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0265 SEAPUIT ROAD - Health
�015 Seamr.:i toad A --095 - 004 4Ds O.Se)U k t_\-7.S w Doc=1 3 28S Y 340 02-17-2016 8 i 32 BARNSTABLE LAND COURT REGISTRY DEED RESTRICTION WHEREAS,Nicholas David Samra, a/k/a N. David Samra and Erica Pearson(the "Grantors")are the owners of the property known as and numbered 265 Seapuit Road, Osterville, Barnstable County, Massachusetts, as is more particularly described in the Land Court Certificate of Title No. 204739, and in a deed'dated October 20, 2014,registered in the Barnstable County Registry District of the Land Court as Document No. 1256594, and as shown on Land Court Plan 5725-H as Lot C, dated March 22 1928, and Lot 1 on Land Court Plan 5728D, dated August 3, 1954 (the"Property"); WHEREAS, by Decision of the Barnstable Board of Health on,January 18, 2016 ("Decision"),the Board approved a conditional variance to construct an onsite sewage disposal system incorporating innovative/alternative technology ("the System")on.the Property; WHEREAS, the Grantors have agreed to a restriction as to the number of bedrooms which can be included in any home built on the Property for as long as said Property is served by the System; WHEREAS, as a condition of said approval by the Barnstable Board of Health, and as a pre-condition to authorizing the issuance of a building permit for the construction of a single . family home on this property, and to granting a disposal works construction permit for the System in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, the Board is requiring that the `agreement for the restriction on the number of bedrooms be put on record with the Barnstable County Registry District of the Land Court by registering this document; NOW, THEREFORE,the Grantors do hereby place the following restriction on the Property, which restriction shall run with the land and be binding upon successors in title: 1. The dwellings constructed on the Property pursuant to the Decision shall be limited to a maximum of seven(7) bedrooms for as long as said Property is served by the System. Grantors agree that this deed restriction affects the land more particularly described in the Land Court Certificate of Title No. 204739, and in the deed dated October 20, 2014, registered in the Barnstable County Registry District of the Land Court as Document No. 1256594, and as shown on Land Court Plan 57251j as Lot C, dated Q&zk u, 19Z8, and Lot 1 on Land Court Plan 5728D; dated August 3, 1954. A Executed as a seal instrument this `day of11�lRGtl��, 2016. i N. aid amra Erica Pears n STATE OF CALIFORNIA ss. ; 2016 On this day of ,2016, before me,the undersigned notary public, personally appeared N.David Samra,proved'to me through satisfactory evidence of identification, which was ,to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. . • �>za� �� ���� ��� � Geri, Notary Public My Commission expires: STATE OF CALIFORNIA ss. 12016 On this day of , 2015, before me,the undersigned notary public, personally appeared Erica Pearson, proved to me through satisfactory evidence of identification, , which was ,to be the person whose name is signed on the preceding or attached document, and acknowledged to me that she signed it voluntarily for its stated purpose. Notary Public My Commission expires: 2895152.2 -2 - CALIFORNIA ALL-, PURPOSE CERTIFICATE OF ACKNOWLEDGMENT 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 , u fonuko On ft I't 2I tl before me, N&A T tNa N Rtb C j ( ere insert n e nd td e o the o f per)cpersonally ap eared �f(C�'t, ��usoll �h 1� iG�96�G 5 Vayf fl Jamm who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) 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. CLIFTON TAM WIT S and and official seal. Commission#2113368 z • Notary Public-California = z San Francisco County M Comm.Ex Ires Ma 29,2019 Notary Public Si ature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed;should be completed and attached to the document.Acknowledgments from other states may be completed for documents being sent to that state so long Wadois as.the wording does not require the California notary to violate California notary law. (Tale or description of attached document) • State and County.information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Title or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date commission followed by a comma and then your title(notary public). •_Print the name(s) of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forts(Le' lie/she/d*y,-is/ere)or circling the correct forms.Failure to correctly indicate this Individual(s) information may lead to rejection of document recording. Corporate Officer The notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines. If seal impression smudges,re-seal if a (Title) sufficient area permits,otherwise complete a different acknowledgment form. O Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact .1 Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. Other Indicate title or type of attached document,number of pages and date. ❑ 46 Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www.NotaryClasses.com 800-873-9865 • Securely attach this document to the signed document with a staple. .THE Town of Barnstable BarBarnstabler P y� Board of Health j All-AmedcaCft nneY, BLE, ! 200 Main Street, Hyannis MA 02601 �a39�A�0 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi January 18, 2016 Revised Mr. Sean M. Riley, P.E. Coastal Engineering Co. 260 Cranberry Highway Orleans, MA 02653 RE: 265 Seapuit Road, Osterville A = 095-004 Dear Mr. Riley, You are granted conditional variances on behalfrof your client, David Samra and Erica Pearson, to construct an onsite sewage disposal system incorporating innovative/alternative technology at 265 Seapuit Road, Osterville. The variances granted are as follows: Section 360-1 of the Town of Barnstable Code: To install a soil absorption system 79 feet away from a marsh, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install the septic tank zero (0) feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install the pump chamber zero (0) feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a soil absorption system zero (0) feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. J - 310 CMR 15.211 M To install the septic tank zero (0) feet away from a coastal bank, in lieu of the minimum 25 feet separation distance required. Q:\WPFILES\265 SeapuitRdOst CoastalEng Jan2016Revised.doc i 310 CMR 15.211 (1): To install the pump chamber zero (0) feet away from a coastal bank, in lieu of the minimum 25 feet separation distance required. 310 CMR 15.211 M To install a soil absorption system zero (0) feet away from a coastal bank, in lieu of the minimum 50 feet separation distance required. These variances are granted with the following conditions: (1) No more than seven (7) bedrooms are authorize.d.at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to seven bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The designer, contractor, applicant, and system owner shall adhere to the applicable conditions contained within the fifteen page Per-Rite Drip Dispersal approval letter from the Department of Environmental Protection (DEP) entitled `Certification for General Use' dated March 15, 2007, revised March 20, 2015. These conditions include requirements for proper construction, operation, maintenance, and monitoring of the system. (4) The engineer shall revise the plan to include a "break-line" or notation indicating there are 22 lines (not 11) within the 48' X 22' drip dispersal field, entitled `Top Feed Z126 Zone Detail' on the engineering plan. (5) The septic system shall be installed in strict accordance with the revised engineered plans with revision date on pages 1 through 3 of January 13, 2016. (6) The engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised engineered plans. Q:\WPFILES\265 SeapuitRdOst CoastalEng Jan2016Revised.doc These variances are granted because the proposed plan appears. to meet the maximum feasible design standards contained within the State Environmental Code, Title 5 and local Health' Regulations. This property is surrounded by wetlands and the designing engineer designed the location of the proposed replacement septic system in an attempt to maximize setbacks to wetlands. Sincerely yours, r C Wayne iller, M.D. Chairm n 1 . b Q:\WPFILES\265 SeapuitRdOst CoastalEng Jan2016Revised.doc z )o��D 260 Cranberry Highway d ` ram,_ Orleans, MA 02653 TRANSMITTALPo 508.255.6511 P 508.255.6700 F COASTAL Orleans I Sandwich I Nantucket ��e engineering ca. coastalengineeringcompany.com lug G / To: Barnstable Board of Health Date: 1/4116 Project No. 18236.00 Barnstable Town Offices 200 Main Street Via: ❑1st Class Mail❑Pick up ® elivery ❑Fed Ex,_ Hyannis, MA 02601 t Phone: Fax: G� 1� Subject: Board of Health Variance Revised Plans No. of pages to follow: Proposed Site Redevelopment and Sewage Disposal System Upgrade David Samra & Erica Pearson 265 Seapuit Road Barnstable (Osterville), MA Map 095/ Parcel 004 ® Plans ® Copy of Letter ❑ Specifications ❑ Other We are sending the following items: Co ies Date No. Description 4 Rev. 1/4/16 C2.1.1 "Proposed Sewage Disposal System Plan", 4 Rev. 1/4/16 C2.4.1 "Plan Showing Sewage Disposal System Details", 4 Rev. 1/4/16 C2.4.2 "Plan Showing Proposed Sewage Disposal System Details", a 4 3/20/15 DEP Certification for General Use for PERC-RITE Drip Dispersal System These are transmitted as checked below: ❑for approval ®for your use ❑as requested ❑for review& comment ❑ Remarks: Attached please find the listed documents for the referenced project. The public hearing is scheduled for the January 12, 2016 Board of Health meeting. If you have any questions, please contact our office. cc: David Samra & Erica Pearson, Homeowner—via email By: Amy Lipkind Sarah Turano-Flores, Nutter McClennen & Fish LLP—via email Garret Avery, Catalano Architects —via email Sean M:,Riley, P.E., Coastal Engineering Co., Inc. —via email D:IDOCIC182001182361PermittinglBOHV 20151Trans to BOH.doc NOTE:If enclosures are not as noted,please contact us at(508)255-6511 I 1 EXCERPT FROM THE BOARD OF HEALTH RESULTS OF DECEMBER 8 2015: II. Septic Variance: A. Sean Riley and John Schnaible, Coastal Engineering, representing David Samra and Erica Pearson, owners — 265 Seapuit Road, Osterville, Map/Parcel 095-004, 87,610 square feet lot, house addition, multiple variances. CONTINUED TO JANUARY 12, 2016 The engineer willl list the variances on the plan itself, they will include the pump chamber information, the Board members will receive the DEP approval booklets for general use to read prior to January meeting, the water line will be put onto the plan, and the bottom of second page will be corrected to reflect the system as H2O. r de n_ a COASTAL engineering co. February 22, 2016 C18236.00 Board of Health c/o David Stanton 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. Stanton: As required under DEP Certification for General Use Letter for the PERC-RITE Drip Dispersal System and as the System"Designer", I, Sean Riley, P.E., hereby Certify that the submitted design conforms to the Approval,the Company Design Guidance and the Code. Please contact me with any questions or requests for additional information. Very truly yours, COASTAL ENGINEERING CO., INC. Q� Sean Riley, P.E., CFM Civil Engineering Division Manager SMR/dlb 0:\DOC\C38200\38236\Permitting\BOHV 2015\Designer Certification Letter 2-22-16.doc Of18dt15 ISdtldWiCf1 ,I NdntUCk2CWedhl � N. David Samra and Erica Pearson `38 West Clay Street San Francisco CA 94121 r+ V r CT� February 11, 2016as I By In Hand Delivery W Thomas McKean, Director Health Department Town of Barnstable 267 Main Street Hyannis, Massachusetts 02601 Re: 265 Seapuit Road, Osterville; PERC-RITE Drip Dispersal System Owner Certification -Dear Mr. McKean: Pursuant to the Vote of the Barnstable Board of Health at its meeting on January 12, 2016, and pursuant to Section II, Design and Installation Requirements, Paragraph 24(c) of the Massachusetts Department of Environmental Protection's Certification for General Use, as Owners of Record of the above-referenced property, we hereby certify the following: i) We have been provided a copy of the Approval,the Owner's Manual, and the Operation and Maintenance Manual for the above-referenced System, all of which are attached hereto as Exhibits A, B, and C,respectively, and we agree to comply with all terms and conditions contained thereinl; ii) We have been informed of all the Owner's estimated costs associated with the operation, including, when applicable: power, consumption, maintenance, recordkeeping, reporting, and equipment replacement; iii) We understand the requirement for a service contract; iv) We agree to fulfill our responsibilities to provide a Deed Notice as required by the Approval and 310 CMR 15.287(10)2; ' As Owners of Record,we intend to ensure compliance by hiring duly qualified design engineers, installers and operators who will be retained for..the specific purpose of ensuring compliance with these provisions. 2 310 CMR 15.287(10)states:"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 or Land Registration Office,as applicable,a Notice disclosing both the existence of Mr. Thomas McKean February 11, 2016 Page 2 v) We agree to fulfill our responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5)3; vi) Our design does not provide for the use of garbage grinders and, thus, we understand and accept that garbage grinders may not be installed; vii) We understand that, whether or not covered by a warranty, we must repair, replace, modify or take any other action as required by the Department of Environmental Protection or the local Approving Authority, if the Department or the local Approving Authority determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303. Very trul urs, N. David Sa a and Erica Pearson cc: Mr. David Stanton, Barnstable Health Inspector 3041497.1 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." 3 310 CMR 15.287(5)states:"Prior to the transfer of any ownership interest in an alternative system,or of any right or responsibility to operate an alternative system,the owner or operator shall provide written notice to the proposed new owner or operator that the system is an alternative system. Such notice shall include notice of the general conditions and any special conditions applicable to the system and its owner.In addition,the owner shall include either a copy in full or a reference to the notice of the alternative system described in 310 CMR 15.287(10), and the recording information for that notice, in the instrument of transfer of any such ownership interest.In the event of the transfer of any such right or responsibility without a transfer of ownership interest,the owner or operator shall include a copy in full or a reference to the notice of the alternative,system described in 310 CMR 15.287(10),and the recording information for that notice,in the agreement transferring such right or responsibility." .,...,,o 260 Cranberry Highway AUTHORIZATION FOR Orleans,MA 026S3 TECHNICAL 508.255,6511 P 508.255.6700 F COASTAL Orleans i Sandwich i Nantucket engineering co. :oastalengineeringcompany.com SERVICES To: David 6 Erica Samra Date: 02/09/2016 Project No.WBA011.00 38 West Clay Street Project: Perc-Rite Drip Disposal Operation 6 Maintenance San Francisco, CA 94121-1231 VIA EMAIL: david.samra(a artisanoartners.com e`lpssemail@ ay hoo,corh Location: 265 Seapuit Road, Osterville,MA Assessor Map 95, Parcel 4 Coastal Engineering Company, Inc. (CEC)will perform the following professional services relating to the referenced project. Fixed Fee: See Attachment 2 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/dib SUBJECT TO TERMS AND CONDITIONS ON REVERSE SIDE AUTHORIZED FOR COASTAL ENGINEERING! ® We are proceeding with service(s) noted as per your By: direction. Immediate notification in writing is required if you wish to alter this authorization. (/A - Chad A. Simmons, WWTPO ® Please execute this agreement. February 9, 2016 AUTHORIZED,BY CL ENT: ® This document will become our original agreement, {: Acceptance of this agreement by signature authorizes COASTAL Signature' Oat ENGINEERING to proceed as described.This proposal expires in 90 days If not signed by both parties. Printed Nam and Tit PLEASE SIGN AND RETURN ONE COPY DA 00C\W\WBA\011\Contracts\2015-02-09-Samra ATS.doc i COASTAL STANDARD CONDITIONS FOR ENGAGEMENT TECHNICAL SERVICE CONTRACT engineering CO. 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 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 GEC'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. i David b 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 O&M 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. David 6 Erica Somra 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 (dl$250 semi-annually Barnstable County Database Management Fee* $50.00 ................................................ 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. *Barnstable County assesses an annual database management fee of$50.00 for each wastewater treatment management system in Barnstable County,They will send an assessment notice to Coastal Engineering.Coastal will pay the fee for you and include the$50.00 charge on your next invoice as a reimbursable expense. I i r T .-..,.;-.,.s,�.-.,�I. �.e.r+.-y�- �..-.�-.,� .:,�:.Y-..I_. .__I_..ts,._.--1:.-._�---Is--.r_- .-• -� .c w�...._ � - - -- r a _- - - _ . '^l i".'." - iW i C 1 Elk- 4 .. �.. j p -Go- Le p L D a IVJ. 4 g(!�{�10M f �nrp•�JW on �II1/�l� 114 WtUY� r, VG� 1rv,�j dar; JeN PAQ re kC� jay `,1 1V�c�J1d?Ry,,�j Pl l I(Alll AJJ�"rr fvre ��r �6�-r�R t-c��uw� C-,4 ,Jkd„� f y � I � 1 ~ o � 1—j ,� �. c, " � � � � � �, � ,1 � � � � s`' � - � �� � _ J �. n Y 1 (. '? s � <_ I 260 Cranberry Highway � Orleans, MA 02653 508.255.6511 P 508,255.6700 F_ TRANSMITTAL COASTAL Orleans I Sandwich �Nantucket engineering co. coastalengineeringcompany.com To: Barnstable Board of Health Date: 1/14/16 Project No. C18236.00 Barnstable Town Offices 200 Main Street Via: [:]lst Class.Mail Pick up ®Delivery QFed Ex Hyannis, MA 02601 Phone: T Fax: j Subject: Board of Health Variance Revised Plans No. of pages to follow: Proposed Site Redevelopment'and Sewage , Disposal System Upgrade David Samra 6 Erica Pearson 265 Seapuit Road 1 Barnstable (Osterville), MA `?XJ Map 095 /Parcel 004 jl _3``-1 ® Plans ❑ Copy of Letter - ❑ Specifications Other, r�J We are sending the following items: Copies Date No. Description 4 Rev. 1/13/16 C2.4.1 "Plan Showing Sewage Disposal System Details" UC These are transmitted as checked below:R for approval ®for your use Elas requested for review 6 comment Remarks: Attached please find copies of the revised plan for the referenced project. '(rP_f1 If you have an d �I277II� i1 y y questions, please contact our office too, r cc: David Samra 6 Erica Pearson, Homeowner—via email 'By:r Amy Lipkind' Sarah Turano-Flores, Nutter McClennen 6 Fish LLP—via email V N ^ I l of Garret Avery, Catalano Architects —via email Se� S) ° Sean M. Riley, P.E'., Coastal Engineering Co., Inc. -via email C J a I D:\DOC\C18200\18236\Permitting\BOH�209�15\Trans to BOH.doc. NOTE:if enclosures are not as noted,please contact us at(508)25576511 260 Cranberry Highway Orleans,MA 02653 TRANSK T AL 508.255.6511 P 508.255.6700 F COASTAL Orleans I Sandwich I Nantucket engineering co. coastalengineeringcompany.com To: Barnstable Board of Health Date: 2/5/16 Project No. 418236.00 Barnstable Town Offices Via: 01st Class Mail ❑Pick up ®Delivery❑Fed Ex 200 Main Street Hyannis, MA 02601 Phone: Fax: } Subject: Board of Health Variance Revised Plans No.of pages to follow: Proposed Site Redevelopment and Sewage Disposal System Upgrade David Samra 6 Erica Pearson 265 Seapuit Road Barnstable (Osterville), MA Map 095 / Parcel 004 ® Plans ❑ Copy of Letter ❑ Specifications ❑ Other a We are sending the following items: Copies k111133/116 No. Description Z ReC2.1.1 "Proposed Sewage Disposal System Plan" Z ReCZ.4.1 "Plan Showing Sewage Disposal System Details" 2 ReCZ.4.Z "Plan Showing Proposed Sewage System Details" These are transmitted as checked below: ❑for approval ®for your use ❑as requested []for review 5 comment ❑ Remarks: please lease find copies,of the revised plan for the referenced project. , If you have any questions, please contact our office. • cc: Sean M. Riley, P.E., Coastal Engineering Co.; Inc. — via email By: Amy Lipkind a DADOC\C18200\38236\Permitting\BOHV 2015\Trans to BOH 2-5-16.doc NOTE:If enclosures are not as noted,please contact us at(508)255-6511 aI► ��to �DD CL v . Go f� D cc J — �22 �vr - 64 d ff- y , ?y�P/Y) je Gr1 f 2 �a'ri.✓ar°fie 3 a ► b a, R 2i o P-� C10)� - ,..� ► No �,•� �� r-e ��^� d 4- a} L CAA a V1\ c Jy r.. Y�G coolc. c,-: �-e A F c)Orv�,f caa. U L t,✓ �J God- � � . � _ ' � Go recur a f Message Page 1 of 1 Stanton, David From: Stanton, David Sent: Wednesday, February 10, 2016 3:02 PM To: Sean Riley i Cc: matt@kenvona.com' Subject: 265 Seapuit Rd, Osterville Hi Sean, I have reviewed the revised plans for 265 Seapuit Road, Osterville. In order for us to issue a building permit for said property, a septic permit must be issued first. This does not mean that a licensed Installer must be chosen at this point. In order to issue a septic permit number so that we can sign off on the building permit application we need to receive the following: ` e • I V-Deed restriction for 7 bedrooms recorded at the Barnstable County Registry of Deeds -Deed notice recorded at the Barnstable County Registry of Deeds (in accordance withinD- DEP IAA approval requirement) /� , fThe attached homeowner certification form filled out and signed by the homeowner V , ✓, -A Title V septic permit application filled out completely (with the exception of the installer and installer signature if an installer has not been chosen yet) _- -The fee for the Title V septic permit application, which is V00 Thanks, David W. Stanton,RS Health Inspector Town of Barnstable 200 Main Street - Hyannis,MA 02601 Direct phone: (508) 862-4647 Health Dept.phone: (508)862-4644 Health Dept. fax(508)790-6304 2/10/2016 ® Commonwealth of Massachusetts Executive Office of Energy &Environmental Affairs Department of Environmental Protection One Winter Street,Boston, MA 02108.617-292-5500 Charles D. Baker ;: Matthew A.Beaton Governor Secretary Karyn E.Polito Martin Suuberg Lieutenant Governor Commissioner CERTIFICATION FOR GENERAL USE Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: American Manufacturing Company, Inc:, 22011 Greenhouse Road, PO Box 97 Elkwood, VA 22718 - Trade name of technology and model: PERC-RITE Drip Dispersal System, Models QM(WD), ASD45, ASD-25 &ASD-40' (hereinafter called the "System"). A schematic drawing of a typical System, a Design Manual, = an Installation Manual; and an inspection checklist are part of this.Approval: Transmittal Number: X250379 - Date of Issuance: March 15, 2007, revised March 20, 2015 - Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000 ("Title 5" or"the Code"), the Department of Environmental Protection hereby issues this.Certification for General Use to: American Manufacturing Company, Inc., PO Box 97, Elkwood; VA 22718 (Hereinafter "the . Company"), for the System described herein. Sale and use of the System are conditioned on and subject to compliance by the Company,the Designer, the Installer, the Service Contractor, and the System Owner with the terms and conditions set forth below. Any noncompliance,with the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000., March 20, 2015 David Ferris, Director Date Wastewater Management Program . Bureau of Water Resources { This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617.292-5751.TTY#MassRelay Service 1-800-439-2370 MassDEP Website;www.mass.govr'dep Printed on Recycled Paper Certification for General Use Page 2 of 15 PERC-RITE Drip Dispersal System—March 20,2015 I. Purpose 1. Department approved Drip Dispersal Systems provide alternatives to a conventional leaching system and alternatives to some of the other design requirements of Title 5. 2. This Certification is for the installation of a System to serve a facility for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the Approving Authority and the site meets the siting requirements for new construction.. 3. This Certification shall not be used'for the installation of a System to upgrade or replace an existing,failed or nonconforming system, unless the facility meets the siting requirements for new construction, including a reserve area. All other proposed upgrades utilizing this System shall be in conformance with the Remedial Use Approval issued by the Department for this System. 4. With the other applicable permits or approvals that may be required by Title 5,the Certification for General Use authorizes the installation and,use of the System in Massachusetts. All the provisions of Title 5, including the General Conditions for Alternative Systems (310 CMR 15.287), apply to the sale, design, installation, and use of the System, except those provisions that specifically'have been varied by this Approval. 5. Provided that the local approving authority approves the System in conformance with - the Department's General Use Certification for the System, Department review and approval of the site-specific System design and installation is not required unless the Department determines on a case-by-case basis, pursuant to its authority at 310 CMR 15.003(2)(e), that the proposed System requires Department review and approval. 6. The Department has determined that the System is equivalent to a pressure distribution system designed in accordance with the Department's Pressure Distribution Guidance. 11. Design and Installation Requirements 1. The Drip Dispersal System may only be used for disposal of wastewater effluent from a Title 5 septic tank meeting the most current standards.for new construction or from a secondary treatment unit Certified for General Use by the Department: In addition to the requirements of this Approval, when a secondary treatment unit precedes the Drip Dispersal System, the Designer, the Installer, the Service Contractor, and System Owner shall be responsible for compliance with the requirements of the Department's secondary treatment unit Certification. 2. The System is a pressure distributed subsurface wastewater drip dispersal (disposal) system that replaces a conventional soil absorption system (SAS). The System is designed to distribute septic tank or.secondary effluent and pressure discharge it at a. . depth of at least 6 inches below finished grade. The System includes a pump, control panel; a filter module/hydraulic unit and drip dispersal zone(s) with drip tubing incorporating discharge emitters. The dispersal zone(s) include small diameter flexible Certification for General Use Page 3 of 15 PERC-RITE Drip Dispersal System—March 20,2015 polyethylene tubing with pressure compensating emitters. The emitters operate on a pressure differential across the emitter, with wastewater discharged in small doses. Dispersal field dosing is timed and controlled electronically to provide pre-programmed volumes of effluent for discharge to each dispersal zone(s). The System allows periodic backwashing of the filtration system and forward-flushing of the dispersal tubing with the flush/backwash effluent conveyed by return line to the septic tank. The System may include single(the QM/WD model) or two-stage (the ASD models)automatic backwashing disc filters within the filter module and air vents in each dispersal zone. Each zone shall have air release valves at the high points of manifolds and check valves on each return manifold in multi-zone systems. The System shall be equipped with a totalizing flow meter. i 3. The System shall include the following: a) Pumps capable of providing pressure of 10-60 psi throughout the dispersal zone(s). Each drip dispersal zone shall be dosed a minimum of four times per day, or as recommended by the Company. Duplex pumping shall be provided for facilities with design flows of 2,000 gpd or greater. The pump chamber,combined with available storage in the pretreatment units, shall provide at least one-day storage, as required by Title 5. b) Timed dosing for the drip system with a timer controller capable of operating the system during peak flow events without high-level alarms. c) Automatically backwashed filter(s) capable of screening particles larger than 115 microns prior to discharge of the effluent to the drip tubing.Filter(s) backwash shall be conveyed back to a separate settling tank or to the septic tank. d) Air vents in a zone shall be placed at a higher elevation than the drip tubing in that zone but below the ground surface. Air vents shall be'accessible"from finished grade and insulated to prevent freezing. e) Drip tubing lines installed as level as possible on contour and a minimum of 6 inches below finished grade. Drip line spacing is typically 24 inches with drip tubing emitters spaced 24 inches on center. The drip dispersal tubing shall be . automatically forward flushed after a pre-programmed number of dosing cycles as determined by the Company. Flushing velocity shall be at least 2 feet per second at the distal end(s) of each drip dispersal lateral within a zone. All drip line flushwater shall be conveyed back to the pump tank, a separate settling tank or to septic tank. f) The dispersal area shall not be installed under a paved surface, or in areas of routine traffic, parking or storage of heavy equipment. In addition no planting or soil excavation shall be done in or within 5 feet of the drip disposal area after its installation. The system may be designed to allow for installation of drip tubing up to five feet from a building cellar wall. , g) No change in,existing surface slope over the dispersal field is required.. 4. The System may be installed in soils with a percolation rate of up to 60 minutes per inch (MPI) in Class I, II, III, or IV soils, subject to the restrictions of the Approval., The Certification for General Use Page 4'of 15 PERC-RITE Drip Dispersal System—March 20,2015 f System shall only be installed in Class IV soils, as defined in 310 CMR 15.243,when the design has been reviewed and certified by the Company (see Paragraph V.3). 5. The System may be installed in the A, B or C soil horizon or in fill material meeting the current Title 5 specifications,at a depth of at least 6 inches below,but not more than 24 inches below the finished grade. The use of the A horizon(or fill material) shall not be included in the determination of the required minimum of 4 feet of naturally occurring pervious material. For proposed installations in the A or B soil horizon, a soil evaluation_ shall be performed to determine whether or not these soils are the most restrictive layer and the appropriate loading rate for the design of the Drip Dispersal System. The soil = evaluation of the A and B horizon must be acceptable to the local approving authority and may include, but not necessarily be limited to, a sieve analysis or a modified shallow percolation test. 6. The minimum effective dispersal area provided for the System shall be based on the soil loading rate(gpd/sq.ft.)derived from the Company's Design Guidance or the limitations imposed by this Approval,whichever is more stringent. 7. The effective dispersal area shall be calculated as the bottom area of the drip tubing system. No sidewall effective dispersal area credit shall be given for Drip Dispersal Systems. 8. The effective dispersal area provided by each emitter shall not overlap with the effective dispersal area provided by an adjacent emitter: 9. The effective dispersal area shall be a maximum of 4 square feet per emitter(2 feet by 2 feet), provided that adjacent lines of the tubing are spaced at least 2 feet apart and the emitters are at least 2 feet apart along the length of the tubing. 10. The minimum spacing between lines of drip tubing shall be 12 inches. The total number of emitters in the effective dispersal area shall not exceed one,emitter per 1 square foot. of the effective dispersal area. „ 11. The System may have a layout which is different than a conventional system in terms of shape. Accordingly, a reserve area must be provided that meets the dimensional requirements of a conventional soil absorption system using either standard or pressure distribution loading rates. ` 12.The record drawings, on file with the local approving authority, shall clearly indicate an area capable of supporting a primary conventional leaching system separate from a reserve area'for a conventional leaching system. The drawings shall indicate that the area for a full-sized primary SAS and the area for a full-sized reserve SAS are for the sole purpose of upgrading the System, if necessary, without any increase in flow. The System Owner shall not construct any permanent buildings or structures or disturb' the site in any manner that would require encroaching on the approved'reserve area to install, in the future, a full-sized conventional SAS': Certification for General Use Page 5 of 15 PERC-RITE Drip Dispersal System—March 20,2015 13. If additional drip tubing is installed in the future,the effective dispersal area for each existing and new emitter must be recalculated based on the new separation distances and the requirements above. 14. Residential Systems less than 2000 gpd, Alternative Design Standard to 310 CMR 15.2420)(a) Effluent Loading Rates—For residential Systems with design flows less than 2000 gpd, the required effective dispersal area may be reduced up to 50 percent " when using the loading rates for gravity systems of 310 CMR 15.242(1)(a), provided that the Drip Dispersal System is preceded by a secondary treatment unit with General Use Certification that allows for a 50%reduction in effective leaching area. Any reduction in effective leaching area shall be in accordance with the requirements and limitations of the secondary treatment unit General Use Certification and this Certification. No reduction is allowed in addition to the reduction allowed under the secondary treatment unit General Use Certification. For residential design flows of 2000 gpd or greater and for all nonresidential systems, no reduction in the effective dispersal area is allowed. The record drawings must indicate an area for a full-sized conventional primary SAS and the area for a full-sized conventional reserve SAS are for the sole purpose of upgrading the on-site sewage disposal system in the future, if necessary; without any increase in flow. (The effluent loading rates provided in 310 CMR 15.242(1)(b) for pressure distribution may be utilized, but no reduction in the effective leaching area may be taken when using these loading.rates,as stated in the regulation.) 15. The supply lines, drip tubing manifolds, and headers shall be sloped to allow effluent to drain back to the effluent pump (dosing) chamber by gravity to prevent freezing or installed at a depth of least four feet.The drip tubing and shallow manifolds shall be designed to drain into the soil upon completion of the pump cycle. 16. For Systems with a design flow of 2,000 GPD or greater,the System shall be equipped with a flow meter and automatic remote telemetric notification to the Service Contractor. 17. Except for septic tank covers•which are not required to be at grade, the frames and covers of all other access manholes and ports of the System components shall be watertight, made of durable material; and shall be installed and maintained at grade,to allow for necessary inspection, operation, sampling and maintenance access. Manholes brought to final grade shall be secured to prevent unauthorized access. No structures which could interfere with performance, access, inspection, pumping, or repair shall be _ located directly upon or above the access locations. 18. The System shall be.equipped with sensors and high4evel alarms to provide notification s to the System Owner and Service Contractor of a high water situation"due to pump failure, pump control failure,1oss of power or system freeze up. The control panel including alarms and controls shall be mounted in a location always accessible to the Service Contractor. 19. The System does not require a five foot over dig as indicated-at 310 CMR 15.255(5).L Certification for General Use Page 6 of 15 PERC-RITE Drip Dispersal System—March 20,2015 20. All System control units, valve boxes,drip dispersal lines,conveyance lines and other ' System appurtenances shall be designed and installed to prevent freezing per the Company's recommendations. 21. System unit malfunction and high water alanns shall be connected to circuits separate from the circuits to the operating equipment and pumps. 22. Any System structures with exterior piping connections located within 12 inches or below the Estimated Seasonal High Groundwater elevation shall have the connections made watertight with neoprene seals or equivalent. 23. Installation of inspection ports as described in 310 CMR 15.240(13) is not required for this System. 24. .Upon submission of an application Tor a Disposal System Construction Permit, (DSCP),the Designer shall provide to the local Approving Authority: a) for any proposed non-residential System, any System to be installed in Class IV soils, or any residential System with a design flow 2,000 GPD or greater, certification by the Companyass ecified in Paragraph V.3. b) certification by the Designer that the design conforms to the Approval, the Company Design Guidance, and the Code- and c) a certification, signed by the Owner of record for the propertyto be served by the Technology, stating that the property Owner: i) has been provided a copy of the Approval, the Owner's Manual; and the Operation and Maintenance Manual and the Owner agrees to comply with all terms and conditions; ii) as een informed of all the Owner's estimated costs associated-with the operation including; when applicable:power consumption, maintenance, c recordkeeping, reporting, and equipment replacement;,. iii) understands the requirement for a service contract; iv) agrees to fulfill his responsibilities to provide,a Deed Notice as required by the Approval; v) agrees to fulfill his responsibilities to provide written notification of the Approval to any new.Owner, as required by 310 CMR 15.287(5); vi) if the design oes rovide for the use of garbage grinders, the restriction is understood and accepted; and vii) whether or not covered by a warranty, the System Owner understands the requirement to repair, replace, modify or take any other action as required by the Department or the local Approving Authority, if the Department or the local Approving Authority determines the System to be failing to protect public health.and safety and the environment, as defined in 310 CMR 15:303. 25. The System Owner and the Designer shall not submit to the local Approving Authority a DSCP application for the use of a Technology under this Certification if Certification for General Use - Page 7 of 15 PERC-RITE Drip Dispersal System—March 20,2015 the Certification has been'revised, reissued, suspended, or revoked by the Department prior to the date of application. The Certification continues in effect until the Department revises, reissues, suspends, or revokes the Certification. 26. The ys em wner shall not authorize or allow the installation of the System other than by a person certified by the Company to install the System. UA 27. Prior to the commencement of construction,t e System Installer must certify in (� writing to the Designer, the local Approving Authority, and the System Owner that . (s)he is a locally approved System Installer and has been certified by the Company as qualified to inst 11 the System. 28. Except where the Approval specifically states otherwise, the Alternative System shall be installed in a manner which does not intrude on, replace, or adversely affect the . operation of any other component of the subsurface sewage disposal system. 29. Drip tubing may be installed with a vibratory plow,a static plow,,a narrow trencher(<6" width),by hand trenching,or by scarifying the surface and bedding the drip tubing in clean sand meeting the current requirements for fill material in Title 5 with cover consisting of sand and topsoil meeting the 6 inch minimum depth requirement. Vegetative cover must be replaced for installations where it is removed or buried during installation. 30. Drip tubing shall not be installed when soils are frozen or saturated. 31. The Installer shall maintain on-site,-at all times during construction,•a copy of the approved plans,the Owner's manual,the O&M manual, and a copy of the Approval. 32. Prior to the issuance of a Certificate of Compliance for the System,the:Company or its designee shall submit to the local approving authority and the System Owner a signed certification that the Alternative System has been installed in accordance with the Company's requirements, the approved plan, and the Approval. This certification in no way changes the Title 5.requirements for the Designer and Installer certifications. 33. Prior to the issuance of a Certificate of Compliance by the local Approving Authority, the System Installer and Designer must provide; in addition to the certifications required by Title 5, certifications in writing to the local Approving Authority that the System has been constructed in compliance with the terms of the Approval. 34. The Department has not determined that the performance of the,System will provide a level of protection to public health and safety and,the environment that is at least equivalent to that of a sanitary sewer'system. - a) If it is feasible.to connect a new or existing facility to the sewer, the Designer shall not propose an Alternative System to serve the facility and the facility Owner shall not install or use an Alternative System; and b) when a sanitary sewer connection becomes feasible after an Alternative System has been installed, the System Owner shall connect the facility served by the System to the sewer within 60 days of such feasibility and the System shall be Certification for General Use v ' Page 8 of 15 PERC-RITE Drip Dispersal System-March 20,2015 abandoned in compliance with current Code requirements, unless a later time is allowed in writing by the Department or the local Approving Authority. III. Operation and Maintenance - { . To ensure proper operation and maintenance (O&M) of the System,the System Owner shall enter into an O&M Agreement with a qualified Service Contractor whose name appears on the Company's current list of Service Contractors. Prior to commencement of construction of the System,the System Owner shall provide to the local Approving Authority a copy of a signed O&M Agreement. 2. From start up an ereafter, the System Owner and Service Contractor shall be responsible for the proper operation and maintenance of the System in accordance with this Certification, the Designer's O&M requirements, the Company's O&M requirements and the requirements of the local Approving Authority. The System Owner and Service Contractor shall be responsible for compliance with all monitoring and inspection requirements. All inspection, operation, maintenance, and monitoring requirements remain in effect until the conditions are modified, terminated, or superseded by a new Approval. 3. Prior to issuance of the Certificate of Compliance,a clean water test of the System shall be performed in the presence of a Company representative and the Service Contractor to check for leaks and for the proper distribution of effluent and to ascertain and verify system design flush and dose rates. The local approving authority shall be given adequate notification and opportunity to witness the clean water test, or at their discretion, may accept a letter from the Company representative certifying that the System operated properly during the clean water testa 4. For design flow rates of less than 2,000 gpd,the Service Contractor shall inspect and service the System at least annually, in accordance with Company requirements and checklist. 5. For actual or design flow rates of 2,000 gpd or greater, the System shall be inspected and serviced at least quarterly, consistent with the pressure distribution inspection requirements of 310 CMR 15.254(2)(d) and in accordance with Company requirements and checklist. 6. At a minimum, the Service Contractor shall clean the effluent tee filter according to 310 CMR 15.227(7), inspect pumps, controllers, air relief valves, and other system filters, and provide service, as necessary. E , Certification for General Use Page 9 of 15 PERC-RITE Drip Dispersal System—March 20,2015 , 7. Each time an Alternative System is visited by a Service Contractor the following shall be recorded, at a minimum: a) date, time, air temperature, and weather conditions; b) observations for objectionable odors; ' c) observations for signs of breakout of sanitary sewage in the vicinity of the Alternative System; d) identification of any apparent violations of the Approval; e) since the last inspection, whether the system had been pumped with date(s) and volume(s) pumped; f) sludge depth and scum layer thickness, if measured; g) when responding to alarm events,the cause of the alarm and any steps taken to address the alarm and to prevent or reduce the likelihood of future similar alarm events; h) any cleaning and lubrication performed; ' i) any adjustments of control settings, as recommended or deemed necessary; j) any testing of pumps, switches, alarms, as recommended or deemed necessary; k) identification of any equipment failure or components not functioning as designed; 1) parts replacements and reason for replacement,whether.routine or for repair; and' m) further corrective actions recommended, if any. 8. Unless directed by the local Approving Authority to take other action,the System Owner shall immediately cease discharges or have wastewater hauled off-site, if at any time during the operation of the Alternative System the system is in failure as described in 310 CMR 15.303(1)(a)1 or 2, backing up into facilities or breaking out to the surface. IV. Additional System Owner and Service Contractor Requirements' o commencement of construction of the System and after,recording-and/or registering the Deed Notice required by 310 CMR 15.287(10), the System Owner shall provide to the local Approving Authority a copy of. a) a certified Registry copy of the Deed Notice bearing the book and page/or . document number; and p b) if the property is unregistered land, a copy of the System Owner's deed to the property as recorded at the Registry, bearing a marginal reference on the System Owner's deed to the property. The Notice to be recorded shall be in the form of the Notice,provided by the Department. 2. Prior to signing any agreement to transfer any or all interest in the property served the System, or any portion of the property, including any possessory interest, the System Owner shall provide written notice, as required by 310 CMR 15.287(5) of all Certification for General Use Page 10 of 15 PERC-RITE Drip Dispersal System—March 20,2015 conditions contained in the Approval to the transferee(s). Any and all instruments of transfer and any leases or rental agreements shall include as an exhibit attached thereto and made a part of thereof a copy of the Approval for the System. The System Owner shall send a copy of such written notification(s)to the local Approving Authority within 10 days of giving such notice to the transferee(s). 3. The System Owner shall provide access to the site for the Service Contractor to perform inspections, maintenance, repairs, and responding to alarm events, as,may be required by the Approval. e System Owner and the Service Contractor shall maintain an O& reement at all times. The duration of the O & M Agreement shall be a least one year nd shall include the following provisions: a) The name of a Service Contractor, who meets the qualifications specified in the Approval, shall be included; b) The Service Contractor's responsibilities for inspection, operation, maintenance, monitoring, recordkeeping and reporting, as required by this Approval shall be t included; c) In the case of a System which is determined to be failing to protect public health and safety and the environment, as,defined in 310 CMR 15.303, an equipment failure, alarm event, components not functioning as designed, or violations of the Approval, procedures and responsibilities of the Service Contractor and System Owner shall be clearly defined, including corrective measures to be taken immediately. The System Owner and the Service Contractor shall maintain on-site, at all-times,.a copy of the O&M Agreement, the approved design plans,the Owner's Manual, and th�0&M Manual. /- 5. The Service Contractor shall submit to the System Owner the O&M report and inspection checklist within 60 days of any site visit. r 6. The System Owner and the Service Contractor shall maintain copies of the Service Contractor's O&M reports, inspection checklists, and all reports and notifications to the local Approving Authority for a minimum of three-years. 7. Upon determining that the System is in violation of the Approval or the System is failing to protect public health and safety and the environment, as defined in 310, CMR 15.303, the Service Contractor shall notify the System Owner immediately. 8. Upon determining that the System is failing to protect public health and safety and the environment, as defined in 310 CMR 15.303,the System Owner and the Service Contractor shall be responsible for the notification of the local Approving Authority within 24 hours of such determination. 9. In the case of a System that has been determined to be failing to protect public health and safety and the environment, an equipment failure, alarm event, components not functioning as designed, components not functioning in accordance with I Certification for General Use Page 11 of 15 PERC-RITE Drip Dispersal System—March 20,2015 t manufacturers' specifications, or,violations of the Approval, the Service Contractor shall provide written notification within five days, describing corrective measures to the System Owner, the local board of health, and the Company and may only propose or take corrective measures provided that: , a) all emergency repairs, including pumping, shall be in accordance with the limitations and permitting requirements of 310 CMR 15.353; b) the design of any repairs or upgrades are consistent with the System Approval; c) the design of any repairs or upgrades requiring a DSCP shall be performed by a Designer who is a Massachusetts Registered Professional Engineer-or a Massachusetts Registered Sanitarian, provided that such Sanitarian shall not design a system with a discharge greater than 2,000 gallons per day. . d) the installation shall be done by an Installer with a currently valid Disposal System Installers Permit and the Installer shall be certified by the Company as qualified to install the System . The System Owner shall also be responsible for ensuring written.notification is provided within five days to the local board of health. 10. The System Owner and the Service Contractor shall provide written notification to the local Approving Authority within seven days of any cancellation, expiration or other change in the terms and/or conditions of a required O&M Agreement with a Service Contractor. The Service Contractor shall provide written notification to the Company within seven days of any cancellation, expiration or other change in the terms and/or conditions of a required O&M Agreement. 11. By February 15th of each year, the System Owner,and the Service Contractor shall be responsible for submitting to the local Approving Authority all O&M reports and inspection checklists completed by the Service Contractor during the previous 12 months. 12. By February 15th of each year,the Service Contractor shall be responsible for submitting to the Company copies of all O&M reports including alarm event responses, violations of the Approval; inspection checklists completed by the Service Contractor, notifications of system failures, and reports of equipment replacements with reasons during the previous 12 months. 13. The Service Contractor shall notify the System Owner of any changes to the terms and conditions of the Approval within 30 days of any changes. 14. Within one year of any changes to the terms and conditions of the Approval;the System Owner shall amend, as necessary,the O&M Agreement required by Paragraph III.1 to reflect the changes to the terms and conditions of the Approval. 15. To determine whether cause:exists for modifying, revoking, or suspending the Approval or to determine whether the conditions of the Approval have been met,the System Owner shall furnish the Department any information that the Department M requests regarding the System, within 21 days of the date of receipt of that request. s f Certification for General Use Page 12 of 15 PERC-RITE Drip Dispersal System—March 20,2015 16. The Approval shall be binding on the System Owner and on its agents, contractors, successors, and assigns, including but not limited to the Designer, Installer, and Service Contractor. Violation of the terms and conditions of the Approval by any of the foregoing persons or entities, respectively, shall constitute violation of the Approval by the System Owner unless the Department determines otherwise. V. Company Requirements 1. e Approva s only apply to model units with the same model designations specified in the System Approval and meet the same specifications,operating requirements, and plans, as provided by the Company or its authorized agent at the time of the application. Any proposed modifications of the units, installation requirements, or operating requirements shall be subject to the review of the Department for inclusion under a modification of the Approval. The Designer shall be responsible for the selection of the appropriate model unit except, for systems of 2,000 gpd or more,the Company or its authorized agent shall be responsible for verification of the appropriate model unit as part of the review of proposed installations under a General Use Approval. 2. Prior to submission of an application for a DSCP,the C mpan or its'authorized agent shall provide to the Designer and the System Ow er: a) All design and installation specifications and requirements b) An operation and maintenance manual, including: n i) an inspection checklist; ii) recommended inspection and maintenance schedule; " iii) monitoring (i.e. water use); iv) alarm response procedures and troubleshooting procedures; c) An owner's manual, including alarm response procedures; d) Estimates of the Owner's costs associated with the operation including, when applicable: power consumption, maintenance, recordkeeping, reporting, and equipment replacement; - e) A copy of the Company's warranty; and Lists of certified Installers and trained Service Contractors. - 3. Prior to the submission of an application for a DSCP, for all nonresidential Systems, all Systems to be installed in Class IV soils, and all Systems with design flows of 2,000 gpd or greater, the Company or its authorized agent shall submit to the Designer and the System Owner, a certification by the Company or its authorized agent that the design conforms to the Approval and all Company requirements and that the proposed use of the System is consistent with the System's capabilities. The authorized agent of the Company responsible for the design review shall have receive,d technical training in the Company's products. 4. The Company must maintain programs of training and continuing cation•for Service Contractors, Training shall be provided at least annually.Ut Company J- Certification for General Use Page 13 of 15 PERC-RITE Drip Dispersal Syste , rgq 'res trained Designers and Installers, the Company or its authorized agent shall institute programs of training and continuing education that is separate from or combined with the training for Service Contractors. The Company or its authorized agent shall maintain, annually update, and make available by February 15t"ofeach year, lists of trained Service Contractors,.certified Installers and, if training is provided,trained Designers. The Company or its authorized agent shall certify that the Service Contractors and, if training is provided, Designers and Installers on the lists have taken the appropriate training and passed the Company's training /qualifications. The Company or its authorized agent shall further certify that the / Service Contractors on the list have submitted.to the Company all,the reports require by Paragraphs IV.9, 10, and 12. 5. The Company or its authorized agent shall not re-certify a Service Contractor if the Service Contractor has not complied with the reporting requirements for the previous year. 6. The Company or its authorized agent shall not sell the System to an Installer unless the Installer is certified to install the System by the Company or its authorized agent. The Company or its aut orize ageri['31iRtl req ' t,that distributors and resellers of the Technology shall not sell the System to an Installer unless the Installer is certified to,install the System by the Company. 7. As part of any training programs for Service Contractors, Installers, or Designers,the Company or its authorized agent shall'provide each trainee with a copy of this Approval with the design, installation, O&M, and owner's manuals that were submitted as part of the Approval. S. The Company shall provide, in printed or electronic format,the System design, installation, O&M, and Owner's manuals, and any updates associated with this System_ Approval, to the System Owners, Designers, Installers, Service'Contractors, vendors, resellers, and distributors of the System. Prior to publication or distribution in Massachusetts, the Company shall submit to the Department for review a copy of any proposed changes to the manual(s)with reasons for each change, at least.30 days prior to issuance. The Company shall request Department approval for any substantive changes which may require a modification of the Approval: 9. Prior to its sale of any System that may be used in Massachusetts,the Company shall.' provide the purchaser with a copy of this Approval with the System design,installation, O&M, and Owner's manuals.;In any contract for distribution or sale of the System, the Company shall require the distributor or seller to provide the purchaser of a System for use in Massachusetts with copies of these documents, prior to any sale of the System. 10. To determine whether cause exists for modifying, revoking, or suspending the Approval or to determine whether the conditions of the Approval have been met, the Company shall furnish the Department any information that the Department requests regarding the Technology within 21 days of the date of receipt of that request. i Certification for General Use Page 14 of 15 PERC-RITE Drip Dispersal System—March 20,2015_ 11. Within 60 days of issuance by the Department of a revised Approval, the Company I shall provide written notification of changes to the Approval to all Service Contractors servicing existing installations ofthe.System and all distributors and resellers of the System. 12. The Company shall provide written notification to the Department's Director of the Wastewater Management Program at least 30 days in advance of the proposed transfer of ownership of the System. Said notification shall include the name and - address of the proposed owner containing a specific date of transfer of ownership, responsibility,coverage and liability between them. All provisions of this Approval applicable to the Company shall be applicable to successors and assigns of the Company, unless the Department determines otherwise. 13. The Company shall maintain copies of: a) the Approval; b) the installation manual specifically detailing procedures for installation of its System; c) an owner's manual, including alarm response procedures; d) an operation and maintenance manual, including: i) an inspection checklist; ii) recommended inspection and maintenance schedule; iii) monitoring requirements, if any (including water use,and power consumption when required); iv) alarm response procedures and troubleshooting procedures. e) estimates of the operating costs provided to the Owner,including,when applicable: power consumption, maintenance, recordkeeping, reporting,and equipment replacement; f) a copy of the Company's warranty; and g) lists of trained Designers (if any), certified Installers, and,trained Service Contractors. 14. The Company shall maintain the following additional information for the Systems installed in Massachusetts and make it available to the Department within 30 days of a request by the Department: a) the address of each facility where the System was installed, the Owner's name and mailing address (if different), the type of use (e.g. residential, commercial, institutional, etc.), the design flow,the model installed; b) the installation date, start-up date, current operational status; c) the name of the Service Contractor, noting any cancellations or changes to any Service Contracts; and d) copies by of all Service Contractor records submitted to the Company, including all O&M reports with alarm event responses, all monitoring results, inspection f Certification for General Use Page 15 of 15 PERC-RITE Drip Dispersal System—March 20,2015 checklists completed by the Service Contractor, notifications of system failures, and reports of equipment replacements with reasons. 15. The Approval shall be binding on the Company and its officers, employees, agents, contractors, successors, and assigns, including but not limited to dealers, distributors, and resellers. Violation of the terms and conditions of the Approval by,any of the foregoing persons or entities, respectively, shall constitute violation of the Approval by the Company unless the Department determines otherwise. VI. General Requirements , 1. Any System for which a complete Disposal System Construction Permit("DSCP") Application is submitted while the Approval is in effect, may be permitted, installed, and used in accordance with the Approval, unless and until: a) the Department issues modifications or amendments to the Approval which - specifically affect the installation or use of a System installed under the Approval for the System; or b) the Department, the local approval authority; or a court requires the System to be modified or removed or requires discharges to the System to cease. 2. All notices and documents required to be submitted to the Department'by the Approval shall be submitted to: Director Wastewater Management Program ° Department of Environmental Protection One Winter Street- 5th floor Boston, Massachusetts 02108 3. The Department may suspend, modify or revoke the Approval for cause,including, but not limited to, non-compliance with the terms of the Approval, for obtaining the Approval by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Approval, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to the.Approval and/or the System against the Company, a System Owner, a Designer, an Installer, and/or Service Contractor. ' 4 r OAKSON1, INC . , Wastewater Product Sales Installer's Checklist for the Perc-Rite Drip Dispersal Sy teth lnslallatian ,S'e atenc ' 0 Rope off dispersal area to protect from traffic and/or compaction Q Set septic tank,and pump tank 0 Place hydraulic unit and control panel ° O Install Cool-Guide and.pump ' ❑ Install.float tree ❑ Dice ditches for supply and return lines and install Install drip tubing ❑ Install loops.(flex tubing) connecting ends of drip tubing ❑ Dry fit pressure limes,field manifolds and air release valves ❑ Glue all fittings and place air release valve boxes-do not final fit air . release valves at this point a ❑ Connect electrical components(and phone line to control panel if applicable) ❑ :Provide clean water in tank(above".Grip Enable"float)for start-up C3 Remove air release blush all laterals through air release valves d Final fit air release valves ❑ Pressure check all httings and lines ❑ :Find.any leaks and repair 0 Backfill once lines and laterals are determined to have no leak-s- ; Backfilling is to be controlled to prevent damage to the pipes or fittings. o not compress soil over the field' ❑ Grade, seed and mulch site nakson}Inc. is:committed to excellence Tease feel free to contact its Wth questions regar&ng any issue February 07 } 2 Blackburn Center, Gloucester, MA 01930 e Phone 978-282-1322 6 Fox 978-282.1318 a wAww,oalcsoninc.COrn - t COASTAL ENGINuiuNG COMPANY,INC. 260 Cranberry Highway,Orleans,MA 02653 0 508.255 6511 Fax 508.255.6700 in coastalengineeringcompany.com C18236.00 November 23,2015 Barnstable Board of Health By Hand Delivery Barnstable Town Offices 200 Main Street Hyannis, MA 02601 Re: Board of Health Variance Application Filing Package Proposed Site Redevelopment and Sewage Disposal System Upgrade David Samra&Erica Pearson 265 Seapuit Road Barnstable(Osterville), MA Map 095/Parcel 004 , On behalf of our client,David Samra,we are submitting an original plus three copies of a Board of Health Variance Application Filing Package, an original check for municipal filing,and four copies of the plan for the above-referenced project. The following items are enclosed: • Board of Health Variance Application • Variances Requested List • Board of Health Variance Justification Letter • Authorization for Representation Letter • Abutter Notification Letter • Septic Plan Checklist • Copy of$95.00 check made payable to Town of Barnstable for-filing fee • Proposed floor plans entitled,"Samra Residence", prepared by Catalano Design, ,dated 11/23/15 • Plan entitled,C2.1.1,"Proposed Sewage Disposal System Plan",dated 11/23/15 • Plan entitled,C2.4.1,"Plan Showing Proposed Sewage System Details",dated 11/23/15 • Plan entitled,C2.4.2,"Plan Showing Proposed Sewage System Details",dated 11/23/15. Please schedule this for the December 8,2015 public hearing. If you have any questions or require additional information, please give our office a call. Thank you. Sincerely, COASTAL ENGINEERING CO., INC. A Sean M. Riley, P. Enclosures:As Stated cc: David Samra&Erica Pearson, Homeowner—via email Amy Lipkind.,Coastal Engineering Co., Inc.—via email Sarah Turano-Flores, Nutter McClennen&Fish LLP—via email Garret Avery,Catalano Architects —via email D:IDOCICI8200V 82361PermittinglBOHV 20151Samra-App Trans ketter.doc r ,Message Page 2 of 2 Designers do not have to be certified. Oakson will review designs before they are submitted to the BOH for approval. We have worked with Sean and his firm on many occasions and he always interacts with us during the process. He has a great understanding of Perc-Rite Drip Dispersal. Feel free to contact me with any additional questions. Thanks, Rob Sarmanialc General Manager . 6 Sargent St. e Gloucester, MA 01930 . 282-1318 fax 4- 9 . (978)282.1322 x801 off[c . 04e �EkS�MR IN nr,A �� (978) w . (781) 844-8237 moblie . www.oakson.com Click here for a map of Perc-RiteD- installations } From: Stanton, David [ma i Ito:David.Stanton @town.barnstable.ma.us] Sent: Friday, February 05, 2016 9:14 AM To: info@oaksoninc.com Subject: certified perc rite designer Good morning, I am a Health Inspector for the Town of Barnstable, MA reviewing a septic permit application for a property in Town proposing a perc rite system. Does your company require designers to be. certified? If yes, can you please let me know if Sean M. Riley, PE from Coastal Engineering in Orleans, MA is certified to design perc rite systems. They have not chosen an installer yet, but I will ask you that as well once they decide on one. Thanks you, d David W. Stanton, RS ; Health Inspector Town of Barnstable 200 Main Street Hyannis,MA 02601 Direct phone: (508) 862-4647 Health Dept.phone: (508)862-4644 Health Dept. fax(508)790-6304 f 2/5/2016 Wessage Page 1 of 2 Stanton, David From: Rob Sarmanian [rsarmanian@oaksoninc.com] a Sent: Friday, February 05, 2016 11:14 AM To: Stanton, David Subject: RE: certified perc rite designer There is no pre-certification required to install a Perc-Rite system other than the contractor being licensed in the corresponding town. We send a technician to every project to oversee and assist with the installation. First time installers will participate in a call with us prior to construction day. Every step is outlined to ensure the day goes smoothly. We have learned over the years that classroom training is not as effective as on the job training and have modified our practices accordingly. We want every project to be a success and take the proper,measures to ensure that. Thanks, t= Rob Sarmanian ` General Manager , 6 Sargent St. Gloucester, MA 419.30 . 0 A K S N (918)182-1322 x801 ofke; ® -Ra d grix �. is a (978) 282-1319 fax a, (781) 844-8237 mobile:, r www.oakson.com x , Click here for a map of Perc-Rite& installations From: Stanton, David [ma ilto:David.Stanton @town:barnstable.ma.us] W Sent: Friday, February 05, 2016 11:08 AM To: Rob Sarmanian Subject: RE: certified perc rite designer Great, thank you very much. Do you require Installers to be certified? Thanks, David -----Original Message---- From: Rob Sarmanian [mailto:rsarmanian@oaksoninc.com] Sent: Friday, February 05, 2016 9:42 AM To: Stanton, David Subject: RE: certified perc rite designer Good morning David, 2/5/2016 r r ftEC�IVED CAs oN, I c. 1 9 Z013 Drir:l�tptixal:Gllviei..Reie S;liii,ant Tu:41!5itri Cl�ariri j'LrK?.,(i1G. ROUTINE OPERATION AND.MAINTENANCE,PROCEDURE F4R' PERC-RITE® DRIP`QISPERSAL SYSTEM MODELS: ASD,. QM, WD A; Field Cond"ittons and. Preparation` 1, Obtain records: frorn prev iouss'v 1sit;(start-up: 2. 1NaIk.the field td deterrnrne.if-wet areas are present> 3 Open hydraulic unit:and documerltfilbw`meter reading 4. Calculate and d:gc�mr 014 daily 'wader usage 5 Dpen pum, charrrber aid check l >a' �d [eve (/floats 6.: Tn99=er 0.1 f{Qat; 7;. Open:valve. box and inspect air rele`ae valves B., Control Lights :and S;vu�tch: Posi �ons< 1 'Open:;the control panel 2. Make sur..e all HOA switches a.re in ahe automatic positi'an 3. Microprocessor.; confirm power and: run lights are ors 4.'Verify float LE=D disPfay corresponds with float s positions in pump charnb:er C. Pump and Valve Operation 1...Turn all HOA. switches in control panel to "OFF" 2. Inspect (a.nd clean if necessary) .disc filter(s) 7 3. Manipulate each HOA switch to test solenoid and: valve operation. The flow meter should only turn when a zone valve js_open and pump is on 6 Sargent St;;Gloucester,MA 01930 (978)282-1322::off1ce(978)282 1318 faz www.oaksoninc.com info@6aksohinc.coni June 2012 11Page RECEIVED OAKSOKINC., FiB 1 28.1 Drip Displ A d;&;).Wer'R¢iri :Sc[utr urs f o,A�l S+tes ]}(( (+ 4 Pface :all HOA:switches ih: th.e "AUTO!' position. Ho.id 'rn the "RESET,/ GLE $TART'`button (apprax Si secan;ds) until 'you hear al click a . At'the: hyd.rauli.c: un(t, you hound witness-:a. cornp.lete system cycle b After pressurization time,. document the flow raters) by reading the flow meter for a timed; minute ;,. e Ccrrnpare de rgn flow`to timed flow lo-0/6 . toteranee _ � d Fl`Qw, rarratron is most;common sign ,o s �ystetn issue: - t e Inspect air release va ves'for normal: dperat%onr D Septic and/orreYtreatr %Qnt Tanks (if �ncorp`oraed into O&M eo,ntract� -� ]:... xamirte::and Cleo <effl.uer�t filters 2 L�oCutn s: s�udgeiscum I:evels, rn tari`k 3.R ecommmend p-ump:ing �f necessary 4 Servece pre treatment system s Es Finish'ing Up 1 AN !-CAA swatches in Control panel should be: in "AUTO" P:osmon Z. Clo e.and: secure all tanks, hydraulic unit, control panel, and air release valves 3, Fill out operator checklist Provide copies to homeowner, lbcafl BOH,-and Ookson within 60 days 6 Sargent St,610.ucester,.MA 01930 ! (978)2824322 office(978)282-1318 fax r vwvw oaksaninc.com info.@oa ksen inc.corn June2012 21 Page OAKSON, INC. Drip Dispersal&Water Reuse....Sol odnm For All Sites ROUTINE OPERA TION AND MAINTENANCE PROCEDURE FOR PERC-RITE® DRIP DISPERSAL SYSTEM MODELS. ASD, QM, WD Property Address: Date: Time: Air Temperature: Weather Conditions: FIELD CONDITIONS A. Drip dispersal field: visible wet spots YES NO objectionable odor YES NO Comments: B. Air release valves: functioning properly YES NO Comments: FLOAT OPERATION A. Floats: register on PLC YES NO Comments: B.Alarm float audible/visual YES NO Comments: CONTROL PANEL A. HOA Switches: functioning properly YES NO Comments: B. PLC (microprocessor): power/run lights on YES NO Comments: 6 Sargent St.,Gloucester,MA 01930 (978)282-1322 office(978)282-1318 fax www.oaksoninc.com info@oaksoninc.com" June2012 1 Page OAKSON, INC. Drip Dispersal&T-Hater Reuse....Solutions Far All Sites HYDRAULIC UNIT A. Disc Filter(s): cleaning required YES NO Comments: B. Valves: opening/closing YES NO Comments: C. Condition: signs of erosion/Infiltration YES NO settling/movement YES NO Comments: SEPTIC and/or PRE-TREATMENT TANKS (if included in contract) A. Effluent Filter: cleaning required YES NO N/A Comments: B. Septic tank: pumped since last visit YES NO pumping recommended YES NO 1. Sludge.depth: 2. Scum depth: Comments: C. Service pre-treatment system YES NO N/A Comments: Operator signature License No. Comm ents/Observations: Flow Meter Reading: Dose Rate(s): Flush Rate(s): 6 Sargent St.,Gloucester,MA 01930 I. (978)282-1322 office(978)282-1318 fax www.oaksoninc.com info@oaksoninc.com June 2012 2 P a g e Owner's Manual AMERICAN "PER C-RITE° u WASTEWATER DRIP SYSTEMS 2 ZONE or 4 ZONE SIMPLEX or DUPLEX PATENT #'s: 5,200,065 8,984,57413 6,261;45261 ,• 1 1 ZONE 2 P ZONE 1 �V TRAL UFO ) SUPPLY O TO W SEPTIC TANK PUMP TANK OWNER'S NAME HEALTH DEPT. ID NO. LOCATION NAME STREET NAME CITY, STATE ZIP Table of Contents American Manufacturing Limited Warranty 2 Introduction 2 Safety Precautions and Warnings 2 Owner's Responsibility 3 Overview of American Perc-Rite° Drip 3 System Parameters of American Septic Drip 5 Data Registers & Component Specifications & Details 6 Startup Log 8 MANUFACTURED BY: AMERICAN MANUFACTURING COMPANY INC. 5517 WELLINGTON ROAD, G.AINESVILLE,VA. 20155 1-800-345-3132 ©American Manufacturing Company, Inc., 2006 - 1 www.americanonsite.com AMERICAN MANUFACTURING LIMITED WARRANTY For one year (12 months) after the date of purchase, American Manufacturing Company, Inc. will repair or replace any product or portion thereof which proves to be defective due to materials or workmanship of American Manufacturing. We reserve the right to repair or replace defective materials at our discretion. This warranty does not cover the following conditions: 1. Defects or problems caused by improper installation or maintenance of materials. 2. Abuse, neglect or accidental damage of products. 3. Normal maintenance or upkeep of products. 4. Lighting, war, floods, or other acts beyond our control. 5. Misapplication of our products for their designed purpose, or misapplication according to local, state or national codes when in effect. 6. American Manufacturing Company or its representatives are not responsible for the labor for the replacement-of defective parts. Defective or warranted materials must be returned to us or a place designated by American Manufacturing. All returns must be accompanied by a return authorization number supplied by,American.Manufacturing. American Manufacturing will in no way be responsible for any losses or damages incurred by failure of equipment, parts or service. NOTE: Some states do not allow exclusion of damages so this may not applyto you. There are no other warranties written or implied. INTRODUCTION Congratulations! You are now the owner of a state of the art wastewater treatment and recycling system by American Manufacturing Company, Inc. We have been in business for over 20 years and are considered one of the leaders in the On-Site Wastewater industry. With a staff having over 100 years collective experience in providing solutions to new sites and sites in need of repair, we are able to deliver an ecological, economical, easy to install and off-the-shelf Perc-Rite°Drip to owners like yourself. When and How to use manual This owner's manual should be read cover to cover initially, and then as needed to answer any questions or assist the owner in fulfilling their maintenance and inspection responsibilities. When and Where to call for assistance or get additional information If at any time you have a question about the Perc-Rite® Drip or observe any alarm or unusual condition, you should call your qualified service representative or installing contractor as soon as possible. The owner should record in the back of this manual, the contact name and telephone number of the qualified service representative and installing contractor. If further assistance is needed, call American Manufacturing Company, Inc. at 800-345-3132, or visit us at www.americanonsite.com. Overview of Manual The manual is organized to cover safety precautions and warnings, an overview of the Perc-Rite°Drip components, and the owner's responsibility.. A startup log and limited warranty are in the back of this manual. SAFETY PRECAUTIONS AND WARNINGS The owner or operator of the Perc-Rite®Drip should take precautions consistent with operators working with sewage and/or electricity while working with, or around any of the system components. Electrical Hazards The Perc-Rite° Drip incorporates pump(s), float switches, relays and many electrical components that use 230 volts, 120 volts or 24 volts AC. Improper use of equipment can cause an electrical shock and may lead to serious injury or death. Sewage Hazards Proper attention should be given to cleanup when working in and around the septic and pump tanks and wastewater handling equipment to insure that disease causing bacteria are not transmitted to persons or contact surfaces. The septic and pump tanks can allow for a toxic buildup of poisonous gasses that can lead to serious injury or death if inhaled. Heavy Lifting Hazards The owner and/or operator should exercise proper caution when lifting heavy system components, such as pump tank lids. Improper lifting of heavy components can lead to loss of limb and/or mobility.. ©American Manufacturing Company, Inc., 2006 -2 - www.americanonsite.com OWNER'S RESPONSIBILITY Preventative Maintenance The drip field area should receive only the most passive type yard uses. No use is recommended when conditions are wet. Under no conditions are any autos or heavy machinery to be allowed on the site. In order to prevent erosion, the site should be established and maintained as a healthy lawn, or if wooded, mulched and stabilized. Erosion of the site and the adjacent areas should be controlled and eliminated. Surface waters should be diverted away from all components. Scheduled Inspections Within a month of operation the owner should contact the installer to have the system inspected for proper startup. After three months of operation the drip field should be walked and the system inspected. Symptoms to look for on the field walk inspection are patches of wetness. If symptoms are identified, notify your service provider immediately. The drip field should be walked &inspected at least annually. A trained professional service provider, your American Dealer, should inspect the septic tank and pump chambers at least once a year. The septic tank should be pumped when the sludge level reaches 25% or approximately 12 inches, or when the scum layer on top is excessive. The flow meter reading in the hydraulic unit should be recorded with the date on a quarterly basis. Alarms- Notifying Service Provider of alarm events The system controller is equipped with an audiovisual alarm-to-alarm high water level condition. The high level alarm may be silenced by pressing the "silence" button on the side of the control. Since a high water level condition can be caused by pump failure, excessive infiltration, or an unusually large peak water use, the owner should call the service provider to determine the cause of the alarm prior to requesting service. If at any time there are any indications of failure, such as the flow meter not moving during a dose or wetness in the area of the drip field, notify your service provider immediately. Monitor&Regulate waste input to septic tanks Since all processes in this sewage disposal system use biological activity to treat the wastewater, only typical biodegradable household wastes are to be disposed of in drains leading to the septic tank. Never dispose of pesticides, oil or grease based products, or non-fecal solids (especially feminine hygiene products) into the system. Minimize disposal of high strength over-the-counter type products such as bleach, and do not use colored toilet tissue. OVERVIEW OF PERC-RITE® DRIP SYSTEM The Perc-Rite° Drip System is a unique fluid handling system for dispersal of effluent wastewater in soil systems. The system incorporates filtration, time and level controlled application and ultra low rate drip distribution. In conditions where aerobic dispersal, such as "Low Pressure Distribution", of septic effluent is required or where land application with the use of conventional soil absorption fields are not acceptable, this system offers a unique method for subsurface distribution of the waste water effluent. The Perc-Rite® Drip System will accommodate virtually any type of pretreatment process, whether septic tank (anaerobic), aerobic, lagoon, or any type of treatment facility. Only primary treatment(the removal of large settleable solids) of sewage is necessary for the operation of the system. Local soil and site conditions may require additional treatment for excessive organics, oil and grease or other contaminants. Since the installation of the field distribution lines causes very little soil disturbance and effluent discharge volume from each emitter hole is insignificant, the installation of the system has very little site impact even in established lawns or park areas. After installation there are virtually no visible indications that the installation site is being used for disposal purposes. This system is especially suited for landscaped or wooded areas near buildings, trailer parks, apartment complexes or residential subdivisions. The Perc-Rite° Drip System is operated via a "state of the art" controller, which is activated by level sensing devices (standard mechanical differential float switches) located in a dosing tank downstream•from the pretreatment process or processes (typically a septic tank). When activated by the rising level of effluent in the dosing tank, the controller will enable the disposal cycle, and as dictated by the time clock, pump the effluent through a 115-micron disc filter and then to final drip dispersal. Drip Tubing The drip field supply line conveys the effluent to the drip absorption zone that is being dosed where it is discharged below the soil surface through a patented chemical-resisting pressure compensating self cleaning "drip" poly-tubing emitter. The emitters or "drippers" are located every two feet in the tubing and emit 0.65 gallons per hour per emitter. The dripper lines are automatically scoured (forward flushed) every 25 dosing cycles. This function is activated by the controller, which opens the field flush valve, thus allowing the flushed effluent to be returned to the pretreatment tank. The duration of this cycle is approximately three minutes. The flushing cycle produces a high ©American-Manufacturing Company, Inc., 2006 - 3 - www.americanonsite.com i r velocity cleansing/scouring action by the effluent along the inside walls of the dripper tubing and P.V.C. Manifolds. The tubing emitters are self-cleaning and require no maintenance. The construction of the drip tubing is unique in that the internal diaphragm and labyrinth provide for an exact amount of effluent to be discharged from each of its emitters, which are..spaced at two-foot intervals along the entire length of the drip tubing. Each emitter maintains a constant flow over pressure ranges of 7 to 70 psi. Because the effluent is distributed at an ultra low rate, large quantities of effluent may be economically distributed over large areas during controlled periods of time without saturating the surrounding soil. Air Release Valves The drip field return line conveys the effluent from the drip absorption zone (used to"flush"or clean the tubing) back to the pretreatment device. Each zone will have an air release valve housed in a small,valve box at the highest point of the return manifold pipe. This valve will close when the water pressure arrives at the valve during each dose. The air release valve allows air to reenter the tubing after each dose to allow the tubing to drain. This also prevents the uphill tubing from draining water into the downhill tubing and overloading downhill tubing. In the event of damage to the air release valve, effluent may leak from the system. This condition should be fixed immediately by replacing damaged parts. Air release valves should not be covered with soil or other material and should always be accessible to the service personnel. Sequence of Operation: PERC-RITES DRIP SYSTEM The pump control panel is equipped with four float switches to control the timed doses to be discharged.The four float switches, "Redundant Off", "Standard Dose Enable", Peak Dose Enable" (optional), and "High Level" function as follows: Redundant Off-The water level must be high enough to overcome the "Redundant Off' (first&bottom) float in order for the pump to be permitted to run. . Standard Dose Enable- When the water level rises high enough to overcome the "Standard Dose Enable" (second) float and the time clock has timed out the preset time delay of 180 minutes (rest between dosing cycles for two zone designs) the pump will activate and the lead zone is dosed. The pump will continue to run for the length of time as adjusted on the pump run timer and then shut-off. The pump will remain off until the internal time clock again times out the preset time delay (180 minutes) after which the pump will activate (as long as the "Standard Dose Enable" float is still up) and will run until the pump run timer finishes timing out.This process will repeat until the water level drops below the "Standard Dose Enable"float and the pump run timer has timed out. The rest time automatically varies with the number of Zones. Peak Dose Enable-The control system will be equipped with a "Peak Dose Enable"circuit to manage peak flows and excess water use. If the rising water level activates the "Peak Dose Enable" (third) float, the "Pump- Off- Pump& Alarm"switch is set to "Pump", and the preset time delay has exceeded 108 minutes ("Peak Dose Enable" rest between cycles for two zone designs), the lead zone will be dosed:When the peak circuit has been deactivated the normal pumping cycle will resume. If the rising water level activates the "Peak Dose Enable" (third) float, the "Pump- Off- Pump&Alarm"switch is set to"Pump&Alarm", and the preset time delay has exceeded 108 minutes("Peak Dose Enable" rest between cycles for two zone designs), the lead zone will be dosed and the "Peak Dose Enable" alarm will be activated. The audio portion of the alarm may be silenced by pressing the Test-Normal-Silence switch to the silence position. When the "Peak Dose Enable" float has returned to the down position the alarm will be deactivated and the normal pumping cycle will resume. The rest time automatically varies with the number of Zones. High Level - If the water level rises enough to overcome the "High Level" (fourth) float, the audiovisual alarm will activate. The audio portion of the alarm may be silenced by pressing the Test-Normal-Silence switch (located on the outside of the control panel) to.the silence position. The alarm circuit will auto reset when the "High Level"float returns to its normal (down) position. The high-level alarm float is a wide-angle float in order to latch the alarm signal CONTROLLER The "state of the art" controller is enclosed in an outdoor electrical control box located near and connected to the hydraulic unit.The control panel uses 115 or 230 volt power and the microprocessor has 120V and 24V AC inputs and relay outputs for automatic operation of the Perc-Rite°Drip System. When in the"Hand"or"Off"position, the manual switches (Hand-Off-Auto) on the door of the control panel completely bypass the microprocessor. The"Hand" position will allow manual operation of the component in the event of a microprocessor failure. NOTE: THE HOMEOWNER ASSUMES FULL RESPONSIBILITY FOR CONDITIONS OR MALFUNCTIONS DUE TO CHANGES IN 'PUMP RUN TIME BY ANYONE OTHER THAN A QUALIFIED SERVICE REPRESENTATIVE. LEAVING THE PUMP CONTROL IN THE "HAND" POSITION WILL FORCE THE PUMP TO RUN CONTINUOUSLY AND MAY RESULT IN PUMP FAILURE. ©American Manufacturing Company, Inc., 2006 -4- www.americanonsite.com L i Normally Open Flowmeter Supply Valves Disc Filters Normally Closed Field Mush Valve 0 Normally Closed Zone Valves Backflush Valves Supply From Return To Pump Tank Septic Tank Hydraulic Unit The submersible pump delivers unfiltered effluent through each filter. The filter backflushing schedule is triggered at the beginning of each dose cycle. The backflushing sequence is as follows. One filter valve closes, thus blocking the flow of unfiltered effluent to that filter. After a short delay, the other flushing valve opens, thereby backflushing the unused filter. The accumulated impurities discharge back into the.pretreatment unit. The closing and opening procedure of the filter and back flush valves causes a change of flow within the unit to provide effluent from one filter to backflush the other filter. The backflush procedure lasts approximately fifteen seconds then the back flushing valve closes. Only after the first filter has completed its backflushing cycle, will the second filter begin its cycle of backflushing in the same manner as the first. Effluent will then be pumped through clean disc filters, then through the flow meter and finally through the zone valves to the drip field supply line. During extended dose times the disc filters are re-backwashed to assure optimum operation. System Parameters Simplex System w/ 1 or 2 Zones & 2 Disc Filters a. System Fail indicated by high level alarm or unusual wetness in the field. b. Standard Rest time between doses = 180 minutes, 4 doses per day per zone. c. Peak Rest time between doses = 108 minutes, 6.6 doses per day per zone. d. Flow meter on hydraulic unit(record periodically to monitor activity). e. To remove pump or zone from service place its'control switch to"off". System Parameters Simplex & Duplex System w/ 4 Zones &2 Disc Filters a. System Fail indicated by high level alarm or unusual wetness in the field. b. Standard Rest time, 4 doses per day per zone; • 4 zones in use doses = 90 minutes, • 3 zones in use doses= 120 minutes, • 2 zones in use doses = 180 minutes, c. Peak Rest time between doses • 4 zones in use doses = 54 minutes, • 3 zones in use doses = 72 minutes, • 2 zones in use doses = 108 minutes, d. Flow meter on hydraulic unit(record periodically to monitor activity). e. To remove pump or zone from service place its'control switch to'off'. ©American Manufacturing Company, Inc., 2006 - 5 - www.americanonsite.com AMEmrCAN "PERC-RITE°" WASTEWATER DRIP SYSTEMS 2 ZONE or 4 ZONE SIMPLEX or DUPLEX CONTROLLER SIEMENS MICROPROCESSOR - INPUTS AND OUTPUTS The Siemens microprocessor has inputs on the bottom and outputs on top. The two zone units have 8 inputs (0-7) and 6 outputs (0-5). The three and four zone has the following; Output QO 1 .0 1 .1 1 .2 1 .3 ..4 1 .5 1 .6 .7 1 Q1 1 .0 .1 Input I0 .0 .1 .2 .3 .4 .5 .6 .7 I1 .0 .1 .2 .3 .4 5:: . MICROPROCESSOR - INPUTS AND OUTPUTS R. R R R R R E E E E E E F F F F. F F A B C A B C Input Input Input Description Output Output Output Description I0 I0 i0 QO QO QO .0 .0 .0 DOSE CUTOUT .0 .0 .0 PUMP 1 .1 .1 .1 OFF LEVEL FLOAT .1 .1 .1 ZONE RETURN .2 .2 .2 DOSE ENABLE FLOAT .2 .2 .2 FILTER 1 .3 .3 .3 PEAK ENABLE FLOAT .3 .3 .3 FILTER 2 .4 .4 .4 RESET/CYCLE START .4'- .4 .4 FIELD 1 .5 .5 .5 PUMP 1 .5 .5 .5 FIELD 2 .6 .6 .6 ZONE 1 VALVE .6 .6 FIELD 3 .7 1 .7 .7 IZONE 2 VALVE .7 .7 FIELD 4 0 .0 ZONE 3 VALVE 1 .0 .0 IPUMP 2 Input Input Input Output Output Output I1 I1 I1 Q1 Q1 Q1 .1 .1 ZONE 4 VALVE .1 .1 ZONE MASTER .2 .2 PUMP 2 .3 .3 CURRENT SENSOR .4 .4 HIGH LEVEL(OPTION) .5 .5 AUX. INPUT 1 References:"REF A " is Two Zone Simplex System "REF B " is Four Zone Simplex System "REF C " is Four. Zone Duplex System ©American Manufacturing Company, Inc., 2006 -6- www.americanonsite.com outputut ov�aao�a�oo O O 3 `n ,-- 0 C1 0 0 Eg 0 00 oa00000ao 115V tph DHc PILOT CIRCUIT 11BV P ALARM CIRCUIT Input Lights O O MP $1 SUPPLY FEED O O PEAK RESET7 FILTERBACKFLUSH ZONE MASTER LEVEL CYCLESTART W rsn 14w 2 ,vs wrasaum a 0 0 O O JPUMP2 PUMP ZONE ZONE1 ZONE2 a ZONE . WW40NALft x rdADNA, HvAaS ,+.dagMb w�eauu, Q 120VAC----124VAG-- TB-3-----� --12DVAC51 -------� t PC OF P HL AC / 4 4 A H1 2 P2 Al Pl OJ I i DVC 1 I (DIRECT CUTOU TALE 1 OFF 1 I I I (Blower Fail Option I I 115V115V STANDARD) I I I I TIMER ENABLE F1 Z2 413 G l�l{� �CL3\ F2 Zt Z3 PEAK ENABLE IFANTI— TI— PILOT NEUTRAL M NEUTRAL SOLENOID FIIDTERAL#VES iEATEI� (MAY BE JUMPED TOGETHER F2 FILTER #2 I I IF SEPARATE SUPPLIES 21 ZONE ARE NOT REQUIRED) HIGH LEVEL Z2 ZONE 1 20YA5XOO Z3 = ZONE p3 I O Z4 - ZONE 14 DRY ALARM CONTACTS ZM = ZONE MASTER (OPTIONAL REMOTE ZR — ZONE RETURN LOCATION ALARM) 1) Leave switches in "Auto" or "Off" Never leave switches in "Hand" or "On" position. The Off position will take component out of service 2) To Silence Alarm On outside of control push "Test-Off-Silence" switch to "Silence" and release. 3) Leave power "on" - There is a strip heater in the hydraulic unit which is:powered by the control panel. Power must be left on to protect unit from freezing. 4) To start automatic cycle - Push and hold "Reset" button for over 5 seconds until an automatic cycle starts. Then release button. 5) Manual Operation - Place "H-O-A" (hand-off-auto) switch to "Hand": This position is like an "on switch" and should operate the individual component regardless of other conditions. ©American Manufacturing Company, Inc., 2006 - 7 - www.americanonsite.com Name: Date: Owners'Address: American Perc-Rite Drip Startup Log USER LOG Line As-Built Description Number of Zones:_ Date Date Date Date No. Value 1 BEDROOMS 2 GALLONS PER DAY 3 TEXTURE GROUP 4 GPD/FT2 DESIGN SOIL LOADING RATE 5 TOTAL LINEAR FEET TUBING 6 GPD/LF FT DESIGN TUBING LOADING RATE 7 METER READING 8 ZONE 1 LINEAR FEET OF TUBING 9 ZONE 1 NUMBER OF FIELD FLUSH CONNECTIONS 10 ZONE 1 GPM DOSING FLOW RATE 11 ZONE 1 GPM TOTAL FLUSHING FLOW RATE 12 ZONE 1 RUN TIME 13 ZONE 2 LINEAR FEET OF TUBING 14 ZONE 2 NUMBER OF FIELD FLUSH CONNECTIONS 15 ZONE 2 GPM DOSING FLOW RATE 16 ZONE 2 GPM TOTAL FLUSHING FLOW RATE 17 ZONE 2 RUN TIME 18 ZONE 3 LINEAR FEET OF.TUBING 19 ZONE 3 NUMBER OF FIELD FLUSH CONNECTIONS 20 ZONE 3 GPM DOSING FLOW RATE 21 ZONE 3 GPM TOTAL FLUSHING FLOW 22 ZONE 3 RUN TIME 23 ZONE 4 LINEAR FEET OF TUBING 24 ZONE 4 NUMBER OF FIELD FLUSH CONNECTIONS 25 ZONE 4 GPM DOSING FLOW RATE 26 ZONE 4 GPM TOTAL FLUSHING FLOW 27 ZONE 4 RUN TIME 28 PEAK ENABLE CYCLE COUNTER 29 HIGH LEVEL CYCLE COUNTER 30 CONTRACTOR STARTUP REPRESENTATIVE: STARTUP DATE: Ell I Lj CONTRACTORS NAME & PHONE: Note to Owner: Any changes to pump run timer should be recorded in manual on this page. AMERICAN MANUFACTURING COMPANY, INC. P.O. BOX 97, ELKWOOD, VA 22718-0097, 1-800-345-3132 ©American Manufacturing Company, Inc., 2006 -8 - www.americanbnsite.com r AM iv f i k yg 4} a , x . jrin z A Lp _ O y Al. a� n 4r .•N v .. '. _ ,, =a ' OAK,SbN' - INC 1 .4 ".... �u is g 54 IduHf rj:cl Fz t)�far ctya:..,.a.;Ia turd#�fr�ldt x 5'C -�' �'�"� � �'�.a`�"%i"��x�' i�..„ ^'a � 'f(�an$' E- r "��t�*"�'+( '"P.- ��e'�x"��'u.��„sY� ,�8•'m c-.,�� y �[}. p � �•.� �k�: ��r: �- *'��' ��"' �°j � �'�9�• � x - ., = as,� � � A � i �. � 4 "�' y> o, ''.�.� C r. 'ter'. far.: ,�, � �. „�� �� a �, �. �` �"� ,�.s+r„ 'N, sad �` � 'a is '�? "� ,` "�f'r,.� a��^•'�" '_ � �v8-� �.50 }�s a liou � �;��' �,.� -r� y � �t' c�_ a�^� ,C.aa�s '�� ^� ., ':.' r�." r `;y-hy� ,r1'� .*, rd.,� � �.�€`,a: ,.�� ^, "• �'�;%. � "-"�� MASSACHUSETTS PERC - RITE DRIP DISPERSAL DESIGN .GUIDE Pere-Rite"is a registered trade name of 1lmeri.can anufacarcin.r Comr.)a IV,lric ,.L]kwood, V;1 This Guide contains three parts: • Design Information - Page 3 • Internal Checklist for Designers - Page 15 • Design Examples - Page 16 r N9a sachusetts Design Guide-Pe.rc.-Rite°Drip Dispersal Syst:eni(January 2013) Copyright:(c)201.3 Oakson,l:nc.. Gloucester, N1 tssachusett This Design Guide is to assist you in specifying a Perc-Rite® Drip Dispersal System. This technology has General Use and Remedial Use approval letters issued by the Massachusetts Department of Environmental Protection. These letters are available on Oakson's website. Our goal with this guide is to have you understand the key'design factors when using a Perc-Rite® Drip Dispersal, system and also to make sure you know we want to, and enjoy, assisting designers with their projects. This Guide focuses on smaller systems typically seen on a residential scale such as single family houses or small apartment units. Designs incorporating larger flows can easily be accommodated with assistance from Oakson or perhaps completed by you after reviewing and understanding this Guide. The design parameters included in this manual will provide a good starting point for understanding larger projects. Perc-Rite® Drip Dispersal highlights: • Can disperse septic tank effluent or secondary effluent • You simply need to calculate the area of the leach field in accordance with Title 5, then use Oakson's design tools to select the tubing spacing within that footprint area and the manifold system that will pressurize the tubing • The loading rate chart in Title 5 for pressure distribution can be used. Also, wherever Title 5 requires pressure distribution (such as for systems larger than 2,000 GPD) Perc-Rite® Drip Dispersal can be used in those instances as well • There are some parts of.Title 5 which are specifically exempted when using Perc-Rite® Drip Dispersal such as allowing the A soil horizon to remain in place, and eliminating the need for an inspection port or a 5' overdig, plus others • The drip tubing can be placed following the land contours, rather than in a flat bed configuration as typically the water table follows the contour of the land above it Massachusetts Design Guide-Pere-Rite°Drip Dispersal System(January 2013) Copyright @ 2013 Oak-son, Ine..Gloucester. kl ssac'husetts 3 I` r • There is no stone beneath the tubing and there is a minimum finished cover of 6" which together provide for a significant reduction in finished height • Offset to groundwater and soil depth requirements are the same as in Title 5, with variances or Local Upgrades Approvals allowed as with any other leaching facility • Perc-Rite® Drip Dispersal is a pre-engineered, packaged system which incorporates timer-based dosing of the drip tubing, filtration to protect the tubing from clogging, a pump capable of handling a range of distances and elevations, and emitters which are spaced evenly along the tubing at 2' intervals. The application of small doses of effluent into the soil throughout the 24 hour cycle is key to effective treatment, disposal and management of the effluent • Each Perc-Rite® Drip Dispersal system is manufactured in the United States and factory tested before shipment • The Perc-Rite® Drip Dispersal system is covered by a manufacturer-provided one year product warranty Please remember that this manual is intended to assist you in the design process for a residential-scale Perc-Rite® Drip Dispersal System in a rectangular shape. Other shapes and sizes. are easily designed but would typically need a little bit of design guidance. If you require additional assistance or just want someone to walk you through each step of the process, an Oakson staff member will help at no additional cost to you or your client. P M.assachuseas'Desi�,n Guide- Perc-Rite°Drip Dispersal System(January 2013) Copyei ht n 20]3 Oakson,.1ne-Gloucester, Massachusetts 4 DWELLING CONTROL PANEL SEPTIC OR PUMP TREATMENT CHAMBER ( O AIR RELEASE VALVE HYDRAULIC UNIT ZONE SUPPLY a - - _.-._ - - - — p t C — — — — — — — — - _C:� � C — a . �J TYPICAL ZONE LAYOUT DETAIL NOT TO SCALE Basic Design Principles • Area needed is the same as a leach field under Title 5 (you can use the regular or pressure distribution loading rate table in Title 5) • Within the area you are going to use as the drip field the only design determinations needed are: o What type and configuration will the manifold system be in order for it to be assured to work properly and o What will be the spacing of the tubing within the footprint (It is explained how these are determined later in this Guide) • While any shape field can be configured with drip tubing, sticking with rectangles that have the contours of the land parallel to the long side of the rectangle is the easiest to design and build • Please contact Oakson for free assistance with these type of design situations: o Systems larger than 2,000 GPD o Systems with more than 2400 feet of tubing Massachusetts Design Guide-Perc-Rite°Drip Dispersal System(January 2013) Copyright @ 2013 Oakson; Inc..Gloucester,Massachusetts 5 o Systems with a leach field size less than 400 square feet o Systems in a shape other than a rectangle, and o Non-sanitary wastewater applications such as stormwater dispersal • Oakson would like to partner with you in every way possible to make your design project a success. Please send along questions, site photos or draft design plans so we can assist HOUSE HYDRAULIC UNR RUSH RETURN FROM HU . ZONE SUPPLIES - ZONE 1 ZONE 2 SEPTIC TANK/ COMMON RETURN TREATMENT TANK PUMP CHAMBER UPPLY TO HYORAUUC UNIT t TYPICAL SYSTEM HYDRAULIC PROFILE NTS Perc-Rite Drip Dispersal Design Rules V 1. Number of Feet of Tubing The Title 5-required area divided by 2 is the minimum number of feet of tubing needed 2. Round up Tubing When.the result is less than 4.00' of tubing, round up the amount to at least 400' and simply place the tubing closer together within the same area (note that the single family house package contains at least 500' of tubing so there is no downside to rounding up the amount of tubing to 400' or more) 3. Figure out the Manifold Layout The drip field will be fed by a manufacturer-provided high-head pump which will also be used to automatically flush out the tubing to keep it clean and operating correctly. The need to maintain a certain flushing velocity in the tubing is the design limiting factor. Therefore the amount of tubing we have will determine the Massachusetts.Deli n Guide-Perc-Rite°Drip Dispersal System(January N13) Copyrioht Cc)2013 Oakson,:I tic.,Gloucester,.tN1 tssachasetts 6 number of zones of tubing we will have, how many laterals within each zone there will be, and how many runs of tubing there will be within each lateral. Once these are determined in accordance with procedures provided in the Guide, this configuration will be certain to provide the needed flushing velocity a. To provide the correct pressure and flow rate the tubing is broken up into one or more zones. Up to 1200' of tubing is a one-zone system which will have all the tubing fed at the same time when the pump turns on. Systems with 1200'-2400' have a two-zone system which has half the tubing fed alternatively each time the pump is turned on DWELLING SEPTIC OR PUMP CHECK VALVE TREATMENT CHAMBER AIR RELIEF VALVE HYDRAULIC ZONE 2 SUPPLY UNIT ZONE 1 SUPPLY - _ - ZONE 1 - o C .- _ - - - :e__. - — - — C - - - - - - ._ -- — — - � C - m ZONE 2 C - - C—— _ —_. _ ._._ TYPICAL MULTIPLE ZONE LAYOUT DETAIL NOT TO SCALE b. The tubing within each zone can be placed at 2' on center or as close as 1' on center. Start by using 2' spacing and determine how much tubing that is i. e. 1000 sq. ft. area would have 500 linear feet of tubing at 2' on center. Divide the total amount of Massachusetts Design Gwide-Fero-Rites Drip Dispersal System(January 2013) copyciaht 2013 Oakson,.lne..Gloucester,.Massachusetts tubing by the length of the drip field to determine how many runs of tubing there will be It is necessary to have even lengths of tubing within the leach field area so if the end result is not a whole number, simply round up to the next whole number. For example, .1000 feet of tubing going into a field that is 75' long would result in 13.3 runs of tubing if placed exactly 2' on center. Simply increase the number of tubing runs to 14 in this instance (and decrease the on center spacing) to achieve the next whole number Alternatively, if the site has flexibility in the dimensions of the leach field, one can extend the length and decrease the width of the leach area to yield a whole number of tubing runs. For example, 450 feet of tubing going into a field that is 42' long would result in 10.7 runs of tubing. One option would be to round up to 11 runs of tubing to make it a whole number of tubing runs. Alternatively, if the site configuration allowed the leach field to be extended to a length of 45' with an appropriate reduction in the width, we could then need only 10 runs of tubing If the end result is an odd number of tubing runs, this will mean the supply and return manifolds will be built on'opposite ends of the drip fields. On some sites this will amount to more digging than desired in those instances so one can simply insert an additional tubing run and reduce the on-center spacing to produce an even number of tubing runs. Systems with an even number of tubing runs will have the supply and return lines on the same end of the leach field. For example, 675 feet of tubing going into a field that is 75' long would result in 9 runs of tubing. To avoid digging a trench to either side of the leach field, simply increase the number of tubing runs to 10 in this instance which. would result in the supply and return lines being built on the same side of the drip field Remember that pre-packaged residential drip dispersal systems come with rolls of drip tubing that are 500' long so Massachusetts Design Guide-Pere-Rite°Drip Di,persal System(January 2013) Copyriol;t @ 2013 Oakson,lac.,Glouce,st.er..N1 tssach.usetts r adding a run or two of tubing as indicated above to make the construction easier is�not a problem c. Within each zone, the` tubing is supplied by a manifold that feeds the tubing in several locations so that at no time is there more than 300' of tubing being fed from one point on the manifold. Each of these sections of 300' or less of tubing within a zone is called a lateral. Typical drip fields have 2, 3 or 4 . laterals but other layouts are used as well F r a t , Four-lateral, Top Feed supply manifold 4. Figure out Tubing Spacing Once the amount of tubing in the system is know, simply divide the number of runs by the width of the drip field to yield the spacing between the runs of tubing S. Select a Manifold Manifolds exist at the end of the tubing and assure the effluent is applied uniformly and promptly upon the pump turning on. Massachusetts:Design Guide-Perc-Rite®Drip Dispersal system(January 2013) Cbpyripl-it©2013 Oakson.l:nc.,Glouce;tei,.A-tassachnsetts 9 Manifold systems are slightly different for flat sites (slopes less than 3%) than they are for sloping sites as follows: • On flat sites, the manifold configuration is called a Side Feed Manifold • On sloping sites it is called a Top Feed Manifold. CAD details for both these manifolds are on the Engineering Support tab of Oakson's website Whatever manifold is selected for the supply side of the drip field, the same manifold configuration will be used for the return end. The return manifold will be built on the opposite end of the drip field when there are an odd number of tubing runs in the zone, or on the same side as the supply manifold when there is an even number of tubing runs in the zone. When built on the same side, the two manifolds will often be constructed in the same trench 6. Piping Size The pipe from the pump to the hydraulic unit will be 1.5" diameter Sch 40 PVC as is the pipe which returns a small amount of effluent from the hydraulic unit to the septic tank inlet. The pipe (or pipes, if it is a 2-zone system) leaving the hydraulic unit to the drip field supply manifold will be 1" diameter Sch 40 PVC, as is the return line from the drip field return manifold heading back to the hydraulic unit. You may wish to label this on the plan for clarity by the site contractor 7. Gravity Return The hydraulic unit has a gravity return to the septic tank inlet so it must be placed in a location where this can be accomplished,-and should be shown on the design plan. The hydraulic unit is typically placed on top of the ,septic tank or pump chamber (unless site grading is not suitable for the 18"-high hydraulic unit enclosure in which case the hydraulic unit can simply be placed off to the side) 8. Pump and Hydraulic Unit The provided high-head pump will overcome almost all typical configurations and continue to feed the tubing at the proper pressure. There are a few limitations with the standard pump: % assachusetts Design Guide-.Pere-Rite°Drip Dispersal System(January 2013) Copyright©201.3 Oakson,hic..Gloucester,.t11 rssaehnsetts 10 • Place the hydraulic unit within 30' horizontal and 10' vertical of the pump. • Place the drip dispersal field and the hydraulic unit within 100' of each other • The above limitations can be easily overcome with customized piping size changes if needed so contact Oakson for assistance if you encounter one of these The system components have been pre-engineered with the provided pump so calculations or pump curves are not needed 9. Floats There are four floats provided inside the pump chamber. The bottom one prevents pump burnout if the water level drops in the tank. The second one up engages the timer to go into the normal operating mode. The third one up engages the timer to go into a more frequent operating mode to overcome peak surges of water: The fourth float is the alarm in the event of a malfunction The bottom two floats are always set at 16" and 20" off the tank bottom. Capacity for the daily design flow should be provided between the second float at 20" off the tank bottom, and the alarm float. This distance is a function of the daily design flow and also the tank shape which determines the number of gallons per inch. The third float should be set half the distance between the alarm float and 20" off the tank bottom. Required emergency storage would be needed above the operating zone (alarm float setting) You will see that using deeper wet-wells versus standard pumpy tanks when possible allows for a more efficient design as less effluent volume is retained in the bottom of the tank below the 20" operational float setting Massachusetts.Deign Guide-Perc-Rite Drip Dispersal System(January 2013) Copyright CO 2013 Oakson, Inc.,Gloucester, Massachusetts 11 D=THE DAILY DESIGN FLOW FOR THE SITE FLOAT TREE SCH 80.UNION GATE VALVE JUNCTION BOX CHECK VALVE SUPPLY LINE ATTACH BELOW FROST AS PER OR INSULATED NOTE 1 TO HU EXTENSION COLLAR (BY TALARM WATERTIGHT OTHERS) ID/2 SEAL PVC COUPLING -PEAK EN 4 BLE (BY OTHERS) S,7 D/2 NO WEEP DRIP EN BLE HOLE TO BE 20 OFF DRILLED 16" COOL GUIDE AND PUMP 10. Tubing Placement Depending on the soil conditions and the water table at the site, the tubing will either be plowed- into the existing ground, or placed on a bed of sand meeting the specifications of Title 5 AIR RELEASE VALVES WITH 1/2"SUPPLY&RETURN COVERS TO GRADE MANIFOLD LOCATED ABOVE DRIP TUBING TO ALLOW MANIFOLDS TO DRAIN EXISTING GRADE �� ---—---- PERC:RITE DRIP TUBING_a_�, VERTICAL SUPPLY DRIP TUBING COVER TO CONSIST &RETURN LINES OF 3"OF CLEAN SAND WTH 9"OF INSULATED(PER LOAM AND SEED ON T7 COLD CLIMATE NOTES)---,,,, MAIN SUPPLY& 5'MIN.: c:''.` /2"PVC FLEX RETURN COMMON RETURN LOCATED ABOVE DRIP TUBING LINES LOCATED TO ALLOW DRAINAGE BELOW FROST LINE ESHWT SOIL HORIZONS A&B TO BE REMOVED AND REPLACED WITH SAND MEETING TITLE 5 SPECIFICATIONS 310 CMR 15.255 PERC-RITE FIELD(12.5'x 50') (NOT TO SCALE) If built on a sand bed, it is typical to have the sand fill follow the existing contours if the water table does the same - this will help t'lassachusetts Design Guide-.Pere-Rite'D Drip Dispersal System(January 2013) Copyright 0 201.3 Oakson;Inc.,Gloucester,klassachusetts 12 I� reduce the needed volume of sand and the visual impact. You should indicate on the plan or details if this is a plowed in or sand bed installation, and also how much cover material is desired. Perc-Rite® Drip Dispersal requires only 6" bury depth or 6" of cover material if placed on a sand bed. Also remember that for raised systems there is no 5' overdig required. It is typical to specify 1' of sand beyond all tubing and then whatever wall or barrier might be needed to meet breakout requirements 11. Soils Acceptable soil conditions to place the drip dispersal system can include the A soil.horizon as long as it is naturally occurring and pervious. If desired to retain the A soil layer it must be correctly classified during the soil evaluation, and have a percolation test performed in it (if it is the"most restrictive soil layer to remain beneath the drip tubing). Designing the leach field underneath a parking area is not acceptable because the pavement or compacted soil will prevent good oxygen transfer 12. Paperwork Like all non-traditional system, used under Title 5, there are requirements for routine preventative maintenance by trained personnel, as well as paperwork needed as indicated in Perc-Rite's DEP approval letters. Contact information for certified service providers in your area is available by contacting Oakson and draft paperwork can be obtained from Oakson as well Massachusetts De,�i-n Guide-Perc-Ritz®Drill Dispersal System(January 201.3) COpyciht CO 2013 Oakson,l nc.,Gloucester. Massachusetts 13 This Guide is intended to assist in the design process for a;Perc-Rite® Drip Dispersal System. If you require additional assistance or just want someone to walk you through each step of the process, an Oakson staff member will help gladly at no cost to you or your client. We are more than willing to review design plans before they are submitted, assist with laying out a drip field or providing CAD,details so please feel free to share draft or final design plans with us before submitting for review. 1-877-OAKSONI Or , info@ciaksoninc.com Oakson, Inc. is an authorized user of the Perc-Rite@ trade name and related materials for drip dispersal systems J } Massachusetts.Design Guide-Perc-Rite@ Drip Dispersal System(January 2013) Copyitht:(0 201.3 Nkson,:I ae..Gloucester,Massachusetts 14 Perc-Rite Drip Dispersal Checklist for Designer Use ❑ Manifold system selected and detail provided ❑ Tubing spacing calculated and shown on plan ❑ Pipe sizes labeled ❑ Hydraulic unit location shown ❑ Return line from hydraulic unit to septic tank inlet shown ❑ Float height and emergency storage calculations completed and results shown on plan ❑ In-ground or above-ground detail provided ❑ If desired, system flow profile, construction notes and other standard details from Oakson website added to plan ❑ Operation and maintenance documents, deed notice and other documents prepared It1 ssactursetts.Deli a Guide-Pere-Rites Drip Dispeisal'Systenl(January 2013) 2013 Oakson.Inc..GIoucester. N'Iassaclhasetts Copyrio ht© 15 r . The best way to see how to select a manifold system and identify the tubing spacing is to look at a few examples. There are two rectangular shaped examples here but triangles, diamonds, arcs, and almost any other shape needed can be designed with assistance from Oakson. Example 1 If Title 5 tells us that a 2,000 sq. ft. leach field is needed, and we have a rectangular area that is 100' long and 20' wide, the design would begin by dividing 2000 by 2 to yield 1000 feet of tubing needed. Since this is less than 1,200 feet of tubing, we know will have a one zone system. 1000 feet of tubing across 100' yields 10 runs of tubing. This is an even number of tubing runs so the supply and return lines will be coming to, the same end of the drip field (which is a desirable, but not required, outcome). We now know how many zones we have and how many runs of tubing there will be within that zone, now we simply need to determine the number of application points along the manifold which the tubing will be fed from, called laterals. Since there cannot be more than 300 feet of tubing per lateral and we have 1000 feet of tubing in this example, we would need to establish at least 4 laterals. However, if we broke this up into only 4 laterals, we would have three of them with 200' of tubing and one of them with 400' of tubing, which is unacceptable. Therefore, we will break this zone into 5 laterals each with 200' of tubing. This example resulted in a manifold system with 10 runs of tubing broken into 1 zone, 5 laterals, and 2 runs of tubing per lateral. The name for this manifold is a Z152. Congratulations, you have now completed your first manifold layout. Now we simply need to figure out the tubing spacing and the type of manifold needed. With 10 runs of tubing on a field that is 20' wide, the spacing will be 2' on center. M."&.'achusetts.Design Guide-Pere-Rite°Drip Dkpe sal System(January 2013) Copyright©2013 Oakson..I nc..Gloucester,.Nlassacluisetts 16 If in our example we had a 6% slope to the land, we would need a top feed manifold. To complete the design plan for submission, select the manifold detail of a Z152 with a top feed configuration from the CAD file on the Engineering Support tab of Oakson's website, and insert that onto your design plan, indicating the tubing spacing of 2' on center. AIR RELEASE VALVE ioo1 2tr ZONE I SUPPLY 2' O.G. TYPICAL RETURN a TOP FEED Z152 ZONE DETAIL (NOT TO SCALE) Another way to design the above example and come up with the same result is to use Oakson's Design Calc Tool available on the Engineering Support tab of Oakson's website (Oaksonlnc.com). By providing the length and width of the rectangle, one can insert that information and have the same Z152 with 2' tubing spacing result returned to you by our tool. You would then simply need ,to determine the slope of the land in order to know if it would be a top feed or side feed manifold, and then select the. appropriate manifold detail from the CAD sheet on the Engineering Support tab of Oakson's website. ,ice - i ,a i� ers' 1 System(January 2013). �Iassachu.c,tts Dc,..i�n Guide Pere R tL Drip D...p a S} ( Copyright©20 13 Oak-son.lne.,Gloucester;�lassachtlsetts 17 f Example 2 If Title 5 tells us that the leach field needs 550 sq. ft. of area and we have 4' long and 10.2' wide we would divide 550 b 2 to a rectangle that is 5 o g y yield 275 feet of tubing needed. Since this is less than the preferred minimum of 400 feet:, we will start our design with 400 feet of tubing within the same 550 sq. ft. area (remember that a single family house package contains at least 500 feet of tubing so there is no concern with adding more tubing to the minimum needed). Since this is less than 1,200 feet of tubing, we know this will be a 1 zone system. 400 feet of tubing across a 54',long field results in 7.4 runs of tubing. The number of tubing runs needs to be a whole number so we would round up to 8 runs of tubing being placed within the 550 sq. ft: area. With 8 runs of tubing at 54' long, we will have a total of 432 feet of tubing. 8 runs of tubing is an even number which has the supply and return lines coming to the same end of the drip field (which would be desirable in this instance). We now know how many zones we have and how many runs of tubing there will be within that zone, now we simply need to determine the number of application points along the manifold which the tubing will be fed from, called laterals. Since we cannot have more than 300' of tubing per lateral, we would need to establish at least 2 laterals in this example, each with 216' of tubing. Since there are 8 runs of tubing, each lateral would serve 4 tubing runs. This example resulted in a manifold system with 8 runs of tubing broken into 1 zone, 2 laterals, and 4 runs of tubing per lateral., The name for this manifold is a Z124. Congratulations, you have now completed your' second 'zone manifold layout. Now we simply need to figure out the tubing spacing and the type of manifold needed. With 8 runs of tubing in a field that is 10.2' wide, we will end up with spacing that is 1.25' on center. Nfassachuxetts.Design Guide-.Pere-Rite°Drip Dispersal System(January 2013) C:olm-i"ht(O 2013 Oakson,Inc..Gloucester,Massachusetts 18 6 1 If in our example we had a 1% slope to the land, we would need a side feed manifold. To complete the design plan for submission, select the manifold detail of a Z124 with a side feed configuration from the CAD file on the Engineering Support tab of Oakson's website, and insert that onto your design plan, indicating the tubing spacing of 1.2S' on center. AIR RELEASE VALVE (TYP.) -T 10.2' 1.25' O.C. (TYP.) z 54' SUPPLY SIDE FEED Z124 ZONE DETAIL (NOT TO SCALE) r Another way to design the above example and come up with the same result is to use Oakson's Design Calc Tool available on the Engineering Support tab of Oakson's website (Oaksonlnc.com). By providing the length and width of the rectangle, one can insert that information and have the same Z124 with 1.25' tubing spacing result returned to you by our tool. You would then simply need to"determine the slope of the land in order to know if it would be a top feed or side feed manifold, and then select the appropriate manifold detail from the CAD sheet on the Engineering Support tab of Oakson's website. Massachusetts Design Guide-Perc-Rite°Drip Dispersal System(January 2013) Copti•rioht Co)2013 Oakson.luc..Glouce,ste.r, M tssachusetts 19 Town of Barnstable P# Department of Regulatory Services tiAR\AfAlil$ : Public Health Division Date B HAM 1619. 200 Main Street,Hyannis MA 02601 Date Scheduled Titne Fee Pd. Soil S itability Assessment for Sewa Disp sal t � l l Performed By. W AWm%vA �. � - Witnessed By: �,A i LOCATION&GENERAL.INFORMATION Location Address �t S �U l� 4 PNo Owner's:Name ill(��p �p R q y Address Assessor's Map/Parcel: O�5 Q Q f Engineer's Name tPS l ry�PL► 1`� r s'i3 NEW CONSTRUCTION REPAIR _ 'Telephone �6 Cie) -� r n%t. .:.` Land Use `�{��, Slopes(%) '2) Surface Stones_ Distances from: Open Water Body 0 O ft Possible_WetArea 100 k__fl Drinking Water Well baud ft Drainage Way 100 "F ft Property Line '�G T ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) V�� .00 / DECK 9 \ \ I I OE I 1 I io.2 rr; iHBESHOLD 1 Tsai lei u \ \ \ \ P W 9,1 I I A. yy� \ \ / / / / acfiA Ir,b, 6. / tl / F B LtNpSUB�CT _ _ -l" W 0 OOF1.oWAGE \\Z�punh 4.1 /= & /�� I Parent material(geologic.) V`Wa5 I` Depth to Bedrock 1 Depth to Groundwater: Standing Water in Hole: 0 4r1 Weeping fr/om�Pit Face��d`p� S Estimated Seasonal High Groundwater ha o%L 0% ol— 4/ GLA—-Q A-TA DETERMINATION:FOR SEASONAL HIG;I WATE�2 TABLE ®r1 Method Used: 1Y�01a�'�2_1f.�t� s rim 'D iry P "— C-CA O uM 6✓.1 J�`�� Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level Observation PL+RCOLATIOTTEST- Date Time. :^ servahon .,. —, Hole# Time at 9" �_.Ll l� Depth of Perc � Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. + Q:\SEPTIC\PERCFORM.DOC t/ DEEP OBSERVATION HOLE LOG, Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel v o14- -12vce Span f-5 l005� -DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. - Consistency,%Gravel _z_ tr o d�c DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% ravel .3 kA 0^ y 0 o IL Of - i a L 06St DEEP OBSERVATION HOLE LOG Hole:# Depth from Soil Horizon Soil Texture Soil Color Soil Allier' Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency%Gravel) •3 ®wh Nh o <,&a�Ilq Loos� Flood Insurance Rate Mao: .Above 500 year flood boundary No X Yes Within 500 year boundary No Yes NA Within 100 year flood boundary No Yes Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pe us material exist in all areas observed throughout the area proposed for the soil absorption system? - If not,what is the depth of naturally occurring pervious material? Certification a I certify that on WWI l� (date)I have gassed the soil evaluator examination approved by the Department of Environme 1 Protection a t above analysis was performed by me consistent with the required training xpe an peri c,de ri d in 310 CMR 15.017, Signature Date Q:\SEPTIC\PERCFORM.DOC Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is Osterville MA 02655 November 5 2008 required for , every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: When filling out A. General Information forms on the computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name rab 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code 508-428-1779 SI 12855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑:F ils ❑ Needs Further Evaluation by the Local Approving Authority , November 5, 2008 s � Inspector's Signature Date =c �fv) The system inspector shall submit a copy of this inspection report to the Approvi g Auth@dy (B'oard of Health or DEP)within 30 days of completing this inspection. If the system is a hared jyastem r '=f has a design flow of 10,000 gpd or greater, the inspector and the system owner; hall subs t thr report to the appropriate regional office of the DEP. The original should be sent t ,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. LAt 101 08-273 Willard.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Tanks are not in need of pumping at this time, pumps and alarms are functioning properly and leaching field shows no signs of saturation or surcharge. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the'❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed 08-273 Willard.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 265 Seapuit Road Property Address Ralph Willard Owner Owners Name information is Osterville required for MA 02655 November 5, 2008 every page. 151tyrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: 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 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. 08-273 Willard.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation,is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or,cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow ❑ ® 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. 08-273 Willard.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. El ® 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. r 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 ❑ El the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered°yes",in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 08-273 willard.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) i ® ❑ 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 omsite? ® ❑ 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)] 08-273 willard.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form! - Not for Voluntary Assessments wM 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 6 Number of bedrooms(actual): 6 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 660 Number of current residents: 0 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes '® No Laundry system inspected? ❑ Yes ❑. No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage d N/A Irrigation 9 ( Y 9 (gP ))� system. Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancyiuse: Date Other(describe):, i 08-273 Willard.doc•08106 Title-5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: None Was system pumped as part of the inspection? r ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy - ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): i Approximate age of all components, date installed (if known) and source of information: 1990 Were sewage odors detected when arriving at the site? ❑ Yes ® No t 08-273 Willard.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments, . wM 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 1 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): 2' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Two 1000 gal tanks Sludge depth: 0" Distance from top of sludge to�bottom of outlet tee or baffle Scum thickness 0" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Visual 08-273 Willard.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M ,••' 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Cisterville MA 02655 November 5, 2008 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Liquid levels are at bottom of outlet inverts and tees are intact. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete, ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 08-273 Willard.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments . �M 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA' 02655 November 5, 2008 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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 Distribution Box (if present must be opened),(locate on site plan): 011 Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.):, Both boxes have no solids or high stains, liquid levels are at bottom of outlet pipes. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No Alarms in working order: ® Yes ❑ No 08-273 willard.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):. Pumps and chambers are in good condition, floats are properly positioned. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries - numberr: ❑ leaching trenches' number, length: ® leaching fields number, dimensions: One 30x24 field. ❑ 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.): Area of SAS shows no signs of saturation and vegetation is normal. Lateral lines in field were video inspected and no evidence of surcharge were found. 08-273 Willard.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts - Title 5 Official Inspection Form_ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert _ Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes_ ❑ No Comments(note condiition 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.): 08-273 Willard.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 •� Commonwealth of Massachusetts Title 5 Official InspectionForm o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is Osteryille MA 02655 November 5, 2008 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 38 \�\f\/\�♦!\f♦! 31 25 Pressure line from cottage 37 � 43 r / / / J r J , r / / • ! , r / / , / f / / /\/\f\!\f\/\f\f\f\r\/\f\J♦f\rt�\f♦/\/\/\/\/.\/\r\/\/♦f\f\/ 5 A \f\!\/\/\J\J\!\J\/\!\/\/ \r r / \/\f\1\J\/♦r\/\/fir\/ Y /27 \/\I\/\/\r\f\/\ 6 f,r\r\/\f\r,/\/\ Front . 29 r j • Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 265 Seapuit Road Property Address Ralph Willard Owner Owner's Name information is required for Osterville MA 02655 November 5, 2008 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 ground water: '" 8'feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation:' T Surface water at rear of property is 8-9' lower than leaching field. 08-273 willard.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 v DA .3/11 /98 PROPERTY ADDRESS: ' MAR 2 4 1998 Osterville Mass. TOWN OF; O! HEALiF� 02655 On the above date, I Inspected the septic system at the above aCdre85 Tnls system consists of the following: 1 . "1 -150.0 gallon septic t4nk.5 . 24 ' x30 ' leachingfield. 2 . 1 -Distribution box. 5- pump chamber. 4-sewage pump with a 112" discharge line. 6a6e-d on my InPre•ctlon. I certlfy the following conditions: 6 . This •is a title five septic system. :( 78 Code ) 7 . The septic system is in proper working order at the present time: �- • "SIG N AT U R A : Name : _J _P . Hecomber Jr.. Company : J . P_Macopber 8 Son Inc .. , � ddreas :_�-bb------a------- � __Cencervi l Le �Hess__02632 Phone :---5OZ-7.7-5.J338------- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. • T�nkrC�upoolrl�ichllelda Pump+d L Inaullyd Town Sower Connoctloni P.O. Box 66 ' Centerville, MA 02632.0066 775-333.8 7)5-6a12 I V COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS _ DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON, MA 02108 617-292.5500 WILLIA,t F.WELD TRUDY COX Govcmor Secreta ARGEO PAUL CELLUCCI DAVID B STRUF Lt.Govcmor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commission 'PART A CERTIFICATION Property Address:265 Seapuit Road Osterville,MA Address of Owner: Date of Inspection: 3/11 /98 (If different) Name of Inspector:,Tnga=h P Ma camber Jr. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: J.P.Macomber & Son Inc. Mailing Address: BOX 66 Centerville,Mass . 02632 Telephone Number: c,G R_7 7 5_'1-4-I R CERTIFICATION STATEMENT I cenify that I have personally inspected the sewage disposal system at this address and that the information reported below is uue, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper iunction and maintenance of on-site sewage disposal systems. The system: Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: l %. Date: J�� The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. 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. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiftratron, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Pays 1 of 10 DEP on the World Wide Web: http:/nvww.magnet.state.ma us/dep Printed on Recycled Paper 'I _ ram'. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 265 Seapuit Road Osterville,Mass. Owner: Kinlin & Grover Properties Date of Inspection:3/1 1 /9 8 B) SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to oroken or obstrLced pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of ine Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipets). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed CJ FURTHER EVALUATION 15 REQUIRED BY THE BOARD OF HEALTH: 4h Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to pro(ec? the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: .4)6 Cesspool or privy is within 50 feet of a surface water �j Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface .pater supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER (rwisod 04/25/)1) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 265 Seapuit Road Osterville,Mass. Owner: Kinlin & Grover Properties Date of Inspection: 3/1 1 /9 8 DJ SYSTEM FAILS: You must indicate ei;•.er "Yes" or "No" as to each of the following: N1j I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary io correct the failure. Yes No / J/ Backup of sewage into facility or system component due to an 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 bove outlet invert due to an overloaded'or clogged SAS or cesspool. ' u4d.Ate/ C <)Y y 7 liquid depth in ces&peel is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more th@n 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. _ Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply //,} the system is within 100 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 265 Seapuit Road Osterville,Mass . Owner: Kinlin & Grover Properties Date of Inspection:3/11 /9 8 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for �signs of breakout. _ All system components,'�Acluding the Soil Absorption System, have been located on the site. — The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: _ The facility owner (and occupants, if djfferent from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)) (revised 04/25/97) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM ANFORMATION Property Address: 265 seapuit Road Osterville,Mass. Owner: Kinlin & Grover Properties Date of Inspection:3/11 /98 FLOW CONDITIONS RESIDENTIAL: Design flow: 40_g.p.d./bedroom for S.A.S. Number of bedrooms: 41 Number of current residents:e Garbage grinder (yes or no)) Laundry connected to system (yes or no):A? Seasonal use (yes or no):-2�y Water meter readings, if available (last two (2) year usage (gpd): Sump Pump (yes or no):.,VQ IC197- /5' iOQ 6, #,6r Last date of occupancy:—UAZX COMMERCIAUINDUSTRIAL• Type of establishment: AIA Design flow: AIA Rallons/day Grease trap present: (yes or no)-&14 Industrial Waste Holding Tank present: (yes or no)�i� Non-sanitary waste discharged to the Title S system: (yes or no)elo Water meter readings, if available: A/r� M Last date of occupancy: A OTHER: (Describe) Last date of occupancy: i GENERAL INFORMATION PUMPING RECORDS and so r e of information: tiv S' ��. System pumped as part of inspection: (yes or no), If yes, volume pumped: .,'A gallons Reason for pumping: TYPE O�YSTEM --j1p/Septic tank/distribution box/soil absorption system Single cesspool Ve Overflow cesspool AM Privy yAy Shared system (yes or no) (if yes, attach previous inspection records, if any) ," VA Technology etc. Copy of up to date contract? Other ly/ APPROXIMATE AGE of all components, date installed (if known) and source of information: 104- y Sewage odors detected when arriving at the site: (yes or no)�� (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 265 Seapuit Road Osterville,Mass. Owner: Kinlin & Grover Properties Date of Inspection:3/11 /9 8 BUILDING SEWER: (Locate on site plan) Depth below grade:�� Material of construction cast iron0 PVC _ other (explain) Distance from private water supply well or suction line A Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) 45 D1�S t1'.Vi SEPTIC TANK:Zjo—e/pg� (locate on site plan) Depth below grade: Material of construction: oncrete _metal _Fiberglass _Polyethylene _other(explain)zc If tank is metal, list age A�4 Is age confirmed by Certificate of Compliance v4 (Yes/No) Dimensions: le; l' Sludge depth: Distance from top of Judge to bottom of outlet tee or baffle:riv4L�- Scum thickness: Distance from top of scum to top of outlet tee or baffle: e Distance from bosom of scum to bottom of outlet to or baffler How dimensions were determined: Comments: (recommendation for pumping, conditi of inletand outlet ees or baff es, de th of liquid level in relation to outlet invert, structural integrity, evidence of leakage, tc) �` �- e GREASE TRAP:VQyC— (locate on site plan) Depth below grade:-d.224 Material of construction;,,�concrete4Wmetal VAFiberglasWAPolyethyleneA,0other(explain) Dimensions: � Scum thickness: /- Distance from top of scum to top of outlet tee or baffle: A14 Distance from bottom of scum to bottom of outlet tee or baffle: 44 Date of last pumping: A1�1¢ Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 265 Seapuit Road Osterville,Mass . Owner: Kinlin & Grover Properties Date of inspection:3/1 1 /98 TIGHT OR HOLDING TAN K:�.,f—(Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade:Al,4 Material of con struction:&4concreteot Nmetal, rAFiberglassA Polyethylene.Vhother(explain) isA AA Dimensions: /UA Capacity: .4,A gallons Design ilo-:_J_ gallons/day Alarm level:— A),4 Alarm in working order Yes;,(A No Date of previous pumping: X— Comments (condition of inlet tee, condition of alarm and float switches, etc.) ZZhE 1 r A/)e AVE DISTRIBUTION BOX:_ (locate on s,te plan) Depth o: liquid level above outlet inven:- Comments: In if level and distribu 'on is equal, evidence of solids carryover, evidence of leakage into pr out of box etc.) qC PUMP CHAMBER:-Y-ecj (locate on site plan) Pumps in working order: (Yes or No)" Alarms in working order (Yes or No) Comments: (n condition f pump chamber, conditio of pumps and a p nenances, etc. t ti d (revis•G 04/25/97) P.g• 7 of 10 r L� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property address: 265 Seapuit Road Osterville,Mass. oNner: Kinlin & Grover Properties Date of Inspection:3/1 1 /98 SKETCH OF SEWAGE DISPOSAL SYSTEM: :,uoe ties to at least two permanent references landmarks or benchmarks 1c:ate all wells within 100' (Locate where public water supply comes into house) J' cy -;- 3r-n.co U1�jj . .cs� i (revised Ci/25/97) Page 9 or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 265 Seapuit Road Osterville,Mass . Owner: Kinlin & Grover Properties Date of inspection:3/1 1 /9 8 SOIL ABSORPTION SYSTEM (SAS): ;locate on site plan, if possible. excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number: leaching galleries, number: leaching trenches, number,length: ) )����)� [�'�)� r 1 leaching fields, number, dimensions:l /�Ft?,Yj�l(. .G81'i<ai vj� G' �"'y /—®15 overflow cesspool, number: Alternative system: h Name of Technology: 2J d Comments: (note condition of soil, signs of hydraulic failure, level of p nding, condition of vegetation, etc.) S' CESSPOOLS: (locate on site plan) Number and configuration: AM r Depth-top of liquid to inlet invert: AN Depth of solids layer: 41,41 Depth of scum layer: A24 Dimensions of cesspool: A.A Materials of construction: AJ/4 Indication of groundwater: A-14 inflow (cesspool must be pumped as part of inspection 7 � - Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) P R I VY: '+,r�e (locate on site plan) Materials of construction: �iS� Dimensions: Depth of solids:! Comments: (note condition of soil, signs of-hydraulic failure, level of ponding, condition of vegetation, etc.) 7 ' lz.vl�•d 0�/15/97) D&g• 0 of 10 SUBSURFACE SEWAGE DISP(: .t SYSTEM INSPECTION FORM C SYSTEM INFOI !ION (continued) Property Address: 265 Seapuit Road Osterville,Mass . Owner: Kinlin & Grover Properties Date of Inspection3/11 /9 8 Depth to Groundwater 7'� Feet Please indicate all the methods used to determine High Groundwater HC-ation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole basenx(t'simp etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Grounciv/,rerElevation. Must be completed) Hand Augered test hole for 7 ' 6" • This is 5 ' below the leaching field. No water encountered. Soil was becoming damp. This was done at high tide. Also used water contours map. Gahrety & Miller Model 12/16/94 (revised 04/25/91) Pac, 'lbof 10 .. .-n •rnranr•ntra ns-+.r.reer. .. �rr.•.+m+ rrrrs '"fTT r•, r9�l-r- 1TR".1T�-.Af. lit.TCTi 'lS" .. I SUI1SUItFAC TOWN OF Barnstable BOARD OF HEALTH F SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D •- CERTIFICATION If �- �«.�...-r...-..•--.,tr.-.-rn.rr+n'nrrrZrs•.sTtrrn'rn'�-•.'tr'S.me-.arntvr-�rtmss'as ns'smra-s+r�er� n,m n�*rm*rsrs-rrn�r+r.•.-.rrrr-�. -. -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 265 Seapuit Road Osterville,Mass. ASSESSORS MAP, BLOCK AND PARCEL # _ C q- D_6 OWNER' s NAME Kinlin & Grover Properties PART D - CERTIFICATION i NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber & Sen ' Inc. COMPANY ADDRESS Box 66 Centerville,Mass. 02632 street Town or City Stat• tIP COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and complete as of the time of .inspection , The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check one : System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 16 , 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* \ I The inspection which I have con acted has found that the system fails to Protect the jiublic health and the environment in accordance with Title ,5 , 3.10 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . r Inspector Signature Date 3/11 /98 One copy of this certification must be provided to the OWNER, the BUYER ( Where applicable ) and the BOARD OF HEAL7111. * If the inspection FAILED, this owner or"operator shall u within one year of the date of the inspection, unless allowed dortrequiredm otherwise as provided in 3.10 ChJR 15 . 305 . partd . doc n r 1 � r-77---- v' -V ti S b-yV -7l THE COMMONWEALTH OF MA.SSA.CHUSETTS DEPARTMENT OF ENIVZRONAENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTE� D TITLE S SYSTEM INSPECTOR as provided in 310 CMR 15_340 and Section 13 of Chapter 21A of the General Laws _ Issued by The Department of Environmental Protection. Acting [)hector of the � i toll oA W21er Pollution Control t�ti f TOWN OF BARNSTABLE LGCATION o2 LLg po ? /?, SEWAGE # I®-czF 6 VILLAGE C"S 7_E'2111�je ASSESSOR'S MAP & LOT O J_ ®® INSTALLER'S NAME & PHONE NO. A2CAI C-)- SEPTIC TANK CAPACITY / 0&10 s 7- LEACHING FACILITY:(type) AG6r �i� �D (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER/26/� BUILDER OR OWNER 9 7 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No a W CIS 0 y i r� b 11�� Oy _ j- TOWN OF BARNSTABLE LOGA'I-16rl At) SEWAGE # 90-"{Sd VIL LACE �s ��Lv�/�� ASSESSOR'S MAP & LOT OAS o D INSTALLER'S NAME & PHONE NO. 142G4 SEPTIC TANK CAPACITY /s-o a S 7-- LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATERPvb BUILDER OR OWNER /o DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ". 1SooSI n d4 d Vnc/ �.. 'dd 3d J 5 � TOWN OF BARNSTABLE LOCA., ON SEWAGE # VILLAGE 19�$i ASSESSOR'S MAP & LOT INSTALLER'S NAME& PHONE NO.. SEPTIC TANK CAPACITY LEACHING FACILPIY: (type) � 4`7 r (size) !�l��P� � NO.OF BEDROOMS 31 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 VFacty (If any wetlands exist within 300 feet f leachi ) Feet Furnishe 4' ��� d�'d ., " ��� ,' � -�� i�� ° � �� .e i ^ �� �U3 d - � �� ��. � ai . ,� i .� � � � � ��� .� No.--•-•---------- --•----�� �� >cs •�A THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ( TOWN OF BARNSTABLE Applirntion for Disposal Works Tonstrnrtion rantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Is Location- ddress or Lot No. • !''1 °` E�- V--------L n-T-------------------------••--•--..... --------.S.�?r"` .------------........--------------------------------------.............-- Owner Address W �?- ........... ........ .5 11 T1�?�-----------------------•----------- .....`'��_. .�1...(�h1A ....._ -.4 �i .........._....... ,-1 Installer Address Q Type of Building �,,yr, ' 3' Size Lot---A:1....o .............Sq. feet U Dwelling—No. of Bedrooms.Ca_%T9.�?____.2--..................Expansion Attic ( ) Garbage Grinder ( ) p, Other—Type T e of Building No. of persons............................ Showers Q, YP g --------•-----------------•• P ( ) — Cafeteria ( ) p" Other fixtures ...................................................... Design Flow.._.Tic)............C� gallons per person per, day. Total daily flow____-._.I-ID........................gallons. W i iaa WSeptic Tank—Liquid capacityj}�..gallons Length-___9-_-_---_ Width. .!A........ Diameter................ Depth_•.............. Disposal sposal Trench—No..................... Width.................... Total Length[?_ `l_Q__. Total leaching area_S00_---_---sq. ft. Seepage Pit No-_------------- iameter..................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( � Dosing tank Percolation Test Results Performed by-------- �__--� .................................... •Date....T!?! ....0 111st..__... ,.a Test Pit No. I................minutes per inch Depth of Test it.................... Depth to ground water_-_________-_._----__-_. fT Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth'to ground water........................ W --••---•-•-•------•--•.---•--••-•......................•---.------......------...........----...---......----------...----....------------------------------ xDescription of Soil.....:.L=0-44c1t...._S.44.0y............i'�R�l1i .}�t�A i-s,------ ---------------------•-------------------•---------------- ---------------------------------------------------- --------------- --•--------------------------------------------------------------------------------------------------------------------------------- W VNature of Repairs or Alterations—,Answer:when applicable-----------.......................................•.........._.........._..._.._._.._......._.. -------------------------------------------------------•-------------=----------------------.......------....-------------------------------------------------------------------------------•---------•. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is d b t boa he Ith.: �Signed�Application Approved BY ------ -------- D+ ems=�d "arr " LTate pplication Disapproved for the following reasons: .• � to Permit No. - �� d. ... Issued -' ------------------------------ ---- THE COMMONWEALTH OF MASSACHUSETTS ti BOARD OF HEALTH r TOWN OF BARNSTABLE Ger#ifirale of Tompliance THIS IS TO CERTIFY, Tha the Individual Se a,e Disposal System constructed or Repaired ( ) �.p l/ `LDll1.--_--------------------------------------------------------------------------------------------------------- ------------ --- L.. ......... d...Kl.-f het --- -- -- ---------- at --------- ---- - has been installed in ac or dance with the provisions of TITLE of The State Environmental- or c dca dated the application for Disposal Works Construction Permit No. - -..-F...-- _... S U ANTEE THAT THE THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CO S SYSTEM WILL FJN6110 ATISFACTORY. �'1 Inspector .---...----- THE COMMONWEALTH OF MASSACHUSETTS F,� ASS {fit 7S b BOARD OF HEALTH TOWN OF BARNSTABLE Appliratilan for Dispnott1 Works Tonstrnrtinn ramit Application is hereby made for a Permit to Construct or Repair (,f )',an Individual.Sewagej Disposal Ssraty :L ....__�.:.�ws....5 ,,�'',T -R a---------------------- -----�S:c-� �� ---...'!`' - ---_------.--------------_-_----- Location-Address 1.91 or Lot No. .... b2 IE �E� .............:`�?=---------------------- ..................................- ..--- . ........ r ) d Owner Address _ W �.12c-W Cow St—..... U> t'l�Zi US � ( tee ...::1.....•!`ssrs, -� -------------- Installer ` _. --` - Address -j-- ` -- l �• Type of Building t�p�lx S Size Lot:_. G?.. ..... feet Dwelling No. of Bedrooms.Cu�.. �---2=................Expansion Attic-(- '` `"`�Garba e Grinder Other—T e of Building No. of ersons.....__... '_.L_ '' ' a YP g ---------------------------- P -•-=----- Showers ( ) t Cafeteria d Other fixtures .. ....................................... W Design Flow.._..��U.............. gallons per person er,day. Total daily. flow._....... :10..........._..._...._._gallons. t 07730�-- P Y Y WSeptic Tank—Liquid capacity_i.}.tS]��-.gallons Length..... Width--_�,._... Diameter---*------------�Dryepth................. x Disposal Trench—No..................... Width.................... Total Length�?._Y J.'4.. Total leaching area-_9,.Ob----_.._sq. ft. Seepage Pit No..................... iameter.................... Depth below inlet.................... Total leaching area........_..........sq. ft. Z Other Distribution box ( ✓� Dosing tank ( ) p a Percolation Test Results Performed by........ ----- Date..... _...�?�-!.�`i�........ Test Pit No. I................minutes per inch Depth of Test Pit......._._._...._._ Depth to ground water........................ LX4 Test Pit No. 2...........:i,__minutes per inch. Depth of Test Pit.................... Depth to ground water-----.___-_--___.._-_-_. x ---------------------------------------------------------------------------------------••...........---••---- :...... O Description of Soil.......ngAr—xI....--�n`-'nzl.----------- L2i ..�. s ti.�e...... .............................................. uj ; = x e W 1 . , , . ., 11 .. , r: -, U Nature of Repairs or Alterations°— e Answer when applicable................................r.-------_...................................._. ----- ---------------------------•----•--....--•---....-----------------------------....-•----------------------=------------....................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal.System in/accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the F system in operation until a Certificate of Compliance has been issued by the•boa of health. Signed`'!'� ��-- -�1 � .------------------- Date r �> ----- '----...... . 4 -- 1 f"� .9� ' Application Approved BY ------ ... ----- r a / Application Disapproved for the following reason .................................. F ' '" ` ------------------------------------------------�. -------------------------------------------------------------------------------------------------------------------------------- to ' Permit No. Q - g 4 . 8 .... Issued ......�'-'... . 4 t Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE I Terfifirate of (gantylia re _ - ` THIS IS TO CERTIFY.ThaVhe Individual Sewa S Disposal System_constructed or Repaired by ------- ------ ..... = 1 5 aller d has been installed in ac&dance with the provisions of TITLE 5 of The State Co ate Env de as described in the application for Disposal Works Construction Permit No. .Y.0. 4� .... dated .�--�`�d THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS T UEFA S A GUARANTEE THAT THE SYSTEM WILL F'N�CTjIO�N ATISFACTORY. � , DATE.:...............................II------ ............................................................ Inspector --------..........----------------------------•--------------------------- ---------------- • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ����yy No..s�.r1........!'��' TOWN OF BARNSTABLE FEE.A�u..�. Disposal Works/ Tunstrurtion ramit. Permission is hereby granted.................��'',�T...._.......... .... to Construct ( 1.1 or Repair ( ) an Individual S Wa Di Sal at r,pel . ... .. Street as shown on the application for Disposal Works Construction Permit No. �` •.....................--.. o ...................... _� _ ^ Board of Health DATE............... -•----.....�.......�..........�..-...........--•-•-•------•-- FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS THE TOWN OF BARNSTABLE T�� re�Pw ♦° OFFICE OF BLBd9TLBL i MA6R BOARD OF HEALTH � 0 0o z639- 0MPY \e0 367 MAIN STREET k' HYANNIS, MASS.02601 May 30, 1990 1' r Edward Kelley Cummaquid Survey; Inc. 45 Collie Lane Cummaquid, MA 02637 Dear Mr. Kelley: You are granted variances, on behalf of your client, Mary Ellen Cabot, to install a replacement onsite sewage disposal system located off Seapuit Road, + Osterville, listed as parcel 4 on Assessor's Map 95, with the following conditions: (1) The plan shall be completed to meet all the regulations contained within Title V, the State Environmental Code. (2) The existing cesspools shall be pumped and filled or removed. (3) The contents of the swimming pool water. shall not be discharged into any wetlands and water courses. (4) The dwellings shall be connected to Town water. (5) The designing engineer or registered sanitarian shall supervise the installation of the onsite sewage disposal system and certify in writing , to the Board the system was installed in strict accordance to the submitted plan. The variances are granted because the existing cesspools are in all probability sitting in groundwater and are located in close proximity to the wetlands. The proposed replacement septic system appears to meet all the regulations contained within Title V, the State Environmental Code. Sincerely yours, II Grover C. M. Farrish, M.D. Chairman BOARD OF HEALTH I TOWN OF BARNSTABLE GF/bs ; %THE T0�0 TOWN OF BARNSTABLE OFFICE OF BABa9TABL i BOARD OF HEALTH MM& A 1639. `� 367 MAIN STREET HYANNIS, MASS.02601 September 11, 1990 Donna J. Vorhees McGregor, Shea & Doliner 18 Tremont St. Boston, MA 02108 Dear Ms. Vorhees, Enclosed are copies of all documents you resquested concerning the variance granted to Mary Ellen Cabot. Please remit $3.75.to cover the copying costs. Please be advised that a Disposal Works Construction Permit was not granted for this project. Sincerely yours, Thomas McKean Director of Public Health �Q�oFTHE ro`o TOWN OF BARNSTABLE d OFFICE OF Bsa L MASIL i BOARD OF HEALTH y A66 iM 9. MAY 0 367 MAIN STREET �' HYANNIS, MASS.02601 May 30, 1990 Edward Kelley Cummaquid Survey, Inc. 45 Collie Lane Cummaquid, MA 02637 Dear Mr. Kelley: You are granted variances, on behalf of your client, Mary Ellen Cabot, to install a replacement onsite sewage disposal system located off Seapuit Road, v' parcel 4 n Assessor's Ma 95 with the following conditions: Oster ille, listed as pare o p g (1) The plan shall be completed to meet all the regulations contained within Title V, the State Environmental Code. (2) The existing cesspools shall be pumped and filled or removed. (3) The contents of the swimming pool water shall not be discharged into any wetlands and water courses. (4) The dwellings shall be connected p Town water. (5) The designing engineer or registered sanitarian shall supervise the installation of the onsite sewage disposal system and certify in writing to the Board the system was installed in strict accordance to the submitted plan. The variances are granted because the existing cesspools are in all probability sitting in groundwater and are located in close proximity to the wetlands. The proposed replacement septic system appears to meet all the regulations contained within Title V, the State Environmental Code. Sincerely yours, Grover C. M. Farrish; M.D. Chairman BOARD OF HEALTH TOWN OF BARNSTABLE GF/.bs No. Date Fee oFIHETo� TOWN OF BARNSTABLE p OFFICE OF ' , S . HsairsTm NUIL BOARD OF HEALTH i639' 367 MAIN STREET HYANNIS, MASS. o26oi VARIANCE REQUEST FORM All variance requests must be submitted fifteen (15) days prior to the scheduled Board of Health Meeting. NAME OF APPLICANT ItI410X C-Z6&-7V el-gBoT TEL. NO. ADDRESS OF APPLICANT_. ZB C1&-3T/Vy7- ST2LrZ-7- NAME OF OWNER OF PROPERTY SUBDIVISION NAME L/,WZ> ai,,er pub -67Z6-y DATE APPROVED ASSESSORS MAP AND PARCEL NUMBER 1-14P 96- /%zcez 4 LOT SIZE LOCATION OF REQUEST Off -SG �pr� T IZX4?� DSTLs/i�� G 7 VARIANCE FROM REGULATION (List Regulation) 7f1,9-,✓ /.PC, o.y 11G-4,,v //.GN W,9 7-72 .pro "q2s. / �r1 /a ✓GsGG�-T!�T T�' 21-Fse7zV ►�JL-7=L/a-N� ( �'a 'Hrao)�-L-77- /�GsCI3�.�3 -7j_ REASON FOR VARIANCE (May attach .letter if more space is needed) /-W/S /S oNLy/ 7*4-r IS �ri�?� �L-'�T �?Zc�� /�1%f,.y /-la.b NL-�'�-iZ A1,4yan2 7�6G PLAN= TWO COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPROVAL Grover C.M. Farrish, M.D. Chairman +, Ann Jane Eshbaugh James H. 'Crocker, Sr. BOARD OF HEALTH TOWN OF BARNSTABLE �x- 1� WGREGOR, SHEA & DOLINER GREGOR I. McGREGOR ATTORNEYS AT LAW, P.C. RALPH R.WILLMER JOHN F.SHEA' DONNA J.VORHEES HARLAN M. DOLINER 18 TREMONT STREET—SUITE 900 PETER J.FEUERBACH GLENN A.WOOD BOSTON, MASSACHUSETTS 02108 SUSAN A. BRENT ROBERT A. FASANELLA (617)227-7289 ANDREW W.DANIELS FAX (617) 227-3591 Environmental Planners LOIS J. BRUINOOGE NANCY KAPLAN CAROLYN W. BALDWIN** Of Counsel 'Admitted in ME also "Admitted in NH only September 7, 1990 Thomas McKean Barnstable Board of Health 367 Main Street Hyannis, MA 02601 RE: Request Pursuant to the Massachusetts Public Records Statute M.G.L. c. 66, Section 10, as amended Dear Mr. McKean: This is a request for a complete copy of all Board of Health records and plans regarding a May 30, 1990 variance granted to Mr. Edward Kelley, on behalf of his client Mary Ellen Cabot. (A copy of the variance is attached to this letter for your reference) . I already have a plan entitled "Site Plan in Barnstable (Osterville) for Mary Ellen .Cabot, " dated May 14, 1990 and revised July 15, 1990 (two sheets) and therefore do not need a copy of this plan. ' This request is made pursuant to the Public Records Statute, M.G.L. c . 66; , Section 10, as amended. I am specifically interested in learning whether a Disposal Works Construction Permit was ever granted for this project and, if so, I request a copy of such permit and any Board of Health records relating to it. Without limitation, the information .requested above includes all documents, broadly .defined (written, printed, typed or graphic matter of any kind or nature) ; mechanical or electronic sound recordings or transcripts of such recordings; letters; agreements; correspondence; communications; memoranda; written comments; notes, telegrams; summaries or .recordings of telephone conversations; personal communications, conversations, meetings and interviews; pamphlets; publications; diaries; photographs; reports, charts; papers; drawings; diagrams; indices; notebooks; maps or charts; worksheets; data sheets; data processing sheets; plans; summaries or records of investigations; opinions or records of consultants; circulars; press releases; drafts; studies ; calculations ; analyses; models; computer models; marginal notes; and any .other writings . l s= McGREGOR, SHEA & DOLINER 2 I would very much appreciate having these records mailed to me. Please call me with the cost of copying the records I have requested. Thank you for your prompt attention to this request. Sincerely, Donna J. Vorhees nb. 760 . 3 .djv a 05-007 �r TOWN OF BARNSTABLE d� UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS NAME '"11 1e Y 191:.LUoU C /-60% ADDRESS 2(Q &FA-PUl T teQ VILLAGE �-5T-E2Cl(LLG LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS j 12/23/15 BUILDING PERMIT SET Mop 010 a� • i�'Y ��� ;;it �r-�.ads. .. - -- � � - �� - r� " - , ` '. .; -.....:his-,...---ir-r-r<--.:t .:.-+-�•.':- _ Y .1. - fir -i._ .'r- sQ 'IG ••� �;iB+'" € -a' _'� �.�"�. `+£�', ,, s-.7 .�,? �,'�Y - ��� "'�.,s�� - `k y I - - ~�I I,�� � � �i �•a �� `,t� G- J �� � -- r k T� ems+t; ,• 7 II 17 INDEX OF DBAWAGS- Building Permit, Set Wednesday, December 23,2015 DRAWING j INDEX i1^ \`�A:> OS�Er4-Pv �i %J I A1.0 Site Plan A4.1 Wall Sections S1.0 Main House and Pool Cabana Foundation J A0.0 Site Plan:Basement S1.1 Main House First Floor Framing Plan A0.1 Site Plan:First Floor S1.2 Main House Second Floor Framing Plan i. A5.1 Exterior Profiles g _l ®Gla�znn nrz6Reas�n<. A1.0 Main House:Basement A5.2 Exterior Details S1.3 Main House Attic Floor Framing Plan AA ,/�r-KA W/v . 6 1 -_ y;g^, .&&&-7 A1.1 Main House:First Floor A5.3 Exterior Details GBS1.1 Garage Building Framing Plans '"\�1� K' , A1.2 Main House:Second Floor GHS1.1 Guest House Framing Plans A1.3 Main House:Attic Floor GHS1.2 Guest House Framing Plans j Samra Residence A1.4 Main House:Roof Plan P �G GHA1.1 Guest House Plan S2.0 General Notes 265 Seapuit Road Barnstable MA GBA1.1 Garage Building Plans S2.1 Typical Details M�I �)out S2.2 Typical Details 1_' 1� A2.1 Main House Elevations S2.3 Typical Details y-�^;� I<e,A v D nq . C eµ A2.2 Main House Elevations S2.4 Typical Details GHA2.1 Guest House Elevations ° GBA2.1 Garage Building Elevations COVER SHEET A3.1 Building Section SCAtE 1' - 1'-G A3.2 Building Section : A3.3 Building Section i DATE:12R2/15 A3.4 Building Section A3.5 Building Section A3.6 Building Section C A3.7 Building Section e A3.6 Building Section A3.9 Building Section assaftselaaast Its A3.10 Building Section + e8ng ne617.3eet e-744710 r pTPS ne 617.338-7447 e A3.11 Building Section ( era -Ioe ,- .. .. .e-.. .. v.... ..... .P .-. .t.. 0 LO KERS J < ato RAFTEPD tG"OC. —1. 1 yr \ \••r t ,,JJA�II '�f f.SIB II TAPER 6ANY RED LEO � �\�7r+L. I I I eOAF 7-, I 5lEMYK.aURE CERM1LA5 WI Y S=1. Pl..hO OIG OG 1 N 2NO 1-111 9TOKAGEVKRS JJ ! SLOPE PRESEINATNE IR<cA MENT �I _ V I r� OIG Oti. BOATHOUSE i, , ato DGE efnn 1\ �_LF,UP STaRnc {a _. F -oot 12/23/15 BUILDING PERMIT SET r . CGr in NER9 .1 K I1101 ............--......... Nil rSEA,a RODF Floor Plan Roof Plan Roof Framing SCALE:va. r-0" IR-ATTI LEVER, - y 1 P 1 P L i I os,ur11 04 u�� oa P ros uF /-F o - ROOM III,Ell, . 3 alo n,BEAM _ . li i1 + Aswoe�TIE_^ B_• I T-- - I .�-;-iPr zb.alsT5016'c 1 >I I T" II 1 �I II �'Pr32 _1 ..:L ka1� BIT Jlli__� I11.i _ I �oPEN P < - II �$ ,I .'' eo+E.� I— - M G 11 1 11 I Im - L aka `"�. w 61- . rosr ___3alo eEnl.l rowTIJI _ [ nnroiD SNCATHING II I l ,z-mF. I 11 I rnuo, I wNrnuBE_ L _ _ ____ �CTUBE 11 _�1 i eELQ.,I 1 eELa• ! l I L 6J05i5GtGOc —> I 1 t 3V2 92 a,aPSL�, Po F(✓'151E' ! } PR.a1 UI' { P051 OF `POST DN —Dr BOB D 1 P05T Drl Foundation Plan First Floor Framing Ceiling Framing �J 7 SCALE:1/<'= 1'-0' Y SCALE:110' 1'{Y �J SCALE:1/C'= 1'-0' 5/d"aI TAPEK 5111 RED CEDAR SHAfiE 5/6"aI TAPEP,SntvN P,ED CEDAR.SHN:E. 5/d"11 TAPER SAWN RED CEDAR SHAt:E. S/d"aI TAFEK 5AW11 RED—F,SHARE. CERTT—PP.ESER.VATNE TREATED F- LEP,T—TPRESE.—F iREATEDO-K EP,DUS CESERVATNEiKfnrE0— CERTI'LAsr FRESERVAT—RE—DOVER A DHEKKEC ICE ADD O✓ER GRE—VE CEDARBKEAT HERO ER BIEI'SELF- A—RDICEAR ERIHILE"vELi- EDAR SP.EATHER OiEK-C-RKE'SEIF 0 P.00F PEN; / nDHEKEO ICE AND WATER eHELD IT P14 ROCFPEAK AJL I ETi 111-1C B.—TIVEP.3l KOOF E I: / R EDICEAND 00D SHETHIII 3/a• POJF PEnI �ADHEREDICEANDWAIEV.—ATI VER3/a"/a -T a• --'K '�" '- - MAR NE v^.ADf PLriMCDS-IEA1H r1G 0 -� - - -P,ADC pLnK1)D SHEATH NG 0 �--"��� _. ._.. ._ ._ - � NEC-BADE PLrKLOD SHEATH NE 0-'- P.NCCPnOE PLY�DSHEATH NG E1 2a0L FtnTeEN.tLLt OhRCEA O111611 1 _ T ,.Y TCHELD FOP HK MpLE6II., FOP.HR TEM,tvA.tEP.SHELATbN i OVEP,TAPERED P,GUNSULATON Z Z ...2 \ / GVER iAPEREO P.IGD NSULAi ON I OVER rAPEP.FD RIGD rSULAibll 0 O. iK00F I --. fFLAT- / TAF iQ CaRI Arch-RE, FLOOD FLNE . LIE PIA I _ •—i3U—__--- ---`- -- —=-- --- RCbC - -- ------ -----�—li3nJ ----- - ----------- �— --------- ----- --------- -- 0 0-- - - - ! I Samra Residence 265 Seapuit Road Barnstable MA I F Y.ST FL(IOK FI FLOOR ..I..^...t.: S_.J _.. I. L. FKSi COE f II1 FIpDT FLOCIR eyT,i�ls 9 '(a.9) .. , \—FtK FLn15"yyCCFIRIM 0'S3 aIJP t`1, M'FLAT 5i0LI:iP,IM Qu5 0 I TsH GI 0 G.AGE t 1 I I vfl;rcK rQG I <: I t vERIKAL rce- 1 1 \ `- ocr�r,IM DJ 1 1 RTIAT TSGI:TeIM 1 ALE:1/4' 1'-0' \r ..vEERTe TT.� NI --"` I Drawings Boat HODS@ I. rve eoARDs I. I .l we eoARDS 1 I 1 A,BC D6 1 1 1 we MARDS ED A Bq.50N01UeE 1 80,5GNOr BF q _ _ 1_J t_J _ 'I—i .c f t3 3-toq•1M rl. .�`.. _. _ _ lJ. � _ - -., .. _LI e ,.� _o_ l_.J .. _. I_f 0 eo 5o mudE � � - �\`� C /• t3.3 0 1/16 �P 1aP rchitects Inc. 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Samra Residence 265 Seapuit Road Barnstable MA Main House: First FI. Plan SCALE: 1/4' = 1'-0" DATE: 11/23/15 _Palalano Architects Inc. \ \ \ 1 Boston,5 Broad Massachusetts 02110 telephone 617-338-7447 facsimile 617-338-6639 Y A r � Proposed Secopd'Floor Finished Area: 2,973 GSF Prop pd-Second Floor Unfinished Area: 0 GSF tip 1 /y 1 o r -----\- �O D,N , GIA4 i �j�,�p """1�'� �4T2 l urr° ; / � �' / �`�a• r.8•, c �, ------ � EXERggE I I �� / \ / 6'g rc AQ91I I� � �- 1 2 I — I b BEDROO M / 004A _— ©Catalano Architects Inc. 004A Samra Residence / 265 Seapuit Road Bamstable MA ER 1 Main House: Plan cond FloorSCALE: 1/4' = 1'-0' DATE: 11/23/15 / / 1 Catalano Architects Inc. / / 115 Broad Street Boston,Massachusetts 02110 telephone 617-338-7447 facsimile 617-338-6639 1m2 s Proposed fktcic Floor Finished Area: 396 GSF i-�r vvsed kiu� riuu-Unit,as1;ed Area: 369 uSF i t / 4, Ro �rDgCR it / `\ I ZU RS ODO 5/8"SLUE80ARD —� BLE WALL I I I 1 r I t / ®Catalano Architects Inc. 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