HomeMy WebLinkAbout0037 SETH GOODSPEED'S WAY - Health _ . _
37 ��'r� C—ob���E�r
f
i
O
O .,
it n
n
i
D
u
e o
TOWN OF BARIVSTABLE
LOCATION ] SEWAGE#
1
VILLAGE ASSESSOR'S MAP&PARCEL /ZZ
INSTALLER'S NAME&PHONE NO. Pca11`� rrlej 'YT 7
t
SEPTIC TANK CAPACITY 00 k+ t U `- vSki ,
LEACHING FACILITY:(type) (20Z0 3 ro t is (size) r,(.f Y 2 U
NO.OF BEDROOMS
—
OWNER a,rf'Lu, C n s Cc qe
PERMIT DATE: I Sf 1 Z t 1 COMPLIANCE DATE: l 5 — Zo l 1
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching.Facility AI& kVir Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching,Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY 1^ U ,
�� Yo
Ry sy��
a3,9
S32 a-7f
3� coo:o
No. V --� t Fee U
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
2pplitatlon for Misposal 6pstem Construrtlon jhrmit
Application for a Permit to Construct{ ) Repair V) Upgrade O Abandon( ) ❑Complete System Individual Components
Location Address or Lot No.31 Sm4avc,415peed,y W4� Owner's Name,Address,and Tel.No. 5ieeA" C".1 C0 keA
051,COLs;%kQ Z5'0Wayl�iarti STiee;7-
Assessor's Map/Parcel 12 W. I ef,,,r v�
Installer's Name,Address,and Tel.No. �,aP � ��,,,�cJ Designer's Name,Address,and Tel.No. S.C. tr, een .
P e e3.?,e 7�,3 285Y CAar�yrirr�
C e..rv,,t i t.,tea
Type of Building: Z r Z o C-
Dwelling No.of Bedrooms 2 Lot Size j e, 2-5' 1-sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures C a„ #,L,4 AVE
Design Flow(min.required) b 0 gpd Design flow provided 35S. 2 o gpd /y
Plan Date �- [ 3-2.011 Number of sheets G Revision Date �io ,f
Title-3-1 5e-rff 6npJSge,, j LA)A-,, 85"r0b-( -t! '
Size of Septic Tank /01040 C s i�7 T Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 1 )bt21 Ci/L � (i1t /�✓ D „3�
16
Date last inspected: `f,ot
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Si Date 5- /(o -?� (1
Application Approved by , Date ._ /(y ^-2 off/
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
No. DiV ill _ll I Fee U
! THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSET,TS ; Yes
application for Disposal 6pstem (Construction Vermit -
Application for a Permit to Construct( ) Repair(x) Upgrade( ) Abandon( ) ElComplete System Individual Components
Location Address or Lot No.,3q S j t--16� oc�Gpge c WAY Owner's Name,Address,and Tel.No. 4,�0?A" C,„
0,$T ;ate. Zsc CN�ii'�nM S%ieer
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. y td, ri
L Designer's Name,Address and Tel.No. 57,
%7a r3�x IQ3, �U� s�� r4 3 -►7 Z65r C�ar4r.,•y �f
�_r." rx- i t; c. a wq L wit r�r n-ti-,
Type of Building:
Dwelling No.of Bedrooms Lot Size /60, (a Z � �sq.ft. Garbage Grinder( )
Other Type of Building NA445sonD t3`e Showers( ) Cafeteria( )
Other Fixtures 4}1.,. -.��. o.1�r ��^ �.aF �a 70�. OP✓ ,nrr Z�- yU� l)js �Uuc
Design Flow(min.required) 3 4 0 d Desi n flow provided J�
� �� gP g P �.�.5. Z� gpd F
Plan Date !j- r %, - 11 Number of sheets Revision Date
�
Title., ;'i"]'�• E +., � 5��r(!;����.�• �����:"�.. r�S t(�fZv Ala
Size of Septic Tank /c .�E, C�f•s,f Type of S.A.S.
Description of Soil
(o
Nature of Repairs or Alterations(Answer when applicable) \�,) 1tV6, ! - �''u
Date last inspected: �ipl
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Sign ,/ Date
9d .® 1
Application Approved by .Date -�2 o!1
Application Disapproved by Date
for the followngye�asor@ {,e
U //
Permit No. r� (� l tt p Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(_ Upgraded( )
Abandoned( )by ( .dsl.r. ),'I n
at 2a S l� a�S.2(���� (,/ i. has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. d a f/'(t(b dated
Installer ,q,nDe,J t I�.D Y.f� f %✓,TP I .t Designer
#bedroomsy 'J�/'" Approved design flow 6 gpd
The issuance of this'ernyt shall not be construed as a guarantee that the system will fun ti�n as designed
Date it Inspector Jl.,
-------------.---- ----t------+---------------------------------- ---- _ =
No. :2 O l I- �t In Fee /O U
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
Disposal �&pstem (Construction 'ermit
Permission is hereby granted to Construct( ) Repair K) Upgrade( ) Abandon( )
System located at
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction in be completed within three years of the date of this permit.
1_
Date /r; // j Approved by �iUV _Ca -
05/20/2011 00:32 5082730387 #0174 P. 002/003
{
Town of Barnstable
Regulatory Services
Thomas F.Geller,Director
z Public Health Division
�as9 Thomas McKean,Director
200 Main Street, hyanais,MA 02601
Office: 508-862-4644 Fax: 508490-6304
Date: 5-20^l 1 Sewageiermit# 1I`(C'.Assessor's Map/Parcel i 2 2 /(4 Y
Installer&Designer Certification Form
Designer: SG 'bn 0ee.rtrl , TOC. Installer: Gce&Icic. FrtEer�ctses
r U 0>< -7
Address: �sy'1 Ccc�r,herc >k Hw Address:
�As1 Wacdncam YI,4 02,539.
- Co '
On ( l-da '� P 01- C`-was issued a permit,to install a
(installer) v
septic system at 3' SAAV1 (r o46.e eed`5 Way eased on a design drawn by
(address)
G l;n�► +rercv�� , Inc dated` MY 13 , 20 t k
(designer)
" I certify that the septic system referenced above was installed sub,t;intially wording to
the"design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. .StHpout (if required) was inspected and the soils
were found satisfactory.
I certify that the o septic system ill
pU y tem referenced above was installed with major changes(i.e.
greater than 10' lateral relocation of the SAS or any vertical relocadUrt of any component
of the septic system)but in accordance with State&Local Regulations. Plan revision or
certified as-built by designer to follow, Stripout(if required) ns ected and the soils
were found satisfactory. OF
JOHN L, .� `
CWURC!,tt.l,
J7.
(Ins er's Signatur NIL.
OW
signers Signature A tx Dc gn . Here)
P SE RETURN TO ARNSTABLE I'IYIgY,IIC HEAL DIVISION. CERTIFICATE
`OF COMPLIANCE WILL NOT BN ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THIS BARNSTAHLE Y U13LIC 11F LTH DIVISION.
THANK YQU:
S:1oCicn f'arma�desisnercertifcationform.tloc
of
Town of Barnstable P# 11
Department of Regulatory Services
MAM
Public Health Division }
200 Main Street,Hyannis MA 02601 Date
Date Scheduled
a Time Fee Pd.
or �'��!vyge
Soil Suitability Assessment 7 •
,f Dasposal `
Performed By:_r�►�ftWleA W •l 6I7 GS E
Witnessed By: ��
LOCATION&GENERAL INFORMATION
Location Address
3 S�ti� �oe� S�2 Owner's Name
V L Address -
Assessoes Map/Parcel:
2/6-4 y Engineer's Name 61-po" J4 i-;� tgyneacc, e
NEW CONSTRUCTION `�j4ic`
REPAIR Telephone# q7 2 $�1 t D
8-273 6 37 7
Land Use 5engle �ami 1y cj�.I�C `
ng Slopes(%) Surface Stones P
Distances from: Open Water Body ft Possible Wet Area
ft Drinking Water Weil
Drainage Way ft Property Line > t o
--�ft Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
see- e(ael
Parent material(geologic) 0 u t waS�n b
Depth to Bedrock 7 f Z a `og,3
Depth to Groundwater. Standing Water in i lole: - 12,0 g S
We from Pit Face J S
Estimated Seasonal High Groundwater _ 12� ��s
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used: Dcrect o'osetu-41--n
Depth Observed standing in obs.hole: 7 t20 in, Depth to soil mottles:
Depth to weeping from side of obs.hole: `7 126 In.
Index Well# --- _- Readin Date: .• in. Groundwater Adjustment
Reading Date: Well level •„r,..Adj,factor• ,m 4 pdj,praundwater Level
PERCOLATION TEST bate " N't Time_Vis/lvy "
Observation
Hole# Time af4"
--'- —� —
Depth of Pere 1 Time At 6"
Start Pre-soak Time @ 9,'55 AIf
• 'lime(9„•6
End Pre-soak j 0:i p A rl
Rate MinAnch L Z
Site Suitability Assessment; Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back--------
***If percolation test is to be conducted within 10W of wetland,you must first notify the.
Barnstable Conservation Division at least one(1) week prior to beginning,
QA.SEPTICUPERCFORM.DOC
DEEP.OBSIIMVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture
Surface(in.) Sdil Color Soil. Other
(USDA) (Munsell) Mottling (Structure,Stones;Boulders.
onsistency 96 t3rav n
`I
3/1 A
rill
12-30
t3 i-S -
3a-"lzo _
NS 2.5Y64
DEEP OBSERVATION HOLE LOG Hole# 2-
Depth from Soil Horizon Soil Texture
• Surface(in.) Soil Color Soil Other
(USDA) (Munsell) Mottling (Structure,Stones,Boulders.
-r
oien %
ravel
-12 F•L
j,r 3/1
6
rl S 5-f&A
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil
Surface(in.) (USDA) Other
(Munsell) Mottling (Structure,Stones,Boulders.
it
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling
(Structure,Stones;Boulders.
-Consistency,
,t
Flood Insurance Rate Map:
Above 500 year flood boundary No- Yes
Within 500 year boundary No Yes -
Within 100 year flood boundary No. Yes
Depth of Naturally Occurrine Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system? --files _
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on JD'1�'y�.� (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with .
the required training,expertise and expert ce described in 3 l0 CMR 15.017.
C �
Signature Date -5 -l
Q,%.S.EvnC%PERCFORM.DOC
E _ _�;U�MMUNWI�A.t;l'll UI- MASSAC13tJSE'1'L'8
Exi.,(;U LIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DETAR'MENT OF ''NVI.RONMF=N'1'Ai, I'RO'I'I;CI'ION
c9xNr, w
t.J af��. I,N'PF,R STIZEE-7, BOSTON MA '112109 (617) 292-5500
g 2p00 .
M a TRUDY COXF:
n R144tiS;A81F Secretary
zSU 'RFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
ARCFn PAUI. CFLf lJC(av r4mBS,U..
Governor PART A DAVID B. STRUIiS
CERTIFICATION Coininissioner
MAP PAR
PROPERTY ADDRESS': ADDRESS OF OWNER:
DATE OF INSPECTION: tr:t
NAME OF INSPECTOR
I atn a DEP.approved system inspector pursuant to Section 115.340 of Title 5 9310 CMR 15.000)
COMPANY NAME: l�
MAILING ADDRESS:
TELEPHONE NUMBER:
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,
accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the ro er
y function and maintenance of on-site sewage disposal systems. The system: p p
t/ PASSES
CONDITIONALLY PASSES
NEEDS FURTHER EVALUATION BY THE LOCAL'APPROVING AUTHORITY
FAILS
INSPECTORS SIGNATURE: � �;4!��� ✓�l/ DATE:
The system Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) 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
is 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.
NOTES AND COMMENTS:
SITE OVER ALL PASSES,INSPECTION OF SYSTEM IS BASED ON CONDITION OF SYSTEM AT THE TIME
OF THE INSPECTION.THERE IS NO GUARANTEE ON THE LIFE OF THE SYSTEM.
P Ublic Health Division
Town of Barnstable
PO Box 534
° Massachusetts 02601
Hyannis,
. ` Fax(508)775-3344
Phon (508)7g0-6265 K
revised 9/2/98
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
' PART A
CERTIVICATION (continued)
Property Address:5-5- .e-e�y
Owner: /";qe}}//
Date of InspecYon: R�
INSPECTION SUMMAR
Y:
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: &„t Je,rQA < AA-,1%e4
B SYSTEM CONDITIONAL Y PASSES: 7C;,
One or more system components as described in the"Conditional Pa" section need to be replaced or repaired. The
System,upon completion the replacement or repair,as approved b the Board of Health will pass.
Indicate yes,no,or not determined(Y,N, r ND). Describe basis of dete ation in all instances. If"not determined",explain why not)
The septic tank is metal,un ss the owner or ope r has provided the system inspector with a copy of a Certificate .
Of Compliance(attached)in ating that the was installed within twenty(20) years prior to the date of the
inspection;or the septic tank, ethe of metal,is cracked;ifr`ucturally unsound,shows substantial infiltration or
exfiltration,or tank is failure' • anent. The system will pass inspection if the existing septic tank is replaced with a
conforming septic t s approve y the Board of Health
Sewage backup or breakout or high state water level observed1h the distribution box is due to broken or obstructed
.. pipe(s)or due to a broken,settled or unev distribution box. the system will pa
pass inspection if(with approval of the Boar of Health). < 'ID"
broken pipe(s)are replace
obstruction is removed
distribution box is leveled or replaced
The system required pumping more than four times a year due to broken or obstructed
pipe(s). The system will pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
a:
revised 9/2/98 2
II
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: $5 S't-��/9�ypspu
Owner: 1114AY N494L
Date of Inspection:
C] FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH
t1 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to
protect the public health,safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303
(1)(b)THT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. a
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 AND
SAFETY AND THE 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 soil absorption system and the SAS is within a Zone
1 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 ooliform
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 and is equal to or less than 5 ppm. Method
used to determine distance (approximation not valid).
3) OTHER
revised 9/2/98 3
' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
,k
Property Address: SS S'�f/�9vnOS�cc/�
Owner: /'fAP_y A111,
Date of Inspection:7_
D]SYSTEM FAILS: r
You must indicate either"Yes"or"No" to each of the following:
A,Q I have determined that one or more of the following failure conditions exist as described in 310 CMR
16.303. The basis for this determination is identified below. The Board of Health should be contacted to
Determine what will be necessary to correct the failure.
Yes No
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 over-
loaded 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 Soil Absorption System,cesspool or privy is below the high groundwater.
elevation.
Any portion of a cesspool or privy is within 1 00 feet of 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. `
E) 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 200 feet of a tributary to a surface drinking water supply,
the system is located in a,nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or
mapped Zone II of a public water supply well)
The owner or operator of.any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local
regional office of the Department for further information.
t
revised 9/2/98 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address:
Owner: /yy/L y 11417 ,
Date of Inspection:
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 not 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,including 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:V),5v A( Zx SptG f u h' A I 0
✓ Existing information.Ex.Plan at B.O.H. /"V—hS vtE n f 67Pt p 0A&t jS
�— 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)] .
The facility owner(and occupants,if different from owner)were provided with information on
the proper maintenance of Sub-Surface Disposal System.
revised 9/2/98 5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION +",
Property Address:
Owner:
Date of Inspection: '
ay-yy s
-. ,FLOW CONDITIONS°
RESIDENTIAL: `j K
Design flow: _ g.p.d./bedroom for S.A.S. '`y
Number of bedrooms(design) 'ice Number of bedroomsA(actual).
Total DESIGN flow
Number of current residents:
Garbage grinder(yes or no): ddZ
Laundryse arate system)( p ys ) (yes or no): If yes,separate inspection required
Laundry system inspected(yes or no): "
Season
4
al use(yes or no) �j _ � •L �
Water meter
e er readings,if avails able last two(?),year r
9 ( ( )Y usage(gPdY � Y)
Sump Pump(Yes or no): ., ' ; t_b 7—° 4 S,00o
Last date of occupancy:,
e
COMMERCIAL/INDUSTRIAL:,
IV -
A
Ty
pe of establishment:
Design flow: Gpd.(Based on 16.203)
Basis of design flow
Grease trap present:(yes or no): d
Industrial Waste Holding Tank present:(yes or no)
�., .
Non-sanitary waste discharged to the Title 5 system:.(yes or no) - V
Water meter readings,if available:
Last date of occupancy:
OTHER:(Describe)
Last date of occupancy
-INFORMATION W _
PUMPING RECORDS and source of information:'
System pumped as part of inspection:(yes or no)
If yes,volume pumped: gallons'`
Reason for pumping. _ Y
,
TYPE OF SYSTEM.
Septic tank/diikr .Yise/soil absorption system
Single cesspool
Overflow cesspool
Privy
Shared system(yes or no)(if yes,attach previous inspection records,if any)
I/A Technology etc.Attach copy of up to date operation and maintenance contract.
Tight Tank Copy of DEP Approval }
Other
APPROXIMATE AGE of all'components, date installed (if known) and source of.information.
Sewage odors detected when arriving at the site:(yes or no)
revised 9/2/98 6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION' FORM
PART C
SYSTEM INFORMATION (continued).w r
Property Address: $'S se{yam?SPcO
Owner:NuvZr N'9gLz
Date of Inspection: —
a
y
BUILDING SEWER:
(Locate on site plan)
Depth below grade: .
Material of construction A" cast iron ✓40 PVC other(explain) "
Distance from private water supply well or suction line '
Diameter l
omments:(condition of joints,venting,evidence-of leakage,etc.) AA
T [.t'i /N el- •-O j 41a r 6zy, i v y. Aft AleA
SEPTIC TANK:
(Locate on site plan)
Depth below grade:
Material of construction X concrete metal _ Fiberglass _ Polyethylene _ other(explain)
If tank is metal,list age Is age confirmed by Certificate of Compliance (Yes/No)a
Dimensions: �,f, X �/�/U �n/'C Y OU�C� 3
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle: • S/ / , R
Scum thickness: _
Distance from top of scum to top of outlet tee or baffle: i
Distance from bottom of scum to bottom of outlet tee or baffl :
How dimensions were determined PRE �- rAAC 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.) p
f�e,Ih >� ` ,a✓I�i n 9 /�lra�re_ u��,t� �,�,;/r S �?/!.� i�. /lA<� �i
GREASE TRAP:
(locate on site plan) '
Depth below grade:
Material of construction _ concrete _ metal _ Fiberglass _ Polyethylene other(explain)
Dimensions: ,
Scum thickness: fi
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments: b ,
(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 9/2/98 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM tl
' PART C
SYSTEM INFORMATION (continued)
Property Address:
Owner: � ..
Date of Inspection: i
TIGHT OR HOLDING TANK. (Tank must be pumped prior to,or at time,of inspection)
(Locate on site plan)
Depth below grade:
Material of construction _ concrete _ metal Fiberglass Polyethylene other(explain)
Dimensions:
Capacity: Gallons
Design flow: gallons/day
Alarm present
Alarm level: Alarm in working order: Yes; No
Date of previous pumping:
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
DISTRIBUTION BOX:
(locate on site plan) 5,
Depth of liquid level above outlet invert:
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc,)
PUMP CHAMBER:
(locate on site plan)
Pumps in working order:(Yes or No)
Alarms in working order(Yes or No)
Comments:
(note condition of pump chamber,condition of pumps and appurtenances,etc.)
• e. �. ti— T � III
R
revised 9/2198 8
SUBSURFACE SEWAGE_ DISPOSAL SYSTEM INSPECTION FORM )
PART C
.SYSTEM INFORMATION(continued)
Property Address: SS ec�
Owner: /y�ArLy �lia- ,
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods)
If not located, explain:
Type.
Leaching pits,number: 4000 441' ANEW A f
Leaching chambers,number. '
Leaching galleries,number:
Leaching trenches,number,length:
Leaching fields,number,dimensions:
Overflow cesspool,number,
Alternative system:
Name of Technology: .
Comments:
(note condition of soil,signs of hydraulic failure level of ponding,damp soil,condition of vegetation,etc.) �
i o 1
CESSPOOLS:
(locate on site plan)
Number and configuration:
Depth-top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer. j
Dimensions of cesspool
Materials of construction:
Indication of groundwater:
inflow(cesspool must be pumped as part of inspection) ,
Comments::
(note condition of soil,signs of hydraulic failure,,level of ponding,'condition of vegetation,etc.)
PRIVY:
(locate on site plan)
Materials of construction: Dimensions: {
Depth of solids:
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
r
revised 9/2/98 9
t
SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 55 yei#1010 o
Owner:07402y
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'(locate where public water supply comes into house)
6fJ IeX En1IKS Z*x,,l r,tg on TAkv A.emr le-Al r/JL
L�414V,
� t f�VV/ oAl
. a
,.. . • i. -
revised 9/2/98 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:ss S��HpGn�S�rc�
Owner: /11,141
Date of Inspection: R
NRCS Report name
Soil Type
Typical depth to groundwater
USGS Date website visited
Observation Wells checked
Ground water depth: Shallow' Moderate Deep
SITE EXAM Slope
Surface water
Check Cellar
Shallow wells c
Estimated Depth to groundwater Feet
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record ,
Observation of Site(Abutting ir y( g observation hole,basement sump eta)
Determine it from local conditions `
t z
✓ Check with local Board of health
Check FEMA Maps s
Check pumping records
_j Check local excavators,installers a
Use USGS Data 4
Describe in your own words how you established the High Groundwater Elevation. Must be completed) .T i
Lrt!c,���4�iv A� ✓�/ � � ¢v ^/� yG�. F � of , /S v ,�vn7 w.
JV4 fe
G% c Gv3At %tl est•' /filly A�qeNl i4,io J�tCMiht-�. ,<�e tv4s Nv llgf (geoid
GU�f� i•, tSCUs iQ�eza, • . ,
revised 9/2/98
sY F
LO-CATIO � ``� S S E W A G E PERMIT NO.
77
VILLAGE
.j A -�7
INSTA LLER'S N ME /&/ AD ESS
B U PL D E R OR OWN ER
D,.1•TE ERMIT ISSUED _ . _
DATE COMPLIANCE ISSUED
l
i
it
• I
1 1]111
i
COMMON WEA.1 TJ I OF M/1SSA( I Lt1SE'I'.l'S
EXECUTIVE OFFICE OF ENVIRONMENTAL AF t`j1RS ITf
DEI'AR'IVENT OF ENVIRONM_EWPAL PRO'1'I; uk)NA
ONE WINTER STREET, BO STON MA 02109 (617) 297.-5500 1 UG o
roftoF9gg
COXF
� izrt'eI.nry
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
ARGEO PALL CELLUCCI �° )AVIt S'I'RU11S
Governor PART A- Commissioner
CERTIFICATION
MAP PAR 4� '
PROPERTY ADDRESS: ADDRESS OF OWNER:
DATE OF INSPECTION:
NAME OF INSPECTOR :
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 9310 CMR 15.000)
COMPANY NAME: �.Qi+lt!/
MAILING ADDRESS:
TELEPHONE NUMBER:
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,
accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper
function and maintenance of on-site sewage disposal systems. The system'.
t/ PASSES
CONDITIONALLY PASSES
NEEDS FURTHER EVALUATION BY THE LOCAL APPROVING AUTHORITY
FAILS
INSPECTORS SIGNATURE: / iy �.+�j•� �� DATE: e
The system Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) 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.
NOTES AND COMMENTS:
SITE OVER ALL PASSES,INSPECTION OF SYSTEM IS BASED ON CONDITION OF SYSTEM AT THE TIME
OF THE INSPECTION.THERE IS NO GUARANTEE ON THE LIFE OF THE SYSTEM..
revised'9/2/98
•
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIVICATION (continued)
Property Address:531 ve�jy5i2': sRe 4
Owner: / �,e� �7
Date of Ins pection�VR &—
INSPECTION SUMMARY: Check A,A C, orD: ,
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: " "X/i�b&he n &g j%e-
/inrdh m�It/1 .to�/ir 4i�pf G %w.��t A..�f 4 12 11ae gQWp +
B SYSTEM CONDITIONALLY PASSES:
One or more system co onents as described in the"Conditional Pa section need to be replaced or repaired.'The
System,upon completion the replacement or repair,as approved b the Board of Health will pass.
Indicate yes,no,or not determined(Y,N, r ND). Describe basis of dete ' ation in all instances. If not determined",explain why not)
The septic tank is metal,un ss the owner or ope r has provided the system inspector with a copy of a Certificate
Of Compliance(attached)in ating that the was installed within twenty(20) years prior to the date of the
inspection;or the septic tank, ethe of metal,is cracked,structurally unsound,shows substantial infiltration or
exfiltration,or tank is failure' ' anent. The system will pass inspection if the existing septic tank is replaced with a
conforming septic it s approve y the Board of Health.
Sewage backup or breakout or high state water level observed in the distribution box is due to broken or obstructed
pipe(s)or due to a broken,settled or unev distribution box. The system will pa
pass inspection if(with approval of the Boar of Health).
broken pipe(s)are replace '
obstruction is removed
distribution box is leveled or replaced
The system required pumping more than four times a year due to broken or obstructed
pipe(s). The system will pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
revised 9/2/98 2
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 5$ S��9p�D5pu
Owner: ^49Y N-1-76
Date of Inspection:
C]/FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
A Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to
protect the public health,safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303
(1)(b)THT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 AND
SAFETY AND THE 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 soil absorption system and the SAS is within a Zone
1 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 and is equal to or less than 5 ppm. Method
used to determine distance (approximation not valid).
3) OTHER
revised 9/2/98 3
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: SS
Owner:ln4oL.y Avg91e. "
Date of Inspection:7_ 29-91
Dj SYSTEM FAILS:
You must indicate either"Yes"or"No" to each of the following:
A,DL I have determined that one or more of the following failure conditions exist as described in 310 CMR
16.303. The basis for this determination is identified below. The Board of Health should be contacted to
Determine what will be necessary to correct the failure.
Yes No
," 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 over-
loaded 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
1/ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s)
Number of times pumped
1/ 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 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.
E)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 200 feet of a tributary to a surface drinking water supply .
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or
mapped Zone If of a public water supply well)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local
regional office of the Department for further information.
revised 9/2/98 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
x
Property Address: $'S SGI,91?wo*pecO
Owner: Iy,g2y
Date of Inspection:J-ozv
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 not 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.
7 The site was inspected for signs of breakout.
�— All system components,including the Soil Absorption System,have been located on the site.
—1� 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:v1/jvA j -1NSpec�j pK jnjo ,n d��� I
✓ Existing information.Ex.Plan at B.O.H. /'V—4S`.� � � 7 S
4— Determined in the field(if any of the failure criteria related to Part C is at issue,approximation
of distance is unacceptable)11 5.302(3)(b)]
The facility owner(and occupants,if different from owner)were provided with information on
the proper maintenance of Sub-Surface Disposal System.
revised 9/2/98 5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: SS SeYf190W5.,GcO
Owner: ^ ,tY A1,9 76L `
Date of Inspection:
FLOW CONDITIONS
RESIDENTIAL:
Design flow: OW g.p.d./bedroom for S.A.S.
Number of bedrooms(design) 'Z Number of bedrooms(actual):
Total DESIGN flow AZ C
Number of current residents:
Garbage grinder(yes or no): AO
Laundry(separate system) (yes or no): ti0 If yes,separate inspection required
Laundry system inspected(yes or no): .
Seasonal use(yes or no) A
Water meter readings,if available(last two(2)year usage(gpd):
Sump Pump(yes or no):
Last date of occupancy: C�Iif(
F -
COMMERCIAL/INDUSTRIAL:
Type of establishment:
Design flow: Gpd(Based on 15.203)
Basis of design flow ¢ ,
Grease trap present:(yes or no):
Industrial Waste Holding Tank present:(yes or no)
Non-sanitary waste discharged to the Title 5 system:(yes or no)
Water meter readings,if available:
Last date of occupancy:
OTHER:(Describe)
Last date of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
. � n
System pumped as part of inspection:(yes or no) _
If yes,volume pumped: gallons
Reason for pumping
TYPE OF SYSTEM
L,,-' Septic tank/dWl*l=b=WK/soil absorption system
Single cesspool
Overflow cesspool `
Privy
Shared system(yes or no)(if yes,attach previous inspection records,if any) ,T
I/A Technology etc.Attach copy of up to date operation and maintenance contract.
Tight Tank Copy of DEP Approval
Other
APPROXIMATE AGE of all components,date installed (if known)and source of information:
Sewage odors detected when arriving at the site:(yes or.no)
revised 9/2/98 6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 3-5-
Owner:I"Aozy N9y,&
Date of Inspection:
BUILDING SEWER:
(Locate on site plan)
Depth below grade: . S"
Material of construction #4w cast iron ✓40 PVC _ other(explain)
Distance from private water supply well or suction line
Diameter
Comments:(condition of joints,venting,evidence of leakage,etc.) 6� �° f ,.�
/N er .0 nor 6.+n 4 i a AV �ov►A� � i.c� cla,:�o C4,1
SEPTIC TANK:
(Locate on site plan) ✓
Depth below grade: •3
Material of construction X concrete _ metal Fiberglass _ Polyethylene _ other(explain)
If tank is metal,list age Is age confirmed by Certificate of Compliance (Yes/No)
Dimensions: Al,/Uie/C / 71 Y.J
Sludge depth: �•
Distance from top of sludge to bottom of outlet tee or baffle:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle: ou
u
Distance from bottom of scum to bottom of outlet tee4 or bbaffl
How dimensions were determined
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.) > p
GREASE TRAP:
(locate on site plan)
Depth below grade:
Material of construction _ concrete _ metal _ Fiberglass _ Polyethylene _ other(explain)
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments:
(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 9/2/98 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
Owner:
Date of Inspection:
TIGHT OR HOLDING TANK: (Tank must be pumped prior to,or at time,of inspection)
(Locate on site plan)
Depth below grade:
Material of construction _ concrete _ metal _ Fiberglass. _ Polyethylene _ other(explain)
Dimensions:
Capacity: Gallons
Design now: gaUonstday
Alarm present
Alarm level: Alarm in working order Yes; No
Date of previous pumping:
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
DISTRIBUTION BOX:
(locate on site plan)
Depth of liquid level above outlet invert:
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc,)
PUMP CHAMBER:
(locate on site plan)
Pumps in working order.(Yes or No)
Alarms in working order(Yes or No)
Comments:
(note condition of pump chamber,condition of pumps and appurtenances,etc.)
a
revised 9/2/98 8
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: $-5 5e111f -VXvrc0
Owner: /y�2y VAS L_
Date of Inspection: '
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods)
If not located, explain:
Type:
Leaching pits,number: 7`41ZO C441 k&41 pY.
Leaching chambers,number.
Leaching galleries,number:
Leaching trenches,number,length:
Leaching fields,number,dimensions:
Overflow cesspool,number,
Alternative system:
Name of Technology;
Comments:
(note condition of soil,signs of hydraulic failure level of ponding,damp soil,condition of vegetation,etc.)
'009 n
S, *i1 e P
CESSPOOLS:
(locate on site plan)
Number and configuration:
Depth-top of liquid to inlet invert: t
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater:
inflow(cesspool must be pumped as part of inspection)
Comments::
(note condition of soil,signs of hydraulic failure,,level of ponding,condition of vegetation,etc.)
PRIVY:
(locate on site plan)
Materials of construction: Dimensions:
Depth of solids:
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
revised 9/2/98 9
• SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 55 Y0#70 ,0*"�o
Owner:01,gay N4QCz
Date of
Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'(locate where public water supply comes into house)
Almlex E,il-ekS P4x4p',tg on 7-4-v :.Con
t _
C�Q�AR� J5,4r X0 r
o
i
revised 9/2/98 10
f
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:Ss � ypGt��S
Owner: /y�ISIZy
Date of Inspection:
NRCS Report name
Soil Type
Typical depth to groundwater
USGS Date website visited
Observation Wells checked
Ground water depth: Shallow Moderate Deep
SITE EXAM Slope
Surface water
Check Cellar
Shallow wells
Estimated Depth to groundwater Feet x
Please indicate all the methods used to determine High Groundwater Elevation:
Obtained from Design Plans on record
Observation of Site(Abutting property,observation hole,basement sump 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 Groundwater Elevation.(Must be completed)
1• 6164V41ivn. 41 97 s�
� C'� Lvd�y /fit/ �'�M ��� /�l�t� �Sc•,� AHo �f�cM,�-�- �� u,As Nv /�,f� G,eE,Lnp
�''?!'�c'� Lvo¢� /ftci�•��t.�e>Jt`e� 1�liLYr��O/?s•.
revised 9/2/98 11
Mel "�' �►+.� i�+�`+�
L `
a
11'' `1-� i•v� -
71aOM
Health Complaints
16-Sep-99
Time: 3:46:30 PM Date: 9/16/99 Complaint Number: 2085
Referred To: DONNA MIORANDI Taken By: LS
Complaint Type: GENERAL
Article X Detail:
Business Name:
Number: 37 Street: SETH GOODSPEED
Village: OSTERVILLE Assessors Map_Parcel:
Complaint Description: NEIGHBORS ARE UNHAPPY ABOUT THE
SEWAGE ODOR COMING FROM SCOTT
CAMPBELL'S TRUCK FROM A B CANCO.
HE WASHES IT THERE ALSO AND THE
WATER RUNS IN THEIR YARD. THEY ARE
SICK OF SMELLING IT AND CAN'T OPEN
THEIR DOORS OR WINDOWS. THIS HAS
BEEN GOING ON FOR 2 YEARS AT THIS
RENTAL HOUSE. HE ALSO WOOD CHIPS
TREES IN THE BACKYARD AND THE PILES
ARE PUSHED UP AGAINST A COMMON
FENCE.
Actions Taken/Results:
Investigation Date: Investigation Time:
r
7
SEW&C�'E ER
T MO.
L A
r
VILLAGE '. — � — — � - -----
1-t�lS LLER S _ E
. _ _
_ -BUILD R 5 .Q-At ItE,SS_
aTE PE-RWT ISSUED
DATE COMPLI &&ICE
-A)T
7�
No.......... Flms... .....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O-E HEAL H
Gic�J-� .....OF........./!��
3� Appliratiun -fur Bitiviaiittl Works C onstrurtinn Vaunt
Application is hereb made for a Permit to Construct or Re air an Individual Sewage Disposal
PP Y (�P ( ) a P
System G'G` sC
t C
--••--•----------•--------•-.--•----------- -s: ! ?✓4---_ .. - ....................................
/2 Lbcaf`'o -Address�(�/y r L of o.
r/ Ad"ress
W /z 4 ��y ........... �j��
r Owner
1�2
Installer / Address S� J
UType of Building / Size Lot... f_________________Sq. feet
,-� Dwelling—No. of Bedrooms------------ __________________________Expansion Attic ( ) Garbage, Grinder ( )
Other—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
dOther fixtures ..-...... —-------------------------------------•----------- ---•--------------•---•••-------------•-----------------------
W Design Flow........5d............................gallons per person per day. Total daily flow..................12- 0.Q_-.--...._gallons.
WSeptic Tank—Liquid capacity/a670gallons Length---------------- Width------.......... Diameter................ Depth:--.---__--.-_.
x Disposal Trench—No- _________________- th___---__---____-- �tal Len�th_._____- ✓.___._. otal leaching area....................sq. ft.
Seepage Pit No......!� " Di � '�` E3fh ��
-------`' `6 niet.. Total leachin area....... ----------sq. ft.
Z Other Distribution box ( ) Dosing tank ( ) ?, �
aPercolation Test Results Performed bY---------------------..................................................... Date----.--------------------------------...
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water--.----.-__--.---.------
�14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------
-----------------
11�
x : - --
1ZO ! - - a a ----
esg ri o 'n •---- ° L------------ --------- ------- ----
-----------------------------------------------------------------------------------------------------------
w -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
U Nature 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has beef issued b the bpa rd of health.
Si d. -� --------
"`
Application Approved B ----- . -•---- .. --------- 7 ..
PP PP Y ��
e Date
Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------------
--------------•------•--•--•-•--•--•--------------------------••••••• --•-----------•--•-••••-----------------•---•------------••--•---•---•---•---------.......•--••---••--...-••--•--•---------------.
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........ ._OF......... ./!.....,1, rT^w n < � �T_<'......_,���.............
Appliratiun -fur Mopuiittf Workii Tomarurtion Vrrnift
Application is hereby made for a Permit to Construct (Z, or Repair ( ) an Individual Sewage Disposal
System at
} Location-Address or Lot No.
............ _:_�' - ..,.>_-.w!._�..____ ` _.!_n.:t,!^' �/ "6
.... v. .. ..... ---•---•--•....... .......................• -- . y x
,.�/ ✓ Owner `�-� / � AddreIV � ss
f.
ll�c�' J `vN Address
Yn�;a
Type of Building Size Lot_._A&... . ----Sq. feet
Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building _,.-'-._._-9 '. -�"No. of persons............................ Showers ( ) — Cafeteria ( )
P4Oth -r dXt Tres --------•-----------•------••--•------------------ ----------•----...-------•------------••----...........-•-•-c� F-1- -- ------••--•---•-------
W Design Flow-------------------------------- per person per day. Total daily flow--------------------------------------------gallons.
WSeptic Tank—Liquid capacitv_...........gallons Length x............ Width.-_ .....-Diameter--_.-_- -_____ Depth----------------
Disposal Trench ---------- leaching area--------------------sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth bej �41e�e__ZA. Total ]cacliia'1' ire G------------sq. it.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed bY-------- '--------•------------------------•---------•--••-------•-------- Date------------------------ --------------
a Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water..........-----._-.--.-.
(X, Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth t ,ground water----------- _------.
w x Descript' n of Soil--... a.;_-.l U �......G.__..�"i� � a
/vU _!
V fJ -�<(� U ..---"----------------------------------------------------------------------------------------------------------------------------------------- ---
W
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------
U Nature 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
g �
W4.
Application Approved BY --------------- -----------
Date
Application Disapproved for the following reasons:..........•-'---------------------------------------------------------------------------- ---------------------
............................... ------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT!�✓l.,�,-Sri.._.........OF 'f .:. ZrZ .................
....... %. ..
Trrtifiratr of wontphaurr
THIS IS�TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( )
by................. = c
Installer
at..'--------` --- 7�� r`y �...
--- ---
has been installed in accordance with the provisions of per X�pfdT e State Sanitary(Codeds/eF,,cri Xd�in the
application for Disposal Works Construction Permit N ............... ....................... dated..................................:.............
THE ISSUANCE OF THIS CERTIRCATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE- ;� -----// -----------�C2--------------- Inspector--c ---- ----- .......... . . ..... ---------................
THE COMMONWEALTH OF MASSACHUSETTS
BOAI
HEALTH
>G J — --
....
. ...2��.1.::�..�-..........OFR`.�OF .... -----•.......:...........
No. 1--- �------. ` cam ., �'
. �i��u,� I urk,� t�u��trttrtivat rrntit
6 �
Permission is reby granted = -� ------J'' +;��'
to Construct ) or Repair ( ) � Individual Sewage Disposal S/ysst'ee;r
at No. --------- v - ` c
/-J... ..
Street ��II
as shown on the application for Disposal Works Construction Pe---r it o�___._. .__.__�
1��-6--
-- ---- /
/� _ ..........................
Board of Health
DATE-------���--- -- ------------ -/.._. ._
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
! ki r``
,,, .., I . . I. - - - I 4 I . ,I ,--- � I.-.. 'I", ,q,,"',f`�'--� 1;'-� �.- .t,,',* ) ".-- . -��,,�,, � ,,,�, �.;!,
l / 3
;i X (..I-1�..1:.,\.I\0i.I.1,-��,-A-.�,�L®T�.I,,":�:.I-I-1'.,I-.��;-,,.-1':.1::.�i I,.�d--,L!��--....,II,-�;-I.,�.��.;,!�,-��I4,�.,".....-:"..-:,�,-.,.',..��,,.I,,1;."�',.I,I..�,�,I q:�I.�.I�-,';,..,,1....,:,'�1,./'e77'�-,�-.I�'4.,�..�II..,,.,�I:I..iI...T��.�,.�-�..-..,1 I,.i--�,-."..�-',,...;i.-.�I"�'I%I-..,�-,I-I I.,,,:,I,I...,II,�1--�..�,1-..-,.I�I��..�I.-,1 I,.7., I�o.,�,,-i,.'1.4.',11,�.,;�:..�1.I1.,.'I t.,1��,�.1,�I�,-.1,�I;1�.,1;.�.,,I,.,..-,-,,'I-,-,��.:-�,,i.�I I���,,..I t,�.--.'.f,;t.I,,--,..,1�,--�,-.�I.',-e.�4.i,I,_-.,,,:,.�.,'.7".-�I I1I"�_I::�,.,�-�1,..-,-.�.�:���.I�-.�-�t�,�.,..,,I 1��,'.I&�:.,.�,1-��1 II,,,�,�1-!.��-.,1-I.j.,..�1.,I�-,,-.,,i--,I,,�1.,.-,.-,..,�.�..,1..4�-�-..1i�r `.�-.'..-.,..-.'6....-�,-1.,1�,.,"-�.'w-!:.-:.':,��,-;.*.,;-1 z.�-.,"1�,' . .j,I..�.,,.��",I..;�.1p,,.'".-.,.,,ti:I'.,..,"--I.,-'%�.,�,�-�I",��.,::
i'�I.�!.`%.�I-!"-.,I1,,"-I.:;,�-,.,bi,�--�:,-I,11i,,:��,�I�,i�;-,�:,1--"(-"���);f,kI,h,-:,.�.w�.A'-I'"�1:.,1,.:�j-�1,;,'',.1�,,,."i--.,,,.,-,1,.--,-�,��.--',",,��4 1.,.��,�,i��,,�tr'�4It,�,.1:�v,-L.�",I!--�,,�,f1.�'%. s ..11�.,t.,l-�---�-'.,,"��`.l_,I VII i"-':,r--"','.,.'��,-,"�;,I'�1�t��.-n-'-i:.�I!.I�,',�,,,.I',,,",�.,.-t-U.I.,--,-1-�,"�-��-..-�Ii..A,;,�-I�:I.�.,�,;..,.,1�,,4444�-"1-,:1,11�,�.',.,I',,.A,."',,t�7",�i 1.X..'1�,�;1.�,,_��;";�!,1r.-,�,,.F,';,���-,r.'...��,t,"Axr,!.,-�-!.:..;,-,,",,)�.�,,,I�.,,,;.-.�i.,�.:�,--i�,,,"—,,,-J',1...;F��:�",���,,.
I.,�,.I!�-,-�-�.I...""j-',,,,��,,,-..�1 oI,
n-�--�—�.1��4-..1-,''-,-,:d'.1�,-.!.,,'-�..-.�.-"',,,g'�..'��.,".4�4;,-,,I`.;-1��L,I,F,1.,1���1--,'.�,�.f;��.,,�,:,;,1.��z,4:�'"0�,.-f,..i,,1'',,,�-�.�1�.i...��.�-
_ �,,e,-I
�'h '1,":-'-,T�",�..��,..t::1m,, ,.tj:"4 .�,Ir,--,..i,
.1 I,,.I---��...,.�-....��.,-1�,I.e I.,..,.r-I I II;1,-1I.::"I1I1.-i.,..�.I..1'�I.�.I I,�It��.�I.�I.�,.�I I��.I�.,.I4�!I,lI-j.:."....�,I.�.I::I.%�1 m I1.I...I-T1I.:I*..;,'II4,�I1�II l.-."I-1iI.JII".�.'.,.�,��?�.I,��1k 11�!.,,;.I I,..1.�,.p1.,:",,,"V1�;,�,.,,I�,;T`-�.�-!.�-I.I.'..�....,,�1I'�"�!��-.61-:,il7�,,�I.z.�q.,1I,,,-.I..I��!1,;;I,
':-..,,1,II���--1-,.,.�.'l,,-�."-1-;1,!;,1";..,,I�,A7I-:.I1;-I..�,I".:,�t',.,;,V��1:,%,-.--I:,;*O.F�,._,.1,;'�;..-I,,j I.�..-l.7,'.;�I z-1:-..-�.&��:,..�4,.:..;eMtu.I.�.-..:.;L-1,.V-
P e:I,-:.l*..I.7,,,..I:,1 t�.,II I-,1..��.,...�.�.-�;7-".�I,..,�1..�.1',:�";l�.�,I1,.�,..mI"l.,.-�..,",.I-,,,.,.�r,t 1 I.�,;';1.�I.,,t-V-�!-.rI"�,��7,1-,�...1 t.,.*.�,�,1.�'...-,,�,-,,.�',%�I:,1":;b'�,t.-�.��,�.,-",�:,-*..�:,,-,,,�,1,I�.,�'.-:;1�1'.�I�I�,..I.�-,.-2�I,.�.:;/I"1-,�,-���.;-zK�.l.,f..,.,-7i,W.I,.�:.,,1%,'I I..I,%,,,�,-;-..-1.l;-,,�.I..�,k
.I,.*.,,.j�,,.I;�1�a,.�..1:;�.�6�..,-..,�.,I.-.�.�,,I 1-��-,.i....-�,,,.,,�"I,,.;�.t..�,-�1-,.-,..,�,�z1.",I'.-I,.*-.,,,.'�.-:�.f',.-,!.i"1..��,-k o':!--1�,"1.I.-&."-1.�.1.;:,4-.4,�;�7 1.&�*I_��.1.6-...1�.I..:�,..'"�,,",z.,,,,--.!I,1,-1,�,.;.....":1;..,1.,��,.I--.,;:I*.',,I�:,.:��,;.��I..,.,�.,,�-..,;�.�,,.�,-,..,.;.-.,�-.�`-��!..�,,i�.-,"-�%.14�.-�,2,T..,;-I.�..:��,I�.�"!I.."�,1t,.1"-�,1 1-,,�I 1;,-.,-,4.�7,1'�,t,',,�..-;�I,1�-;.I,0..
.-1,.,o,;-.1�,o?."�o.-�..J,,4.,,,1".,,..z,.1.,...7,j;�,..I�.,:I-.'1k...:,.;...�,1-��I,�—11-.:I-��:,,..�I.
-..:%II:"I-,"'�,�,,i*','...:-,.ii'."��,I/.��.eI..,.I;'�I.�,�.,.-��;4...-,.,.;...I.-1.�,I.,,�-.7-:.,.-,..�-1-a.I.'.1..-`Iw,;�I,,�;.'.-.,,I�i,,,..'",-�:.�..,.;.'-,..Q;,,—,!',7�..1-�-.`e-.-,I.'rI�i,I.,..�.�..,,,
�.�..:-,,",'.;..;.,�I-N�.-,�,..,.,.I�,"II?,,.�;.r�f.,t.—'I I��.,�.It.I:.!:.;.1,1"I-�..�.r.,,II�.�;.,.�".I:�1;q.:..,4.�I-I.j7'..,e...—�.I..,.W!.I....,...,--.-:1..��,.I.���,.���i�&��"�-.1.�k,,.:.I-.�t.,�,;-:"�,,.","�"I1�:".:�.;1.1',.t..I.":,.I.-,.,"I:)..1V,:I.�1"T,.,ie..�,...1.-c'%�,,.—.1.0 I..I,,.-,-.-,.",.;�,0II�I I-.I.�.�.-7 I..,�-,.I..�I�:..7.)�..I:�;;-..�b--,�I-4 1 r—,,�,...',,�;.i!I2..f5 II.,,I.�-.,.r�-,,�I�..,"�._I 1�.�AII 1:.I:-.1.I��A I.�...�..�`1,.I-/i.i��I,,-�.I,I.,,q.�l-.-.I.�"I,.....-:
1,_..5,�,1.�..-I...6 1�"�I�..:-�.
1 - 4 J .E �f@ x-A t r S� 1 -C 1 �...-;4�:- r ly t�^f
t�,I
�.,—I....4,..-�-I I.....II-�I I,II4�.11 I...�;-
�-o�.._,.,,.,.;-II-.:;I'III:.,.,.:,.,,��,4.,2 I-,1.,.,,�-.�"I.�...-,1...'I;T,.�.--�"."':I;..-.i,',9.,�I.)I-�I"..�-�,.1,,.,,I.�I.�,1;...I,�.�..�...,-,.-I��.I
.II'.i.��I.�
..,i I�."�.-.-III.�".I-1.--�,-1.�..I�,..I.I!�-'�,,�.1,,:I.��.,�;,I�,.,..-,�..�1.i,�I�I..-I,,".��w,;
.Ij�",.I.-�.�..:I�I,"I.-ra j."�,-..-�.1�,!..,.I-...,,;,��.-I-I.;:`I�.�,�,,1II.�.�1�*�I.'�I�,:1,.�,�.-..2I�L..1
.�:,�-,..,�.�.,-.�1 I,�:�I.:,-1,;-I-�,',.,I�:�..�I�,��.�.�-�!I,%.��i�I:,,I�.;I'i-,-�I.�,I.,,.I.
:�:."�..I I�.w_,W I
I..�.�.��.I,�/,,��,�..�,1*.,1.:,,-.--...,.-�.,;I.1 1-,�%�..-�-�,.�i.1:.:.I 1.�-,,.:,..,o.",I,.I.;.',.1I.I-..1-�.1.I1'.1I
-,,.�...1..,.,?.�,-1�1.-...-.I.I:,,...I,'�I I I...�...,.-�.-II�"1,�.,,.-i-..;.'��7,zi I�1,.,��I V.i,,II,;-�I"I-,"�.-,I�.�.I�-..�-�t.,.I;.:,1-�,,-.I,I,,�...-:-.���:,,-,-1..-,,..,��,1�:.;I.--,"1��.,�'�.,I.�-.-,I.,.�;,-1�.I;,..1.i�"�4����,�,i,..'...I1I..�,.,I-,,
I�..�,�.,_�'..-,"..�1:.,i,,
I.�-.�.�.,..I.�,f,z.,.��,-�,,1i..1.','�,-t.:;.e1 I
-�,=,,1.,,�-�..�1 f.-.�1�I�,.,1.1 4I;V-,',.,��,..-��q"4i:�;,�".--,..,�-.�P[�...II,l,;,-1'1.".I"I:�..�1-.:.,.I
-.:.��--;�i,,,�.,.;,,,�,���,��I.,I�.�,I.v�."5%,,.1,�.t,�I,I7�.��"-�;;.I"�1,I'�;.,�-,,.--�I,�.'"/;..��1'��,�.-Z-..I"4I,�"'1..��z`�.:i,-;1�
,,�.,,,-,'k 11.,,1.,i".-.I.-1:�'11'.jI,l'�"��,,I,.1.;,�:�t_,,�'--1...:,9.-,-",�.1l..r.:,'j...,��,,;,,�i.,�.,'-.--;.,,,-!.,-1�',,1,�;--1�,�.�-"r,I,t,�.�!..,�I r l�,.,.,--"-�,*.'�'-.,i-:"�-;1�,t,:.,.�-.Y..-i.�-.,.-�
I,.��,�;-,I,-,.Q,�1-1,�-.,�,-i=-�i-;".%-,1��,-.,�.-�V.:
,,,-.�,,'I"��.,���,_-,.".-j��:�,1,,.'�,:,I�"�1-,,�-7,��j�-,,,,-�i,--I.'-_..�,-..-!-;�,..--j,
'�7.�"�..�''.1�.,-,,-
,..',,,.,.�-II�-,;`"..--,1,,..1IiI.I.6',;.-"�-..;1-�.1�'.",i..��,,�-�.*1;Z,A�,.,,�%-..�-:.-,��,I,,.,z.:,.��`,�.1';'0 1'-'.',I�.,,�",.I�,;il�-�..1-�,,-�-..1",l:��.�,�:1
5,1'.;:.Z%-,*,1�'.,�..�.,,.j��.A�-.--"q,.,,�.,.,,..�-.�:.��-�-��.�-.:",.�:,":,.;!�:,�",.I�-!,'.71,'-',,-,-,,,�:',,.�I:,�I..:..;--,i:�t��"_,z'-`�--.3�,�-,�",-j.�i1.�
,��,t�,,,.,�--f,.�'.,1,.�"--,,�,�,.'Q-�,q�'I,',-,.�,:,,(,I.,'-,",.�-�.!e-.,'.,1-?,',�.�:,�'q..j1,,..-e�I,`.�.,��,-�..I��....;,,�,,i',,�--.,-�."-1.,t T"�
-�.,�b�r";�,,,1.�1"-�i,4-.,,-...,�,,,l-�,7-`,����f:1�.�-..,,-�)��-.-V1'.4�,,,1.�,,,�,:--",,,,.,W,",',.--.1'.,.�1,,,,,,�1.4I.,.-1.�,;,,,.-
7�,"-�.��.,t,,".�;..%�I11-�..,,.�:,,;��--�K�II"tN�...-..1.,r���.�
r,...:.x,,,���':1�,-.1 i1_1,1,-i.�--,-;,�.,...;v��,-�,-�,,�",�-,�l,."-Z.4-c...,-�1.:.f,I,"��-,:�4!,�.,�-,-'��,1,�.�'',�,�,',�-
.�,,,11"v�,--,:�_.,'..,,��".':1�,I--,,-1;I-�,,���,,-,.',-',-",j,�,1,�.�-�"-1.P,�-.I 1...--.1,;_"'J"",�,;��--�iI�-��!�.�.�-'.1.Y,'�.xt�".,�-.-i.,-��,.%:,�',u",�'�".��:��.�--.".I:.�11,,-�I�-,-,��;N-�.I',;���.1,?1',f'.�,-,z',I�..��:.,I-",.�.;,,',�--,'�,�i
,t.,:1,.R,�,.,.:.,�:��-.
.,.,.�:::!,I...�4v,,,,�-,�"i,I,�r r..,.jj.,..'��'t"�,-"",'�.".vvt 1'.."�.�-.1,.,.,�-��:,�,,.,.':!'
-,--,��,�t-,11,-,r,1""%;;;;,"!,-��.,,,,.����-�I,1�-,".i;-,.1-,..4�'�,.I,."��,.,,II��1,�.11i.,.tt,4-"-,-�-II-��:-'�`:.�.�-��;-�,;J;,,:�,,--i�..:-..,-.,''"1;-',,�i.;,,-,
,,1�1".,,.X1,....1,.,�:.,�,11,j,-.,,.,�<.-',,I.�-�
n',�,..�"�I.-",1t"-.,�-,I�,-,,�.�i1-�,"i-,."..-.;�-"-.,-I---A,,.Z.,-��,-��.��,;1"-1'.,,��.�-,,�'�r_�!_�..��N-,�:�-,-'f",-�--,�'��-,I Q 1".,�j�,,
G1-I...�,"I`,�:.,,4,,.,�.,,,.,,',.:��-_-.�,�-.A-!,�;�.,:',",I:.1..;-.,;��.�I-.'�".-
.w,,,.:�-,.-,,I,'�,.1;%-",,",-�;i',
-;,.,I,,.1,o.%,.!r,,,�I,�'.�.--
,..,-,-,�:1�.,,4,'�,�,---'�"i-.,.,,,.`..�,��1�,-.,w�,-1-.1--e--.-,-.�,,�,.�-t;7�,I1A,'qI!,,"X,..,�:1,2I.N.,i-
�.�-;;"---�:��.,�-..,----."�,-�p,.-e'.-.,-,.i),;,..I--.,--,,.",:,'i--�,':,'.-,I--.-"'�"-,.,
"I-;,1%...-""1*,I,.,",�,.-I,-";","-,,..�:�.,;OQ.,�-*"4�-,..,;,..Z��.�,.-I;.
"�,-'�-:�;;""�:'.�,,..�,.,-,.,1-.l'.�,!.m,�'I,-�,N",��,�.9,,i,:"1l'�',*.-�.1I.�"-!,3.-�:-i,�".-.�'k.���i."'-.i L1,'"�.'".,-,�-1-l�v,.'.-'-.-�"!,.
v�k--,�,�.1,1.1
o�;".,",,,.'',-.`A�'-,-�;-.l.v,�11��-'
,,..I.,''�-..;I,--.;,�.i��..i'-,.-*.i,�,,.�O II i��."'�..�'.�,,.�,'T�-'-,.
.-.1--,f";�'-..,.,,-,,���1,,,',��.,.�',7-..-_,:J.,���l,1--,..�'"";.�.,"l,,,I,-..-.-,,'�,..I'....*;',,1,!',�*.��--1.-��,f�-.��e,1�'���.R-I'.'1...,,,��oI1."1���'1'�1",�.'I,)-1V1,t1.�4,,-,1"!?..,,"_.,�,,�,.,z�,�I�1t.,..�'.!-.I,�-I!�����-,�,.-".1�-�1..,�56 1�-",�,',1,��I�-,-i,�V
'.?i,-,!.I-,,,�.,..!�4�.�1k�'�-".-��,,�1.,�t,-
.--.fi,1`�-..,'.-4,.,.1","---'1-:�.�?--�D''::,A.--.ir.,-
--:,
.�,�I,,..IIfI"7!.�,.l,1,'--�l
1,�I-I,...,..-r-i,;1�,1�".T w
_,�-�,-I,-.t-".I-,,",1 i"-._..r��4�m,-,..j:
..�,"-1.0,;�,.!�-Q41I 4.l�.I�,I"�-.!��',.-",-
,-,-v--�"7,,1I'4i*"-n,-.s....i,,,,',.;
,,,�,,"_�,,'�,,-i,kI-��-1I'If�4 U,'y"�.�",..o"�I:�K�-1��1 I.,,.A;
T,-,�I''���R,p,��,;.",jI���,��.'�q,.-!;-L%:.II-;.-*4'.i
�.��--L�"
-,`'��-V;-,,N-�"—�,�,;.�',.i�?o'�-��-�
-,,%,1!--,,,,..,.;1'-,i..�.,�'�.,K,--,��.','ii;,�1L-1I���'..,".,,,.".-,,�A 1Ai,,.
',"�"�''."�,-
Ii,��,,�"'��--)'`Ci��".-w.
,1--.,-1-,-,.,LJ�---;,
N,1�.;"ii,�"*"1,,,--.-�,�",,I,1.j,��'.J
,<�-,:;t��,,.;-�,.�;,1&o---',;1i1�,4..
,,.,,-,,I,1
-R,...,n�..----,,,�O",-144,-:.�'R-,,.11;0��
�I,��..I_I,-.��..�kc1-.-,,:"-1-��:�-"1r-I.�I�,.--;�,,�,�;�I�-
�,4�,I-1�."
�,�,v"-�-,,�,�.,.*.-
,,--...
-,-",�w1,I'",;,�",-T----.-�,1',3`,",-",11-�-'1I,,�.4-.1..,,-�,-1,:::v
,,I.,�-,�/S1,.-,S..4--I-,,--,��,1���,,,-X,*"-"�-...,.,.,�"�.�-.J-�,�
1-.,.4,O-'4-i�,.'.�Z.
��''-'.,;
�",1,�l,��-
.:,-�-yF"!P I"-,"�,�j-.j,�-
.�-;.--4-"-.
-'!�.Y,r.�4,zi�+�"'"�-rl I",;:,-�,,,.-I""!!
.;�1,,�,&_41��;-1",,r,..��,����-,"s 1,-,,:�.;'l"V;,;111'l�:�,o
-,I�-;,.;��.',,
",.�,
,,".",,1A`-.,,.'.1'
sPj�,',,
j�i-.%,�l;-��.,-.4,
�-s1....,-,,",��,',p.i,
"1'�P�1",I,
-1`�;e,-
It-
-,
x f. r.. ,v 7yg e eye"-7
1 - t ' ,Y 4r '- s *`5 Yh� ',{' air R>b
k _ i +r + s i 7S q"rgiu ,7 3 .i 5:' 1 x sly
..t '.:r�::..�.I�4�,,.,,'1";...,I�-..,..,..!)�1,,I'..,.�..I,.-,..,'I 1;,II..=..,l-;,.../,I.��,-!.I.,--.�.,I.,--.,I%...,-.I..�"-�.I.,�..�-I�;-..0�I."---�.VI.��:i.,.,..I��I�.4 I..�I.�I9...�-.�..ImII 1 1"1�.:-m.I,,".�..6..,:.i,.�,��I 1-&,-.�r-1%1 I,II!:10..j�I-...;:I I",,.,I...,�1.�"1"[-j=00�I.-,IC.I*-AI..7o I.,.�.W..�.�.�I—1...4 I—I 1 1e-�—!.I I-.,:,,1�-:,-1�-�....'..1---`�7�-,0,I�U,I.I,,I.I1,.�rmI-...1:1-I�.l.,.,t,�.-..---�.-.I-..*.".F:!I 1-I.�.�;I.*..I.1=-1 5.�o.1�,..-,..-�:..oI4-.1�W.1-,-*���-/I,.=I',1.r,��I�,7".I:��I�.�,—.I�.II.—�.��I-�I,1�7��,I.-,-..1,.,��&.-.I-�",)-I.7..,-.,I.�I III_,�:-,-.�I C..I.1.-�"-:4 2..-�1,....-.l.II-_''w.�..�-1"-..�-g,�i.�1;I1 Ii.I.'I.I�Z�t�IC II,:-.I.�-��,..-AI.;.�:.��_I`��7:-�,-.;,I�-;e�--I A-.!I 7--�_I.,Ii�.:�,1.II Ig.�.e.....I�.:!1�,.r1.n,..a�,A.-...O
1 ��, '_.�_ j .., ."t -'.# to #gr i,.`ariifi^�F
4 _ t �.�...-.'��.,I.-���.1P.�,-�.:d,,-1��,.7 a...:,�,�,,*;�:1:,,.:.."I:III)I I 1��.—1..�..,,.�,,I,� .�� .t a ti i t , i , t A V c�)y, -x ry N- i0.'-T
i '�' .(' k �.,
--..1..Z��,�tI 7�.I,,-��..I.�,,..;I�.�.')C.j I.,...-'.I,5:,A.�I�.-'I,.I-,I�,.�.�.I l-I..,Iv—/5.,.-��;�,�...I:1;.�!A.1�W..-,,I 1/�:I 1.I:-�.I�.,.i/..�,,..S,-�.�;�.*I,.1�:.I-,I--�-I.�-.�f:1...�_=,,I,.1�-.�fi,1...,,��7".II,-.�XI.,;...�.I.4�1 1'.:..:I1.I-,�.-I�,.�.,II2..Ie.1-—1'I..!:O I..1"-.�.../�..-:.��III.I.I�C..1,�.,,�I e�..,I.1�.���.�,"-,-m I�1,II.III.-j,-.Ii,mII.Z.'L 7,.—.-.�..-I..��,0��.."��.1,!I I.�.I I-4I.I1 I��..1,.I7.,�...,-.-";,�I I6 II,-.r>I.4�.".I IE.C....,.��,/I.�".I,1,.;-,I.!�.�i=,-�,,-.1,�-.;.-.I1I':,_I,.1,-..�:_�:.�.7 I.,�'-�:,,I��I,.t.0:-o.-.I�-,..--.&I,I.�II..-i.-.�.�-I�...-.1:�.,.,�.��.I,-.��.�,i.�.1��.�-\?I I�;I I.-�..,I.0�..I....�—,,.,�..,I��I.,,,-'�,�I;,-I,r,..,.-.I�?I1 I��I I,:.,I.I.1,I.�.,,I�I�I�.t2I.�;I/%.�:.-I�.I-..,-:;..,�,��..—I.,.1..91.j I..!rI.,.;I e-1�;,E I1.�,.%�'�-�:.�.,tI-�.I�.I.,-:,�--,:,-,-1...-�,�-I,�IIz.,..-.,i".�,�;7 w�e I,I-:.-.,..I."I..I 1��"-Ai 1.I.I1.I I-I I I%1-�;�,,-..—1 FI�,�]1,I.-l:.1�41�I,-I,,.I��-.II,:I—�,1t!''�1�,,I a..2"�I�/1,1....,
,,I I.��..�,II�.,,:I..I,�-�.IIq.�-.�1.I:......I.��..,-I.,,,".-,,/..".I.,.f II,�;I-I."I.m�1.5�.,-.I..�.f1�:I--I,-I.51 e�.1�I;.I I.:1.:l,..,.0.I�.-..1":5�,.I1,I II I-�1;1,.I.�...-..I�.�I,1I5�.'�,.I..-1'i I�-�.-I,.�.-.I,.!.I 2 I.,'�,
d ; O
,--,.,�.e,"I�,I,.-,,.e,A",4.-�;..-L
..",;;�;,��,��,
l..
- - it I ? [_ tX 1 S t 1� 1 i-, n{ Jft x
is I^ \ + 3 t ir: z4L {d,�r , r .��5.. �-tj,�,'",
,r
A:
1. tia, I 6..eV I," #a' YrS lEfx�tUi"�-Ii " g,
...�--
�-,,�
Ii
,
,"I-,��.,-
i I
.\ J _ +fah Y ifi 4 � ; 3 i4 -t
r r: 2 { i k[
1
t 9 I LF�d t xs ` rX t t *. , a 1
'j .1�
O I T S d 5 to ,,3.
' N 1 1 f 5$ r z
= fi 1 .
} IRI � Y ra 4s..
t:
F i 4s
/ r r <
. j { ' I r ^ ._7 ( '}, 1 fyr;% 6 i.Y td'Aft..i' .,." }�y",
ly t ? 7 i „-- I. 1
1 ft
s I i,.)' z a r n f Y t a c s i ail.i " ,t,,.-
a 1 4 '' si d i >X'x ,.y }i i i'iy..
_ t w. i ti,# 1 i k .
} t a , iv .. 1 rX e .. ii
J f Y 5-,8 . 'v. ) ) ,` f, .-R[ tr., r ,i -, ati 10. - ,.Fr,..27)a{ .l r Sl[[
g .. * r' 7 t
A ( pj
t�,
b
�1,-��9Ii
4 } * ;a t P-
�/ QA7F-+" � 6'as _..B"— :�06�v ®' ti'/ r, k r 'i' ni.Y r,r'`. ,39 :
��,"1�,�
O
�.�-t�.�1,�
-'--�zf-
y y
!�,'.�
7�.Z`!�I �—I I. �I�.'2I I
S -a *L, �° a_:_ fir- 2p.' �e t7 0 a O x, _ /��Q. C�TvI s t >�/a��- — 'ih-A y t
4-1.�i..,%�1',.o1��...�,1,,,.,�.-!-,-II�.i�I,%..�1 i!-Z%���1,.,z I-1,,,..;.
iS �� Pr� i {. `` , .' `J ,.. /!'- r, y i�j, '�.0 Sr H $� y 'j t[.. y
"�,
1 1 :') p .; 1 .r 4 .. �.. w. ti "a, yt Sy.'X ,, h :-., t6/./ I�✓.' �.AiGl'�.(/.i"7x�,F �y�.
I.�t�� —Jz,,l-.9�. �.. ..,w =7 C.� :_6���F6�"'„e'._.?'.a a{i -$gyp4� '�",-7 Yi+ "# s.
k{,+-.,.s_ v'.. :s.._.L-....+.n ` i� 4 �r :i[r J',t!#r '{.c }rho :"'' .'1},, -..,Mt't)f�[ �8� '"`"
F a 2 i , .. a ti i,.. .a t .:,<'.. ,:. , i r 'S r� {)4£ 4 4 t^r+,` 1 [* t i' 4r 1„ i "4.', �.Ax',�
�' :Gd®'C'.' sT- "CE. '7/=1•' 74igT, T,LI� �C!/LA/.VG I --, t4!"r r t #� , yy,3 i� ear
"'1 °.» q t a >r S t m ;$ r2 >,!' .as},at It iS
Adc3Aa✓g✓ ^OIV �N/-5 ,AP4sQA✓ / L0C9,TL�. d/L✓...T�✓_ ` Y d1' Jr k rit�S �S
J 'r7GYA/E� R9.� 1'�idC►d1//1d f�@ E�O16L✓:' e4A./17' , 7'"oll IT /T';'; ' „�F b , -' ' �!! a r
�! a y N
,; a17 C0A./Ic'O.-wA,O` Pl ' TN �►.C.//A✓ ..r xf�r t, * r j "
p., ..., gg
C �J
j'� YY
.0 � QI0 - t
Wn.. .coo coop eP7 //'7CC�/P'7 z " #f2� � , 1- - y;`n_.�, ` � . a
4 O 9 _ - j% yew', ,y1o1 ,i+iir4a� v.,4� " k1f
C/VI,(- LF"a/AL/eee's A , ,
a r;C�&;* �4^^*v-n,e --fOC/T<-1, ".QS5. e- �C i?ta. .9cJ.�'v+��Z ri `�' k,: ,�:
r.
4r,
T.O.F. EL.= 64.2'± INISH GRADE OVER D-BOX= 58.6'± 4"SCHEDULE 40 PVC MIN. SLOPE 1 % PROPOSED 4" PVC VENT FINISHED GRADE OVER BIODIFFUSERS= 57.2' - 59.0' GENERAL NOTES
f PROVIDE EXTENSION RISER SLOPE @ 2% MIN.
1
WITH COVER OVER INLET REMOVABLE WATER-TIGHT COVER OVER INSPECTION PORT WITH . UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
OUTLET WITHIN 6"OF F.G. RISER TO WITHIN 6"OF FINISHED GRADE ACCESS BOX TO WITHIN METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
FINISH GRADE F.G. OVER TANK EL. = 5$.4'± 3"OF F.G. (ONE PER ROW) CODE AND ANY APPLICABLE LOCAL RULES.
@ FND. EL.= 60.0,± 5" DIA. OUTLET(S)
2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
DESIGN ENGINEER.
PROPOSED 4" 9 MIN. SEE NOTE 21
36" MAX. 48"MAX. TOP OF SAS/B.O. = 55.00' 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
EXISTING 4"
-�- ---- PVC SEWER PIPE SYSTEM UNLESS OTHERWISE NOTED.
SEWER PIPE \ 1 __ __
_ � i
6" 3" 3" DROP MAX 3" 9" LL L - 33'± PROVIDE WATERTIGHT4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
2" DROP MIN MIN.SLOPE @1% JOINTS(TYP.) ELEVATION =55.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
10" \ 4" PVC IN FROM 1.33' TA1_11
„ 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF
14" * ,$'± SEPTIC TANK 4"PVC OUT TO (TYP.) 10.75"(TYP) I THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
CONTRACTOR TO PROVIDE 56 • 0 90
LEACHING FACILITY + 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
SPECIFIED DROP BETWEEN "
INLET AND OUTLET CONTRACTOR CONTRACTOR SHALL OUTLET TEE 55.17' MIN. 6 55.00' 54.57' �- 53.67' (laid flat) 2.875'(34.5") 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
SHALL VERIFY SIZE 48" VERIFY CONDITION OF (TYP.) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
AND CONDITION OF EXISTING TEES GAS BAFFLE 5 0' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
6"CRUSHED STONE (TYP.) 5'MIN. 14.375'
EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
TANK NECESSARY COMPACTED BASE REQ'D
20.0' AND DESIGN ENGINEER.
5 OUTLET DISTRIBUTION BOX (TYP.) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 60.00' ESTABLISHED
- -- ---- -------- TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV= < 47.00' BIODIFFUSERS (END VIEW) ON THE CORNER OF AN EXISTING BULK-HEAD AS SHOWN ON PLAN.
-- -- --- ---- BASE. FIRST TWO FEET OF OUTLET 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
EXISTING 1 ,000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. BIODIFFUSERS (PROFILE) THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
(BY ADVANCED DRAINAGE SYSTEMS, INC.) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
CROSS SECTION VIEW TO THE DESIGN ENGINEER.
`CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL ARC 36HC (#3616BD) BIODIFFUSERS (H-20) 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
TO ANY WORK & NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE
11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
�� -- TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM
( ' • f `�` PERC NO. 13269 APPROPRIATE AUTHORITY.
INSPECTOR: Donald Desmarais 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS
e EVALUATOR: Michael Pimentel, E.I.T. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
C.S.E. APPROVAL DATE: Oct. 1999
13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
- '` ZONE 2 ,�/ �3 , DATE: May 9, 2011
- TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
�, ,� El` '• �� l MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
ELEV TOP = 57.00' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
ELEV WATER= <47.00' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
E �- .� r o PERC RATE _ <2 min./inch
ll } SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
0 LOCUS `r r
c> I ��r = 30" 48"
L6 �� �, DEPTH OF PERC - 16. PROPOSED PROJECT IS LOCATED WITHIN:
N TEXTURAL CLASS: 1 ASSESSOR'S MAP 122 PARCEL 64
- M %� } ) i z" OWNER OF RECORD: STEPHEN &PATRICIA CINCOTTA
a �� ("� ----- --- _ - -- --- ADDRESS: 250 WALTHAM STREET
I 0" WEST NEWTON, MA 02465
p v \M `� " Litter 56.67'
MAP 122 Jf '� I 4" Fill
62'' \ l r 1 �� g 56.33'
PARCEL 63 �X�XE C �� �1 Loamy Sand FEMA FLOOD ZONE C
'� ;'2 10Yr 3/1 56.00' COMMUNITY PANEL# 250001 0015 C
5029,52�1 g Loamy Sand 17. DEED REFERENCE: L.C.C. #103127
STONE DRIVE / s r
i
S7 5932. ��� \ w -�,� \ r - � \ " 10Yr 5/8 18. PLAN REFERENCE: L.C. PLAN 32225-B
1 TELE •..."
_... \, 30 ...�_. 54.50
PROPOSED 4" PVC VENT PIPE; J i -f
EXACT LOCATION PER OWNER 1 9 Perc 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
N • • Z
r •
E 's \ : , ! /� 48" 53.00' 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
G ��! _ • } •��'�.- ` • \\� FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
el FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
MAP 122 i z ~ � t° O -' e ' -- C Medium Sand
36� CAS w---" O 2.5Y 6/6\��� ~ 21. IN ACCORDANCE WITH 310 CMR 15.401 -15.405, THE FOLLOWING LOCAL UPGRADE
PARCEL 54 No CA) x -w �, Q �� APPROVAL IS REQUESTED FROM 310 CMR 15.221 (7):
0 o J N-A _ I \ 0 (n (loose) (1.) A 1.0'WAIVER(3.0-4.0') FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM.
--58 - ROP. O #37 <
�. D-BOX \ ` EXISTING I �0 �- LOCUS PLAN / _ 3�,-
1 236 TP 1 2-BEDROOM Q 1. (I
57xo' \ / DWELLING I (P SCALE: 1"= 1000' 120" 4700' t
LP 3131 -- TOF = 64.2'+ \ . V
PROPOSED INSPECTION PORT
"0 ' O o N ; 7, No Mottling, Weeping or Standing Observed
WITH ACCESS BOX(TYP OF 5) �
55x4 53 DESIGN DATA TEST PIT DATA LEGEND
\ s -PROP. TOTAL 20 ARC 36HC (#3616BD) ❑iHiw\ ❑/Hiw PERC NO. 13269
BIODIFFUSERS H-20 GUYWIRE IN A FIELD CONFIGURATION N I-- INSPECTOR: Donald Desmarais P.#t 3 50x0 EXISTING SPOT GRADE
E.I.T. - 50 -- - - EXISTING CONTOUR
EVALUATOR: Michael Pimentel, - -
EXISTING LEACHING PIT (approx. loc.) TO BE PUMPED,54x4' --� � � � NUMBER OF BEDROOMS (DESIGN) 3 (MIN. PER TITLE 5)
C.S.E.APPROVAL DATE- Oct. 1999 50 PROPOSED CONTOUR
FILLED WITH CLEAN COARSE SAND & ABANDONED \ TREELINE (TYP.) - 1 \ DESIGN FLOW 110 GAUDAY/BEDROOM May:
9
SF�. \ TOTAL DESIGN FLOW 330 GAUDAY DATE , 2011 2 ❑/H/W EXISTING OVERHEAD UTILITIES
EXISTING D-BOX TO BE ABANDONED 54x7' TEST PI_
DESIGN FLOW X 200 % = 660 GAUDAY TELE EXISTING TELEPHONE LINE
MAP 122
EXISTING 1,000 GALLON SEPTIC TANK ELEV TOP= 57.00'
TO BE UTILIZED IN THIS DESIGN PARCEL 64 USE EXISTING 1,000 GALLON SEPTIC TANK ELEV WATER= <47.00' _W W- EXISTING WATER LINE
2 16,625 S.F.± Benchmark PERC RATE _
B.H. Comer GAS - EXISTING GAS LINE
Elev. =60.00' DEPTH OF PERC=
MAP 122 Approx. M.S.L. INSTALL 20 - ARC 36HC (#3616BD) BIODIFFUSERS (H-20) TEXTURAL CLASS: 1 TEST PIT LOCATION
PARCEL 53
MAP 122 SWING-TIES SCALE: 1"=20' SYSTEM CAPACITY \ \l EXISTING 1,000 GALLON SEPTIC TANK
PARCEL 65 DESCRIPTION
HCA HC-2 (TOTAL L.F. OF BIOS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)=GPD 0" 57.00' I ll
(100.0')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 355.2 GAL. LEACHING/DAY 4" Fill Litter 56.67'
A/E
8" 56.33 [3 PROPOSED DISTRIBUTION BOX
PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE
BIODIFFUSER CORNER(1) 36.1' 55.3'
BIODIFFUSER CORNER(2) 45.7' 52.5' TOTALS: Loamy Sand 10Yr 3/1
TOTAL NUMBER OF BIODIFFUSERS: 20 12" 56.00'
Q PROPOSED ARC 36HC(#3616BD) BIODIFFUSER(H-20)
MAP 122 BIODIFFUSER CORNER(3) 60.7' 72.5' TOTAL NUMBER OF COUPLINGS: 0
g Loamy Sand
PARCEL 52 BIODIFFUSER CORNER(4) 53.9' 74.5' TOTAL LEACHING AREA: 480.0 10Yr 5/8
- ------ TOTAL LEACHING CAPACITY: 355.2 REV. DATE BY APP'D.
30" 54.50' DESCRIPTION
PROPOSED SEPTIC SYSTEM UPGRADE
NOTE:
PREPARED FOR:
EFFECTIVE LEACHING AREA OF 4.80 SF[LF OBTAINED FROM THE CAPEWIDE ENTERPRISES
DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER
(4 "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO ADVANCED C Medium Sand
HC-1 DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003 (LAST MODIFIED (loosee)) LOCATED AT
t, JANUARY 11, 2011). TRANSMITTAL NUMBER=W000052. (loose)
1) 37 SETH GOODSPEED'S WAY
a #37 OSTERVILLE, MA
0 EXISTING
NOTES: (3 2p0, 2-BEDROOM SCALE: 1 INCH = 20 FT. DATE: MAY 13, 2011
DWELLING 120" 47.00' 0 10 20 40 80 FEET
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF EACH SEPTIC 2) TOF - 64.2'± No Mottling, Weeping or Standing Observed �a , MA��c
SYSTEM COMPONENT. - RESERVED FOR BOARD �H ,F
2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE PROPOSED yu, PREPARED OF HEALTH USE " CHUF:'11LL m JC ENGINEERING, INC.
LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN.
He-2 N �" 2854 CRANBERRY HIGHWAY
REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH
TEST PIT DATA. EAST WAREHAM, MA 02538
3.) ENTIRE PROPERTY IS LOCATED WITHIN THE GROUNDWATER PROTECTION OVERLAY SITE PLAN 508.273.0377
DISTRICT AND THE ESTUARINE WATERSHED. SCALE: 1" =20' Drawn By: MCP Designed By:MCP Checked By: JLC JOB No.1988