HomeMy WebLinkAbout0183 STURBRIDGE DRIVE - Health 183; Sturbridge Drive
Osferville
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TOWN OF BARNSTABLE
LOCATION 3 ��vr r�q�, SEWAGE# O ��
VILLAGE 0S42.fdf��e ASSESSOR'S MAP&PARCEL qrl
i4 INSTALLER'S NAME&PHONE NO. Mi ko, M y-e-S ha04 66 �43-mnn
SEPTIC TANK CAPACITY 9 S 60 a Co m Pa'a'4 T A► g k,
LEACHING FACILITY.(type) ChPwnb.CS (size) yy I�
NO.OF BEDROOMS 3
OWNER jy)&-�* COI'tbaUSkq S
PERMIT DATE: 3 I%3113 COMPLIANCE DATE:
Separation Distance Between the: <�
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility (,1�7 S 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 Q
300 feet of leaching faci' :f ' Feet
FURNISHED BY ��.
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No. .013
t3 " V g D a i Fee$
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
1 i
ftplitation for Disposal *pstem Construrtion Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. f b 3 S'i vb ONo
Cwner's Name,Address,and Tel.No.
S1S
Assessor'sMap/Parcel ��� Q� A1,444 Carb4vS�fss �' �SaLS
Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. .T k6WW,-s
MT M"C'ske4t Fe*ha o` eAA a O o3S �� I` 6��a IrQ �erG49� -.
Type of Building: J-� I— q Y ^ S $ a -
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building s F N No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) S 3 ® gpd Design flow provided 1330 gpd
Plan Date 3 1 a l 1 Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil P,Pam.
-SEE P-A
Nature of Repairs or Alterations(Answer when applicable) i
IrJ/ If Ik V
S•r .S-9�.w�
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
acc( dance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Comp4iance has been issued by this Board of Health. �t
4 Date
Application Approved by Date 3 y 3
Application Disapproved by Date
for the following reasons
Permit No. a OB ^ y W b Date Issued S11311-3
-------------------- - - -- - — — — --———
a ���.�0
No. ,4 -. Fee
THE COMMONWEAUTH1OF MASSACHUSETTS Entered in computer: Yes
1*
PUBLIC HEALTH DIVISION - T®.�Vlla.lrJ BARNSTABLE, MASSACHUSETTS
._,...._
f 0[pplitation for Vsposff 00$tem Construction Permit
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. W3 510,rbr b rie ,` Owner's Name,Address,and Tel.No.
s,
Assessor's Map/Parcel 1 6 97 M444 ( ar beius
Installer's Name,Address,and Tel.,No. Designer's Name,/ Alddress, 1and Tel.No. .T�0�4 J i2o1
3 PGak L.4aE
� C06,15 �\ 1� 4�U"r7��G�lJ�'
mu Mske_4� lFo3Ll4e o MA (�e�lGl� m s
Type of Building: 10 Q— 9 15 17 ' .S 2 a_.�
Dwelling No.of Bedrooms 3 Lot Size 9 �-� sq.ft. Garbage Grinder( )
c Other Type of Building SF N No.of Persons Showers( ) Cafeteria( )
Other Fixtures
X Design Flow(min.required) 3.3 0 gpd Design flow provided .3 3 Q gpd
Plan Date 3 ►t l Number of sheets 1 Revision Date
Title-
Size of Septic Tank 1500 Type of S.A.S:
Description of Soil
SEE
Nature of Repairs or Alterations(Answer when applicable) „•
Ze_p\c�,e FF6. W W 1 i$fir V
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
}Compliance has been issued by this Board of Health.5ignek e, Date
Application Approved by 5! Date 3 113 1 3
• _ P
Application Disapproved by i r ;.` Date
for the following reasons i. }
E
Permit No. a��3 y d Date Issued 3 13 13
--------------- -- ------=-------=--------------------------
TH E COMMONWEALTH OF MASSACHUSETTS- I
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(v< Repaired( ) Upgraded( )
Abandoned( )by (Y)RV MUKr S1i eG A
,p�r- 0 S has been cons cted in accord tce
at I S4-u b+ jr-k
with the provisions of Title 5 and the for Disposal Sys in Construction Permit No dated
Installer �, d��✓� Designer 7MFi En i-eer,
#bedrooms 3 Approved design flow 'C) gpd
The issuance of this p it shall of be construed as a guarantee that the system w ll fihnction as desi ne . 9
Date Inspector
-------------------------------------------------------------------------------- ------------------ ----
No. c u�3 b16 d Fee ��
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
i
Misposal 6pstem Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( )
System located at I `�3 5f�v b r�d1 e by',',,e
L�S�cr•/il(�
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must b omp 0ted within three years of the date of thi permit.
Date �`3��73 Approved y
• t
Town of Barnstable
oF1HE T Regulatory Services
P� �rti
Thomas F. Geiler, Director
sn tE,MASS. f Public Health Division
9� 1639. '
i°rFn�,�s°i Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Date: a l3 Sewage Permit# Assessor's 1Vlap/Parcel
Installer& Designer Certification Form
nn
Designer: `�,�` �o��u���CX . Installer: mofeShaa4.
Address: 10 Thom ae S Address: C-a-n-e.
er1� . MA rox�o� M449S 6Q(til
On (YN\VL Ma�esl was issued a permit to install a
(date) (installer)
septic system at %3 �t u�br'a`aJ� �r`�� based on a design drawn by
(address)
dated 4 4 113
(designer)
✓ 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 system referenced above was installed with major changes,(i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation,of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow. Stripout.(if required) was inspected and the soils
were found satisfactory.
m►� �v► o -
(In aller's Sign e) f
- ..- ,,.,f • -
esigner's Signature) (A ff Yx.De's ;> k '"re)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
f OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD'ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
q:\ofce forms\designercertification form.doc
. 24 QUICK4 STD 'INFILTRATORS.
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1500 GAL
SEPTIC TANK
POLY a o a
BREAKOUT
BARRIER $ A A,P. . 166197
r .
11000 .SF-
ECK
.........
......... ...........
........
183 SWING. TIES,
K, ......... ........ .
...EX15T:3_BDRM::::: o A B
�. $ Noes£:.:•::...:....:
C 14.4 31.8'
D 13.0' 35.5'
E 25.5' 51.0'
a F 32.5' 37.2'
Q7
'�TURBRIDGE DRIVE
SEPTIC SYSTEM OWNER SHALL -HAVE SEPTIC TANK
INSPECTED & PUMPED OUT AT`LEAST ONCE EACH
YEAR AFTER CONSTROCTION. 41
rtN(T GARBAGE GRINDERS ARE NOT ALLOWED.
w LLIAM
0 AL` J I CERTIFY THAT THIS SEWAGE.DISPOSAL
G SYSTEM IS IN GE1VE'W CONPLMNCE
o. ¢ WlrH.THE APPROVED DESI
V. GN PLAN AND
WITH 777LE & TOWN 0�
'-EE'GULATlONS.
AS-BUILT AS :: BUILT ,PLAN
' ELEVATION SCHEDULE ELEVATION
TOP OF FOUNDATION ''" inn n '183 STURBRIDGE DRIVE
OSTERVILLE, MASSACHUSETTS ,
SEWER INVERT-AT FOUNDATION PREPARED FOR. MIKE MOR£5H£AD
SEWER INVERT INTO SEPTIC TANK 95.41 SCALE: 1"=30'
SEWER INVERT OUT OF SEPTIC TANK 95.11 DATE: 6/291 13'`
SEWER INVERT INTO DIST:' BOX 93•6 .D M G., OJfG ASSOCU=
SEWER INVERT INTO CHAMBERS" 93.42 Taun+roh,'aea. 0278a
SEWER INVERT 0 END OF TRENCH' 92.81
ELEVATION OF GROUND WATER (DESJGNj 65.5
'ail 3 G 4�
' - - 72'
24'-0 5/8" ', 11'-11 8" 23'-9" 12'3
8- 6-1.13/16 2'6 4'-73/16"
+
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10. - ...-4'-1' 7'-103/8" 6 2'-7 9/16"
782-6' 3-7 2'
LIVIN � 7Q
24-0 5/8"- 3'-3" � 6-17/8" 23'-9" 12'-3"
72' N
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ATTIC
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LIVING A/REA644 sq
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LIVING AREA Q_
Commonwealth of Massachusetts
City/Town of
Form 11 - Soil Suitability Assessment for On-Site Sewage .Disposal
A. Facility Information
Owner Name
- -D- 1Z.- - 1166 lq7
StreafAddress Map/Lot#
city State Zip Code
B. Site Information
1. (Check one) ❑ New.Construction ❑ Upgrade Repair -
2.. Published S011 Survey Available? ❑ Yes No If yes: Year Published Publication Scale Soil Map Unit
Soil Name Soil Limitations
3. Surficial Geological Report Available? ❑ Yes —' NoNo If yes:
G Year Published Publication Scale Map Unit
Geologic Material Landform
4. Flood.-Rate Insurance Map
Above the 500-year flood boundary? es ❑ No Within the 100-year flood boundary? ❑ Yes
,r
Within the 500-year flood boundary? ❑ Yes No Within a velocity zone? ❑ Yes
5. Wetland Area: National Wetland Inventory Map A
Map Unit Name
Wetlands Conservancy Conservanc Program Map </Map Unit Name
6. Current Water Resource Conditions(USGS): Month7Year Range: [I Above Norma Normal El Below Normal,
7. Other references reviewed: i
t5form11.doc•rev.1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8
Commonwealth of Massachusetts-
City/Town of
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (minimum of two.holes required at every proposed primary and reserved disposal area)
Deep Observation Hole Number:
Date. Time Weather
1. Location
Ground Elevation at Surface of Hole: Location (identify on plan):
2. Land Use — A10
(e.g.,woodland,a ricultural field,vacant lot,etc.) Surface Stones Slope(%)
Vegetation Landform / Position on Landscape(attach sheet)
-h
3. Distances from: Open Water Body feet Drainage Way feet Possible Wet Area feet
Property Line feet Drinking Water Well - G feetOther feet
4. Parent Material:
Unsuitable Materials Present: ❑ Yes ❑ No
If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock
5. Groundwater Observed: �—❑ Yes �No ,i If yes: Depth Weeping from Pit Depth Standing Water in Hole
Estimated Depth to High Groundwater: l ��
inches elevation
t5form11.doc rev.1/10 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8
Commonwealth of Massachusetts
r
City/Town of
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
C. On-Site Review (continued)
Deep Observation Hole Number:
Redoximorphic Features Coarse Fragments
Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soil oil
Depth(in.)
Layer Motet(Nunes))) (USDA). Structure Con$istence Other
_ Cobbles& Struct (Moist)
Depth Color Percent Gravel Stones
i
to Y
Additional Notes: j
i
i
. i
i
I
i
t5form11.doc-rev. 1/10: Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 3 of 8
-C--\ Commonwealth of Massachusetts
City/Town of
Form 11 - Soil Suitability.Assessment for On-Site Sewrage Disposal
D. Determination of High Groundwater Elevation
1. Method Used:
Depth observed standing water in observation hole A. . Vv AV', B.
Inches inches
B.
Depth weeping from side of observation hole in �� inches
inches
Depth to soil redoximorphic features (mottles) A. B.
inches inches
❑ Groundwater adjustment(USGS methodology) In B.
nches inches
2
Index Well Number Reading Date Index Well Level
Adjustment Factor Adjusted Groundwater Level
E. Depth of Pervious,Material �.
1. Depth of Naturally Occurring Pervious Material T
a. Does at least four feet of naturally occurring pervious material exist In all areas observed throughout the area proposed for the soil
absorption system? _
Yes ❑ No
b. If yes, at what depth was it observed? Upper boundary: inches Lower boundary: inches
t5form11.doc•rev.1/10 Form 11 —Soil Suitability Assessment for On-Site Sewage Disposal •Page 6 of 8
� Commonwealth of Massachusetts
City/Town of
Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal
ry
F. Certification
I certify that I am-currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil
evaluations and that the above analysis has been performed by me consistent with the required training, expertise and experience
described in 310 CMR 15.017. 1 further certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form,
are ac to and in accordan with 310 CMR 15.100 through 15.107.
Is
SlOifureloKSoll Evaluator Date
Aw, 6 0-w s 9
Typed or Printed Name of Soil Evaluator/License# Date of Soil Ev luator Exam
Name of Board of Health Witness Board of Health
Note: In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and
to the designer and the property owner with Percolation Test Form 12.
t5form11.doc•rev.1/10 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 7 of 8
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24 QUICK4 STD INFILTRATORS
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1500 .GAL
SEPTIC TANK
POLY 000
BREAKOUT
BARRIER B A A,P. ' 166197.
'11000 SF
183... SWING TIES
o -
::::EXlST..7.8DIN A B
Naus£...::.:::::
C 14.4' 31.8'
D 7 3.0' 38,5'
' E 25.5' 51.0'
Q F 32.5 37:2'
w � ,
110
STURBRID GE 'DRIVE
SEPTIC SYSTEM OWNER SHALL HAVE SEPTIC TANK
INSPECTED & PUMPED OUT AT LEAST ONCE EACH
R ALTER CONSTRUCTION.
SN OF GARBAGE GRINDERS ARE NOT ALLOWED.
WILLIAM E.
OTTIWALD J I CERMY THAT TFI£5 SEWAGE VISFOSAL
t'L SYSTR{'IS IN GRNE'RAL COMPLIANCR
. 2 0ITH THE APPROVED DESIGN PLAN AND
WITH YTIM V& OF
REGULATIONS.
ELEVA TION SCHEDULE AS—BUILT AS--BUILT PLAN ,
ELEVATION
TOP OF FOUNDATION 183 STURBRIDGE DRIVE
OSTERVILLE,: MASSACHUSETTS
SEWER INVERT AT FOUNDATION 96.D . PREPARED FOR: MIKE MoREsHEAo'
SEWER INVERT INTO SEPTIC' TANK 96.41' SCALE:, I�=JO'
SEWER INVERT OUT OF SEP TIC` TANK a 95.11 DATE: 6/29113,
SEWER INVERT INTO DIST BOX' 93.6 D m G DUG.ASSOCIATES
SEWER INVERT INTO CHAMBERS 93.42 TAUN70N, MA. 02iBO
SEWER INVERT @ END OF TRENCH 92.81
ELEVATION OF GROUND WATER (DESIGN)l 85.5 '
} .t3/12/2013 22:21 5088805114 GOTTWALD PAGE 03
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Soil Stivahil ty Assessment for Sewage Di.►pn,%Yzl
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03/12/2013 22: 21 5088805114 GOTTWALD PAGE 02
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Town of Barnstable Barnstable
�p THE Tp�
;yP��°�, "�M caY
c
m'"RegulatoryServices DePartment
11 RARNSrABLEr Public Health, Division 2007
200 Main Street Hyannis MA 02601
Office: 508-862-4644 Thomas F.Geiler,Director'
FAX: 508-790-6304 Thomas"A.McKean,CHO
CERTIFIED MAIL# 7008 3230 0602 5178 2817_
December 18, 2012
Bobbie Berlet, Estate of'
c/o Sandi Every TR
183 Sturbridge Drive
Osterville, MA 02655
The septic system located at 183-Sturbridge Drive,.Osterville, MA was last inspected
on 12/11/2012 by James D. Sears, a certified septic inspector for the State of.
Massachusetts.
The inspection of the septic system showed that the system"Failed"under the guidelines;
of 1995 TITLE 5 (310 CMR 15.00)due to-the following::
• The septic system is in hydraulic failure „
You are ordered to repair or replace the septic system within sixty (60) days from the
date you receive.this notification.
Failure to.re air/re lace the septic'system.within the deadline eriod will result in future'
p p p Y p
enforcement action.
PER ORDER OF T BOARD OF HEALTH
V
o ean,.R.S. C -
Agent of the Board of Health
-x Q
,p
Q:\SEPTIC\Letters Septic Inspection Failures or Future Eva1\183 Sturbridge Dr.Ost.Dec2012.doc
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
4
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner owner's Name
information is Osterville MA 02655 12-11-12
required for every
page. Cityrrown State Zip Code Date of Inspection
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.
Irnpoltantwnen A. General informationfillngouk
an'thecomputer, �
\```��N�CF�f
knee tonly
mrn�iee our 1. Inspector. ��• • - cy
cursor-do not ,lames D.Sears JAME$
use the return s v— �si�'J' y
key. Name of Inspector . * *e
CapewideEnterp rises,L LC
o:. c
fry \
Company Name �`
i�� 8r IN iliIt
153 Commercial St
Company Address
Mashpee MA 02649
Cityfrown state Zip Code
608-477-8877 S1623
Telephone Number Ucense Number
S. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
Information reported below is true, accurate and complete as of the time of the inspection.The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems:I am a DEP approved system inspector pursuant to Section 16 340 of
Title S(310 CMR 15.0.00).The system:
❑ Passes ❑ Conditionally Passes. ® Fa.ils
❑ Needs Further Evaluation by the Local Approving Authority
ZE
Mp
Y l2poectoes Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authodt;(Board
of Health or DEP)within 30 days of completing this inspection. If the systernl is a Shared system or
has a design flow of 10,000 gpd or greater,the inspector and the system owner shalf&bmit<the
report to the appropriate regional office of the DEP.The original should . sent to thesystem owner
and copies sent to the buyer, if applicable, and the approving authority.
""`Thus 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.
15hs•11110 rdis 5 ofiusi 1lspeclim Form:Subsurlaoe Sewage Disposal System•Page 1 of 17
e
Dec 12 12 01:25p p.2
Commonwealth of Massachusetts
Title 5 Official Inspection form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is 0 terville MA 02655 12-11-12
required for every
page. City[Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
❑ I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old" or the septic tank(whether metal or not)is structurally
r 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):
I
151ns 11110 Title 5 Official Inspection Form:Subsurface Sewaga Disposal System•Page 2 of 17
Dec 12 12 01:25p p.3
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
µ 183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is Osterville MA 02655 12-11-12
required for every
page. Citylrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes(cunt.):
❑ 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 ❑ NO(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ NO(Explain below):
❑ The system required pumping more than 4 tames 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 ❑ NO (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
I5ins.11110 Title 5 olfical Inspection Fonn Subsurface Sewage Disposal System•Page 3 of V
Dec 12 12 01:26p p.4
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
163 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet _
Owner Owner's Name
information is
required for every Osterville MA 02655 12-11-12
page. Cityrrown state Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health(and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well'".
Method used to determine distance:
*'This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to this form.
3. Other.
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes"or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® 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 dogged SAS or cesspool
® ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less
than Y2 day flow i iv TyF o°.►sr
t5 ns•11110 Tifla 5 Official Irspeclion Form:subsurface sewage oisposat system•Page 4 of 17
Dec 12 12 01:26p p.5
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
w ' 183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is required for every Osterville MA 02655 12-11-12
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cunt.)
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 primate 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 20009pd-
10,0009pd.
® ❑ 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
El ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes" to any question in Section E the system is considered a significant threat,
or answered "yes"in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304.The system owner should contact the appropriate
regional office of the Department.
t5ins-11110 Tltle 5 OfAcial hspedlon Fora subsurface Sewage Disposal System•Page 5 of 17
Dec 1212 01:26p p.6
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is required for every Osterville MA 02655 12"11-12
page. Cityfrown 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
0 9 Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
N,4 ❑ ❑ Were as built plans of the system obtained and examined?(If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered,opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?.
The size and location of the Soil Absorption System JSAS)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): NA Number of bedrooms(actual): 2
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220
t5ins•11110 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System-Page 5 of 17
Dec 1212 01:27p p.7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owners Name
information is Osterville MA 02655 12-11-12
required for every
page. City[Town state Zip Code Date of inspection
D. System Information
Description:
The system is a 1000 Gal precast tank and over flow cesspool
0
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available(last 2 years usage (gpd)): 2010-22,000GaIs2011-17,000Gais
Detail:
Sump pump? ❑ Yes No
Last date of occupancy: NADate
Commerciallindustrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15203): Gallons per day(gpd)
Basis of design flow(seats/personsfsq.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-11110 Title 5 Official Uispet7ion Form:Subsurface Sewage Disposal System-Page 7 or 17
Dec 12 12 01:27p p.8
Commonwealth of Massachusetts
-- Title 5 Official Inspection Form
s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owners Name
information is required for every Osterville MA 02655 12-11-12
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: NA
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: I gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank,distribution box, soil absorption system
❑ Single cesspool
® Overflow cesspool
❑ Privy
❑ Shared system(yes or no)(if yes, attach previous inspection records, if any)
❑ Innovative/Altemative 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 IIA system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•11110 Title 5 Official Wgxn ion Forth:Subsurface Sewage Disposal System-Page 8 of 17
Dec 12 12 01:27p p.9
Commonwealth of Massachusetts
Title 5 Official Inspection Form
' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is required for every osterville MA 02655 12-11-12
page. Citylrown state Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
NA
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 14"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.):
Pipeing house to tank cast iron Pipeing tank to cesspool orange burge
Septic Tank(locate on site plan):
Depth below grade: feet
Material of construction:
®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1000 Gal Precast
Sludge depth:
Gins•11110 We 5 Oftial Inspection Form Subsurface Sewage Disposal System-Page 9 of 17
Dec 12 12 01:28p p.10
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is required for every Osterville MA 02655 12-11-12
page. Ckyffown State Zip code Date of Inspection
Q. System Information (cont.)
Septic Tank (cont)
Distance from top of sludge to bottom of outlet tee or baffle 29e
1"
Scum thickness
Distance from top of scum to top of outlet tee or baffle
12"
17"
Distance from bottom of scum'to bottom of outlet tee or baffle --
How were dimensions determined? Tape-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.):
Tank and inlet cover at 10" below grade w/out let cover at 6"_ Outlet baffle in bad shape, No
sign of leakage Inlet baffle
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
t51ns-1 V10 Title 5 Official Inspection Foam:subsvriaca Sewage Disposed System•Page 10 of 17
Dec 12 12 01:28p p.11
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is Osterville MA 02655 12-11-12
required for every
page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
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: bate
Comments(condition of alarm and float switches, etc.):
Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
15ins•11l10 Title 5 oRdal Inspection Forth:Subsurface Sewage Disposal System•Page 11 of 17
Dec 12 12 01:28p p.12
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is Osterville MA 02655 12-11-12
required for every
page City/Town State Zip Code Date of Inspection
De System Information (cont.)
Distribution Box (if present must be opened)(locate on site plan):
Depth of liquid level above outlet invert
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
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.):
Soil Absorption System (SAS)(locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•11/10 Idle 5 Official tnspecdon Form:Subsurface Sewage Disposal system-Page 12 of 17
Dec 12 12 01:29p p.13
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owners Name
information is required for every Osterville MA 02655 12-11-12
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number.
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
® overflow cesspool number:
1
❑ 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.):
Leaching is a 7' block cesspool w/cover at 21",2"water. Note: Wails show sign of being
full in the past Need to replace leaching
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•11flo Me 5 Ortidal Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17
Dec 12 12 01:29p p.14
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
requion
r a fu isr every 0 terville MA 02655 12-11-12
requir ed f
page, Cityfrown 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.):
15in5.11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 or 17
f
Dec 12 12 01:29p p.15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is Osterville MA 02655 12-11-12
required for every
page. CitYrrown State Zip Code Dale of Inspection
U. 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
o �
i5ins•11110 Tile 5 Offidal Inspedion Forth:Subsurface Sewage Disposal System•Page 15 of 17
f
Dec 12 12 01:30p p.16
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
183 Sturbridge Dr.
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is Osterville MA 02655 12-11-12
required for every ---
page. Cityrfown State Zip Code Date of Irspedion
D. System Information (cons.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water: I. feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting propertylobservation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Abutting property drop's off some 12'+
f
Before filing this Inspection Report,please see Report Completeness Checklist on next page.
15ins-11110 Title 5 Official Inspection Form Subsurface Sewage Disposal System-Page 16 of 17
Dec 12 12 01:30p p.17
Commonwealth of Massachusetts
- Tithe 5 Official Inspection Form .
k,4v��� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
183 Sturbridge Dr
Property Address
The Estate of Bobbie Berlet
Owner Owner's Name
information is Osterville MA 02655 . 12-11-12
required for every
page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
j
TOP FND
ELEVATION = 100.0 MAXIMUM COVER OVER FIELD /S 3' OBSERVATION TEST PITS
USE RISERS TO BRING ZABEL FILTER IN ANYTHING GREATER WILL REQUIRE VENTING
COVERS TO WITHIN 6" OUTLET TEE
OF FINISH GRADE
INSTALL MAGNETIC :TAPE TP 1 TP 2
O ,r ELEV= 95.6 ELEV= 95.6
N COVERS
ti
FIN. GRADE EL. SL A 10YR2/1 SL A 10YR2/1
3" MIN MIN. OF FIRST 2 FEET FIN. GRADE
BRING D-BOX TO WITHIN 6" OF OF OUTLET PIPES TO BE 6' 6'
FIN. GR. WITH RISER. MARK LEVEL 2" MIN LS B 0YR516 LS B 0YR516
4" PVC SCH.40 t 6 95.25 " 4" PVC SCH.40 COVER WITH MAGNETIC TAPE 40 ' »
INV= 9 0 INV= 4 LF OF 4" TEE 40
S= 29, '� _14_ TEE S= 2% j;lS_=
C 1 2.5Y5/3 C 1 2.5Y5/3
I N V.= TITLE V MED MED
INV- 10 TEE 6 92. 17 0 0 0 0 0 0 0 0 0 0 0 0 �qND SAND SAND
INV.=96.00 0 0 0 -0 -0 -0 -0 ; _000
4' LIQUID 1500 GAL. 92.58 92.25 TITLE
DEPTH SEPTIC TANK cqs 'oo00000oc SAND
BAFFLE /� '^°"°"°"°" 121" 121"
LEVEL STABLE DISTRIBUTION
BASE A 0 26' 0 PERC. TEST PERC. TEST
0___ '8-_FT. ®-------FT.
i00000000c 6" CRUSHED STONE NTS OVERO/G .3__MIN/IN _____MIN/IN
SEPTIC TANK )000000000
0 0 0 o c ��
NTS 00000o0o�c W/BAFFLE YES WATER EL= WATER EL=
NONE NONE
FIN GR. SOIL TEST PITS AND PERC. TEST PERFORMED BY
PROFILE OF LEACHING FIELD SEXAGE DISPOSAL SYSTEM 12" MIN NATIVE BILL GOTTWALD DATE : 3/8/13
BACKFILL
4" TITLE 5 SAND W1 TNESSED B Y.-
BARNSTABLE BOH
TYPE OF BUILDING EXIST 3 BDRM HOUSE
DESIGN FL 0 W 3 x 110 GPD/BDRM = JJO GPD 34" 91.5
6'
SEPTIC TANK
WATER ELEv GENERAL NOTES:
2001&-,- OF DESIGN FLOW= 330 x 2.0 = 660 GALLONS
= 85.5 (DESIGN)
USE 1500 GALLON SEPTIC TANK 1. THE SEPTIC TANK SHALL BE 1500 GALLONS MINIMUM, UNLESS OTHERWISE SPECIFIED
ON THIS DESIGN PLAN, AND FITTED WITH SCHEDULE 40 PVC TEES OF PROPER LENGTH
SEPTIC TANK CONSTRUCTION SHALL CONFORM TO 310 CMR 15.226. THE SEPTIC TANK
GARBAGE GRINDERS LOCAL UPGRADE APPROVAL/ VARIANCE REQUESTS. OUTLET COVER SHALL BE BUILT UP TO WITHIN 6" OF THE FINISHED GRADE UNLESS
OTHERWISE SPECIFIED..
NOT ALLOWED! REDUCE REQUIRED 20' SETBACK FOR SAS FROM 2. SEPTIC TANK ANF DISTRIBUTION BOX SHALL BE PLACED ON A 6" MINIMUM COMPACTED
1. FOUNDATION WALL TO 17 AS PER 310 CMR. A GRAVEL SASE.
POLY BARRIER WILL BE INSTALLED
3. ALL JOINTS MUST BE WATERTIGHT, SEALED WITH SUITABLE CEMENT FOR THAT
i
SPECIFIC COMPONENT.
LEACHING FIELD 4. SOIL PREPERATION FOR THE LEACHING AREA SHALL CONFORM TO 310CMR 15.246 &
15.247
DESIGN PERC RATE = 3 MIN/IN 5. ANY EXCAVATION OF UNSUITABLE MATERIAL DESIGNATED ON THE PLAIN SHALL CONFORM
TO CONSTRUCTION IN FILL REQUIREMENTS AS OUTLINED IN 310CMR 15.255 (1-6)
SOIL CLASS
6• FILL MATERIAL FOR SYSTEMS CONSTRUCTED IN FILL SHALL BE COMPRISED OF -CLEAN
EFFLUNT LOADING RATE _ • 74 GPD SF GRANULAR SAND, FREE FROM ORGANIC MATTER AND DELETERIOUS SUBSTANCES.
GRANULAR SAND, FREE FROM ORGANIC MATTER AND DELETERIOUS SUBSTANCES.
AGGREGATE SPECIFICATIONS SHALL.CONFORM TO -310 CfJR 1 S.247. '
330 GPD = • 74 GPD/SF 446 SF OF LEACHING AREA 24 HOUR NOTICE REQUIRED FOR INSTRUCTIONS
INSTALL 1 INSPECTION PORT CONSISTING OF A Pf RFORATED 4" 'PIPE ANY ALTERATIONS MUST BE REPORTED TO THE DESIGN ENGINEER ,PRIOR TO
PLACED VERTICALLY DOWN INTO THE SAND TO THE NATURALLY OCCURING PROCEEDING "WITH CONSTRUCTION.
z > SOIL OR' SAND FILL BELOW THE INFILTRATORS. THE PIPE SHALL BE CAPPED W/ t
PER INFILTRATOR DESIGN GUIDLINES A SCREW TYPE CAP & ACCESSIBLE TO WITHIN 3" OF FINISH GRADE. MARK CONTRACTOR TO VERIFY SOILS 7. NO HEAVY EQUIPMENT SHALL BE RUN OVER THE COMPONENTS OR LEACHING BED DURING
EFFECTIVE LEACHING AREA, = 4. 72 SF/LF OR 18.88 SF/CHAMBER BENCHMARK. w/ MAGNETIC TAPE. AT TIME OF INSTALLATION CONSTRUCTION.
TOP OF FND $ DEEP TEST HOLE INFORMATION INDICATES SOIL'CONDITION, PERCOLATION RATE AND
WATER TABLE ELEVATION AT THE TIME AND •LOCATION OF ACTUAL TESTING ONLY. IF
EL. = 100. 00 UNSUITABLE MATERIAL OR A HIGHER GROUNDWATER ELEVATION IS ENCOUNTERED, THE
(ASSUMED BOARD OF HEALTH AND DESIGN ENGINEER SHALL BE NOTIFIED.
9. AREAS DISTURBED DURING CONSTRUCTION SHALL BE STABILIZED TO HELP PREVENT
446118.88 = 23.6 CHAMBERS EROSION. THE AREA OVER THE SYSTEM SHALL BE GRADED TO A MINIMUM OF 2X
USE 4 ROWS OF 6 CHAMBERS ea. EXISTING LEACH PIT SLOPE, TO PROVIDE POSITIVE SURFACE DRAINAGE.
TO BE PUMPED PRPOSED 12 x 26' 10. NO STRUCTURE MAY BE CONSTRUCTED OVER THE RESERVE AREA.
AND REMOVED INFILTRATOR QUICK 4 STANDARD CHAMBER BED
_ _ _ _ -, USE 4 ROWS OF 6 CHAMBERS w/TWO ENDCAPS ea 11. THE SYSTEM SHALL BE VENTED IF THE TRENCH LENGTH EXCEEDS 50' OR IF IT IS
92- - -- - _ __ . COVERED BY IMPERVIOUS SURFACE. ALL PUMPED SYSTEMS ARE TO BE VENTED.
DESIGN 12• IF ANY COMPONENTS OF THE PROPOSED SYSTEM ARE SPECIFIED AS HEAVY DUTY,
ELEVATION SCHEDULE \ THOSE COMPONENTS SHALL CONFORM TO ALL STATE AND LOCAL REQUIREMENTS FOR
ELEVA TION 94- - - - - - - -- - AASHTO H-20 LOADING.
TOP OF FOUNDA TION 100. 0 INSTALL 40 m/ POLY BARRIER \ 13. THE SYSTEM MUST BE INSPECTED BY THE BOARD OF HEALTH AND THE DESIGN
SEWER INVERT AT FOUNDATION 96.0 BETWEEN SAS AND FND ` \ ENGINEER, PRIOR TO BACKFILLING.
14. UNLESS SPECIFIED IN THE BASIS OF SANITARY DESIGN, THIS SYSTEM IS NOT
SEWER INVERT INTO SEP Tl C TANK 95.50 96- _' _ SHED : . ;1 : , \\ _ - DESIGNED FOR THE USE OF A GARBAGE GRINDER OR OTHER HIGH WATER USAGE DEVICE
SEWER INVERT OUT OF SEPTIC TANK 95.25 1 15, IF THE 0-BOX IS DOSED OR THE INLET SLOPE EXCEEDS 890, AN INLET TEE OR
EXISTING BAFFEL IS REQUIRED.
SEWER INVERT INTO DI S T. BOX 92.58 1000 GAL 00 PROPOSED 1500 GAL 16. ALL CONSTRUCTION SHALL CONFORM TO 310 CMR 15.00, TITLE V AND THE
SEWER INVERT OUT OF DIST. BOX 92.25 SEPTIC TANK TO BE , REGULATIONS OF THE LOCAL BOARD OF HEALTH.
SEPTIC TANK
PUMPED & CRUSHED � MlN OFF FND
SEWER INVERT INTO CHAMBERS 92. 17 �A.P. 10 09 7 10__ I / 17. IT IS THE CONTRACTORS RESPONSIBILITY TO SECURE ALL-NECESSARY PERMITS PRIOR
11000 SF TO ANY SITE ACTIVITY. A STAMPED COPY OF THE APPROVED PLAN SHALL BE KEPT
BOTTOM OF CHAMBER 91.5 98 \ DECK f I ON-SITE
ELEVATION OF GROUND WATER TABLE 85' .5 1 s. ANY EXISTING UTILITIES SHOWN ARE APPROXIMATE ONLY. CONTRACTOR TO VERIFY
. . . .:::'GAR:':':: :':':':': •:.:':...:':':':':':.:. .. :: : :: :::: PRIOR TO EXCAVATION.
:•.•:•:•:•:•:•:•::: :;::: ::: :;:•:.. ..;. #183 ;; ;; 19. ALL KNOWN PUBLIC AND PRIVATE WELLS PER 310 CMR 15.220(k) ARE SHOWN.
o EXIST 3 BDRM
:. .... . .... .. ....... . HOUSE.'. .. . . .. :':': 20. CONSERVATION COMMISSION APPROVAL MAY BE REQUIRED.
.'.'.'.'.'. .'.'.'.'.'.'.'. 21• FOR OPTIMUM PERFORMANCE, THE SEPTIC TANK SHOULD 8E INSPECTED ANNUALLY AND
WHEN THE SOLIDS AND SCUM DEPTH EXCEEDS 113 OF THE LIQUID DEPTH, THE TANK
W SHOULD BE PUMPED.
p OWNERS:
MATTHEW GARBAUSKAS
j 69 NEPTUNE
ci S. YARMOUTN, MA REPAIR
110
SWIFT �' ON-SITE SEWAGE DISPOSAL SYSTEM
STURBRIDGE DRIVE 183 STURBRlOGE DRIVE
"CF OSTERVILLE, MASSACHJSETTS
m wrLLrAM
0 AL
LOCUS " PREPARED FOR: MIKE MORESHEAD
N . 38
ff(moro MAP SCALE: 1"--20' DATE: 3/1111J
D I V! G DMG ASSOCIATES
40 THOMAS RD.
BERKLEY, MA
508-951-1169