM &SEED -III-III-IIII ( ( -� I (�) I II I (-III DOUBLE WASHED CRUSHED STONE INSULATED (PER /fEXISTING GRADE (SEE LANDSCAPE PLAN) �� � I-I I ( � f � �_I I II � ( (TYp,) AREA OTHER THAN THE MINIMUM REQUIRED TO INSTALL THE SYSTEM. COASTAL 3. ALL INSTALLATION AND CONSTRUCTION TECHNIQUES SHALL CONFORM TO THE STATE AND LOCAL CODES PERTAINING TO ON-SITE COLD CLIMATE WASTEWATER SYSTEMS AND THE PERMIT FOR THE SITE. EI1gII18@CII1g CO. NOTES) 4" SCH. 40 PVC.S=0.01 MIN. O 4. IF SITE CONDITIONS ARE DETERMINED TO REQUIRE THE INSTALLATION OF THE SYSTEM TO DEVIATE FROM THE DESIGN PLANS, ALL WORK z6o cranberry Hwy.Orleans,MA oz653 DEPTH" ® ® 3/4 - 1 1/2 DOUBLE WASHED SHALL STOP IMMEDIATELY AND THE DESIGNER AND INSPECTOR SHALL BE NOTIFIED. ANY ONGOING WORK SHALL BE THE SOLE 10.20 ® ® CRUSHED STONE RESPONSIBILITY OF THE CONTRACTOR. 508.255.6511 P 508.255.6700 F 5. DRIP TUBING MAY BE INSTALLED WITH A VIBRATORY PLOW, A STATIC PLOW, A NARROW TRENCHER(< 6" WIDE), BY HAND TRENCHING, OR BY SCARIFYING THE SURFACE AND BEDDING THE DRIP TUBING IN CLEAN SAND MEETING THE REQUIREMENTS FOR FILL MATERIAL IN THE STATE CODE. FOR SAND FILL SYSTEMS, COVER CONSISTING OF 2" OF THE SAME SAND AND THEN TOPSOIL MEETING THE APPROVED DEPTH SOIL HORIZONS A&B TO BE REMOVED AND REPLACED REQUIREMENT SHALL BE PROVIDED. T MIN. WITH CLEAN SAND MEETING THE REQUIREMENTS FOR BOTTOM OF STONE EL.=8.20 6. ALL DRIP TUBING IS TO BE INSTALLED PARALLEL TO THE CONTOUR. MAIN SUPPLY& FILL MATERIAL IN THE STATE CODE 2' 1 41 2' 7. AIR RELEASE VALVES SHALL BE PLACED BELOW THE GROUND SURFACE IN AN INSULATED VALVE BOX BUT AT AN ELEVATION ABOVE THE COMMON RETURN (TYP.) (TYP.) (IYP.) HIGHEST DRIP LINE IN THAT PARTICULAR ZONE. LINES LOCATED -� 1/2" PVC FLEX 8. VEGETATIVE COVER MUST BE REPLACED FOR INSTALLATIONS WHERE IT IS REMOVED OR BURIED DURING INSTALLATION. BELOW FROST LINE ESHWT RETURN LOCATED 8' (TYP.) 9. ALL CUTTING OF RIGID PVC PIPE, FLEXIBLE PVC, AND DRIP TUBING OF SIZE 2" OR SMALLER SHALL BE ACCOMPLISHED WITH PIPE CUTTERS. NO ABOVE DRIP TUBING SAWING IS ALLOWED. CHAMBERS ARE TO BE LAID LEVEL 10. ALL RIGID PVC PIPE, FLEXIBLE PVC PIPE AND DRIP TUBING SHALL HAVE THE ENDS COVERED WITH DUCT TAPE AFTER CUTTING TO PREVENT PERC-RITE FIELD TO ALLOW DRAINAGE CONSTRUCTION DEBRIS FROM ENTERING THE PIPE. Note: All s Rite components shall be obtained TYPICAL END VIEW OF LEACHING RECHARGE BASIN (LRB) from Oakson,on, Inc, Gloucester, MA., 978-282-1322 (NOT TO SCALE) 11. PRIOR TO GLUING, ALL JOINTS SHALL BE INSPECTED FOR AND CLEARED OF ANY DEBRIS. ALL JOINTS SHALL BE CLEANED AND PRIMED WITH w PVC PRIMER PRIOR TO BEING GLUED. v1 (NOT TO SCALE) 12. ALL PVC PIPE AND FITTINGS SHALL BE SCH 40. Z NOTES: 13. WHENEVER POSSIBLE, ALL FORCE MAINS SHALL BE TESTED FOR LEAKS PRIOR TO BEING BACK- FILLED BY PRESSURIZING THE SYSTEM AND W �. NOTE: THE DRIP TUBING SHALL BE THE LOWEST NOTE: RETURN MANIFOLD 1. ALL RIGID AND FLEXIBLE PVC ARE TO BE LOCATED ABOVE THE DRIP LINE TO ALLOW ALL DRIP LOOPS ARE TO BE LOCATED 2" ABOVE THE DRIP LINE TO OBSERVING FOR LEAKAGE. POINT TO ALLOW FOR DRAINAGE FROM BOTH THE THE PIPES TO DRAIN. 14. THE HYDRAULIC UNIT SHALL BE PLACED ON TOP OF THE SEPTIC/TREATMENT TANK, PUMP CHAMBER, OR ON A BED OF 4" - 6"THICK 3/4" O F- U VERTICAL INSULATED SUPPLY AND RETURN PIPES AIR RELEASE TO BE LOCATED ABOVE ALLOW FOR THE LOOPS TO DRAIN. SUPPLY MANIFOLD 2. THE AIR RELEASE VALVES SHALL BE PLACED AT THE HIGHEST POINT ON THE SUPPLY U d z DRIP TUBING TO ALLOW DRIP GRAVEL IN A LOCATION WITHIN 30 OF THE PUMP. x a a., o 1/2" PIPING TO BE VALVE AND RETURN LINE. TUBING 15. IF STANDING WATER IS A PROBLEM IN THE VICINITY OF THE HYDRAULIC UNIT, A SCREENED DRAIN TO DAYLIGHT IS REQUIRED. O THE MANIFOLD TO DRAIN 1" MIN. LOCATED ABOVE DRIP 3. EACH ZONE TO HAVE TWO AIR RELEASE VALVES. 16. ELECTRICIAN TO PROVIDE SEPARATE CIRCUITS FOR THE PUMP AND CONTROLS/ALARM, OR AS REQUIRED BY STATE AND LOCAL CODES. WW PRESSURIZED RADIUS w r� TUBING TO ALLOW THE 4. RETURN LINES TO BE CONNECTED TO A COMMON RETURN LINE. RAM INSERT 17. ALL CONDUIT ENTERING THE CONTROL PANEL SHALL BE SEALED AT BOTH ENDS TO PREVENT CONDENSATION OR GASES INSIDE THE PANEL. w Q MANIFOLD TO DRAIN + DRIP TUBING + a O w + + + + #++ ADAPTER VALVE BOX WITH 1/2" MIN DRIP 12' to + + a + + + + RIGID FOAM INSULATION LOOP (TYP) PVC FIP VERTICAL INSULATED + + ♦ 1/2" FLEX PVC TUBING INSTALLATION INSTRUCTIONS: w �+ , AIR RELEASE +y INSERTED UNDER COVER ADAPTER x RETURN PIPE + + VALVE + ++ + 1 4' LENGTH P (PER COLD CLIMATE ' '+ + + � ) 1. MEASURE THE DISTANCE FROM THE BOTTOM OF THE TANK TO 6 DOWN FROM THE TOP OF THE RISER. CUT THE EXTENSION PIPE (BY OTHERS) +' + + f VERTICAL INSULATED AIR RELEASE TO THE LENGTH NECESSARY To REACH THIS HEIGHT. CUT HALF OF THE PIPE DOWN 12"TO 18"AWAY FROM THE TOP OF THE PIPE FOR A PUMP NOTES) FINISH GRADE • RETURN PIPE VALVES TYPICAL DRIP LOOP CONNECTION DISCHARGE PIPE AND ATTACH TO RISER. (SEE DETAIL A) (PER COLD CLIMATE + 2. GLUE THE EXTENSION COUPLING (BY OTHERS)TO THE EXTENSION PIPE AND TO THE COOL GUIDE. 1/2" PVC RIGID NOTES) (NOT TO SCALE) 3. FOR REUSE OF EXISTING CONCRETE PUMP CHAMBERS: GLUE ON THE COOL GUIDE FLAT CAP AND PLACE THE COOL GUIDE FIRMLY IN THE BOTTOM RETURN OF THE TANK. ATTACH THE EXTENSION TO THE RISER WITH THE ANCHORS AS SHOWN. COMMON RETURN PIPE MANIFOLD PVC PRIMED TREADED CONNECTION WITH 4. FOR USE IN NEW CONCRETE PUMP CHAMBERS: ANCHOR THE FLAT CAP TO THE BOTTOM OF THE TANK IN THE PROPER LOCATION TO HOLD THE BELOW FROST LINE SUPPLY AND GLUED TEFLON TAPE COOL GUIDE AND EXTENSION. THE CAP MAY OR MAY NOT BE GLUED TO THE DEVICE. ATTACH THE EXTENSION WITH THE ANCHORS AS SHOWN. 1 PVC SUPPLY PIPE BELOW FROST LINE 1" PVC RIGID MANIFOL 5. PLACE THE PIPE DOPE ON THE COOL GUIDE ADAPTER THREADS AND THREAD THEM INTO THE PUMP DISCHARGE. DRIP TUBING III 6. ATTACH COOLING COLLAR TO ADAPTER WITH SET SCREW PROVIDED. 00 00 00 INSTALLATION DEPTH 6" MIN 7. GLUE PIPE INTO FLOW COLLAR AND WITH PUMP ATTACHED LOWER INTO THE GUIDE TUBE. �"ll� w AS PER DESIGN 1/2" PVC FLEX DRIP 8. ATTACH TO DISCHARGE PIPE VALVES AND CONNECT ELECTRICAL AND SPECIFIED. N o FOIL WRAP INSULATION SHALL TUBING o 0 o Q BE INSTALLED OVER TUBING FORCE MAIN INSTALLATION *** 1 2 FLEX PIPE SITE CONTRACTOR TO COORDINATE / 11 1" RETURN (PER COLD CLIMATE NOTES) DEPTH TO BE BELOW THE FROST LINE 1" SUPPLY \ RETURN (NP) ADAPTER FITTING BARBED RAM LOCATION OF IRRIGATION LINES WITH SEPTIC (NP) 1/2" SUPPLY PVC FIP INSERT FITTING •., N � o STANDARD DRIP SYSTEM (SIDE FEED MANIFOLD) SYSTEM INSTALLER PRIOR TO THE INSTALLATION COLD CLIMATE NOTES: z OF ANY SEPTIC SYSTEM COMPONENT.*** TYPICAL MANIFOLD CONNECTION CONNECTING DRIP TUBING TO FLEXIBLE PVC PIPE (NOT TO SCALE) (NOT TO SCALE) 1. ALL ATTEMPTS SHOULD BE MADE TO PLACE THE HYDRAULIC UNIT IN A LOCATION WITH AN OPEN SOUTHERN EXPOSURE FOR WARMING SEAL PURPOSES. 2. ALL PIPES ENTERING AND LEAVING THE HYDRAULIC UNIT SHALL ELBOW VERTICALLY DOWN 90 DEGREES TO A DEPTH BELOW THE FROST LINEAve el, ; FLOWMETER PRIOR TO EXTENDING AWAY FROM THE UNIT HORIZONTALLY. 51 SUPPLY VALVE 3. THE SUPPLY AND RETURN LINES SHALL BE INSTALLED BELOW THE FROST LINE. WHEN THIS IS NOT POSSIBLE, RIGID FOAM INSULATION (MIN lk1 DISC FILTERS Ill THICK) SHALL BE PLACED OVER THOSE PIPES THAT ARE ABOVE THE FROST LINE. 4. THE VERTICAL SECTIONS OF PIPE THAT TRAVEL THROUGH THE FROST ZONE AND CONNECT THE SUPPLY AND RETURN LINES TO THE HYDRAULIC t a. '16715 HOUSE UNIT MANIFOLDS SHALL BE INSULATED SCH 40 PVC PIPE.-INSULATION SHALL CONSIST OF FOAM PIPE WRAP INSULATION AND 1" RIGID FOAM FIELD FLUSH VALVE o �0� - INSULATION STRIPS MADE INTO A BOX. (SEE INSULATION DETAIL) , S. FOIL WRAP INSULATION SHALL BE PLACED OVER THE SUPPLY/RETURN MANIFOLDS AND LOOP CONNECTORS SO THAT AT LEAST 1' OF e TO SEPTIC TANK 1 1/2" GRAVITY RETURN INSULATION EXTENDS EACH DIRECTION BEYOND THE FITTINGS. (SEE INSULATION DETAIL) a X FLUSH RETURN FROM HU 6. AIR RELEASE VALVE ENCLOSURES SHALL BE INSULATED WITH BAGGED STYROFOAM PEANUTS, FOIL WRAP INSULATION, AND RIGID FOAM a (0.5% MIN. SLOPE) FIELD INSULATION INSIDE THE LID. (SEE INSULATION DETAIL) SUPPLY 7. ALL LOOPS CONNECTING DRIP RUNS SHALL BE SLIGHTLY ELEVATED (MINIMUM 1" - 2") SO THAT THEY DRAIN INTO THE DRIP TUBING AFTER S THE PUMP SHUTS OFF. IT IS THE CONTRACTOR'S RESPONSIBILITY TO ENSURE THAT THESE LOOPS STAY ELEVATED DURING AND AFTER THE SEPTIC TANK/ LOOPS ARE BACKFILLED. BACKFLUSH VALVE TREATMENT TANK PUMP COMMON RETURN 8. DENSE VEGETATIVE COVER IS TO BE ESTABLISHED OVER THE SUPPLY TRENCH, RETURN TRENCH, MANIFOLDS, AND DRIP TUBING PRIOR TO THE 1" COMMON SUPPLY TO CHAMBER FIRST EXPOSURE TO FREEZING TEMPERATURES. IF VEGETATION CANNOT BE ESTABLISHED THEN THE ENTIRE DRIP DISPERSAL FIELD IS TO BE �; w HYDRAULIC UNIT W RETURN COVERED WITH A THICK LAYER(MINIMUM 6 ) OF MULCH, STRAW/HAY, OR FROST BLANKET UNTIL SUCH TURF COVER IS ESTABLISHED. F, 1 1/2" SUPPLY FROM 9. VEGETATION HEIGHT OVER THE DRIP DISPERSAL AREA SHOULD BE A MINIMUM OF 4" - 6"THROUGHOUT THE WINTER MONTHS. PUMP CHAMBER 1 ZONE SUPPLIES ` l 6' DIAMETER (H-20) PRECAST CONCRETE LEACHING BASIN. sHOREY LCB-1000-H-20 oRPERC-RITEHYDRA LIC UNIT 15 GPM TYPICAL SYSTEM HYDRAULIC PROFILE , Q � EQUAL w (NOT TO SCALE) FLOW M �` FLOW (NOT TO SCALE) con 3/4" - 1 1/2" DOUBLE WASHED CRUSHED STONE (TYPICAL ALL DRAINAGE Q RECHARGE BASINS) a04 Cool Guide (14' DIA. x 6' D) GREEN VALVE BOX COVER VALVE HOLE IN FOILWRAP ID THROUGH SULATION7„ CI) V Patent No. 6,262,689 CONTROL UNIT PANEL AT FINISHED GRADE N H^ MOUNTED IN AN EXTERNALLY �--I TYPICAL DETAIL OF LEACHING RECHARGE BASIN (LRB) MANIFOLDS AND LATERALS BENEATH 2' Detail A PERC-RITE HYDRAULIC UNIT (15 GPM) ACCESSIBLE LOCATION FOIL WRAP INSULATION SHALL >:'i''" " X 2' FOIL WRAP INSULATION LAID FLAT >-q W (NOT TO SCALE) (LOCATION MUST BE NOT TO SCALE BE INSTALLED OVER TUBING ' ll APPROVED BY OWNER PRIOR (PER COLD,CLIMATE NOTES) T * FINAL LOCATION OF HYDRAULIC UNIT TO INSTALLATION) PRECAST CONC. RISERS W/ ALL LATERALS SLOPE W ................. .... . I12"-1811 MUST BE APPROVED BY LANDSCAPE SEALED JOINTS RIGID INSULATION BOX DOWNHILL TO DRIP TUBING D=THE DAILY DESIGN FLOW FOR THE SITE ARCHITECT PRIOR TO INSTALLATION AROUND VERTICAL PIPES FOR SELF DRAINAGE O w 26" HEAVY DUTY CAST IRON SCH 80 UNION RIGID FOAM INSULATION FRAME&COVER TO FINISH GRADE O� FLOAT TREE NO WEEP HOLE CONDUIT TO PANEL GATE VALVE TO BE DRILLED BY CONTRACTOR 4 MIL POLY OVER A 4" _ - _ _ FINISH GRADE TOP VIEW W W LAYER OF 1/8"TO 1/2"STONE JUNCTION BOX _ VALVE BOX INSERTED AIR RELEASE RIGID FOAM INSULATION Q, Z =1l HYDRAULIC 11= ; THROUGH 7" HOLE IN VALVES MANIFOLDS AND LATERALS Q F CHECK VALVE UNIT* „ FOIL WRAP INSULATION BENEATH FOIL WRAP INSULATION SUPPLY LINE FLUSH RETURN TO /,l/,//,//,ll�ll�l�ll�ll=ll=l � �11�11; : PRECAST F" E- 6 DIA. SDR 35 PVC UNLESS M ADAPTER BELOW FROST OR SEPTIC TANK. /,//,//,//,/�//,//� ; ; OTHERWISE NOTED ON PLAN AT FINISHED GRADE ATTACH CONCRETE FOIL WRAP INSULATION SHALL BE U LEACHING RECHARGE BASINS � W INSULATED z � W LEACHING INSTALLED AROUND VALVE BOX& STYROFOAM PEANUTS CC) AS PER 1\=111.\1.11' VERTICAL PIPE TO BE o IN BAG as a COOLING COLLAR UNDISTURBED 6" GRAVEL � � BASIN H-20 ABOVE MANIFOLDS AND LATERALS Ln NOTE 1 1 UNDISTURBED EARTH _// INSULATED En M CePER COLD CLIMATE NOTES N .TO HU \' EARTH _ , ( ) 1-1/2" SCH 40 EXTENSION 3/4 TO 1 1/2 SCALE ROOF DRAIN COLLECTOR PIPES FROM SUPPLY AND RETURN LINES AS NOTED :::. I ll-ll-11-11-_Il " DOUBLED ,� :::. 8 OF STATIC LIFT TO HU(MAX) DRAIN SPOUTS USE 6 DIA. SDR 35 PVC CLEAN 1/4 - 1/2 CRUSHED STONE BELOW FROST ZONE ' 4-0 6-0 4'-0" WASHED STONE (TYP 4) DRAWING FILE 3 COUPLING COLLAR(BY ALARM \=11=11=11= `//_I/�//�//�// INSULATE LINES WITH RIGID C18614-CAPTAINS DRIP.dw WATERTIGHT //_//,//,// FLUSH RETURN (TYPICAL) w OTHERS) ,1 1=�11=11=\v 9 10 SEAL 11=11%11=1� `'I�/%// �- SUPPLY FOAM BOARD WHEN PROPER DATE A PVC COUPLING PEAK ENA E 11 \11\l ' 14 FLEXIBLE FOAM OR RUBBER FROST DEPTH CANNOT BE " P `- (SEE PLAN) PIPE WRAP INSULATION ` INLETS INSERT (BY OTHERS) AROUND VERTICAL PIPES 10" =11\1-N- PUMP DISCHARGE TO HU ACHIEVED. DRAWN BY ,�1%11%11%11 1-0 DRIP ENA L a.11,11�11.1, TYPICAL END VIEW OF LEACHING RECHARGE BASIN (LRB) PMJ 4 ° ° OFF 11=11=11=11=� DRIP ENABLE FLOAT ELEVATION NOT TO SCALE RIGID INSULATION BOX CHECKED BY 0 0 0 0 0 0 0 a SEE INSERT a .11.11.11=11%11� NOTES: 00 0 0 0 16 AROUND VERTICAL PIPES 0°0 0 o SCH 40 PVC 20 �1.1=11.11�11,\` CROSS SECTION - ��,\l�1\%11�\1=1�� 1. ** DRAINAGE RECHARGE STRUCTURES TO BE PLACED IN CLEAN COARSE SAND. CONTRACTOR TO COOL GUIDE AND ��=��=��=11=11=11=11' PERFORM A SOIL TEST AND NOTIFY ENGINEER FOR ON SITE INSPECTION OF SOILS PRIOR TO \�11�11 SIEVE PERCENT INSULATION DETAIL O OPTIONAL PUMP INSTALLATION OF ANY DRAINAGE SYSTEM COMPONENTS. STRUCTURE MAY BE PLACED ABOVE SIZE PASSING c; �-�1�2 FLAT CAP ANCHOR BOLT 30' MAXIMUM DISTANCE COARSE SAND LAYER PROVIDED CONTRACTOR PERFORMS A 5' SOIL REMOVAL AROUND BASIN ° (NOT TO SCALE) DOWN TO THE COARSE SAND HORIZON. REMOVAL TO BE FILLED IN ACCORDANCE WITH NOTE #2 # 50 10/0 100/o THROUGH END #4 0 00/0 0 U C2o5o5 v CAP TO TOP OF STRUCTURE. (CONTRACTOR SHALL INCLUDE A UNIT COST FOR REMOVAL AND # 100 0%-20% 0n o REPLACEMENT IN THE BID PRICE). # 200 0%-5% CAPTAINS HOUSE 2. FILL MATERIAL FOR SYSTEMS CONSTRUCTED IN FILL SHALL BE CLEAN GRANULAR SAND, FREE OF r- ORGANIC MATTER AND OTHER DELETERIOUS MATERIALS. THE SAND SHALL BE GRADED SUCH DRAIN. & SDS DETAILS TYPICAL PUMP TANK & HYDRAULIC UNIT DETAIL THAT NOT MORE THAN 45% OF THE SAMPLE, BY WEIGHT, SHALL BE RETAINED ON THE #4 SIEVE. CIO (NOT TO SCALE) THE FILL SHALL NOT CONTAIN ANY MATERIAL LARGER THAN 2 INCHES. THE MATERIAL THAT RE-ISSUED FOR REGULATORY REVIEW 04-��-2D 1 V of SHEETS Q PASSES THE #4 SIEVE SHALL MEET THE FOLLOWING GRADATION REQUIREMENTS: PROJECT NO. w v C18614.00 JOB NAME SHAH RESIDENCE EAST BAY ROAD Osterville, Massaych/'u7sre�tts 161 A JOB NUMBER : I ' I i I � I I I I : I - ---- ---' .... I ._....... x: o .... _ ..awz1 .. ....,n .. . 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T WRITTIIV C AVTXORiZATTON pP SHOPB RRNO WNART ON AFSOCGTRS i —� �� —r----T � — I I I I I I I ISSUE DATES CAPTAIN'S HOUSE I --————————— ——————————————J Issued for Construction 2017.09.28 , Issued for Building Permit 2017.08.28 I , I Second Floor- Finish Plan A290 1l4"=1'-0' SHEET TITLE SECOND FLOOR-FINISH PLAN SHEET NUMBER