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0045 QUAIL ROAD - Health
45 Q Osterville Quail �o4( ). A=117-013 � r n �1 Q TOwN•OE EAS NvSTABLE DP 1,6 a tr,�r e:a pq � + N I• r .0 :PEDESTAL s— N cv 27X22 0 i W �\ CY) ' , ;i ' .53 . � ©S�_.-� - �-/tee s/���.►�/2 • 2 9 4 n -. I-.___ -_�__�..- ___-•- .. 3,3311 in SHOWER AREA - I i - i 35" X31 —33 3 „ : PEDESTAL c� 27X22 © ; IN ;.. ----------.....__ ..-.__.... --- ---._......_..._....--_............_...._..._.._. 5311 : TOWN OF BARNSTABLE LOCATION �37 SEWAGE# ZOo 1^ (� VILLAGE ns#en LA -ASSESSOR'S MAP&PARCEL 10 - 1 ,3 INSTALLER'S NAME&PHONE NO. Cade w tde f,'J g2g - Cie)z 9- SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 17h Clsn o fa ' , ,���(size) s vc 43.7 NO.OF BEDROOMS OWNER NSA4 .' n6 W�, v PERMIT DATE: COMPLIANCE DATE: lei Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) �1 � �,,,, Feet FURNISHED BY CL tom"�J� ' %1- ) LL C t LEI -,c i TOWN OF BARNSTABLE <� T i�>—WrION �9 �� J / SEWAGE # � � e VfLLAGE ASSESSOR'S MAP &LOT R NAME&PHONE NO. icJ SEPTIC TANK CAPACITY AV LEACHING FACILITY: (type) d 1C / c� (size) /410 NO: OF BEDROOMS BUELDER OR OWNER PERMTTDATE: 7`—`L COMPLIANCE DATE: Separation Distance_Between the: I - Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist I on site or within 200 feet of leaching facility) i V Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 fee of leac ' ',4� Feet Furnished by \ T to, II r: � f J� TOWN OF BARNSTABLE LC'%ATION IV &9? 4 SEWAGE # VI+LAGE ® /���e�L ASSESSOR'S MAP& LOT D STALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACIL=: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum'Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private WaterSupply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by _ _ J.. I� ``��� � I t � ���� � �- Qs� P `� � � �� � � i�� ,r� � h � _ -- ,� _ ;; i No. 1/ } Fee v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN Ur BARNSTABLE, MASSACHUSETTS Yes Rppltratton for 30i!5po!6o1 *pztem Con5trurtton Vermtt Application for a Permit to Construct O Repair(4 Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. y 5' QV lAl L rt c,44 Owner's Name,Address,and Tel.No. A• Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Ca4etw4,1v Eh Ic1,47 PCs Designer's Name,Address and Tel.No. +eti►G�.�.'c a v�+'f 4h4✓c L. . Type of Building: &D��n^� f © /� fe Dwelling No.of Bedrooms �" Lot Size oZ17�� f sq. ft. Garbage Grind ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �/ Design Flow(min.required) �"l C� gpd Design flow provided q�T • —7 gpd Plan Date 0 g Number of sheets Revision Date Title Q,y,a Size of Septic Tank OQ p 42X;3 Type of S.A.S.(720 ';Fa g_ ej2j Description of Soil Nature of Repairs or Alterations(Answer when applicable) ti X/1I f,it, s:A101?z )_*"1e_ /b A) e-i -D - �13oX '[�u -rw o (2) ra'i_1 eS_ 13i1� - 1� 1�-cfSo� Date last inspected: 7-,0o2 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 Health. Signed ce Date. 6 ' t GP Application Approved by Date �„ T/t_ —(j!J Application Disapproved b Date for the following reasons Permit No. Rvo Date Issued 10 0 No. O V ! y Fee Entered in computer: t' THE COMMONWEALTH OF MASSACHUSETTS p PUBLIC HEALTH DIVISION - TOWN _OF-B-ARNSTABLE, MASSACHUSETTS Yes 21pprfcation for 33t,5poal 4>%tem eons tructton Permit Application for a Permit to Construct( ) Repair(4 Upgrade(' ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. �� '• •��vst-�/� Assessor's Map/Parcel 11113 V)�I � `t l'e• Installer's Name,Address,and Tel.No.C.ta 7vJ J,.. (.,4+[", 1C S Designer's Name,Address and Tel.No. J. L �u2_ 1 .1 I✓vr3aA 7c y Z6��([ Y�fnt,Ps� 15 Type of Building: / � J �( MJ U& J U - C��I�^� Dwelling No.of Bedrooms % Lot Size S 3 7 S 4 sq. ft. Garbage Grinde ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) L4"-(y gpd Design flow provided 7 Y • —7 gpd Plan Date 1 p Number of sheets Revision Date Title u _ Size of Septic Tank UO jI- �7 Type of S.A.S.( � SQLJ (t?SS r-(own CC-) Description of Soil Nature of Repairs or Alterations(Answer when applicable) (" )r J,4z, }- F�1/C % ✓L /o /r��-�� -Tu 7L,_)O Z1 5S7,A ?ei-sC TL-o Date last inspected: v o� Agreement: J 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 atertificate of Compliance has been issued by this Board of Health. Signed, Application Approved-by ! m le- - Date Application Disapproved b Date for the following reasons Permit No. Do'/ Date Issued — — 0 01, T THE COMMONWEALTH OF MASSACHUSETTS NeM ®�9 BARNSTABLE, MASSACHUSETTS .5- ,j ,,,,,-kCerttficate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (y_) Upgraded ( ) Abandoned( )by d J�11-6 ESA K f Of •S C S C C at /Z o 4-y 05 (-C e..1 0 P has been constructed in accordance /t with the provisions of Title 5 and the for Disposal System Construction Permit No. �� 00 q' I'N dated b Installer ,A 0AA_A e_�x Y IJ 1 c Designer ) , C . Qu )t D A-,, ,� J t #bedrooms (_/ Approved design flow I(//U gpd The issuance of this permit shall not be construed s a guarantee that the system wtfrT-u-lsti n s designed. Date „� % �'l� � Inspector f ! , Fee- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS x1h5 pour �&pgtem Construction Permit Permission is hereby granted to Construct ( ) Repair O Upgrade ( ) Abandon ( ) System located at U ✓?,V, d a and as described in the above Application for Disposal System Construction Permit.The appJ.icant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. 1 Provided: Construction m{tst be completed within three years of the date of this permit. t, Date f /0� • Approved by ° � ol r t F Town ox .sarnstame Regulatory Services i tR nLt p Thomas F. Geiler, Director "'"9'' Public Health Division I'hamas McKean, Director 200 Main Street,Hyannis, MA 02601 . Office; 508-862.4644 Inst�t Ber & Desl._ aner, ertiticatian Fgrm Date: 9' 2 .0 `] , Uesi� tern C-� theect n G.�__._ Iastallet• -�.c� %w _ ---� Address: zb.C>y CrOVOOCcr t b►wc, _. ' .�__.�__. _. Address: ` C;tS* Wo(-On tam Hf} 6Z 53 f;On - �rc, was issued a perrriit to install a (installer) - septic system based on a design drawn ;. . - �G dated yh I certify that the septic. system referenced above was installed substantial the design, which niay include minor approved changes such as lateral rel cati;., distribution box and/or septic tank, W I certify that the septic system referenced above was installed with major greater than 10' lateral relocation of the SAS or any vertical relocation of any cc: of the septic system) but in accordance with State & Local Regulations. pjwl 1C, certified as-built by designer to follow. tiL iv;t (Designer's (Ai es )vLE S N. U 1 H agnor's arraFi F l ere j i F c UR a IF.k i1 I, A 'I-!. , Q Health/Septic/Desijmar Certification Fon11 10 •d 2920 21LZ 809 SNI2133NIDN30r Wd TZ: S0 600Z-tPT-d3S Commonwealth of Massachusetts W Title 5 Official Inspection Form. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' M 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information S14 forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name P.O.Box 763 Company Address Centerville Ma. 02632 City/Town State Zip Code (508)428-4028 S14454 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 6/16/2009 Inspector's Ignature 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. Ll l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town 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 septic system is in proper working order at the present time. 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•09/08 Tile 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, 45 Quail Rd (system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than %day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. CityrTown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS,cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be•considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems,you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins-09/08 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 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No ®, ❑ Pumping information was provided by the owner,occupant,or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® 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): 1 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Tftle 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 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town state Zip Code Date of Inspection D. System Information Description: The septic system consists of a 1000 gallon septic tank,1 Cesspool,and one 4'leaching pit. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d NA 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 6/16/2009 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 117 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Quail Rd (system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ❑ No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank,distribution box,soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes,attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is Osteryille Ma. 02655 6/16/2009 required for every page. Cityrrown State . Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 1 feet Comments(on condition of joints,venting,evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank(locate on site,plan): 6" 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: 1000 gallon Sludge depth: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 45 Quail Rd (system right side) Property Address A.D.Whittemore Owner Owner's Name information is psterville Ma. 02655 6/16/2009 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 30" 1" Scum thickness 7„ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 13" Measured How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Pump septic tank every two years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank appears to be structurally sound 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-09/08 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 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches,etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 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.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber,condition of pumps and appurtenances,etc.): Soil Absorption System(SAS)(locate on site plan,excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Forth: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 M 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1-4' ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ® overflow cesspool number: 1-6'x8' ❑ 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.): Sandy dry soil.No signs of hydraulic failure Leaching pit dry at time of inspection with stain line 28 below invert. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration 1 Depth—top of liquid to inlet invert 24"below invert Depth of solids layer 0 Depth of scum layer 0 Dimensions of cesspool 6'x8' Materials of construction concrete block Indication of groundwater inflow ❑ Yes ® No t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 45 Quail Rd (system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) , Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Overflow Cesspool has been fuul at one time.New leaching pit was installed off cesspool. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Map Page 1 of 2 Town of Barnstable Geographic Information System.. Parcel Viewer Custom Map Abutters Map Size ■ ■ Zoom Out 1 1 1 1 1 I,In Pft KL R ' C t a 1 q O y V 3 a3 38 . a 20 Fee ; ...... Set Scale 1" =1 20 I Aerial Photos I MAP DISCLAIMER r`nnvrinhf)nnA_7M0 Tn.,.of R—fahln KAA All rinhfc—..na httn•//www tnwn hnrnctnhlP ma nc/arnimc/anndPnann/man acnY9nrnne.rtvTT)=1 17011Rr.man Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. Citylrown 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: Bottom of CP 4.2' Bottom of LP4.7' 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: . As-Built ❑ Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 45 Quail Rd.(system right side) Property Address A.D.Whittemore Owner Owner's Name information is required for Osterville Ma. 02655 6/16/2009 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary:A, B,C, D,or E checked ❑ Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ❑ System Information—Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Town of Barnstable � of P# �pl Department of Regulatory Services wuveTeat:, : Public Health Division DateMASS 200 Main Street Hyannis MA 02601 rF0 Date Scheduled r"Vv?Time Fee Pd. Soil Suitability Assessment for S age is oral Performed By: MlemAEG r,mFNrE� �.0.� �,�, � rum Witnessed LOCATION& GENERAL INFORMATION : Location Address i,f 6'a J A;j_ j,A 4 Owner's Name 7j)a,j L,+f �STt41 iil� Address 11 33Cv,i2f- '114•rca C 4/a z? F/ 33 9 7.7 Assessor's Map/Parcel: 117/01 . Engineer's Name NEW CONSTRUCTION REPAIR °/ Telephone# `/"ZF Y o'—V Land Use 110510C-1 O tj L.AWP1 Slopes(30) Z"5`�u Surface Stones N 14 Distances from: Open Water Body >IGa ft Possible Wet.Area ft Drinking Water Well ISO ft Drainage Way `010 ft Property Line 9 td ft Other a. ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 5fe AnAC+aEp 'Pt ANs Parent material(geologic) OurwASH ?IAItil Depth to Bedrock >IZp" �•G.S• Depth to Groundwater. Standing Water in Hole: >ILG �.C+.�• Weeping from Pit Face Estimated Seasonal High Groundwater >110 rZ.Co•S. DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: "biQFrr OfftEUAron1 Depth Observed standing in obs.hole: in, Depth to soil mottle: '_Ito 6GS in. Depth to weeping from side of obs.hole: > SG in, Groundwater Adjustment ft. Index Well# — Reading Date: Index Well level Adj,faetor Adj.6—widwnter Level n PERCOLATION TEST bate 12116196 Thne LO:tS AJY Observation Hole# t Time at 4" — - Depth of Perc 2(0-''14� Time at G" Start Pre-soak Time @ Time(9"-6") End Pre-soak /� 2 Rate MinJlnch Z Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) A/ Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at.least one(1) week prior to beginning. Q:SEPTICAPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% ravel 21`-2t: A LoAllay SAwO t6yR ;�t ZG"-5c, 3 MEOluot .9& L.60X DEEP OBSERVATION HOLE LOG Hole# a Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) V ttl. 2i'-2l0' A 10 YQ. 5Sti � IZo" C rv►EaoM SANG Z, G • . y �� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, a Grave DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Cons t n ,t Flood Insurance Rate Map: Above 500 year flood boundary No-- Yes ._✓_____ Within 500 year boundary No '� Yes Within 100 year flood boundary Noz Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? e S If not,what is the depth of naturally occurring pervious material? Certification I certify that on i0-L7-9 g (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,exper'se and experience described in 310 CMR 15.017. Signature Date Q:\SEVMOPERCFORM.DOC I s c DATE: 8./,2'Q%96: PROPkRTY ADDRESS:_15 Quail Road RECEIVE 0.sterville,Mass. AUG 2 19s6 '02 6 5 5 HEALTH G:a�� TOWN OF BAF;,..a' On the above date, I Inspected the septic system at the above Address. This system consists of the.following: 1'. 641,- IM gallon septic tanks. Z 2-61x8l block cesspools 3. 1-41 pre-cast leaching pit. Based bn my Insoaction, I certify the following conditions: 1 . :-This .is a-. title five septic 'system.:_,(: 78 'Co:de ) 2. Thisiis a .split'• system: 3. the septic system is in proper working ,order at the. present' time. _ 4. ' No repairs needed at 'the present tune. SIGNATURE: / Name. J P Macomber Jr, i . Company:_`.P_Macon)ber_ & Son•`Inc. ; Address: " __CentervilieLMass__0.2632 ` ,• Phone:---�aB--J_75,:3338______ '•1 THIS CERTIFICATION*DOES 'NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOM13ER & SON,. INC. i Tanka•CesspoolrLeschflelds Pumped & Installed i Town $ewer Connections P.O. Box 66' Centerville, MA 02632-0066 7.�3-3338 . 775-6A,12 s. Commonwealth of Massachusetts Executive Office of Environmental Affoirs Department of Environ mental. Protection , WUUam F.weld ooww . . Trudy Cox# ' Ar #o Paul 60"W P Uucc 0 G David B.Struh# LL Qawmot Conunlwbrw SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION 'ropertymaresa: 45 Quail Road Osterville,•Mass . AddrewotOwaer. )ate otInspeotton: 8/12/96 .i (If different) Unie of Inspector. Joseph P. Macomber Jr. :ompany Name,Address and Telephone Number. .P.Macomber & Son Inc. Box 66 Centerville,Mass. 02632 508-775-3338 1ERTIFICATION STATEMENT certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,atxusate nd complete as of the time of inspection. The inspection was performed based on my training and experience in the proper unction and taintenancs of ca-sits sewage disposal systems. The system: Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails ispector's Signature: � fl�L�/2 U .Date: Le System Inspector a submit a copy of this inspection report to the Approving Authority within thirty(90)'deys of completing this spection. 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 port to the appropriate regional office of the Department of Environmental Protection. he original should be sent to the system owner And oopies sent to the buyer,if applicable and the approving authority.. ISPECTION SUMMARY: Check A,B,C,or D: I SYSTEM PASSES: I have not found any Information which indicates that the system violates any of the failure criteria as defined in 310 CUR 15.303. Any failure criteria not evaluated are indicated below. SYSTEM CONDITIONALLY PASSES: One or more system components used to be replaced or repaired. The system,upon completion of the replacement or repair,pagees inspection. iicate yea,no,or dot determined(Y,N,or ND). Descry basis of dsterminatlon in all instances. U`not detarmiasd",esplala.pl;y not) ,dJ6 The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exilltration,.or tank failure is imminent. The system will pass inspection it the existing septic teak is replaced with a Foaforatiag septic tank as approved by the Board of Health. tvised 11/03/95) 1 One Wlntef Street # Boston,Massachusetts 02108 # FAX(617)U&I049 # Telephone(617)292-MM ��pmtd on Rwydd p&per I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontinued) Property Address: 45 Quail Road Oster..ville,Mass . Owner. Beverly Hance Date of Inspection: g/12/9 6 B)SYSTEM CONDITIONALLY PASSES(continued) 114aVe, Sewage backup or breakout or high static water level observed in the tion boa is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system peas inspection if(with approval of the Board of Health): broken pipe(&)are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four tiratii`u 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 CI FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: IVD Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT'rHE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: lip 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC 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 supply or tributary to a surface water supply. �Q The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tan:t and soil absorption system and is within 50 feet of a private water supply well. A)p The system has a septic tank and soil absorption system and is Is"than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free- from pollutidn from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or Is"than 5 ppm. 3) OTHER ' lid (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontinued) Property Address: 45 Quail Road Osterville,Mass.. Owner. Beverly Hance Date of Inspeotion: g/12/9 6 DI SYSTEM FAILS: , • JQ I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. d;j) Back-up of sewage into facility or system-component due to an overloaded or dogged SAS or cesspool. .w Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or doaaW SAS or cesspool. A iWe Static liquid level in the distribution boz bove outlet invert due to an overloaded or clogged SAS or cesspool. ,dZ Liquid depth in cesspool is less than 6"below invert or available volume is less than IN day flow. Required pumping more than 4 times in the last year NOT due to dogged or obstructed pipe(s). Number of times pumped_ Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. /0 Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone n of a public water supply well) The owner or operator of any such system shall bring the system and facility into full comps— with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for Anther information., (revised 11/03/95) 3 I ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST DY Property Address: 45 Quail Road Osterville,Mass. Owner. Beverly Hance Date of Inspection: g/1 2/9 6 • Check if the following have been done: 1:4umping information was requested of the bwner,oopu:aat,and Board of Health. . .,L rione of the system componer}ts have been pumped for at least two weeks and the system has been receiving normal ilow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ]�As built plans have been obtained and examined. Note if they are not available with N/A. , The facility or dwelling was inspected for signs of sewage back-up. ( The system does not receive non4anitary or industrial waste flow ,/The site was inspected for signs of breakout. f/All system components,iuding the Soil Absorption System,have been located on the site. , The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baMea or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. ,/The size and location of the Soil Absorption System on the site has been determined based on cdating information or approximated by non-intrusive methods. 2TThs facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sulu. Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION PropertyAddre" 45 Quail Road Osterville,Mass. Owner. Beverly Hance Date of Inspeotiou: g/12/96 FLOW CONDITIONS RESIDENTIAL- Design ilow• 5y d ns 0er day • Number of bedrooms:- Number of current residents: Garbage grinder(yes or no):-'ALS Laundry connected to system(yes or no):I Seasonal use(yea or no):_" pry Water meter readings,if available: /9k /a'dd /0 Last date of occupancy:Al2k COMM ERCIAL/IND USTRLAL: Type of establishment: /li4 Design flow:_,6 g lions/day Grease trap present: (yea or no)j&ZA Industrial Waste Holding Tank present:(yes or no)A29 Non-sanitary waste discharged to the Title 5° stem: (yea or no)djR Water meter readings,if available:_ A)di Lest date of occupancy: OV OTHER(Describe) Last date of oocupancy: GENERAL INFORMATION PUMPING 0 d source information• 7i �cr,�ozwh&>L&w -Z'-'e' System pumped as part of inspection: (yes or no)tie If yes,volume pumped: A&e gallons Reason for pumping: /40 TYPE 0�SYSTEM Septic tank/distributiori bWsoil absorption system c7 Single cesspool _A,10_ Overilow caaspdol _ !4 Privy I 7 Shared system(yea r n ) (if yes attach previous inspection repo er(explain) 2!// ) 7 APPROXIMATE AGE of all components,date installed (if known)and source of information- 'd /,t- Sewage odors detected when arriving at the site: (yea or no) (revised 11/03/95) 6 TOWN OF BARN STABLE, MAA:I ASSESSORS VAPI ?yam 2b pL O Y pox 1•� 10 10 c { Ill \ . Ili10 .47Ar �VI /.9aa L Cn .jBAt •v., {7�J I •p y,11. ,W 13 SS.G. 22i 1 o w P' S,• B w 10 � ?D ?I .c. t1.C. �1 .71 Ac. .O.C.. ,{'`{4,S'`` I 'y •1 rot r.o. ~,f f rn Uf 'l t ro 1r4 f' rro m 151 150 no 1 •! .1S.C. .9Ac. 149 - 146 .+..c. AQAC. 1A5 146 35.95IL .c 1 y i 3 f j „` Ij PREPARED UNDER THE DIRECTION OF THE - SARNSTASI.E BOARD Of ASSESSORS '234 1y,L1.� t 1 AVIS AIRMAP INC. i 1 CONNECTICUT ~ - .MASSACHUSETTS _ . 17 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C- SYSTEM INFORMATION (continued) Property Address: 45 Quail Road Osterville,Mass. Owner: Beverly Hance Date of Inspection:8/12/96 SEPTIC TANK;1400911111� (locate on site plan) Depth below grade-.-„_ Material of construction: concrete_metal _FRP_other(explain)aw Dimensions: i i• y e1 Sludge depth:-' Distance from toek!jludge to bottom of outlet tee or baffle:2�ZC- Scum thickness:_ (nA--e, Distance from top of scum to top of outlet tee or baffle:;?!;�EL Distance from bottom of scum to bottom of outlet tee or baffle.— � Comments: (recommendation for pumping, condition of inlet and outlet tees or baffle. depth of liquid level in relation to outlet invert,structural �rity, evidence of leakage, etc.) Pump s 41ptie- tangy e-r;�y WatQ rig? .dis asa3 resent• Pum other se tic tank s• Tn Ln o t on tan i t signs of leakage. GREASE TRAP. /�py� (locate on site plan) Depth below grade:,149 Material of constrlortlon; W zoncrete_metal_FRP other(explain) Dimensions- AW _ Scum thickness;. . „ Distance from top ul scum to top of outlet tee or bafile:_IV& Distance from bottom nr Srum in borlom of oullel lee or baffle!_ r Comments: (recommendation for pumping, condiori of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, eu i., _ - IV") (revised $115195) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ProperVAddresa: 45 Quail Road Osterville,Mass./ j Owner. Beverly Hance Date of Inspection: 8/12/9 6 TIORT OR HOLDING TANI-&API& ' (locate on site plan) • Depth below ZEE Material of construction;dconcrets_metal_FRP_other(e:plain) vh Dimensions:_ /U Capacity: ons Design 11ow: ona/day Alarm level: Comments: (condition of inlet tee,condition of alarm and float sv+itches,etc.) DISTRIBUTION BOXs)VLfle (locate on site plan) Depth of liquid level above outlet invert:_ Comments: (note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box,etc. x�7 a PUMP CHAMBER:,d,&C (locate on site plan) Pumps in working order:(yep or no) 12, Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) til w. (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Address: 45 Quail Road Osterville,Mass. Owner. Beverly Hance Date of Inspection: 8/12/9 6 SOIL ABSORPTION SYSTEM(SAS):,_ (locate on site plan,if powthL;excavation not required,but may be approximated by noniatrusive methods) It not determined to be present,explain: Type: leaching pits,number.t , . leachiaS chamber4,number: •� ' ::. leachia galleriA number; leachtag trenches,aumber,hutAL leaching gelds,number,dimensions: overgow cesspool,aumber: L Comments:(note condition of soil,signs of hydraulic failure,level of poadir,&oonditiou of vegetation ow.) e CESSPOOLS: (locate on site plan) Number and conggaration•.� Depth-top of liquid to inlet invert: Depth of solids layer. Depth of scum layer. Dimensions of cesspool: Materiel of ooaatavction: �, rc-T ncs Indication of groundwater: inflow(cesspool must be pumped as part of inspection) Comments:(note o0adition of soil,signs of hydraulic failure,level of pon&&condition of vegetation,etc.) PRIVY:Q1p (locaio on site plan) Material of construction: /1//fi Dimensions. Depth of solids:- j0— Command (note condition of soil,signs of hydraulic failure,level of poadin&condition of vegetation,etc.) (revised 11/03195) 8 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ,FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L_SPOSAL SYSTEM: include ties to at least two permanent references landmarks. or benchmarks locate all wells within 100' Centerville,Osterville Marstons Mills Water Company 428-6691 DEPTH TO GROUNDWATER _ depth to groundwater m.�th�od of determih ion -or a proximation: No we _afit`Ar_1hi.gna1 ,system was installed. i � pp W _ sbyY '3r71 THE COMMONWEALTH OF MASSACHUSETTS' DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT :roseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the. title CERTIFIED TITLE. 5 SYSTEM INSPECTOR, as .pr'ovided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. June 8, 1995 Acting Director of the ' ' ion of Water Pollution Control i A; vp a•wnffrnf—nfrlr-lT'fenraw•r+tAR'nrta�+RaRrNrfT�rnpAr**rrt+f mrnL fnl�+rtinwT TR7t'�r�.1r*m":i.1r.r— TOWN OF Barnstable BOARD OF 11EALT11 ' SUBSURFACE SEWAGE. DISPOSAL SYSTEM INSPECTION FORM - PART_ D•- CERTIFICATION v �"'4t'1-T•:"t:f—T.1171�T.TT1l1'Inll'It.'.T(T9ltflltlf/tt�tJ.T.rt•iT'IVnITfl7AT1�T't�.�fr.�t.�'�� ttI111 MP�'r'1►'11+i -TYPL OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 45 Quail Road Osterville Mass. ASSESSORS MAP, BLOCK AND PARCEL # 117-13 OWNER's NAME Beverly Hance PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME J.P.Macomber & 9�iinc. COMPANY ADDRESS Box 66 Centerville,Mass. 02632 Street Town or City state L1P COMPANY TELEP11ONE S0 ) - FAX ( ) - .R177ta11■fat.R1RCRTfIITl�Rt�tO 08 775 3338 508 790 1578 BfattJ CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system al this address and that the information reported is true, accurate, and complete 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 . • u i Ilti{.t, Check one: : CXXXXXXXX,'System PASSED The inspection which I have conducted has not found any informati on 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* The inspection which. I have conducted has found that the system fails to protect the jiublic health and the environment in accordance with Title 5 , 310 CMR 15 .30.3, and as specifically noted on PART C - FAILURE CRITERIA of this inspection form. Inspector Signature14Ld114Wz1, Date _8/2•b/96 One copy of this certification must be provided to the pWNER, the BUYER (where applicable) and the DOARD OF HEALTH. i... * If the inspection FAILED, th'e owner ornp operator shall upgrade 'the System. within o'ne year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 CMR 15 . 305 . ' 4 Z V Y �ZQ ULLI . 4 --------------------------- ,v-i•x;o-s-------------------------- - i --------------- -- ---- ,' g W L' ------------- --- -� � m m z qt 6 ---- --' -" - W � Ul { LL m l Q5 ---- ---------------------- ---- oj . ----------------------------- --- - ---------¢'n-K•Q:4------------'___ Q -4 -------------- 4-1 } ' - i I S A. jl�,, t� Vl/�f`�7 a 4✓a�'�(yG���. H L fO CAT 10 SEWAGE PERMIT DLO. ;VILLAGE > IRSTA LLER': HA ADD-RESS F RTSL tlDCn�v aI GUILDER d OR OWNER DATE PERMIT ISSUED '.D.ATE COMPLIANCE ISSUED 01V _1 R vgd � � 3 V 2 J �Y TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS. ASSESSORS MAP NO. l PARCEL NO. T1 ADDRESS: s Loco � �p VILLAGE: 0;��v 17AME;._..�Q•W,-Qs. 4"— Li_ �� . -cm�_-. _`�ej).oy .,....5�r �$avicp J - CONTACT PERSON c 'G!-Mer 6 4� 44-Ggiy1 -,J'C' PHONE NUMBER LOCATION OF TANKS: APACITY: . ..TYPE-.OF- FUEL AGE: TYPE: LEAK OR CHEMICAL:. DETECTION SYSTEM; C left- DATE OF PURCHASE OF EACH: -1. � 9 SO + 2. 3. 4. 5. DATE OF FIRE DEPARTMENT PERMIT:112-9—to TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. 'O i o C� ^ Iol U v� �� �i. l O `v � C�` �I,�f l V �,Nygjb V .\v^�+� MW ` �; �J"e,�` O ., ��99 NO......- .................. FEB.............................. 013 ,r,n THE COMMONWEALTH OF MASSACHUSETTS ri 1 BOAR® OF HEALTH ................... .................OF...-.....-...........-.......:---..__.- Appliratinn for Uhipas al Works Tongtrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: -- ----------------------------------- ---------------------= .............................................................. Loca ion-Address '® or Lot No. L-:..-C'{�Id.. 1. ...... .................... 0-�_Aset �-sc....---......0..............---------.............----... �j Ow Address ........ .,...._.••........ ..................... Installer Address Type of Building Size Lot___.........................Sq. feet V Dwelling—No. of Bedrooms.___.___ .._._Expansion Attic ( ) Garbage Grinder ( ) �+a — Other—Type of Building ____________________________ No. of persons............................ Showers ( ) Cafeteria ( ) d Other fixtures .................................................... ---------------------------------------- ------------------------ -----------------------•---- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.............gallons Length................ Width................ Diameter__-_____________ Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-, Percolation Test Results Performed by--••-----•••••--••--••---•••--------...:................................. Date........................................ Test Pit No. 1___.............minutes per inch Depth of Test Pit.................... Depth to ground water........................ 93, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' -----------------------------------•----....-----------------------•------------•---•••-•••••_-_-_--................................-------------_----------- 0 Description of Soil...........................................................................................................................•- W - V --------------- ------------ ---------------- ------- ------------------------------- •------ __--------------------------- ------------------- ----------------------------------------- _--•-- W U Nature of Repairs or Alterations—Answer when applicable.......Ift.1.0Q......OAVV.._._.� ..... W ______- Agreement: - t The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITIE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance ac hP issued b the he lth. Signed••• ..... �` L -- ----- - ---- -------•-------------- -----t-Ca Dat e Application Approved By..•••--•-•-•--•--•-----if�A..... .......................... Date Application Disapproved for the following reasons--------------------------------•--------------------------------------------------------------------......_..... . ----------------------------------------------------•---••-----•---_.._..•---------......._--•-._.._._._..---•--•--•-••------•--•----•••---------••--•-•....................................................... Date PermitNo......................................................... Issued-----------------------------------•-•--.............. Date POW,— No......eul_"� YmB 7r*e.........-1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ .............................OF.......................................................................................... ip Work s Ton rurtion rrutit tit P Appliratiou for Bit osal Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ........................................... .................................................................................................. Loc tion-Address or Lot No. ..................... ................. ....................................................................... 0 pe Address ..................... Installer Address Type of Building.,, Size Lot............................Sq. feet Dwelling—No. of Bedrooms...._..I I................................Expansion Attic Garbage Grinder 04 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria PL4Other fixtures,.....................................................................11................................................................................ W Design Flow.............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width._............._ Diameter_........._....:Depth............._.. Disposal Trench—No. ................... Width..............._._.. Total Length___........... ... Total leaching area....................sq. ft. Seepage Pit No-----------------_-- Diameter.___._._._...._..... Depth below inlet.................... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) 04 Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. 1................minutes pe> inch Depth of Test Pit...........__....._. Depth to ground water-.--_-_______._......... t-_4 �T4 Test Pit No. 2................minutes per inch Depth of Test Pit..............__.... Depth to ground water.........._............. P4 ............................................................................................................................................................. 0 Description of Soil....................................................................................................................................................................... U .......................................................................................................................................................................................................... ............................................................................................................................................................................................... ------- U Nature of Repairs or Alterations—Answer when applicable.`_-_.V3'0 ............................. ......X_eee.-e..... jcp.. ........................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'11 TALS 5 of the State Sanitary Code—The undersigned further'agrees not to place the system in operation until a Certificate of Compliancre Las bxm issued d b thebeafd-of lie I h t Signed ............. .... .. Date ....... Application Approved By........ Date Application Disapproved for the following reasons:............ ....................................................................................... ........................................................................................................................................................................................................ Date PermitNo................................................... IssuedL....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF....................................... .................................... murdifirate of Toutplittuirr THIS IS TO. CER—TIFY, Tat the Individual Sewage Disposal System constructed or Repaired by----------------------- ......................................................................................... .................................... Installer at....................... .......444�-------- ................... .....................................................................I........... has been instilled in accordance'with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__ ......... dated---.' .......................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED Al A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................................. --- Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................0 F................................................I................................... No......................... FEEI.57............... p,�Vion "r rutit Permission is hereby grpted.................... .................. ------------------------------*--------------........... ......to Construct �/ -ror�Repa�.Se,�an�ndivid eivage DispoA 5yjaem at No. ----------------*-------------------------- ----------------------------*............*-------- Street as shown on the application for Disposal Works Constructiop-Pprmit No..................... Dated,.._...._._....................._..'....' ................................................................ ------------------------------------ i Board of Health DATE..........................I....... ............................................... FORM 1255 A. M. SULKIN, INC., BOSTON PROVIDE PRECAST CONCRETE GENERAL NOTES T.O.F. EL.= 21 .9' '�' EXTENSION RISER WITH CONCRETE INISH GRADE OVER D-BOX= 18.5± FINISHED GRADE OVER SAS= 18.72' - 16.1 O' -PROPOSED VENT WITH CHARCOAL COVER TO WITHIN 6"OF F.G. OVER FILTER TO ABOVE GRADE INLET AND OUTLET COVERS. REMOVABLE COVER OVER RISER TO 1. UNLESS OTHERWISE NOTED ALL SYSTEM COMPONENTS AND CONSTRUCTION ___ __ _.___ __._.__ _ ____. __.__ _ __ _ ____ _-____ ___ _--_.___ ___ _ METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE FINISHED GRADE __ ____ @ FND. EL.= VARIES -_ FINISHED GRADE_OVER TANK EL. = 20.9't 5"DIA. OUTLET(S) CODE AND ANY APPLICABLE LOCAL RULES. 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE ACCESS PORT WITH BOX TO F.G. ACCESS PORT WITH DESIGN ENGINEER. - - PVC SEWER PIPE 36"MAX. SEE NOTE#21 (ONE PER TRENCH) TF BOX TO F.G. (TYP) 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL EXISTING 4'° D 4 SEWER PIPE TOP OF BIODIFFUSER I &BREAKOUT= SYSTEM UNLESS OTHERWISE NOTED. - g6' 3" 3"DROP MAX " ^ PROVIDE WATERTIGHT i 14.22' -- 2"DROP MIN 3 9 MIN.SLOPE 1% JOINTS(TYP.) 4. _ BREAKOUT, EVENT BREAK E PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN L _ ELEVATION 14.22' FOR DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 10" - 4"PVC IN FROM - f__ __ __ __ __ __ _ __ __ __ _ __ __ __ __ _ _ __ __ 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF -� 14" ' `�*15.9'-} SEPTIC TANK 4" PVC OUT TO _ _ THE LINER IS NOT LESS THAN THE BREAKOUT r • LEACHING FACILITY = - 1 16"(TYP) UT ELEVATION. _ _ _ __ _ .33 EA O 10 - -- --70-94- 11.3-(TYP) 5 SLOPE ALL SOLID PIPE AT 1.0% MINIMUM CONTRACTOR CONTRACTOR SHALL \ 1 rj,QQ' MIN. 14,83' 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF OUTLET TEE BOTTOM = AND CONDITION OF EXISTING TEES - - - 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK EXISTING SEPTIC AND REPLACE AS MODEL#A1801-4x22 OVER MECHANICALLY 1289 22"ZABEL FILTER 6"CRUSHED STONE , ' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS � � � TANK NECESSARY NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 3 COMPACTED BASE 6.25'(75") EFFECTIVE LENGTH (TYP.) 5'MIN. 2.83'(34") 5.66' 2,83'(34^) AND DESIGN ENGINEER. OUTLET DISTRIBUTION BOX 43.7' FOR FIRST TRENCH I 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 15.50' ESTABLISHED _ 'TO BE INSTALLED ON A LEVEL STABLE 37.5 FOR SECOND TRENCH BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV.= < 770' 11.32' EXISTING` _ ON A NAIL SET IN AN OAK TREE AS SHOWN ON PLAN. . , ---�, 1,000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION BIODIFFUSER PROFILE VIEW BIODIFFUSER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT SEPTIC TANK PROFILE CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES *CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR DISTRIBUTION BOAC DETAIL H-20 16" HIGH CAPACITY ADS (#1600BD) BIODIFFUSERS DETAIL S TO THE DESIGN ENGINEER. TO ANY WORK & NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. _ NOT_T_O S_CA LE ___ _ _ NOTE: ENTIRE LOCUS IS LOCATED WITHIN A DEP APPROVED ZONE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING j ( ° � • (�• i TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM f7 • , I APPROPRIATE AUTHORITY. iwi i ~ c• • • PERC NO. 12433 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS G1r, f 7 S S z' S �• a w 1r LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE • INSPECTOR: Donna Z. Miorandi, R.S. THEY SHALL WITHSTAND H-20 LOADING. f 4 EVALUATOR: Michael Pimentel, E.I.T. •''� o 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. MAP 117 �^��'�17�n �M �e� ��f•�,,�-, c� S��S_ �L �,y L,�.�.°,.�✓..�,4;� i / � DATE: December 10, 2008 ( p I TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE 1r MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. PARCEL 177 j,I ('��' ?p fv ?j.k c�,i��p ��.4,-�;V- 4"", � �' • Jr � ELEV TOP= 17.70' µ QUAIL ROAD f ,/� t - s * REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, ELEV WATER= <7.70' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). (40'WIDE LAYOUT) w `�` t^°t � d (,L fG•n i a• r EXISTING 1,000 GALLON 0� id \ 3' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN d "` •• . . PERC RATE _ <2 min./inch \ SEPTIC TANK TO BE UTILIZED \\ ,' . ° . . SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. AS PART OF THIS DESIGN /�-`�_\ IX 1 w : • o w• •„ DEPTH OF PERC= 26"- 16.i / PROPOSED PROJECT IS LOCATED WITHIN. 'T/C EXISTING LEACHING PIT TOI " a �•. ' t r \, E,T, a t a • TEXTURAL CLASS: 1 ASSESSORS MAP 117 PARCEL 13 4, `', �T BE PUMPED AND FILLED WITH - �a/r� CLEAN, COARSE SAND Y rr * • ° - OWNER OF RECORD: DOUGLAS A. &KIMBERLY WHITMORE O LOCUS 8 ADDRESS: 1433 BUTTERFIELD COURT PROPOSED DISTRIBUTION BOX 00 • •"� • • 0 17.70' \ \� FELINE g " , , Fill MARCO ISLAND, FL 33937 \ \ \ ) PROP. 16 - H2O 16" HIGH CAPACITY n \ < ' ;.� �\ , G . 22" 15.8T FEMA FLOOD ZONE C ADS (#BD1600) BIODIFFUSERS l ..� R _ � r s • , Loamy Sand �c 3 A 10Yr 3/1 COMMUNITY PANEL# 250001 0016 D " �Rr PROPOSED ACCESS PORT(TYP OF 2) / - - �' • ; r ,- -__ __ . 26" W 15.54' 17. DEED REFERENCE: BOOK 10428 PAGE339 k ' �► \ �Ac \ `// .. ••, Perc r; c r •ti . . • 44" 14.04' 18. PLAN REFERENCE: PLAN BOOK 196, PAGE 153 \\ HG1 t . `F �o� 4 6 51,10^E +� t1 a • " ` �� • • ISO Medium Sand 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. E� ) 't 2651j. MAP 117 �► •p • • ��f. i ° O �� ; �•"� B 10Yr5/6 Benchmark - PARCEL 16r •• '• • • f{ • ' • : 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY \ ( 9 . •• • `r� �� * • FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY Nail in Tree ( _ / � "`rrr - • r -DTP 1 � \ Elev. - 15.50' i � �> � � ` " * � . 58" 12.8T FOR USE,,-OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.\ I I • o� � \ (1 17.7 \ - J A Pox. M.S.L. •--_'-`- an I I � ,II • N #45 I :; � �r 21. IN ACCORDANCE WITH 310 CMR 15.401 - 15.405, THE FOLLOWING LOCAL UPGRADE J._.:..� z S \ �.. •' APPROVAL IS REQUESTED FROM 310 CMR 15.211: EXISTING I \ I I pit 1.) A 1.5'(4.5'-3.0')WAIVER FROM MAXIMUM COVER OVER PROPOSED LEACHING FACILITY. 5-BEDROOM ��-� �� 3 �4� Medium Sand DWELLING s ' ' I C 2.5Y 6/6 -WETAREf LOCUS PLAN (Loose) f "�, cry MAP 117 TOF 21.9'± / ` .,. / ro O \ N REMAINS D FLAG PARCEL 14 % / H - e/�o o �� , I SCALE: 1"= 1000' 120"1 7.70' No Mottling, Standing or Weeping Observed \ DECK / ( O� \ ' -18� 2 'o� DESIGN DATA LEGEND O \ � I TEST PIT DATA PROPOSED PVC VENT �iL� O PIPE; EXACT LOCATION I 'oo� 'A \ NUMBER OF BEDROOMS (ASSESSOR) 5 PERC NO. 12433 \ I PEROWNER - O 4 I I NUMBER OF BEDROOMS (DESIGN) 4*(SEE BELOW) INSPECTOR: Donna Z. Miorandi, R.S. 50x0 EXISTING SPOT GRADE rn \ ` \ \ - - 50 - - EXISTING CONTOUR \ cP I DESIGN FLOW 110 GAUDAY/BEDROOM EVALUATOR: Michael Pimentel, E.I.T. MAP 117 \ \ / �� _ _ �� ?� \ WETLAND FLAG REMAINS TOTAL DESIGN FLOW 440 GAUDAY DATE: December 10, 2008 50 PROPOSED CONTOUR PARCEL 13 \ I ` DESIGN FLOW X 200 % = 1100 GAUDAY 52,759 S.F O TEST PIT 1 T E/T/C EXISTING UNDERGROUND UTILITIES \ \ O� 1 USE EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP= 16.50' A rn W W- EXISTING WATER LINE \ y , ELEV WATER= <6.50' Aj WETLAND FLAG REMAINS INSTALL 13 - H2O 16" HIGH CAPACITY ADS (#BD1600) BIODIFFUSERS � PERC RATE _ .�. TEST PIT LOCATION �o DEPTH OF PERC r�\ / - \ SYSTEM CAPACITY Lp EXISTING LEACHING PIT MAP 117 PARCEL 168 - TEXTURAL CLASS: 1 (TOTAL LINEAR FEET OF TRENCHES)(7.90 SF/LF)(0.74 GPD/SQ.FT.)- GPD _ O O EXISTING 1,000 GALLON SEPTIC TANK -WET AREA- \ m (81.2')(7.90 SF/LF)(0.74 GAUSQ.FT.)= 474.7 GAL. LEACHING/DAY 0" 16.50' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE Fill TOTALS: 22" 14.67' ❑ PROPOSED DISTRIBUTION BOX A Loamy Savid TOTAL NUMBER OF BIODIFFUSERS: 13 26^ 10Yr 3/1 14.34' PROP. H-20 16" HIGH CAPACITY(#1600BD)BIODIFFUSER I b TOTAL LEACHING AREA: 641.5 SQ.FT. CO - N TOTAL LEACHING CAPACITY: 474.7 GALJDAY s oM, � \ � o cis N REV. DATE BY APP'D. DESCRIPTION Medium Sand _-___ __.-_____._--_..____. ----- ._- _-.-- ----___-----`-__- MAP 117 B 10Yr5/6 PROPOSED SEPTIC SYSTEM UPGRADE PARCEL 22 EFFECTIVE LEACHING AREA OF 7.90 SF/LF OBTAINED FROM THE N75.1j'30 DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER 58" 11.67' PREPARED FOR: 264 95, CERTIFICATION RAINAGE SYSTEMS, INC. ON OCTOBER 3,, 2003(LAST CAPEWIDE ENTERPRISES ADVANCED D MODIFIED JULY 23, 2008). TRANSMITTAL NUMBER=W000052. MAP 117 LOCATED AT PARCEL 20 Medium Sand 45 QUAIL ROAD C 2.5Y 6/6 *EXISTING SAS LOCATED ON THE RIGHT SIDE OF THE EXISTING HOUSE HAS A (Loose) OSTERVI LLE, MA CALCULATED SYSTEM CAPACITY OF 330t GPD(per 1995 Title V). THE PROPOSED ---- - SWING TIE MEASUREMENTS SYSTEM PROVIDES 474.7 GPD RESULTING IN A TOTAL OF 807.7 GPD(i.e.330+ SCALE: 1 INCH = 20 FT. DATE: DECEMBER 11, 2008 474.4),WHICH IS GREATER THAN THE REQUIRED DESIGN FLOW OF 550 GPD FOR 120" 6.50' 0 10 20 40 80 FEET DESCRIPTION HC-1 HC-2 A FIVE(5)BEDROOM HOUSE,THEREFORE OK. No Mottling, Standing or Weeping Observed,of BIODIFFUSER CORNER(1) 33.3' 40.2' 'r� JOHNS PREPARED BY. RESERVED FOR BOARD OF HEALTH USE � cH �Ni,i `�� JC ENGINEERING INC. 0 4 C7 BIODIFFUSER CORNER(2) 77.0' 57.5' c v 2854 CRANBERRY HIGHWAY BIODIFFUSER CORNER(3) 71.9' 62.2' NOTE: EAST WAREHAM, MA 02538 BIODIFFUSER CORNER(4) 35.7' 51.5' SITE PLAN 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG 508.273.0377 SCALE: 1"=20' P EDGE OF EACH SEPTIC SYSTEM COMPONENT. Drawn B : BSM Designed B :JLC cn Y 9 Y edced By.JLC JOB No.1539