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Home My WebLink About0151 STURBRIDGE DRIVE - Health i p 451 Sturbridge'Drive , Osterville rn A= 166 014, { o Commonwealth of Massachusetts - Title 5 Official inspection Form t Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 151 Sturbridge Drive, Osterville Property Address Brian F Turner Owner Owner's Name information is 151 Sturbridge Drive CisterviAe MA 02655 7/18/19 required for every 9 page- CltyTown state - Zip Code Date of-Inspection Inspection results must be submitted on this fonn. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the:form. Important:When A. Inspector Information filling ouCforms p 12Q�p Information- on the computer, Jorge Miguel D / QQ use onlythe.tab: 9 .g Chavez key to move your Name of Inspector cursor-do not Speakman Excavating LLC use the return key. Company Name 15 Speak Way ill Company Address Harwich MA - 02645 CitylTown state Zip Code 608432-5565 S114294 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000), I have personally inspected the sewage disposal system at the property address listed above;the information-reported below is true;accurate and complete as of the time of my inspection;and the inspection was performed based on my training:and experience imthe proper function and maintenance of on-site'sewage disposal systems.. After conducting this inspection I have determined that the system: 1. ® Passes 2. 0 Conditionally Passes t 3. ❑ Needs Further:Evaluation by the Local Approving.Authority - 4. E Fails Inspe or's Signature ,. Date The system inspector shall submit a copy of this inspection report to the Approving.Authority(Board of Health or.DEP)within 30 days of completing this inspection: If the.system has a design flow of 10,000 gpd or greater; the.inspector and the system owner shall submitthe report tothe appropriate regional office of the.DEP..The.original form should be sent to the system:owner and copies sent to the.buyer, if applicable,and.the approving authority. Please note:This report only describes conditions at the time of inspection and under the conditions of use at that time.This Inspection does not address how the system will perform In the future under the same or different conditions of use'. . t5insp-doc•rev.7/26/2018 Title 5 Official inspection Form:-Subsurface Sewage Disposal:System+Paget of 18 . e a Commonwealth of Massachusetts r F Title 5 Official Inspection Form 11 Subsurface Sewage Disposal System Form Not for Voluntary Assessments 151 Sturbrid a Drive, Osterville 9 Property Address Brian F Turner Owner Owners Name information is required for every 151 Sturbridge Drive, Osterville MA 02655 7/18/19 page. Citylrown state Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3; or 5 and all of 4 and.6. 1) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310.CMR:15.30.3 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: f 2) System Conditionally Passes: ❑ One;or more system components as described in the"Conditional Pass"section need to be r replaced orrepaired.The system, upon completion of the replacement or repair, as approved by the Board of.Health,will pass. Check the box for"yes","no"or"not determined"(Y, N, ND):for the following statements. if"not determined,"please explain. The septic tank is metal.and over`20 years old*or the septic tank(whether metal or not)'is structurally Unsound,exhibits substantial infiltration or exflltration 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 soundi not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5insp.doc-rev-MUM 8 Title 5 Officid Inspection Form;Subsurface Sewage Disposai System•Page 2 of 18 r , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 ' 151 Sturbridge Drive, Osterville , Property Address "' Brian F Turner Owner Owner's Flame information.is � required for every 151 Sturbridge Drive,Osterville MA 02655 7/18/19 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System conditionally Passes(cunt.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired.. ❑ Observation ofsewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or to_a broken, settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): El distribution box is leveled or replaced ❑ Y ❑ N. ❑ ND(Explain below): The system required pumping more than 4.times a year due to broken or obstructed pipe(s).The system will pass inspection.if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND:(Explain below): ❑ obstruction is removed ❑ Y [] N 'O.ND(Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine.if the system is failing to protect public health, safety or the environment. a. System will pass unless Board.of Health determines in accordance.with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,, safety and the environment: t5insp.doc•rev.712612018 Tide 5 Official Inspection Form;Subsurface SMMv S Disposal'System•PaIe3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage.Disposal System Form-.Not for Voluntary.Assessments 151 Sturbridge Drive, Osterville Property Address Brian F Turner Owner Owner's Name information isw required for every 151 Sturbridge Drive, Osterville MA 02655 7/18/19 page. Cityfrown State Zip Code Date of.h5pedion C. Inspection Summary (cont.) C] Cesspool or privy is within 50 feet of a surface.water , Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fall 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, Saf ety sty and environment: „ ❑ The system has a septic tank and.soil absorption system(SAS)and the SASI is within 100 feet of a surface water supply or tributary'to a surface water RP Y supply. I". E] The system has a septic tank and SAS:and the SAS is withina Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a:private.water supply well. ❑ The system has a septic tank and SAS and the SAS is less than-100 feet but 50 feet or more from a private water supply well*.*. Method used to determine.distance: *"This system passes if the well water analysis, performed at a DERcertified laboratory, for fecal coliform bacteria indicates absent and,the'presence of ammonia nitro nitrate nitrogen is equal to or less than 5 ppm, provided.that no other failure,criteria are:triggered,A copy of the analysis must be attached to this form. c. Other: ; 's 4) System Failure Criteria.Applicable to All Systems: Youbust.indicate"Yes"or"No"to each.ofthe 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 , tSinsp.doc•rev.7M2018 Title 5 Offiiciallnspec ti.on Fotm:�Subsuitace Sewage Disposal System•Page 4 of 18 t Commonwealth of Massachusetts #:, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary.Assessments 161 Sturbridge Drive, Osterville Property Address Brian.F Turner Owner Owner's Name information is 151=Sturbridg a Drive, Osterville MA 02655 7/18/19 required for every page. Cityrrown state Zip Code Date of Inspection C. Inspection Summary (cont.) , 4) System Failure,Criteria Applicable to All Systems:(cont.) Yes No ❑ ® Static liquid level in the.distribution box above outlet invert due to an overloaded or clogged SAS or cesspool 0 ® 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. ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ Any portion of a cesspool or privy.'iswithin:50 feet of a private water supply well: 0 0 Any portion of a cesspool or privy is less than 100 feet.but greater than 50 feet ° from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.) ❑ ® The system is a cesspool serving a,facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails.l have determined that one or more of the above failure. criteria exist as described in 3.10 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. 5) Large Systems: To be considered a-large system the system:must.serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the. questions in Section CA. Yes No ❑, the system is within 400 feet of a surface drinking:water supply, the system is within 200 feet of a tributary to a surface drinking water supply ❑ the system is located in..a nitrogen sensitive area(Interim Wellhead.Protection. Area-IWPA)or a mapped Zone ll of a public water supply well t5insp.doc.rev..7126/2018 Title 5 Official Inspection rc rm;subs Zce Semge Disposal System•.page 6 gf 18 f 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form-.Not for Voluntary Assessments 161 Sturbridge Drive, Osterville Property Address ` Brian F Turner Owner Owner's Name ` information ie g . required for every 151 Sturbridge Drive,Osterville MA 02655 7/18/19 page. Cityrrown state Zip Code Date of Inspection C. Inspection Summary (cont.) If you have,answered"yes"to any question in Section C.5 the system is considered.a significant threat, or answered"yes"to any question in Section CA above the large.system has failed.The owner or operator of any large system considered a significant threat under SectionC.8 or failed under Section CA shall upgrade the system in accordance with 310;CMR.15.304. The system owner should contact the appropriate regional of ice.of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections:. Yes No El ® Pumping information was provided by the owner,occupant, or Board of Health El ® Were any the system components pumped.out in the previous two:weeks? ® ❑ Has the system received normal flows in previous two week period? 0 ® Have large volumes of water been introduced to the system recently oras part of this inspection? ® ❑ Were as built plans ofthe system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located onsite? ® ❑ Were the.septic tank manholes uncovered, opened, and the.interior of thetank 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 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 G is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] t5insp.doc•rev.7/26=18 TlUe 5 Offreial inspection Form:Subsurfsae Sewage Oisposel System Page 6 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form Not for Voluntary Assessments I 151 Sturbridge Drive, Osterville Property Address Brian F Turner Owner Owner's Name ` information is required for every151 Sturbridg a Drive, Osterville MA 02655' 7/18/19. page. City[Town State Zip.Code Date of Inspection D. System Information 3 1. Residential Flow Conditions: Number of bedrooms(design):. 4 Number of bedrooms(actual): 3 DESIGN flow based on 31.0.CMR 15.203(for example: 110 gpd x#of.bedrooms): 509 Description: a Number of current residents: 1_ ' Does residence have a.garbage grinder? 'El Yes ® No Does residence have a water treatment unit? ❑ Yes ® :No If yes,discharges to: Is laundry on a separate:sewage system?.(Include laundry:system.inspection information in.this report.) ❑ Yes 0 No. Laundry system inspected? ❑ Yes ❑ No. Seasonal use? - ❑ .Yes No Water meter readings, if available(last 2 yearn usage(gpd)):' Detail: 2017:23,000 " ,2018: 15;000 Sump pump? ❑ Yes ® No Lastf date of occupancy: Current t Date tSlnsp.tloc•rev..712fi2018 Title 5 Official Inspection Form:Subsurface Sevrage Disposal system•Page of IS o Commonwealth of Massachusetts' _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form.-Not for Voluntary Assessments 151 Sturbridge Drive,.Osterville Property Address Brian F Turner Owner Owner's Name information is 151 Sturbridge Drive Osterville MA 02655 7/18/19 required for every g } page, CitylTown state: Zip Code�Y Date of Inspection D. System Information (cont.) 2. Commerciallindustrial Flow Conditions: Type of Establishment: Design flow(based on 31'O.CMR 15.203): Gallons per day(gpd) Basis of design flow',(seats/persons/sq.ft., etc.): Grease trap present? _ ❑; Yes ❑ No Water treatment unit present? ❑` Yes ❑ No If yes, discharges to: " Industrial waste holding tank present? ❑ Yes [] ,No Non-sanitary waste discharged to the Title 5 system? 0, Yes ❑ No Water meter readings;if available: Last date of occupancy/use: r safe Other(describe below): 3. Pumping Records: . Source of information: Was system pumped as part of the inspection? ❑ Yes 0 No If yes, volume pumped; f`gallons Now was quantity pumped determined? f Reason for pumping: t5insp.doc.rev:7/26/2018 Tide 5 Official inspection Form:Subsurface Sewage Disposal system.•Page 8 of 18 " Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 151 Sturbridge Drive, Osterville Property Address Brian F Turner Owner Owner's NameInfo _required is 151 Sturbridge. Osterville :MA 02655 .7118/19. required for every 9 _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: F Septic tank,distribution box, soil absorption system 0 Single cesspool El Overflow cesspool El Privy ❑ Shared system(yes or no) (if yes,attach.previous inspection records, if any) Innovative/Alternative technology.Attach a,copy of the current operation.and maintenance contract(to be obtained from system owner),.and 1.a copy of.laItest inspection of the.1/A system.by system operator under,contract 1 Tight tank.,Attach:a copy of the DEP approval. Other(describe): . Approximate age of all components,date installed(if known)and.source of information:. 10/6/06>per COC Were sewage odors detected when.arriving at the site? ❑ Yes ® No 5. Building Sewer(locate:on site plan): Depth below grade: Under slab feet Material of construction.- El cast iron ®40 PVC E other(explain): Distance from private water supply well or suction line. '10'+. , feet Comments.(on condition of joints,venting,evidence of leakage;.etc.): .s Building sewer under slab for what can be seeing in good condition I t5lnsp.doc•rev.7W2D1B Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9.of.18 f ,M Commonwealth of Massachusetts Tithe 5 OfficialInspection Form- Subsurface Sewage Disposal.System Form-Not.for Voluntary Assessments 151 Sturbridge Drive; Osterville Property Address Brian F Turner Owner Owners Name information required for every 151 Sturbridge Drive,Osterville MA -02655 7/18/19 --_— , page. City/Town State Zip Code. Date of Inspection D.'System Information (cont.), , 6. Septic Tank(locate on site plan): 4" Depth below,grade: - feet Material of construction: ' Z concrete E metal ❑fiberglass El;polyethylene other(explain) If tank is metal,list age: years: Is age confirmed by a Certificate of.Compliande?(attach,a.copy of certificate) ❑ Yes ❑ No Dimensions: ` 1500 gal Sludge depth: 411 Distance from top of sludge to bottom of outlet tee or baffle 30/ Scrim 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 13" How were dimensions determined? Measured'+! ` Comments(on pumping recommendations, inlet.and.outlet tee or baffle.condition; structural integrity, liquid-levels as related to outlet invert, evidence of leakage,.etc): Tank is in good condition, PVC:tee on inletand outlet in place„no.evidence of leakage. t5lnw,doc•rev.7126MI8 Tille 5 Official InspectionToim:Subsurface Sewage Disposal System•Page 10.of 18' F Commonwealth of Massachusetts Title 5 Official - Inspection Form Subsurface Sewage Disposal System"Form-Not for Voluntary Assessments 151 Sturbridge Drive,Osterville Property Address Brian F Turner Owner Owner's Name information is required for every 151 Sturbridge Drive, Osterville MA 0265.5 7/18/19 page. City(rown State Zip Code. Date of Inspection. D. System Information.(cont.) 7. Grease Trap(locate on site plan) Depth below grade: - feet Material:of construction: . C]concrete E metal D 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:): 8. Tight or Holding Tank(tank must be pumped at time of inspection)_(locate on site plan): Depth below grade: Material of construction: ❑concrete Q metal ❑fiberglass polyethylene [I other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day, " t5insp.doc•rev.7/2612018 rtle 5 official Inspection Form:Subsurface Sewage Disposal System-Page'11 of 1s Commonwealth of Massachusetts Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form-.Not for Voluntary Assessments 151 Sturbridge Drive;Osterville Property Address Brian F Turner Owner Owner's Name information is required for every 151 Sturbridge a Drive, Osterville MA 02655. 7/18/19 _ page. C1tyfrown state Zip Code Date of Inspection D. System Information (cont.) 8. Tight.orHolding Tank(cont.) , Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Dater Comments(condition of alarm and float switches,etc.) *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution,Box(if..present must be opened) (locate on site plan) Depth of liquid level above outlet invert 0 11 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.): Dbox in good condition,water tight,no solids carryover or vegetation; 1 outlet. { i Mnsp.doc•rev.7/28/2018 Title 5 OfficW hispection Form:Subsurface Sewage Disposal System•Page 12 of 18 e . a t�\ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Aisessments 151 Sturbridge Drive, Osterville Property Address Brian F Turner Owner Owner's Name information required for every 151 Sturbridge Drive, Osterville MA 02655 7/18/19 page_ City[Town State Zip Code Date of.Inspection D. System Information (cont,) 1.0. Pump Chamber(locate on site plan): Pumps in working.order. ❑ Yes '❑ No* Alarms in working.order: ❑ Yes ❑ No" Comments(note condition of.pump chamber, condition of pumps:and appurtenances, etc.) a "If,pumps or alarms.are not in working order, system is a conditional pass. 11. Soil.Absorption System(SAS) (locate on site plan,excavation not required): If SAS not located, explain why: Type. M leaching pits number: leaching chambers. number.: (5).3050 infiltrators ❑ leaching galleries number; leaching trenches number, length: El leaching fields number d'i men sions; El overflow cesspool number: innovative/alternative system Type/name of technology: t5insp.doc rev,7/262018 Title 5 Official Inspection Form Subsurface Sewage Disposal system Page 13 of 18 ` Commonwealth of Massachusetts Title 5 Official Inspection Form y Subsurface Sewage.Disposal System Form-Not for Voluntary Assessments 151 Sturbridge Drive, Osterville Property Address Brian F Turner Owner Owner's Name information is required for every 151 SturbridgeDrive, Osterville MA 02655 7/18/19 page. Cityrrown State Zip Code Date of Inspection D. System information (cont.) 11: Soil Absorption System(SAS) (cont.) ` Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): Inspection;port on chamber shows bottom ofaeaching to be dry no evidence of ponding or hydraulic failure. t 12. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth-'top of liquid to inlet invert Depth of solids layer Depth of.scum layer Dimensions of cesspool Materials of construction d Indication of groundwater inflow El Yes ❑ No Comments(note condition of soil, signs of hydraulic failure,level`of ponding, condition of vegetation, etc.): l5insp.doc-rev.7l2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form Not for Voluntary Assessments ' 151 Sturbridge Drive,.Osterville Property Address Brian F Turner Owner Owner's Name information is 151 Sturbridge Drive Osterville MA 02655 7/18/19 required for every g page. Cityfrown state Zip Code Date oflnspection D;System Information (cunt.) 13. Privy(locate on site plan): Materials of construction Dimensions Depth:of solids Comments(note condition of soil, signs of hydraulic failure, level of,ponding, condition of vegetation, etc.): t5insp.doc rev.712612018 Title 5 Official Inspedonform:Subsurface Sewage Disposal System-Page 15 of 1e ' t Commonwealth of Massachusetts Tithe 5 Official Inspection Forme Subsurface.Sewage Disposal System Form-Not`for Voluntary Assessments 151 Sturbridge.Drive,Osterville Property Address Brian F Turner Owner Owners Name Information regdired every for 151 Sturbridge Drive, Osterville MA 02655 7/18/19 page. Cttylrown State Zip Code Date of Inspection D. System Information (Copt:) . 14. Sketch Of Sewage DisposalSystem: Provide a view of the sewage disposal systerri, including ties to at least two permanent reference landmarks or benchmarks. Locate.all wells within 100 feet. Locate where public:water supply.enters the building. Check one of the boxes.below: 0 hand-sketch in'the area below drawing attached separately t5inep.doc-rev,712612t)78 Tiffs 5 official Inspection Form:Subsurface Savage Disposal System:-Page,6 of t a Commonwealth of Massachusetts : Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 151 Sturbridge Drive;Osterville Property Address Brian F Turner Owner Owner's Name information is 151 Sturbridge Drive, Osterville MA 02655 7118/19 required for every � page. Cityrrown State Zip.Code Date of Inspection D. System Information (cont.) 15. Site Exam: y ® Check Slope Surface.water ° ® Check cellar , ® Shallow wells Estimated depth to high ground water: 51'from bottom of leaching feet , Please indicate all methods used to determine the high ground water.elevation: , ® Obtained from system design plans on record - If checked,date of design plan reviewed: 9/25/06 Date ❑ Observed.site{abutting property(observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explainr r • ❑ Checked with local excavators,.installers-(attach documentation). ❑ Accessed USGS database-explain:. You must.describe how you established the high ground water.elevation:' Engineer letter on file certifying the installation dated 10/26/06 ,° Before filing this Inspection Report,please see Report Completeness.Checklist on next page. e. °_ P i5nsp.doc-rev.7128/2018 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 78 Commonwealth of Massachusetts lull Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 151 Sturbridge Drive, Osterville Property Address , Brian F Turner Owner Owner's Name information is 1.51 Sturbridge Drive, Osterville MA 02655 7/18/19 , required for every page. Citylrown state Zip Code Date.of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A.Inspector Information: Complete all fields in.this section. ® B.Certification: Signed& Dated and 1,2, 3, or 4 checked CAnspection Summary: 1, 2,3, or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed 0 D.System Information For 8: Tight/Holding Tank—Pumping contract attached For 1.4:Sketch of Sewage Disposal System drawn on pg. .16 or attached For 15:;Explanation-of estimated depth to high groundwater included t5insp.doc•.rev.7J2812018 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page IS of 18 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 151 Sturbridge Drive J Property Address , J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 s page. City/Town State Zip Code Date of Inspection W W Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not A.Riker use the return Name of Inspector key. R.L.C. r� Company Name PO Box 726 Company Address South Yarmouth MA 02664 City/Town State Zip Code 508-776-6460 S1 4590 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority �f 10/04/2016 Insp s Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments b 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osteryille MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: At time of inspection there were no failures observedat septic tank,distribution box or area above S.A.S.. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will. pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this forrn. 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 '/2 day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well . If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. CityTrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? � ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage backup? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid,depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: . ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 GPD t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information Description: house was unoccupied at time of inspection Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): 2015=231 GPD 2014=220 GPD Detail: Sump pump? ❑ Yes ® No Last date of occupancy: unknownDate Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if.available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: no current Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: not required at time of inspection/regular pumping recommended. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) .Approximate age of all components, date installed (if known) and source of information: Tank original and distribution box and leach chambers installed 10/06/2006 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.5 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.): plumbing was under foundation floor in interior Septic Tank(locate on site plan): Depth below grade: .4 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Precast Concrete tank If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ® No Dimensions: 8'6x5'x5' Sludge depth: 5" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 29" Scum thickness 2" ' Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): PVC outlet Tee in place and PVC inlet Tee was missing and replaced at time of inspection . Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M r 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Ostefville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert equal to both outlets 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.): Distribution box had no evidence of carry over or water stains above single outlet invert . Pump Chamber(locate on site plan): ' Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W TitleOfficial 5 0 c a Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5x 3050 chambers ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soils above SAS were dry and free of any effluent staining or odors.Chambers had no standing water in bases . S.A.S. is constructed of five 3050 chambers in stone 12'wide 40' long and Winches deep. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 0 io e - aq 3= 36 f6 a� 0 Si6il t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: no water at 10' 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: 09/24/2006 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Engineer letter and soil logs on file. ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: Witnessed soil test on file 09/21/2006 with engineered plans and Certificate of complainace on file, Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts N W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 151 Sturbridge Drive Property Address J.Shea Owner Owner's Name information is required for every Osterville MA 02655 10/04/2016 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, 6, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BAARNSTABLE �',OCATION 157 P A- SEWAGE# VILLAGE Or7�lt ASSESSOR'S MAP&PARCEL JGO INSTALLERS NAME&PHONE NO. J G• ��, �fv Cons: S�� Nd� �S y3� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) /or 3OR7 g (size) l a'W A' W L X .2,0 NO. OF BEDROOMS OWNER PERMIT DATE: GJ'o? 7'®ly COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY -----------� f , IA 1 ` *115 LV w No.y7� i FEE . C®MM®NVALTI ®I~ MASSACHUSETTS Board of Health, ~ li MIP SrVAOJ4�, MA. � i APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct(VRepair( ) Upgrade(VJ00Abandon( ) - ❑Complete System ❑Individual Components Location ./� Owner's Name /cl Map/Parcel# i ,� :y i Address !�/ s7vr�r,`�/ e Rd Lot# Telephone# ' Installer's Name C as Designer's Name Address Address OYLE AND ASSOCIATES o,1.?oy 3 3 y s>1117s . / AWSFEP 42 C Telephone# MOO 8_c� -G! Telephone# EAST FALMOUTH,MASSACHUSETTS 025M Type of Building Lot Size �sq.ft. wellin - o.of Bedrooms ti' '-' G�grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow (min.required) iD gpd Calculated design flow 4,k Design flow provided gpd Plan: Date Ei —ZA--®(, Number of sheets Revision Date Title a Description of Soil(s) irpt3 Soil Evaluator Form No. Name of Soil Evaluator • WS Date of Evaluation 'A Zk DESCRIPTION OF REPAIRS OR ALTERATIONS t The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agree o of o place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date -- ` i �� I° �" Q �,� f �� ` � 14 i � � +ti r '` r ', i ,� � �� '� �� I �� t _ _ ___. . _ _�. � I No.41 /I FEE% L7 C®MM®NWIrAti ff OF MASSACHUSETTS r Board of Health, 4f1►i.0 _., MA. APPLICATION F09 DISPOSAL. SYSTEM CONSTRUCTION PERMIT Application,for a Permit to Construct(v,)'rRepairO Upgrade(,yy'0Abandon( - ❑Complete System ❑Individual Components e EMap,tion 1 STt,t rf'lA4 � d �. tj Owner's Name Parcel# , ( � ,,.. �� Address Telephone# Installer's Name J AA �fs Designer's NSUPAEN J.DOYLE AND ASSOCIATES Address Address r42 CAN E IF O, /3vx 3 3 EAST FALMOUTH MASSACHUSETTS 02 ' Telephone# r' 0� ��_ q -cis Telephone# a2634 Type,of Building Lot Size 1' /. 40-7 sq.ft. Dwe>;,No.of Bedrooms 3 1� -.�► f ,c �►�.va+\ t-r' Ar Garbage grinder ( ) Other-Type of Building i yp g No.of persons Showers ( ),Cafeteria( ) } Other Fixtures 1 Design Flow (min.required) �.'�} Q gpd Calculated design flow A'ie 6 Design flow provided gpd Plan: Date Number of sheets Revision Date Title: "� ¢ J`r�►�.. `�4s �r7"fii►!+f 5 /a tat a,t 1 ti .i�"1'� w7d iftt "" � a Description of Soil(s) �J' rCt'� �1 _ ,,, �k j,• 'E�•t�re, 1 Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation - Z��►+�C,� DESCRIPTION OF REPAIRS OR ALTERATIONS t � 4 The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agreeslto/not to place the system in'operation until a Certificate of Compliance has been issued by the Board of Health. - Signed 'C% Date �`- �- 0�n„/ Ins ections d. No.� ( ( FEE COMMONWEALTH OF MASSACLLUSETTS Board of Health, grin 5lAG/ MA. CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded (VrAbandoned ( ) by: J C at JS� f?c�✓�y-rr1�P (�Y. �S�c3Yy l/{' has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. f?dated 6 Approved Design Flow (gpd) hlstaller Designer: Inspector:, { Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. A //15 FEE /'�f� ✓ COMMONWEALTH OF MASSACHUSETTS Board of Health, //e , MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( Up�grJade(-rAbandon( ) an individual sewage disposal system at 12r, (5,S V as described in the application for Disposal System Construction Permit No., !dated Provided: Construction shall be completed within three years�of the dates oft•i p�mit. AllfI Cal fconditions must be met. /A 9'� 1 Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA!s Date � Board of Health /i �� 5 ' S�v �. ;� tFiSl ss ,Il ,k, J }d^. ':;, ♦ L ;-R t , P 1 3a !�• � �.(r11V . 49 1• � 1•�� iF .,S��,ir�4,S q} t �'...-� tt :��I($� { 1�`+1 �rl "' R•� A�-�h �ii"��Y.��,Fi ��.�aL t,f,d {Y Ci r v.n...... .. - r 5• 4 --rr 11 tt fa ! r Iez -�nA rl r2l n.w.W,unu.,un+^•� �p t '-Y i k 7'1 i• Jt.�- , 'Y`k7{'F I L k ,P S ME>5, w .r� e YF{p l , r'. � � ! ", qF �• S rjS t i'c�Nt� ..5 05 S y� i. ,. r, . N • y�q f.}a3 '� ,�{�'!!t der i�,r ;J1�1xlk' rJ t JI{I .Fi, ,t I I � l`d�.l �� Zl ►l. � / �1 I � is lye k � 11 Jt� SESF ti' 1 ,) ri Ir i•' - 9 1' .� ��,yl Goa ��}tS�L�Ftl 1y[,1IL � �1F yn '�. ,.1, s .. !. •� r � `�W.��r/�' � t�{45111�t 11 iliJ. i! Sl . IIS I� t ... .I , J ��3��5- �'y � It (,.J i: •�� 'F' . �•y}� FT AS e°1.t. ,1"+�.!15 t1i{t IIf , �"' 1\• / !H+��. �,_ . ' r "!6 TV F 9.5 . C. I` r: Jl.ri,y la! .� w I � ram✓. �. a� F ' ..•- :.E Mr. Georgq A. Velartli .�151 Sturbridge dr. Osterville, MA. 02655-1460 ki U" /�c)o.�� Town of:Barnstable " _ °� TO"ytio .-� • Regulatory Services Thomas F. Geiler,Director s � - � IASNSfABLE. � ^ . MAM .�0 Public Health Division Thomas McKean;Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: in Sewage Permit# a 006 -,'//7 Assessor's MaplParcel��, Designer: Installer: 42CANTERBURYLANE Address: �TFALMO MOUTH,MAscec►;I1S=: rg 02538 Address: t7, 73i�X. 508/540-2534 On /Q -A4,-p 6 L,.� AA L.�,� was issued a permit to install a (date) (installer) septic system at 141 based on a design drawn by (address) ,(designer) r 9stL dated -=Pi 2 .Zun I, . certify that the septic system referenced above was installed substantially.according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic stem referenced above was installed with P Y mayor changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if re ed) was inspected and the soils were found satisfactory. �tN of CHRISTINE FAIRNENY (Insta ler's Signature) No. 926 �R' ¢� �O J o Si_,J. s �� GIST�� { ` OOYLE PIALc ,A (Designers S' ature (Affix Designer's Stamp PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. 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Soil Suitability Assessment for Sewage Di al Performed By: i &.LIS , Witnessed By: t LOCATION& GENERAL INFORMATION Location Address c/L/ S�'GI'/!✓r G� I Owner's Name /Q,'f y Ile�gr� ye � ,''✓� III -q� Address /S J Assessor's Map/Parcel: 60 rv/GJ '- Engineer's NamePa NEW CONSTRUCTION REPAIR Telephone# i I Land Use =�✓i a.�ral_ a��.. Slopes(%) ,2_ Surface Stones i Distances from: Open Water Body L l el;k ft Possible Wet Area _ft Drinking Water Well Z ft Drainage Way > _ft Property Line _ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands proximity to holes) i � y A �g ,�� Lo �► a. Parent material(geologic) Depth to Bedrock Depth to Oroundwater. Standing Water in Hole: Weeping from Pit Face �IAE-3 i„ Estimated Seasonal High Groundwater 7 te Cz° DETERMINATION FORISEASONAL HIGH WATER'� TABLE Method Used: "oJ19 d>di I Depth Observed stanng in obs.hole: in. Depth to soil mottles: CP CIn. Z'�.. Depth to weeping from side of obs.hole: in. Groundwater Ad)ustmettt Index Well# Reading Date: Index Well level Acti.fhctor— Adj.C)routidwster Level, PERCOLATION TEST Date Ski nwe_ ;t-' Observation Hole# ,_ Time at 4" Depth of Perc --�-4— i Time at 6" Stan Pre-soak Time @ o 0 MoLL 'Time(9"-6") End Pre-soak Rate Min./Inch r--A,r Wiiti6+rf'�Co Site Suitability Assessment: Site Passed j 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 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole#( Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Muns�ll) Mottling (Structure,Stones;Boulders. on isten Gravel) " -3�� , ''f,aA N.: ��► '�_yam. �, (� v„ i��'-`Idc2r.ty. sa:� . I DEEP OBSERVATION HOLE LOG Hole#JQz � Depth from Soil Horizon Soil Texture Soil Color Soil r Surface(in.) (USDA) (Munseyl) Mottling (Structure,Stones,Boulders. nsi ten %Gravel) nark DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravell y / IL C7t ��► i ! DEEP OBSERVATION HOLE LOG Hole# 4+2 Depth from Soil Horizon Soil Texture Soil Col Soil Soil Other Surface(in.) (USDA) (Munsel) Mottling (Structure,Stones:Boulders. • onsi ten 1 ty b A �i„ 'D Dt-k d �,,tea �. d- .- ��► - �� ZtJ Flood Insurance Rate Mae: Above 500 year flood boundary No_ Yes z.' Within 500 year boundary No— Yes Within 100 year flood boundary No— Yes .�. Depth of Naturally Occurring Pervious Material . Does at least four feet of naturally occurring p4pe s materia�exist in all areas observed throughout the area proposed for the soil absorption system? %If not,what is the depth of naturally occurring ous mater}a17 Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protect ion and that the above analysis was performed by me consistent with the required training,expertise and experience described in 3 0 CMR 15.017. Date o .• ` b Signature z� j Q:\SEVrlCVERCFORM.D0C a r• Y Search for Map/Parcel J166014T V Town of Barnstable 's + For Business Name:e l 166014 �� _ _ _ Rental Property(Y/N) _ 1 Zone of Contribution(Y/N): i I , Area Number Contaminant Rel(Y/N): 1r � r-- Phone: l__ Fuel Storage Tank Permit: 1 Card On File: Lj Disposal Works Perc Test Well Permit Construction File/Permit No; �11438 l� �� r2006417 Issuance Date: �09/27/20060 Completion Date: �) �10/06/2006 Size of Septic Type/Size of SAS: 5 infiltrators j Tank: x1500�� Comments: Aalto 4 bedrooms***need both*** ��J mappar: !166014� 'Owner: (VELARDI,GEORGE A �`proploc: J 151 STURBRIDGE DRIVE— � I Innovative/Alternative Technology Septic Systems Single or --- Clustered -- I/A Type I/A Service Type: C add delete records? � LO�-CATION �SI SEW PERMIT NO. VILLAGE INSTA LLER'S NAME & ADDRESS %) G J of BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED `�v�� a_ � 7 - rt ti t Y7 t` .t� 4 rf�v�e No.._..._l d.....---.. FEs.............................. THE COMMONWEALTH OF MASSACHUS S BOAR® OF !-1 A H .......OF.........4............ .. . ------..-.--.-.-..---.-.-•---- Applira#ion for Dispas al Works Tnntitrnrtiun Vamit Application is hereby made for hermit to Cons uct ( ) or Repair (kj"an Individual Sewage Disposal System at: I - - 01'6Je'r Location-tad ress or Lot No. Owner a ..... Address t....................... .--=' ----.--- •---..----.---•..•..••---.... ..-----...--.-••------...----...----------. Installer ess of TypeDwellindli�No. of Bedrooms............................................Ex anion Attic SizderLot-Garbage....................Sq. feet I' g . P ( ) g Grinder ( ► Y�S p., Other—Type of Building .4!2,114,re 4?... '�No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ---------------------------•--.-------------------------------------------------- •-------------•-----------...._.......... w Design Flow...... __4i............................ga%3b s per person per day. Total daily flow............��.�-_••--------------_gallons. WSeptic Tankuid cap city�5�..gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No............. ..... Width..... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........./........ Diameter--- -/�.-!.... Depth below i et................... Total leaching area._ !i!.P_......sq. ft. r Z Other Distribution box ( ) Dosing tank ( ) MIA, /41-7 — ��- 7 7. � Percolation Test Results Performed by..�____�O_�s_��_. -....../�� ...... Date---Z2.".�&.'?.� Test Pit No. 1....<.2-...minutes per inch Depth of Test Pit.................... Depth to ground water•--__--______-_------_-. Grq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R' ......... / (' O Description of Soil---•-_. -- O'�'a'ys- - sw�`- .Z---- 2---'....................... L! l� .............. x w UNature 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 iITL% 5 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 t board of health. Date Application Approved By-----------• .......-- fi�/b x-..-- 9' 7 �---------- Date Application Disapproved for the following reasons:.........------•----•------•------------------------------------------ f .. .......... ---•-------------- �J`, Date Permit No.:...- ...--- .__. �. l Issued... = Date 7 11% > No........ Fins............................. THE COMMONWEALTH OF MASSACHUSETTS - -T BOARD OF HF;A A� 0 F................................. ..................................................... Appliration for Dispoiial lVorkfi Touiitrurtwi 'n "prrutit Application is hereby made fora Permit to Construct or Repair ( rS�a1 Individual Sewage Disposal System at:, .......................................... ............................................7.6-........................................ Address _3 6 o.DL / i /it/ �'dlde .................................................. I................................................ .t ........... .............. kar A, Owner Address U40.. �/ .....R .................................................. .................................................................................................. Installer Address I o o:: Type of Build Size Lot....{..................Sq. feet Dwelling No. o. of Bedrooms___.. ........Expansion Attic Garbage Grinder Other—Type of Building .............. No. of persons............................ Showers Cafeteria Otherfixtures,tl:.............................................................................................................................................. Design Flow...__ . ................ ...........gallons per person per day. Total daily flow_._........ ...................gallons. Septic Tanker quid capacit)') ..gallons Length................ Width___............. Diameter-_--------_--_- Depth.....:._....._.. Disposal Trench—N Width ...... Total Length....__.............. Total leaching area___-_ ___ .......sq. ft. Seepage Pit,No....._.. ------ Diameter... .... Depth-below�ijilet.. h Total leaching area. PZ......sq. ft. Z Other Distribution box Dosing ta_q� A- 14 /1 -.;?Acw- 7�*7 Percolation Test Result Performed by..e----ff.6iJ)..r1j., ........ ...... Date......................................... Test Pit, No. I________________minutes 1 per inch Depth of Test Pit....__.....-.._.___. Depth to ground water._......_.:;........-_ Test PioNo. 2................minutes per inch Depth of Test Pit....__.._........... Depth to ground water......................... ........... . .................... 0Soil.__. -- ----------- -------- ...... .. --- ----J..... Z Description of ..D --------------- ...... ................................................ ------------------------------------------ ----------------------------------------- ---------------- ----------*__,"�i--------------- -------------------------------------------............................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable....................................................------I..................................... ................................................ ....................... .............................................................................................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T I TIZj 5 of the State Sanitary.�)Code—The undersigned further agrees not to place the system in operation until a Certificate,of Compliance has''b�`e�en issue by tht)'board of health. -- ------- ---------------------------------- -------------'a"te*---......... D Application Approved By. ... S............ Date Application Disapproved for the following reasons,,,t�............................................................................................................. .........................................Z.................................... ........................................................................................................................ Date Permit No.._...........------ -- Issued.. . . ..-------- - Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF. HEALTH Vhfl ...... .......OF . . ... ................. 'up rdifit' atr of Toutphattre THI T 4 C RTIFYI That the IndividualSewage ?Isposal System constructed &1.Repaired by......... ...... ........... .............. . ......... 'Inst . ... .... at ....... ......... .. .. t•. - ....0.............. has been installed in accordance witili'AlTe"provisions of T --F 5 of The State Sanitary Cod' described in the r-Disposal.Works Construction Permit ................................. . dated_.,..----- -- --------------------------------- application'fo., 43 A- THE ISSUANCE OF 141S CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION-,SATISFACTORY V: ec.,&'t Paz ............... AT Z/ .......... ......... .2� ........................ 7,7 U THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH,, OF.... 41.......... ........................... No.......I.A.9....... FEE.... ........... i staro ii Xongtruction "pamit Permission is heere-6,y granted......... . .. . ....... .................... .......................... ............................................ to Con I d ridu , SAage DUSP st I f=441....7...J.... ........... "u" ?salA ........................ "k P, an p il at-Nd- 07"duct ..j..... /. Street rye-rpiit Ne as shown oil the application for Disposal Works ConstructionDated.. 0.'4117 .......... Board- Healt DAT8--.Y/ ............................................... FOR%M 1255 HOBBS & WARREN, INC., PUBLISHERS ' 1 - 1 !� .+ ' MJI&b Grade & 475't TflMT6" - �k Grade 4�'t )Till) 11,, � !I t 6�l! `�l�fi/1lll lull ll ll fl l llllr 1/8" TO 1/2" WASHED STONE 1/8" TO i/2" WASHED STONE BAM AT 3" THICK AT 3" THICK BMW Fin. Grade El. 47'--48': Fin. Grade El. 47=48't SLAB EL 47.61' 3/4" TO 1 1/2" WASHED --- OBSERVATION OBSERVATION 3/4" TO 1 1/2" WASHED INV EL 1O"Jan 14'�a I1YY EL STONE AT SIDES AND ENDS PORT (TWO-SEE PLAN VIEW) EL 44.98' PORT STONE - SIDES AND ENDS (TWO-SEE PLAN VIEW) EL 44.98 INtW 8L ��I�slon F!o Llae/'�- , JGn 8 EL ;.;,;;?' *r = :=ii•'ti3:: INV. EL 44.15' 4B4t' 48.15 45.9 sum :•.s.c. i. r�Qa ie�r 4a" INP EL P 44.45 .-° �:........•;�..•... ' 1 •h••.•.•.M.•M•.• .• •.�.�. •�ii• :i. is�. �- � 44.65 ••s"stone, - INV EL ° ;a a a:° d a a a a a• a a a a a�• +HIGH DENSITY °©•a a .r�44.15' ;d., .tl.a a:a•a. 'a d '4,d 4 HOLE DISTRIBUTION BOX •a:d•dd d s •d.a •°*a a a POLY MFILTRATOR .a'd'. d " H2O LOADING a:a•°.d•a d:d•d.a°a AT B&Pt� a�'•d. MODEL 3450 . :Q,�a 30 EXISTING 1500 GALLON SEPTIC TANK 'a:d•a a a 'd•d•a a° a'a LEACHING CAMBER ° 'd d 5y 15" EL 42.15 15" .AA'• 50" 48".d , 37.5 a a •a'd. El 42.15 ,SEPTIC TANK sHALG BE MODLFIEL► As FOLLOWS* 40' 12' Tees shall be constructed of Schedule 40 PVC and shall extend a FIVE INFILTRATORS H2O LOADING minimum of 6" above the flow line of the septic tank and be on BM: TOP CB FND. ED 48" STONE AT SIDES AND .15'" AT ENDS PROPOSED HIGH DENSITY the centerline of the septic tank located directly under the ELEV. 52.87' 48 SAS�OLTRAATOR Note: INFILTRATRR TRENCH clean-out manhole. DATUM: GIS 50 TRENCH (12' )/WIDE X 40' LONG) The .inlet pipe elevation shall be no less than 2" nor more than 3" 52 Remove all unsuitable material 5 around SAS „ „ , I�VE' INFILTRATORS` - 7.5' LONG above the invert elevation of the outlet pipe. down to the C2 la yrer (El 42 8) and replace with clean " " Septic tank shall be installed level and true to grade on a leve4 54 Q46 xranularsand er 310 CMR 15.255 48 STONE AT SIDES' AND 15 AT ENDS e at has been meebanicall co acte N83.26' " p (H20 LOADING) stable base that p compacted and on which , 40 y�y 6" of crushed stone has been placed to ensure stability and , 98 42 aBottom of Deep Observation Hole El 37:0' to prevent settling: Septic tank shall have a minimum cover of 9" ` 1. 2 ,p1 High Ground Water �Elet� 20' (GLS) Two 20" manholes with readily removable impermeable covers of durable material shall be provided with access portsa oo-= to The outlet tee shall be equipped with gas baffle. 00 2 EMSTINc Locus �' • 6 1500 GAL 52 !V? 54 ""�. TANK TO REMAIN 58*5 „ 19.7' Q) 9 s6 oQp _ \ 284 t �' JOSHUQ SAS RESERVE AREA J / /� POND '�� STURBRIQGE OR. PRECAST REINFORCED CONCRETE DISTRIBUTION BOX 3 4 \ 1 Install on a level base _ �' Ali imum wall thickness = 2" ,'Q _ 40.()o 48\ 3D' '2• - - �� VE Minimum .inside dimension = 12" _ Outlet inverts shall be equal to each other and at 2 minimum below :inlet invert ' •�( � Y The distribution lines from the distribution box shall all have ABANDON EXISTING 52 28' 0 - - - 10/1 equal inverts as determined by flooding the distribution box to LEACH PIT P�' - X3' the height of the distribution line invert after all lines have 59.9• / been sealed In place. Invert adjustments shall be made by filling with durable and - nondeforma ble material permanently fastened to the line or _ �,y1 i EAST reconstructing the lines until all inverts are of equal ele va do / 5 x7 =- _ _- ��25 iQP� ROAD EAY LOT 7 1 ,471±S.F. _ 29 N 54 = ` cgs �� AP 20 64 i ASSESSORS DATA: ") o �,') �� i �� MAP 166 PARCEL 14 GENERAL cONSTRUCTl©N NOTES •� ',�, '�\ �. /Q� i. All the workmanship and .materials shall conform to D..E.F Title 5 52•3 `t' REFERENCE CERT` 72651 and the Town of Barnstable rules and regulations for the subsurface 575.54'S5»� X 1sa \` �' O�` /�/ h' �'RENCE PLAN LC 31373E 2 disposal of sewage. • , __ P g' _1 �''�& FEMA DATA: ZONE "C" 2. At least one access port over tank tees shall be accessible 122.08 i ��: PANEL 250001 0016 D within 6" of finish grade, with any remaining access ports brought 53.1' � MAP REV JULY 2, 1992 to within 6" of finish grade. "'`�•. i 3. All components of the sanitary system shall be capable of `� o�w LOCUS ADDRESS withstanding H--10 loading unless they are under or within IO It \ y #151 STURBRIDGE DRY OSTERVHZE of drives or parking. H-20 loading shall be used under or within 10 It of drives or parking unless :noted. Plastic equals may be i yti'` Y ' used In lieu of all recast units S ER TIC S YS TEM PLA�(` 4. The excavator/contractor shall call dig safe and verify the location Health Agent. D. Desmaris �j l GRAPHIC SCALE Prepared For.- of all site utilities prior to any excavation, and shall be responsible for 20 o 10 20 40 so all matters relating to electric easements Test Date 09-21-06 151 STURBRIDGE DRIVE 5. Sewer pipes shall be 4» Schedule 40 PVC laid at a min '.02 slope. In 6 Any masonry units used to bring covers to grade shall be Steil Evaluator.- S. Doyle ( u+t ) mortared in place. - .Y 7. .Finish grade shall ha ve a minimum slope of 0.02 It per .foot ti 4lo 1 inch = 20 ft k-I{of CAS t G 1`"Vlll e, Massachusetts 8. Pumpand remove old septic tem. TH ;� �... 47.0' � #2 EL. 50.o TH £L. 53.0 , P system. TH #4 EL. 51.8 � CHRISTINE s� Scale. 1 20 Date. September 24, 2006 PERC C2 MIN/INCH PERC <2 MIN/INCH PERC Q MIN ANCH PERC <2 MIN/INCH fAIRNENY 9. The excavator/contractor shall be responsible to check. all grades o» 0' 0" 0b � gin. 926 � Prepared By.- and elevations and to contact Doyle .Associates of any discepaneies, A SL 1Or 3/2 A SL 10YR 3/2 A SL 1OYR 3/2 A SL 1OYR 3/2 � q F Stephen J. Doyle and Associates prior to construction s" s" s" s" ��sT�.� 42 Cante bury Lane,�E. Falmouth, MA 02536 10 The excavator/contractor shall be responsible to contact B Ls 1OYR 4/6 B LS 1OYR 4/6 B Ls 1oYR 4/6 B LS 1OYR 4/6 SANITAR►PN Telephone. 5081540--2534 Doyle Associates 24 hours prior to any required inspections 36" 34" 35" 30" Gv V R vi 3 v S 1 ca c k FINE SAND FINE SAND FINE SAND FINE SAND C, WITH 2.5Y 5/6 C, WITH 2.5Y 5/6 C, WITH 2.5Y 5/6 C, WITH 2.5Y 5/6 Des4n Data: FINES FINES FINES FINES EL 42.8' 50" EL 45.8 50" EL. 48.8' 50" EL 47.6' 50" �►A AAAA. Three Eacisting Beds -- One Proposed. = 4 Bedroom Design " " oY r�Iass Four Bedrooms = 4 X 110 440 d Required Flow C2 -PERC 7s c2 C2 c2 --PERC s4 �P�� icy $! _ baP 4 MED. MED. MED. MED. �a G's:ERfi� Gs� SAND 2.5Y 7/4 SAND 2.5Y 7/4 SAND 2.5Y 7/4 SAND 2.5Y 7/4 o� Q� �U No Garbage Disposal Allowed � � NEts N Use.- Infiltrator Trench 40'L x 12'W x 2' Eff/Depth pon [40' t 40' f 12' f 12J x 2.0 = 208 1 120" 1 120" 120" 120" 3�o NO WATER ENCOUNTERED NO WATER ENCOUNTERED NO WATER ENCOUNTERED NO WATER ENCOUNTERED .� 4fJ' x 12, = 480 EL 37.0' EL. 40.0' EL 43.0' EL 41.8' 688 x a 74 = 509 GPD Total Design Flow ®�'�t1��j 2l�-�,{r NO. DATE DESCRIPTION t { �iE/t/Gf•� �7 ,, /y 7 c!.7 i 1 ; ld� 76 .� __s'�' ,y,�• 0� N i / G Z. OR / /(J:) �.'..✓ ,-. Fes/colJ.�!f'"t•.Cc E,% o — TES 7— A-71 O L. E 1� E S UL TS I k_' 7-0w/e/ 7--' FCOE'J) I ID 1 5,2 - 3 7-c w/\4 i,✓A %E ,e / 5 A .'A / t_ A T3 L E /,�� f: �Jc��e•vFry 'v //� cF_ r'3A. �' E'EC�U! IZ E/"IcN-rS D.2 VIE l./14?_IV A-' U T TO TL3E OC CD O ? OSc_ Z) 8ED2oo1-7 iP _S E `.i E )e lo�U' E S>'S 7- � � ' 7 s D E S i Gam' �_� O-� / -330 c:) 1DES / GN L_ o � v /n /S C/s_-. 17 a�Po7�oSED LEAeH � F,v ` OO 7_/0 SY' ST-E /�? 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