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HomeMy WebLinkAbout3040 FALMOUTH ROAD/RTE 28 - Health (3) 3040 Bldg A Falmouth Road (Rte Osterville P n J o a M a c i 4 v i \ eKe F i I F i i 4, Commonwealth of Massachusetts q / '030 ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name : information is required for every Osterville, MA 02656 08/28118 , page. Cityrrown 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:When A. Inspector Information 71 13a (o.:J- filling out forms on the computer, use only the tab Paul W. Davis key to move your Name of Inspector cursor-do not Rosario Davis Sanitary Pumping, Inc. use the return Company Name key. 9 Rocky Lane Company Address Cohasset MA 02025 Cityrrown State Zip Code 781-383-8888 SI 49 Telephone Number License Number B. Certification I.certify that:l aria a DEP approved system inspector in full compliance with Section 1.6.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 08/29/18 r Inspector's Si ature 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 z Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville, MA 02655 08/28/18 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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 determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. 'A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA , BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 08/28/18 required for every � page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): t ❑ 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): 3) 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. a. 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: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:'Subsurface Sewage Disposal System-Page 3 of 18 s Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments e Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 08/28118 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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 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 must be attached to this form. c. Other: 4) 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 ❑ Z Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page.4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 08/28/18 " page. CityrFown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 ❑ ® 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 water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Z 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.] ❑ U The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. Yes No ❑ z 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02665 08/28/18 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ Z Were any of the system components pumped out in the previous two weeks? Z ❑ 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? 0 ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) 0 ❑ Was the facility or dwelling inspected for signs of sewage back up? Z ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts 1= - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road,Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owners Name information is required for every Osterville, MA 02655 08/28/18 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 gpd Description: Number of current residents: Unknown Does residence have a.garbage grander? ❑ Yes ® .No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? Elo Yes ❑ No Seasonal use? ❑ Yes No Water meter readings,if available(last 2'years usage(gpd)): Detail: Water meter readings were not available at time of inspection. Sump pump? ❑ Yes ® No Last date of occupancy: Building occupied t5insp.doc.rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 08/28/18 required for every � page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No { Non-sanitary waste discharged to the Title 5 system? El Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Condominium Association on semi-annual pumping schedule. Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1,500 gallonsgallons How was quantity pumped determined? Sight glass on pump truck. Reason for pumping: To determine structural integrity and watertightness of septic tank. i t5insp.doc•rev.7r2612018 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville, MA 02655 08/28/18 page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) 4. 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 i ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: Previous inspections indicated compliant in 1995. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 28"feet Material of construction: ❑cast iron ®40 PVC ❑other(explain):: Schedule 40 PVC inlet pipe. Distance from private water supply well or suction line: No known wells in immediate are. feet Comments(on condition of joints, venting, evidence of leakage, etc.): Inlet pipe appeared to be clean and flowing freely. No evidence of leakage. t5insp.doc•rev.7262018 Title 5 Official Inspection Form:Subsurface Sewage,Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments c Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 08/28/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 24"w/inlet and outlet covers on risers to grade. Material of construction: Z concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) Precast concrete septic tank. If tank is metal, list age: years Is age confirmed by a.Certificate of Compliance?.(attach a.copy of certificate) ❑ Yes .❑ -No Dimensions: 5'wide x 5'deep x 10.5'long 5, Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 1,. Distance from top of scum to top of outlet tee or baffle 61. Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Measured with a tape. Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic tank was pumped at time of inspection.Tank was structurally sound and watertight and all effluent levels were at an appropriate height. Inlet tee and concrete baffle in place.There are no repairs recommended at this time. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts UTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 08/28/18 required for every � page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle . Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form k"��P"M"" Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville, MA 02655 08/28/18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" 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.): Box was structurally sound and watertight and providing even distribution of effluent into SAS.Carryover was moderate. There are no repairs recommended at this time. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts UTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 08/28/18 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): *If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ' ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Fond:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts UTitle 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville, MA 02655 08/28/18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System(SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): There was no surface wetness or breakout observed.There were no signs of hydraulic failure observed. Leaching pit had 32"of water in it.SAS appeared to be in proper working order. There are no repairs recommended at this time. 12. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doe•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING"A" 19.'. - Property Address Multiple Owners Owner Owner's Name information is required for every Osterville, MA 02665 08/28/18 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 .Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 08/28/18 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 14. 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: Z hand-sketch in the area below E] drawing attached separately i i rd! A ' Q 1 bear try' � y i I 6 o i 77 0-6,, I Ri O l' AI as 3 a 3� I 3 5i, ill ag' a aot . 3 33% t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02665 08/28/18 required for every �' page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: SEE BELOW feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Previous inspections. i ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: During previous inspections the high groundwater was indicated to be 22' below grade.This determination was by USGS groundwater maps. It was by this non-intrusive method that it was estimated that separation exists from the bottom of the SAS and the seasonally high groundwater elevation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.70612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines-3040 Falmouth Road,Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 08/28/18 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete.all applicable,sections of this form.inclusive of:. ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2; 3, or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated'depth to high groundwater included USGS groundwater maps i Yr�1.11 U�LnvvJ1) W A:S.is t5insp.doc•rev..7/26/2M— — — ._ Taie 5 Official Inspect m Forrn:40surfam Sewge Disposal Syst@pi•Page-Mof 18 Commonwealth of Massachusetts s W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name Ln ,' information is required for every IV l.Gl ah 03 MA 02655 09/18/14 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:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Paul W. Davis use the return Name of Inspector key. Rosano Davis Sanitary Pumping, Inc. Company Name 9 Rocky Lane Company Address Cohasset MA 02025 City/Town State Zip Code 781-383-8888 SI49 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 09/25/14 Inspector's SI nature 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. U I � t5ins•3/13 Title 5 Official Insp n onn:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 09/18/14 required for every � page. Citylrown 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: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM Osterville Pines-3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 09/18/14 page. City(rown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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 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. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection 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 M Osterville Pines-3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owners Name information is required for every Osterville MA 02655 09/18/14 page. Cityfrown 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 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 must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments ;M Osterville Pines -3040 Falmouth Road,Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02656 09118/14 required for 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" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,M Osterville Pines -3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02665 09/18/14 required for every � page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (if they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? Z ❑ 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): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 gpd t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 09/18/14 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: Unknown Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: Water meter readings were not available at time of inspection. Sump pump? ❑ Yes ® No Last date of occupancy: Buildingoccupied. 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 I Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M Osterville Pines -3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville, MA 02655 09/18/14 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: Condo Association on semi-annual pumping schedule. Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1,500 gallons gallons How was quantity pumped determined? Sight glass on pump truck. Reason for pumping: To determine structural integrity and watertightness of septic tank. 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-3/13 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 for Voluntary Assessments �M Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is Osterville, MA 02655 09/18/14 required for 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: Previous inspections indicated compliant in 1995. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 28"feet Material of construction: ❑ cast iron ®40 PVC ® other(explain): Schedule 40 PVC inlet pipe. Distance from private water supply well or suction line: No known wells in immediate area. Comments(on condition of joints, venting, evidence of leakage, etc.): Inlet pipe appeared to be clean and flowing freely. No evidence of leakage. Septic Tank(locate on site plan): Depth below grade: 24"w/covers to grade on inlet and outlet. Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Precast concrete septic tank. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 5'wide X 5'deep X 10.5' long. Sludge depth: 5" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 09/18/14 required for every � page. Cityrrown 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 25"to concrete baffle. Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Measured with a tape. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic tank was pumped at time of inspection.Tank was structurally sound and watertight and all effluent levels were at an appropriate height. Inlet tee and concrete baffle are in place. There are no other repairs recommended at this time. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G1M , Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 09118/14 required for every � page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 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.): I "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M , Osterville Pines -3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 09/18/14 page. Cityrrown State Zip Code 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" 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.): Box was structurally sound and watertight and providing even distribution of effluent. Carryover was moderate. There are no repairs recommended at this time. 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.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments wM Osterville Pines-3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owners Name information is Osterville MA 02655 09/18/14 required for every � page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ 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.): There was no surface wetness or breakout observed.There were no signs of hydraulic failure observed. Leaching pit had 36"of water in it. SAS appeared to be in proper working condition. Cover is at grade.There are no repairs recommended at this time. 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•3/13 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 °M Osterville Pines-3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owners Name information is required for every Osterville MA 02655 09/18/14 page. Cityrrown 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.): I t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 o. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owners Name information is required for every Osterville MA 02655 09/18/14 page. Cityfrown 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 13 LO F, "I 0_64 i ' Pf f'O 0 3 A 3 s a 900 3 -33% t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments GM , Osterville Pines-3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 09/18/14 required for every � page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high groundwater: SEE BELOW feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Previous inspections. ❑ Checked with local excavators installers- attach documentation ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: During previous inspections the high groundwater was indicated to be 22' below grade.This determination was by USGS groundwater maps. It was by this non-intrusive method that it was estimated that separation exists from the bottom of the SAS and the seasonally high groundwater elevation. Before filing this Inspection Report, please see Re port Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 •� Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M Osterville Pines -3040 Falmouth Road,Osterville, MA BUILDING "A" Property Address. Multiple Owners Owner Owner's Name information is Osterville MA 02655 09/18/14 required for every � page. City/Town 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 USGS groundwater maps ------------- �.1A,eL t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 p Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Volunt ry Assessments 4M , Osterville Pines -3040 Falmouth Road, , MA _ BUILD.ING—A . Property Address Multiple Owners Owner Owner's Name information is required for every 0steT®rlle I I S MA ' 02655 03/02/11 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:When filling out forms A. General Information ' I ' on the computer, f .� use only the tab 1. Inspector: key to move your cursor-do not Paul W. Davis use the return Name of Inspector key. Rosario Davis Sanitary Pumping, Inc. Company Name VILA 9 Rocky Lane Company Address Cohasset MA -02025 City/Town State Zip Code 781-383-8888 SI49 ' Telephone Number License Number B. Certification - l.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 Ev by the Local Approving Authority 03/15/11 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. L�A- • I t5ins•09/08 Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface age Disposal System•Page 1 of 17 r ' Commonwealth of Massachusetts' Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M Osterville Pines -3040 Falmouth Road, Osterville, MA a BUILDING"A" Property Address Multiple Owners ' Owner Owner's Name information is required for every Osterville . MA . .02655 03/02/11 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. t ` 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 determined" (Y, N, ND)for the following statements.,If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass, inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. b *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): , t5ins•09108 Rosano Davis Sanitary Pumping,Inc 781-383-8888 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 �M ,••''p Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners • - Owner Owner's Name information is required for every Osterville MA 02655 03/02/11. 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 due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipes) 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: i ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR- 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•ogio8 Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection 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 GM , Osterville Pines -3040 Falmouth Road, Osterville, MA I,. _ BUILDING"A" Property Address Multiple Owners Owner Owner's Name ` information is required for every Osterville MA , 02655 03/02/11 page. Cityrrown 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: r D1 stem S Failure Criteria Applicable All Systems: Y PP . 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 El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow t5ins-09/08 Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 03/02/11 required for every ' page. Cityrrown 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: ❑ Z, 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"or"no"to each of the following, in addition to the questions in Section-D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking,water supply , ❑ ❑ 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•ogios Rosario Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, ,M Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 03/02/11 required for every page. Cityrrown 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? El ® 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 El 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): 4- Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 gpd. . f t5ins•ogio6 Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 r Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA ' 02655 03/02/11 page. Cityrrown State Zip Code Date of Inspection D. System Information. Description: Y Number of current residents: Unknown. 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)): Detail: Water meter readings were not available at time of inspection. Sump pump? ❑ Yes M No •Last date of occupancy: 03/02/11 -Building occupied. 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•ogioa Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts - Ij Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments f Y Osterville Pines-3040 Falmouth Road, Osterville, MA : * BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA ' 02655 03/02/11 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: Condo Association on yearly`maintenance ° schedule. . Was system pumped as part of.the inspection? ® Yes ❑ No - If yes, volume pumped: 1,506 gallons gallons , How was quantity pumped determined? Sight glass on pump truck. Reason forpumping: Yearly maintenance&to determine structural . integrity &watertightness of septic tank. Type of System: ' ® Septic tank, distribution box, soil absorption system 6 ❑ ° 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 i inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•og/oe Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 it r . Commonwealth of Massachusetts ° Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address w Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 03/02/11 page. Cityrrown State Zip Code Date of,nspection- D. System.Information (cont.) Approximate age of all components, date installed (if known)and source of information:. Compliant in 1995 per previous inspection. . i Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): - 28" • Depth below grade: feet Material of construction: - ❑ cast iron ® 40 PVC ❑ other(explain): Schedule 40 PVC inlet pipe. , Distance from private water supply well or suction line: No known wells in area. feet Comments (on condition of joints, venting, evidence of leakage, etc.): All piping appeared to be clean and flowing freely. No evidence of leakage. Septic Tank(locate on site plan): Depth below grade: 24"w/covers to grade on inlet& outlet. . Material of construction: ® concrete ❑ metal' ❑ fiberglass ❑ polyethylene ❑ other(explain) Precast concrete septic tank. If tank is metal, list age: years, Is age confirmed by a Certificate of Compliance?.(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 5'wide X 5'deep X 10.5' long.' 6„ Sludge depth: t5ins-o9/o8 Rosano,Davis Sanitary Pumping,Inc 781-383-8888 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 Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name ' information is Osterville MA 02655 03/02/11. required for every page. CityrFown 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 24"to concrete baffle. 4" Scum thickness Distance from top of scum to top of outlet tee or baffle 7"to concrete baffle. Distance from bottom of scum to bottom of outlet tee or baffle 14"-to concrete baffle. _ How were dimensions determined? Measured with a tape. Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Septic tank was pumped at time of inspection.Tank was structurally sound and watertight and all effluent levels were at an appropriate height. Inlet tee and concrete baffle in place. Recommend recementing inlet cover for safety.-- Grease Trap(locate on site plan): _ Depth below grade: feet Material of construction: ❑ concrete '❑ metal ❑ fiberglass ❑ polyethylene"` ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle - Distance from bottom of scum to bottom of outlet tee or baffle Date of-last pumping:- Date t5ins•og/oa Rosario Davis Sanitary Pumping,Inc. 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 03/02/11 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of.leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day f 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.): r *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-og/oa Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M s Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 03/02111. page. CityrFown State Zip Code 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 0.1 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.): Box was structurally sound and watertight and providing even distribution of effluent. Carryover was moderate. There are no repairs recommended at this time . • F Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: 0 Yes ❑ No� Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): - a Soil Absorption System (SAS) (locate on site plan; excavation not required): 'If SAS not located, explain why: 6 t5ins-ogios Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA - BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 03/02/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 -leaching pit. ❑ 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.): There was no surface wetness, breakout or signs of hydraulic failure observed. Leaching pit had 40" of water in it.There was 26" of out capacity. Cover is at grade. Leaching appears to be in proper working condition.There are no repairs recommended at this time. 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 d Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•o6/m Rosario Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 official Inspection :Form Subsurface Sewage Disposal System Form -Not.for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is Osterville MA 02655 03/02/11 required for every " - page. Cityfrown 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: r Dimensions Depth of solids Comments(note condition of soil, signs'of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•ogioa Rosano Davis Sanitary,Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 4a-, Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines -3040 Falmouth Road, Osterville, MA, 'BUILDING "A" Property Address Multiple Owners Owner Owner's Name - information is required for every Osterville MA 02655 03/02/11 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 Pear W. I$idi A 13 602 Pif O E a Al a� 3 � 3 s%' 3 3 3; t5ins 109108 Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 f • r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M Osterville Pines -3040 Falmouth Road, Osterville, MA BUILDING "A" Property Address Multiple Owners Owner Owner's Name information is required for every Osterville MA 02655 03/02/11 - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) , Site Exam: ' ❑ Check Slope ❑ Surface water ❑ Check cellar ; ❑ Shallow wells Estimated round depth to high water: SEE BELOW p . g g feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed' Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Previous inspections. ❑ Checked with local excavators,-installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: During a previous inspection the high groundwater was indicated to be 22' below.grade.This determination was by USGS groundwater maps. It was by this non-intrusive method that it was estimated that separation exists from the bottom of the SAS and the high groundwater. Before filing this Inspection Report, please see Report Completeness Checklist on next page. tsins•osioe Rosano Davis Sanitary Pumping,Inc 781-383-8888 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts- ANS r Title 5 Official Inspection+ Form , Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Osterville Pines 3040 Falmouth Road, Osterville, MA BUILDING"A" Property Address Multiple Owners r Owner Owner's Name ' information is required for every Osterville MA . 02655 • 03/02/1,1 page. Cityrrown n 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 USGS groundwater maps k 'a \ l Y Wa:Lt7 , r , . t5ins•Qsioe Rosano Davis Sanitary Pumping,Inc 781-383-8888' Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of_17 . COMMONWEALTH OF MASSACHUSETTS ct- S EXECUTIVE OFFICE OF ENVIROI N�` TAW A --A It cI .E DEPARTMENT OF ENVIRONME p OTECTION PARCEL 5�0v TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION d MAP Property Address: 3040 Falmouth Road,Osterville Pines,Bldg AARC . < 3 Owner's Name: Osterville Pines Condo Trust,c/o Huntingest Management Owner's Address: 40 Industry Rd,Marstons Mills,MA 02648 Date of Inspection: 02/20/05 Name of Inspector: Brian T.Axon Company Name:A&K Septic Systems Plus Mailing Address:565 Carriage Shop Road,East Falmouth,MA 02536 Telephone Number: 508-540-6706 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 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 03/08/05 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. Notes and Comments: System functioning fine. There is no evidence of failure criteria. System consists of a 1500 gallon tank with d-box and 1000 gallon pit. ****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. y Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 3040 Falmouth Rd,Osterville Pines,Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/20/05 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 3040 Falmouth Rd,Osterville Pines,Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/20/05 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply- - The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 3040 Falmouth Rd,Osterville Pines,Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/20/05 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: ,. Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool x Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool x Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool x Liquid depth in cesspool is less than 6"below invert or available volume is less than'/z day flow x Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped x Any portion of the SAS,cesspool or privy is below high ground water elevation: x Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. x Any portion of a cesspool or privy is within a Zone 1 of a public well. x Any portion of a cesspool or privy is within 50 feet of a private water supply well. x 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.] no (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet 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. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:3040 Falmouth Road,Osterville Pines,Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/20/05 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No X Pumping information was provided by the owner,occupant,or Board of Health x Were any of the system components pumped out in the previous two weeks? x Has the system received normal flows in the previous two week period? x Have large volumes of water been introduced to the system recently or as part of this inspection? x Were As Built plans of the system obtained-and examined?(If they were not available note as N/A) x Was the facility or dwelling inspected for signs of sewage back up? x _ Was the site inspected for signs of break out? x Were all system components, excluding the SAS, located on site x _ 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? x — 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: Yes no x _ Existing information.For example, a plan at the Board of Health. x _ 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: 3040 Falmouth Road,Osterville Pines,Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/20/05 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):4 Number of bedrooms(actual) : 4(4-1 bedroom units) DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: 5 Does residence have a garbage grinder(yes or no): no Is laundry on a separate sewage system(yes or no):no[if yes separate inspection required] Laundry system inspected(yes or no): no Seasonal use: (yes or no):no ' Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no): no Last date of occupancy: current COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203):' apd Basis of design flow.(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: system on regular maintenance program Was system pumped as part of the inspection(yes or no): If yes,volume pumped:,How was quantity pumped determined? Reason for pumping: r TYPE OF SYSTEM X Septic tank, distribution box,soil absorption system _Single cesspool Overflow cesspool _Privy _Shared system(yes or no)(if yes, attach previous inspection records,if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: compliance in June 1995 Were sewage odors detected when arriving at the site(yes or no): no r Page 7 of 11 . i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3040 Falmouth Road,Osterville Pines,Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/20/05 BUILDING SEWER(locate on site plan) Depth below grade: 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 leakage,etc.): SEPTIC TANK x (locate on site plan) Depth below grade: covers to grade Material of construction: x 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: 10.5'x 6' x 5' Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: 26" Scum thickness: 3" Distance from top of scum to top of outlet tee or baffle: 7" Distance from bottom of scum to bottom of outlet tee or baffle:4" How were dimensions determined: field instruments Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage, etc.): Recommend pumping every two years. Structural integrity is fine. Liquid levels in relation to tees are fine. There is no evidence of leakage. GREASE TRAP: NA(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 outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage, etc.): Page 8 of 11 ' OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3040 Falmouth Road,Osterville Pines,Bldg A . Owner:Osterville Pines Condominium Trust Date of Inspection: 02/20/05 TIGHT or HOLDING TANK: NA (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal. fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no):' Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: X (if present must be opened)(locate on site plan). Depth of liquid level above outlet invert: working level 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.):No evidence of solids carryover or any evidence of leakage. PUMP CHAMBER: NA(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): L Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3040 Falmouth Road,Osterville Pines;Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/20/05 SOIL ABSORPTION SYSTEM(SAS): x (locate on site plan,excavation not required) If SAS not located explain why: Type X leaching pits,number: 1 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.): 1000 gallon leaching pit. Cover is to grade.No sign of hydraulic failure. CESSPOOLS: NA (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer.- Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation,etc.): PRIVY: NA (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.): Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3040 Falmouth Road,Osterville Pines,Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/23/05 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 o e l✓1 �-(�dt' Pit 0?0 r Page I 1 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3040 Falmouth Road,Osterville Pines,Bldg A Owner: Osterville Pines Condominium Trust Date of Inspection: 02/20/05 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 22 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) x Accessed USGS database-explain: You must describe how you established the high ground water elevation: USGS groundwater maps 10 I yasl �� N I y S a.69 COMMONWEALTH OF MASSACHUSETTS x EXECUTIVE OFFICE,.OF;ENVIRONMENTAL AFFAIRS . a DEPARTMENT OF ENVIRONMENTAL PROTECTION '1.y y,•e Pam..• � ° .. LOT TITLE 5.; . OFFICIAL INSPECTION FORM. NOT.FOR.VOLUNTARY'ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM . PART A CERTIFICATION Property Address:. Owner's Name: ..Zge�, Owner's Address: J RECEIVED Date of Inspection4!W tom_ Name of Inspector: please print) r •�1, y' FEB .�. `. -zooz' Company.Nam. -� '-C Mailing Address cjp S TOWN OF BARNSTABLE 0�Vol, HEALTH DEPT. Telephone Number: - 7`7/- 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 pursuantto Section 15.340 of Title 5(310 CMR 15.00.0). The system: F� Passes Conditionally'.Passes •. Need Further Evaluation by the Local Approving.Autbority.. 7 Fails Inspector's Signature: Dater The system inspector shall submit a copy of this inspection report to the.Approving Authority(Board of Milth-or DEP)within 30 days of completing this inspection.If the.system.is a shared system or has.a design flow of 10,000 ZIP 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 serit.to the buyer,if applicable;and the a-prtaving., authority. Notes and Comments., ****This report only describes conditions at the time of inspectiomand under the conditions of use at that time. This inspection,does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/20.00, page 1 Page 2 of I 1 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART-A CERT FTCX"-Tlb n nued). J Property Address' Owner: Date of Inspection; Inspection Summary: Check A,B,C,D or R/ALWAYS complete all of Section D y stemPasses:, 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 asAescribed in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,'as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N;ND)in the for.the following statements. If"notdete,rmined".please explain: The septic tank is metal and over 20 years old* or the septic tank(whether,metal,or not)is structurally unsound,exhibits substantial infiltration or exfiltrafion or tank failure is irnminen .,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.ifit is.structurally sound,not-leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND'explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a"broken,settled or uneven distribution box. System will;pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Boardof Health): broken pipe(s)are replaced obstruction is removed . ND explain: 2 Page 3 of 1'1 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM:INSPECTION,FORM PART A .. CE.RTIFICATI.ON.(continued) Property Address: Owner16 Date of Inspection: C. Further Evaluation is Required by the Board of Health: , Conditions exist which require further,evaluation by the Board of Health in order to determine if.the system is failing to protect public health, safety or the environment. 1. Systein-mill pass unless Board of'Heaith determines in.accordance with 310.CMR:15.303;(1)(b)that the system is not'funct oning'in a manner which.will protect public::heaI h;: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)defermines that the system is.functioning in,a manner that protects the public health;safety and environment: _ The system has a septic soil abso tion .. p rp system(SAS)and the SAS.is wrthin.: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, 'ithin'a.Zone I of a public water,suppI The system has.a septic tank and SAS'and the SAS is within.50.feet.of a private water supply.well: . — The system has a septic,tank.and SAS and the.SAS is less than 100,feet but.50 feet.'or.,more from a private water supply well"..Method"used to determine.distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform: bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the-presence of ammonia nitrogen and.nitrate nitrogen is equal io�or less than 5 ppm;provided that no other failure criteria are triggered.A,copy of the,analysis must be attached to this form: 1. 3. Other: 4 3 �. Page 4 of 11 OFFICIAL:INSPECTION;FORM-NOT FOR;VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFhCATION(continued) . .p Property Address:. N Owner: Date of Inspection: i or D. System Failure Criteria a.pplicableto all systems.: You must indicate"yes"or"no"to each of the following for all inspections: Yes N _ Backup of sewage into facility or system cornponentdue to overloaded.or clogged SAS or cesspool Discharge Ior.pon.ding 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 '/2 day flow _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number / of times pumped l� 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 •J water supply. v An onion of a cess oof or ri is within a Zone-1 of a. ublic well. Y P P P �'Y P _ 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 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.] 1 r (Yes/No)The system fails.I have determined that one or more of the above failure'criteria exist as described in 31 O CMR 45.303,therefore the system fails.The system owner should contactthe Board of. 'Healthto determine what will be necessary to correct the failure.. E. Large Systems: To be considered a large:systemthe system mustserve a facility with a-design'flow of 10,000.gpd tor15,000 gPd You mustindicate either"yes"or"no"to.each of-the following: (The following criteria apply to large-systems in addition to the criteria above) yes no the system-:is within 400 feet ofa surface drinking water supply the system-is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone Il.of a public water supply well If you have answered"yes"to any question in Section E the system is considered.a significant threat, or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the.system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. - ,4 Page 5 of 1.1 =� OFFICIAL.INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SE.WAGE`DIr. SPOSAL SYSTEM INSPECTION'FORM `PART B CHECKLIST Property Address: Owner: ✓C � L Date of Inspection: ® ' 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 _ZWere.any of the system.components pumped out in the previous two weeks?`~ Has the system received normal flows in the previous two week period? — _ZHave-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,ofsewage backup V _ Was the site inspected for signs of breakout? 6 t/ _ Were all system.components, excluding the SAS,located on site.? , V _ 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?` facility Was.the fac and ants if different from owner).provided with information on the proper. _ y owner( occu I? 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 15.3 02(3)(b)) , 5 . , Page 6 of 11 OFFICIALINSPECTIONFORNI—NOT-.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION:FORM PART C _ SYSTEM INI+'ORMATION Property Address 4. Date of Inspection: Oel RESIDENTIAL F OW CONDITIONS Number of bedrooms(.design).. Number of bedrooms(actual). DESIGN flow based on 310 CMR l 3.203 (for example: 110 gpd x#of bedrooms): ? t� Number of current residents: r�%a-� .Does`residence have:a garbage grind er-(yes;�or no Is laundry on a separate sewage system'(yes or Trot[if yes separate inspection required] Laundry system inspected,(yes or no): Seasonal use:(yes or no):J24..uAzzela Water meterreadings, if available(last 2 years usage(gpd)): Sump pump(yes or n . Last date of occupancy: /L L�z�7r (jam.. G'L� COMMERCIAL/INDUSTRIAL�iL�' Type of establishment: Design flow(based on 310 CMR.15.203): gpd Basis of design.flow'(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no):— Non-sanitary waste discharged to the Title 5 system(yes or no):- Water meter,readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records _ J Source of iriformation:: ,C�C Was system pumped as,parrof the inspection(yes or n4 _ If yes,volume.pumped:. gallons--How was quantity pumped determined? Reason'for pumping: TYPE OF SYSTEM L-Sre—Wic tank, distribution box,soil absorption system - Single,cessp961 _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 copyof the DEP.approval Other'(describe): '/)Al5proximate:age of all components,datef installed(if known)and source of information: Were sewage odors-detected when arriving at the site-(yes or no) ' 6 Page 7 of 1 I OFFICIAL INSPECTION FORM.—NOTFOR VOLUNTARY:ASSESSMENTS SUBSURFACE:SEWAGE (DISPOSAL SYSTEM,INSPECTION FORM -; PART C• • SYSTEM INFORMATION(continued) Property Address: � 7�,(/,C,: �• � Owner l � iKCYc�Pit Date of Inspection:� ,. C 5?..' BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:. cast.iron _40 PVC. other(explain)- -„ Distance from private water sbpply well or suction line. g ` Comments(on condition of joints,venting,evidence of leakage,etc.) •,t SEPTIC TANK: --"'(locate on site plan) Depth below grade:. ? , Material:of construction:_,concrete metal._fiberglass Polyethylene _other(explain) If tank is metal list an: •Is age confirmed by a Certificate of Compliance(yes or no).-(attach a.copy of certificate). Dimensions: /0 Sludge depth: ''-l0" Distance from top of sludge to bottom of outlet tee or baffle: - Scumthickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum.to.bottom of outlet tee.or baffle^�,� : y How were.dimensions determined: C� - Comments(on pumping recommen ations, inlet and outlet tee or baffle condition,structural integrity,liquid levels. related to outlet invert, evide ce of leakage, etc.): /aidAlies P 0 GREASE TRAP:j .-ate on:site plan). Depth below grade:. Material of construction:_concrete_metal fiberglass—..polyethylene other, (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from'bottom of scutn to bottom of outlet tee or baffle: Date of last pumping: Comments-(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,.liquid leve1. ls . as related to outlet invert,evidence of leakage,etc): d w - i Page 8 of 11 . OFFICIAL INSPECTION FORM=.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORAATION(continued) Property Address: t � b .Owner: Date of Inspection: .)(70 a TIGHT or HOLDING TANK�A�ank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete. metal fiberglass.. - .polyethylene other(explain): Dimensions: Capacity: gallons Design'Flow: p gallons/day Alarm present.(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping;' Comments(condition of alarm and float switches,etc.): DISTRIBUTION:BOX:—Z(ifpresent must be opened)(locate on site plan) 01 Depth of liquid level above outlet invert; )'J/ Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of 1 ka e into or ou of box, etc.): GlJag- PUMP CHAMB9 locate on site plan) Pumps in working order{yes or no):. Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances;etc:):. 8 Page 9'of 11 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE-SEWAGE SYSTEM INSPECTION.FORM PART G SYSTEM INFORMATION(continued) Property Address: Owner: .:�ic Date of Inspection: V v U SOIL ABSORPTION SYSTEM (SAS):. y" (locate on site plan,excavation not required) If SAS not.located,explain why- Type , Ieachin-.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 part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: } Indication of groundwater inflow(yes or no): Comments(note condition of soil,.signs of hydraulic failure,level of ponding,condition of vegetation;etc). ' PRI (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.): _ . 9 - Page 10 of 11 OFFICIAL JNSPECTION FORM—.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:. � 2 Owner 6u Date of Inspection: Z V)�CX� 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. kt� off. AV-41 . a� r 0. 33. . 10 Page 11 of I 1 _ OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C f SYSTEM INFORMATION(continued) ; Property Address: -Owner Date of Inspection: p�,ta SITE EXAM. Slope Surface water Check cellar. Shallow wells- Estimated depth to ground water Z2 feet Please indicate(check)all methods used to determine the high ground water*elevation: Obtained from system design plans on record-If checked,date of design plan reviewed:- Observed site(abutting property/observation hole within 150 feet of SAS) Checked.with local Board of Health-explain: -7/hecked with local excavators, installers-(attach documentation) Accessed USGS database:explain: You must describe how you established the high ground water elevation: �1 f kee 43.111AYPI Irk a PGr1 NumnFr: v. Da­ Comai.eted hv: rx'. GH GROUND tol-,A,I c , LEVEL COM?U l TAT!0'N. Site Location• �. ot No_ : >, r Owner: Address_ - Contractor' Address: MA, STEP .1 Measure death to water'-bi- tonearest r!TQ L ........._.__.............. ........ ..----....__..................... :._........ .Date month/day%year STEP 2 . Using.Water-Level.Ranae'Zone. L'd and Indez-W,: lI map tocate site and determine: •Appropriatw index w.elL_:. ........... ........ OA O;Water-level rang .zone'.._ _.. ^-!77 ............... -.. --_. ...I G STEP 3 Using mbn'thly report"Cur rent I' Water R-sources-Conditions" ) determine currant depth:to waterlevel'for. index,well ................... �1 Month/year.- STEP' n Using L.abie of Wo�r-levelAdji semen ! for-!Index:welt(STEP 2A),,cur.rent depth - !- toF water Ievel for-n- deh well. (STEP 3), and water-level zone.(S!EP23) determine wa er Level adjustment, ;...: _...,..:. _ .__.... _ S T_P :S Esirnate depth to'nigh wat=r by subtracting the.water- level adjust!ri-ent (STEP 4) rro!n measured depth Lc water level aL site.(STEP_L 1). Z 13 Recrco!.'cble col-110(J1211l7n ICI tl - -1. y y . . 3 1998 BORTOLOTTI CONSTRUCTION, INC. 765 WAKEBY ROAD,MARSTONS MILLS,MA 02648 6 - 508-771-9399 508428-8926 FAX: 508428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A 3 6 CERTIFICATION 0k . Property Address: Date of Inspection: '7 /5%iF Ins tor Name: er's Name d Address: I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true,accurate and complete as of the time of inspection.The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal stems. The System: V i Passes - Conditionally Pass *l Needs Further tion By Local Aproving Authority Fails Inspector's Signature: Date:_ The30 mp Inspector shall submit a copy of this inspection report to the Approving authority Within thir ty,( )da ys„of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd.or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to thg system owner and copies sent to the buyer, if applicable and the approving authority. i flVSPE .TION iMMARY• PASSES: ;I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system,upon comple- tion of the replacement or repair,passes inspection. Indicate yes,;noroor not determined(Y,N,OR ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal,cracked,structurally unsound,shows substantial infiltrmtion or ekfiltration,oritank failure is imminent. The system will pass inspection if the existin8W ti c tank is replaced ced with a p a conformlitig septic tank as approved by The Board of Health. Sewage backkup or breakout or high static water,level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. The ,system will pass inspection if(with approval of The Board of Health): - 1 _ ok SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four times a year due to broken or obstructed pipe(s). 'The system will pass inspection if(with approval of The Board of Health): Broken pipe(s)are replaced Obstruction is removed C)FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEAL H DETERMINESICH THAT PROTECT TH SYSTEM IS NOT FUNCTIONING IN A PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 Feet of a surface water Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh. y 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND:PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS.FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENTt The system has a septic tank and soil absorption system and is within 100 Feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zoge I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 Feet but Feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from i the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D)SYSTEM FAILS: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health.. should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent to the surface of the ground or surface waters due to an " overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above.outlet invert due to an overloaded or clog- ged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow: p . Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped -2- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. i Any portion of a cesspool or privy is within 100 Feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 Feet of a private water supply well. Any portion of a cesspool or privy is less than 100 Feet but greater than 50 Feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to.be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds;ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS; The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant threat to public healtb,and safety and the environment because one or more of the following conditions exist: The system is within 400 Feet of a surface drinking water supply The system is within 200 Feet of a tributary to a surface drinking water supply The system is located in a nitrogen sensitive area Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well. .The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B ,u, x CHECKLIST. . . . Chwk if the following have been done: jhimping information was requested of the owner,occupant,and Board of Health. . one of the system components have been pumped for atieast two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As-built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _ All system components,excluding the Soil Absorption System,have been located on site `'{'he septic tank manholes were uncovered,opened,and the interior of the septic tank was in-'" ..spocted for condition of baffles or tees,material of construction,dimensions,depth of liquid, i depth of sludge,depth of scum. The size and location of the Soil Absorption.System on the site has been determined based on existing information or approximated by non-intrusive methods. -3- V x: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) V different from owner provided with information on The facility owner(and occupants,d d )were the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM_ ' PART C SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL Design Flow; gallons Number of Bedrooms: Nwnber of Current Residents: Garbage Grinder: did Laundry Connected To System Seasonal Use: A)d Water Meter Readings,if available. Last Date of Occupancy: COMIVIFRGLAUMDUSTRIALi AID , Type of Establishment: s Design Flow: QalIonstday Grease Trap Present: (yes or no) Industrial;Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings,If Available: Last Date of Occupancy: OTHER:!, Describe) Last Date':of Occupancy: GENERAL INFORMATION #LIMPING RECORDS and source of inform t►on: . System Pumped as part of inspection: l) If yes,volume pumped: gallons Reason for pumping: TYPE OF SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,attach previous inspection records,if any) Other(explain): ARTROXIMATE AGE of all components,date installed(if known)and source of information: Sewage odors detected when arriving at the site: -4- i .:, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: v Depth below grade Material of Construction: k---"Concrete metal . FRP—Other (explain) Dimisionsa0,6- X�o A' 1 Sludge Deptlu- 2# Scum Thickn Distance from top of sludge to bottom of outlet tee or baffle: 3S' Distance from bottom of scum'to bottom of outlet tee`or baffle: 7 Comments:,(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid l in lion to det invert, structural integrity,evidence:of 1 age,etc. / iiea GREASE TRAP: Depth Below Grade: Material of Construction:_concrete metal FRP—Other (explain) — Dimensions: Scum Thickness: r Distance from top of scum to top of outlet tee or baffle: •tomments:1(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage, etc.) TIGHT 04 HOLDING TANK:/—. Depth Below Grade: Material of Construction:—concrete_metal_FRP_Other(explain) i 'Dimensions:: Capacity; gallons Design Flow: gallonstday Alarm Level: C61nments: (condition of inlet tee, condition of alann:and float swi(ches,etc.) DISTRIBUTION BOX: Depth of liquid level above outlet invert: Comments:;(note if el and cis ibu 'on�s u evide Me of solids carryover evidence o leakag into or ut of lax,etc. PUMP CHAMBER: Pump.is in working order: ' Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) 5' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) SOIL ABSORPTI&SYSTEM(SAS):_,/ (Locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) i If not determined to be present,explain: Type: Leaching pits,number:_ Leaching chambers,number: Leaching galleries,number: Leaching trenches,number,length: Leaching fields,number,dimensions: Overflow cesspool,number: Comm te:(note condition of soil signs of ydra is failur level of po ding,condition of on. etc.) iu it - .CESSPOOLS:- Number and configuration: Depth-top of liquid to'iniet invert: Depth of solids layer: Depth of scum layer: Dimensions of Cesspool: Materials of construction: Indication of groundwater: Inflow(cesspool must be pumped as part of inspection)N. ; Comments: (note condition of soilk,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) PRIMIL Materials of construction: Dimensions: Depth of Solids: Comments:(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.)` -6- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. � 16 DEPTH TO GROUNDWATER: Depth to groundwater. V Feet Meth oDel rmination or A pro 'oration: ✓lr�T. u37 -7 PROP SMH#3 O RIM=61.8 4"INV.(IN)=57.54 BLDG"A" LP CONC. APRON WITH FENCE BLDG.0 N 62 x 4M INV.(IN)=57.54 BLDG."B" EXISTING S TIC TANK (TYP.) 62 WOODS v ( c+ LP Cs INV. 6UT=57.34 LP X x x----- ci TF = 62.8 ( P 63 4 BDRMS. '� x ' 4- x BDR S ry LEGENDI'° Q .� -v-- SINGLE POST SIGN MATRH LINE s» ERRY ° c AREA DRAIN `° M/4 TC H LINE UTILITY POLE .� T E--- N ------ E--�,E . r -� CLEANOUT co N T E �"�- T�--�----7 / LIGHT POST 63 �- - - r - -_-- r �" --� -r E-- ,[-" i BLDG. A *So n� _ __ WATER SHUT OFF VALVE 0 PROP. 4" 40 PVC TYP. / F TF = 63.0 F �� { � BLDG. B FBP r r HYDRANT �� 6j • ? TF = 62.9 - _ + 1 4 BDRMS. FBP _-- 4 BDRMS. _ + f �1 CATCH BASIN BENCH MARK - TOP OF CONC. BLDG. G HED i r_ - 62 ------- BULKHEAD ELEVATION 63.6 TF = 64.3 1 I MAILBOXES , FBP cLEANour UMPSTER AREA I PROPOSED 4000 GAL 3 BDRMS. ---, 63 FBP FENCED BRICK PATIO EQUALIZER/DENITE WOODS T K� { c 6� � / f s FBP BLDG. H � 62 �' p TELEPHONE OR CAN PEDESTAL PROP SMH#5 i G TF = 64.1 PUMP BACK LINE RIM=64.0 r G S 4" INV(tN)=57 BLDG- 0 ---__i 2 BDRMS. O GAS SHUTOFF 2" AIR INTAKE LINE 6"NV.(IN .60 �► 6"INV. T)=57.50 c5� W- UNDER GROUND WATER LINE PROPOSED SEPnTE ro G F PAVED DRIVE PARKING PROCESSOR MOD 150ON -x rn PROP SMH#4 WOODS E- UNDER GROUND ELECTRIC LINE I PAVED DRIVE / PARKING 1 4"INV.(IN)=60.06 B 'G.;M" - GROUND GAS LINE _ " �---x ■ \ _ J G UNDER 2 2 FORCE MAINS DUMPSTER A EA `� pETEp SDR 35 VC PIPE rn'• 6"INV.(OUT) 53.� -� - UNDERGROUND CABLE TV OR CLEANOUT (TYP.) PB � �, PROP. 61 / TELEPHONE LINE F, � � p 6"X6"X4" WYE MP.) 00 h x x x STOCKADE FENCE 4 LP LP PAVED DRIVE / PARKING ❑ DISTRIBUTION BOX 13 tK EXISTING SEPTIC TANK (TYP.) F 6 • PU BACK LINE T T T O (O 1000 GAL. SEPTIC TANK _ -' .. `� so WATER METER PIT 3" W- T. PINE • ❑ ----- BLDG. MLA (SEE NOTE #1) o 0 1500 GAL. SEPTIC TANK TF = 63.9 / � TIP r � � 7» OAK 4 BDRMS. CNI LP LEACH PIT / 6 �`� / m EC-� S E o0 �, co CV c1q : s 10' - 16» OAK Q �. E (UNLESS OTHERWISE NOTED) / Qo ti 2 W l , / �•--- 16 36 WHITE PINE IEL 64. , 3 � � L (UNLESS OTHERWISE NOTED) �` TF = 64.5 �^ 64 ©) Q ` crn 0 CLEANOUT (TYP.) j ; , Sn-TEM PROPOSED 50'W X 541 ______ BLDG. J r LEACHING FIELD w TF = 64.6 WOODS PROPOSED ELECTRIC SERC VI 7 BDRMS. SEPTIC TANK TOP PAVED DRIVE / PARKING WOODED AREA OF STRUCTURE ELEV. FBP WOODS UNIT A 60.4 ' - UNIT B 59.9 ------ UNIT C 60.6 UNIT D 59.8 BUILDINGS J & L TOTAL UNIT E 61.9 LOT AREA OF 7 BEDROOMS. 0) UNIT F 62.3 UNIT G 61.7 249,962E S.F. c� UNIT H 62.6 5.74E Ac. sQ UNIT L & J 62.3 64 , UNIT M 62.9 T3 UNIT N 60.1 UNIT 0 62.3 ° WOOD GAZEBO ,X HE EROW OF ARBORVITAE WOODS 00 L=586:72' �R 040.00' / 61 `% f ca �c 63 LOCUS M *-X-X x X x ��XJ 6 f x x x X� s 3 6�� 62 SCALE 1"=20W:k EDGE OF PAVEMENT 0 6� BENCHMARK - RR SPIKE FND >r7EE T f OF 5 IN UTILTY POLE EL. 65.65 1. THE LOCATION OF EXISTING UNDERGROUND UTILITIES SHOWN ON THIS PLAN IS APPROXIMATE BY PRIVATE DIGSAFE. EXISTING CONDITIONS SITE PLAN a ROSANO ` DAVIS = SPA'TH ENGIRT ERING FLOOD ZONE k . fDISPOSAL � YSTEI� REI� A� � ZONING DISTRICT E AGE � w fj _I� i � ROCKY Z L ZONE C AREA DETERMINED TO BE OUTSIDE THE 500-YEAR FLOOD PLAIN, o. 304 p . C O HAS S ET, M.A. 02025 UK Pr1T/fICE + COMMUNITY PANEL 250001 0015C NMN. FRONT SE low AUGUST 19, 1985 3 ' Z ` a7 �. x��w Ex.+' 781- 383- 1234 BARNSTABLE ( OSTERVIL L E ) , MA UK SETBACK ,V DATE - PHILLIP H. SPATH P.E. MK R� SETBACK Iff SURVEY SERVICES & SOIL EVALUATION PROVIDED BY: *21E a LIQGi m vmm T ap INDU MAIS IMIMI OWNER off 508-362-4541 `` aWQi�.AY OISII�ICT• OSTERVILLE PINES CONDOMINIUM fax " OSTERVILLE PINES CONDO , TRUST C/o HUNTINGEST MGT. CO, a�� N fax 1 P.O. BOX 340 DANIEL down cape €,' �Il e�.t'111inc.,,-,,. MARSTONS MILLS, MA 02648 U oJALA y p g: DAM O M Igo No.floss CIVIL ENGINEERS s �= REFERENCE 1 N 3f zw-7 "osu u LAND SURVEYORS,:" y r.. OW SM 3W PMEM DATE DANIEL A. OJALA P.L.S. l�FT PLAN 800K 3Q3 PAGE 11, 13 I1IIS ![ st. �fumouthport, ma {�`2 5 _'. �� bVVV NOTES 1. PRIOR TO CONSTRUCTION WATER SERVICES TO BE LOCATED AND RELOCATED AS REQUIRED IN ORDER TO MAINTAIN TITLE V SETBACK DISTANCES FROM THE SEWAGE DISPOSAL SYSTEM. WHENEVER A SEWER LINE' MUST CROSS A WATER SUPPLY LINE. THE SEWER LINE SHALL BE CONSTRUCTED OF OR SLEEVED IN CLASS 150 PRESSURE PIPE OR ENCASED IN CONCRETE FOR A DISTANCE OF 10' FROM THE WATER SUPPLY LINE'. LEGEND 2. EXISTING LEACHING PITS TO BE PUMPED AND REMOVED OR BACKFILLED WITH CLEAN FILL. 3. MAGNETIC .TAPE TO BE INSTALLED OVER ALL BURIED COMPONENTS TO AREA DRAIN ALLOW FOR FUTURE LOCATIONS. 4. ALL TANKS, INCLUDING SEPTIC TANKS, DISTRIBUTION BOXES. PUMP �. 71) UTILITY POLE CHAMBERS, DOSING CHAMBERS AND GREASE TRAPS, SHALL BE EITHER: (A) LOCAL UPGRADE APPROVAL WATERTIGHT THROUGH MANUFACTURE'S SPECIFICATION AND WARRANTY, OR LIGHT POST (B) MADE WATERTIGHT BY THE MANUFACTURER, EQUIPMENT SUPPLIER OR 1. 310 CMR 15.405(l)(b) DEPTH OF COVER OVER INSTALLER USING ASPHALT OR SYNTHETIC POLYMER SEALER SPECIFIED BY 4Sp THE CONCRETE OR SYNTHETIC MATERIAL MANUFACTURE, AS SPECIED IN EQUALIZATION DENITE TANK AND PROCESSOR TANK WATER SHUT OFF VALVE 310 CMR 15.221(1). (SYSTEM"A") AND EQUALIZATION/�DENITE TANK (SYSTEM )"B" . Is �� INCREASE THE REQUIREMENT OF THIRTY SIX 36 INCHES OF xC- HYDRANT 5. EFFLUENT FROM THE SEPIITECH SYSTEM SHALL BE MONITORED ) t ,' QUARTERLY. AT A MINIMUM THE FOLLOWING PARAMETERS SHALL BE COVER TO SIXTY FOUR (64) INCHES OF COVER MONITORED: PH, 80%. TSS,. TKN, NITRATES, NITRITES AND ALKALINITY. EQUALIZATION/DENITE TANK AND THIRTY SIX (36) INCHES ��1 CATCH BASIN EVERY TIME YHE SYSTEM IS MONITORED, A WATER USE READING SHALL WOODS / ALSO BE DOWNLOADED. ALL MONITORING DATA SHALL BE SUBMITTED TO TO SIXTY EIGHT (68) INCHES PROCESSOR TANK r-------- THE DEPARTMENT BY JANUARY 31 OF EACH YEAR. AFTER TWO YEARS OF (SYSTEM A ) AND THIRTY SIX (36) INCHES OF COVER TO 1 1 zlolry MONITORING AND AT THE REQUEST OF THE OWNER/OPERATOR, THE LOCAL FOURTY FOUR (44) INCHES OF COVER I 63 APPROVING AUTHORITY AND DEPARTMENT MAY REDUCE OR ELIMINATE THE FBP FENCED BRICK PATIO MONITORING REQUIREMENTS. EQUALIZATION/DENITE TANK {SYSTEM�,B"). a � CS TELEPHONE OR CATV PEDESTAL 6. OUTLET TEES TO BE PLACED AT THE OUTLET OF ALL EXISTING SEPTIC TANKS I AND TO BE SCHEDULE 40 PVC. TEES TO BE CENTERED UNDER MANHOLE COVERS. gars-yc? _ _ V GAS SHUTOFF Aj�' W- UNDER GROUND WATER LINE N ram•,. - E- UNDER GROUND ELECTRIC LINE G - UNDER GROUND GAS LINElp T _ UNDERGROUND CABLE TV OR TELEPHONE LINE LOCUS M x x x STOCKADE FENCE WOODS 10= W ® DISTRIBUTION BOX WOODS 62 0 O 1000 GAL. SEPTIC TANK0-1 c°'s+ LP SHEET 0 01500 GAL. SEPTIC TANK WOODS 2 OF 5 PROPOSED ELECTRIC SERVICE LP LEACH PIT 63 ACTIV CARBON EXISTING CONDITIONS SITE� LPPROP sMH#1 FlLTER T PLAN 10.y - 16 OAK (UNLESS NOTED) p RIM=63.0 6- INV.(IN)-58.30 LP 6"INV.(OUT)=58 2O Q �° SEWAGE DISPOSAL YSr"" E P A I R 16" - 36" WHITE PINE (UNLESS NOTED) O CLEAT BLDG. 0 EXISTING ` TIC TANK (TYP.) Y' TF = 65.8 tp Nou (TYP.) 3____,,•-''� 8 BDRMS. 0 -62 �� BARNSTABLE , A p 4& 0 �' 2 64 RELOCATED ELECTRIC & TELEPHONE SERVICE 5-.021. 0 PROP. 6' EYED SDR 35 PVC PIPE PROP. �,� A� / ZI5 P . 6 'X6"X4" WYE ( ') O,o / 6e ,� 64 I ��G -_� ;__; �s OSTERVILLE PIN Cuow"AN009 TRUST ro 10 A IPA 19s 2008 SEP77G TANK TOP 1 BLDG. E �piy p R G ' FBP 8 BDRMS. BLDG. F FBP 1 TF = 63.8 OF STRUCTURE ELEV. 1 � F UNIT A 60.4 TF = 64.1 1 UNIT B 59.9 7 BDRMS. NIT C 60.6 U / UNIT D 59.8 UNITE 61.9 �o� PROP SMH#2 SYSTEM '� � ,p .o�� UNIT F 62.3 3 63 RIM=61.8 .iP� cry r PROP. LEACHING RELD °� '.° 6 4"INV.(IN) 57.56 •O" sEE SYSTEM LAYOUT 1-a -0 7 UNIT G 61,7 = G "` UNIT H 62.6 E` 6- INV.(IN)=57.36 ,, 01 4 F �9 DATE PHILLIP . ATH P.E. UNIT L & J 62.3 6"INv.(out)=57.26 , k; UNIT M 62.9 �a, all CLE UT (TYP.) WOODS UNIT N 60.1 % FBP `.°- �' UNIT 0 6 2.3 EL BE C & TELEPHO ERVICE AILU H or M • �t��-j ASSq BLDG. D o� NIEL cy� X x �"`^ E E E PUMP BACK LINE. � DA N A. a a TF = 62.8 0 ���/` a N a OJALA 4 BDRMS. 1 i---X c5� ; BENCH MARK - TOP OF CONC. DUMP 6.2 PAVED DRIVE / PARKING �, BULKHEAD ELEVATION = 63.0 ` 0� 9NOSURv�y°� STER REA DATE DANIEL A. ALA P.L.S. PROPOSED SEPIITECH PROCESSOR MODEL M300ON i 2- AIR INTAKE UN N X X X X X X-i FBP ; �' 01 BLDG. N ,/� x d��r-'" LP PUMP BACK LINE TF = 63.2 ROSANO # A WOODS x PROPOSED 8000 GAL ------__,. UAUZER/DENITE T " 0 8 BDRMS. ENGINEEIRUNG x PROP. 6 X6 X4 W ( ') '�O,ti G 9 ROOKY LANE 16" DECID. TREE IN GROUND Pool x �, --x FBP C O -IA E°Ta A 02025 l � -- ` �� � '� -- 333- 1234 G x �� �' , � PROP SMH#3 x �''�_ 0 RIM=61.8 LP CONC. APRON WITH FENCE ' BLDG.0 cV eINV.(IN)=57.54 BLDG"A- 0 LP c, 'INV.(OUT)=57.34 LP EXISTING C TANK. (TYP.) SURVEY SERVICES & SOIL EVALUATION PROVIDED BY: 62 x �, 4 INv.(9N)-57.54 BLDG. B 62 WOODS ix-x-x- 0 TF = 62.8 P� a Wlk off �-362-48+F1 63 x x 4 BDRMS. ®` ��, fax �1-362-I 61DG, 0 cl MAIM LINE 6" ERRY � c down cape t 2,gi eer•ang, M* c. _ l ,. MATCH LINE - - - CLEANouT - - - - r - - - - - - Tr E- - - - - N - _._ - - .� --E--��E -`- ; - _-�1 - - - CIVIL ENGINEERS LAND SURVEYORS r o 3 E--T- T } 1 ___"__, BLDG. A 939 main st. yaranoufihport, ma2675 1 _� 61 TF = 63.0 ���`"• PROP. 4- 40 PVC (TYP.) ,, �fTl �' BLDG. B FBP ; ---- 1 / 6 3 TF = 62.9 4 BDRMS, FBP 74 REVISIONS: No. DESCRIPTION DATE EXISTING SEPTIC TANK INVERT SCHEDULE OBSERVATION HOLE DATA OBSERVATION HOLE DATA . INVERT. OUT i q p GRND ELEV.= 63.5 TESTED BY: DANIEL OJALA P.E.,P.L.S. OBSERVATION GRND ELEV.= 62.0 TESTED BY: DAVID FLAHERTY R.S. BLDG. SEPTIC TANK SYSTEM "All SYSTEM �,B�, OBSERVATION DON DESMARAIS R.S. HOLE # 1 GW ELEV.= N/A WITNESSED BY: DON DESMARAIS R.S. HOLE # 3 GW ELEV.= N/A WITNESSED BY: A 59.0+/ DATE: 5-16-05 MOTTLING ELEV.= N/A CERTIFIED BY • DANIEL OJA P.E. P.L.S. DATE: 2-28-07 MOTTLING ELEV.= N/A CERTIFIED BY: DAVID FLAHERTY R.S. - . AL ELEV. SURFACE SOIL SOIL SOIL SOIL OTHER ELEV. SURFACE SOIL SOIL SOIL SOIL OTHER B 58.5+/- INVERT ELEVATIONS: INVERT ELEVATIONS: 63.5 DEPTH HORIZON TEXTURE COLOR MOTTLING 62.0 DEPTH HORIZON TEXTURE COLOR MOTTLING LOAMY 10YR4 2 N/A 61.4 LOAMY 10YR4/1 N/A 4" INVERT AT SEPTIC TANKS SEE INV. SCHEDULE 4" INVERT AT SEPTIC TANKS SEE INV. SCHEDULE 63.0 0"-6" A SAND / 0 -7 0/ACE SAND L 59.2+/- ►' » „ 7"-24" B LOAMY 10YR s s N/A D 58.4+/- 6 INVERT AT EQUALIZ. TANK (IN) 57.10 6 INVERT AT EQUALIZ. TANK (IN) 56.12 60.5 6 -36 B SAND 10YR 6/6 N/A 60.0 SAND / 6" INVERT AT EQUALIZ.TANK (OUT) 56.85 6" INVERT AT EQUALIZ.TANK (OUT) 55.87 MED TO COARSE 24"-34" Cl LOAMY 2.5Y6 3 N/A E 60.0+/- 56.5 36"-84" Cl SAND 2.5Y6/4 N/A 59•2 SAND / - 6" INVERT AT PROCESSOR (IN) 56.81 6" INVERT AT PROCESSOR (IN) 55.83 MED TO COARSE " „ C2 MED TO COARSE N A 5% GRAVEL F 64. 1 +/ 4 -132 2.5Y5/6 / 52.2 4"-135„ C2 SAND 2.5Y8/3 N/A 51.0 SAND G 60.3+/- 2" INVERT AT PROCESSOR (OUT) 56.56 2" INVERT AT PROCESSOR (OUT) 55.58 SOIL MOTTLES .OBSERVED 0 135" TOP OF PERC 60" PERC RATE SOIL MOTTLES OBSERVED 0 132" TOP OF PERC 62" PERC RATE (ELEV.=52.2) HOLE ® ELEV. 58.5 >2 MIN./INCH (ELEV.=51.0) HOLE 0 ELEV. 56.8 <2 MIN./INCH INVERTS AT LEACHING FACILITY: INVERTS AT .LEACHING FACILITY: H 61 .2+/- 11/4 " INVERT AT BEGINNING 11/4 " INVERT AT- BEGINNING J&K 60.9+/- OF LEACHING FIELD 61.00 OF LEACHING FIELD 58.50 OBSERVATION HOLE DATA OBSERVATION HOLE . DATA - I 11/4 " INVERT AT END 11/4 " INVERT AT END GRND ELEV.= 64.0 TESTED BY: DAVID FLAHERTY R.S. GRND ELEV.= 62.0 TESTED BY: DAVID FLAHERTY R.S. M 61 .5+� OF LEACHING FIELD 61.00 OF LEACHING FIELD 58.50 V OBSERVATION OBSERVATION HOLE # 2 GW ELEV.= N/A WITNESSED BY: HOLE # 4 DON DESMARAIS R.S. GW ELEV.= NZA WITNESSED BY: DON DESMARAIS R.S. ELEVATION AT BOTTOM ELEVATION AT BOTTOM DATE: 2-28-07 MOTTLING ELEV.= N/A CERTIFIED BY: DAVID FLAHERTY R.S. DATE: 2-28-07 MOTTLING ELEV.= N/A CERTIFIED BY: DAVID FLAHERTY R.S. N 58.7+/- OF FIELD 60.50 OF FIELD 58.00 ELEV. SURFACE SOIL SOIL SOIL SOIL OTHER ELEV. SURFACE SOIL SOIL SOIL SOIL OTHER 64.0 DEPTH HORIZON TEXTURE COLOR MOTTLING 62.0 DEPTH HORIZON TEXTURE COLOR MOTTLING O 60.9+/- NO GROUNDWATER ELEVATION 52.2 NO GROUNDWATER ELEVATION 51.0 LOAMY 10YR4/1 N/A 63.6 p"-5�� A 61.5 0"-6" /A E LOAMY 1OYR4/1 N/A TP#1 TP# #3 & #4 SAND SAND 5"-24" B LOAMY 10YR 6/8 N/A 6"-36" B LOAMY 10YR 6/8 N/A 62.0 SAND 59.0 SAND DESIGN CRITERIA: DESIGN CRITERIA: 24 -72 C1 MED 2.5Y6/4 N/A 59� GRAVEL COARSEOAMY VARIABLE DEPTH DESIGN FLOW: 58.0 „ 58.0 36"-48" ClC1 SAND 2.5Y6/3 N/A BETWEEN 36"-48" DESIGN FLOW: SAND _ BEDROOMS AT 110 G.P.B./D 1760G.P.D. _ BEDROOMS AT 110 G.P.B./D 5170G,P.D. MEDIUM MEDIUM 53.0 2"-132" C2 SAND 2.5Y7/3 N/A 51.0 8�-132" C2 SAND 2.5Y5/6 N/A SOIL MOTTLES OBSERVED 0 132" TOP OF PERC - PERC RATE SOIL MOTTLES OBSERVED 0 132" TOP OF PERC - PERC RATE (ELEV.=53.0) HOLE * ELEV. - - MIN./INCH (ELEV.=51.0) HOLE 0 ELEV. - MIN./INCH SEPTIC TANK PROVIDED: SEPTIC TANK PROVIDED: USE EXISTING .�.GAL. USE Ex�ISTING GAL. SIZE OF LEACHING FACILITY REQUIRED: SIZE OF LEACHING FACILITY REQUIRED: » » m m DESIGN PERC. RATE: >2 MIN./ INCH >2 z� CLASS I SOIL DESIGN PERC. RATE: MIN./ INCH r PHILLIP PROFILE SYSTEM B . NOT TO SCALE: M , . cLAss I solL rn- 9� CLASS i ELR = .74 G.P.D. S.F. CLASS I ELR = .74 G.P.D./S.F. f� 1*4 x n 1760 G.P.D. .74 GAL S.F. 2380 - S.F. ,._ _�o "�t` +�•+ - 5170 G.P.D. / .74 GAL/S.F. =6987 S.F. Tip`. REMOVE & REPLACE NOTES _ I " THIN THE AREA SHOWN. ALL UNSUITABLE MATERIAL (SOIL ABSORPTION SIZE OF LEACHING FACILITY PROVIDED: EXIST. cRouNo WI SIZE OF LEACHING FACILITY PROVIDED: SYSTEMS, BACKFILL IN TEST PITS, ETC. SEE PLAN) TO BE REMOVED 50' W X 491 LEACHING FIELD 80W X 901 LEACHING FIELD PHILLIP SPATH P.E. DATE AND REPLACED WITH SOIL CONSISTING OF CLEAN GRANULAR SAND, FREE BLDG. "A" 4" SCH. 40 PVC PIPE 6" SDR 35 GASKETED PVC PIPE FROM ORGANIC MATTER AND DELETERIOUS SUBSTANCES. MIXTURES AND SEPTIC TANK L1=64.1+ / MIN. LAYERS OF DIFFERENT CLASS SOILS SHALL NOT BE USED. THE FILL S=.02'/. MIN. SHALL NOT CONTAIN ANY MATERIAL LARGER THAN 2 INCHES. A SIEVE 50 X 49 = 2450 S.F. x .74 = 1813 G.P.D. 80'W X 90'L = 7200 S.F. X .74 = 5328 G.P.D. ANALYSIS, USING A #4 SIEVE, SHALL BE PERFORMED ON A REPRESENTATIVE SAMPLE OF THE FILL UP TO 45% BY WEIGHT OF THE FILL SAMPLE MAY BE RETAINED BY THE #4 SIEVE. SIEVE ANALYSIS ALSO SHALL BE PERFORMED ON THE FRACTION OF THE FILL SAMPLE PASSING THE #4 SIEVE, SUCH ANALYSES MUST DEMONSTRATE THAT THE -56.12• MATERIAL MEETS EACH OF THE FOLLOWING SPECIFICATIONS: EFFECTIVE x THAT MUST 8000 GALLON TOTAL LEACHING 2450 S.F. TOTAL LEACHING = 7200 S.F. TOTAL CAPACITY = 1813 GALLONS PER DAY SIEVE SIZE PARTICLE SIZE PASS SIEVE PRECAST CONCRETE TOTAL CAPACITY = 5328 GALLONS PER DAY # 4 4.75 MM 100% fQUILIZER/DENITE TANK # 50 0.30 MM 10%_10096 (TO BE SUPPLIED BY SEPTITECH) # 100 0.15 MM 0%-205t; # 200 0.075 MM 0%--576 PREPARED BY: ACTIVATED CARBON ROSANO DAVIS • SPATH FILTER VENT ENGINEERING " >> . NOT TO SCALE: 8 N o 0 9 ROCKY LANE PROFILE SYSTEM B ELEV. VARIES 4"�D4p E VC COHASSET, MA 02025 =a m MIN. EL- 60.0 31 _ z 1` 24" DIA. MANHOLE COVERS MAX. EL- 62.0 781-333-1234 SET TO FINISHED GRADE (TYP.) z .,> ALUMINUM HATCH COVERS 7 DIA n 'a g; �Z z n SET TO FINISH GRADE CONTRL BOX CONTRLABOX SURVEY SERVICES PROVIDED BY: EXIST. GROUND a� z io� a 11 4" LATERALSftix -a°ez-sea�'o' LEACHING FIELD 4 SCH 40 PVC PERFORATED VENT PIPE OCR- 6" SDR 35 GASKETED PVC PIPE down cape engineering, Inc. BLDG. "F" 6 SDR 35 GASKETED.PVC PIPE :•:.. . .. . SEPTIC TANK S=.02'/, MIN. A E D PVC PIPE 6"PVC PIPE ..... a I= p g g, S=.01 '/� MIN. S=.0169 /, MIN. L=OI.8'/. MIN. 1-58.50 OT =58. CIVIL ENGINEERS i=64.1+ - 3' SCH o LAND SURVEYORS (2) 2 PVC SCH 40 NO GROUNDWATER 1=55.58 FORCE MAIN MANIFOLD PIPE O ELEVATION = 51.0 939 main St. yarmouthport, ma 02675 1-55.83 TEST PIT # 3 do 4 1=56.12._ 8000 GALLON (2) 2" PVC SCH 40 PROJECT TITLE: » PRECAST CONCRETE FORCE MAIN PROFILE SYSTEM A NOT TO SCALE: EQUILIZER/DENITE TANK 8000 GALLON SEWAGE DISPOSAL (TO BE SUPPLIED BY SEPTITECH) PRECAST CONCRETE HW ALARM EL = 49.65 a? SEPTITECH PROCESSOR LW ALARM EL. = 48.65 /� MODEL M3000N BOTTOM OF TANK EL 45.83 SYSTEM TE M R E PD A I R ELEVATION VARIES TO BE SUPPLIED BY SEPTITECH AT ( ) MIN. EL=62.I 7 DIA o •" m MAX. EL.-64.0 CO7' DI BOX • 3040 RTE 28 Z z BARNSTABLE, MA 24 DIA. MANHOLE COVERS a a 04 z z SET TO FINISHED GRADE (TYP.) ��o ALUMINUM HATCH COVERS` LEACHING FIELD ASSESSORS' MAP 50, LOT 3 cr X ';9 z n z z > SET TO FINISH GRADE _ ; z w w w w w .► x .: ...,.: PREPARED FOR: XIST. GROUND � a ii: *� �`� \ 1-1/4"PVC SCH 4o LATERALS I=61.00 OSTERVILLE PINES 2" SCH 40 PVC MANIFOLD PIPE CONDOMINIUM BOT L=60.50 C/O HUNTINGEST MGT. CO. 6' SDR 35 GASKETED PVC PIPE 6"PVC PIPE ..•...:..... ,. ... S=.02 '/� MIN. LI-56.85 1=6100MIN. P.O. BOX 340 (2) 2" PVC SCH 40 NO GROUNDWATER 0 ELEVATION=52.2 (TP�1) MARSTON MILLS,MA. 02648 FORCE MAIN ,.... . ... 1=56.56 DATE: JANUARY 16, 2007 .• 1=56.81 COMP./DESIGN: P.H.SPATH 1=57.10 4000 GALLON (2) 2" PVC SCH 40 PRECAST CONCRETE FORCE MAIN CHECK: PHS EQUILIZER/DENITE TANK 4000 GALLON (TO BE SUPPLIED BY SEPTITECH) PRECAST CONCRETE HW ALARM EL. - 53.54 DRAWN:P.H.S. SEPTITECH PROCESSOR LW ALARM EL = 53.24 MODEL M150ON BOTTOM OF TANK EL 50.89 FIELD: 0 1lnESIPItfl1� (TO BE SUPPLIED BY SEPTITECH) RDS JOB # RDS 626 SHEET 3 OF 5 REVISIONS: No. DESCRIP,' ION DATE COPOLYMER POLYPROPYLENE 11"x 16" CONTROL VALVE BOX AS PLASTIC 1/2" GRADE 60 MANUFACTURED BY AMETEK PLYMOUTH 2-2" SCH 4O PVC FORCE MAINS STEEL REINFORCED PRODUCTS DIVISION. PAT. #3858765 3 1/8" FINISHED GRADE 2% MIN OR APPROVED EQUAL CLEAN.OUT (TYP.) TO BE BROUGHT TO WITHIN 6" OF LOAM AND SEED FINISHED GRADE 2-2" SCH 40 PVC MANIFOLDS T T " CONSTRUCTION NOTES: 8 1/4" 1 3/16 » PVC 1. ALL UNDERGROUND UTILITIES SHOWN WERE 2'-0 5-0 5-0 CAP NUT y 2" MIN. OF 1/8" TO 1/4` ALTERNATE PERFORATIONS CLEANouT PLANS AND COMPILED ACCORDING APPROXIMATE ONLY RECORD DOUBLE. WASHED STONE 4'-6" 5-0» 1 1/4" 45' BENDS ASSUME NO RESPONSIBILITY FOR DAMAGES AS A RESULT OF INACCURATELY SHOWN OR c �---- 14 ---� TOP STONE ELEV. 81.50 OMITTED UTILITIES. SEE CHAPTER 370, ACTS In OF 1963, MASSACHUSETTS GENERAL LAWS. THE ' �a , APPROPRIATE PUBLIC ENGINEERING DEPARTMENT o MANHOLE STEP EP DETAIL SHALL BE CONTACTED AS WELL AS DIG-SAFE n 1/8" PERF. 0 1al/4-PVC SCH 40 LATERALS oo » (PH. NUMBER 1-800-322-4844) PRIOR TO L NOT TO SCALE o00 (TYP) oo SET LEVEL AT ELEV. 61.00 0o VENT THE START OF CONSTRUCTION. (2) 2" PVC SCH 40 » 8" OF 3 4" TO 1 1/2" HOLE 2. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE 90' ELBOW 6 OF 3/4 TO 1 1/2 ORIFICE SHIELDS MODEL / GRINDER. (DEED RESTRICTION IS REQUIRED) ALUMINUM HATCH FORCE MAIN DOUBLE WASHED STONE COVER DOUBLE WASHED STONE STF-160 AS MANUFACTURED 3. THIS SYSTEM SHALL BE INSPECTED AS REQUIRED (SEE SYSTEM LAYOUT) TO BE PLACED ADJACENT " SCH 40 PVC MANIFOLD PIPE AS SIM/TECH FILTERS TO 1/8" VENT HOLE BY TITLE 5 AND BARNSTABLE BOARD OF HEALTH ORIFICE SHIELDS (TYP.) MODEL �8 OR APPROVED EQUAL REGULATIONS. ITCH 0.005 K BACK TO FORCE MAIN. AND BENEATH VALVE BOX STF-160 AS MANUFACTURED COPOLYMER POLYPROPYLENE (SEE SYSTEM LAYOUT) 1/8" PERFORATIONS ALTERNATED 4. AT ALL POINTS OF !NTERStCTION OF WATER AS SIM/TECH EQUAL FILTERS 041 APPROVED OR APPROVE PLASTIC 1/2" GRADE 60 ;:, EVERY 5-0" AT 6 O'CLOCK 1/8" PERFORATION TO BE PLACED LINES AND SEWER LINES, ,BOTH PIPES SHALL BE > SECTION A - A F STEEL REINFORCED STEP POSITIONS. (TYP) NEAR THE CROWN OF THE PIPE CONSTRUCTED OF CLASS 150 PRESSURE PIPE AND .. a© OR APPROVED EQUAL IN THE 45' BEND ARE TO BE PRESSURE TESTED TO ASSURE WATER- g:. �? o PRECAST REINFORCED NOT TO SCALE AT THE END OF EACH LATERAL TIGHTNESS. r; 5 5. PRECAST CONCRETE TANK, PUMP CHAMBER a i- CONCRETE TANK AND LEACHING FACILITY TO WITHSTAND H-10 d B B RISER I LOADING UNLESS UNDER PAVEMENT, DRIVES OR 1 11"x 16" CONTROL VALVE BOX AS TRAVELED WAYS WHEREIN H-20 LOADING SHALL 3 i MANUFACTURED BY AMETEK PLYMOUIN APPLY. L 11 PRODUCTS DIVISION. PAT. #3858765 6. SEPTIC TANK, PUMP CHAMBER, ETC. SHALL BE :! . OR APPROVED EQUAL TO BE BROUGHT TO WITHIN 6" OF MANUFACTURED BY PEMBROKE CONCRETE OR AN ►- '.° 12` MIN 0 PVC REMOVABLE CAP EQUIVALENT MANUFACTURER. TOP OF TANK �TYP•) 2-6 FINISHED GRADE 36" MAX 2" MIN. OF . TO 1/4" 7. ALL PIPES IN THE SYSTEM SHALL BE PVC, SDR35, COVER SCHEDULE 40 OR PVC SDR 21 PRESSURE PIPE, Lj DOUBLE WASHED STONE 4" SCH. 40 SOLID PIPE TOP STONE ELEV. 61.50 12" MIN SEE PLAN. 36' MAX 2" MIN. OF 1/8" TO 1/4" 8. GROUT TO BE USED AT ALL POINTS WHERE PIPES °* � COVER ENTER ER OR LEAVE PROVIDE CONCRETE WATERTIGHT STRUCTURES IN DOUBLE WASHED STONE 00 PVC SCH 40 0 oq 9. ALL SHIPLAP JOINTS IN THE SEPTIC TANK SHALL LATERALS. (TYP) % BE SEALED WITH NEOPRENE GASKETS OR ASPHALT b rrn STANDARD TANK RISER DETAIL CEMENT TO PROVIDE A WATERTIGHT. SEAL. 50' NOT TO SCALE 6" OF 3/4" TO 1 1/2" o0 0 00 10. WASHED CRUSHED STONE USED SHALL BE FREE OF ALL DIRT, DUST AND FINES. , (LEANOUT (TYP.) D DOUBLE WASHED STONE 40 00 0o 1/8" PERFORATIONS ALTERNATED 11. UNLESS OTHERWISE NOTED, ALL CONSTRUCTION METHODS AND MATERIALS SHALL CONFORM TO EVERY 5-0" AT 6 O'CLOCK 4" SCH. 40 PERF. PIPE TITLE 5 OF THE STATE ENVIRONMENTAL CODE CLEANOUT FRAME & COVER (SET IN CONCRETE) 6" OF 3/4" TO 1 1/2" POSITIONS. (TYP) ORIFICE SHIELDS MODEL PROPOSED 50 W X 541 MANUFACTURED BY GENERAL FOUNDRIES INC. DOUBLE WASHED STONE AND TOWN OF BARNSTABLE LEACHING FIELD 1I1 " » ITEM # 18111 OR APPROVED EQUAL. » STF-160 AS MANUFACTURED BOTTOM OF LEACHING FIELD RULES AND REGULATIONS. 6 6 4 SCH 40 PVC PERFORATED AS SIM/TECH FILTERS 1 1/4 PVC SCH 40 PVC CAP VENT PIPE (TYP.) OR APPROVED EQUAL LATERALS. (TYP) 12. EXCAVATE ALL UNSUITABLE MATERIAL IN THE FINISH GRADE LEACHING AREA AND BACKFILL WITH MATERIAL AS F A NS = 105 85 PERFORATIONS + 10 VENT HOLES) 13. HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO DESCRIBED ON PLAN. TOTAL PER OR TI0 ( 1/2» SECTION B - B I N S P E C TI 0 N PORT DETAIL SYSTEM " A" LAYOUT 1- OPERATE OVER THE LIMITS OF THE SEWAGE NOT TO SCALE NOT TO SCALE DISPOSAL SYSTEM DURING THE COURSE OF CON- NOT4PVC SCH. 40 PIPE � STRUCTION OF THE SYSTEM. - TO SCALE - 45' BEND 14. NO MODIFICATION TO THE SEWAGE DISPOSAL SYSTEM SHALL BE MADE WITHOUT PRIOR WRITTEN APPROVAL OF THE DESIGN ENGINEER AND THE 4"X4" SCH. 80 WYE LOCAL BOARD OF HEALTH. FLOW CAP END � - DENITE SEPTIC TANK DETAIL: 4000 GALLON PHilll � H2O DESIGN LOADING CLEAN - OUT DETAIL - �a NOTE: DENITE SEPTIC TANK AND TO BE SUPPLIED BY SEPTITECH. NOT TO SCALE \;5 NOT TO SCALE 5. INLET AND OUTLET TEES TO BE SCHEDULE 40 PVC TEES TO BE CENTERED UNDER MANHOLE COVERS. NOTES: 1. SEPTIC TANK SHALL BE STEEL REINFORCED CONCRETE, WITH PHILLIP SPATH P.E. DATE TWO (2) 24" MANHOLES(1) HATCH COVER. ' » » 2. SEPTIC TANK TO WITHSTAND H-10 LOADING PUMP DOSING CALCULATIONS SYSTEM A UNLESS UNDER PAVEMENT, DRIVES, OR TRAVELED WAYS WHERE BY H-20 LOADING B SHALL APPLY. ALUMINUM HATCH 1. DETERMINE VOLUME OF EFFLUENT TO BE PUMPED TO 3. ALL PIPE CONNECTIONS AND CONCRETE LEACHING FIELD: CONSTRUCTION SHALL BE WATERTIGHT. 12' MIN.-3' MAX. OUTLET TEE SELECTED DAILY FLOW = 1760 GALLONS 4. MANHOLE COVERS & ALUMINIUM HATCH COVER COVER " - A I A MATERIAL NUMBER OF DOSES PER DAY = 24 TO BE BROUGHT TO FINISHED_GRADE. � , v 6„ B j THOROUGHLY NUMBER OF GALLONS = 1760/24 = 74 GALLONS 12'-10" 30' BEND .�J COMPACTED DRAIN BACK VOLUME - 1212',-0- NORMAL ATE 2 F:�M ,Ne . (ROTATE AS REQUIRED) • 2" FORCE MAIN & 2" MANIFOLD = 9 GALLONS _ 13 3" LE J_ AN H :N 11 � s WYE-BR C COMPACTED PUMPING VOLUME DOSING VOLUME + DRAIN BACK VOLUME PRECAST s nc AN - z e INLET TEE PREPARED BY: SCREENED 83 GALLONS 74 GALLONS + 9 GALLONS GRAVEL I o o _ e T-5" MIN. 2. DISCHARGE RATE: LIQUID DEPTH ROSANO 9 DAVIS • SPATH . r - M BAFFLES : ENGINEERING 53 PERFORATIONS x .29 GPM/PERF. ® 2.5 HEAD 16 GPM �4 �. T YP s p, FILLED W/ MEDIA �- UNDISTURBED » ( ) 9 ROCKY LAME ���\ �4 MIN. ., o: . :.•,: MATERIAL 3. TOTAL ON/OFF TIME BETWEEN DOSES 60 MINUTES a� » o r COHASSET, MA 02025 6 CRUSHED STONE BASE��a 6 SECTION B - B 4. DOSAGE TIME: PLAN vlEw 781-383-1234 183 GALLONS/16 GPM = 5 MINUTES 11 SECONDS CROSS-SECTION VIEW SURVEY SERVICES PROVIDED BY GROUND SURFACE 5, TIMER SETTINGS: un SW 362-4UI fox soe-362-9eeo ON: 5 MINUTES 11 SECONDS OFF: 54 MINUTES 49 SECONDS down cape engineering, inc. NOTE: ACTUAL DOSING TIME TO BE DETERMINED FROM ACTUAL BUILDING CONNECTION TIME PUMP TAKES TO FILL LATERALS. CIVIL ENGINEERS 4" P 24"CAST IRON FRAMES & COVERS 7ALUMINUM WATCH LAND SURVEYORS MIN. SLOPE 1/ PER FOOT UNLESS NOTE: 939 main st. garmouthport, ma 02675 OTHERWISE DIRECTED DEPTH AS REQUIRED 1. SEPTITECH CONTROL PANEL TO BE PLACED WITHIN PROJECT TITLE: HEATED AREA OF .DWELLING 8,. NOTE ALL PIPE coNrlEcnaNs AND SEWER 2. INSULATE THE SEPTITECH INLET M BE MADE WATERTIGHT DETAIL SHEET COLLECTOR ; PROCESSOR WITH 2 INCH ooNatETE oollsTR11GT10N 2'-10" RIGID FOAM INSULATION ON �' ` 12'-0" ALL SIDES AND AROUND TOP TO MEDIA • • °oo-°o°o°°"°e a°o°e°o°°°"e°e a°e°°a°o°o a°e°e°o`0s°e°e°eaS o$oveooaeae$"°vee°$e••p°ove$ep ; 40M GAL. PRECAST AT FORM AN INSULATED CAP op000popepepepepepopaeopopopo•epe�epea°o°e °e°e°e°s°• o e e e e e e e o e e e e o CONCRETE TANK e'•e• o e°o 0 0 o e°e e$$°e°°.o°°e$aeae a>e e o:o�eeo ova:moo:eye°e.�e�o�.a:e e� • - oe°000 oee eosoo o � COVERING THE TOP HALF OF TANK. e e epepe e e. e epee.e e e e e epe.pep.epeeepe .pop.ope lb oos000eaaaoaea, ozee a4ee:;e e000°esesoeeevaavaaosooe.eses 3040 R T E 28 2:' '-6"_.► o °°uo°o°°oo°oo°oo°oo°eo°eo°eeoe°oeo°eo°o°o°e°°°e°jpgs°C°Y°p°Y°C°Y°G°0°C°COC°YC�°�°�O°O°O°O°O°O O°p°O°O$p°O°e�, I °OOpO•pOppOppOppOppeppe•p0•pepOpQpOpOpepepajQpOpopOpppOpOpOpOpOpOpepppOpdp°p°p°Opepep0°O°pp0°O°p° °e °e°a•:•o•o•o•e°o °'a°o °a°o°°°o°a°o°o°eo°o°o°e°a °ea°.oe a°ee°o / " ' " BARNSTABLE, MA 24"DIA. 8-0 6'-5" fl 7'-0" HIGH WATER ALARM ASSESSORS' MAP 50, LOT 3 SCREENED GRAVEL CRADLE I 6'-0" 6'-10" .r - PREPARED FOR: 3 UNDISTURBED -0 LOW WATER ALARM MATERIAL RECIRPCU PTION OSTERVILLE PINES ,. SECTION A - A im DISCHARGE PUMP CONDOMINIUM F I i PUMP SPEC. C/O HUNTINGEST MGT. CO. PUMP BACK PUMP 1 DUAL ALT. PUMPS PUMP BACK PUMP P.O. BOX 340 16 GPM 0 17' TDH BUILDING SEWER CONNECTION J TODEL5 PUMPS MARSTON MILLs,MA. 02648 L - MODEL 50PN2.4S ,• 6, NOT TO SCALE 4 DATE: JANUARY 1 2007 5 COMP./DESIGN: P.H.SPATH 5" 12'-10" CHECK: PHS PLAN VIEW H2O DESIGN LOADING SIDE VIEW DRAWN: P.H.S. SEPTITECH PROCESSOR FIELD: osTERVILLE PINES RDS JOB # RDS 626 SHEET MODEL M1500N 4 OF 5 I REVISIONS: No. DESCRIPTION DATE CLEANOUT (TYP.) DENITE SEPTIC TANK DETAIL: 8000 GALLON a 4" SCH. 40 SOLID VENT PIPE (TYP.) 80 I D NOTE: DENITE SEPTIC TANK AND TO BE SUPPLIED BY SEPTITECH. NOT TO SCALE 5. INLET AND OUTLET TEES TO BE SCHEDULE 40 PVC fV C cV O I ( NOTES: 1. SEPTIC TANK SHALL BE STEEL TEES TO BE CENTERED UNDER MANHOLE COVERS. REINFORCED CONCRETE, WITH ' TWO (2) 24" MANHOLES(1) HATCH COVER. I I 2. SEPTIC TANK TO WITHSTAND H-10 LOADING ' UNLESS UNDER PAVEMENT, DRIVES, OR ORIFICE SHIELDS (TYP.) MODEL ( I TRAVELED WAYS WHERE BY H-20 LOADING tt STF-160 AS MANUFACTURED SHALL APPLY. ALUMINUM HATCH COVER 1 AS siM/TECH FILTERS 3. All PIPE CONNECTIONS AND CONCRETE 1 OR APPROVED EQUAL CONSTRUCTION SHALL BE WATERTIGHT. 12" MIN.-3' MAX 90' X 80' = 7200 S.F. COVER OUTLET TEE 4. MANHOLE COVERS do ALUMINIUM HATCH COVER I PROP. LEACHING FIELD TO BE BROUGHT TO FlNISHED GRADE. „ °f 6*0 17>—0" a "NORMAL ATE 1 2 I t= I T 13 � LE ^ a PRECAST PTIC ANC _T 3 M z _ e a ' J B B a e INLET TEE G cV ( O 7'-5" MIN. 1 O oI0 LIQUID DEPTH i ZJ �� � � I `• BAFFLES FILLED W/ MEDIA ..� .-��`':-.•-D_�_-..�d.:;;:a• a :.�:e..i�e:.•r::p _I 6" CRUSHED STONE BASE Q 6„ s0' PLAN VIEW ac� �d�r CROSS—SECTION VIEW Tw` ,� CLEANOUT (TYP.) PUMP DOSING CALCULATIONS SYSTEM „B» on � r. I 80' l o 1. DETERMINE VOLUME OF EFFLUENT TO BE PUMPED TO LEACHING FIELD: a 1 112 11a I , DAILY FLOW = 5170 GALLONS O "' t z o I b -,n zn 0 ,n zo in Z, -0 00 -n NUMBER OF DOSES PER DAY = 24 I -� �* -� -� �* NUMBER OF GALLONS = 5170/24 = 215 GALLONS 4 a W I z 2 i L "' I DRAIN BACK VOLUME uQj I I ' d 2" FORCE MAIN & 3" MANIFOLD = 25 GALLONS PUMPING VOLUME = DOSING VOLUME + DRAIN BACK VOLUME ctiN I � I 240 GALLONS = 215 GALLONS + 25 GALLONS OIo 3f M IFo 0 2. DISCHARGE RATE: 152 PERFORATIONS x,.29 GPM/PERF. @ 2.5' HEAD = 44 GPM I ( � I a ( 3. TOTAL ON/OFF TIME BETWEEN DOSES = 60 MINUTES a J _ 4. DOSAGE TIME: 240 GALLONS/44 GPM = 5 MINUTES 27 SECONDS `� .r .r a a .r a .r .r .+ .r . TIMER SETTINGS: NOTE. A t T - 5 ER SE GS. i 4 N OF ON. 5 MINUTES 27 SECONDS 1. SEPTITECH CONTROL �- N N 1 PANEL TO BE PLACED WITHIN ya�P OFF. 54 MINUTES 23 SECONDS HEATED AREA OF DWELLING .' HI IP } a NOTE. ACTUALDOSING 11M T MIN 2. INSULATE THE SEPTITECH D E TO DETERMINED FROM ACTUAL U IU D � TIME PUMP TAKES TO FILL. LATERALS. PROCESSOR WITH 2 .INCH soa J 4 ! RIGID FOAM INSULATION ON 80' ALL ALL SIDES AND AROUND TOP TO .:, ONAL EN. TOTAL PERFORATIONS = 304 272 PERFORATIONS + 32 VENT HOLES FORM AN INSULATED CAP — ALUMINUM HATCH (TYP.) COVERING THE TOP HALF OF TANK. SYSTEM "B 1) LAYOUT PHILLIP sPATH P.E. DATE NOT TO - NOTE SCALE ALL PIPE CONNECTIONS AND "• CONCRETE CONSRtUCTiON TO BE MADE WATERTIGHT 8 17'-0' INLET AjMANHOLE FRAME t s 0 AND COVER - `. � ' ;, •MRRSFnd aAa ata C1\t JAY es \ ',. :. is r- 8000 GAL. PRECAST o " Q • ' NEOPRENE K —N— A T I 2-1 -1 -1 w - CONCRETE TANK INSIDE FACE E E OR SE L B00 ° -"t o —"t o --I � k •� 1 P '1# 3SA a R zV A OF MANHOLE--- { J6tat< S\At AA J ie,asrs �t < r •a. STAINLESS STEEL CLAMP I MORTAR $-7" 12'-2" FORMED OPENING--- ADJUST TO REQUIRED GRADE a`-to " 4'-rod" 1 " 7'_0" $'-o" 24" .; HIGH WATER ALARM WITH A MIN. OF TWO COURSES ( I I I - '" 8" - N OF BRICK MASONRY OR LOW WATER ALARM PREPARED BY: PRECAST REI FORCED !� : DIA: ` REINFORCED CONCRETE I.I � I MEDIA PIPE MEDIA CONCRETE MANHOLE CONE : GRADING RINGS I I I ( `. � � o • ROSANO DAVIS SPATH -I ANODIZED ALUMINUM I I i 2'-1 1" RECIRCULATION RECIRCULATION �� DISCHARGE PUMP PUMP PUMP I o PUMP SPEC. ENGINEERING O—RINGS RUBBER OR STEEL KORBAND • - � � DUAL ALT. PUMPS GASKET JOINTS I ITIIIT 9 ROCKY LANE .., N 44 GPM 022' TDH EXPOSED METAL TO BE PROTECTED FROM �4" 4"- MODEL50PN2.4S L�rri 4• PUMP BACK PUMP PUMP BACK PUMP MODEL P 2 S COHASSE1, MA 02025 EROSION WITH A BITUMINOUS COAT NOTE. ALL COVERS SHALL ..< ;, ° .,. . 781-383-1234 HAVE THE WORD SEWER" FORGED ALUMINUM v FLEXIBLE SLEEVE s s ED BY: SAFETY TYPE .'.: � •�.'� IN 3" LETTERS CAST_ PLAN VIEW. 17'-0" SURVEY SERVICES PROVIDED MANHOLE STEP •r THEREON oll SIDE VIEW -�z-�„ WATERPROOF COATING M PRECAST REINFORCED /� u c H2O DESIGN LOADING OUTER BE SURFED TO 5 CONCRETE MANHOLE PIPE TO MANHOLE 1-I OLG CONNECTION down cape engineering, inn. OUTER SURFACE � � BARREL P b°• g� (TYPICAL) :! . NOT To SCALE SETITECH PROCESSOR 5" MIN. CIVIL ENGINEERS FORM GROOVE IN BASE z LAND SURVEYORS CONCRETE WITH STEEL m >. MODEL M 3 0 0 0 N RING FORM TO RECEIVE 939 main st. Y P armouth ort ma 02675 TONGUE OF BARREL 7" DIA CONTROL VALVE BOX AS 4'-0" DIA. A.C. MANHOLE COUPLING, MANUFACTURED BY AMETEK PLYMOUTH PROJECT TITLE. A.C.-PVC ADAPTER ,.----- PRODUCTS DIVISION. PAT. #3858765 ACTIVATED CARBON OR APPROVED EQUALLY. " " CONCRETE BASE __ _ _ _ RUBBER RING FILTER VENT 11 x 16 CONTROL VALVE BOX AS TO BE BROUGHT TO WITHIN 3" OF INSPECTION PORT FRAME & COVER (SET IN CONCRETE) MANUFACTURED BY AMETEK PLYMOUTH CAST-IN-PLACE �r .:'• � a '•'• WATER STOP FINISHED GRADEMANUFACTURED :$r .,:•:• ..: 4" SCH 40 PVC . PVC PRODUCTS DIVISION. PAL 5876 OR BY GENERAL FOUNDRIES INC. FINISHED GRADE 2X MIN. 5DETAIL SHEET SOLID PIPE CAP NUT PVC ITEM # 18111 OR APPROVED EQUAL, IF IN PAVEMENT. '. " ---PVC SEWER CAP NUT OR APPROVED EQUAL TO BE BROUGHT TO FINISHED GRADE MIN. .• h • " 1 AT 2 MIN. OF 1/8 TO 1/4* " ". •'. ::: DOUBLE WASHED STONE " 0 a• 5'-0— 5'-0" 12� MIN rn, 2'_g PVC REMOVABLE CAP 304� RTE 28 v •` TOP STONE ELEV. 59.00 I ALTERNATE PERFORATIONS SEE SYSTEM LAYOUT ' 36 MAX ) 0 •0 •�'• �• •'o. p. COVER 2- MIN. OF 1/8- TO 1/4" BARNSTABLE, MA • .•, :O: .o, 'o,• 3 5-0 2'-6" 2'-6" 5'-0" CLEANOUT DOUBLE WASHED STONE " -- TOP STONE ELEV. 59.00 12" MIN 4 SCH. 40 SOLID PIPE , CLEANOUT e a TYP a �tq,_ 36" MAX ASSESSORS MAP 50, LOT 3 UNDISTURBED EARTH _12" MIN. 3 MAX. --- --__-- ----------- - -- ---- - " 2" MIN. OF 1 8 TO 1 4" PREPARED FOR: ---__--- __-- o__-__ --- 1/8 04 COVER DOUBLE WASHED STONE p SCREENED BRICK MASONRY ------ » - -- ---�--- -- ---- ----- VENT oo OSTERVILLE PINES GRAVEL VENT O 1/8 PERF. 1/8 PERF. O 1/8 PERF'. oo HOLE 00 1.1/4- PVC SCH 40 O o© OR CONCRETE o0 00 00 00 0o e o 0 0 HOLE O (�) (TYP) (T�) LATERALS. (TYP 'b� CONDOMINIUM 6 OF 3 4 TO 1 1 2 " " C O HU. • .IN .BEST ;T. CO. / / - 11 4 PVC H A A 6 OF 3/4 TO 1 ,1/2 " - / 6 OF 3/4 TO 1 1/2 / CSC 40 L TER LS 6 OF 3 4 TO 1 i 2 STANDARD �'`� pp + /'r'�ry DOUBLE WASHED STONE DOUBLE WASHED STONE / / D 4 O4 P.O. BOX 340 STAND/`1f�U SEWER MANHOLE SEC I IQN DOUBLE WASHED STONE SET LEVEL AT ELEV. 58.50 �+ ro BE PLACED ADJACENT DOUBLE wasHEO STONE o0 00 0o MARSTON MI LS MA. 02648 - TO BE PLACED ADJACENT NOT TO 'SCALE TO 1/8" VENT HOLE TO 1/8" VENT HOLE. M AND BENEATH VALVE BOX ORIFICE SHIELDS MODEL AND BENEATH VALVE BOX 1/8 PERFORATIONS ALTERNATED 2" SCH 40 PVC MANIFOLD PIPE STF-160 AS MANUFACTURED EVERY 5-0" AT 6 O'CLOCK 4" SCH. 40 PERF. PIPE DATE: JANUARY 16, 2007 AS 51M/TECH FILTERS 1 18 PERFORATION TO BE PLACED POSITIONS. TYP 6" OF 3/4" TO 1 1/2" PITCH 0.005%MIN BACK TO FORCE MAIN. OR APPROVED EQUAL / ( ) ORIFICE SHIELDS MODEL NEAR THE CROWN OF THE PIPE STF-160 A5 MANUFACTURED BOTTOM OF LEACHING F COMP./DESIGN: P.H.SPATH / IEI D DOUBLE WASHED STONE 1 8" PERFORATIONS N IN THE 45' BEND 4" SCH 40 PVC PERFORATED AS SIM/TECH FILTERS 1 1 4" PVC SCH 40 / ALTERNATED / CHECK: PHS EVERY 5-0 " AT 6 O'CLOCK AT THE END OF EACH LATERAL VENT PIPE (TYP.) OR APPROVED EQUAL LATERALS. (TYP) POSITIONS. (TYP) DRAWN: P.H.S. — FIELD:SECTION B B INSPECTION PORT DETAIL of naEsa r SECTION A - A NOT TO SCALE NOT TO SCALE RDS JOB # RDS 626 SHEET OF 5