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HomeMy WebLinkAbout0108 EBENEZER ROAD - Health 108 Ebenezer Road Osterville - 123 055 No. 613 THE COMMONWEALTH OF MASSACHUSETTS FEE ✓�U`� _ BOARD OF HEALTH VVj — OF &9, Yba W4 APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct (L4 Repair ( ) Upgrade ( ) Abandon ( ) - ❑Com let S stem Pfndividual Components /off alv- Locat9a _ wner's Nam 123 O Map/Parcel# Address Lat# hone—# �6 Insme Designer's Name Address Address 16 �relephone# 111 Telephone# Type of Building: P�Ihzl( 1 Lot Size Sq.feet Dwelling—No.of Bedrooms arbage Grinder ( ) Other—Type of Building No.of pe��4, Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) gpd Calculated design flow gpd Design flow provided gpd Plan: Date Number of sheets Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DES RIPTION OF REPAIRS OR AL ERATIONS IdY_ 1JW"rf_ DId /� (�C�� 4V %e The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to pl ce the system' ration until a Certificate of Compliance has been issued by the Board of Health. Si ed Date Ingect ons — ! FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 �..�-...r'.�-. ii..�`�ro,t."�„r:'T.{sr"v...._+rn..-�R.,'•W.Y++.r�"`'ir-w+4.r. rtr��{si""�,'+'n^«`�7`('k.'ke.+.4Nlw�,,.-•a..'xpwl.-r•.^•-.e't,i^rytrre"•! -. r. .;... u _ No. THE COMMONWEALTH OF MASSACHUSETTS FEE , -- BOARD OF HEALTH ` 1UWA OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT w Application for a Permit to Construct (t�Repair ( ) Upgrade ( ) Abandon ( ) - ❑Compl ete System ndividual Components Local' wner's Name i I 12-3 &E-T /4 li��1P'" O y1 M p/Parcel# �� Address Lot# 'Telephone—# ly Insta4fers tyame Designer's Name Address Qa �<� Address yd Telephone# Telephone# Type of Building: �2`G/Cr %r/ /�( Lot Size Sq.feet Dwelling=No.of Bedrooms -3 B X- CC pp 41t Garbage GrinderOther—Type of Building No.of peons Showers ( ), Cafeteria ( ) f ! Other fixtures d Design Flow(min.required) gpd Calculated design flow gpd Design flow provided gpd Plan: Date Number of sheets Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTI N OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system' operation until a Certificate of Compliance has been issued by the Board of Health. Sig ed . Date / % 07G' Iris pectons aJ. / - / - .2 u FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 r No. I( 'G 3 THE� COMMONWEALTH OF MASSACHUSETTS FEE ! O!> 1Jr^��3TU11{ BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: J Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: C G-P at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design Mans/as-built plans relating to application No. l/ -0 17 dated Z d// Approved Design Flow VIA (gpd) Installer Designer: Inspector��� w Date f* / The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 No. 20 vl THE COMMONWEALTH OF MASSACHUSETTS FEE UU �6eroi G BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ) Repair( (. I./ pUl grade ( ) Abandon ( ) an individual sewage disposal system at I !1 16 o v r P rr r, d Y, s'n. as described I V - / in the application for Disposal System Construction Permit No. �t 1 1 - 01 3 dated 1/�I ci ./I s � ! r Provided: Construction shall be completed within three.years of the date of this permit.A. local conditions must be met. Date / Board of Health I I✓ 1u, 1 I r FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBSB WARREN TM PUBLISHERS- BOSTON 1 3 Commonwealth of Massachusetts Title 5 Official Inspection Form ,i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 108 Ebenezer Rd. Osterville, MA Property Address ' Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is required for 15 Cape Ln. Brewster, MA 02631 12-3-10 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. Imp°want:When filling out A. General Information forms on the ' computer, use 1. Inspector: only the tab key to move your Darrell Stone cursor-do not Name of Inspector use the return p key. • Cape Cod Septic Inspection Company Name t� PO Box 1466 Company Address ` Harwich MA [aim Harwich City/Town State Zip Code 508-240-2500 S14995 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 16340 of Title 5 (310 CMR 15.000). The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Ne Fu her Evaluation b ocal Approving Authority 12-4-10 LAJ 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. y ***"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. t t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewag isposal System P ge 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Y Voluntary Assessments 108 Ebenezer Rd. Osterville, MA Property Address- -Sovereign 44Y Soverei Bank C/O Pe Gabour Owner Owner's Name 9 information is required for 15 Cape Ln.,Brewster MA 02631 every page. City/Town 12-3-10 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. x Comments: B) System Conditionally Passes: ® One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determin determined," please explain. ed" (Y, N, ND) for the following statements. If"not The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. A metal septic tank will pass inspection if it is structurally sound,not leakingand if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ® ND (Explain below): The septic tank is leaking and needs to be repaired. The water level was found at the seam of the tank. No other problems were encountered. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 108 Ebenezer Rd. Osterville, MA Property Address — — Sovereign Bank C/O Peggy Gabour Owner Owners Name information is required for 15 Cape Ln' Brewster MA 02631 12-3-10 every page. City/Town State Zip Code Date of Inspection B. Certification.(cont.) B) System Conditionally Passes (cont.): ❑ 'Observation of sewage backtap or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. I. System will pass unless Board of Health'determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspect on Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °�.,. 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is required for 15 Cape Ln. Brewster, MA 02631 12-3-10 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 absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and.the SAS is within 50 feet of a private water supply well: -❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a,private water supply well*. Method used to determine distance: **This system passes if the'well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D System y tem Failure Criteria Applicable to All Systems. You must indicate"Yes" or"No"to each of the following for all inspections: Yes. No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded`or clogged SAS or cesspool ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is required for 15 Cape Ln. Brewster MA 02631 12-3-10 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 wel'I water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No El ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is required for 15 Cape Ln. Brewster, MA 02631 12-3-10 every page. CltylTown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided`by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ Was the facility or dwelling 'inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information._For example,a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 cpd x#of bedrooms): 330 t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °y 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Labour Owner Owner's Name information is 15 required for Cape Ln. Brewster MA 02631 12-3-10 every page. City/Town State Zip Code Date of Inspection D. System Information Description: 2 Bedroom residential dwelling Number of current residents: 0 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 Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): 183.56 gpd Detail 2009 -57,000 gallons 2008 -77,000 gallons Sump pump? ❑ Yes ® No Last date of occupancy: 10-2010 Date Commercial/Industrial Flow Conditions: Type of Establishment.- Design flow(based on 310 CMR 15.203): _ Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 - - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .� 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is 15 required for Cape Ln. Brewster, MA 02631 12-3-10 every page. City/Town 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: Unknown 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 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form -Not of for Voluntary Assessments 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O-Peggy Gabour Owner Owners Name information is required for 15 Cape Ln. Brewster MA 02531 -10 every page. Cityrrown State 12-3 of n in Zip Code Date ospection D. System Information (cont.) Approximate age of all components, date installed (if known) and'source of information: 2002 Per BoH Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on.site plan): Depth b 30 p below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Apparent good condition Septic Tank (locate on site plan): Depth below grade: 25" feet Material of construction.- concrete- ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: yea rs Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: ' 1000 gallon Sludge depth: . 10„ t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °.� 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is required for 15 Cape Ln. Brewster MA 02631 12-3-10 every page. City/Town State Zip Code Date of Inspection D. System Information (cost.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 22 Scum thickness 011 Distance from top of scum to top of outlet tee or baffle 30" Distance from bottom of scum to bottom;of outlet tee or baffle -8 How were dimensions determined? Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grade to inlet cover 5" Outlet 6" SCH 40 outlet tee The septic tank is leaking and needs to be resealed. Recommended maintenance pumping within 1 year Recommended maintenance pumping every 2-3 years Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ pol eth lene . Y Y ❑ other(explain).- Dimensions: Scum thickness Distance from top of scum'to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 i Commonwealth of Massachusetts N W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments I 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Pe qy Gaboiar . Owner Owner's Name information is 15 required for Cape Ln. Brewster, MA 02631 12-3-10 every page. CdylTown State Zip Code Date of Inspection D. System Information (Cbnt.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete' ❑ metal ❑ fiberglass 9 ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No„ Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts i W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is 15 required for Cape Ln. Brewster MA 02631 every page. City/Town 12-3-10 State Zip ,ode Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 11 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.): Grade to box 47" Cover 11" Good condition 2 Outlets with speed levelers Norma liquid level No sign of leakage No scum No sign of failure Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition 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 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is P requited for 15 Ca e Ln. Brewster MA 02631 12-3-10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ 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.): 2 (500 gallon) chambers with 4'stone Grade to chamber 55" Cover 11" Bottom 86' Dry No sign of hydraulic failure Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 • � . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Pe gy Gabour Owner Owner's Name information is p required for 15 Cape Ln. Brewster; MA 02631 12-3-10 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 ponding, condition of vegetation, etc.)., Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)-. t5ins•09/08 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner, Owner's Name information is 15 required for Cape Ln. Brewster MA 02531 every page. Cityfrown State Zip Code Date o 1 ate o Inspection nspection 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 ff i i I I �c' G3 P .d A B 2 _Q �3 3 %.._ 4 , (� 5 6 t5ins•09/08 • - - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owners Name information is required for 15 Cape Ln. Brewster MA 02631 12-3-10 every page. City/Town, State Zip Code Date ofJnspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ® Check cellar- ❑ Shallow wells Estimated depth to high ground water: '5 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: 2002 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: Plan on file ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Elevations from design plan 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 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposai System Form - Not for Voluntary Assessments I 108 Ebenezer Rd. Osterville, MA Property Address Sovereign Bank C/O Peggy Gabour Owner Owner's Name information is p required for 15 Cape Ln. Brewster, MA 02631 12-3-10 every page. Cityrrown 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 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 t No. �t�� Fee V ," THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: b/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0[ppIttation for Migpogal opgtem Congtrurtion Vertnit Application for a Permit to Construct( )Repair(✓ )Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. ` !3 e-tj e ZC p`_ Owner's Name,Address and Tel.No. L. C R Assessor's Ma p/Pazce1 dL 3. 24&C -1 G s 5-- v s�C rZ P A Installer's Name Address,and Tel.No. Designer's Name,Address and Tel.No. ce, �r 1E vv Iy,Ut7k t OA 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 3 d gallons per day. Calculated daily flow S gallons. Plan Date - L4 - Number of sheets Revision Date Title �. c.2►-t� �,� I e of S.A.S. v V) Size of Septic Tank C` s cow l Typ Description of Soil i ,0 Nature of Repairs or Alterations(Answer when applicable) Vey a L.l to SZ.-t- �a �3'tJ�L7 ���[ d►/ 4C ' S'Tcid i.� ,P1 Cl.��i1/ 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 and of H alth. Signed Date Application Approved by j -� G` Date l! l��- Application Disapproved for the following reasons I Permit No. 90 0-1 ���- Date Issued r ^ 4 No DdoZ _SS aZ - Fee 5CJ i\ THE C 'MMONWEALTH OF MASSACHUSETTS Entered in computer: Yes�%J PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS. 01pplicatiion for Bigpogal *p$tem Cokaruction Permit N m Application for a Permit to Construct( )Repair( /)UPgrade( )Abandon( ) ❑Com lete S stem El Individual Components nents Location Address or LotlNo. O L3 e 1J e Ze f( Q� Owner's Name,Address and Tel.No. % Le��3 L G/VAL�O C. 12 e (Z A Assessor's Map/Parcel � r' r�C�4 Cis Installer's Name Address,and Tel.No. Designer's Name,Address and Tel.No., r !+ f t/dR WtClf( �L DA' Type of Building: Dwelling No.of Bedrooms Lot Size �- sq.ft. Garbage Grinder(PO Other Type of Building No.of Persons / Showers( ) Cafeteria( ) Other Fixtures ' Deiign Flow 2 3 d gallons per day. Calculated daily flow 3 5. gallons. Plan Date 5 - &c! - 0 l_ Number of sheets Revision Date „r Title Size of Septic Tank 6' 3, s w b, / C-&G -7,a ( Type of S.A.S. S 00 6011 . C Ilk-1 1PA t fr Description of Soil �_71 V Nature of Repairs or Alterations(Answer when applicable) 721 t`T -� 10 r Date last inspected: t 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 Bard of Health. Signed �./tyl "^�:I .�---''�-�..�.,, Date Application Approved by DateUc�-- Application Disapproved for the following reasons Permit No. o200,2 ' S -- Date Issued ——————=————=---—————————— —————— —————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( "�Pgraded( ) Abandoned( )by at I V R 1;�. A a('I r— 9d, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.��'SS-Z dated �a— Installer Designer The issuance`of th-ss permit shall not be construed as a guarantee that the system w1 ill function as}�designed. Date 1 + I �� Inspector 1�1 �, V 41 /t No. c�UDc oZ Fee L50, o b THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migpogal *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair( ✓4pgrade( )Abandon( ) System located at /o? 1�04 0 1, 4 S 71-76�/G L E 11f4 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. w Provided:Construction must be completed within three years of the date of this`permit. Date: /�- Z Approved by TOWN OF BARNSTABLE LOCATION GiG,9/40Z2k SEWAGE #Ag" .�.�.2- VILLAGE dST�i-di ZIe ASSESSOR'S MAP& LOTAV10111d,01Y INSTALLER'S NAME&PHONE NO , Dyr Lam, .sic Sf��-dfj4 3� SEPTIC TANK CAPACITY IboO 11r��.i,•i LEACHING FACILITY: (type),&J"✓DD fA,% Ai lAr llf (size) I K1.f k., NO.OF BEDROOMS '� BUILDER OR OWNER ,0 � Oral;r,s /- PERMTTDATE: k i - 11-0�- COMPLIANCE DATE: I' 2 S S 0 2 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200%feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r l,- �v Aro �_ 33a - 3 ` � s � All VAS �.� jTOWN OF BARNSTABLE FL LOCATION ��lG�22Qf SEWAGE #AZT• VII LAGS ��T� y/ � ASSESSOR'S MAP & LOT pro i T3Z Jy INSTALLER'S NAME&PHONE NOS Dyr i SEPTIC ' ANK CAPACITYLEACHIN G FACILITY: (type) OD w (size) �� )C1.S• '1C�? NO.OF BEDROOMS- Q BUILDER OR OWNERD�lc�� I �ATE: I - I '0 COMPLIANCE DATE: ITD i PERM Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility. 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 Feet within 300 feet of leaching facility) Furnished by 00, S � orb No......................... Fps ..... fj� L�d J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE LTH wL /........ oF... i0 /©�-Ci............................................ Appliratiun for Dispuual Workii Tuntrurttun Vanfit Application is hereby made for a Permit to Construct or Repair ( } an Individual Sewage Disposal System at: oLm/aw / Location- dress ........ ... ....:............................ �� -. 1-- f� `f..a?d_. �/1...`� Owner Address W � . f' - ...I 1. ,fir► . Installer Address U Type of Building Size Lot. . &. .....Sq. feet Dwelling—No. of Bedrooms............................:..............Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building No. of persons......................... Showers f-4 YP g ---------------------------- P --- ( ) — Cafeteria ( ) P4 Other fixtures ------------------------•--------•1 - ----------------- W Design Flow............................................gallons per person per day. Total daily flow__-_- ..................gallons. WSeptic Tank—Liquid capacity/6 aA..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 ( ) ® / / ~' Percolation Test Res is Performed by._......... _t'f Q_-_4'-l"�°_____________________ Date__r/... A-------_-.. aTest Pit No. 1/1.. .......minutes er inch Depth of Test Pit._._.. /._____ Depth to ground water. �_ 44 Test Pit No. 2.7%���: 'minutes per inch Depth of Test Pit..��....._._.. Depth to ground water_-1401.1 l����1'!i' - --- Descnption of Soil ......_..d� ....�.�.......�dr-------------�.- ........ J�... _.. x 04 UI/.......----- 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 Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of h 7,4 /'///Zj.... Signed--- --- -- ...�e -------------•-----.--- _. ll Application Approved BY --- 4'...,�j��--- ................ ..... Date Application Disapproved for the following reasons----------------------------••----------•--------------------------------------------.....--••-•-----------•... -------------------------------------------------••----------...:............---------........-------------••-•-----••----------•--•---------•----------------------------------•----------------•...... Date PermitNo......................................................... Issued........................................................ Date No.. r f T Fxs: ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 t.. .................OF... ------------ 9 � Applirat#ion for Disposal Works Tontrurtion ramit Application is hereby made for a Permit to Construct , ) or Repair ( ) an Individual Sewage Disposal System at: Location- ddress ...................... ..?. ......---•...tr� -- � LN ........... Owner • Address Installer Address " Type of Building ..,x Size Lot .....�............Sq. feet U Dwelling—No. of Bedrooms.........:.................................Expansion Attic ( ) Garbage Grinder ( )'4 Other—T e of Building ....... No. of persons............................ Showers — Cafeteria 04 d Other fixtures ....................==---------•---•------------------••----------•-•--••-•••--••-----•--••-•------ W Design Flow............................................gallons per person per day. Total daily flow.....,......}......................._....gallons. WSeptic Tank—Liquid capacity/O QA..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 ( . ) Percolation Test RestIlts Performed by............ ', `' .. '..................... Date.. .................................. Test Pit No. 1 n-R.......minutes per inch Depth of Test Pit._... 1....._ Depth to ground water-./!..tzi..-C........ 40 Test Pit No. 2: ".-"minutes per inch Depth of Test Pit.-/ .......... Depth to ground water_ ...tT.k!f!r.T... el a' ..-----•-------------••- O :................. .......... Description of Soil ------- --------------• ...- '' i I✓ ,few° r `C{rlr 1t° 1F , .-•--•.......... V ------------•..................••--------- = ... =f ......_.. ----- -------- --................................................................................... U 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 L-LT .. p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health.. Sig ned•-- .....r ✓ -•• f ...............................................°..� ,. `..._ �� �- Date A lication Approved B - /�`� PP PP Y :. ::......... ...'-...............�..r....... ............•.......- ................... ..._.....•.... Date r Application Disapproved for the following reasons-----------------------------•--•--------------•--------•------•-----------------....-----................_-•--•- ..-------••---•-•--•------------------------•---------•--....-------------•--•-••-----------•••-•-•--------•-•--•••-•••••............................................................................. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTY ............OF. ..... .tr�.�,. �. ................................. (Irdifirtttr of TompliFaatrr THIS IS TO CERTIFY, That the IndividualSewage Disposal System constructed (, -) or Repaired ( )Instal er has been installed in accordance with the provisions of IT-1 LE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.�\J:.1_2-S............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................................... ..................... Inspector.......... rf .... .. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH / .. ................................. .......'. .. ®F. y...-:.,c r t: ..............................................- .... 7 i r/ FEE:--�-.................. Disposal Worho Tonstrudion Vamit Permission is hereby granted... " ! P: _..... -✓ .. _ r�t'.'�---•--------------- to Construct or Repair a�(µ1�y/�Ind>v�)l�dual evc>}age Disposal S tem,--/p--,r-�- atNo................... _ .}Street as shown on the application for Disposal Works Construction Permit No_____________________ Dated.......................................... e ` DATE-----�.:�_� . .........................•..... Bo d f Health FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS f i 3 3 V, .s',F. r � r ASM 5Fi �} Mi x }i'. 661 jp so Ot t4 to N OF Al, .41 IRA, 'P 40 .L..•-U / � .. AND. SUR�F�� �z �' LEGEND EXISTING SPOT ELEVATION OXO ''s �® CERTIFIED PLOT PLAN - EXISTING CONTOUR --- 0 --- i ALq�,ZT yc 07 ` 3 FINISHED SPOT ELEVATION �. FINISHED CONTOUR -�--- ® IN L-EA-/��iz v e-..t " APPROVED., BOARD OF HEALTH BONA%- 18A A S TA I; 9,o N A 5+ ;i DATE AGENT SCALE= I � =4D' DATES LOREDGE ENG/NEEIAIG CO INCCLIENT I CERTIFY THAT THE PROPOSED w EGISTE:RE REOISTER.ED JOB N0. �� 0 z3 BUILDING SHOWN ON THIS PLAN CIVIL . LAND CONFORMS TO THE ZONING LA1bS DR. Y� ,�.. OF ®ARNWSTALASS.ENGINEER URVEY � -712 MAIN ST. CH. BYjHYANNIS, MASS. SHEETOF ._.�, DATEND SURVEYOR Nfqjigr 7 41, 71, WIA OX-Eff ONCR-07W,COMCO' 7777 AsT%R ;boy A L "8E• 77Wr-'- -6 ACA Ywk, te -E -4 g ' tit 7Vff S", Z�y 41P Rk. P., CIL- S V V;04 Ott si It M .Q -;�r 10� 4'. AZ.�' W V MA 7APVLA7 n `�ro4JV4A C ZA kw 4 k"i 4 '1. IWAA.�/Af4,0r, ZAW6 V` -;g W ALA a M-M--- .M. 177 ,-�e — " , ewn g Tz.f 4 'Y. zoo-, t4W r A r." . .... ... 7-rVVW AAq CNAMO:P40 R P/r dOO A4 A�i4e`1'/IAW-- A47*A VA • &6 -ii-argt�l, m R nov -e AN 0" 'gxx- M�l 2 Ell ZJJVM�p -4j .fig y M-0 �7 Wram co MR!Wq* R•MR —Ml f4 N ki7 i OA R �OPG Desl � n Calculations C p-T Numb-er of Bedrooms: 3 �0 rZ Garbage Grinder: Not allored with this design. Ro Leaching Capacity Requirlid: 330 Gal,/Day Leaching Area Re uirec: 330 Gal./(�0.74 Ga . Sq Ft.)z--446 Sq.Ft. CC Proposed Leaching Structure: 1-25 L X 13 \iIV, X 2'D Leaching Trgrlch a' �- LeQChing Area Provided: 477 Sq,Ft. Proposed Leashing Caacit)/: 353 gpd > 330 gpd. req'd. 0 SZn F p L�' er 1Vlill ICI \ �0 4 5r 4 C 2" OF 1/8" TO 1/4" SITE ° � V � PEAS70NE (WASHED) ® C 3 C • Q rM C3 \ �� tiQ OZ 24" MIN. vo - ROUTE 28 2 H-10 500 gal. chambers � T,H, #1 3/4" TO 1 1/2" WASHED CROSHED STONE 103,59' N TRENCH CROSS-SECTION N `O NO SCALE LOCUS 0 0 T � 2 C GENERAL MOTES NO SCALE AR A = 34 808± S0. ET. 0> Q 1. ADDRESS: 108 EBENEZER ROAD 6 2. ASSESSORS NUMBER: MAP 123 PARCEL 055 1 - 25 1 X 1 3'yV ,-- 2 , 0 , D r O \ 3. DEVELOPER'S LOT: LOT 32 O 4. TOPOGRV IC INFORMATION WAS COMPLIED FORM AN lea a n(� r-e n c h using 0� 101,77' ON THE C, UND INSTRUMENT SURVEY. _ I� 5. TOWN WATER IS PROVIDED TO SITE AND I "�� S 0 0 g a l . chambers w i t h ` � SURROUNDING PROPERTfES. ' = stone on sides C.X, ends. (� 6. REFERENCE PLAN PLAN BOOK 2HI PAGE 28 99.4 dr���ew � ''�, � 7. NO WETLANDS ARE LOCATED WITHIN 100 FEET OF SAS. 0 Slab pC\,I o 8. NO POTABLE WELLS ARE LOCATED WITHIN 150 FEET OF SAS. 102,32' fl CONSTRUCTION NOTES o G � 1. Contractor is responsible for Digsafe notification J Shed of and protection of all underground utilities and pipes. S provide 4 dla. vent 101,91, `z ^Vv O 2. The septic tank and distribution box shall be set 0�0 r level on 6" of 3/4"-11/2" stone. with carbon filter o O 3. Backfill should be clean sand or gravel with no N 0C- Z stones Over 3" in size. N 0 N 0 0 4. This system is subject to inspectioA. during installation O N = co by Glen E. Harrington, R.S_ °91,01'C 5. The contractor shall install] this system in accordance \\ t�un with Title V of the Massachusetts Environmental Code \� and the Regulations of the Town of Barnstable. 0 Q � % 6. Provide an Acme Precast 5-Hole H-10 (Tl o `i d-box with 2 H-10 500 gal. chambers or equal. 7. No vehicle or heavy machinery shall drive over the 99.86, deck 97.64' septic system unless noted as H-20 septic components. 8. Install gas baffle or equal on septic tank outlet tee end. 100.23, 99 98.45' ��e/h 9. All existing inverts and site conditions shall be verified by contractor. Ilned �aQ '' -------------- 10. Existing LEACH PIT to be pumped and bockfilled, fish M ..........Clt /l 11, Provide 4" dia. SCH 40 PVC vent on SAS as shown on site plan. pond 12. Contractor is to notify Designer & Board of Health atleast 24 hours in advance p0 �S to witness five feet of pervious soil at time of installation. 9 9.0 7� existing leach pit t a b e 1-20"DIAM.ACCESS MANHOLE �` pumped & bockfilled 8.- .. 5 SOIL EVALUATION 101,46' o I Date of Soil Eval.. August 9, 2002 l' Test Performed By: GLEN HARRINGTON, R.S. j Excavator: Joe's Septic Service 34 Test Hole 2 -----.-----: -- _i. No. 1 J STEEL REINFORCED CONCRETE 2 1-j-1(� 50G gal. chambers DEPTH SOILS ELEV. PAN VIEW '. 0 103.59 O - END-SECTION aaOyIA H-10 500 GALLON CHAMBER 12" 1oYR3/z 02,59 \ NOT TO SCALE re r60 ErovRe ad 00.92 USE ACME PRECAST OR EQUAL 0 12 12 sand l' 10YR716 98.59' CD XTI'y G 2 v SITE PLAN INOFMA PROPOSED SEPTIC SYSTEM UPGRADE coarse 2.5Y754n SCALE: 1 =2O �� PREPARED FOR DONALD H. & JUDITH CURRIER 132" 92.59' BENCH MARKON CORNER OF GONG. LEGEND p NO GROUNDWATER ENCOUNTERED BULKHEAD ELEV.=100.00' (ASSUMED) Y TO AT -- o. 1070 j O EXISTING LEACH PIT TO BE 9 Q 108 EBENEZER ROAD PUMPED & BACKFILLED S F P�Gr *NOTE: A L PIPES ARE TO BE 4" 1 SCHEDULE 40 P.V.C. G/S-TE *NOTE: I STALL GAS BAFFLE OR EQUAL ON SEPTIC TANK OUTLET TEE. o O EXISTINGSEPTIC0AGvu / q YJ rAr%' BARNSTABLE (OSTERVILLE), MA 10 in. from q dla, vent house to septic tank provide Septic tank covers must be Finished grade over system=2% slope away with carbon filter Existing House within 6" of finished grade 5 HOLE X 104.46 D-Box cover must be DIST. BOX one chamber cover must be SPOTTDENOTGRADEES tSTING PREPARED B Y: First Floor Elev.=100.81' within 6' of finished grade within 6" of finished grade E '. EXlSTI ADE 9 sting Grade Elev=100'f GLEN E. {NGTON 95 -- EXISTING CONTOUR g LEDA ROSE LANE f I I I I Min. 2"-1/8"-1/2" 3" min U S G.OZ washed stone 36" max cellar 24' =3/4"-11/2" s=01 evel for 2' N � � S-.D, Too Elegy.=96.4 � DEEP TEST HOLE M A R S TO N S MILLS, MA 02648 0 K w 12' Invert Elev.=95.60' o ® ®®® APPROX. LOCATION BAFFLE rn rn N a m o�o a 2a' MIN. Bottom of Leach G - -G --- - G EXISTING GAS SERVICE TEL: 508-428-3862 �- DAL II n Trench Elev.= 93.60' w av 26 1.D't (5' min. required) *See Note #12 W ---- W-----------W APPROX. LOCATION FAX: 508-428-3862 STONE , rn LEACH TRENCH EXISTING WATER SERVICE > Bottom of T.H. #1 Elev.=Ss.aT SCALE: 1 "=20' DRAWN BY: GEH SEPT. 24, 2002 SYSTEM PROFILE 6" of 3/4"-11/2"STONE Not to Scale - - DATUM: ASSUMED FILE: CURRIER.DWG SHEET 1 OF 1