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0251 SEAPUIT ROAD - Health
251 SEAPUIT ROAD Osterville A = 095 — 016 4! O �mO�s a TOWN OF Bg RNSsTABLE met-`'S SaLR .J D LOCATION 5 eR P o rr A-y'. SEWAGE VII:I.AGE 0 S'Tg.R.V I L.eLL ASSESSOR'S MAP & LOT S INSTALLER'S NAME Cz PHONE NONt-T I;-RAP40 T3905 3,2_3665 SEPTIC TANK CAPACITY 1000 GA L LO O LEACHING FACILITY:(type) FLOVJ'D1T-\)$S C)P, • (size) :, w 2 '57610f, NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDE OR OWNER EB ASO It nj S , 3%5 `F.A 57r_ ,Vr, 11 vA tJ W13 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ° 7 VARIANCE GRANTED: Yes No l� 'V �I ;) 1 ,1 a e Z Ln of � 43 /C ° -� •. i 7t G 19 �r MAN TQWN OF BARNSTABLE 5`T. ►nflPN S s tiUf5 LOCATION t'E k11=1 V E`i A'!l SEWAGE # VI12-AGE®(;"r E RV) ),s L E! ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 1000 LEACHING FACILITY:(type) r-LOW bIFQ330PS (size)8 w Z lsyo)jrL NO, OF BEDROOMS-PRIVATE WELL OR UBLIC WATER UILDE OR OWNER iE, '� JOVL13 ,385 ssl)' S`t' `f Aw 1`)I S DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED: - S _ 7 VARIANCE GRANTED: Yes No X G. Qz000 f 5TAiv,5 GCS L �Z i D $O-A CA Immsy 3O ,FLOW VIT-055,04 W/ 2. 1 s-ro�j IL _ LDcATE'D uNo�R :tea COASTAL engineering co. May 15, 2018 C18236.00 Board of Health c/o Thomas McKean, Director Barnstable Town Offices 200 Main Street Hyannis, MA 02601 Re: Designer Certification Proposed PERC-RITE System Design David Samra and Erica Pearson 265 Seapuit Road Barnstable (Osterville), MA Map 095 / Parcel 004 Dear Mr. McKean: Please accept this letter, on behalf of our clients, David Samra and Erica Pearson, that the proposed Perc-Rite sewage disposal system was installed per the approved plans: • C2.1.1, "Proposed Sewage Disposal System Plan", dated 11/23/15 • C2.4.1, "Plan Showing Proposed Sewage System Details", dated 11/23/15 • C2.4.2, "Plan Showing Proposed Sewage System Details", dated 11/23/15. I witnessed the installation of the system, during my multiple trips to the referenced site, and saw this " system was installed per the specifications proposed 6 approved by the Board of Health.'I have . enclosed a copy of the Perc-Rity Drip Dispersal Installation Letter 6 As-Built Plan for your reference. The Designer 6 Installer Certification will be provided by Robert B. Our Company. Please contact me with any questions or.requests for additional information. Very truly yours, . COASTAL ENGINEERINGCO., INC. + 2 Sean Riley, P.E., CFM w Civil Engineering Division Manager SMR/sgc Orleans i Sandwich i Nantucket m0AKSON m YOUR DRIP DISPERSAL EXPERT IN NRV ENGLAND - May 15, 2018 Osterville Board of Health Re: Perc-Rite Drip Dispersal Installation—265 Seapuit Road, Osterville,MA This letter is to inform you that a Perc-Rite Drip Dispersal System has been installed according to the approved design plan and MassDEP approval at 265 Seapuit Road. A Perc- ` Rite technician was on-site during the installation and performed a clean water system start-up on May 15, 2018. The system was designed by Coastal Engineering, installed by Robert B. Our Company, and an O &M contract is with Coastal Engineering. Please feel free to contact me with any questions. Sincerely, Rob Sarmanian General Manager . 6 Sargent Street Gloucester MA 01 g > 3 90 ' (877) OAKSON-1 or(978) 282-1322 www.oakson.com i . + Com 75 monwealth of Massachusetts � Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' r a� 251 Seapuit Road---Main house system 1of 2 ' Property Address Margaret Sullivan Trust XD Owner Owners Name , information is required for every Osterville MA 02655 7/7/j-0 page. City/Town 17 State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may of be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling.out forms on the computer, V use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return key. Name of Inspector Ford Septic Services, LLC Company Name P.O. Box 49 Company Address Osterville MA 02655 ltyrrown State Zip Code 508-862-9400 S 12482 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 GMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ ,Fails ❑ Needs Furth Evaluation by the Local Approving Authority 7/11/17 Inspe t is Signature Date The y tem inspector shall submit a copy of this inspection report to the Approving Authority(Board of Hea th 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. 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System a Page 1 of 17 /r\oald n Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . 251 Sea uit Road - Main houses stem lof 2 Property Address Margaret Sullivan Trust Owner Owner's Name information is required for every Osterville MA 02655 7/7/2017 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: 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): 15ins°3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts AM-: Title 5 Official Inspection Fry Subsurface Sewage Disposal System Form - Not for Voluntary y Assessments 251 Sea uit Road - Main houses stem 1of 2 Property Address Margaret Sullivan Trust Owner information is Owner's Name ' required for every Osterville MA 02655 page. Cityfrown 7/7/2017 State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if Pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with�approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N El 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 functioni.ng in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 7ille 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 - Commonwealth of Massachusetts H Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •'•t 251 Sea uit Road Main houses stem 1of 2 Property Address Margaret Sullivan Trust Owner information is Owner's Name required for every Osterville MA 02655 page. City/Town 7/7/2017 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, perfor med med at P a DEP certified laboratory, for fecal coliform bacteria Indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow (Sins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 commonwealth of Massachusetts = Title 5 Official Inspection For - Subsurface Sewage Disposal System Form -Not for VoluntaryAssessments •, r 251 Sea uit Road- Main house s stem 1 of 2 Property Address Margaret Sullivan Trust Owner Owner's Name information is required for every Osterville MA 02655 7/7/2017 page. City/Town State Zi Code P Dale 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: ❑ 0 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 Well 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. 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection For Subsurface Sewage Disposal System Form -Not for Vol untary Assessments °r 251 Sea uit Road- Main houses stem 1 of 2 Property Address Owner Margaret Sullivan Trust information is Owner's Name required for every Osterville MA page. Cityffown 02655 7/7/2017 C. Checklist State Zip-Code Date of Inspection Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® 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 't 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): $ Number of bedrooms (actual): 7 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 8888--00 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments "M 251 Sea uit Road- Main houses stem 1 of 2 Property Address Margaret Sullivan Trust Owner information is Owner's Name required for every Osterville MA 02655 page. City/I own 7/7/2017 State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: unavailable Sump pump? ® Yes ❑ No Last date of occupancy: currently Date Commercial/Industrial Flow Conditions: ' I 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: l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary ry Assessments 251 Sea uit Road- Main houses stem 1of 2 Property Address Owner Margaret Sullivan Trust information is Owner's Name required for every Osterville MA page. Cityfrown 02655 7/7/2017 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: unavailable Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool El 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): 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official In For Subsurface Sewage Disposal System Form- Not for Voluntary Assessments rT 251 Sea uit Road - Main houses stem 1of 2 Property Address Owner Margaret Sullivan Trust information is Owner's Name required for every Ostervi►le MA page. Cityt I own 02655 7/7/2017 State Zip Code- Date of Inspection D. System Information (cont- Approximate age of all components, date installed (if known)and source of information: system installed 8/5/1987 Were sewage odors detected when arriving at the site? El 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: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 3 feet Material of construction: ® concrete ❑ metal ❑fib erglass ❑ 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: 2000 - H-10 Sludge depth: 3 l5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection For F ° Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 251 Sea uit Road -Main houses stem 1of 2 Property Address Owner Mar aret Sullivan Trust information is Owner's Name required for every Osterville MA page. Cityrrown 026_ 55 7/7/2017 State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 24 Scum thickness 4 Distance from top of scum to top of outlet tee or baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? measure stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural inte rit liquid levels as related to outlet invert, evidence of leakage, etc.): g y' The tank is under a stone patio. Both covers had risers and were 5" under the stone. The tees were resent and the tank was Pumped after the inspection for maintenance. Grease Trap (locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete El metal El 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: ------------- I5ins•3/13 Date Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts H Title 5 Official Inspection Fora A Subsurface Sewage Disposal System p y tem Form -Not for Voluntary Assessments 251 Sea uit Road - Main houses stem 1of 2 Property Address Owner Margaret Sullivan Trust information is Owner's Name required for every Osterville MA _ page. City/Iown 02655 7/7/2017 State Zip Code Date of Inspection D. System Information (Cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural inte rit liquid levels as related to outlet invert, evidence of leakage, etc.): g y, 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 N/a ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: El 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 l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Subsurface Sewage Disposal System Form Not for Voluntary Assessments 251 Sea uit Road- Main houses stem 1of 2 Property Address Margaret Sullivan Trust Owner information is Owner's Name required for every Osterville MA 02655 page. Cityt I own 7/7/2017 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 even 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.): The D-box was under the driveway and unaccessable. Per design plans the D-box and the Flow difussors were designed to be in the driveway and all componets shall be H-20. used a camera and no solids were present. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required):. If SAS not located, explain why: 151ns-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Subsurface Sewage Disposal System Form -Not for Voluntary untary Assessments �- 251 Sea uit Road - Main houses stem 1of 2 Property Address Owner Margaret Sullivan Trust information is Owner's Name required for every Osterville MA page. 0Y I own 02655 7/7/2017 State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 8-flow difussors w/2'stone ❑ leaching galleries number: ❑' leaching trenches number, length: ❑ leaching fields number, dimensions:. ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): The flow Diffussors were dry and clean. They are under the driveway. There was no sign of failure. A camera was used to inspect. 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 ❑f5ins•3/13 Yes El No Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection F om Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 251 Sea uit Road - Main houses stem 1 of 2 Property Address Owner Margaret Sullivan Trust information is Owner's Name required for every Osterville MA page. CitylTown 02655 7/7/2017 D. System information State Zip Code Date of Inspection (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation etc.): There was a old cesspool present with a steel cover to grade. It was part of the old system. Nothin goes to it. Recommend filingit with sand for safte measure. It was shown on the desi n lan. g 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.): N/a t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form = Not for Voluntary Assessments •`r 251 Sea uit Road - Main houses stem 1of 2 Property Address Margaret Sullivan Trust Owner Owners Name information is required for every Osterville MA 02655 .7/7/2017 page. Cityrrown State Zip Code Date of inspection- D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately STA►cs � B ,A fA a i ii ly a o a ao ay 3 ay 8 Py 3 (Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 251 Seapuit Road - Main house system 1of 2 Property Address Margaret Sullivan Trust Owner Owner's Name information is Osterville MA 02655 7/7/2017 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high groundwater. 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 987 Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Topo and water contours map. ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Per design plans high tide water was observered at 8.5'when installed Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins•M3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts N Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Seapuit Road- Main house system 1of 2 Property Address Margaret Sullivan Trust Owner Owner's Name information is required for every Osterville MA 02655 7/7/2017 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 151ns-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Commonwealth of Massachusetts O/(o Title 5 Official Ins ection F ~ Subsurface Sewage Disposal System Form -Not for Voluntary 1 � y Assessments 251 Sea uit Road-Guest House/Garage system 2of 2 CP Property Address Owne Margaret Sullivan Trust r information is pwner's Name required for every Osterville page. MA Citylrown 02655 _ 7/7/2017 State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be alt way. Please see completeness checklist at the end of the form. Bred in any Important:When A. General Information filling out forms on the computer, J use only the tab key to move your 1• Inspector: cursor-do not James Ford use the return key. Name of Inspector Ford Septic Services, LLC 4 tab Company Name P.O. Box 49 Company Address Ostervllle 0Y I own MA 02655 State Zip Code 508-862-9400 S12482 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. 1 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 valuation by the Local Approving Authority Inspect r Signature 7/11/17 Date The s m 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 Io,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. 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection - p Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 251 Sea uit Road -Guest House/Garage.system 2of 2 Property Address Margaret Sullivan Trust Owner information is Owner's Name required for every Osterville MA 02655 7/7/2017 page. Cityrrown State Zi Code P Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B;C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria indicated below. .not evaluated are Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound; not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y. ❑ N ❑ ND(Explain below): 15ins•3113 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Seapuit Road-Guest House/Garage system 2of 2 Property Address Margaret Sullivan Trust Owner Owners Name information is required for every Osterville MA 02655 7/7/2017 page. Cityrrown State Zip Code Date of inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due \' to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will t 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 15ins-3/13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •`` 251 Sea uit Road -Guest House/Garage system 2of 2 Property Address Margaret Sullivan Trust Owner Owners Name information is required for every Osterville MA 02655 7/7/2017 page. Cityffown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply., ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: '*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ [E 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 1/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Sea uit Road -Guest House/Garage system 2of 2 Property Address Margaret Sullivan Trust Owner information is Owner's Name - required for every Osterville MA 02655 page. City/Town 7/7/2017 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. El ® 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 attache d tot th is 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 11 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. 15ins•3113. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts u 0, Title 5 Official Inspection For 3 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M ProPro perty Address Road-Guest louse/Garage system 2of 2 ' Margaret Sullivan Trust Owner information is Owner's Name required for every Osterville MA 02655 page. Cityfrown State 7/7/2017 C. Checklist Zip Code Date of Inspection Check if the following have been done. You must indicate "yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out,in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? El ® Have large volumes of water been introduced to the system this inspection? recently or as part of ® ❑ 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): 1 Number of bedrooms (actual): 1 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 110 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Sea uit Road -Guest House/Garage system 2of 2 Property Address Margaret Sullivan Trust Owner information is Owners Name required for every Osterville MA 02655 7/7/2017 page. City/Town State Zip Code Date of Inspection . D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? El Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: unavailable Sump pump? ❑ Yes ® No Last.date of occupancy: unknown 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? El Yes ❑ No Industrial waste holding tank present? El Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Subsurface Sewage Disposal System Form -Not for V Form Voluntary Assessments �•a 251 Sea uit Road-Guest House/Garage system 2of 2 Property Address Owner Margaret Sullivan Trust information is Owner's Name required for every Osterville MA page. Cityt I own 026_ 55 7/7/2017 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: unavailable Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: maintenance 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): 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts a t Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Seapuit Road -Guest House/Garage system 2of 2 Property Address Margaret Sullivan Trust Owner Owners Name information is required for every Osteryille MA 02655 7/7/2017 page. City/Town State. Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed 8/5/1987 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: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 10 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 - H-20 Sludge depth: 1 l5lns-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection FormSubsurface Sewage Disposal System Form _ No Voluntary Assessments 2a I Sea uit Road-Guest House/Garage system 2of 2 Property Address Owner Margaret Sullivan Trust information is Owner's Name required for every Osterville MA page. Cityfrown ate Zi of Ins 02655 _ 7/7/2017 Stp Code Date pection D. System Information (cont.) , Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 24 Scum thickness 3 Distance from top of scum to top of outlet tee or.baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? measure stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrit , liquid levels as related to outlet invert, evidence of leakage, etc.): y The tank is in the driveway. A steel cover is to grade on the inlet. The tees were present. The tank was pumped after the inspection. Grease Trap (locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete El 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: t5ins•3/13 Date 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 251 Seapuit Road -Guest House/Garage system 2of 2 Property Address Margaret Sullivan Trust Owner Owners Name information is required for every . Cisterville MA 02655 7/7/2017 page. City/Town 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 grader Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): N/a 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts' 4 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 251 Seapuit Road-GuestHouse/Garage system 2of 2 - - Property Address Margaret Sullivan Trust Owner Owners Name information is required for every Osterville MA 02655 7/7/2017 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 even C omments (note box is level and distribution`to outlets-equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): . The D-box was under the.driveway. Per design plans'the D-box and.the Flow difussor were designed to be in the driveway and all componets shall be H-20 A camera was used Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in'working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain'why: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts N Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 251 Sea uit Road-Guest House/Garage system 2of 2 - Property Address Margaret Sullivan Trust Owner information is Owner's Name required for every Osterville MA V 02655 page. Cityrrown State Zi Code 7/7/2017 p Date of Inspection D. System Information (cont.) Type: 0 leaching pits number: ® leaching chambers number: 17flow difussor w/2'stone ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number; dimensions: ❑ overflow cesspool number: , ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil,-condition of vegetation, etc.): The.flow Diffussor was dry and clean and in the driveway. There was no sign of.failure. A camera was used to inspect. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth top of liquid to inlet invert . Depth of solids layer Depth of scum-layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins 3/13 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts: Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' °�.. 251 Seapuit Road -Guest House/Garage system 2of 2 - Property Address Margaret Sullivan Trust Owner Owners Name information is required for every Osterville MA 02655 7/7/2017 page. Cityrrown State, Zip Code Date of Inspection D. System Information (cont.) t� Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a [Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official: Inspection Form Subsurface Sewage Disposal.System Form Not for Voluntary Assessments °r 251 Sea uit Road -Guest House/Garage s`stem 2of 2 Property Address Margaret Sullivan Trust Owner Owners Name information is required for every Osterville MA 02655 7/7/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately /� P . x ar A Q 13y ai t - 'riuw+Ay Ca y foD t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a d Subsurface Sewage Disposal System Form -Not for Voluntary Assessments •e 251 Seapuit Road -Guest House/Garage system 2of 2 Property Address Margaret Sullivan Trust Owner information is Owner's Name required for every Osterville MA 02655 7/7/2017 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: 8.5' 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: 9/29/1987 Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: Topo and water contours map. ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database explain: You must describe how you established the high ground water elevation: Per design plans high tide water was observered at 8 5'when installed Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 251 Seapuit Road - Guest House/Garage system 2of 2 Property Address Margaret Sullivan Trust Owner information is Owner's Name required for every Osterville MA 02655 7/7/2017 page. City/Town State ZIPCode 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 l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ?f Notice of Alternative Sewage Disposal System M.G.L. c. 21A$ § 13 and.310 CMR 15.0287(10) This Notice to be recorded and/or filed for� registration in the chain of title of the Property served by.an Alternative ewage Disposal System("Alternative System").] NAME(S) OF OWNER OF PROPERTY SERVED BY ALTERNATIVE SYSTEM. N. David Samra and Erica Pearson ADDRESS OF PROPERTY SERVED BY ALTERNATIVE SYSTEM: . 265 Seapuit Road,Osterville;,Barnstable County,MA. TITLE REFERENCE FOR PROPERTY SERVED BY ALTERNATIVE SYSTEM check and complete each that applies]: _Deed recorded with the Registry of Deeds in Book ,Page X Certificate of Title No.204739 issued by the Land Registration Office of the Barnstable Registry District _Source of title other than by deed - [if Alternative System Owner(s)is,other than Property Owner(s),complete the following:] Alternative System Owner Name: Alternative System Owner Address: WHEREAS, Section 15.280 of Title 5 of the.State Environmental Code.("Approval of Alternative Systems"),provides for the Massachusetts Department of Environmental Protection(the "Department")to approve or certify,as appropriate,all proposals'to construct,upgrade or replace on-site sewage disposal systems using alternative systems; WHEREAS, owners and/or operators of approved or certified alternative systems are subject to general conditions,as specified in Section 15.287 of Title 5 of the State Environmental Code,310 CMR 15.287,and may be subject to special conditions,as specified in the Department's approvals or - certifications; such general and special conditions potentially including,without limitation,requirements relating to the use of trained operators,periodic inspections,maintenance,sampling,reporting and/or recordkeeping; { WHEREAS, Section 15.287(10)of Title 5 of the State Environmental Code,310 CMR 15.287(10),requires that"prior to obtaining a Certificate.of Compliance for installation of a new or upgraded system,the system owner shall record in the chain of title for the property served by the alternative system in the Registry of Deeds and/or Land Registration.Office,as applicable,a Notice disclosing both the existence of the alternative on-site system and.the Department's approval of the: system. The system owner shall also provide evidence of such recording to the local Approving ; Authority[J"and WHEREAS,the Property is served by an alternative sewage disposal system: NOW,THEREFORE,Notice of an alternative sewage disposal system is hereby given for the above-referenced Property, as follows: 1. Existence, An alternative system has been installed as a new or upgraded alternative sewage disposal system,on or adjacent to the Property, and serves the Property.,The trade name and model number(s)of the alternative system arc as follows: Trade name of technology:, Pere-Rite Drip Dlspersal System Manufacturer Name: American Manufacturing Co.,lnc Model number(s): QM(WD),ASD-15,ASD-25 &ASD-40 E Page I of 2 2. Approval/Certification. On March 20,2015.r [date];the Department;pursuant.to its authority . under the section of Title 5 as specified below,approved or certified the technology-used in the above- referenced alternative system,under MassDEP Transmittal Number X7_5Q 3-19 [Transmittal Number of approval or certiricationl. [Check one of the following,as applicable:] Approved for remedial use under 310 CMR 15,284 —Approved for piloting under 310 CMR 15.285 Provisionally approved under 310 CMR 15.286 X Certified for general use under 310 CMR 15.288 A copy of the Department's Approval/Certification.is availablei from the Department_in person or on- line at the Department's website: htto://www,mass,aov/dep WITNESS the execution hereof under seal this d"ay of 1 20 ,.made by' the above-named Alternative System Owner nat (Alterna iv Y tent Owner(s)l Print N e(s) dl :.l ma A, .�4 {fie s ss COMMONWEALTH .T 55ACHUSET2S On this day of .20_;before me,the undersigned notary public,personally appeared (name of document signer),proved to me through satisfactory evidence of identification,which were. . . ,to be the person whose name is signed on the preceding or attached document,and acknowledged tome that(he)(she)signed it voluntarily for its stated purpose. (official signature and'seal of notary) -- <--- ----------- - -- -- -- - - ----- ----- - ---------- - - - ---- --- (Complete the following Property'Owner(s)Consent if Alternative System Owner(s)is other than the Property Owner(s):] CONSENTED TO: [Property Owner(s)) _ Print Name(s): Date: COMMONWEALTH:OF MASSACHUSETTS ss On this day of 20_ before me,the undersigned notary public,personally appeared (name of document signer),proved to me through satisfactory evidence of identification,which were ,to be the person.whose name is signed on the preceding or attached.document,and.acknowledged to me that(he)(shi )signed.it voluntarily for its stated purpose. (official signature and seal of notary) Upon recording, return to: [Name and address of Property Owner(s)] Page 2 of 2 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document, State of California County of �,am �uinc&,u ) On f"_ N �A.i before me, ate . Here Insert Nme'and Title._ the Officer. personally appeared , Yi C+� 1'CA YSav) Name(s)of Signer(s) who. proved.to me on :the.basis 'of satisfactory 'evidence'to' be the person(s) whose name'(' Qre sub,cribed to the within instmrnent and acknowled d to me that he/she/they executed this.same in his�thelr authorized capacity(ies);and that by'his/ /theie signatures)on the instrument the person(s) or the.entity,upon behalf of which,the person(s) acted,executed the instrument... I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. JOHANNA C.NYE. Commission t 206199t3 g WITNESS my hand and official seal. -e► Nowy Public-CaIhomia Y: San Francisco County Camrn.. fires Mr22,2018 . Signature Signature of)yb ry Public Place Notary Seal Above OPTIONAL - - Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document: Description of Attached Document Title or Type of Document: - Document Date: . Number of Pages: Sigrier(s) Other. Than :Named Above: { Capacity(ies) Claimed by Signer(s) Signer's-Name: Signer's Name:. ❑Corporate Officer — Title(s): - ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑Partner -- ❑Limited ❑General O Individual ❑Attorney in fact O Individual D.Attorney in Fact ❑Trustee ❑Guardian or Conservator . ❑Trustee 0 Guardian or Conservator El Other: CI Other: Signer Is Representing: - Signer Is, Representing'_ eM .�2 ; 02014 National Notary Association -www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 0 t CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California ) County of Yl_MM t le,S( U ) ` , C,�v Nc�tu f6 ►CI On YVt"�a ? �ti� 1 before me, _ YU) i lea"te Here Insert l me and True o the Officer personally appeared - NC..I1G'1 yv�Va Name(s)of Signer(s) 1. t who proved to me on the basis of satisfactory, evidence to be th erson(s) whose name(s) is re Qer/their scribed to the within instrumentand acknowI dged to me that she/they executed the same in authorized capacity(ies),and that by is er/their signatures)on the instrument the person(s); or the entity upon behalf of which the person(s) acted, executed the instrument. i certify under.PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph ' is true and correct. JOHANNA C.NW WITNESS my hand and official seal. Commission#2061996 Notary Public-California San Franclsoo County [ .Cbmm•E; Oes Mar,22,20.t6 Signature- a o• Signature of No a Public • k t Place Notary Seal Above OPTIONAL Though this section is optional, completing_this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document . Title or Type of Document: Document Date: Number of Pages: . Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) ; Signer's Name: Signers Name.. Q Corporate Officer"— Title(s): C7 Corporate Officer - Title(s): D Partner — 0 Limited ❑General ❑Partner ❑Limited ❑General l Individual ❑Attorney in Fact ❑:Individual ❑Attorney in Faet ❑Trustee El Guardian or Conservator ❑Trustee O Guardian or Conservator Q Other: - ❑ Other: Signer Is Representing: Signer Is Representing:,,. 02014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907 S i AUTHORIZATION FOR 260 Cranberry Highway Orleans,MA 02653 TECHNICAL 108,251,61111 101,211,1100 F COASTAL Orleans i Sandwich I Nantucket engineering co. coastalengineeringcompany.com SERVICES To: David 6 Erica Samra Date: 02/09/2016 Project No.WBA011.00 38 West Clay Street Project: Pere-Rite Drip Disposal'Operation 6 Maintenance San Francisco,CA 94121-1231 VIA EMAIL: david.samrajalertisanpartners.com elpsenail a�yahoo.com• ; „ Location-: 265 Seapuit Road, Osterville,MA Assessor Map 95, Parcel 4 Coastal Engineering Company, Inc, (CEC)will perform the - Fixed Fee: See Attachment 2 s following professional services relating to the referenced project. Contract Duration:Ongoing SCOPE OF SERVICES: Coastal Engineering Co., Inc.(CEC)will perform the services outlined in Attachment 1 regarding the Operation and Maintenance of the Wastewater Treatment System at the above-noted location. CAS/dlb SUBJECT TO TERMS AND CONDITIONS ON REVERSE SIDE AUTHORIZED FOR-COASTAL ENGINEERING.. ® We are proceeding with services) noted as per your By: direction. Immediate notification in writing is required if you wish to alter this authorization. Chad A.Simmons,WWTPO ® Please execute this agreement•. February 9, 2016 AUTHORIZED;BY GL ENT: ® This document will become our original agreement. Acceptance of this agreement by signature authorizes COASTAL Signature OaE. ENGINEERING to proceed as described.This proposal expires in 90 days if not signed by both parties, t Printed Nam" and Tit e PLEASE SIGN AND RETURN ONE COPY D:\DOE\W\WOA\011\Contracts\2015-02-09-somro ATS.doc , r 1 .-Ih CO /� C�/� LSTANDARD CONDITIONS FOR ENGAGEMENT AS A TECHNICAL SERVICE CONTRACT engl eerin ,: a. FIXED FEE PROPOSAL January 1,2012 COMPENSATION FOR SERVICE CONTRACT: Coastal Engineering Co., Inc. (CEC) OWNERSHIP OF DOCUMENTS: All documents, including original drawings, bases its compensation for services on this project on the fee given for the estimates,specifications,field notes,and data,are and shall_remain the sole project. CLIENTS are advised that Additional Services requested.beyond the and exclusive property of CEC as instruments of service.The CLIENT may,at Scope covered by the fee proposal or change orders attached thereto will be his/her expense, obtain record prints of drawings, in consideration of which, based upon the time input according to our current hourly fee rate schedule. the CLIENT will use them solely in connection with the above described Fee proposals for services are prepared to the best of our ability based on project and not for the purpose of making subsequent extensions or facts available at the time of submission, enlargements thereto. TRANSPORTATION:Time and travel"expenses incurred,when travel is in the USE OF DOCUMENTS: Services performed and documents prepared by CEC interest of the project, will be charged for in accordance with our fee under this agreement shall be for the benefit of CLIENT only and may not be schedule. relied upon by any third party(ies)unless specifically agreed to in advance by CEC and CLIENT. SUBCONTRACT SERVICES: CEC may engage subcontractors and/or other professionals to perform required services such as soil borings, drilling, USE OF STAKES: CLIENT,CLIENT'S contractor, or any third party may not use construction, etc. That subcontractor's charge plus a service charge will be stakes or other markers set at the site by CEC before obtaining verification added to our fee. from CEC that the stakes or other markers were set for the intended purpose and are in place to the accuracy appropriate for the intended use. REIMBURSABLE EXPENSES: Reimbursable expenses will be.billed at our cost plus a service charge,Examples of reimbursable expenses ordinarily charged ELECTRONIC FILES:Electronic files are transmitted for informational purposes are replacement equipment, plumbing and hardware supplies,and chemical only and at the request of the CLIENT or CLIENT's agent.CEC's official product supplements for process control. is limited to its signed and sealed hard copy of plans, specifications, and/or studies. The CLIENT agrees to hold CEC harmless for any damages from PAYMENT:Invoices will be rendered monthly or as work progresses.Invoices inappropriate or illegal uses by others from any electronic transfer of are due and payable upon receipt. Amounts over 30 days past due are information that was requested by the CLIENT or CLIENT'S agent. subject to a service charge of 1.5% per month (18% annually). The CLIENT agrees to pay reasonable attorney's fees and any collection fees incurred in INDEMNIFICATION AND LIMITATION OF LIABILITY: CEC agrees to indemnify the collection of any amount owed hereunder and not paid when due. and hold CLIENT harmless against damages and liability resulting from the negligent acts, errors,or omissions of CEC.The CLIENT agrees to limit CEC's CHANGE OF SCOPE: If, during the performance of services under this liability, resulting from errors and/or omissions in services furnished to the Agreement, there is a Change in the Scope of Services requested on the CLIENT directly by CEC to an amount not to exceed our fee. The CLIENT basis of an oral or written order by the CLIENT, or as required by. agrees to require a like limitation from any contractor engaged to perform circumstances to address contingencies, or to revise plans upon the request work for which we have provided reports, plans, and/or specifications. The of the CLIENT, CEC will perform these services in accordance with our fee CLIENT shall further indemnify and hold CEC harmless from any liability schedule. CEC reserves the right, at our discretion,to issue a Change Order resulting from the acts, errors, or omissions of the CLIENT or CLIENT's to this Agreement. However, a Change'Order is not required prior to agents,contractors,or assigns.Such indemnification shall include the cost of rendering such services and the CLIENT agrees to pay for such additional defense arising in any way with claims connected with any such liability ,y services. excepting only.such liability as may arise out of CEC's sole negligence in performance of services. CLIENT agrees that any and all damages arising SUSPENSION OF SERVICES: If the CLIENT fails to make payment of invoices from negligent act,error,or omission shall be made against CEC directly and when due,CEC may suspend performance of services under this Agreement, shall not be made personally against any of its directors, officers,agents,or In the event of a suspension of services, CEC shall have no liability to the employees. CLIENT for delay or damage caused by such suspension of services. CONSEQUENTIAL DAMAGES:Notwithstanding any other provision hereof, CEC TERMINATION PROVISION:This Agreement may be terminated by either party shall not be liable to the CLIENT for any incidental,indirect,or consequential upon five (5) days written notice in the event of failure of performance of damages arising out of or connected in any way to the services rendered terms and conditions of this Agreement by the other party through no fault of hereunder, including, but not limited to, loss.of use, loss of profit, loss of the terminating party. CEC shall be compensated for services performed up business,loss of income,or loss of reputation. to the time of termination. ' NO WARRANTIES: CEC makes no warranties, express or otherwise, in INSURANCE:CEC is covered by Worker's Compensation Insurance and Public .connection with CEC's services except for those which may be specifically and Professional Liability Insurance. We will furnish certification upon stated in the operation and Maintenance Scope of Services. request. RIGHT.OF ENTRY: Unless otherwise agreed, the CLIENT furnishes right-of- entry on the land for CEC to make measurements, soil tests, or other required explorations. CEC will take reasonable precautions to minimize damage to the land from the use of equipment, but we have not included in our fee the cost of restoration from damage that may result from our operations.If we are required to restore the land to Its former conditions,the cost of doing so will be added to our fee. J David 6 Erica Somra February 9,2016 ATTACHMENT 1 OPERATION AND MAINTENANCE SCOPE OF SERVICES The following is a summary of the scope of services to be provided by Coastal Engineering Co.,Inc.(CEC): The treatment system shall be operated by a Certified Wastewater Plant Operator in accordance with the requirements of 257 CMR 2.00 and the Board of Certification of Operators of Wastewater Treatment Plants.The treatment system shall also be operated in accordance with the conditions established by the Massachusetts Department of Environmental Protection(DEP)under 310 CMR 15,000 Title 5 of the Massachusetts Environmental Code for the permitted use and with the local Board of Health. EQUIPMENT MAINTENANCE 1. Within design capacity and capability of the equipment,maintain the system for the benefit of Client. 2. Certify and document all maintenance for the system. Maintenance reports will be provided on an annual basis or by request of the Client. 3. Certify and document all repairs to the equipment. 4. Perform other services that are incidental to the services specified here including facilitating emergency repairs in.the most _ expeditious and cost effective manner at an additional cost as requested by Client. 5. Pump maintenance to be performed in accordance with manufacturer's specifications by subcontractor and invoiced by them directly to the client. PERC-RITE DRIP DISPOSAL SYSTEM MAINTENANCE In accordance with the Perc-Rite Drip Disposal System operation and maintenance(06M)requirements,conduct 06M inspections using the Perc-Rite technology checklist to document the findings of each inspection. Perc-Rite inspections to include: 1. Standard maintenance as follows: a. Inspect the disposal field for visible wet spots. b. Check the control panel for proper operation. ' c. Check the liquid level of the pump chamber to confirm proper.switch operation. d. Check the pump and valves for proper zone operation. e. Examine the hydraulic unit. • Clean filters as needed • Check all hydraulic components for leaks. • Determine and record flow f. Check the zone dosing rates. g. Examine tanks and pumps and clean effluent screen,filters, and floats,as needed. 2. Maintenance frequency: Conduct semi-annual operation and maintenance visits to perform standard Perc-Rite system maintenance. REPORTING:Prepare summary report following each inspection and file reports with the Department of Environmental Protection, Barnstable County,and the local Board of Health. NOTES: 1. Coastal Engineering will perform no procedures requiring confined space entry. 2. Services under this contract specifically do not include or cover any responsibility for system malfunction attributed to process design,equipment specified and/or installations as provided by others. 3. Client must provide access to all system components at time of the 06M visit. 4. This service contract assumes year round occupancy of the dwelling or facility.The Owner shall notify CEC if occupancy becomes seasonal. S. CEC will notify the appropriate authority of any event of electrical or mechanical failure within the treatment system,or of any event which may adversely affect the performance of the treatment system. 6. In the event that the system alarm is activated and the system fails,the OWNER shall notify CEC who shall notify the DEP and Board of Health within 24 hours.Corrective action shall be taken immediately. i David 5 Erica Samra February 9,2016 ATTACHMENT Z COST OF SERVICES 1. The yearly fixed fee costs for the services outlined in Attachment 1 shall be as follows; Operation, Maintenance,and Reporting:,, $500 yearly ------------------- Billed (0$250 semi-annually 1 Barnstable County Database Management Fee' $50.00 i 2. Services performed in addition to those noted,including responding to alarms,will be invoiced at$85.00 per hour Monday thru Friday lam to 5pm.After regular business hours and holidays will be billed out at$125,00 per hour. 3. The cost for replacement equipment,supplies and process control chemicals will be invoiced at our cost plus surcharge in accordance with our Standard Conditions for Engagement(copy attached). 4. Additional sampling and testing,if required,will be invoiced at time and expense,in accordance with our standard rates. In the event that state or local regulatory bodies change sampling requirements and/or Operation and Maintenance requirements,the cost estimate will be revised to reflect these changes. 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R( 1G L (3 k,00W If W99-n7 7 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) Xw-- (size) NO.OF BEDROOMS n Co .OWNER PERMIT DATE: COMPi, E DATE:7-r ,-R 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 �. y ._. 37 43 35 k Y 4 Y 4 Y \ J J J r J r r ! r r J J r r r J 1 J 1 f r f 4 Y \ \ 4 \ \ \ \ \ \ ♦ \ \ \ Y Y Y Y \ \ Y Y Y Y +. ♦ \ 4 Y \ Y 4 k Y Y 4 4 \ 4 k ♦ k 4 4 ♦ \ ♦ ♦ Y \ `. Y ♦ 4 Y 2 4 \ 4 \ \ Y 4 ♦ ♦ \ \ Y \ Y Y 4 ♦ '\ 4 45 "x"� ♦ ♦ \ ♦ \ Y Y \ \ \ \ Y, 4 4 k 4 4 ♦ ♦ \ \ Y \ \ \ ♦ \ Y Y•Y Y 4 - r f r J J 1 J .✓ J J / f f r f ! f J f J f / / 1 f J r ! ! I f f 27 4 \ Y Y Y Y \ 4 6 Front \ Y 4 4 4 4 \ 1 Y Y Y Y \ k 4 4 29 • TON N OF BARNSTABLE Lt4.C:A-,-QON Jr -7P SEWAGE # VII LACE ��I�f t�l/ � /�d���✓ , ASSESSOR'S MAP & LOT INSTALLER'S NAME& PHONE NO. SEPTIC TANK CAPACITY LEACHING FACII.I'I•Y: (type) �� � -b f/ (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 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 any wetlands exist within 300 feet eaching ac' ' Feet Furnished by n 1, I,� w Old e I No. )61/47 T ( Fee .�G 1- TH COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARN STABLE" MASSACHUSETTS Yes 01pplitation bisp08Ar 6pstr tt Construction Permit C� �3L��� Application for a Permit to Construct Repair( ) Upgrade( Ab don( ) Complete System ❑Individual Components A. �-• Location Address or Lot No. U r r s Name,Address,and Tel.No. CC,I r Assessor's Map/Parcel /AaP Oct S pane / OQy oo vl Cl S�DYy►ax anj 16rica P.Car: '0rl Installer' ame,Address,and Tel 1�1 ,eZS014,1 �j�,) De ' per's N e, ddress,and Tel.No. : U fl~ `(t Type of Building: '` Dwelling No.of Bedrooms .. u(Y re'/L t Size 6/0 Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) ~ Other Fixtures Design Flow(min.required) 7 7 O gpd Design flow provided 7 8 gpd Plan Date Z?l " 2 0 Number of sheets Revision Date f �3 2O/6 Title Pr®pos-Dc_l ��i,✓ct�� ©1s�rora� S)ej -eA--1 P/4y, Size of Septic Tank 2�rOt:7 6'&1 ,. 2"CcM-�e 'Type of S.A.S. y� L 22 i✓ Pier c" I21'Ir Description of Soil �'e SDI t!!Q S Q' S'1 to 2 0 f '3 C 2_ L/o Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construct' n d maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envir ental Code d not to place the system in operation until a Certificate of Compliance has been issued by this Boa b Heal Date -Application Approved by hY�J Date Application Disapproved by Date for the following reasons Permit No. Z O i n Date Issued `1 ' No. 16 . ' k TS EnteredF.inee computer: om uter:HE=T MW X A44" . L►-� Yes PUBLIC HEALTH DIV/, IC N -, OWN OF-BARNSIYA 13E, Mi4SSACHUSETTS _- �. applitattoli � ° Is DBar stem Construction Vermit J Application for a Permit to Construct- Repair( ) Upgrade( Abandon Complete System ElIndividual Components Iti Location Address or Lot No. G ry ScG ,/rf- ��. � �O` ner's Name,Address,and Tel.No. ` Assessor'sMap/Parcel tt ,McfP OA /T_el ..`pq oo vl'� S&mr(A a,J tr(CA P4,65,.l Installer' Name,Address;and Tel. . . Designer's� Name Address,and Tel.Now. U (, / -"j� u t t r, C)r O v {� ft Q26SJ ,1 Type of Building: �0-�10 Dwelling ,No.of bedrooms' /r✓f.(r`e i` Lot Size �) sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures r r 'Design Flow(min.required) ��7 ,-gpd Design flow provided 8 ' gpd r Plan ,Date �I- Z 3 - 20 7 Number f sheets :_ l�j Revision Date "�3 20/6 Prop oSc r W y e ©15 P Title � e C. /leld sj�f J-eh't,i P1Gl') i Size of Septic Tank 2/50f� 6i n Type r 2 Cu T e of S.A.S. crC_ Description of Soil SQ.e SD 1 p L 0 g s 6 r S'hr_e+ 2 of 3 G 2_ �► Nature of Repairs or Alterations(Answer when applicable) f ' Date last inspected: Agreement:. z The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in acco dance.\ith the provisions of Title 5 of the Env' mental Code d not to place the system in operation until a Certificate of Compliance has been issued by this Boar f Hea / ^� i nd d/ Date ttApplication Approved by LAiv. �.r Date Application Disapproved by Date for the following reasons { l ` Permit No. 2 0 n q 5 Date Issued 2 y / -- ------------------ ----------------------------------------------------------------- ,- -- -- --------- 2. THE COMMONWEALTH OF MASSACHUSE�T'TS BARNSTABLE MASSACHUSETTS THIS-IS TO CER�,tat the On-s'te Sewa e.Diis osal system Constructed Repaired Upgraded( � (( � g , P Y ( ) P ( ) . ) Abandon d( )by at 1 Lp CIO t./. , ;� has been constructed in accordance wi the provisions o itle 5 fl9the for Disposal System Construction Permit No. 0 v C/ dated Installer Designer #bedrooms _ p gQ J- rj,/ Approved design flowll and The issuance of this perivits all t be construed as a guarantee that the system will` ction estgne . Date Inspector \ --------------------------f- ------------------------------------------------------------------------------- k--------------------------- No. 2G( 6 0 LI 5 Fee 0o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ` 6pstput Construction j3prutlt Permission is hereby granted to Construct(�) Repair( ) Upgrade( ) Abandon( ) System located at 2 L �P fibv/ i o r and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. �• � Date 2 J J l( Approved by Town of Barnstable Regulatory Services Thomas F. Geiler,Director UAn=g Public Health Division Fo ° Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax 508-790-6304 ' Installer &Designer Certification Form d1� — �3 Assessor's Ma Date: _ Sewage Permit# \Parcel P � . Designer: w InstaIler: Address: 4A!�.�,Address: s-e 3 �� t� () was issued a permit to install a (date) (installer) / septic system at old S ��� /L�( based on a design drawn by (address) . e60 viI&V dated '/ (designer) the septic system referenced above was installed substantially according to I certify that eP roved changes such as lateral relocation of the the design, which may include minor approved g 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 i c ed as built by designer to follow. • SER G R1 I w (Installer's S e) 5 i " FSSIpNM,E�G . (Designer's Signature)_ ( Designer's Stamp Here) ON. ply, SE RETURN TO BARNSTABLE PUBLIC HEM FORM I[ AS--BUILTT CARD ARE COMPLIANCE WILL NOT BE ISSUED UNTIL ATY, OF BOTH RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVLSION. THAI�IK YOU, Q..Healthlsepticoesiper Certification Form 3-26-04.doc �o TQWN OF BARNSTABLE Mfl � S YSLd� LOCATION 8 E- g Q V I SEWAGE # -ram VILLAGE() ASSESSOR'S MAP & LOT- Co INSTALLER'S NAME & PHONE NO. V ETMI W 0 $P®L°) 3roZ 3 r,(fl SEPTIC TANK CAPACITY 20_0 o G;) L LOQ LEACHING FACILITY:(type) FLOW1:21FA (To (sue) W 2 NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATER �UILDER)OR OWNER , '$ �O K�.15 ,3 g� S� S'T N l�►.s 1J 1 S _DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: - VARIANCE GRANTED: Yes No X a Z o 0c) G(t L \Z D 19 ox r 3a / $ 'FLOW 1))T moz cr LO G ATSID r< J BAXTEt & NYE, INC. ` : Registered Land Surveyors and Civil Engineers- - 7 Parker Road / Osterville, Massachusetts 02655 /-Tel. (617)4428-9131,` r WILLIAM C.NYE,R.L.S.-President RICHARD A.BAXTER,R.L.S.-Vice President ` -PETER SULLIVAN,'P.E.V-Vice President-Engineering R January `11, 1988 Town of Barnstable .. Board of Health - P.O. Box 534 m M1 Hyannis, MA 02601V RE : Schlott Residence, Seapuit Avenue '. St. Mary's Island Permit No 87-414 - Installer - Veterino Dear Board: Per terms,+ of your, permit ,..:, this -office -has; " provided inspection supervision-" -for the"`.i-nstallaton-of the above- septic system The system has beep-installed as per the approved plan. Very =-truly y ° - - ours - , y Peter Sullivan,, P .E_ r p .,Baxter & Nye,.. Inc. PS/fmj >1 N No P=" ER oti - SULLIVAN SUL G" , r _ o No. 29733 r ti p MEMBERS OF r CAPE COD SOCIETY OF:PROFESSIONAL ENGINEERS AND LAND SURVEYORS I AMERICAN CONGRESS ON SURVEYING AND MAPPING MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS T WN OF BARN TABLE LOCATION 5 ER p to t"'9' AY S SEWAGE VILLAGE-0 STj�P,1/ LLLV— ASSESSOR'S MAP & LOT 9 S INSTALLER'S NAME & PHONE NO.Vtj V-e.R1f aQ YB RO S 3r,,2 36r r- SEPTIC TANK CAPACITY ' l 00 Q GA L L 01.3 ` LEACHING FACILITY:(type) FL6V1'blV-t1S S DP, (size) 1. w! 2 �5T6N' NO. OF BEDROOMS I PRIVATE WELL OR PUBLIC WATER BUILDE OR OWNER Vb I�A01-R1S , `5r65 SEAL 5`rt*-eT, OyAt1W DATE PERMIT ISSUED: ~ DATE.,, C011PLIAN'CE ISSUED: 7 VARIANCE GRANTED: Yes No ANK °-30x /� , 5TOT ESIGNI JG ENGINEER MAST SUPERVISE: .,ZITALLATiON AND CERTIFY IN WRITiN' `t SYSTEM WAS INSTALLED IN � No......-••.. ............ Fizs........ .. ...... ^" TQ P! M THE COMMONWEALTH OF WASSACHUSETTS BOARD `OA R D OF HEALTH � .P,�J b�- ........OF...... �................... Appliration for Displaiial Marks Tonstrnr#ion amit Application is hereby made for a Permit to Construct ( ) or Repair (K) an Individual Sewage Disposal System at: . :T�'�.t�k'�.ir; l........ _�� �?...�.....---•- _.Q.��r S..�i���1_�.�:.....�3a................. Location- dress or Lot No. 41..1. Imo... �..� ..... -- = f ................ -----------------------------------•---...........---- Owner Address W Installer Address ' ^ Type of Building Size Lot........................"_Sfjr feet- Dwelling—No. of Bedrooms.. .® �_�f-%).___._...Expansion Attic ( ) Garbage Grinder (Q� '4 Other—Type e of Building p,, yp g A�.. .............. No. of persons..O_Q_E�...........Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................ Design Flow..5.57................ . .. . lions per person er a Total daily fiowliSOCP ® " ---�>4 to 0� Septic Tank—Liquid capacity..%.t}t��allons Length .�._ .,,� Width .�,._ .. ��Diameter________________ Depth. t x fteape Trench—No......&-......._.. Width.... .. ......... ota ength� _i_..____ Total leaching area.�gT.......sq. ft. ��1Vro?� v4 _.. 1 e€2�� .�. n-pth 1,dQm ix tetA__ Total leaching area.1;7- sq. ft. z Other Distribution box ( ) Dosin tank ( ) '-' Percolation Test Results Performed by. 1::El�S1C.................. Date..Q Ili Test Pit No. l......Z-_._.minutes per inch Depth of Test Pit...I.o_._....... Depth to ground water....... f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ................................ ..---- O Description of Soil-:T.T.`.1._.......43.......... _a_ .�.._.'T S_ L ._ )•L... .......................... -'�1GNjfj(j EN�Call�Yiti m rv��u Y .��. U Nature of Repairs or Alterations—Answer when applicable..____._ -�-���� a�- *� tT........._.. y-p--p �y y---y-pwY •Jl ALLA l 1Ur4 A'Wiu ...•-------•------•••-•-•---••••••-••••••-•-••••••-•--•••-•-••••••••••••••-••••••-••-••--•••---•...................•--•__-- �,-,o-=-- •ae� n�Q.Tws•A-lsP'L It,,t C:TRt :? Agreement: ^•ORDANCE TO PLAN. The undersigned agrees to install the aforedescribed Individual Sewage Dis System in accordance with the provisions of iITALE 5 of the State Sanitary Code e undersigne rag snot to place the system in — operation until a Certificate of Compliance has bee y the boa Sined- •••--� .......... • -•-•- ........••--- •---•... . ......... .......................... ..y..� ........................................Date Application Approved By........ .---------.•_ll.1_N�-----...--•----• -••-----•................... Date Application Disapproved for the following reasons---- -----------------------------------------------------------------------------------•......-•..._......--••- •---------•----------•------••---•-----------------------------------------------•--....--••---------------•--•-•-------•-•••-•••-•-------•••-•----••••--••------•---••--•--•••--•--•--•--•-•••...._.... .� cfte PermitNo.... � � L., Issued....................•-.- r.......---•-•---------- �.it-•--• s1 Date---•...............a..'.-.... ems^_ No Finc THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........OF..... .. .................. Appliration for Bispaoal Warks Tonstrurtion Vamit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: D......... ..0.. ...I...... S ..U.J.1...... 0..................... joca ior,y dress .....or.Lot No. ,t� . .,_.y .. ................ ..................................... ..................................................... Owner Address ........... ......... .... Installer Address Type of Building Size Lot...5' Z A r, U ?.-................. Dwelling—No. of Bedrooms..0 .........Expansion Attic Garbage Grinder (Q)O . j.... Other—Type of Building ALP.. .............. No. of persons..O..Q.F............ Showers Cafeteria ther 04 Otherbxtures ...................................................................................................................................................... !I1 - Design Flow...!S., .................... y1lons per persotyprga .1...1.1,y, Total daily ,:4 Septic Tank—Liquid capacity..V004aflons Length Width 5;#-9fDiameter................ Depth..!� ..,A, gt "' a P t4�r qh—N�o. .....6 Width...S.7-*........ Total-Length,( ... Total leaching area./nat.?......sq. ft. _44 f Ile 0 -Ina, ;-Iet..l.. ........ Total leaching area_tZ. _sq. ft. Seepage .....tee§p Z Other Distribution box Dosing tank aPercolation Test Results Performed .......... Date..(6/1.6,40......... ,_l Test Pit No. 1......Z.....minutes per inch Depth of Test Pit....1_0......... Depth to ground water./.... �_4 �Z4 Test Pit No. 2................minutes per inch Depth of Test Pit..._................ Depth to ground water.---..--.....--......... P4 ............................................... -------------------------------------------7------------------------------------------------------------------ 3 . , -1-,0 PS CIP,......SV-... .......................... 0 Description of Soil..Tp. I.........0......................................................... ...U .. ....... -- - ----=rW..... .............. ------- ......................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............ 5z miz,...j�IRT.Aj.!.En .......................................................................................................................... ....................................I....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with e undersigned agrees not to place the system in the provisions of TITILj 5 of the State Sanitary Code—A d, I TE rEl .operation until a Certificate of Compliance has bee .1"by the boa 0 "y Ifu_Ss ..........................Signed.- .......................................... .................... Date Application Approved By..-.. fA ----------- .............................................---------------------------- ........................................ Date Application Disapproved for the following reasons:................................................................................................................ ............................................................................................................................................................................................*------------ Date PermitNo..... . .....7.............. . .... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS OF HEALTH "4 ..........................................OF..................................................................................... Tntifiratr of TOutpliatta T IS S TO C.PRTIFY, That the Individual Sewage Disposal System constructed or Repaired 4, -S by.......... < ..................................................................................................................................................................... -filer IS CZ Inst. ................C��.I.C-.f\.S.................................................................................. at..................................... i�. =................. ......t has been installed in accordance wit i the provisions of TIT 4 of Tfif State Sanitary Cole as describ d injhe application for Disposal Works Construction Permit No......................................... date THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............Lf..13=11....................................... Inspector............. .................................................... THE COMMONWEALTH OF MASSACHUSETT!EFSIGNING ENGINEER MUST SUPERVIS 'STALLATION AND CERTIFY IN WRITiK BOARD OF HEALTH IE SYSTEM WAS INSTALLED IN STRIC f)Rr) t Ll ANCE ...........................................OF..........M�� To PLAR. ................................................................ No......................... FEE....................... DisposMI Permissionis hereby granted..........................*............................................................................................................. to Constr Repair an Individual-Swage Di sal S stem A ZYON atNo........................................ . .............................................................................................................................. Street rR i as shown on the,application for Disposal Works Cons ruction-Permit-Nb.. .................. ...® 7. .................. Board of H ealth --------------------------------- DATE.------.... ..............(..................... . 7....................."... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Prof THE TOi TOWN OF BARNSTABLE J dw ` ♦�` OFFICE OF DAHI7TABLL BOARD OF HEALTH MMl 367 MAIN STREET HYANNIS, MASS. 02601 Sewage Permit # Applicant IOU, Proposed Installer: The plan for the on-site sewage disposal system at V1�1at� has been approved with the condition that the design engineer must be on-site and supervise installation as well as certify in writing that the system was installed in strict accordance to the approved plan. f -- ZY l 19-7 Approved By. ate VW�f TAP 4 P e F:\SDSKPROJ\C18000\C18236\C18236-00\C18236-CONSTRUCTION-LAYOUT.dwg May 15,2018-12:26pm , r -) rr D T t D C O C7 _rl - nLn T N -� -0 N I _ Ln y0m D Z OZZ O ' li m Z Crn cAi( v co v J N N N 0 m O _ - CD A .00 OD U1 m p 71mcn oD c:) ova= CD U oo rr =O= C7 r-o `\ m D f m m' / O m m CD041 L;y Y u �—QO ' y n O 0 �O� a v) rl �V " Ew x >�' �7z` ° zzoz -iV- 0 Lk•, tk041D _0 Tt LXr r. 00 c' O O 0.D zoo ' CD ' mc� O rn A N l- I .�O�O�I m o <�4 33 6 ❑ ` ` z D '1 0 7 , o Z tom, X t t, ev r y 1 o-0m Dr ' r n 0 r-m Z i� m o �. 4 v�� -0N I S 1356x1 p,x W o• \�I^ 1,3 9g, o ; �' , N ia , , - L=155.08' \ 0 o N N o D R=253.87` 0 v0 U o c,, T%i 91) CD I.jj fl ad ��q o' O 88 � � � ZZ to T7 25 TI v v m z 00 WO� �z \ m N v v N N 70 11>,cli co m —I V) a m m m m o� II O W 0 0 0 o mZ -n - -o -0 -0 m m m m I zC-1 Z Z n C<7 C<7 O C<-J �I - U ; Z n D < < < < < O O W D O C7 OOD CT W O cm N L� Ln N 00 O� b. v W z MASS. COORD. SYSTEM NAD 1983 MAINLAND ZONE C18236-CONST.^..dwg DRAWN BY:JLH , Coastal Engineering Co.,Inc.© 2018 - PROJECT SHEET NO. PROJECT NO. NICHOLAS DA•VID SAMRA . SCALE c18236.00 COASTAL SEWAGE DISPOSAL SYSTEM AS-BUILT C1.4.1 AS NOTED engineering co. DATE 508.255.65U2H 508.255.E 0 026� 265 SEAPUIT ROAD BARNSTABLE OSTERVILLE MA ` ' 05-15-2018 0 5TLRV I LL le+ i L 00t ` } 1 ti . � + -i�,f` fill . T' `..t r , + A •* Fr. ,.r+f " f'^' �.�. �r�jt 5yr f a w , q ' 1 !.P1' - • "'�, ynF 11 .[ ( J � �� • � _ �� 11 `.^��� t �'• '' , 'J . 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F"FL1C,AlaL U'fv1Ll"T`� CpWPiAt,-)eS AV 1-_eli)ST ` Z. 5Y�TL!� GaMP01..�t=NTS RP , N OUWLS P RjC -M 7'0 cxCA V.AT 1 uG A`T T H 51 T E E�c15T 1 K3- 7. P t) 5 5 Y)PI L L c L P��S I rj c7 1�oZ>GSf U �E p�'�� o A,�,`�" T SEt1�YL L I W�5 GR•4 SS 1r\.lA�`>ER- S!)1�L�T L 1 �J�S '5117F�.ylrJA L�I..- S ��-���� � � ' S'To�>; IRE431STEF F-U' L ,W'D SURVE R s 1 � x 'H V- Z. 1 + 3. � "oi5 6 S 5 b)FITS ) 4 *-%oS Zao GPIP L Fe. Co I WSERS �or-r o N1 r,$� 544 I.0 = 54 4 G r i7 19 $ so4 G PD a.K . GENERAL CONSTRUCTION NOTES DESIGN CALCULATIONS LANDSCAPE NOTE: PLAN REFERENCES: FALMOUTH RD - RTE 28 COASTAL 1) GARBAGE GRINDERS ARE NOT ALLOWED WITH THIS DESIGN. DESIGN FLOW: PROPOSED 7 BEDROOMS AT 110 GAL. PER DAY PER BEDROOM = 770 GPD REFER TO WILKINSON ECOLOGICAL DESIGN & / 2) THE INSTALLER IS RESPONSIBLE FOR ASSURING THAT COMPONENTS OF THE SEWAGE 770 GPD X 300% = 2,310 GALLONS - USE 2,500 GALLON TWO COMPARTMENT H-20 SEPTIC TANK HAWK DESIGN PLANS FOR FURTHER DETAIL ASSESSORS MAP 095, PARCEL 004 ENGINEERING 1 DISPOSAL SYSTEM ARE DESIGNED WITH SUFFICIENT STRENGTH TO SUSTAIN ALL LOADS A 481 x 22'W PERC-RITE DRIP DISPERSAL FIELD CAN LEACH: WITHIN VEGETATED AREAS, TREE REMOVAL, L.C. PLAN 5725-H LOT C �� N TO BE IMPOSED ON THEM. ANY COMPONENT OF THE SYSTEM SUBJECT TO VEHICULAR Vt = (48' x 22') x 0.74 GPD/SF = 781 GPD PLANTING PLANS & SPECIFICATIONS. ,ff' L.C. PLAN 5728-D LOT 1 COMPANY, INC. TRAFFIC MUST COMPLY WITH A MINIMUM STANDARD OF A.A.S.H.T.O. H-20 WHEEL CTF. #204739 / \�) BU,yp 260 Cranberry Hwy.Orleans,MA 02653 LOADS. / �\ S Rw 508.255.6511 Fax:508.255.6700 3) PRIOR TO SETTING ANY SEWAGE DISPOSAL SYSTEM COMPONENT, INSTALLER SHALL INSTALL: ONE ( 1 ) - 48'L x 22'W PERC-RITE DRIP DISPERSAL FIELD Vt = 781 GPD > 770 GPD REQ'D. L.C. PLAN 5728-E VERIFY EXISTING CONDITIONS, INCLUDING ELEVATIONS OF EXIT INVERTS, AND REPORT ONE ( 1 ) - 2,500 GALLON TWO COMPARTMENT SEPTIC TANK (H-20) ANY DISCREPANCIES TO THE DESIGN ENGINEER. ONE ( 1 ) - 2,500 GALLON PUMP CHAMBER (H-20) FLOOD NOTE: 4) ALL GRAVITY SEWER PIPE SHALL BE 4 DIA. SCH 40 PVC UNLESS OTHERWISE NOTED. THE MINIMUM SLOPE OF 4" DIA. SCH 40 PVC SHALL BE 0.01 FT/FT. FLOOD ZONE AE (EL 13) AND � \ � SEAPUIT � 5) NO PART OF THIS DESIGN SHALL BE ALTERED WITHOUT PRIOR APPROVAL FROM THE O 1 NORTH DESIGN ENGINEER AND THE AGENT OF THE LOCAL BOARD OF HEALTH. ALL REQUESTS S01L REMOVAL NOTE OQ' ' ZONE AE (EL 12) AS SHOWN ON ( BAY\ RD FOR CHANGES SHALL BE MADE IN WRITING PRIOR TO CONSTRUCTION. :/ Q- • FEMA FIRM PANEL #25001CO544J / 6) THE USE OF ALTERNATE MANUFACTURERS FOR SYSTEM COMPONENTS SHALL NOT BE REMOVE TOPSOIL AND UNSUITABLE MATERIAL WITHIN 1' OF THE DRIP EFFECTIVE JULY 16, 2014 APPROVED IF THE USE OF THEIR EQUIPMENT REQUIRES CHANGES IN DESIGN. DISPERSAL FIELD DOWN TO THE "B" SAND HORIZON (AS SHOWN IN = / DATUM NOTE: l �� BARNSTABLE (OSTERVILLE), MA v 7) THE INSTALLER SHALL ASCERTAIN THE LOCATION OF EXISTING UNDERGROUND SOIL LOGS.) REPLACE WITH SAND FILL TO ELEVATION 8.0t IN " H v UTILITIES PRIOR TO EXCAVATION, AND SHALL PROTECT UTILITIES WITHIN THE WORK ACCORDANCE WITH NOTE #10. DAM POND z w w ELEVATIONS SHOWN HEREON ARE BASED w AREA DURING CONSTRUCTION. �� s �6�5�10" ON THE NORTH AMERICAN VERTICAL KEY MAP u 8) THE EXISTING SEWAGE DISPOSAL SYSTEM (INCLUDING CESSPOOLS) SHALL BE PUMPED, E NO SCALE w z ,.�''" / _ O v FILLED WITH SAND, AND ABANDONED; OR SHALL BE REMOVED WITH SURROUNDING �-- .�-•-- 53 f---_ 69 DATUM 1988 (NAVD 1988)f CONTAMINATED SOILS AND BACKFILLED WITH CLEAN COARSE SAND. �- �4 BENCHMARK: h x 9) ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING TAPE OR A �_ TOP OF BOUND ua �" A > 3 16• a � �. �_ rn " 00- ELEV.= 4.14 (NAVD 88) Ln Q COMPARABLE MEANS IN ORDER TO LOCATE THEM ONCE BURIED. -E • • % o LEGEND o �E w 10) FILL MATERIAL FOR SYSTEMS CONSTRUCTED IN FILL SHALL BE CLEAN GRANULAR `�°N • + • *� un SAND, FREE OF ORGANIC MATTER AND OTHER DELETERIOUS MATERIALS. THE SAND ''� / + + ` + + + + + + + + + + + EXISTING PROP o w o SHALL BE GRADED SUCH THAT NOT MORE THAN 45% OF THE SAMPLE, BY WEIGHT, r' �► + + + + + + �/ � � W� �, SHALL BE RETAINED ON THE #4 SIEVE. THE FILL SHALL NOT CONTAIN ANY MATERIAL °s ��P --' I= • • • • • • • • • '' ■ BOUND 5 CONTOUR LARGER THAN 2 INCHES. THE MATERIAL THAT PASSES THE #4 SIEVE SHALL MEET THE FOLLOWING GRADATION REQUIREMENTS: °4�RP J S oN� '� • • • • • • • • ,441 EDGE OF VEGETATION +5.0 SPOT GRADE 5 p O 3 `A of A w 3.8 EDGE OF WETLAND/MARSH SIEVE PERCENT � s = =--� - �-�'_ ♦ -� • + • • • I � � � LIMIT OF WORK/ O o � O SIZE PASSING _ _ '� ♦_"� SEDIMENTATION z O 4 1009� -_ a ♦ _ _ .._� - ,--- -- �T OF � - ♦ _ �, • • • • � CONTOUR � A � R� /.� . . . • . . . . . . z u, � a 50 10�-1009� _ -- � - ♦ • • • • • • k • C.O. CLEAN OUT O A 100 09o-20% ASSESSORS MAP 095 ♦ _- ,�. • • SPOT GRADE PLANTINGS o Q 200 0%-5% PARCEL 005-001 - ��ooPs1P - � ♦ ♦ � O.P. ORNAMENTAL � a cn ,,%� --� _ • ♦ ,. . ( I ) OAK WATER SERVICE _ o -F GRAVEL ;a5.fi C , • � LOCUST DRIVE (DIA) 1 a5!"�0 .+.� I CEDAR + • ,� -`�-,. .�., •.•,--�-'' ,: �:� 4 DIA. SCH 40 PVC � �. -' , ;.,.•. �� , - ,.., `� r . y � � , , Y <. INV OUT 8 3 t ® _ ( I )0— MISC. ,�� _ . •� {. �e 1 12 MT TREE X : •cC9 /►� �1�. 10 C ,, .., , . �.� � APPROXIMATE LOCATION OF EXISTING SEWAGE f , r� / -;� STD. 4' DIA. MH o -may- ` fl?�s ALL EXISTING ` `� DISPOSAL SYSTEM PER PLAN ON FILE WITH THE INV. IN (SW)=8.1't \� c° J BARNSTABLE BOARD OF HEALTH "' �`' �" z BUILDINGS TO INV. IN (NE)=8.1't + ` BE DEMOLISHED ,; N AssEssoRs MAP os5 ' X 4 PARCEL 007-001 INV. OUT (SE)=7.9't AND REMOVED SEAL 6• O ' " OFF SITE (TYP.) =1!1 PROPOSED �oxl 4 DIA. SCH 40 PVC _ I PERGOLA Q Q 0P INV. OUT=7.8'f 4VA R/A N CES Y M 1 / ' : c,Q' L=35.3't, S=2.2% pRp ft co \ / 4" DIA. SCH 40 PVC , �* D ��£D R p T .. ! _ / + ` O 6EQGE ,+ 310 CMR 15.000 (TITLE 5) INV. OUT=9.0 t ��� , +10.0 a, olk `� IL 15,211 (1) MINIMUM SETBACK REQUIREMENTS: ti SEPTIC COASTAL BANK }4.i..- , TANK LESS THAN 25' FROM C ��SS�ONAL ENG w i (25 VARIANCE REQUESTED Ell + 5 �OQOQ ' h PROPOSED 1 �� x S �2s A \ 2r°a�\\. - PUMP B 25' FR, A T 1 p `1K • R - v' f 1 / • Q ,'` C.O. ' 2,500 GALLON n-\,` �a°OS£D t �,06.7 ,� � � � ... C(25' VARIANCE REQUESTED) M ..__... C4c � f / + PUMP CHAMBER Q RRq APRROX. LOCATION s' - SOIL ABSORPTION SYSTEM LESS THAN 50' FROM "OASTAL BANK � � / + - � + �' O• PROPOSED � ����! -` EX. SEWAGE DISPOSAL \ � � ' OQ• O 2,500 GALLON (50 VARIANCE REQUESTED) � � APRROX. LOCATION � • � -•, i + • x SEPTIC TANK SYSTEM (SEE NOTE 8' 4.4 W � EX. SEWAGE DISPOSAL +76 � rI ;, _' • a PROPOSED �` o �l? SYTEM (SEE NOTE 8) \ - :: �� • ` � TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIDNS • �O HYDRAULIC io W UNIT �•; ';.µ� ;xi. O.p• ; ��. `� - BACK REQUIREMENTS: , P. 360 1 SE Q, ' - LEACHING FACILITY LESS THAN 100 FROM MARSH I•rj � M...� /� '/ b Q• p, PROPOSED (21' VARIANCE REQUESTED) a ay + ` • ` Q "'� ` ' y b .. O _ -o �� i P��' I r ` RELOCATION OF \ - SEPTIC TANK LESS THAN 100 TO DEP COASTAL BANK aa�� l� -`� 100 VARIANCE REQUESTED) w Q EXISTING SHED '� ( a � / / • • • �:` i �`' pSlip 6 - PUMP CHAMBER LESS THAN 100 TO DEP COASTAL BANK / Q l / ZONE AE (EL 12) 'T - (100' VARIANCE REQUESTED • • 4" DIA. SCH 4G PVC - RIANC ) (� � • • J / 7 +,���` LEACHING FACILITY LESS THAN 100' TO DEP COASTAL BANK ll ( - / / • • • INV. OUT=9.8't ` '``� . / ZONE AE (EL 13) �' � � Vcd / / • • • • • L=88 t, S=2.09� 9 6` a� 3 __- _ _ (100' VARIANCE REQUESTED) ^ I I 1� • OQ �, a PROPOSED \ w EFAl, 4.5 • . • Q O. :!1 OF e • • Ac¶o �= ,_(• � WATER SERVICE S � - •� � � ^ a TY ( ) 08, .- x:a_5 3.2 — - - STAL BANK LAWN ,� - __ _-<. -��. / y. • • _... _ Q„I AREA • .,-. -_ _ _____ ____ `. �.� �,`- �� � � Q, PROPOSED H •�y . I 1 . .. WALKWAY � � •' - - ,� PROPOSED APRROX. LOCATION I '� STONE TERRACE -0 °F 3�0 ` .� C �1 EX. SEWAGE DISPOSAL \ X Rs Q, 3 = SYTEM (SEE NOTE 8) - - x-o.3 I a PROPOSED EDGE �' xo.4 w \ so PROPOSED DRIP DISPERSAL Q, �� • ,..� + OF LAWN (TYP.) ASSESSORS MAP 095 , �o FIELD SEE SHEET C2.4.1 AND MIDDLE POND PARCEL o03 1 3.0 � -- • :,. • • �O\``'l , � � • • • • AREA � �ti� ��-��� C2.4.2 FOR SYSTEM DETAILS �► , � '6 3.7 �-�% (MAL) x w cr^ \ 1® + . • . . • 87,010 S.F.t12-0 \ • • (2.00 AC.t) BENCHMARK: , - + + + + TO MHW r °�' �o TOP OF RODCAP , v 'vc `�� \ / �� • + + + 0 � �- ' ,� ��` -�`` ELEV.= 4.48 (NAND 88) kn �. w + + - �� ` • ` • ` • • • • • _ '� \C\�' `....., SCALE 2" X 2" X 3' WOODEN STAKE 10' ON CENTER \ ` �� • • • • ` . • • • • • • ' AS NOTED (MAX.) 0.4 /.. A WING FILE _ \ ` ` 4 ` —1.4 DRC18236-C3D-PLAN B.dwg \ •\ • + ♦ ) ;_ ` �w DATE 12" FILTREXX SILTSOXX • . NOTE: I N SPE`„TI ON NOTE DRAWN BY OR EQUIVALENT • •� • �_., N \� • ` 4 • ` • ` + ` • ` ��j� + ` «f; ALL WATER FIXTURES TO BE WATER TESTED BY CONTRACTOR TO THE STATE ENVIRONMENTAL CODE TITLE 5 REQUIRES INSPECTION S SRK SLOPE .•. R,. � + ./ VERIFY ALL SEWER EXIT LOCATIONS PRIOR TO INSTALLATION OF OF THE SEWAGE DISPOSAL SYSTEM BY '11�E DESIGN ENGINEER.O CHECKED BY �i '' • • • ANY SYSTEM COMPONENTS. ` . + • • • INSTALLATION CONTRACTOR MUST NOTIFY THE DESIGN ENGINEER w AREA TO BE •' R TG� ` • . • . � + • • ' 3 31 PROTECTED ,` 4. , • • + , • PRIOR TO THE START OF INSTALLATION FOR DISCUSSION ON N tz M - PLAN REQUIRED INSPECTIONS. ,.� t • 20 10 0 20 60 c NOTE: o0 C2o1o4 • . • . + . + . . + . • . . THE INFORMATION HEREON HAS BEEN PREPARED ACCORDING TO SIL TSOXX SIL T BARRIER DETAIL ` ` s • � + 1 inch = 20 ft- THE REQUIREMENTS OF TITLE 5 OF THE STATE ENVIRONMENTAL � CODE FOR SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND NOT TO SCALE (THIS AREA IS SERVED BY TOWN WATER) LOCAL BOARD OF HEALTH REGULATIONS. w 1 OF 3 SHEETS U X-1 2 o PROJECT NO. C18236.00 U DEEP OBSERVATION HOLE LOGS DATE OF TESTS, SEPTEMBER 11, 2015 NOTE: AIR RELEASE VALVE PERCOLA11ON RATE : LESS THAN 5 MINUTES PER INCH ALL WATER FIXTURES TO BE WATER TESTED BY CONTRACTOR TO FALMOUTH RD - RTE 28 COASTAL NO SCALE DROP IN THE B HORIZON IN DOH #3. VERIFY ALL SEWER EXIT LOCATIONS PRIOR TO INSTALLATION OF 48' DEEP OBSERVATION HOLE 1 EL. = 6.0f AND LESS THAN 2 MINUTES PER INCH ANY SYSTEM COMPONENTS. ENGINEERING DROP IN THE C HORIZON IN DOH #4. DEPTH FROM SOIL SOIL SOIL COLOR SOIL OTHER COMPANY INC. N ' SURFACE HORIZON TEXTURE MUNSELL MOTTLING WITNESSED BY : JOHN SCHNAIBLE, R.S., CEC INSPECTION NOTE DAVID STANTON, R.S., HEALTH AGENT TITLE 5, REQUIRES INSPECTIONS) \ e�M,os Rw 260 Cranberry Hwy.Orleans,MA 02653 0" - 26" FILL - - THE STATE ENVIRONMENTAL CODE, l 1 508.255.6511 Fax:508,255.6700 26" - 32" A LOAMY SAND 10 YR 2/2 OF THE SEWAGE DISPOSAL SYSTEM BY THE DESIGN ENGINEER. RD 22' �� INSTALLATION CONTRACTOR MUST NOTIFY THE DESIGN ENGINEER r 32" - 42" B LOAMY SAND 10 YR 5/8 - - PRIOR TO THE START OF INSTALLATION FOR DISCUSSION ON REQUIRED INSPECTIONS. ( ~1 � COARSE TO �� NORTH �N1 RD IT �2 42" - 120" C SAND 10 YR 5/4 - GROUNDWATER ENCOUNTERED 0 60" MED. SAND, (ELEV.-1.0') NOTE: ( BAY ` `r LOOSE THE INFORMATION HEREON HAS BEEN PREPARED ACCORDING TO ti r THE REQUIREMENTS OF TITLE 5 OF THE STATE ENVIRONMENTAL ZONE 1 SUPPLY DEEP OBSERVATION HOLE 2 EL. = 8.5t CODE FOR SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND 1 O.C. �1 i LOCAL BOARD OF HEALTH REGULATIONS. TYPICAL BARNSTABLE (OSTERVILLE), MA DEPTH FROM SOIL SOIL SOIL COLOR SOIL OTHER COMMON RETURN zCn SURFACE HORIZON TEXTURE MUNSELL MOTTLING KEY MAP j " _ " _ _ 1/2° SUPPLY&RETURN MANIFOLD TOP FEED Z126 ZONE DETAIL NO SCALE t- 0 66 FILL LOCATED ABOVE DRIP TUBING TO O O PERC-RITE DRIP TUBING ¢ U O ALLOW MANIFOLDS TO DRAIN Z-126 CONFIGURATION (NOT TO SCALE) H �H 66" - 72" A LOAMY SAND 10 YR 2/2 - - AIR RELEASE VALVES WITH q o v COVERS TO GRADE 72" - 84" B LOAMY SAND 10 YR 5/8 - - DRIP TUBING COVER SHALL CONSIST FOR DRIP DISPERSAL FIELDS WITH NO DISCERNIBLE SLOPE o w » COARSE TO OF 2" MIN CLEAN SAND AND p Cn z 84 - 132 C SAND 10 YR 5/4 - MED. SAND GROUNDWATER ENCOUNTERED 0 90 REMAINDER TO BE LOAM &SEED GENERAL PERC-RITE DISPERSAL SYSTEM CONSTRUCTION NOTES: �' (ELEV.-1.0) VERTICAL SUPPLY& N O a LOOSE (SEE LANDSCAPE PLAN) U RETURN LINES 1. The system shall not be installed in wet or frozen soils. INSULATED (PER FINISH GRADE 2. Do not park, drive large equipment, or store materials on the dispersal area. No activity should occur on hdispersalw O a p ty the area other w z o DEEP OBStRVATION HOLE 3 EL. = 6.3t COLD CLIMATE than the minimum required to install the system. O AA NOTES) 3. All installation and construction techniques shall conform to the state and local codes pertaining to on-site wastewaters stems and �" w DEPTH FROM SOIL SOIL SOIL COLOR SOIL OTHER 3 . . q p g Y vw, � SURFACE HORIZON TEXTURE MUNSELL MOTTLING the permit for the site. w 3 1 D 4. If site conditions are determined to require the installation of the system to deviate from the design plans, all work shall stop z A 0" - 36" FILL - - immediately and the designer and inspector shall be notified. Any ongoing work shall be the sole responsibility of the contractor. o _ _ 5. Drip tubing may be installed with a vibratory plow, a static plow, a narrow trencher (< 6" wide), by hand trenching, or by scarifying 36" - 42" A LOAMY SAND 10 YR 2/2 - _ EXISTING GRADE - - - -- - - -- - �, � •• • • ••• • '' • • �• '•• the surface and bedding the drip tubing in clean sand meeting the requirements for fill material in the state code. For sand fill 42" - 60" B LOAMY SAND 10 YR 5/8 - - PERC 0 4s" MAIN SUPPLY& SOIL HORIZONS A&B TO BE REMOVED AND REPLACED ' systems, cover consisting of 2" of the same sand and then topsoil meeting the approved depth requirement shall be provided. WITH CLEAN SAND MEETING THE REQUIREMENTS FOR . COMMON RETURN 6. All drip tubing is to be installed parallel to the contour. 60" - 120" C SAND 10 YR 5 4 _ COARSE TO GROUNDWATER ENCOUNTERED 0 6Y FILL MATERIAL IN THE STATE CODE / MED. SAND (ELEv=t.t') LINES LOCATED 1/2" PVC FLEX 7. Air release valves shall be placed below the ground surface in an insulated valve box but at an elevation above the highest drip line LOOSE BELOW FROST LINE -. ESHWT RETURN LOCATED in that particular zone. �. ABOVE DRIP TUBING 8. Vegetative cover must be replaced for installations where it is removed or buried during installation. DEEP OBSERVATION HOLE 4 EL. = 7.2t TO ALLOW DRAINAGE 9. All cutting of rigid pvc pipe, flexible pvc, and drip tubing of.size 2" or smaller shall be accomplished with pipe cutters. No sawing is A allowed. DEPTH FROM SOIL SOIL SOIL COLOR SOIL OTHER 10. All rigid PVC pipe, flexible PVC pipe and drip tubing shall have the ends covered with duct tape after cutting to prevent construction SURFACE HORIZON TEXTURE MUNSELL MOTTLING g p p p�P P 9 p g PERC-RITE FIELD (48'x22') debris from entering the pipe. 0" - 24" FILL - - (NOT TO SCALE) 11. Prior to gluing, all joints shall be inspected for and cleared of any debris. All joints shall be cleaned and primed with pvc primer 24" - 36" A LOAMY SAND 10 YR 2/2 SEAL Note:All Perc-Rite components shall be obtained prior t0 being glued. - - from Oakson, Inc,Gloucester, MA.,978-282-1322 PERC-RITE DRIP TUBING Z-126 12. All PVC pipe and fittings shall be sch 40. 13. Whenever possible, all force mains shall be tested for leaks prior to being back- filled by pressurizing 36" - 60" B LOAMY SAND 10 YR 5/8 - - PERC o ss" NOTES: NOTE: leakage. the system and observing for �o� N SE N COARSE TO GROUNDWATER ENCOUNTERED 0 74" 1. ALL RIGID AND FLEXIBLE PVC ARE To BE LOCATED ABOVE THE DRIP LINE ALL DRIP LOOPS ARE TO BE LOCATED 2"ABOVE THE DRIP LINE TO ' o Y 60" - 120" C SAND 10 YR 5/4 - MED. SAND, (ELEV.=1.0� TO ALLOW THE PIPES TO DRAIN. ALLOW FOR THE LOOPS TO DRAIN. 14. The hydraulic unit shall be placed on top of the septic/treatment tank, pump chamber, or on a bed of 4" - 6" thick 3/4" gravel in a IL N E LOOSE 2. THE AIR RELEASE VALVES SHALL BE PLACED AT THE HIGHEST POINT ON location within 30' of the pump. } 671510 THE SUPPLY AND RETURN LINE FOR EACH ZONE. „ 15. If standing water is a problem in the vicinity of the hydraulic unit, a screened drain to daylight is required. IFS c�STER G��� E 3. EACH ZONE TO HAVE TWO AIR RELEASE VALVES. RADIUS 16. Electrician to provide separate circuits for the pump and controls/alarm, or as required by state and local codes. s`ONAL N is 4. RETURN LINES TO BE CONNECTED TO A COMMON RETURN LINE. RAM INSERT 17. All conduit entering the control panel shall be sealed at both ends to`prevent condensation or gases inside the panel. FLOWMETER ADAPTER SUPPLY VALVE DISC FILTERS RIGID BOX WITH 1/2" MIN 12' -`� COLD CLIMATE NOTES: RIGID FOAM INSULATION CNP) I PVC FIP "INSERTED UNDER COVER 1/2" FLEX PVC _ ADAPTER 1. All attempts should be made to place the hydraulic unit in a location with an open southern exposure for warming purposes. W FIELD FLUSH VALVE TUBING 2. All pipes entering and leaving the hydraulic unit shall elbow vertically down 90 degrees to a depth below the frost line prior to a AIR RELEASE 4' LENGTH . .CHECK VALVE DRIP extending away from the unit horizontally. 1.4 a 1 1/2" GRAVITY RETURN VALVES NEEDED FOR (TYP) DRIP TUBING 3. The supply and return lines shall be installed below the frost line. When this is not possible, rigid foam insulation (min 1" Cn 0 1."e TO SEPTIC TANK MULTIPLE ZONE Loop ne. en thick)shall be placed over those pipes that are above the frost line. SYSTEM ONLY En s (0.5% MIN. SLOPE) TYPICAL DRIP-LOOP CONNECTION 4. The vertical sections of pipe that travel through the frost zone and connect the supply and return lines to the manifolds shall be w insulated sch 40 pvc pipe. Insulation shall consist of foam i wrap insulation and 1" rigid foam insulation strips made into a box. ~� w S p p�p • pipe p � g' p (NOT TO SCALE) n BACKFLUSH VALVE RETURN (see insulation detail) MANIFOLD 5. Foil wrap insulation shall be placed over the supply/return manifolds and loop connectors so that at least 1' of insulation extends 1" COMMON PVC PRIMED TREADED CONNECTION WITH each direction beyond the fittings. (see insulation detail) w „ RETURN SUPPLY AND GLUED TEFLON TAPE 1 1/2 SUPPLY FROM MANIFOLD �, 6. Air release valve enclosures shall be insulated with bagged Styrofoam peanuts, foil wrap insulation, and rigid foam insulation inside PUMP CHAMBER 1 ZONE SUPPLIES /, the lid. (see insulation detail) � 7. All loops connecting drip runs shall be slightly elevated (minimum 1" - 2") so that they drain into the drip tubing after the pump w \ 1" RETURN FLEX PIPE TUBING DRIP shuts off. It is the contractor's responsibility to ensure that these loops stay elevated during and after the loops are backfilled. \ 1/2° 8. Dense vegetative cover is to be established over the supply trench return trench manifolds and drip tubing prior to the first 0 1" SUPPLY \ RETURN ) ADAPTER FITTING BARBED RAM PERC-RITE HYDRAULIC UNIT (15 GPM) ( ' NP) 1/2" SUPPLY PVC FIP exposure to freezing temperatures. If vegetation cannot be established then the entire drip dispersal field is to be covered with a M-�I (NOT TO SCALE) INSERT FITTING thick layer (minimum 6") of mulch, straw/hay, or frost blanket until such turf cover is established. 9. Vegetation height over the drip dispersal area should be a minimum of 4" - 6" throughout the winter months. TYPICAL MANIFOLD CONNECTION 9. DRIP TUBING TO FLEXIBLE PVC PIPE CONS I IZ UC!1 ON NO 7ES (NOT TO SCALE) 1) REFER TO SHEET NO. C2.1.1 FOR GENERAL CONSTRUCTION NOTES. a RAISE CODERS TO WITHIN 6" HYDRAULIC UNIT ~ ROPOSED DWELLING/ OF FINISH GRADE (SEE THIS SHEET AND PROPOSED STANDARD 32" HDPE "SEAL-TITE" SHEET C2.4.2 FOR DETAILS) PERC-RITE DRIP DISPERSAL FIELD rT� 4' DIA. MANHOLE FRAME AND COVER TO BUOYANCY CALCULATIONS: FINISH GRADE SEE THIS SHEET AND SHEET C2.4.2 FOR PERC-RITE FINISH GRADE=9.0'f DRIP DISPERSAL FIELD DETAILS ice, PROPOSED 2500 GALLON TWO-COMPARTMENT SEPT►C TANK ( PROPOSED 2.500 GALLON PUMP CHAMBER (( Q,) TDROP: ,. s" MIN. 9; MIN. s" MIN. AND �I 10 3 MAX. 3 MAX. 2 MAX. � W ASSUMPTIONS: ASSUMPTIONS: Low. 3' MIN. COVER � " Q w ' 2" AVER F 1 8 TO 192 STONE 4" DIA SCH 40 '' - ' `' '' ''_ : LINE' ZABEL FILTER " / TANK IS EMPTY TANK IS EMPTY • • TANK DIMENSIONS= 11'L x 6'W x 8.58'D + 0.5'L x TH x 5'W BAFFLE WALL TANK DIMENSIONS= 11'L x 6'W x 8.58'D PVC PIPE2" min. OR EQUIVALENT •` "'• ( ') U w TANK WEIGHT= 30,450 LB PER SHOREY PRECAST ST-2500-H-20 + BAFFLE WALL) TANK WEIGHT= 28,000 LB (PER SHOREY PRECAST ST-2500-H-20) PIPE AS REQUIRED ; . 3 max. WEIGHT OF RISERS AND COVERS NOT INCLUDED WEIGHT OF RISERS AND COVERS NOT INCLUDED BY MA. PLUMBING i; 10" 10" < " CODE WITHIN 10' SE 4 DIA SCH 40 a N 7.03' BELOW BELOW PVC PIPE f• DEPTH TO OBSERVED HIGH GROUNDWATER = 6.7'f BUOYANCY FORCE ON EMPTY TANK: (ASSUMING 100 YR FLOOD EL. 12) BUOYANCY FORCE ON EMPTY TANK: (ASSUMING 100 YR FLOOD EL. 12) OF BUILDING LIQUID DEPTH s.75 SCALE `'� ',' 6.78' 2,500 GALLON H-20 ,•, 6.75' AS NOTED DISPLACED WATER VOLUME= 111 x 6'W x 8.58'D DISPLACED WATER VOLUME= 111 x 6'W x 8.58'D SEE PLAN COMPARTMENT 1 COMPARTMENT 2 • PUMP CHAMBER OBSERVED HIGH GROUNDWATER ELEVATION 1.26 f 1,540 GALLON : 770 GALLON SEE SHEET C2.4.2 (USING DATA LOGGER IN MONITORING WELL) DRAWING FILE VOLUME= 566 C.F. VOLUME= 566 C.F. (MIN.) (MIN.) FOR PUMP DETAILS C18236-C3D-PLAN B.dwg BUOYANT FORCE UP= 566 C.F. x 64 LB/CF= 36,224 LB BUOYANT FORCE UP= 566 C.F. x 64 LB/CF= 36,224 LB s SZ GROUNDWATER WITHIN TEST HOLE DATE DOWNWARD FORCES' ". FLOOR EL=0.45 •• 1 ;» , ELEVATION AT DOH# 3= 1.1't ---- --- DOWNWARD FORCES: ,;. ••• •' "% •' ' + INSTALL 9 CONCRETE TO COUNTER �• ^^ ^^� •• •3•• •.4. ~ ••' '� •• - TANK WEIGHT= 30,450 LB TANK WEIGHT= 28,000 LB `• ;. r i •t ON-SITE BUOYANT FORCES DRAWN BY SRK M THE MINIMUM SLOPE FOR 4" DIA GAS BAFFLE CHECKED BY A SOILS ON TOP OF TANK: SOILS ON TOP OF TANK= SCH 40 PVC PIPE IS 1/8" PER FT COMPACTED BASE COMPACTED BASE TOTAL SURFACE AREA OF TANK - (3) 26" DIA. COVER/RISERS = 55 S.F. TOTAL SURFACE AREA OF TANK - 32" DIA. COVER/RISER = 60 S.F. SEE PLAN wc�RusHEDYSTONE OR APPROVED 3't w/ s" LAYER OF 22't EQUIVALENT CRUSHED STONE N A COVER SATURATED SOILS= 1.5' (AVG.) x 55 S.F. x 80 LB/CF= 6,600 LB COVER SATURATED SOILS= 1'(AVG.) t x 60 S.F. x 80 LB/CF= 4,800 LB OUTLET TEE DEPTH 2,500 GALLON H-20 O LIQUID DEPTH BELOW FLOW LINE TWO COMPARTMENT C 'A' PROFILE CILE TOTAL DOWNWARD FORCE= 37,050 LB 9" POURED CONCRETE IN PUMP CHAMBER BOTTOM= 4 FT 14 INCHES SEPTIC TANK (H-20) SCHEMATIC F U CONCRETE VOLUME= 101 x 5 W x 0.75 D 5 FT 19 INCHES W/ SANITARY TEES LO II �j o NET DOWNWARD FORCE= 826 LB VOLUME= 37.5 C.F. 6 FT 24 INCHES on POURED CONCRETE WEIGHT= 37.5 C.F. x 130 LB/CF= 4,875 LB 7 FT 29 INCHES ALL INSTALLATIONS MUST CONFORM TO THE MINIMUM REQUIREMENTS OF TITLE 5 1 •C2 • PERC-RITE SYSTEM MUST BE INSTALLED BY A TOTAL DOWNWARD FORCES= 37,675 LB CERTIFIED INSTALLER APPROVED BY ENGINEER. NET DOWNWARD FORCE= 1,451 LB ?of 3 srrEETs U o PROJECT NO. C18236.00 v NOTE: THE DRIP TUBING SHALL BE THE LOWEST RETURN MANIFOLD POINT TO ALLOW FOR DRAINAGE FROM BOTH THE TO BE LOCATED ABOVE SUPPLY MANIFOLD VERTICAL INSULATED SUPPLY AND RETURN PIPES DRIP TUBING TO ALLOW FALMOUTH RD - RTE 28 COASTAL 1/2' PIPING TO BE AIR RELEASE AIR RELEASE THE MANIFOLD TO DRAIN ENGINEERING LOCATED ABOVE DRIP TUBING TO ALLOW THE VALVE PRESSURIZED VALVE MANIFOLD TO DRAIN + + DRIP TUBING + + CHECK VALVE FOR _\ COMPANY, INC. + + + + MULTIPLE ZONE HOUSE HYDRAULIC / \�/ 9(7MA 260 Cranberry Hwy.Orleans,MA 02653 + + + + + SYSTEMS ONLY UNIT VERTICAL INSULATED + + 1\ S RSV 508.255.6511 Fax:508.255.6700 i RETURN PIPE + + (PER COLD CLIMATE \ + VERTICAL INSULATED FLUSH RETURN FROM HU NOTES + ,/`� RETURN PIPE ZONE SUPPLIES ' ) + FINISH GRADE + "� COLD CLIMATE ZONE 1 ZONE 2 NOTES) MAIN RETURN PIPE _ NORTH ��< RD BELOW FROST LINE COMMON RETURN PIPE i SEPTIC TANK/ ( Y r B A ` `n!` TREATMENT TANK PUMP COMMON RETURN BELOW FROST LINE CHAMBER SUPPLY TO 1/2" PVC RIGID HYDRAULIC UNIT W �+ 1/2" PVC FLEX DRIP TUBING 1" PVC RIGID BARNSTABLE (OSTERVILLE), MA INSTALLATION DEPTH 6" MIN Z AS PER DESIGN 1/2" PVC FLEX FOIL WRAP INSULATION SHALL KEY MAP 4` BE INSTALLED OVER TUBING FORCE MAIN INSTALLATION TYPICAL SYSTEM HYDRAULIC PROFILE i PER COLD CLIMATE NOTES) DEPTH TO BE BELOW THE FROST LINE NO SCALE O v U ( (NOT TO SCALE) STANDARD DRIP SYSTEM (TOP FEED MANIFOLD) 4ue Cn O (NOT TO SCALE) i- w 00 (A **■ SITE CONTRACTOR MM COORDINATE '' N \ \ 1q 4 rA w WITH LANDSCAPE ARCHITECT PRIOR TO "4 � "„� � ,,,,.-' ��.. ~m,,,,. � V R ,,• ,, a' i SETTING FINAL ELEVATION OF COVER O 32' DIA. HEAVY DUTY CAST IRON FRAME AND COVER *** e GREEN VALVE BOK COVER VALVE BOX INSERTED - --' .. O O CONCRETE COLLAR ,� ` AT FINISHED GRADE THROUGH 7 HOLE IN �,-� �`�t ��d�, v � , ` _ >,\� � Y .. „: .� .; ���,,,-� � �,,, - . ,.- .f ,�', Z � � � , .- FINISHED GRADE v a c .r 0 - Cn FINISH GRADE FOIL WRAP INSULATION;+ sy tt� �+ ay, \` °` $° PROPOSED �\ A 2,500 GALLON ' ,. FOIL WRAP INSULATION SHALL BE MANIFOLDS AND LATERALS TWO—COMPARTMENT � w ' INSTALLED OVER TUBING BENEATH 2'X 2' FOIL WRAP �" ' � '� "r�` rt ' + a r^ ADJUST TO GRADE WITH U r• ,°.•!;Y §+:." J`: 'gym �k �� +� � +',�p� P� �yk \9 '� �k��'nn ('����r g -�Yld kNa� "{��6^��'.S,C+ `I W'� A C�• � � � � � IU / ..»' / y vJ . k � ^ • r SEPTIC TANK — 0 x ; - A 4 H 2 �4 BRICK COURSES OR GRADE PER COLD CLIMATE NOTES) INSULATION LAID FLAT :. �,�,�� ,. �, '� ,,: � ,�r �,• ( ) ;' � � A T ,r WW " RINGS AS REQUIRED,. ."t, �� ref �`�,: -� 7• 30 DIA. � e , ;• `' ,., � .,.. Y"'� ,, t r t-t re• ,��'.... '' �l"`":..`-� .r •. , r.. Guy b�i � ham; . - ,. J " MIN. � : � r( ,.� ,, ���� �� �iF�w't> . �' i •" Y 'i ��+`+ ': I � 1 ,..�`" /. / � ••� •? .T._,. >cI Pq ,�`;1. a ;"a r: �ali�g"�aa ° ���NS�,�; `n,.,.. ..: . >" `a" k� t �+d "a �"" .,." .-' • • . � 1 W '.�V f. 3k ��"' rF � � ' - � 4' W, � h i V LY.✓ • � p � .�, r rd s r v,n�r d�'ti� c',Alt t `''t.." � ' i✓i ;.:.. ECCENTRIC RIGID INSULATION BOX „ Vr I? ALL LATERALS SLOPE v r§zk°, � ' r °i ¢ y •� :.���'.; d ' �`r�;,i tt �'t'�r r i�� {�"�°�R� »�at i g Q� l r'" ...•'' 0 CONE SECTION AIR RELIEF tx . \ AROUND VERTICAL PIPES " N .IP S E I, DOWNILL TO DRIP TUBING rra , f o,. A r aE i ,�i 3, v.`ta."' E ate,. i� x ,v ' ',' a ww ( ) FOR SELF DRAINAGE �s ��� • � ° r: , . � 4fi r"� �t r�!�+'x"',� " ��'�� ., '• . .,.. f 7 at�1�cG �w. ,..., � � ,..y ' �`° PROPOSED :��riay 2,500 GALLON '� BUTYL JOINT SEALANT (TYP) TOP VIEW � � � \ �`� � APRROX. LOCATION y`�" PUMP CHAMBER EX. SEWAGE DISPOSAL •, H-20 \ �� SYSTEM (SEE NOTE 8) q RISER SECTION 4'-0"0 5" sa r ¢ AIR RELEASE RIGID FOAM INSULATION ' VALVE BOX INSERTED VALVES MANIFOLDS AND LATERALS h ' THROUGH 7" HOLE IN BENEATH FOIL WRAP RETURN S 9°yG FOIL WRAP INSULATION' INSULATION PROPOSED pROPOS \ N : .; . HYDRAULIC 1.OScn FQ / • SUPPLY �' EL r _. FINISHED GRADE UNIT s, _ \ OR�P(p X? ,6� SF o, _ / ' 7 No. 46715 FOIL WRAP INSULATION SHALt BE STYROFOAM PEANUTS FF 1/2"/FT ,\ Sp£RSq — � RHO CEP �, �+ _1 �° �F �� INSTALLED AROUND VALVE BOX ABOVE MANIFOLDS AND LATERALS IN BAG ,cQ �. E��cR tt\ s o/N rL a�� 5`•) ' Fg � A BASE SECTION "; Og6'� // PIPE OPENINGS CAST TO PLAN (PER COLD CLIMATE NOTES) (?,� `"w `' ��• / "t SUPPLY AND RETURN LINES CLEAN 1/4" - 1/2"CRUSHED STONE �' ,.r �% BELOW FROST ZONE(TYP 4'). ' 6 ;n :a, INSULATE LINES WITH RIGID / : ;i 5�e, ,�..:;afr :+e!s:?ti'zC,' ��+s",.'' r WHEN PROPER o t,:;•. ;" ..k•; , �. tn� ut FOAM BOARD SEE NOTE 2 `�` �"� ter•^ FLOW CHANNEL DEPTH EQUAL TO OUTFLOW PIPE DIAMETER FLEXIBLE FOAM QR RUBBER n• / , " A FROST DEPTH CANNOT BE, :,ti'x;s;rr?: .. �. ..._•r,z,�.:„. ;+:.•; :+.:.:.;..xs,., PIPE WRAP INSULATION ACHIEVED. � PROPOSED 1 t " AROUND VERTICAL PIPES j SOIL REMOVAL _ . "_•_ _ _ . '" -"" ��"`----++ 6 CRUSHED STONE n} :ati y+ 9 6- .000 RIGID INSULATION BOX <i 8 y H SEWER MANHOLE NOTES: �oy� 1. MANHOLE SHALL BE CAPABLE OF SUPPORTING AN H-20 WHEEL LOADING. AROUND VERTICAL PIPES �3 X3•4 CROSS SECTION 2. ALL REINFORCING STEEL MUST CONFORM TO THE LATEST ASTM A185 AND/OR A615 GRADE 60, SPECIFICATION 0,12 SQ. IN/LINEAL FT. INSULATION DETAIL s 3. STEEL REINFORCEMENT FOR BASE SECTION BOTTOM SHALL BE A MIN. OF 0.12 SQ. IN/LINEAL FT. (BOTH f WAYS) (NOT TO SCALE) 4. MORTAR SHALL CONFORM TO SECTION M4.02.15 OF THE MASSACHUSETTS D.P.W. STANDARD SPECS. FOR HIGHWAYS AND BRIDGES. /—PLAN OF LE/"1 CHRELD AND SEWAGE 5. ONE POUR MONOLITHIC BASE SECTION. DISPOSAL SYSTEM COMPONENTS 10 5 0 10 30 6. ANY NECESSARY ADJUSTMENTS DURING CONSTRUCTION WILL BE DONE BY SAW-CUTTING AND/OR CORING ' ONLY. NO JACKHAMMERS, HAMMERS, CHISELS OR PNEUMATIC TOOLS WILL BE ALLOWED. SCALE 1�=1 O' 7. STEPS SHALL BE STEEL REINFORCED COPOLYMER POLYPROPYLENE PLASTIC. INSTALLATION INSTRUCTIONS: ►"�i >. Measure the distance from the bottom of the tank to 6" down from the top of the 1 � 10 ft. 1 8. RED CLAY BRICK SHALL CONFORM WITH SECTION M4.05.2 CLAY BRICK OF MASSACHUSETTS D.P.W. QI STANDARD SPECS. FOR HIGHWAY AND BRIDGES. riser. Cut the extension pipe (by others) to the length necessary to reach this 9. PIPE TO MANHOLE CONNECTIONS SHALL BE MADE USING PSX POSITIVE SEAL CONNECTIONS AS height. Cut half of the pipe down 12" to 18" away from the top of the pipe fora Detail A MANUFACTURED BY PRESS-SEAL GASKET CORPORATION, OR EQUAL. pump discharge pipe and attach to riser. (see detail A) CONTROL UNIT PANEL 2. Glue the extension coupling b others to the extension pipe and to the cool guide. * MOUNTED IN AN EXTERNALLY p g ( y ) p p g 112"-18" FINAL LOCATION OF HYDRAULIC UNIT ACESSIBLE LOCATION STANDARD PRECAST CONCRETE 3. For reuse of existing concrete pump chambers: glue on the Cool guide flat Cap and I MUST BE APPROVED BY LANDSCAPE Q D=THE DAILY DESIGN FLOW FOR THE SITE place the cool guide'firmiy in the bottom of the tank. Attach the extension to the (LOCATION MUST BE ' MANHOLE DETAIL ARCHITECT PRIOR TO INSTALLATION APPROVED BY OWNER PRIOR � W 4 SEINER M riser with the anchors as shown. TO INSTALLATION) NOT TO SCALE 4. For use in new concrete pump chambers: anchor the flat cap to the bottom of the SCH 80 UNION RIGID FOAM INSULATION NO WEEP HOLE CONDUIT TO PANEL FLOAT TREE H 0 tank in the proper location to hold the cool guide and extension. The cap may or GATE VALVE TO BE DRILLED BY CONTRACTOR may not be glued to the device. Attach the extension with the anchors as shown. 5. Place the pipe dopeon the cool guide adapter threads and thread them into the UNCTION Box H w pump discharge. _ =ll HYDRAULIC 11- C) NOTE: 6. Attach cooling collar to adapter with set screw provided. CHECK VALVE SUPPLY LINE FLUSH RETURN TO - - UNIT * \�� \1 U " , , , , , , , , ALL WATER FIXTURES TO BE WATER TESTED BY CONTRACTOR TO 7. Glue pipe into flow collar and with pump attached, lower into the guide tube. ADAPTER BELOW FROST OR SEPTIC TANK. ATTACH VERIFY ALL SEWER EXIT LOCATIONS PRIOR TO INSTALLATION OF 8. Attach to discharge pipe, valves, and connect electrical and specified. AS PER _ INSULATED ,!,�� � � „ -- ••- a cv v� s _ 6" GRAVEL EIRTICAL INSULATED IPE TO BE SCALE ANY SYSTEM COMPONENTS. COOLING COLLAR NOTE 1 TO HU UNDISTURBED UNDISTURBED EARTH ,ll EARTH ,�_ �l AS NOTED 1-1/2" SCH 40 EXTENSION \=11=Ii-1�=1' / ' �l�11,11=1I ill ill 8' OF STATIC LIFT TO HU (MAX) DRAWING FILE INSPECTION NOTE COUPLING COLLAR(BY ALARM \=11=11%1\: ��l ill ill ill ill C 18236-C3D-PLAN B.dW9 OTHERS WATERTIGHT -l�,/ //-ll FLUSH RETURN DATE 10" SEAL \\1 11\; ..11-ll ZONE 1 SUPPLY -�1--23-20f5- THE STATE ENVIRONMENTAL CODE, TITLE 5, REQUIRES INSPECTION(S) \`�11' ' OF THE SEWAGE DISPOSAL SYSTEM BY THE DESIGN ENGINEER. PVC COUPLING PEAK ENA L E ZONE 2 SUPPLY DRAWN BY �\ INSERT BY OTHERS) 10" - '11=11= PUMP DISCHARGE TO HU SR{ INLETS (; ETS .. � ,- M PRIOR TO THE START OF INSTALLATION FOR DISCUSSION ON DRIP ENA L CHECKED BY E OFF 11-\1-\1-11- REQUIRED INSPECTI NS. W 0 0 0 0 DRIP ENABLE FLOAT ELEVATION f w FLOW >�" -4W FLOW 00 0 0 0 0 o SEE INSERT 20 10 0 0 0 SCH 4.0 PVC 16" NOTE: A THE INFORMATION HEREON HAS BEEN PREPARED ACCORDING TO OIL GUIDE AND THE EQUIREMENTS OF TITLE 5 OF THE STATE ENVIRONMENTAL OPTIONAL PUMP � CODE FOR SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND FLAT CAP ANCHOR BOLT r� 30' MAXIMUM DISTANCE c LOCAL BOARD OF HEALTH REGULATIONS. THROUGH END C2*4*2 c Cool Guide Patent No. 6,262,689 CAP PERC—Rg BY A CERTIF EIDEI STALLERSYSTEMMUST APPROVEDSLED BYLENGIN ER. GENERAL CONSTRUCTION NOTES PERC-RITE HYDRAULIC UNIT (15 GPM) W 3 OF 3 SHEETS � TYPICAL PUMP TANK & HYDRAULIC UNIT DETAIL y 1 REFER TO SHEET NO. C2.1.1 FOR GENERAL CONSTRUCTION NOTES. (NOT TO SCALE) (NOT TO SCALE) o PROJECT No, U U