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HomeMy WebLinkAbout0130 SEA VIEW AVENUE - Health (4) 130 Sea View Avenue Oster-ille A= 162 - 019 V, t Commonwealth of Massachusetts /lOa" 0/9 �m I� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ro u 130 Seaview Ave r Property Address r Owner Wianno Club( Stables dorminatory) p ; information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City�Town State Zip Code Date of Inspection 'k 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` A. Inspector Information When filling out p forms on the computer, use Douglas A Brown only the tab key Name of Inspector to move your D.A.Brown Inc cursor-do not Company Name use the return key. P.o Box 145 Company Address 16 Centerville Ma 02632 City/Town State Zip Code 508-420-4534 S14297 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 11-4-19 Inspe Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 110,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Seaview Ave Property Address Owner Wianno Club( Stables dorminatory) information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: At time of inspection this system met or exceed all passing requirements. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 ears old is,available. P 9 Y ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . 130 Seaview Ave Property Address Owner Wianno Club ( Stables dorminatory) information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Citylrown, State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 130 Seaview Ave v Property Address Owner Wianno Club ( Stables dorminatory) information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts I1F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 130 Seaview Ave Property Address Wianno Club ( Stables dorminatory) Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. CityTTown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow El ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® 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 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CM 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design,flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts iip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments v 130 Seaview Ave Property Address Wianno Club ( Stables dorminatory) Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® 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? I ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official. Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments j 130 Seaview Ave Property Address Wianno Club ( Stables dorminatory) Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 3440 gpd Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Description: system is a designed for a dormitory with a design flow of 3440 gpd Number of current residents: Does residence have a garbage grinder? ❑ Yes ❑ No Does residence have a water treatment unit? ❑ Yes ❑ No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ® Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Detail: Wianno club has separate documents on water usage Sump pump? ❑ Yes ❑ No Last date of occupancy: seasonal Date t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts �. iip Title 5 Official Inspection Form l to Subsurface Sewage Disposal System Form Not for Voluntary Assessments 130 Seaview Ave Property Address Wianno Club( Stables dorminatory) Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: dormitory Design flow(based on 310 CMR 15.203): 3440 Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if availab�e: attached separatey Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Facilities manager states pumping anually Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped:. gallons How was quantity pumped determined? Reason for pumping: maintenance t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4� ~^6 � 130 Seaview Ave Property Address Wianno Club( Stables dorminatory) Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): dosing system Approximate age of all components, date installed (if known) and source of information: 3-6-06 per as-built Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. 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: feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a � 130 Seaview Ave L Property Address Owner Wianno Club ( Stables dorminatory) information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 3 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal list age:ge: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 11,000 gallon Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 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 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.): tank was functioning properly at time of inspection. Tank is on a regular maintenance pumping schedule. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts rm lip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Seaview Ave Property Address Wianno Club ( Stables dorminatory) Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 4 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: El concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts e Title 5 Official Inspection Form (/t Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4'n v 130 Seaview Ave Property Address Owner Wianno Club ( Stables dorminatory) information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts �n itF Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4� 130 Seaview Ave Property Address Owner Wanno Club ( Stables dorminatory) information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No* Alarms in working order: ® Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): 7000 gallon dosing tank. * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 2 at 48x50 ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts �m Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Seaview Ave Property Address Owner Wianno Club ( Stables dorminatory) information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Area of leaching system showed no signs of failure. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts 'd I Title 5 . Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 130 Seaview Ave Property Address Owner Wianno Club ( Stables dorminatory) information is Owner's Name required for Clsterville Ma 02655 11-4-19 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 130 Seaview Ave Property Address Wianno Club ( Stables dorminatory) Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts 1n iip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Seaview Ave v Property Address Wianno Club ( Stables dorminatory) Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: e 8 ft from bottom of s.a.s no gw encountered 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: attached Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Attached design plan. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts �m Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 130 Seaview Ave V Property Address Wianno Club ( Stables dorminatory) - Owner information is Owner's Name required for Osterville Ma 02655 11-4-19 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria)and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION Ave. SEWAGE#01046-9'0/ VILLAGE 'Ile ASSESSOR''S/MAP&PARCEL XQ/619 INSTALLERS.NAME&PHONE NO. _IILLC�-/�S%cam 549 S�dB-5s A9 SEPTIC TANK CAPACITY J/O00 &�S. �(,H A0J LEACHING FACILITY:(type) (size) oZ A%:8 X 50, NO.OF BEDROOMS v OWNER D rki PERMIT DATE: 3 -6-0 d 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 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 s a— a4' 31' 14�- Liou 43' oe2 g 0113 fq __7 t 71 http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=162019&seq=2 8/20/2018 r PtivmaOvv�gpmnA�aC®ouvmama0.mnc�uxq�xuWirydYc 3-0M<-03 6.500'112.0 OPM0 29.00 Pr •I �Iwu vnmgtlttavl•enree -- r�l. x-iou•.9'.r• I DOSING CHAMBER VOLDME �L P_ a . WASH/N4TON � STREET d:•n:� •` :•�.ai.e ww. Is.w. s u �x /_� �. LOCUS PLAN / .—� �\ � - .w.,..w x��,... a..ImP.eMrax DIxr,Irr•AP rs/ � -T � —-,��<on.acnox lT.xl � rN urewvumw.rz. �' lAl Arco�2.sTP[ .w...e,....o.=a.M.. �/� �x.,_ _ �\\ \ ,e S_� �":.rd �a •.x.r�xw. x......K......�... .�..�... „v ,At Jl.,'IsAN ..E -40 O _ 19_� rxx••_LtLCTON VIEW SEAV/EW AVENUE xl x•' ^^ s ir Al- PLAN slow .. I ff .,.. I .... H° Fe•i�.. ,„ �k_ � ,s� �J ID=tloen Sl,do e.ImF.wx.m na.nN.®xNaz rw w.e oa OVERALL LOCUS PLAN i.•q+m.�a..w.e r.e..anr..m.eem l.n.w�r. j�dtw��'� i.`e.�avm,m.`�"`i.� lo G egw..w Fn,P®F ,uweaum. �e..L xxPs vOw.ETAILS c•vn`mva.�Mxw - _ e..,. ....�., a.1..o �_..- - c I� I �'�•i� ax .. ®xs -dw .� as x .>e .., TABL,:�DdEN6IDN5w. M1 _ � . onrb,lirpl I wxm 0vxl urx.•o.Mm. E nc srsrEM DEAIax IT MANIFOLD OETNL 'o = u.ca.w•e�.w x-xo SITE PLAN SEPTIC SYSTEM REPAIR AT 150 SEA VIEW AVENUE L-- _----_—J I �_ -----__—� wa"� OSTERVI`NCL S. I THE WIANNOCL UB L i SCAlE A55NOMN DATE S1 I3,1-1�_J Pl oxxcnw.mrmrrr�Pwa Wert.aeonwwsb.ems mw..ww.�.. SVIOVERWxEESINt. s u ggnnon . DEVELOPED PROFILE OFPROPOSEDSEPTICSYSTEM ,m Pm SeUR$DOSED FIELD s m -o° w.usrara M..umoomxvm xx w5.xx 3 3 o f 1HE►� Town ofBarustable Dep.114111eut of Regulatory Services BABNBrABIJ. f Public Health Divisloll 1639 `d$ ZUU Main Strccl,Hyannis MA 026UI "/eo inns" Date Schedulcd hcc 1'd.= l v[�,[)�I_ Soil SuitabilityAlssessme' it for JSTeivage ,Dis oral Performed Dy:�UI I►Yan ))�(/r)Ci/1 �)`► .1,hCL WitnesscJ lly: LOCATION & GENERAL INFORMATION Location Address , Owner's Name r IrGE/)�g 61 e uL /30 .SaLvj� %)✓e . . �j s der Y ,I/r- Address 00. 0 'r8 a y g Assessor's Map/Parcel: I -4 Eugiuccr'sNaroeSC.�I��Ylil) NEW CONSTRUCTION REPAIR �� Telephone 11 J Grrt' �l✓��}'" j�' '/`� Land Use QgnjjfQi t jt '' lA` Slupes(%)- 0—S 6K0 Surface Stones 0A Distances front: Opco Water Body q00 fl Possible Wet Arca c? —_11 Drinking Walcr Wcll Il i Drninage Way c fl 1'rolieUy Line It Otlrcr�� It { SKCTCII:(Stree(mmne,dimensions of lot,exact Incntious of,tesl holes&litre tests,locate wetlands in proximity to boles)- . .. $t1lNutpN <•�r� � i. VJ P p 1 . CIA— . -3 I c I<s r Pamilt material(geologic) Dcplb to Buttock 0 s DepUr to Gruundwater: Standing Water in Ilule: /VOAE Wccping front l'it Fnce �l 1 p Estiulntcd Sensounl l ligb Groundwater i(p_S C- , _ DETERMINATION FOR SEASONAL HIGH WA'I'LR TABLE• Method Used: jkh e- Sc2 Depth Observed standing in obs.bole: in. Dcplb to soil mottics: Depth to weeping from side of ubs.iota in. Groundwater.Adjushuent Il. Index Well N Reading Date: Index Well level Adj.factor Adj.Groundwater L.cvcl PERCOLATION TEST Date`( r otQ Time Observation, .� tole rY Z Time at 9" Depth ofrere yZ 3( 37 Time At 6" Start Pre-sonk Time© ZS (Ocsl`av►S I'insc(9"-6") End Pre-sonk 5ti-,45^ (e^klxSCC Rnlc Min./Inch n She Suitability Assessment: Site I'nssed, Site Pnilcd: Additional Tcsting Needed(YIN) Original: Public IIcn11h Divisiun 4 Observation l lole Data'l'o Fle Completed on Back----------- ***If percolation test is 16 be conducted within 100' of wetl;uld,you 111t15t first Ifotify (lie Barnstable Conservation Pivision at least one(1) weel( prior to beginning. O:I11?AI TII/WIP/I'I;ItCFORM ', I'I'El Ell OBSERVATION HOLE LOG I.I:ull: It-- Depth frmrt Soil flutizon Suil Textrua Soil Color Suil Ulhcr 511rAcn(111.) (USDA) (Munsoll) Molding (5lruclnro,SAnws,Uuuldcls. - �=�4ttuS1ss41L4v "" rnvcD. -- 0—g ; skN lo1l��ly 13 Zit l oy y/ D 24-Rd �- srw -Z�s`( to DEEP OBSERVATION HOLE LOG hole/I Depth from Soli Iforizon Soil TcxIurc Soil Color Soil Othcr Surface(in.) (USDA) (Munscll) Mottling (S(ructure,Stuncs,I)uuldcrs. Consistulcy %Gravcl)rp — O-S — ,r S-8 3w s� toYl�31y -- DEEP OBSERVATION HOLE LOG hole 11 � Depth front Soil Horizon Soil Texture Soil Color Soil . Olhcr Stance(in.) (USDA) (Munscll) Molding (Struclurc,Stones,Boulders. tt , DLLP"OBSERVATION HOLE LOG Hole 11 Depth from Soil Ilutizon Suil'rcxturc Soil Color Soil 011icr Surface(111.) (USDA) (Munscll) Molding (Slrtnchuc,Slums,Uuuldcls. _S J�IISis1C-1 CLq cl) )Flood Insurnncc Rate Mnp: Above 500 year flood boundary No, Ycs y Within 500 year boundary No✓ Ycs Within 100 year flood boundary No ✓ Yes Depth of Natul•ally Occurring Pervious Ma(crisll Does at(cast four feet of•naturally occurring pervious tunterial exist in all areas obseeved thrvughvut llle area proposed for tine soil absorption systcm7 yP" If not,what is the depth of naturally occurring pervious material? certiticalion I certify flint on I (datz)I have passed the soil evnluntor examination approved by the Department of l;nviroilmentnl Protection and that the above analysis was perrurnied by me consistent will, the required training,expertise and experience described i13 10 CMR 1.5.017. Signature Date Q:I WALTI UW ref t_'RCroilM r Massachusetts Department of Environmental Protection 100100310 Bureau of Waste Prevention—Air Quality Decal Number Project Revision Notification For Asbestos Notlflcation ANF-001 and AG 06 When filling out A. Facility Location forms on the WIANNO CLUB-WAYSIDE BLDG computer,use . _. only the tab key 1.Name of Facility to move your 130 SEA VIEW AVE' cursor-do not 2.Street Address use the ream MA key. BARNSTABLE 3 city4.3tate 5.Zip Code 5082747SU 6.Telephone Number INSTRUCTIONS S. Project Cancelled 1. This form Is only available for Check here If this project is/was cancelled. online Illing of project data - revisions. 2. al Enter number. C. Project Dates decal number. 3. Validate that 01129/2010 01/28/2010 the project 2.Original End Date fmmlddhnrw) location Is correct 1.Original Start Date(mm/ddlyyyy) for the entered 01/27/2010 01127/2010 decal. 3.Latest Revised Stan Date(mmlddlyyyy) 4.Latest Revised End Dale(mealddlyyyy) 4. Enter your new project dates. 5, CenMi your noMcadon. D. Revised Project Dates Submit date changes. 01/28/2010 1.Revised Start Data(mm/ddIM) 2.Revised End Date Date(mmiddIM) E. Other Project Revisions F. Revision History _ ,-t EDEP:011201201012.21:23 PM IL? EDEP:0112512010 04:30:22 PM t `' 92 V! anf06pdm.doc•rev.216104 ;a Commonwealth of Massachusetts ■ 100100310 Ll Asbestos Notification Form ANF-001 DecalNuff4w hen ta"t WMen filling out A. Asbestos Abatement Description forms the computer,use 1 ®. Is this facility fee exempt-city,town,district,municipal housing authority,owner-occupied only the lab key residence of four units or Iess? Yes No to moue your cursor-do not b. Provide blanket decal number if applicable: Blanket Decal Number use the return key' 2. Facility Location: WIANNO CLUB-WAYSIDE BLDG 130 SEA VIEW AVE 6.Name of Facility b.Street Address BARNSTABLE MA 02655 (508)274-7584 . c.City/Town d.State e.Zip Code f.Telephone Number INSTRUCTIONS 3. Worksite Location: 1.al sections of this WAYSIDE BLDG BASEMENT form must be a.Building Name/Building Location b.SuUding 8 r~V ft d.Floor a.Room completed In ortfer to comply AM 4. Is the facility occupied? Yes No DEP notification requirements of 310 CMR 7.15 5. Asbestos Contractor, and the DiAslon of Occupational AIR SAFE INC 61 ENDICOTT STREET Safety(003) a.Name b.Address noticatlon requirements Of 453 NORWOOD 02062 7817623390 eme CMR OA2 c.Gtyfrown d.Zip Code e.Telephone Number AC000464 g.Contrad Type: V Written Verbal f.DOS Lioense Number h.Facility Contact Person i.Contact Prison's Title JAIME E AMAYA ASOBOB47 6' a.Name of On-Site Supervlsor/Fweman b.Supw*or/Foremen DOS Certification Number SAM COHEN AM060787 7' a.Name of Project Monitor b.Pto)eet Mw for DOS Cerftetion Number d ENVIROTEST LABS AA000128 a.Name of Asbestos Analytical Lab b.Aabeai06 AnaNfical Lab DOS Certlt)catlon Number 9 01/28/2010 01/28/2010 o a.Prolact Statt Data(mrNddlyyyy) b,End Deis(rnnddWyyyy) 0 7AM -SPM N c.Work hours Mon-FA. d.Work hours Set-Sun. 0 10, a.What type of project is this? o Demolition Renovation Repair Other,please specify: b.oes&E 11, a. Check abatement procedures: o Glove bag Encapsulation o Enclosure Disposal only Cleanup Other, specify: Full containment b•Describe z a 12, Is the job being conducted: r' Indoors? Outdoors? enf001ap.doc•10/02 Asbestos Notification Form•Page 1 of 3 Commonwealth of Massachusetts 100100310 Ll Asbestos Notification Form ANF-001 A. Asbestos Abatement Description (cunt.) 13, Total amount of each type of Asbestos Containing Materials(ACM)to be removed, enclosed,or encapsulated: 200 150 a.Tow pipes or ducts(Omer ft) b.Total etMr sufaoes(square it).' c.Boiler,breaching.dud tank so d.Irauladng cenfeM surf ca coaWW Lin.fL SO.It. Un.It SQ.ft a.Corrugated or layered paper 200 f.TmweW$prayw co&&Vs pipe insulation Lin.IL Sq.fL Un.fL Sq.R p,Spray-on Ilreprooing Un.fL Sq.fL n.Transits board.wall board Un.tt Sq.it I.Cloths,woven fabrics J.Olher,please specify. 100 Un.fL So.ft Un.R Sq.!L k.Thermal,solid core pipe GROUND DEBRIS Insulation Lin.ft. Sq.1t 1.Specify 14. Describe the decontamination system(s)to be used: 3 CHAMBER DECON 15. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): 6 MIL POLY BAGS 16. For Emergency Asbestos Operations,the DEP and DOS officials who evaluated the emergency, a.Name of DEP Official b.Titie c.Date(mnVddNyyy)of Authorization d.DEP Waiver! e,Name of DOS 0111cial F.DOS Official Tift a 9.Date(mm/ddNm)of AuMorization h.DOS Waiver! c 17. Do prevailing wage rates as per M,G.L.c. 149, S 26, 27 or 27A—F apply to this project? Yes of No ° B. Facility Description N 0 1. Current or prior use of facility: SOCIAL CLUB 0 2. Is the facility owner-occupied residential with 4 units or less? Yes V No SAME 3. a.Facility Owner Name b.Address v ' o c City/Town d.21p Code e.Telephone Number(area code and extension) CHRISTOPHER MAFFEI 4' a.Name of Facility Owner0s On-Site Manager b.On-Sits Manager Address �Z 609-2?4-73" < c.Cityrrown d,Dp Code e.Telephone Number(am&code and extension) , an=1ap.doc•10102 Asbestos NottAcallon Form• e 2 of Commonweaft of Massachusetts 10011003110 Ll Asbestos Notification Form ANF-001 Del Number B. Facility Description (cunt.) 5. a.Name of General CoMelor b•Address c.CRY/Town d.ZIO Code e.Telephone Number(area code and exrenslon) f.Contractors Workers Comp-Insurer 9.Policy Number h.Eim.Die(mm/ddt0W) 6. What is the size of this facility? a.Square Feet b.Number of floors C. Asbestos Transportation and Disposal 1. Transporter of asbestos-containing material from site to temporary storage site(If necessary): AIRSAFE Note:Transfer a.Name of Transporter b.Address Stations must comply with the C Clty/rown d.Zip Code e.Tele0wo Number Solid Waste Division 2, Transporter of asbestos-containing waste material from removalhemporary site to final disposal site: Regulations 310 CMR 19.000 a.Name of Transporter b.address c ClWrown d.Zip Code e.Telephone Number 3. a.Refuse Transfer Station and Owner b.Address c.City/Town d.Zip Code 9.Telephone Number 4. 1 NO REMOVAL..DISTURBING ONLY DHCDd a.Final Disposal Site Location Name b.Finai Disposal Site Location Owners Name NO REMOVAL.DISTURBING BOSTON c.Final Disposal Sft Address d•City/Town MA 02108 e.State f.,Zip Code g,Telephone Number 0 D. Certification N ' The undersigned hereby states,under the OF WALSH o b.Authorized Signature penalties of perjury,that he/she has read the a.Name , c Commonwealth of Mssuchusetts regulations VP for the Removal,Containment or a Poaltion/11tie d.Daft(mmlddlwvv) Encapsulation of Asbestos.453 CMR 6.00 and (701)?62.3390 AS 310 CMR 7.15, and that the Information �o contained in this notification is true and correct 9.Telephone Number f.Representing to the best of his/her knowledge and belief. 61 ENDICOTT o U.Xddrew NORWOOD 02062 h.City/Town i.Zip Code Z I� . a an1001 ap.doc•10l02. Asbestos Nottl1 atlon form•Page 3 of 3 TOWN OF BARNSTABLE LOCATION l30 Segv(`ecj BVe- SEWAGE#A�DDD'�/O/ VILLAGE d Sre cw c'll c, ASSESSOR'S/MAP&PARCEL l�Q/d 19 INSTALLERS NAME&PHONE NO. , SEPTIC TANK CAPACITY 000 1: /S . CW ab) LEACHING FACILITY.(type) (size) 02 9% !Y.S X Sd v NO.OF BEDROOMS 6 OWNER C/9 Q Cki PERMIT DATE: 3 '( ' 0 6 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 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 8► - \1 3 6 � x �-' celkat 14 z IL'p1�10 tr? 1 J3 g Y Ste°e TOWN OF BARNSTABLE 9LOCATION St,A ymw AVe - SEWAGE# VILLAGE OSTfU,16. ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY CtSf IAIR LEACHING FACILITY:(type) CL VP W IS At (size) NO.OF BEDROOMS OWNER WA G(U PERMIT DATE: 'AQ COMPLIANCE DATE: Separation Distance Between the: I Maximum Adjusted Groundwater�i66a'ble 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) Feet FURNISHED Z FOf 2 , �$ 4130 r �►ter - a i , 3 --/ -- :x7..:4*+ri+Lt.. �'+e�e � ,.. ,..r.--w...-_.r=�:_-. _._:���..-.�...r•,J..�._- ...� �.�e-.-.,.,�_,..�.-,....,. .. �._ .. '- - No. 1 THE COMMONWEALTH OF MASSACHUSETTS •Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for �Bigozal �&pttem Con.5tructiun Permit Application for a Permit to Construct( ) Repair 00 Upgrade( ) Abandon( ) ®Complete System ❑Individual Components Location Address or Lot No.1'3® SEA vl rC w AVE Owner's Name,Address,and Tel.No. 0STERvILL1E /►1AS5 WIAt4NO CLUB P.O. (Box '2 4 9 Assessor's Map/Parcel Z ® I q OStERV I LLC J I�IQ,SS Install ' Name, ddress, Tel.No. Designer's Name,Address and Tel.No.6o wifr-42S-334'1 I-.,��tcze0AV kd- SULLIVAP✓ hEty&IN EUTANlr INC 41,�8- c7 ST L.Rv 1�L E M A S S Type of Building: Dwelling No.of Bedrooms 'a-Ll Lot Size 2-6-7 Ac ss . Garbage Grinder V0) Other Type of Building poRM IToRY No.of Persons Showers( ) Cafeteria( ) Other Fixtures Z \A/ASk l NCB M AGN I NL'S Design Flow(min.required) 5 4 H O gpd Design flow provided 3 5 S Z C-P® gpd Plan Date SEPT. I'3, -2.00& Number of sheets Revision Date Title S l'T C FLAN - L..a ilia SE1�FTI C SY STE-FA RF-'PAI R Size of Septic Tank 1 1 J 0 00 &A/ L. Type of S.A.S. PIZE SSURC- Do5E D Sy STELA Description of Soil C CMA.VEL &A(ZDPAGIL 3 0R1<• YC-0I5; 1. QRN,LoAtAY SAPID 10YR S/41 DR%<.YEL%SH BR-1 . SAND L-oAM 10%/R 4A j 0Ll VE YELLOW mEQ SAND '1-SY 4/ Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental C de and not to place the system in operation until a Certificate of Compliance has been issued by this rd of H al Sign Date Application Approved by d Date Application Disapprovediby: Date -for the following reasons Permit No. Date Issued I 1'Y 1 i 005D� fir .= 44/ ` {No. Fee xt iTHE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS, application for �hgpogal *p5tem Construction Permit � Z�r >^•" Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ® Complete System ❑Individual Components Location Address or Lot No..13 0 •S EA VI E w AV t= Q S-ra R v 1 L L E M 5 S laOwner's Name,Address,and Tel.No. ,�IAPINo CLUB p.0. Sox 24q Assessor's Map/Parcel (0 2 O 1 q OSi•L RV I LLG� MASS f Installer's Name,.)�ddress,and Tel.No. ,- Designer's Name,Address and Tel.No. :5-0 -4�-S-3 34 y 4'1C SULLIVAN L-'NGIN L'RING- INC. !/�-5:� 7 r=ARI<EM RP ST 0� . OSTL RvILLL MAS5 Type of Building: Dwelling No.of Bedrooms -2-y/ Lot Size 2-,6-7 A sq-4. Garbage Grinder (No Other Type of Building" Do RM IToRY No.of Persons Showers( ) Cafeteria( ) Other Fixtures Z WA SH I f-C> MAC-PI WC-.5 Design Flow(min.required) , 3 y H U gpd Design flow provided 3 5 5 Z- C—P O gpd Plan Date S L'PT. 13, Zoo& Number of sheets I Revision Date Title SITL:- (PLAN - 6.i:-,T1C SySTCM REPAIR Size of Septic Tank I I) 000 GAL TypeofS.A:S. PRESSURC DOSED 51-/STEM Description of Soil _ C•2.A�/6L�{I4RDJ--A CY— IN DRI<• YG LII SH. ORN.LOAMY SAND 10 YR 3/H , OR(<. YE12tsw SRN, SAND LOAM taYR HAP 0LI V& YELLow IVILSD. SAND '1,5/ �fis ` Nature of Repairs or Alterations(Answer when applicable) 3 Date last inspected: t - Agreement: •'• The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title.5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Heal•vea,,�&"a g �'l Si ne es, Date Application Approved by ��1 f� / rl < � 1t41� �> `e /j o Date ,7 Application'D_isapproved by: / Date , for'.�he following reasons v i Permit No. Date Issued A THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( X) Upgraded ( ) Abandoned( )by S H0 2 1 I�\c Cj;11 I at 13o SEA view Ave , a sTi=RV I L L G, MASS has been co struct ' in accordance with the provisions soof'Title 5 and the for jDisp�osa'l.System Construction PermitNo��%� � dated Installer�)� C.�i � �I,FY�/,�1�;C ,r Designer SUL,-L►VAN ENGI►vLERs INC- #bedrooms �--4 Z WASN Itti� 1019CAW�S Approved design flow 3,�5 2-- / gpd The issuance of this /ple> nit �hall not b �onstruedd as a gnu antee that the system will'function as,desig//e/d. Date / �'l�x `7//J►�t/� lJ� Inspector ��� � L!// / -- U / No. C..''fC/ �------ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS lwigont �&p.5tem Construction Permit Permission is hereby granted to Construct ( ) Repair ( X ) Upgrade ( ) Abandon ( ) System located at 13 o S E A V I G w AV E, p s?"�RV I L L tr iy'1 r�s • wear, and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction mustbe c6mp ted within three years of the date of thi pz�it. Date J / Approved by ' Town of Barnstable, IA�NBTTiWt, • , J } Regulatory Services " Thomas F.Geiler,Director y Public Health Division h Thomas McKean,Director 200 Main Street, Hyannis,MA 02601. Office:508-862-4644 µ Fax: 508-790-6304' Installer&Designer Certification Form zoot, DaterH 1 2-S4o5- Sewage Permit# L4,0 i Assessor's Map\Parcel Designer:SraLL+vr�NGN&IiVEeRj►v 1 N� Installer: �2 c C-C_ Address:,o sT621/I 4=4-6 Address., pn 3-6-a � cc �'Ict,cr ��`s�7c was issued a permit to install a . (date) (installer) septic system at 13 c? se=A�s>�=w�d� �s �' r based on a design drawn by .�tiLL%Ylgf�' (address) F—NG•it,gertiey# i/ c'ldated (designer), f • , .`tea . � I certify that the septic system referenced above was installed substantially according to the design,which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. ; I certify that the septic system referenced above was installed with major changes (i.e.greater than 10' lateral relocation of the.SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan,revision or certified.as-b ' er to follow. • ����� .F (Installer's Signature) o� su 'T vAW No.297,33 _ �FG¢STE��G AL (Designer's Signature) (Affix Designer's Stamp Here). PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION.CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.THANK YOU. Q:Hedth/SeptidDesig=Certification Form 3-26-04.(Im COMMONWEALTH OF MASSACHUSETTS I ul EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Wayside Dorm Property Address: 130 Sea View Avenue Osterville, MA 02655 ' Owner's Name: Wianno Club Owner's Address: Date of Inspection: 42ril 25, 2006 Name of Inspector: (Please Print) James M. Ford .._, Company.Name: James M.Ford i Mailing Address: P.O.Box 49 T, _ Osterville.MA 02655-0049 6 Telephone Number: (508)862-9400 CERTIFICATION STATEMENT ' = I certify that I have personally inspected the sewage disposal system at this address and that the information reported � . below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CNIR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority ✓ F it Inspector's Signatu're: Date: May7 2006 The system inspector shall sub 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 1.0,000 r 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 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 1 a Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 130 Sea View Avenue Osterville, MA Owner: Wianno.Club Date of Inspection: April 25, 2006 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: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the % existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance ;+ indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to.broken or obstructed pipe(s). The.system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: . 2 h Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 130 Sea View Avenue Osterville, ILIA Owner: Wianno Club Date of Inspection: April 25, 2006 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 bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a -- surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. . The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from.a t private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for colifonn bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other . failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 t Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 130 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 D. System Failure Criteria applicable to all systems: You must indicate either"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 V2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone I of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [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.] Yes (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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) ' Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well i If you have answered"yes"to.any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.,The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 130 Sea View Avenue Osterville MA' Owner: Wianno Club Date of Inspection: April 25, 2006 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? n/a Were as built plans of the-system obtained and examined?(If they were riot 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: Yes No ✓ Existing information. For example;a plan at the Board of Health. ✓ — Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 130 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006' FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): Approx. 17 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): n/a Number of current residents: 0 Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): Yes Water meter readings,if available(last 2 years usage.(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: _ Summer use(dorm) COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): apd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes orrno) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: . Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped yearly for maintenance-Der management Was system pumped as part of the inspection(yes or no): 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation unknown Were sewage odors detected.when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 130 Sea View Avenue Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line Commments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Cesspools acting as a septic tank Depth below grade: Cesspool#1-Cover to grade: Cesspool#2 Cover to grade Material of construction: concrete _metal _fiberglass _polyethylene ✓ other(explain) Cesspool blocks If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: Cesspool#1-5'W x 5'T x 10'bottom to grade / Cesspool#2 4'W x 4'T x 6'bottom to rade Sludge depth: -- Distance from top of sludge to bottom of outlet tee or baffle: 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: How were dimensions determined: Measuring stick Comments(on pumping recoimnendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): Cesspool#1 was dry. Steel cover was to grade. No outlet tee was present _Cesspool#2 had no outlet tee present. NOTE:Some ofthe cesspool blocks have fallen out The cesspool is at risk for cavil in. The cesspool was in the parking lot not H-201oading) The cover was to grade GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping reconnnendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): s 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 130 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection).(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Commments(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: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 130 Sea View Avenue Osterville MA Owner: Wianno Club Date of Inspection: April 25, 2006 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: 2 Innovative/alternative system Type/name of technology: Commments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): Cesspool#3 was 4'W x 4'T x 5'bottom to grade and was dry, No outlet tee was nresent. The cover was to erade. The cesspool was in a dirt parking lot(not H-20 loading). Cesspool#4 was 6'W x TT x 9'bottom to grade and had 12"o slud e on the bottom. The scum line was uL to the inlet ptpe. There were si ns o ` allure. The steel cover was to grade.—The cess ool was in the woods. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.). 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 130 Sea View Avenue Osterville MA Owner: Wianno Club Date of Inspection: April 25. 2006 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. i Mik A f�Af�iilt a 1 3 ' 3 a-7 y �S 1°3 10 Page l l of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 130 Sea View Avenue Osterville, MA Owner: Wianno Club Date of Inspection: April 25, 2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to groundwater 15 +/- ` feet Please indicate(check)all methods used to-:determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: topographic and water contours maw Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours maps the snaps were showing approximately 1 S'+/ to Around water at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report andlor any components of the septic system which have not been located and inspected. 11 .4ti `East B4 ty ' 3MW20M4-03 6.500" 112.0 GPM g 29.00 Ft - ° : 3' • i ,Uz CATALOG CURVE '• •• �.�':.•...3 ;e (Manhole FromeBGrate 5.0 60 110 ";-•a ° (� a' W$e9i'- (Typ.)H-20 Finished Grade 20.0 4.5 55 100 •�;., a :; i i Concrete Risers f 50 90 o�: !•,� eya 4"0 < H-20 Loading 24"s ' 24"� DOSING CHAMBER VOLUME a: a 1.DOSES PER DAY: 4 4.0 45 80 eck • '�^.' +• 9�" a =' "� 0 2.AVERAGE DAILY FLOW: 3440 GPD 3.5 e ,� •' s " ` a A• Inv, 3.MIN.VOLUME PER DOSE: 860 GAL. 40 - Inv.16.38 4.DESIGN VOLUME PER DOSE: 860 GAL. 70 sea. - • ' :e 3'0 Sch.40 PVC Pipe to Emergency Storage 4"0 Sch.40 5.EMERGENCYSTORAGE: 3440 GAL. 3 0 35 LOCUS Dosing Field Volume 3440 Gallons PVC From HP 60 rn Chain Lifting Septic'Tonk 6.USE CAPACITY: 7000 GAL. a. 2.5 0 30 e - �l/ASH/NG'TON v8"0 Weep PUMPS `a 2.0 = 25 N�l50 �� • _ • �e��o STREET 1.NO. PUMPS REQUIRED: TWO 40 a Hole Ala 11.54 2.STATIC HEAD: 20 " a" x' 6 Lo on 11.04 6 3.TOTAL DYNAMIC HEAD AT FLOW: 29'(a)112 gpm 1'S 15 30 Mercury Floot 1=6" �� Switches Leod�on 9.54 4.IMPELLERDIAMETER: 6.50 10 1 2 Valve to Pump Guide 1�"6.. 5.SOLIDS HANDLING: 2.5 min. 10 20LL "Myts1r. G-r2A.�t�.L 05X%V. `_ 3"Check Rails Pum off8.04 t1 6.MANUF./MODEL(OR EQUAL): F.E.MYERS/ 0.5 3MW2OM4-03 5 10LOCUS PLAN d• Pptt\•t/NG• -^---- ,., Valve -0 I -4v Bottom 6.71 > 7.HORSEPOWERISPEED: 2.0/1750 RPM0.0 0 0 rA•.;.tt �•e;¢: a;pa 8.VOLTAGE/PHASE: 23OV/30 rr ; 3 1 O y 13 `��6, 0 100 200 300 400 500 600 700 800 900 1000 S Ca i e:I = 2000 2 HP Pump by Myers or Approved 6Ifflek "Crushed Equal.2 Required Stone ---'�� CONTROL PANEL Flow(GPM) Assessors Map 162 / \ SECTION MANUF:F.E.MYERS TYPE:DUPLEX Parcel 19 \ MODEL:CE-23DW PROVIDE MANUAL ON/OFF Interior Pipe Diameter: 3.00" NEMA 4X ENCLOSURE SWITCH FOR PUMP. Overlay Protection District-AP >=L1.15Ht AIG ` PUMPS TO ALTERNATE- PUMP PeRFotutArtcE DATA Lot Area 2.67 AC 16/ CONNt?CT10N i;,'"C•YP.) 17'-0" Gallons otal DynamicHydraulic Velocity \ ALARM:VISUAL per Head in Efficiency 6" 6" NOTES:CONTROL PANEL LOCATION TO BE minute Feet t FT/sec -fpPOGRAPHtC tr(t=ORt.IIA�'10i�1 T:F1,-Z -'�'" \ �B 'r AKEtV FiZOM`TOM►N Oir / \ 10 DETERMINED BY OWNER. 1 Pump Operating 112 29 48.60 5.08 13AS2tv5TA131� G.x.9. N1AP / ❑T.H,�3 r p p•�M 07 ? r 10; 'O Conduit Thru Chamber tip FLOATS 2 Pumps Operating- 224 29 10.17 r a ForPowerl3 Float 24"0 Opening Above for NO.REQUIRED:4 TYPE:MERCURY SWITCH / Pi / Cables - �cN7 \ `..• 1 Risers aM.H.Frome8iCover(Typ.t MANUFIMODEL:SM15N0. Listed performance is for number of pump(s1 operating in parallel. 3"0 Sch.40PVC / \ '3 o FORGE O \ �. Pipe to Dosing o / ` MAtN Field \ / _r ( ^� 4"0Sch.40PVC From Septic Tank P REMov� E7G\s'T. �yl�_ 162016 L_r_XCH F?iT� - I nQf CL@At4 C>UT 8 _ �' #50 2 162025 . . ) a 47 O ,..•n � Note Al Penetrationstobe �. / Sealed Watertight 162017 10 3000PSI Conc. g # 70 ThrustBlock(Typ.) b .� • - / O O \� i.R rsf;•AJ �•'•D,;r► I fie=• �.���£" sef-Tic. - 2 HPPumpsbyM orsor h DOSING TANK Y q Precast ConcreteDosin �r TANK Approved Equal. Re uriedaO Chamber.(H-20) g SrF,4 x � 20 \ PLAN rz u M p.mXx s-r LL.*\C%4 Pk't It lyri' k 7000 GALLON � 162001 MATET�\At_ - DOSING CHAMBER DETAIL F 82 a•FI L.L w 1'T•41 CL_EAt l EXISTING �• ,�;a'tiU 5r f DORM/TORY i- -'- Not to Scale / (Circa/9001w ; \ I Finished Grade r La Boron Coat Iron LA0910 , x H-20 Volvo Box to Grade of FemaleAdopterd .0 Each End Threoded Plug h4' ° \ Ala 13ua1 DINGrc✓ ON LOB i4RS ,S- 10,-0 �Q�®`� 139077 �F. Qq� 162019f MonM 5Y6-M a 8Y STi.Wf4 W TIX.Ik Poured Conc.Bose 17 ? # 130 / \ SYSTE PAS .! TOWN WATts.R °' ZZ 1/8-f/2 Filter .,;i ,.P t.5Cu.Ft. Pea Stone Fabric Sleeve lu mllow P \ _ - ,: ,.• ,. Movement ? ` : r/ . .,.,. ..,. .:... ,gyp ,�` / \ Orfice Shield ••. •w 2"�Lateral 11/2 0 Sch.40 PVC 900 #'i07 22 �� Elec.Conduit Sweep 4 " " 4"0 Sch.40 PVC Vent. �` �P ---- - 1--"�" Manifold Washed Stone see below i? 3'Ql Sch.40 PVC 3/4-I I/2 Double �L "�� -- -- 139086 'A SECTION VIEW 162 �F� +� q- ®C.B.Rim El.24.1 139085 SEA VIEW `AVENUE I i ,. Do nVentasSSch.40 orwnat. 176 � 162020 Down Vent as Shown. 2 fDSch.40 $ # 150 '� PVC Lateral(TYP) I ` C.B.Rim hoe r • I Cost Iron er P £1.24.� v. Over Flushing p; Connection. 139078 s 6-O O.C. • I �.,p: a ,188 't•1► 162021 It Leaching _ i T& 170 _ PLAN VIEW I` ° Field N 139087 I Ot �1~ 5 .., xi-0 - 5 16 02 �r1 I rn I �9088 Fel•7 533 n a 1 } Scale: 1 =30 . c ( Conc.Base 92' t, 162022 I - O ( Orfice a, `4 ' it l71 M I Shield - -. (T .) P r �► Map: Parcel:019 •. "P• DISCLAIMERS:This map b for planning purposes Doty. It b not adequate for legal f-�1 I boundary determination or repdetory Interpretatlon. Enlargements beyond a scale of Owner MANNO CLUB Selected Pt3�cel LL...�rr I ( a,•:, 1•■100 may not meet estattdsfrd nmp Deanery atandards.The paroel INues on fhb map Co Owner. W E are only graphic represantattons of Ass"wes tax parceb.They are not bus property Acreage:2.67 acres Abutters • boundaries end do not represent somma►e relationships Io physk;W isatures on the map Location:130 SEA VIEW AVENUE • wd,as I Aft bcatbm. Buffer ! ' Inspection Schedule . Pitch Force.Moin a �� _ .... 24 hour minlmUm notice required phone 508-428-3344 Manifold Back to 3 0 Sch.40 PVC OVERALL LOCUS PLAN Dosing Chamber Force Moin. • 1. Soil removal to be inspected when excavation completed for each field. NOTES ' 2. Replacement clean sand to be verified at time of bed installation. Po r I Cubic Ft.Min. PLAN VIEW 1. Water Supply For This Lot is Municipal Water. 3. Engineer to inspect shop drilled orifices to ensure size and burr removal. Thrust Block. 2. Location of Utilities Shown on This Plan Ate Approx. 4. Engineer to inspect pump installation,float levels&alarm. At Least 72 Hours Prior to Any Excavation For This PIPING DETAILS Project The Contractor Shall Make The Required si.-( tt-. Ia•c> r\1.-2 EL, tq,o T.H:_3 EL:sq iC? Notification to Dig Safe(14MO-322-4844) O O O Not to Scale 3. The Contractor is Required to Secure Appropriate G VZ^VF HAS�4�PACHG 10 6'-0" Permits From Town Agencies For Construction DRNNACE SLOTS Defined by This Plan. tbA K Y.E1!�S►l'BRh1 LGnA.MY QXRK VMt1 ISH,9.F 4.t-OA.MY �a 'DARK'4 S%4$RN t_OAAMV StJAP-ON 4. All Structures to be H-20 Loading. taw s+AtVD 1 b YR•3/N Raw SAt�1Ly tQ YFi.3Is1 w SAN,r>.. to Y12 3/L 48'-0° 10'-0 48'-0ar SHIELD 5. Septic System to be Installed in Accordance With t3" 8' . `tar 310 CUR 15.00 Latest Revision And The Town of $ pro ftK va R \5>t evk% SANIaY DA>;2K YIRL.t5f•1 B'RN.ZXN PY t7E+RK VM\:\SH SR14 sAt4Dy ORIFICE SHIELD OS2oo Barnstable Board of Health Regulations. 'aj°t`A \p V R %i/6 t g,r• L a Ah�\ \a Y Ft t f 2' 1 p P;hn 1 Gi Y R {/!o B(T p.) A(T ) B(T ) A T 2.0" SCH-40 PVC LATERAL ORENCO SYSTEMS WC 6. All Piping to be Sch 40 PVC Except Where Noted a L.t ve.Y t_L mow M tirt>, pL IVE. Ye l_t:4aw trt E R7, C3t_tYE Yr~t t oW I�(Ep OR EQUAL C C C' 7. Septic System to be inspected by the Design Engineer + SA N tS 2,'S Y !o/lo ► 5At,1 fi> '�.;5 Y Ib/6. .. S taNS� "2...,S fo./b Vent in accordance with the schedule o.�Ro u N i�wA'rE N 4 • provided t 20 {'20 t 2c7" 8. The Design Engineer Will Provide Written Certification P.4U'SNv 0\iVA-rF.Ci 0 CvR4. wAT C-t� N LIPID To The Board of HealthonS t�ic<t^B : cT/t3/C� . G:DEPTH 31 iNGNE�s`: F'BRG.CaErlo'fl-t:37 INGIataS System Compliance. F'Et�G, N o•' \13$'S GE159 "r1-IP.tJ 2 mk t4.f I NCH t 6 es -t'MAN -2L Mt M,�tV4_f-" r t 9. The First 10 Feet of Pipe From The Building to be Cast By. 3 c>HN o b�A-sRL t L\vAN �t � d' 3/8" Holesrd 8'-0'O.C. d d IN 12 O'CLOCK POSITION Iron in Accordance With The State Plumbing Code Of LATERALS)) �g EM[31NB,ER111G \1VG• f)UCT OIAAfErER HLES Latest Addition. b�P"r1-1- %4?. SHOULD BE SHOP DRILLED WITH NOTE: ORIFICE SHIELDS PREVENT PE46STONE k 10. All Manhole Frame$Covers to be Set at Grade LeSS TLIA N 2. Mt N./INCH A DRILL PRESS TO ENSURE WASHED STONE FROM PLUGGING ORIFICE W►TNT+",t6'9'.�3,bV.SMAPkXtS T.0.e: N N a UNIFORMITY. . REMOVE BURRS &TO be H-20 Loading PRIOR TOTo PLACING PIPE P) ORIFICE SHIELD DETAIL 11. The Septic Tank Shall be a Two Compartment, � 11,000 Gallon tank With a Liquid Level of to-6"The Outlet Not to Scale Tee Shall Extend 36"Below Flow Line With Gas Baffle.The Inlet Tee Shall Extend i0"Min.Below TABLE OF DIMENSIONS(each field) Flow Line.The First Compartment Shall Have a DESCRIPTION VARIABLE QUANITY UNIT Volume of Not Less Than 6880 Gal.And The Vent FORCE MAIN DIA. DF 3 IN. Second of Not Less Than 3440 Gal. FThe Compartments Shall be Inter conectod by a MANIFOLD DIA. Orr 3 IN. Minimum 4"0 Vented,Inverted U-Shape Pipe Which LATERAL DIA. Du. 2 IN. Extends Below The Bottom of The Scum Layer Orifices(Typ.) ( Lateriol (Typ.) #OF LATERALS N 9 EA. And Has a Gas Baffle. ORIFICES PER LATERAL n 8 EA. ORIFICE TYP.SPACING S 72 IN. CL ORIFICE DIA. Do 3/8 IN. BEGINI END OFFSET B 54 IN. � SEPTIC SYSTEM DESIGN -Manifold Orifices (Typ.) c Finished Grade ° ° Design Flow: Existing C - Dormitory:24 Bedrooms (al 110 gpd = 2640 gpd I des 11 c Compacted Filter Washing Machine: 2 @ 400gpd= 800 gpd C. c /O�-O` tcu ° B(T p.) A(T P•) v 2 x 2 TEE - C u Loterlol{Typ•1 A ° .. orb Fill Fabric Total 3440 gpd LA 7FRAL 2"0 -M a c .-•---•-� r.--:-:;. w <sd��ssw. rz Septic Tank _ s '•• •• • • ••L •••-•�-••-•--••••-•••• Sized 200 /o of Design Flow " 6880 allons 1/8 -1/2' Use a 11 000 Gallon Two Compartment a Orifice o ► P - S (T J J S T u. 2"x 3„JE-E Shield -+ - o PeoStone Tank.See Note No.11. A - Lateral (a . I - ~ 3/4"-11/2"Double Leach Field: FORCE MAIN 3"0 { ,�_ $� c washed stone Required Areo 3440 gpd/0.74 = 4649 sf /is¢ii � _ru=,rgi �►,��F;# r, Field Size: 20il48`x 50' = 4800sf I. MANIFOLD 3"0 Field to be Pressure Dosed SECTION A-A All Componentstobe H-20 . MANIFOLD DETAIL Not to scale SITE PLAN. Not to Scale Oi M.H.FromeS cove ta SEPTIC SYSTEM REPAIR Grade.See Note No.10 SEA VIEW Conn nq NeM Inv.IZ58 FlushingFlush 130 SEA Y IEW AVENUE Connection Vent Connection d d F.G.19.0 FG. 2010 Inv.19.5 OSTERVI LLE If MASS. .._ BoLEt.17.00 FOR ... ,. Conc.Slab THE 1NIANNO CLUB 1 8.0 3"pl Pressure I. Bottom of Test Holes Elev.s.o Piping �nv.Is.36 Inv. SCALE: AS SHOWN DATE: SEPT. 13, '2006 Force I No Groundwater - main -y [1� ORIFICES ON ADJACENT LATERALS SHALL 131 ENTIRE BOTTOM OF SOIL ABSORPTION 7;o000oIion 11.000GONon,2Comportment SULLIVAN ENGINEERING INC. BE STAGGERED TO'BEE(3(IIDISTAM'AS AREA SHALL BEWMIMEDTOA Dosing Chamber Septic Tonk.See Note No.If. OSTERVILLEtMASS. SHOWN ABOVE. MINIMUM OF 3 INCHES JUST PRIOR TO PRESSURE DOSED FIELD [21 ALL ORIFICES SHALL BE DRILLED IN CROWN (41 ALL ONE�LLBEDOUBLEWASHE'D. ` DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM Scale: 1/8 = 1 -Orr OF PIPE - Not to Scale