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HomeMy WebLinkAbout0042 MILNE ROAD - Health 1 ,4271lilne Road ille FIR, 8 025 TOWN OF iBARNSTABLE I OCATION IV,�ive l2d Os` , SEWAGE# 200A-.b y9 VILLAGE�if'on';IIP ASSESSOR'S MAP & LOT �UZ� INSTAL L'ER'S NAND' &PHONE NO._lZ ALA&&* �'� �;7 S9yS� SEPTIC TANK CAPACITY ` J D0 E14 L LEACHING FACILITY: (type)AxYy (size). /I),1/ No.OF BEDROOMS BUILDER OR OWNER , !®/e //4s Yrr Lrl/lOBtr PERMIT DATE: �=s�� COMPLIANCE DATE: ✓? o /b Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist ��w4dPf on site or within 200 feet of leaching facility) A ,4. Feet Edge of Wetland and Leaching Facility If any,wetiands exist within.300 feet of leachin aciGty) ®�� Feet Furnished by-- J i- O � � s (Al Ic, x Si e , Q 0 X No. 2do2�d`{9 FEES Jam. COMMO WLALT14 ®F MASSACHUSETTS G Board of Health,&CILS+-al�t AIA. COMM5 11CATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT it to Construct( ) Repair(,k Upgrade( ) Abandon( 00 Complete System O Individual Components lORAL E ' Location 47 to-It%e R Owner's Name Map/Parcel# rVIAlp 118 eq",1 L5- Address 4-2 M, Jnz OSk---' i (Le,, M4 ® ue �s' Lot# (-d - t8 Telephone# L15O8 -3 1-20 Installer's Name ZYThn (o 14 -t�+3 Designer's Name Address 61 m s— A"6 ro Sf- Q 5 k'j� Address '� �Ow Telephone# 4 Telephone# C � 7� j g z&44- Type of Building 1 CUA k CA Lot Size (o q 4 sq.ft. Dwelling-No.of Bedrooms Garbage grinder ( ) Other-Type of Building J No of persons Showers ( ),Cafeteria ( ) Other Fixtures Ajl 4 Design Flow (min.required) 440 gpd Calculated design flow 4-4-0 Design flow provided 43,-z. gpd Plan: Date 7i I 0 2 Number of sheets Z Revision Date /V/A- Title Seer c S y S km 12e yr Z g�� �'Z M11 ne e 5 1l 114 Description of Soil(s) Soil Evaluator Form No.dA S"9413 . -7 Name of Soil Evaluator Pef-6-A GCIT-t6 Date of Evaluation /dZ �d12.c"1 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to'nutall the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further s o t t e system in operation until a Certificate of C In fiance has been issued by the Board of Health. Signed Date O�— Qo Inspections FEE I art A C C t COMMONWEALTH DF MA CHU��ETTS � ✓� r y PETE17i /Board of Health, )6TIONTERMIT' McEMM Nb. 1 �rmit to Construct(: )'Repair(,UpgradeO AbandonO ]Complete System 0 Individual Components Location F pe R Q s�,�d, � Owner's Name . '41 �. I 11Q M _ ` a� Inn Map/Parcel# �y4' �8 '`q, � -5., '. Address �2 mi inn ! 10Skl-VI Lt. f1 Zoo Lot# ( v }� I Telephone# ��� `. �$" 3zo I: Installer's Name Z h(( L h 4—e f Designer's Name h eFi U✓� Address ��. � ?f� Qs{�✓,1i1 M © b ; Add ress. .Z3 Telephone#' . �p� "� Telephone# E �`pb �' 7'S CJ��c44- t Type of Building G Lot Size 8, �0 9 `�` sq.ft. Dwelling-No.of Bedrooms s' Garbage grinder ( Other:Type of Building N I fF No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) 140 gpd Calculated design flow 4—to be flow provided 4 3, gpd Plan: Date�/0 _V ' /� Number of sheets /�j') Revision Date /GUY A— Title sleei<< �y'Skm �ooq,/�� 41�Ca.r I �r!!l� � f✓Jhe ✓ 4 p _• Description of Soils) 0 S / /t-t S l8' a�. L S '�� � © �/. e7, e 3• S°vh,1 Soil Evaluator Form No.dMoJS`,4OL.C- Name of Soil Evaluator Pf-1-6 PIP`AT4C Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS 't _ Er {f The undersigned agrees to' tall.the above described Individual Sewage.Disposal System m accordance with the provisions of TITLE 5 and f' further eto oft .p e system in operation unhl.a Certificate of Cpmpliapce has been issued by the Board of Health. /C/T I s.. Signed_. ti�-; Date InspecticWo' r. No. 'COMMONWEALTH OF MASSACHUSETTS Board of Health, 4 e4 Sf �C MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s). ,Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired,Upgraded ( ),Abandoned ( ) by: 4 at y2 e /d ri�.x Ile- has been installed in accordance,with the pro ions of 310 CMR 15.00 (Title 5) and•the approved design plans/as-built plans relating to application No.2W3-0L14 , dated 2,1 16,z Approved.Design Flow (gpd) Installer Designer: Inspector:. _ In,tf SIN• 1\ Date: 1. a-. The issuance of this permit shall not be construed as a guarantee that the system will function as designed. �s.�:i-a-�` .._--<.v,. .. _.�...5_ '- _ _ �.-.'.-vw,-�.-.:. 'cG��...r-.,#:':• .,r.�i.: .�--,:..-- F• -- -:��.r�.r„��:�+`-;��."xE _:fir".='._�,._.-_w E. No: Od <O t/p) FEE OF COMMONWEALTH MASSACHUSETTS , P I Board of Health, dt 51- v MA. t DISPOSAL SYSTEM CONSTRUCTIONS PERMIT f Permission is hereby granted to; Construct( ) :RepaiN Upgrade( ) Abandon( )an individual sewage disposal system at L42 IMjnP' r, of*rt,�`��a` as described in the application for 1, Disposal System Construction Permit No.2002- 0yq dated. .21 /6 2 Provided: Construction shall be completed within three years of the date of:this:permit..All local conditions must be met. ':Form 1255'Rev.5796 A.M.Sulkin Co Boston,MA Date U�' #_Board of Health ri✓, �'�", :v o { r I TOWN OF BARNSTABLE � LOCATION nr �d Os fi, SEWAGE # �©� VILLAGE-.r�S�p✓ l� ASSESSOR'S MAP & LOT �d INSTALLER'S NAME&PHONE NO. � �I 6'00 3.�1 7 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) D xYy Tm P��y (size) 1 y x /0 NO.OF BEDROOMS— BUILD ER OR OWNER Wiwi- PERMIT DATE: S-o;L COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist 4��/!/ Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility If any wetlands exist Feet within 300 feet of leachin acility) Furnished by_ J I > Al 4 �S i D[SOY 6'r f ¢ s x -� g .-3 %s yo` Vl sVVa A. . �..V��V�v'.V A.''-.AV•11l ✓�i V. L /1�.J� 4.A - • ` ! � t rbr94 NOTICIE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT IIE'SIG.NED 11L S) I, I I c &v fee ft hereby certify that the application for disposal works construction permit signed by me dated Z f t /a 2. w , concerning the property located at ri-e OS k,-,f I :meets all of the following criteria: • This failed system is connected to a residential dwelling only, Thew ate no c-ammercia)of business uses associated Witt;tt:e dwelling. • The soil is classified as CLASS I and the percolation rate is less Char or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the rmpowd septic system • There are no private wells within 150 feet of the proposed septic system • There is no increase in now andiot change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility w iii not he located less,than five feet above the maximum adjusted groundwater table elevation. (Adjust the r,—roundwzter table using the Frimptor method when applicable] • If the S.A.S.will be located with 250 feet of any vegetatcd wetlands, the bottom of the proposed leaching facility will not be located less than fourteen 1,14) feet above she maximum adjusted groundwater table elevation. Please complete the following: A) Top of Ground Surface Eltvalion(using uI5 information) $) G.W. Elevation +the MAX. Hi;h G 'N A.dluserner.t DIFFER E SE T WEEN A and K �8 SIGNED L'�' - DA;E. ;Please.Sketch proposed plan of system on back!. : Based upon the above information,a repair perrnir will be issued for bedrooms maximum. N.� ailditio,ial bedrooms w-e authorized in the.ftiture without cnz ineeted septic system plans. q:health folder:cert — � Del)arkileW of ._ llenllb,SnfetY,nr ( Urvirely 10ptt er•%Public Health Division iccs _ems 167 Main Sitcrl,11yc)s:nis A'iA(ILi4t)i � F(A0.s \rDe�Qm�/ il:ttr. rlte�ltlir.cl ,t iih;r, a r ._ ►pnFCC I'll. S�rJ�I ►ititrr.l�llPt,► �I�•se sment f� J•�JiSeivage Dispi)srf! ,. I'crfi'rn)crl'I7 �T� G Miuis�clllip Nc�' - LOC�A �JN �C GF NP RAl.yt vet .dart .€ is N y, , !.vcn;i nAAdress j}7i +flew (h+lu�r'sNantc_ v /�'1cM a.Sj-ef �2 9 OSfevvijl(Q� MF} Address MffnQ /2e Assmor'+ NI'l)/P-.ln_el:/ "0" //19 fJl;%V c;t;3rJS I I(l!C I ION REP AIR 1 1Ciel hl eu•H I I,a•Ii(Ise f` , _` , e` ') , llistancc�float: tipru Wnlcr I1o(ly_-N / I'• f'otsiYc Wcf w'. f�•- it 't7rinkoi 11' lcr illcH !(/�/ it !,�'Q r ---- N/_ ._._ Sic Ii" CI(; ou cc'i wrom...Ili tnciisiolis of lot,cwn.l!r,capioos of icci 1a;Jcc ct pu•,c'csr1.'li rnrr'+cll:uul� plrO.ei tidy ill hotcs) 1 (dent Inntcrinl cold_ic �7 14Gt' �1 tI I)cp)p':la!3t,lrt ck �� Depth to(;wonowater. Simitliog Wmct in Bole ` A)o/c-C iFr p,Iap xir;.ut I'it I ace " I>stimaied Scnspnnl Iligh Urour 1witer _L 7 r( __ 0 P-':f by DETERMINATION Foft sLA,'SONAL III6'11 WAJ'j,7A(,,TAi TAe f Uepilh Observcd Spending in ohs.hole :'- ,� +vccpii-,g from 5irle r.f rih lfnlc in, J C;nuPnd+vntrr Adpusonctvt : , 1! T Mlles LVcll H Rmlill,Dafc: little:( %Veil 1 vcl A,N I'nelor Adi.E,r,,00d+vnlvt level __---.-PiERCOLATION TI�5,T . N — _— Ilolc H I iltic nt 9" .. s• De 9I9;or I'mf/ Simi 1'rc soak 1in:r.(r� T roc( l> ) .. r u } ,L end pre-soak _ t 'ir—'►•r► — ,.. , Italic Nlc)/pllcli ". _to Sitr S;litahilitq Assrssr)scnt: ;;i1e Pnssecl —1V Silt V1 dlcd: Addilianal felting Nceded(Y/N) Origilral: f'nt,tic!Icalil,Div)sioll Observt94itslt Hole Ont;t To Be Corttlt)Cl d ol4 Iliclt t:or)y Applicant _ ', DEEP OUST+ RWA`Y ION.IIOLE, LOG Depth[roll) Soil Horizon Soil Texture Soil Color Soil 1 other Sur[1Ae tin.} (USDA) (Munscll) Mottling (Structure.Stones,l3oulderes. lei 1t23/z — -- -- - ----- >L S to YrZ 3f4 _��►� --___—_-_____—_ Y -71 _ -- t "REEPtOBS-EAVATION HOLE LOG Hate# Depth from ( SbiI llorizoo Soil Texture ; Soil Color .Soil � Otter Eurfnce.(ut.,j"' , (USDA) (A?unsell) Mritlirg (Structure,Stones,Uoulderes. I ' DE E ' 013SERVATION.I OLE OIG Dole# Depth from Soii Horizon Soil Texture ° 5oil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,l.3ouldcres. —._ _ ---- ---— — oil 5 1 S te Pr. .Zv(j0_v_el] DEt- ' OBSERVATION;HOLE LOG Depth born Soil Horizolt Soil Texture Soil Color Soil Other Surface(in.) (t!SDA) (Mumrell) Mottling (51ruetutc,Stones,Botilderes. __--- r v °�vSdrayL l) -_ — --f- — — I I � 1Hioo(! ins(lredace(ts���� t Above 500 year flood boundary No i Ycs Within 500 year boundary No Yes WW)in 100 year flood boundary No A- Yes-- �? L9�N �i1e�lly�SSl} 111 >Perviou AgUrial Does at least four feet of naMr-al;ly occurring pervious material exist in all areas observed throughout the area proposed for'the soil absorption system? If not, what is the depth of naturally occurring pervious material? Certi_ka i1i _ 1`certify that on (date) I have passed the soil evaluator examination approved by the Department of fsnvironmental Protection and that the above analysis was p-erfortned by me consistent with the required tr 'nittg, expertise and experience described in 310 CMR 15.017. Signature _( �\� ----- Date ,z / �� r ul DATE: 1 /1 8/02 PROPERTY ADDRESS:_ Doug_McMasters_ 42 Milne—Road Osterville,Mass. FAILED INSPECTION l On the above date, I Inspected the septic system at the above address. This system consists of the following: 1 . 3-6 'X8 ' block cesspools. ( In series ) Based on my inspection, I certify the following conditions: 2 . This is not a title five septic system. 3 . This is a sewage system._ ' '4 , All three of the cesspools are 'in hydraulic failure : 5 . The system is in failure. A new title five septic system needs to be installed. 6 . Pump the three cesspools at time of inspection. SIGNATURE:,* _ Name:_J_F _ Macomber ,,Tr,_____ Company: Joseph_P_ Macomber & Son , Inc .. Address: Box 66 RECEIVED -------------------- R Centerville, Ma . 02632-0066 -JAN 2 4 20OZ TOWN OF BARNS"TABLE Phone: 508_775__3338_______ HEALTH DEPT. THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY � i JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools-Leachflelds Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775.3338 775-6412 Ty �� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i TITLE°5 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 42 Milne Road Osterville,Mass. . Owner's Name: Douglas McMaster Owner's Address: 1 /1 R/n Date of inspection: 1 /1 A/I2 Name of Inspector: (please print) Joseph P_Ma nc)mh r Jr. Company Name: J.P.Macomber & san Inc. Mailing Address: Box 66 CPn1-arvi 1 10 Masc . 02632 Telephone Number: 59 �5 3338 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. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes - Conditionally Passes• f -- eeds Further Evaluation by the Local Approving Authoriry rails } t . Inspector's Signature: Date: •117dA - The system inspector shall s mit 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 '•••This report only describes conditions at the-time of inspection and under the conditions of use at that'-s 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 6/15/2000 page I Page 2 of 1 OFFICIAL INSPECTION FORM =NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A , CERTIFICATION (continued) Property Address: 42 Milne Road ' Osterville,Mass. Owner: Douglas McMaster Date of Inspection: 1 /1 8/0 2 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: 1O 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 present sewage system is in hydraulic faiiure. A new - title five septic system needs to be installed. B. System Conditionally Passes: ` - A,'6 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. X&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: i,Z1D/Cbbservation of sewage backup or break out or high static water level in th distribution box ue 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 q, 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 c ND explain: Z - ' ti fy Page 3 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 42 Milne Road Osterville,Mass . Owner: Douglas McMaster Date of Inspection: 1 /1 8/0 2 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: ,V0 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: kb 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 I 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 0 feet or more from a private water supply well". Method used to determine distance l/ � "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. This is a sewage system. System consists of ' 3-6 X8 block cesspools in series.All cesspools are . r in hydraulic failure.New title five septic system needs to-_be _.installaed. - 3 Page 4 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 42 Milne Road, s ervi e, ass. Owner:Douglas McMaster Date of Inspection: 1 /18/02 D. System Failure Criteria applicable to all systems: You must indicate 'yes" or"no" to each of the following for all inspections: Yes No Z _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Tz_ 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 'h day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped�. _ d 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 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 i are triggered. A copy of the analysis must be attached to this form.) (Yes/No)The system fails. I have determined that one or more of the above 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 e 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 ariswered "yes"to any question in Section E the system is considered a significant threat, or answered ••ves" 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 I I OFFICIAL INSPECTION FORM = NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM PART B CHECKLIST ` Property Address: 42 Milne Road s ervi e,Mass•. Owner: Douglas McMaster Date of Inspection: 1 17 02 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 not e�N/) — Was the facility or dwelling inspected for signs of sewage back up? 'r �— Was the site inspected for signs of break out / Were all system components,Ae I ding the SAS, located on site ? t �LK/e 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: Yes no/ v Existing information. For example, a plan at the Board.of Health: ' Determined in the field (if any of the,failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(3)(b)) 5 Page 6 of I I ' a OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:42 Milne Road Osterville,Mass . Owner: Douglas McMaster Date of Inspection: 1 /1 7/0 2 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): q Number of bedrooms(actual): �Z DESIGN flow based on 310 CMI�.45.203 (for example: 110 gpd x# of bedrooms): Number of current residents: 67 Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system (yes or nc):,t [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): .( Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no): Last date of occupancy: COMM ERCIAL/INDUSTRIAL Type of establishment: A111 Design flow(based on 310 CMR 15.203): gpd' Basis of design flow(seats/persons/sgft,etc.): ' Grease trap present(yes or no):dL4 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 G l Q Source of information: Was system pumped as part of the inspection(yes or no): S If yes, volume pumped: gallon -- ow was quantity pumped determined? Ci/l ` Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system l Single cesspool Overflow cesspools d Privy -4)d Shared system(yes or no)(if yes,attach previous inspection records, if any) 47 Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(toy be . obtained from system owner) Tight tank /Attach a copy of the DEP approval Other(describe): Apr xl*m;kTq age of all components, date installed (if known)and source'of information: Were sewage odors detected when arriving at the site(yes or no):-64 6 • Page 7 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM rNSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Milne Road Osterville,Mass . Owner: Douglas McMaster Date of Inspection: 1 /1 7,1D2 BUILDING SEWER (locate on site plan) Depth below grade: Materials of construction. _cast ;-on �40 PVC_.,,�/other(explain); y Distance from private water s•'pply well or suction line: /O`l-- Comments (on condition ofjo;^.ts, venting, evidence of leakage, etc.): Joints appear tight.No evidence of leakage The system is vented through the house vents. SEPTIC TAN}v(f�(locate on site plan) Depth below glade: It/It Maierial of const:-actionconcrete,(&metal4y fibetglass.ef olyethylene AM-other(explain) A: !f tank is metal list age: Is age confirmed by a Certificate of Compliance (yes or no): — (attach a copy of .. certificate) Dimensions; Sludge depth. Distance born top of sluege to bottom of outlet tee or baffle: Scum thickness: ,�lh Distance 6om top of scum to !o? of outlet tee or baffle: �LYf DisLvcc tom bonom of scum to bonom of outlet tee or baffle: tJ4 ::"ow were dimensions determ n.ed: �A Com_menis (on pumping recommendations, inlet and outlet tee or baffle.condition, structural integrity, liquid levels as related to outlet inven, evi_encc of leakage, etc.): The septic tank is not present GREASE TRA9 (loci!: on site plan) Depth below grade:,fL Material of cons tructionAtIconcrete4)&metzVU fiberglasse)44 olyethylene,0 other Dimensions: Scum thickness: Distance l om top of scum to top'of outlet tee or baffle-: Distance 5orn bonom of scut^ to co::om of outlet tee or baffle: 144 - Date of last pt:mp:ng: )14 Comments (on pumping recorn.met.d_tions, inlet and outlet tee or baffle condition, srructural integrity, liquid IeveLs n related to outlet.invent cvi cnce of leakage, etc.): Grease trap is not present: Page 8 of 1 I OFFICIAL INSPECTION FORM'— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued),. Property Address:42 Milne Road Osterville,Mass. 4 Owner: Doualas McMaster Date of Inspection: _1 /17/02 TIGHT or HOLDING TANK4)��(tank must be pumped at time of inspection)(locate on site plan) Depth below grade:_ Material of construction: concrete metalV�2 fiberglass, polyethylene,�� other(explain): Dimensions. Capacity: 1 gallons Design Floti: gallons/day Alarm present (yes or no): " Alarm level: A), Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): Tight or o ing an s are not present. DISTRIBUTION BOXA.&Vt (if present must be opened)(locate on site plan) ` Depth of liquid level above outlet invert: + Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakaee into or out of box, etc.): T Distribution box is not presen - PUMP CHAMBER4,44/e (locate on site plan) Pumps in working order(yes or no): Vyf _ Alarms in working order(yes or no): zh?:. Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):.- Pump chamber is not present. - 8 Page 9 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION PART C SYSTEM INFORMATION(continued) Property Address: 42 Milne Road Osterville,Mas� _ Owner: Douglas McMaster Date of inspection:1 f 17-1(l ,� SOIL ABSORPTION SYSTEM (SAS): r (locate on site plan,excavation not required) 3 6 ' X6 ' block rP�Gn��i � � r} see All c hydraulic failure. A new title five septic system needs to be If SAS not located explain why: installed. Located• Type leaching pits, number" leaching chambers, number: 1)&�_leaching galleries,number: leaching trenches,number, length: AM eaching fields,number,dimensions: D !��overflow cesspool, number: innovative/alternative system Type/name of technology:A-Z/��f' Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): 1�Al1J eels ls~� ;L r of s are wet V 1 _—• nee sZ(Cesspool o e instal-led.- r --- CESSPOOLS: must be pumped as part of inspection)(locate.on site plan) , Number and configuration ' Depth—top of liquid to inlet invert: e7t)g'` Depth of solids layer: Depth of scum layer Dimensions of cesspools k Materials of construction: 6 Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic.failure, level of ponding,condition of vegetation,etc.): Same PRIVYAi�(locate on site plan) Materials of construction: /f Dimensions: 164w Depth of solids: Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Privy . r 9 Page 10 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART C SYSTEM TNFORM.ATION (continued) Property Address: 42 Milne Road Osterville,Mass . Owner. Douglas McMaster Date of lnspectioo: 1 /1 7102 SKETCH OF SEWAGE DISPOSAL SYSTEM Providc a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 Net. Locate where public water supply enters the building. e r. 10 Page 1 I of 1 1 • =.� OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 42 Milne Road ' Osterville,Mass. Owner: Douglas McMaster r Date of Inspection: 1 /1 7/o 2 SITE EXAM , Slope Surface water , Check cellar Shallow wells Estimated depth to ground water feet Please indicate (check)all methods used to determine the'high ground water'elevation: NOObtained from system design plans on record- If checked, date of design plan reviewed:NONE XXXObserved site(abutting property/observation hole within 150 feet of SAS) XXXChecked with local Board of Health-explain: No plans on. record XXX Checked with local excavators, installers-(attach documentation) ` XXXXAccessed USGS database-explain: You must describe how you established the high ground water elevation`: Used; Gahrety & Miller Model 12/16/94 ground water elevation above sea level USGS; Observation well data June 1992 ' USGS; Annual ran es of ground water. 92-�000-1 Plate '#1 ruunn Leaching f. Pit f� ;eet • Groundwater:h Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method Therefore;the vertical separation distance between the botto y ' _ of the leaching pit and the adjusted groundwater table is � feet. 11 ar+*rw+-arts+-�•r-+rnrmr•nm"s-•nn rsrrrrmn�e+ rrrrnr*mrm trs•rny n�'�rren�•t .. . 1 TOWN OF Barnstable WARD OF. HEALTH SUI)SURFACF SFHAGR DISPOSAL SYSTEM INSPECTION FORM - PART -D •- CERTIFICATION •••rr7-t'••.•e .-r.r ^.rrn.11rw•rttrn rwlrlfstrrT'rn:r-•.'I r•11tr+R�arR1R�T�+ROAT�w�n�rt esrnn ..�rrrr-�. �. . -TYPE OR. PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS -42 Milne Road Osterville,Mass. , ' ASSESSORS MAP , BLOCK AND PARCEL OWNER' s NAME Douglas McMaster PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME Joseph P. MAcomber & Svn Inc COMPANY ADDRESS P.O.- Box 66 Centerville Ma 02632 Street Town or CSty State LIP COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 790 _1578 nl CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system nt this nddress and that the information reported is true , accurate , and omplete as of the time of ,inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check one : System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form , System FAILED*. r_Y ... The inspection- which I have con ircted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 , 303 , and as specifically noted. on PART C - FAILURE CRITERIA of this inspection form . r 1 - Inspector Signature Date copy of this rtification must be provided to the OWNER, the BUYER One where applicable ) and the DOARD OF HUAL1111. * If the inspection FAILED, the owner or operator shall upgrade ' the system within one ,year of the date of the inspection , unless allowed or required otherwise as provided in 3.10 CMR 16 , 305 . partd .doc r . t 7,s:4 -Commonwealth of Massachusetts � �� Executive Office of Environmental Affairs - ` De artment of P Environmental Protection , k , Q 4 overno F.Weld a Trudy Coxe 4s: " ;, Secretary � Argeo Paul Cellucci U.Governor —David B.Struhs Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM t PART A f` M CERTIFICATION Property Address: L� n, 1-� I L tJ E �1) 0STeRV 1 A-Le �A ME � y Q�Q Address of Owner. Date of Inspection: RE- .- (If different) . Name of Inspector. R0"d E R7 IF-. S i Mo N, -- : — Company Name,Address and Telephone Number. R. E. SIMON/ASSOCIATES - Consulting Engineers 241 Monomoy Circle CERTIFICATION STATEMENT Centerville, MA 02632 I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper fund' maintenance of on-site sewage disposal systems. The system: p�ZH F it; V Passes o ROBERT Condition Iv Passes " EDWARD SIMON Needs Further Evaluation By the Local Approving Authority No. 11192 Fails a Inspector's Signature: o -A- .� Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check N B, C, or D: n A] SYSTEM PASSES: 1 V 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.YThe system;upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic tank is metal, cracked,structurally unsound,shows substantial infiltration or exfiltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a Fonforming septic tank as approved by the Board of Health: (revised 11/03/95) 1 One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-SSW " ii Printed on Recycled Paper f. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A t y ; CERTIFICATION (continued) Property Address: am I L N"E �s E'Qv'L L C .r Owner MS . R 7T MAO \F ,, k P �Date of Inspection: Rd 21 3, 1 °k9 � B]SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to bro'6n or obstructed pipe(s)' or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of.the Board of':::: Health): broken•pipe(a)are 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 systern,,,'s,;fSailing to protect the. -!public health, safety and the environment. 1) SYSTEM•IWILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONME1►fT:.'; 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 HEALT H (AND PUBLIC WA TER SUPP LIER,IF APPROP RIATE) DETERMINES THAT THE SYSTEM dS FUNCTIONING IN A.MANNER THAT PRO TECT THE PUB'- '•`•.. C•HEALTH AND .:.•..:;: SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water'sl •,ly or tributary to a, . surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water eupply.''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 50 feet or afore_from a private water., <; supply well, unless a well water analysis for coliform bacteria and:volatile organic compounds indic&4:ihat 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 8) OTHER X. (revised 11/03/95) 2 • i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM' PART C M SYSTEM INFORMATION Property Address: L 1'y /�K 17 RV l L 1.E Owner. Mf�S ROO�RT -1�S�Y0.. ��jp,(ZgARA' Date of Inspection: R p 1 .3 , q 6 Y FLOW CONDITIONS RESIDENTIAL - Design flow:.--3 3 0 gallons Number of bedrooms: Number of current residents: Garbage grinder(yes or no):_',D Laundry connected to system(yes or Seasonal use(yea or no):� _ g _ - Water meter readings, if available: 1-' " 1 �(D j fO S I �"o Last date of occupan COMMERC "/IU9 Z-LAJ--� - Type of lishment: Des' ow: ous/day S G trap pre nt: (yea or no) dustrial W Holding T present: (yes no)_ Non•sani waste disc to the Titl system: (yes or no)_ Wate eter readings, vailable: Last date of occupancy: 1� OTHER 1y(Describe) - A Last date of occupancy: GENERAL INFORMATION, PUMPING RECORDS and source of information: f vMPlNI� PRoVit)SD 13Y ' Lidr,.-r oLoTTI Co System pumped as part of inspection: (yes or not Q 5 If yes,volume pumped: a gallons Reason for pumping: C 1 to N TYPE OF SYSTEM F Septic tank/distribution box/soil absorption system °- V Single cesspool s J5 EE' PLAN b VOverflow cesspool 2. .q and '1 co. Privy Shared system(yes or no) (if yes, attach previous inspection records, if any) �— Other(explain) S E L E Sc"(c5 C c�na SE(>jg(a k-ri SAS T C1r55 OOL. See pl&vl e 4t w-a t e o�q e s 40 w\ APPROXIMATE AGE of all components,.date installed(if known)and source of information:' l t4 AFL Y C)AA1 PTV —�."�_ov�'�FLoW C.r�;S:t?.c�o L.•' Qvt-L.� �-�. Sewage odors detected when arriving at the site: (yes or no) lho INS A (_L � (L (revised 11/03/95) 6 I a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: t+o- M 1 L 1-(E 'D owner. MRS. .{�v6ER1 � 1` A, O CAP�t3/�RA' Date of Inspection: APRs L 3� �� 6 t CESSPOOL ovep, 'Low P.v0L (locate on site plan) t T Depth below grade: cZ .�—�o�J v C�VP�t' _ _ __ �ct� I 0 ..�DQ Material of construction:_concrete etal_FRP_other(explain) Dimensions: 1 oyG Q r e lo2w = a : � c3 deep Sludge depth:_a� Distance from to of sludge to bottom of outlet tee or baffle: p „ g� ��— scum thickness: Distance from top of scum to top of outlet tee or bafflers 7 ylV elf k U 11'111 j NVef f Distance from bottom of scum to bottom of outlet tee or baffle:—, f-Q 11'l V 2 Comments: (recommendation for.pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet inve. , structural integrit , evidence of leakage, etc.) �'. S 2 Wl --apt U Y►t e d o l- 0. 10 11 -- ; o {�► ,A vi k s 1 O U`- e YO -44 - -•o 5A 0 12 f-- .e . t u o t vset 1'`e aukupling . GREASE TRAP:_K0 (locate on site plan) Depth below grade: a Material of construction: concrete_metal FRP other(ex ). Dimensions:Scumthickness: ce.from of scum to top of utlet tee or baffle: ce fro tom of scum to ttom of outlet tee baffle: e endation for p ing, condition of inle and outlet tees or baffles, depth of liquid level in relation to outlet:invert, structural integrity ce of leakage, a .1 (revised 11/03/95) 6 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 4 -1, N l L t4 E kD , 0-6-1 1✓RU 1 L Le Owner. 'I1 ROBEiP— MAYO C AR�ARA� Date of Inspection: " P�1 L D) SYSTEM FAILS: t'� -1-` I have determined that the system violates one or more of the following fail criteria as defried in 310 CMR 15.303. The basin for hie determination is identified below. The Board of Health should be ro ctwi to determine what will be necessary to correct the ackup of sewage into facility or system component d to an overloaded or clogged SAS or cesspool Disc ge or ponding of effluent to the surface the ground or surface waters due to an overloaded or clogged SAS or ceaspoo. Static liquid 1 el in the distribution a above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in ce 1 is less 6"below invert or available volume is less than 1/2 day flow. Required pumping more 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times punt Any portion of t e Soil Absorption vstem, cesspool or privy is below the high groundwater elevation. Any port' of a cesspool or privy is wit • 100 feet of a surface water supply or tributary to a surface water supply. An rtion of a cesspool or privy is within a ne I of a public well. Any portion of a cesspool or privy is within 50 feet a private water supply well. Any portion of a cesspool or privy is less than 100 feet b ater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been anal to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds,ammonia nitrogen d nitrate nitrogen. El LARGE SYSTEM FAILS: The f owing criteria apply to large systems in tion to the criteria above: The system es a facility with a design ow of 10.000 gpd or greater(Large System)and the system is a significant threat to public health and safe, d the em ir•onment use one or more of the following conditions exist: the system is ' hin 4 feet of a surface drinking water supply the system is wi 0 feet of a tributary to a surface drinking water supply the syste located in a m gen sensitive area (Interim Wellhead Protection Area(IWPA)or a mapped Zone Il of a public water pply well) The owner or opera of any such system shall bring the m and facility into frill compliance with the groundwater treatment program requirements of 3 CMR 5.00 and 6.00. Please consult the 1 regional office of the Department for further information. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Address: '�. 1 L 1-4� D, `/6 112--VZ V A L L1�7 Owner. M R S (Zo t3 E RT M A '(0 C-uA�43ARp►, Date of Inspection: TIGHT OR HOLDING TANK OKO (locate on site plan) Depth below grade: Material of construction: ncrete .metal F _.9ther(explainj Dimensions Capacity: �_—_ ons Design w: gallons/da level: mments: (condition of inlet tee, ndition of alarm and float switches,etc.) t DISTRIBUTION BOX:_'(0 (locate on site plan) Depth of liquX1bve outlet in rt: Comments: (note if vel and distribut' is equal, evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER 2j O (locate on site plan) Pumps in working otde es or no) Comments: (note con ' 'on of pump chamber, dition of pumps and appurtenances, etc.) (revised 11/03/95) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ` SYSTEM INFORMATION(continued) ~ Property Address: a M ii t-,V4. ;2� , �5-1 f ^V t LLE . Owner. Date of Inspection: AYQ° :01-\ SKETCH OF SEWAGE DISPOSAL SYSTEM: -:r l O Q 01 C include ties to at least two permanent references landmarks or benchmarks j locate all wells within 100' �, J - ; rc�� REAV" o f HODS Lij rf) WOOD T)EcK � I � 0- ov1=Rr LoW 9- C-E55. MAI?s i a �'c� conc, C>�55 PO(D L 5 AS cover . CeVesr �1'L' • 'rep e-C)Y1C , DEPTH TO GROUNDWATER / Depth to groundwater: .:-feet c V method of determination or approximation: -�ro vv,, l ems/ (revised 11/03/95) 9 I-o of cover Top o� cover 9 p of covzv- P aQ la r . (3 00 ' L 9 y 3 7-ANK �� I �Ivdge S AS - SfvC�c�e 1 mfotS - - VatvM PUMP�� C s=5.5 CA.. , 4, LEGEND a Z. Route 28 0: O p 99 PROPOSED CONTOUR m LET Ef18 99 PROPOSED SPOT GRADE Rd ,t e MAP l J�� °ke V°11ey n S River ° x �'`•,� ��:, { —`— 4-(� —� EXISTING CONTOUR � oq Road 4 � PARCEL GAS 30•23 EXISTING SPOT GRADE Rd s Vo11e ; N L�.C, 9755 D x �` 18,694-tS.F. o TEST PIT 'y W; EXISTING WATER SERVICE e'ca o Se uil Rd s7 O \ LOCUS O 112 r '} x 1 �u ..r .....' 770 SA s: •� WSTOP�GE LOCUS MAP N.T.S. PROP GENERAL NOTES. = ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL TIP i 44' � "" BOARD OF HEALTH AND THE DESIGN ENGINEER. ro;S P ELF 109'� J 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS c� , OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 4\ ,C? Cq LOCAL RULES AND. REGULATIONS. ca �' 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE EMTIN6 C£SSPOMS Deck rfi���� DESIGN ENGINEER. To be pumped & SECOND FLOOR FlUed with sand r, Q _f� r` 4° ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING (see notes 9 & 13) co . FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN Ico n ENGINEER BEFORE CONSTRUCTION CONTINUES. x• - EXI�rING ENT. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. a 4 BEDRDM 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF. ,r I HOUSEe42) r° rfr BD•RM�• BATH THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF BENCHMARK ; r,fl,F.-2Q9 28 Q �KC D1N.RM. HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. ca p 7. WATER SUPPLY PROVIDED BY TOWN WATER MAIN. P OF CONCRETE LBO.BULKHEAD CORNER , 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S. x `108__P-EL• 108.76 (asaumed) ` x / L14 9. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND r " W UNSUITABLE MATERIAL IN THE AREA BENEATH AND FOR 5' ON ALL SIDES f — OF THE S.A.S AND REPLACE WITH CLEAN COARSE SAND FREE FROM CLAY, 1p6 ' ENT. FINES OR OTHER UNSUITABLE SOILS AS SPECIFIED IN 310 CMR 15255(3). FIRST FLOOR 10. ALL AREAS CLEARED FOR CONSTRUCTION ARE TO BE LOAMED AND SEEDED UPON COMPLETION OF CONSTRUCTION. 11. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE �f xi0& I THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING FLOOR PLAN CONSTRUCTION, f `- J,1J I 12. PROPERTY LINES SHOWN HAVE BEEN COMPILED FROM EXISTNG DEED AND MONUMENTATION AND ARE APPROXIMATE ONLY. THEY DO NOT �100.00' _ s REPRESENT AN ACTUAL ON THE GROUND PROPERTY LINE. SURVEY. f S 08'48'40' W 13. CONTRACTOR IS RESPONSIBLE FOR LOCATING ALL EXISTING CESSPOOLS, PUMPING AND FILLING THEM WITH SAND. =E e of pavement D SEPTIC SYSTEM REPAIR UPGRADE CU p� c� � Co iDD ""�� L, � � o PETER T, , McENTEE 42 M I LN E ROAD, OSTERVI LLE, MA m �IILN�' R0�4I> o CIVIL ' ' No. 35109 ---" SI ��O Prepared for: Doug McMaster, 42 Milne Road, Osterville, MA EGIE �. Fss G\ Engineering by: Surveying by: SCALE DRAWN JOB. NO. Engineering Words Terry A. WarnerP.L.S 1"=20' P.T.M. 18-=02 23 Deer Hollow Road 22 Long Road - J Forestdole, MA. 02644 Harwich, MA 02645 DATE CHECKED , SHEET NO. (508) 477-5313 (508) 432-8309 2/1/.02 P.T.M. 1 of 2 } l t { a ; -- .� ELEV. TOP .. NOTE. TO PREVENT BREAKOUT, THE PROPOSED FOUNDATION FINISH GRADE SHALL NOT BE < EL.106.5 (Existing) FOR A DISTANCE OF 15' AROUND THE =109.28t I FINISH GRADE: 109.5 PERIMETER OF THE S.A.S. 1'08.6 (EXISTING) EL 1 O8.3t /-EL 109.5t MAX. CQVER OVER S.A.S. 36" MAINTAIN 2% MIN SLOPE OVER LEACHING AREA !' INSTALL H-=20 RISERS W/ HEAVY DUTY STEEL FRAMES k COVERS OVER INLET AND OWLET !' L 10' W/ TRIMS STET TO FINISH GRADE L - 19' 4" SCHI RFD PVC 4" SCH 40 PVC6'1131 L 4' M 'S= 2Y. cMTN,7i` 4" SCH 40 PVC 10' 14. E S= I .. CNIIN) a S= GMIN,> CELLAR FLOOR " PROPOISED a a o o " R e m o a e a a " o 0 0 o a v o 0 '1500 GALLON INV.EL-106.40 a o o e SEPTIC TANK Ib BOX INV.EL-106.217 IPIV.EL.=106.04 INV.EL=106.00 INV,EL=10B.65 1' 5 INFILTRATOR 3050 UNITS= 37.3' TIE IN TO 4" C.I. IINSTA�L INLET & OUTLET TEES 1' PIPE 6' OUTSIDE GAS BAFFLE TO BE INSTALLED ON CELLAR' WALL OUTLET TEE AS MANUFACTURED 6Y EFFECTIVE LENGTH 39.3' INV.EL:106.85 I TUF-TITE, ZABEL, OR EQUAL SOIL ABSORPTION SYSTEM PROFILE rLTA SEPTIC TANK 8c D-BOX SHALL !BE 'SET LEVEL AND TRUE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED BREAKOUT EL. = CHAMBERS ARE TO BE LAID 106.50 ,s 4' LAYER OF STONE BASE, AS SPECIFIED IN 310 CMR 15.221'(2). PIPE INV, EL. = 106.00 DOUBLE WASHED STONE SEPTIC SYSTEM PROFILE - EFF. DEPTH = 2' - DOUBLE 1/2'WASHED STONE (3) 5 DIA.OUTLETS BOTTOM S,A,S. EL. 104.00 2• N TS' 5 MINI ABOVE BOTTOM OF 3' 4.2' 3' -LEVEL ON A SAND BASE T•P, EXCAVATION OR G.W. 99.00 EFFECTIVE WIDTH 10.2' 15 5 6. SOIL ABSORPTION SYSTEM SECTION 2 NLt Q0 SUBSTOU1E A TUF-TOTE 4HD2 HOPE D-°BOX (H-10), 3 - 20' Dio. Covers 'OR EQUAL. DESIGN CRITERIA Qom~` 5'-8" I SO1RE LOG NUMBER OF BEDROOMS: 4 BEDROOMS 0NTH 1 C SOIL. TEXTURAL CLASS: CLASS DATE: FBRUARY 1, 200 DESIGN PERCOLATION RATE: 2 MIN./IN. 2 fl� Af SOIL EVALUATOR: PETER T. MCENTEE P.E. DAILY FLOW=DAILY FLOW: 330 G.P.D. GARBAGE GRINDER: NO PETER T yG o . � SEPTIC TANK REQUIRED: 1500 GAL. CAPACITY d McENTEE I Elev. TP Depth LEACHING AREA REQUIRED: (440) = 594.6 S.F. " CIVIL N 6' Dia. Inlets 4" 6' Dia. Outlets 109.0 p" No. 35109 FILL .74 p 1os:s A 5• USE 4 INFILTRATOR 3050 UNITS AS SOWN LOAMY SAND 10YR 3/2 SIDEWALL AREA: _ 10.39.3 + 2' X 2' 1 .0 S.F. 4.5" ®tip ACCESS PORT FOR iNSPEC110N. 2 98 95,' 1o8.t g LOAMY SAND 91" 130TTOM AREA: 39.3' X 10.2' = 400.9 S.F. 89.5 5'-8" 4'-7 48"Liquid Level 4,_¢„ TDYR 3/4 TOTAL AREA: 598.9 S.F. INSTALLED LENGTH 4" 3" 107.5 Ci MED. 5AN0 18' 1.... ..... •: •., :.. . 10YR'5/3 DESIGN FLOW PROVIDED: 0.74(598.9) = 443.2 G.P.D. 105: 42' - 30" 1500 GALLON CAPACITY H-20 LOADING c2 FINE SAND 5 2.5Y5/6 SEPTIC SYSTEM REPAIR UPGRADE C3 42 M I LN E ROAD, OSTERVI LLE, MA ' 950 INFILTRATOR 3050 INLET ENO 103.5 i 6®" NOMINAL CHAMBER SPECIFICATIONS (OPEN,) MAY SUBSTITUE WITH AN ENVIROPLUS FINE SAND RIBBED POLYETHYLENE SEPTIC TANK, 2.5Y 7/3Prepared for: ou McMaster, 42 Mile 0 terville MA D n Road s SIZE (W x. H x INSTALLED L) 50" x 30" x 89.5" (H-10) OR EQUAL. 99.0 120 WEIGHT 80.0 LBS. Engineering by: Surveying by: SCALE DRAWN JOB. 140. CHAMBERS SEPTIC TANK NO G.W. ENCOUNTERED Engineering Workv Terry A. Warner P.L.S. NTS P.T.M. 18-02 PERC RATE: 2 MIN/IN. "C" HORIZONS 23 Deer Hollow Road 22 Long Road MAL N.T3. Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. (508) 477-531,3 (508) 432-8309 2�1�02 P.T.M. 2 of 2 F I