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Home My WebLink About0069 MEADOWLARK LANE - Health pr 69 Meadowlark Lane Osterville 117-029 a . r u TOWN OF BARNSTABLE LOCATION 6� 9 114 e A /, o cv L A A k i L R SEWAGE #x 6'0 VILLAGE o S'reR V l L Z e ASSESSOR'S MAP &LOT If INSTALLER'S NAME&PHONE NO. .J: /9�.4"C p m SEPTIC TANK CAPACITY —/ o o,;.. 4 2,('0Lgt, 1A4,k LEACHING FACII.ITY: (type) L eA ClI/A/ G 1c%e147 (size) NO. OF BEDROOMS 3 6ct,4 �-QS BUILDER OR OWNER M C L eAA/ .7'f. PERMIT DATE:%��J- COMPLIANCE DATE: I: a D ,� . Separation Distance Between the: Maximum•Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water'Supply Well Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within=300Ffeet of leaching facility) :-Feet Furnished by 5 e. -1 0 I I '� f - _ No. �G 00 0 Fee i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 9ppfieation for Disposal 6pstem Construrtiou Permit Application for a Permit to Construct(ArwoRepair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Aftess or Lot No. Oa/ L,� Owner's Name,Address,and Tel.No. bGet-/ �;Y n — ®�sso� Map/Parcel 1 ��vL `�? �� e� 11� It/C-i`'eS� Installer's Name,Address,and el.No . ny C�Cbcr>" Designer's Name,Address,and Tel.No. 1h-r& - nr- hav=, elaffil LW "Z� Type of Building: �I Dwelling No.of Bedrooms /V Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons _ Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) A&k Mo , r aY� --tiny Date last inspe ed: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o th. Signed Date Application Approved by Date j Application Disapproved by Date for the following reasons 7� Permit No. j Date Issued Fee - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer; Yeses . PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Olptlrication for -MispoBal �&pstrm Construction Permit l Application for a Permit to Construct(W Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components M. Location Address or Lot No. � � p,�/ Owner's Name,Address,and Tel.No. LOCI Assessor sMap/Parcel I _ Installer's Name,Address,and No.'-Ony (-:t,a � Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms / Lot Size sq.ft. ,:,.-Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures , Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. r Description of Soil r "x t Nature Jof Repairs or Alterations(Answer when applicable) A k ��t" ;,h ,r� �' Date last mspe� ed: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of e ate h_.,,, z: - Signed Date AC - Application Approved by / Date j Application Disapproved;by 1� Date for the following reasons Permit No. 7 ► M 1 Date Issued ti. THE COMMONWEALTH OF MASSACHUSETTS j BARNSTABLE,MASSACHUSETTS I ' Certificate of Compliance v THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired{ ) Upgraded( ) Abandoned( )by q / ` at % [�, ; "has been cons ucted in accordance , � , ;� w with the provisions of Title 5 and the f is2saa System Construction Permit No.24�? 1 1'7 0 dated �j? Installer Designer #bedrooms Approved design flow A%l k and i The issuance of this guarantee that t perm t shall not be construed as a he system willnc�ion g as desi ne . Date p t I Inspector - s u--------------------------- Feed �- �� . v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS 30isposar 6pstem Construction J)Prmit Permission is hereby granted to Construct(/Y' Repair( ) Upgrade( ) Abandon( ) System located at Cn M tu C44,,_)144( and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction lmust be completed within three years of the datel of this permit. Date 3 E 2 I Approved by - ( MORTGAGE INSPECTION PLAN. ,s•os:lyc ICATIL ts�M.EA -1.ARK L:4,VE BOSTON • 017y,STA7T,.- OSTERVILLE,WA APPI.ICAA'T; KE/i71\;GNTINC ICE'il.ANGJZ'NIC CERTIFIED TO: SURVEY, HT71Gr1F S 7 vG /+ INC.SCALS: I DVCN=30PUT e.0.130k29o720 DATE: r+LY?2016 CNARLESTOWN,n!A 0212F . 7;utr32S2•f9:?F(t3f7)<'t2+6!l; K'MSaSTO NSURVE''Mc,com. �- LOTs 1�60\ A,13,200;SF ' t t Nb. 89 1.5 STORY WF h a ?a7' . MEADOWLARK LANE r • k PLOOL-DEL4MINATION REF'ERbNCE5 , num i v to Fedunl EmeiQeney Menagraetat Ageney nsapt,the PEED BK 217 2 PG 27 zO hnprnvem on 't leo y rid" xsarea day g�utad es PLAN BK 205 PG 5S µ1H 0i y�q zONE: X S k grpt-x COMMi1NITY ANELNo.� ,� u�S NoT>r:toaMwanetturaercUet>i.spUnnunUea,(nted IFFECTIV&BATE: ocl�gnsaixdjupvlBS xla") �� GE O E ' y !to- i o CO INS +h61:10c+u:.+smrroraur.fp�mvinrueiy)owkdonthtareuaelfsstonm. They citfincen7o,Tmdm the euba.x,rgy3rc;na�d. . of the Jop!cooing ordinutctit in age'a d"fine ntti rd"""",or ate"MY01 by h vioLtito s iforbemant anion under No. .1734 tdfJ.L T'dc VIl,t:htptu 4DA;Section 7;and ttar sm no cougachmcm hrnmfor itnpmwmoni a<mtt fr mp ,linns uerpt 04 .. aMwn and,andhaman. - 'Cy 0 E. tO�,�;g- • -ids is not a boundaq•n.•tidt iniaromesuivey.'/hit plan thtwtd net he ured lweatvtruaian,reeaN�ng pvrpaam or•tritiwricn N SURD ttpropay lints - George C.Collins,PUS . Commonwealth of Massachusetts r da9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 69 Meadowlark Lane Property Address N Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 s page. Cityrrown State Zip Code Date of Inspection N Inspection results must be submitted on this form. Inspection forms may not be altered in any CA way. Please see completeness checklist at the end of the form. P Important:When A. General Information filling out forms I It( on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. S.M.Jones Title V Septic Inspection Company Name 74 Beldan Ln. Centerville Ma 02632 Cityrrown State Zip Code 774-248-4850 smjonestitle5@gmail.com. SI4522 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 6/11/2016 Inspectors 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1looff 17 AOO Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The dwelling located at 69 Meadowlark Ln Osterville is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box and a 26'x26' leach field. The system was found to be in proper working condition at the time of inspection. 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 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 ti 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is Osterville Ma 02655 6/11/2016 required for every page. Citylrown 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 Tide 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 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name 4 information is required for every Osterville Ma 02655 6/11/2016 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 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 El ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Z Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is Osterville Ma 02655 6/11/2016 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- 1 0,000g pd. ❑ ® 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 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 page. Citylrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd t5ins•3/13 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 G M , 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 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: Sump pump? ❑ Yes ® No Last date of occupancy: March 2016 Date CommerciallIndustrial 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-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 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 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: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins-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 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owners Name information is Osterville Ma 02655 6/11/2016 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed (if known)and source of information: system installed 1/10/06 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Joint were ok no leaks vented through the roof Septic Tank(locate on site plan): 2 Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ® polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallons 3„ Sludge depth: t5ins•3/13 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 M 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name_ information is required for every Osterville Ma 02655 6/11/2016 page. Citylrown 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 3' 011 Scum thickness 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 10" How were dimensions determined? opened covers, took measurements 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 in good condition, inlet cover on riser. water level was even with outlet invert, inlet and outlet tees intact and in good condition. 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•3/13 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 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3/13 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 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): 0i. Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box was in good condition, no rot, water level was even with 4 outlet inverts. 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•3/13 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 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number:. ❑ leaching trenches number, length: ® leaching fields number, dimensions: 26x26 ❑ 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-.): soil and stone was dry with no sign of past saturation. Vegetation was normal. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G M , 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owners Name information is required for every Osterville Ma 02655 6/11/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 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 AN✓_ A-( SS 13 13 3 sB t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12'+ feet. Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-,(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 5 69 Meadowlark Lane Property Address Obder& Barbara McLean Owner Owner's Name information is required for every Osterville Ma 02655 6/11/2016 page. City/Town State Zip Code bate of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 No. W (9 1� Fee I Q THF_ COMMONWEALTH OF MAS$ACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for 33i.5pont *pgtem Cou.5truction vermit Application for a Permit to Construct( ) Repair(/S Upgrade( ) Abandon( ) .Complete System ❑Individual Components Location Address or Lot No.(99. MQ%ap( 1�,r1 Owner's Name,Address,and Tel.No.ne 2Ar C Assessor's Map/Parcel "� �� (pq � �t�j� v- -o ry t s�)�75-3335b ( �� Installer's Name,Addres ,and Tel.N Desifner's Name,Addre d Tel.N C��JA17 nn0��) 3 am son c. Type of Building: Dwelling No.of Bedrooms - Lot Size sq.ft. Garbage Grind r (� Other Type of Building No.of Persons Showers( ) Ca ete ( ) Other Fixtures Design Flow(min.required) q� gpd Design flow provided 8E)o gpd Plan Date 10 ( 0S Number of sheets Revision Date Title Size of Septic Tank O J Como Type of S.A.S. �0 1C 220 Description of Soil Nature of Repairs or Alterations(Answer when applicable) - o O Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by t ' B�Haltthh.igned �" Date �O S/ Application Approve Date Application Disapproved by: Date for the following reasons Permit No. C -00 J (9 1 Date Issued f �� Fee Al Q Entered in computer:° t - p THECOMMONWEALTKOF MASS O ETTS " PUBLIC,HEALTH DIVISION - TOWN OF BARNS ABLE, MASSACHUSETTS Yes ZIppCicotion-fox �Digonl *pgtem Zon,5trurtton JernY t Application for a Permit to Construct O Repair(✓j Upgrade Aban`dorP( ) [$Complete System ❑Individual Components f A Location Address or Lot No. Owneerr'ss ame,Adds,and Tel.No. Assessor's Map/Parcel f act p 0 t71 .Ul V�Tdil(V t {))J s )�75 333`b ��y� / Installer's Name,Addres and Tel.No. Des ner' Name dies and Tel.No:6� 7 3 Ya Lc Vi 0�'W Soh 5 , "Type of Building:. _f Dwelling No.of-Bedrooms Lot Size sq. ft. Garbage Grinder (✓) Other Type of Building No.of Persons Showers( ) Cafeteri ( ) Other Fixtures /` Design Flow(min.required) q9S gpd Design flow provided Soo a gpd Plan Date 10�5 Number of sheets Revision.Date 1 1 Title Size of Septic Tank (So O (&MQ4r 4 rKe* Type of S;A.S. Dl�e \Q Description of Soil Nature of Repairs or Alterations(Answer when applicable) 0 h i' S �Jo l� ✓ ) C1 i (S0 +-Ck_ � J Date last inspected: 1 Agreement: ~ The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by,'this oard of Health. Ci_gnedj� � DateApplication Approve _ Date _-,Application Disapproved by: 'Date M�f for the following reasons s: f Permit No. r -00 51 51 Date Issued` ` I 3e) 1 5— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS CErttf irate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( Upgraded ( ) Abandoned( )b ll pk •P Son at P P a-1)' ew-k sll I ob-11 has been constructed in accordance with the pr visions of it`e 5 and the for Disposal System Construction Permit No. 5 6 5 dated Installer u b Yo_ L�fil Designer C �J(C�LYI4�P�f l YU3 #bedrooms Approved design flow � � gpd n The issuance of is permit shall not be construed as a guarantee that the systep nrwill`funct Las desi j ed. pY��j DateInspector 1�d/U(4 Ins ector ———————— /———————————————— ——————————————/—————— No. �O5 51 Fee l O THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Ii.5poot i§p5tem CCon!Aructton Permit Permission is hereby granted to Construct ( ) Repair ( (/ Upgrade ( )q Abandon ( ) System located at (oQ \110 OULo w &r lC and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction mus be completed within three years of the dat of this pe- Date o' )�6 Approved �y J JqN-1 1-2096 02 :23 P('7 JCENG 1 tJEEFc 1 NG 500 273 0367 P. 01 own of isa nstabie Regulatory Services • Thomas F. Geller,Director S M0P ol Public Health Division 0 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 2 ax; 508-790-6304 Installer&Designer Certiflelii2n Form Date: t JI o/0(; Desi er: V- p �C..... tSLCr1'N �CNG=.... i�lC, Installer: Address: Z8S ��t r v �. G Wr4y Address: TO Ox On P'l`2AD 1 06 '_ I was issued a permit to install a (date) (installer) (0 „ �aAl septic system at based ona design drawn by (address) cuk z, 90904.ZN C.J�W4., dated...,...� oC6' (designer.) -- I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and!or septic tank. I certify that the septic system referenced above was installed with major changes (i.e, greater than 10' lateral relocation'of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. N trOFht'k` CH�';C;t1111 a (lnsta atuie) '?:, c:l No 1q f (Designer's ature) - Affix De er s Stamp ere) LEASE RET RN TO BARNSTABLE PUBLIC HEAT DIVISIO . CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FURW AND AS- BUILT CARD AItE RECEIVED BY THE BARNST&BLE PUBLIC REALT14 DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form V 9/16/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, �ahn L• Chu rani�l fir• �•Z. hereby certify that the engineered plan signed by me dated Oct. ri 200 , concerning the property located at (c9 li eaclow 1o�k Cone ps�e:o�i�� A{f{ meets all of the following criteria: • This-failed system is-connected to a residential dwelling-only. There are-no-commercial-or - - - business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct deep test holes and percolation tests at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom..of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation..[Adjust the groundwater.table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) 1 2 1 6 Q ± � t . B) G.W. Elevation +adjustment for high G.W. �� = y UD DIFFERENCE B TWEEN A and B •OU, } SIGNED : DATE: NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:percexmp i Town of Barnstable - ' P# Popp ZHE Tpk� Department of Regulatory Services d N w+ A Public Health Division Date � HARNSTAHGE. v MASS. � 200 Main Street,Hyannis MA 02601 4i"leo rnA�°' Date Scheduled ' Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By. }Jic nae k Q(me�Ee,� E,�, S f t "( G. C . Witnessed By: LOCATION& GENERAL INFORMATION Location Address b9 r,ea6o ;(actc LOdle. Owner's Name 66tc f • NCLean 30cbm41 0. 6s uikke- H R d y65S Address ,q Ke oui lc;k l o•e f 05woiktaI riR 02b55 Assessor's Map/Parcel: f 7 I 2� Engineer's Name -SC 6o Sihee:io%, T-0c NEW CONSTRUCTION REPAIR Telephone# Land Use �estde� a1 �Sir��\e �c___ 'nT Slopes(%) Surface Stones 6ne— >/b 6 ft Drinking Water Well' �1 A ft , Distances from: Open Water Body 7 /0 0 ft Possible Wet Area g 50 ft Property Line Drainage Way 7 0 _ft Other tt SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to.holes) 'Set— elf-lkzAkeA I CroQ05eA �cQ�e 5y5k"Lm Ue3fadC � Loco e8 a� 69 Meaeow 1 ock Lie � �ske�o�t�e I rl Pr o 2��.5 ail cl.pF�� a c;Oou 51 4 Parent material(geologic) ��GfC(Q� Q W aS�n Depth to Bedrock l20 ll 1( i Depth to Groundwater: Standing Water in Hole: Weeping ng b from Pit Face Ai I Makllidn � . • Estimated Seasonal High Groundwater 7 2 5 c� DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Obseeuotw•n (vb Depth Observed standing in obs.hole: PIA in. Depth to soil mottles: ill. Depth to weeping from side of obs.hole: N t IV in. Groundwater Adjustment NI fl ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level— PERCOLATION TEST Date io"3"®s Time 3 ell Observation 2 Time at 9" Hole# Depth of Perc 52-7U -i3 y Time at 6" Start Pre-soak Time a 5,0 1 y;0 7 Time(9"-6") End Pre-soak 3' (2 y' QOu:ec� 24 gallev►S; + Rate Min./Inch L 2 � 2_ �is�ab�e_ to �ce,sonk� v Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back-------- ***If percolation test is to be conducted within 100' of wetland,you must first no the ` Barnstable Conservation Division at least one(1)week prior to beginning. 't l Q:HEALTH1WP/PERCFORM la DEEP OBSERVATION HOLE LOG Hole# l Depth.from Soil Horizon Scil Texture Soil Color Soil 'COther Surface(In.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%.tlravel N c (A s toy,312 �0Yrg/� Ws 2.5 i 6/6 52� 52- 12U C 2 5 2- 5 1 DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) S i 1) 8 - S q „6 �s 10 sip 3N ~ 2.5Ybhb e t91'( s DEEP OBSERVATION HOLE LOG Hole# m Soil Horizon Soil Texture Soil Color Soil Other Depth from Stones,Boulders. p (USDA) (Munsell) Mottling (Structure, Surface(in.) (US ) Consistency.%Gravel DEEP OBSERVATION HOLE LOG Hole# other Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Map: Above 500 year flood boundary No X Yes Within 500 year boundary No_ Yes Within 100 year flood boundary No '< Yes Depth of Naturally Occurrinsl Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? �e5 If not,what is the depth of naturally occurring pervious material? Certification I certify that on /D--2-7-11 (date))have,passed the soil evaluator examination approved by the Department of Enviromnental Protection and that the above analysis was performed by me consistent with the required training,expertis and experience described in 310 CMR 1.5.017. Date Signature Q:HEALTH/W P/PERCFORM f JAN-11-2006 02 :23 PM JCENGINEEPING 508 273 0367 P. 01 'i,own of barnstabie Regulatory Services• Thomas F. Geller,Director / t r�vwar�s� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862.4644 Fax: $08-790-6104 Installer-&Desiiener Certiflc-Mon Form Date: j J10 Desigper: ..-..ETA 17NEarN�..J&VC. Installer: JCD1Y1 2raYIA n Address: . 60 CeN Address: �Q SOA o On )P,l,24r was issued a permit to install a (date) (installer) rC .based on a design drawn by septic system at A9AQX2LAA (address) �iQ1Str:Neg#C-zA1 6,-j;Ak(., dated.,..,....1 C7/4..�O5, (designer.) - I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box andfor septic tank. I certify that the septic system referenced above was installed with major changes (i.e, greater than 10' lateral relocation'of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &Local Regulations. 'Plan revision or certified as-built by designer to follow. ,r of�� CHl%';C!tlll A .fit. (Insta Signature} c�rl Nn 4'lMV b (Designer's ature) - AIx Des er's Stamp ere) LEASE RET RN 'r0 BARNSTABLE PUBLIC HFA T DI'YIS10 . CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC H ALTB DIVISIOiN. TITANIC YOU. Q:Fealth/Septic/I)esigncr Certification Form r'* M a f F ry� k rc I s a a iT - _. _ D `Fq. a#{�y�'_`tr- !:^}^�' M., 'l�H.`r.`M„�n?'�s �•. �.4.; � _r.:Y".".t'..._. _ .+c x..« ...v _ .•.-wr ` D` : .. -.. � � • -.e.. - �..-� � o .. w#' �3. — Ir in) 71T, 0,, cv f t f FINISH GRADE OVER D-BOX= 14.9' 1 - ' TOP OF FOUNDATION= 17.60 '�' PROVIDE PRECAST CONCRETE 4"SCHEDULE 40 PVC MIN. SLOPE 1% FINISH GRADE OVER LEACHING FIELD= �4.38 14.25 GENERAL NOTES f- EXTENSION RISER TO WITHIN 6 REMOVABLE CONCRETE COVER SLOPE @ 2%MIN.OVER SYSTEM " OF FINISHED GRADE OVER TO WITHIN 6"OF FINISHED GRADE 3/4"TO 1-1/2"DOUBLE WASHED STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISHED GRADE INLET AND OUTLET COVERS 5"DIA. OUTLET(S) METHODS SHALL BE IN ACCORDANCE WITH TITLE 5`OF THE STATE f- @ FOUNDATION = VARIES FINISH GRADE OVER TANK EL.= 16.1 Q •F ;,' 2"OF 1/8"TO 1/2 DOUBLE WASHED STONE ENVIRONMENTAL CODE AND ANY APPLICABLE LOCAL RULES. I E 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD 20"MIN.ACCESS COVER PROPOSED 4" FOR 3 12pMIN. i 4"PVC PERFORATED PIPE a OF HEALTH AND THE DESIGN ENGINEER. SCHEDULE 40 PVC (TYPICAL O ) 36 MAX. IN. SLOPE AT 0.50% TOP OF S.A.S. - 13.38 - 13.25 V�� 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL EXIST. " - 12"MIN. PIPE �- 36 MAX. 36"MAX• l � BE USED IN DISPOSAL SYSTEM UNLESS OTHERWISE NOTED. 3'xITVFNT PROPOSED 4"' 12.75 4. TO PREVENT BREAKOUT,THE PROPOSED FINISH GRADE SHALL NOT BE LESS THAN MiN.s�oae�,% 6" 3" 2"DROP MIN. W-6"TRANSFER 3" 9" SCHEDULE 40 PVC PROVIDE WATERTIGHT END CAPS E I�(� ELEVATION = 13.38'FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS -- ---3"DROP MAX. OPENING JOINTS(TYP.) A 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF e 4"PVC IN FROM ti�i �� THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 19" 13.75' SEPTIC TANK 4"PVC OUT TOM1 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. 14.80' ± o 0 0 0 0 0 o 0 0 0 0 0 0 0 0 0 0 0 0 0 �, " • LEACHING FACILITY 6• THIS SYSTEM IS DESIGNED FOR A GARBAGE DISPOSAL. 48 12" 6"FFECTIVE e 7• LOCAL BOARD OF HEALTH TO BE NOTIFIED PRIOR TO BACK FILLING WHEN LIQUID LEVEL OUTLET TEE 13.25' MIN. 13.08' DEPTH „I SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS NOT TO COMPARTMENT 12.88 BOTTOM OF FIELD TO BE LEVEL EL. = 12.25' BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH. 14.001WALL 6"CRUSHED STONE q - 22"ZABEL FILTER 4' 6' 6' 6' 4' ! - 8 ELEVATIONS BASED ON APPROXIMATE USGS DATUM OF 16.00' (48 HRS DETENTION) (24 HRS DETENTION) MODEL#A1801-4x22 CCOMP C ED B SELLY 26' OBTAINED FROM A NAIL IN A TREE AS SHOWN ON PLAN. 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION 6"CRUSHED STONE 5 OUTLET DISTRIBUTION BOXt�- THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= 7.25 I AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY COMPACTED BASE BASE. FIRST TWO FEET OF OUTLET DISCREPANCIES TO THE DESIGN ENGINEER. 5 MIN'. PROPOSED 1500 GALLON TWO (2) COMPARTMENT SEPTIC TANK PIPES TO BE LAID LEVEL. 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE 1 CROSS SECTION VIEW TYPICAL FIELD PROFILE FIELD END VIEW STRUCTURES SHALL BE MADE WATERTIGHT. LENGTH 10'-3.5" WIDTH 6'-1 .5" DEPTH 5'-7.5" DIMENSIONS PRECAST CORP. FIELD DETAILS c�I 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR SEPTIC TANK PROFILE POCASSET,MA DISTRIBUTION BOX DETAIL NOT TO SCALE ZONING REGULATIONS. OWNER/APPLICANT 1S TO OBTAIN SUCH NOT TO SCALE 508-564-6776 a NOT TO SCALE DETERMINATION FROM APPROPRIATE AUTHORITY. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS TEST PIT DATA LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H 20 LOADING. ; • °' , Unwitnessed 13. WASHED CRUSHED STONE SHALL B F L US N AGENT: DOUBLE S DIRT, DUST AND SOIL EVALUATOR: Michael Pimentel, E. I T �. E FINES •` ' . " DATE: October 3,2005 14. WHERE REQUIRED,CONTRACTOR SHALL REMOVE ALL LOAM,SUBSOIL AND F � F TEST PIT#: 1 UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT ON ALL SIDES O LEACHING FACILITY: REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN ELEV TOP: 11.58' COARSE SAND FREE FROM CLAY, FINES OR OTHER UNSUITABLE MATERIAL IN s, ER 7.25' ACCORDANCE WITH 310 CMR 15.255(3). ELEV WATER: 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PERC RATE: <2 Min./In. SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. ti` DEPTH OF PERC: 52"-70" 16. PROPOSED PROJECT IS LOCATED WITHIN: ASSESSORS MAP 117 PARCEL 29 w. TEXTURAL CLASS: 1 17. OWNER OF RECORD: ODBER R. MCLEAN,JR., &BARBARA O. MCLEAN MAP 117 20� P ._ : t � 4 69 MEADOWLARK LANE CB/DH PARCEL 28 T.. ADDRESS' • �;; 0 11 58' • , OSTERVILLE,MA 02655 Fe FND/HLD '; �r r' �r Fill FEMA FLOOD ZONE C. B .� • ` AS SHOWN ON COMMUNITY PANEL# 250001 0016 D 0 - Loamy S. L and UP / ory�v� N�3"19,00 CB/DH ` $ • is A 10YR 3/2 ar . • 18. PLAN REFERENCE: LL 947/3 MAP 117 �`� s/.83• (FND) a • + • . • t + 14" 10.41' 1. PL. BK.205, PG.59 E C + PARCEL 29 LSA - I ., ' ' • Sand 19. DEED REFERENCE: O 19,166 S.F.t J MAP 117 • 1. BK. 1398, PG.�1098, �=� (0.44 Ac.) " � O �h x * • B 10YR 5/8 N `/ / PARCEL 187 ' .• 1 " 8.75' 20. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. 2--, . m •131- • • 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY t DRIVE *� �'r: FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY (ABILITY B.M. ; Med. Sand . Ir a _ Q C1 2.5Y 6/6 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. Nail m Tree a • . • + v k , 1 Elev. = 16.00 r. .-. �4 " Mottling52 , . GARAGE � Approx. USGS • . , ,- �_,: ♦ ��+ „ • • '�` 1'1�� t °��` �►, +�nrr = 10YR 5/8 7.25 , •52 QJ / ,�o Perc. O�cr 2 BRICK 70" Fine Sand 5.75' QO O �t4 / / % `PATIO / LOCUS PLAN 2.5Y 6/6 ,,--PROPOSED 1500 GALLON C2 �� `� / ASA � ENCLOSED / 2-COMPARTMENT SCALE: 1"= 1000' ,Q SEPTIC TANK No StandingObserved Weeping PORCH / 120" 1.58' LEGEND CIO wQ x DESIGN DATA TEST PIT DATA - 50 - - EXISTING CONTOUR #69 20 C AGENT: Unwitnessed EXISTING (1 NFB Michael Pimentel, E. I.T. 50 PROPOSED SPOT GRADES 3-BEDROOM BH `'";' (DESIGN INCLUDES THE USE OF A GARBAGE GRINDER) SOIL EVALUATOR: Z / v DWELLING O I No DATE: October,3,2005 50 PROPOSED CONTOUR � TOF= 17.60'# (2 o NUMBER OF BEDROOMS 3 TEST PIT#- 2 LANDSCAPED AREA(LSA) G,qS o= DESIGN FLOW 110 GAUDAY/BEDROOM , O/H/W EXISTING OVERHEAD UTILITIES CC?NC. C TOTAL DESIGN FLOW 330 GAUDAY ELEV TOP: 12.75 / \ FEU CC EXISTING CESS POOL ELEV WATER: 7.25' W APPROXIMATE EXISTING WATERLINE TO BE PUMPED AND FILLED SEPTIC TANK PERC RATE: <2 Min./In. / --� WITH CLEAN SAND (TYP.) i GAS EXISTING GAS LINE " USE PROPOSED 1500 GALLON 2-COMPARTMENT TANK " " TEST PIT LOCATION 33 POSED D-BOX DEPTH OF PERC: 66 -84 PRO TEXTURAL CLASS. 1 COMPARTMENT 1: _ PROPOSED 1500 GAL. 2-COMPARTMENT SEPTIC TANK DESIGN FLOW x ° ( _ ) TRFF HC DESIGN CAPACITY U !2/3 ex 81500 GAL detention) 1000 `GAUDAY 1jA'F � (3 � `""� a � r' PROPOSED 4"PERFORATED SCHEDULE 40 PVC PIPE 4) COMPARTMENT 2: 0 12.75' i PROPOSED 26.0 x 26.0 ° Fill PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE LEACHING FIELD DESIGN FLOA x 100 !1(i.eX241 hrs GAL tion) = 500 GAUDAY 4" 12.42' DESIGN CAP CITY /3 500 Loamy Sand PROPOSED DISTRIBUTION BOX P 1 7 Ns D •, . �- j '. i 6 r 10YR 3/2 2 A MA 1 7 92� (6 ' P 1 g" 12.08 PARCEL 166 s• -�-:fir r�:z : ,. 11x513 INSTALL A 26 BY 26 LEACHING FIELD 12 _ ° = (required) Loamy Sand !- DESIGN FLOW X 150 !0 495 GAL/DAY MAP 117 1 I �ry PARCEL 34 SIDEWALL CAPACITY B 10YR 5/6 5) NO SIDEWALL AREA CREDIT TAKEN 34" 9.92' - _ REV. DATE BY APP'D. DESCRIPTION W C1 2.5Y 6/6 REMOVE AND REPLACE UNSUITABLE PROPOSED SEPTIC SYSTEM UPGRADE CLEAN COARSE SAND o -MATERIAL WITH CL BOTTOM CAPACITY o (LENGTH x WIDTH) (0.74 GPD/S.F.) = GALIDAY " PREPARED FOR: Mottling 66 r$PROPOSEDIMPERVIOUS Z (26'x 26') (0.74 GPD/S.F.) = 500.2 GAUDAY(provided) 66" 10YR 5/8 7.25' ODBER R. MCLEAN, JR. 40 MIL,GEOMEMBRANE LINER Perc. TOTALS: CB/DH Fine Sand 5.76 LOCATED AT ". (FND) TOTAL LEACHING AREA 676 SQ.FT. 2.5Y 6/6 TOTAL LEACHING CAPACITY 500.2 GAL./DAY C2 69 MEADOWLARK LANE SWING TIES No standing or weeping OSTERVILLE, MA 02655 DESCRIPTION HC CC BH 120" Observed 2.75' SCALE: 1 INCH = 20 FT. DATE: OCTOBER 5,2005 SEPTIC COVER IN (1) -- 18.6' 14.1' 0 10 20 40 80 FEET (N OF SEPTIC COVER OUT(2) - 12.4` 14.1' 'OH" L, ,. PREPARED BY: CHURCHILL �+ CORNER LEACHING (3) 34.3' 29.4' - cnnL JC ENGINEERING, INC. CORNER LEACHING (4) 59.7' 47.6' -- NO. 41 2854 CRANBERRY HIGHWAY CORNER LEACHING (5) 61.3' 65.5' -- SITE PLAN EAST WAREHAM, MA 02538 CORNER LEACHING (6) 37.0' 153.& -- SCALE: '1"=20' 508.273.0377 Drawn By: MLP Designed By:MLP Checked By:JLC JOB No.922 '" i