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0009 THYME LANE - Health
9 Thyme Lane OsterviIle -- A= 165 —006 ti 1 a 4 I Commonwealth of Massachusetts __- • . f Title 5 Official Inspection Form . ' I Subsurface Sewage Disposal System Form Not for Voluntary Assessments41 j ' 9 Thyme Ln _ + J Property Address r h John Sunderland r^, ►+ . _' Owner Owner's Name1 information is Osterville r =, . 1 MA 02655 1-12-18 " ` required for every a page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see.completeness checklist at the end of the form. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services y ; Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S 13971 Telephone Number License Number B. Certification p . I certify that I have personally inspected the`sewage,disposal system at this address and that the information reported below is true;accurate and complete as of the,time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage,disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of ` Title 5 (310 CMR 15.000).'The system: ' .®,,Passes t . El. Conditionally Passes .r ❑ Fails + �^ , ;. - ❑ Needs Further Evaluation b thelLocal Approving,Authority.� •, a y. 1-12-18 Inspector'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 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.doc-rev.•6/16" Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 VS Commonwealth of Massachusetts a� F Title 5 Official Inspection Form f i,. hI Subsurface Sewage Disposal System Form Not for Voluntary Assessments ,!q 9 Thyme Ln Property Address John Sunderland r Owner Owner's Name information is required for every Osterville MA 02655 1-1.2-18 - 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:,,. - _ a5 E ® 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: System is in good working order with no sign of failure. 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 < Commonwealth of Massachusetts :a=1 Title 5 Official Inspection .Form ' .;.I Subsurface Sewage Disposal System Form -Not for.Voluntary Assessments ti i'�':'''�• 9 Thyme Ln Property Address John Sunderland Owner Owner's Name . information is required for every Osterville '. ca t MA 02655 1-12-18 ` State (Town Cit a page. Y 1 t to 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 o'r obstructed pipe(s)•,or due to a'brok. 1 se1.ttled 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): A. ❑ distribution box is leveled or replaced ❑ Y b N ' ❑ ND'(Explain below): A,- tv r I�t t n k ❑ 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.iletermines in accordance with 310 CMR 15.303(1)(b)that the system is not functioningin`a manner which will protect public health, ' safety arid'tFie 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official - inspection Form GJ „� Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments s, 9 Thyme Ln Property Address John Sunderland Owner Owner's Name information is Osterville MA 02655 1-12-18 - required for every ' 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 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 El ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool E] ® Discharge or ponding of effluent to the'surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins.doc"rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System"Page 4 of 17 Commonwealth of Massachusetts _ - + ' _� •. }_ :a=1 Title 5 Official Inspection Form �A Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 9 Thyme Ln T t J' Property Address , John Sunderland f° Owner Owner's Name + information is Osterville" ' ' MA 02655 1-12-18 required for every 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: ❑ [0 Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or ❑` ® tributary to'a surface water supply. + ❑ .,®{ -Any portion of a cesspool or privy is within a Zone 1 of-a public well. to ® Aiiy 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 wand 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. F T'. The system fails.?I have`determined that one or more of the above failure El diteria exist as described in 310 CM 15.303,therefore the system fails. The system owner should•contact the Board of Health to determine what will be j, •. , w :necessary.to correct the failure.,. 'f ` ' r 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 rater_supply ❑ ❑ the system is within 200 feet of a tributary to'a-surface drinking water supply t+ ❑ ;❑ , t , ,the system is located in a nitrogen sensitive area (InterimWellhead Protection Area— IWPA) or a mapped Zone'll 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.doc+rev.6/16 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 u._sf!» 9 Thyme Ln l J Property Address John Sunderland Owner Owner's Name information is required for every Osterville MA 02655 1-12-18 ' page. City/Town 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"umped 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? ® El available as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ . Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ®. - ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid;depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: r ® ❑ 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 a Number of bedrooms (actual): 3 ' � 1 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection form. p } i., . �i� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments -nr , i. . 9 Thyme Ln , t J' Property Address John Sunderland * ;. .,'• , Owner Owner's Name information is Osterville i;• f MA 02655 1-12-18 required for every page. City/Town !: State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder?. ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system insptection,n�- ; Yes ® No information in this report.) '` Laundry system inspected? ,, 1:. Y. __ ❑ Yes ® No Seasonal use? ,, a , t if . aF ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): -r- , Detail: Sump pump? 3ti �, • :, ;._ ❑ Yes ® No ,. Last date of occupancy: r, 2017 Date Commercial/Industrial Flow Conditions: Type of Establishment: i Design flow(based om310 CMR,15.203):, fi Gallons per day(gpd)' Basis,of design,flow;(seats/persons/sq.ft., etc.): Grease trap present?., �i ,nn. tt .•,: : : },. ❑ Yes ❑ No Industrial waste holding tank present?. - .. ^,> rr' =_t El Yes ❑ No Non-sanitary waste discharged to the Title 5 system?, I ❑ Yes ❑ No - Water meter readings, if available: t5ins.doc-rev.6b16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts r r +a Title 5 Official Inspection For' N61it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 9 Thyme Ln Property Address John Sunderland Owner Owner's Name information is Osterville MA 02655 1-12-18 required for every 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: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: Septic tank, distribution box, soil absorption system El 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 I Commonwealth of Massachusetts ; _£;: t -u •, . f� Title 5 Official. Inspection Form- rl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' `W-P.4_+ 9_Thyme Ln Property Address John Sunderland t. Owner Owner's Name information is Osterville MA 02655 1-12-18 required for every ' 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: 2009 " Were sewage odors detected when arriving at the site? ❑! Yes ® No Building Sewer(locate on site plan): �� ,, ,.; r. Depth below grade: ,'r , 4,,F.► ;P 48 11 feet Material of construction: - ' El cast irori ® 40 PVC ❑ other;(explain):,' Distance from private water supply well or suction•line: feet r Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank (locate on site plan): 'Depth below grade: 40" �- 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: .1500 gal Two compartment Sludge depth: , 12" t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page-9 of 17 l Commonwealth of Massachusetts s Title 5 Official Inspection Form ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 9 Thyme Ln Property Address John Sunderland Owner Owner's Name' information is required for every Ostefville MA 02655 1-12-18 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 20" Scum thickness G 2" 611 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Tape 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 with baffles installed and no sign of leakage. 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.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 I Commonwealth of Massachusetts � ri .• a=1 Title 5 Official Inspection Form # ' f.;I Subsurface Sewage Disposal System Form Not for.Voluntary Assessments •R�" � 9 Thyme Ln Property Address John Sunderland Owner Owner's Name information is Cisterville MA 02655 1-12-18 required for every - 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.): ' { 1 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 , Commonwealth of Massachusetts lay Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments - � is 9.s,! 9 Thyme L.n Property Address John Sunderland Owner Owner's Name information is required for every Cisterville MA 02655 1-12-18 page. City/Town t State Zip Code Date of Inspection D. System Information (cont.) r Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): Good condition with water at working level and no sign of back-up from field. 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.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 I Commonwealth of Massachusetts ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 Thyme Ln Property Address John Sunderland Owner Owner's Name information is , required for every Osterville r MA 02655 1-12-18 page. City/Town _ State Zip Code Date of Inspection D. System Information (cont.) s _ Type: ❑ leaching pits number: ® leaching chambers number: 7-Cultec 3050's ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields 'number, dimensions:' ❑ overflow cesspool number: ' ❑ innovative/alternative system r . Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): ; Leach field in good working order and empty at inspection with no sign of back-up into d-box or surrounding stone. 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts =1 Title 15 Official Inspection Form G + l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments !„/ 9 Thyme Ln Property Address John Sunderland Owner Owner's Name information is Osterville MA 02655 1-12-18 required for every ' 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official. Ins ection. Foft' f ' 'N Subsurface Sewage Disposal.System Form -Not for:Voluntary Assessments .: .. 9 Thyme Ln y Property Address John Sunderland Owner Owner's Name _ information is Osterville :° ^' + MA 02655 1-12-18 required for every '-- - page. City/Town r State Zip Code Date of Inspection D. System Information (cont.) F ,,w_r+ . ►.•, ., . 6-:, + 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 j r: t,. . jar. } ,j'...,•i ::ale+ _ ti-... `f' • .. s. � { r. ;r 1.� .' .-. '' *t e.� .,k �-y 4. i•+ r a ar t5ins.doc-rev.6/16 4 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts �a='I Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form -Not.for Voluntary Assessments t ,b; �.s.!, 9 Thyme Ln Property Address John Sunderland Owner Owner's Name information is required for every Osterville MA 02655 1-12-18 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: 12' feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ®- Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database- explain: - You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form IN Subsurface Sewage Disposal System Form -Not for Voluntary Assessments -ssa 9 Thyme Ln Property Address John Sunderland _ Owner Owner's Name information is required for every Osterville MA 02655 1-12-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either.drawn on page 15 or attached in separate file t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 G 'T )WI' oF.B LAST SWAGE L4Cp�'IiION :'VILLA'�� sFssoRl vr.,�.� L07 z. I�tSTA3rI HIR NAIL A PRONE hiD sEF'1"LC TANS CAPACITY , . I:E GgIY1+1Ci'IF+A�C 1Tx On w NO .CDP'E�DdtCttJ1VdS f }iFldtTDA'TL Sepr6ration�tstattca Eetv�een tire' ; Maximumlcl}ust�tl Gtautsciwate�'!'hte to the l3attom of l,caGhen�t��uilitp llvte,Wa4isr Sap�+ly Vlo�l:;a��d�ect�teg Lxaca#aty . 0 any:�zct9s cxfstoi 4t�seta ae wlth�n;2AA felt aF laacturig Ctictuiy) :�. :: .—.�...._ ci't'cyg /et9and acid I.cac ttntg 1Fagitlty( my etlamis exist vttl�at�;3Qt}feet• f caaing tuctta � r. YiV��TOWN OF BARNSTABLE I''II f0 LC-CATION SEWAGE # VILLAGE 125`Tell%///�1 ASSESSOR'S MAP &LOT �D INSTALLER'S NAME&PHONE NO. iJ-1el SEPTIC TANK CAPACITY A O® 4644 LEACHING FACILITY: (type) `� 3 •s r(2`� (size). NO. OF BEDROOMS_ BUILDER OR OWNER L4^ PERMTTDATE: COMPLIANCE DATE: l / 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 ^ ,� ., a g �� . - ® i '� ,. � � �i�.. ��,�._ ��� �� �� � .. ....., �-s>.w,� ,s,.,.. .. ... ---.ti r.-. - �.. ._, .. .,,, „yam�•, No. a oo�_. 656 l�V ' Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 1Applicatiou for �Bigotaf *p.5tem Cou5truction Permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) Xcomplete System ❑Individual Components Location Address or Lot No. -1 Ti�iQ i •C"Q ,0sAewA ke Owner's Name,Address,and Tel.No. 9 Assessor's Map/Parcel I�Q5 /b OCp �C�hfl SVn&r O�C� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �7,SVnZ. C.AVLMGraf SmA}' aye -a 00 1 s Type of Building: t `X Dwelling No.of Bedrooms 4 - Lot Size Z sq.ft. Garbage Grinder (A,4 Yes) Other Type of Building ►J I /a- No.of Persons Showers( Cafeteria( Other Fixtures Lao 3-6-0-r i t\k Design Flow(min.required) (00 gpd Design flow provided Co�+4 r e$ gpd Plan Date 1 } `pT Number of sheets I Revision Date —" Title \Ab pp;Se-A J ao�S"s Q'E'C`m'k, Size of_Septic Tank S�)CDC.%c, Type of S.A.S. Description of Soil Cot�,Pec ttren�r Tfl�ae ` a� x Sii` Xa , Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and m ' tenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environme ode and not to place the system in operation until a Certificate of Compliance has been issued by thisZBoaHSplth Signed Date 3-"1 7`o / Application Approved by c Date 3 f 7'0 / Application Disapproved by: Date for the following reasons Permit No. Date Issued ?J`f_7 No. L — .. ,� Fee THE COMMONWE'ALTH'OF MASSACHUSETTS Entered in computer: ' PUBLIC HEALTH DIVISION - TOWN 1OF BARNSTABLE, MASSACHUSETTS Yes application for �3igpo.5aY q§p6tem (,Con.5tructioj VerMjt Application for a Permit to Construct( ) Repair)4 Upgrade( ) Abandon( ) Complete System Individual Components XI Location Address or Lot No. y(vV Lccxg ,CiSAera,(`,e Owner's Name,A^dddress,and Tel.No. 'C — Assessor's Map/Parcel tj (DQ)(p �Q. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. (�.o 'ir shQr CPtttn e'rj S"a- 531- 49cot". Type of Building: = Dwelling No.of Bedrooms Lot Size Z, ADS S sq. fty Garbage Grinder Other Type of Building N 1 /.a- No. of Persons Showers( p-rCafeteria Other Fixtures Lxi y C �- • S t n k 1. o a nc'Cat Desi n F1ow min.required) �.p (0Q d Design flow provided cc +4 , a R g ( q ) gpd g P gpd Plan Date Number of sheets I Revision Date Title Size of.Septic Tank '7L)DC,ra a ,Type of S.A.S. `r ('otY,�?cx t �- 'Tf)wc 1 a Sri xa ' Description of Soil X_� 4 ( , • t i �` Nature of Repairs or,Alterations(Answer'whenpl•applicable) 1. 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 � fHealIth: Signed I Date t '7 d / Application Approved by �r — Date Application Disapproved by: \ Date for the following reasons v R Date Issued 3` f 7� d � . _ THE COMMONWEALTH OF MASSACHUSETTS i BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (X) Upgraded ( ) Abandoned( )by' �C1C�t~te� S�ec J at has been constructed in accordance /� with the provisions of Title 5 and the forcDiisp al System Construction Permit No. °� Us dated J_r7 y Installer 't`� rP_u� r ti`�.�(le� Designer rr"�(�r�Rt� #bedrooms `� �. Approved design flow , '�IJ j gpd The issuance df this permit shall/not be construed as a guarantee 'that the system wtld�function as designed. Date/ � l� i�t IrM f t (!yl all!7� l �V �l j-i Inspector////I/f( �U /►'/�t�If/tGt J A ------- -- ---n�;�--- --- �-— ------------ No -----------------------==—==—=--=Fee yv� lJ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 3Di!5po!9al i§p5tem Cow6truction Vermit } }` Permission is hereby granted to Construct ( ) Repair (X) Upgrade ( ) Abandon ( ) e System located at N ,Q L-at'1-Q. and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this p it, Date 3 — 1 7- U / Approved by Q - v a , Town of Barnstable �F IME 1p� do Regulatory Services Thomas F. Geiler, Director * BARNSTABLE, • _ MASS. �0� Public Health Division A'ED 39. Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Desi$tner Certification Form Date: 4/l/09 Designer: Shay Environmental Services, Inc. Installer: Rodney Fisher Address: P.O, Box 627 Address: 585 Kelley Street East Falmouth, MA 02536 Harwich, MA On 3/19/09 Rodney Fisher was issued a permit to install a (date) (installer) septic system at 9 Thyme Lane, Osterville, MA based on a design drawn by' ' (address) Shay Environmental Services, Inc. dated 3/19/07 (designer) XX 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. 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. ((Insta r is-Signature) esigner's Signature) (Affi s Her PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH D V ON. 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. Q: Health/Septic/Designer Certification Form APPLICANT: ADDRESS: DESIGN FLOW: gPd REVIEWED BY:. 0 C DATE: N/A OK NO Le�al boundaries den oted oted 3 10 CM R 1522 04 a Street, Lot;tax parcel number and lot number noted on plan.[310 CMR 15.220(4)(u)] Locus Provided [310 CMR 1-5.2204 t Plan proper scale? (1"=40'for plot plans, 1"=20'or fewer for com onents) [310 CMR 15.220(4)] Easements`shown [310 CMR 15.220(4)(b)) System located totally on lot served [310 CMR 15.405(1)(a) for u ades]- i not, a variance is required [310 CMR 15.412(4 - Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220 4)(d) Location all buildings existing and proposed 310 CMR 15.220(4)(c)) Location and dimensions of system components and reserve areas [310 CMR 15.220{4)(e)) S stem Calculations [310 CMR 15.220(4)(0] Bail flow se tic tank cananity (re uired and provided) soil abso tion s stem (re uired and provided) whether system designed for garbage grinder North arrow [310 CMR 15.220(4)( )] Existing.and ro osed contours.[310 CMR 15.220(4)( )) ` Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)(h)) Names of soil evaluator and BOH representative.[3 10 CMR 15.220(4)(h)and (i)] Location and date of percolation tests (performed at proper elevation?) p10 CMR 1-5.220(4)(i)) Percolation test results match loading rate?-[310 CMR 15.242] Certification statement by Soil Evaluator 310 CMR 15.220(4) Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3)and 310 CMR 1,5.220(4)(n)) Location of every water supply,public and private, [310'CMR 15.220(4)(k)] Address Sheet 1 of 7 i within 400 feet:of the proposed system location in the case of surface water su lies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft.'[310 CMR 15.220(4)(1)] . Water lines and other subsurface utilities located [310 CMR 15.220(4)(m) (if water line cross see 310 CMR 15.211(1)111) Profile of system showing invert elevations of all system . components and the bottom of the SAS 310 CMR15.220(4)(o)] Stampof designer 310 CMR 15.220(1) and 310 CMR 15.220(2)] Stamp of Registered.Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate(two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as a- pproved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? [310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75`of system [310 CMR 15.220(4)( )] LZ Materials specifications noted? [various sections of 310 CMR 15.0001 System components.not>36" deep(unless Local Upgrade ,Approval or LUA requested) [310 CMR 15.405(1(b)] Address Sheet 2 of 7 Size OK? _[310 CMR 1-5.223(1)] Inlet tee located.ton inches below flow line 310 CMR 15.227(6)] Outlet tee 14"or 14"+5" per foot for increase ft depth [310 CMR 15.227(6)] Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 15,228(1)] ^ Separation between inlet and outlet tees (no less than liquid depth) 310 CMR 15.227(2)] Inled0utlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for 1up,grades under LUA [310 CMR 15.405(1)(k)] I VI tnimum cover 9" (Tanks buried more than 9"must have risers all openings and on the d=box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20"or greater)- middle access at least 8" (b. 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade - one port for systems<1000gpd, two fors `stems>1000 gpd 310 CMR 15.228(2) All at-grade'covers secured to unauthorized.access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buo ancy calculation Required/Done [310 CMR 15.221(8)] H-20 Where'`a ro riate? [310 CMR 15.226.(3)] Setbacks from resources [310 CMR 15.211] Required when other than single-family dwelling or flow>1000 d [310 CMR 15.223(1)(b)] - First compartment 200%daily flow; Second compartment 100% daily flow 310 CMR 15.224(2) and (3)] "U"pipe through or over baffle, outlet of each compartment with as baffle or approved filter[310 CMR 15.224(4)] Address Sheet 3 of 7 tj ion Located at least ten feet from any water line? [310 CMR 15.222(2) Disposal piping at least 18 below water line (when water and sewer cross, see 310 CMR 15.211(1)[1]) Cleanoufs`re4uire& rovided ? [310 CMR 15.222(8)] Thrust blocks specified in force mains?310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable l[310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) 310 CMR 15.251(9)and 310 CMR 15.252(2)(c)] Siphonproblem/ leachfi.eld below pump chamber) Endca s or vent manifoldspecified? Size and orientation of discharge holes specified?(not smaller than 3/8 not larger than 5/8") [310 CMR 15.251(8)and 310 CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe .types allowed) a Stable compacted base [310 CMR 15.22](2) and 310 CMR LA 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided?(when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if deeper than 9" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum sum 6" [310 CMR15.232(3)(e)] Watertight cover if,<2000gpd);waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] Capacity(emergency storage above working=design flow)? [310 CMR 231(2)] Pro er setbacks [310 CMR 1 1 (same as septic tanks)] Watertight 20-in minium,access ma ole at least 20"MUST BE TO GRADE [310 CMR 15.231(5)]. - Service components accessible(not too deep th pipin disconriects accessible) Alarm floats—alarm on circuit separate from m s sp eci Exceeds two units must have two pumps erating in lead-lag mode. [310 CMR 15.231(6) and(8)] Stable Compacted Base [310 CMR 15.221(2)] Buoyancy calculations needed ?Provided? [310 CMR 15:221(8)] Address' Sheet 4 of 7 rj _ O K U alculations correct? 4 feet of naturally occurring material demonstrated?[310 CMR_ 15.240(1) Required separation to groundwater? 310 CMR 15.212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.241) Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] - Breakout requirements met?(No violation of breakout elevation within.15_ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] Aill Chambers and Gal. in trench configuration supplied with inlet eve 20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole (if>2000 gpd must be tograde) [310 CMR 15.253(2)] Aggregate 1'mint m-4'maximum. [310 CMR 15.253 1)(b)] 2'sidewall credit imum [310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] Width 2'minimum 3.'maxi m [310 CMR 15.251(1)(b)] 100 feet-maximum len [3 CMR 15.251 1) a) Minimum separation 2x effective e or width whiche eater(3x if reserve between trenches d Situated along contours [310 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation bet lines 6' 310 CM R15.252(2)(d)] Maximum separation between lines a e of bed 4' [310 CMR 15.252(2)(e) Aggregate depth below discharge pipes 6"minimum, 12" maximum. [310 CMR 15.252(2)(g)] Se aration:between beds 10'mim�um. [310 CMR 15.252(2)(f)] Bottom area used in calculations only [3'1O—CMR 15.252(2)(i)] r . Address Sheet 5 of 7 =— -- - --._._ Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15:220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative 77 systems under remedial approval [310 CMR 15.254(2).and I/A Remedial Use Approvals] If use in gravel less system-make sure jet is directed as not to scours it interface [Guidance Document] Vnspecti ns once per year(systems<2000 gpd) or quarterly 2000 )good to note on plan [310 CMR 15.254(2)(d)] Construct n in fill -Did the plan specify that the fill shall meet the s ecific ion of 310 CMR 15.255(3)? / Im erviod�,b ier and/or retaining wall?.[Guidance Document] / Imperviou bamer installation must be supervised by designer[310 C R 15.255(2)(b)] Retaining wa must be designed by Registered Professional Engineer[310 C 15.255(2)(a)] Side slope note eed 3:1 ? 310 CMR 15.255(2)] Breakout require ents met? [310 CMR 15.252(2) d Guidance Document] At least 5 ft. from ervious barrier to edge SAS (IOft. recommended) (310 CA 15.255 (2)(e)] pi -XiRti Check DEP Approval l ters for credy s and design conditions If used with pressure do 'ng do no allow pressure discharge to scour soil interface Was DEP Approval Letter rovided and/or have you ` reviewed the letter for condit ns Is the technology bee prop rly.applied and does it meet all DEP Approval Conditio ? Is there a note;on, e plan rega ing the requirement for e etual maintenane agreement? Any alarms i volved on separate kircuits Did the ap icant submit an operate n and maintenance manual? Has ap, cant submitted a co y of a 2Aintenance Are the'variances-listed on the plan ? [31 CMR 15.220 (4)( )] RLS Stamp necessary on plan if a component,is within five feet of property line,[310 CMR 15.412(4)] New construction.or increased flow proposed - [Refer to 310 CMR 15.414] Address Sheet 6 of 7 t .. ...._- _ —-----_._ _.—._- - .___ _...... ......._.._ ... - - Is the system in a Designated Nitrogen Sensitive Area(Zone lI for a public supply e11)? [310 CMR 15.214, 310 CMR 15.215 and. 310 CMR 15.216 -7so e.P c regarding upgrades of such existin s stems] Is the system proposame lot as served by priv ell ?[310 CMR 15 14(2 _ Are_the nitrogen loads proposed in compliance? [310 CMR jNmping to se tic tank? [310 C 15.229 Shared System [310 CMR 15.290 Address Sheet 7 of 7 Town of Barnstable r# Department of Regulatory Services BARMAZEA Public Health Division Date 1639. �u 206 Main Street,Hyannis MA 02601 fDMK�� Date Scheduled Imil o<A Time ' b Fee Pd. Soil Suitability Assessment for Sewage Disposal , Q Performed B :J�1-u:i _ O�ad Y �/� y A� Witnessed By: IJA ' �I����4P1 LOCATION& GENERAL INFORMATION Location Address qo)g ve Owner's Name` oHd© -w /[�f� Address v p rwwu ""t✓ � ..�vl�/YwL d� Assessor's Map/Parcel: //„l-� 00� Engineer's Name NEW CONSTRUCTION REPAIR Telephone# 5 U 36. yU Y a land Use . Slopes(%) �' �-t �o Surface Stones Po Distances from: Open Water Body ft Possible Wet Area I� ft Drinking Water Well t_I(l ft Drainage Way 1y/ ft Property Line aa ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands 1n proximity to holes) l Parent material(geologic) J_A � Depth to Bedrock 1Q Depth to Groundwater. Standing Water in Hole: P. Weeping from Pit Face N Estimated Seasonal High Groundwater. N 1h DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment) ft. Index Well# Reading Date: Index Well level ., Adf,factor Adj,droundwater Level e PERCOLATION TEST bete Q a.► Time 1Q-00 Observation Hole# i.��� a Time at 9" Depth of Perc 66 Time at 6" Start Pre-soak Time @ 10.:Qa Time(9"•6") End Pre-soak Rate Min./Inch O� . Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 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# I Depth from Soil Horizon Soil Texture Soil Color Soil- Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency. ravel Lit ao 10 3 E/ e DEEP OBSERVATION HOLE LOG Hole# 9L Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% rave 4$�- 1 �• DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consiste ncy.%G ve s s DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi t n Flood Insurance Rate Mau: Above 500 year flood boundary No— Yes t Within 500 year Boundary No= Yes„_R Within 100 year flood boundary No— Yes „ Depth of Naturally Occurring!Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? ?JOA> -- If not,what is the depth of naturally occurring pervious material? Certification ' the soil evaluator examination approved by the I certify that on (date)I have passed Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in 3 10 CMR 15.017. Signature m ,i,�o CD Date Q:\SEPTiC%PERCFORM.DOC SECTION A -A SwVl,tcM►Rrbar,eT - VENT PIPE (O Least 24 Inches tall) ' , *NOTE. ALL PIPES ARE TO BE 4• SCHEDULE 40 P.V.C. Schedule 40 PVC w/Charcool ads FNt- PROFILE VIEW OF LEA CHINO SYSTEM �-- an10' min. from j t_. Existing Foundation (house to septic tank Not t0 Scale TOP OF FOUNDATION = ELEV. 100.00 (Assumed) Septic tank covers must be 0--BOX cover must r within to GRADE w w w w r � .,� , I y AarSle , r wthin B in. of finished grade 3 of 1/8 - 1/2 I/aehed Peastone Grade over Septic Tonle- 98.00 Grade over D-9m- 99.00 over SAS-98.003 HOLE DIS BDX 10 \ 314" to 1 112 " I/aehed Orushed Stone 1 ' ' " `� s= 0.02 4 PVC (CAPPED) INSPECTION PORT TO BE 0 Tap OF System- E1ay.-94.50 INSTALLED AND TO BE WITHIN 6` OF GRADE � 'I ;rti � �.;' NEW s=0 01 a Greater 1 EXIST._ n tr - ttY ao SEPTIC foot , v _ rttaM EXIST. FLIlltiDATIDI, ^ /2 = 50' n .500 G N 15' Ol per _ A A 2- Clam 5 a M N ' H-1 0 2' EFF DEPTH l CONCRETE FUT.L FotLNDA '� o A A a o, -� O 0 0 V A OO QO » Effectivwl 4>'20 ov mY, im 5o of cOp.m200e1 NAV720.i"elprTtl�Atlas.Iwo. �. c sc inaf i�4 at". 2• > o o °�' 4' 4' 4' rn 24 S2dewaZL c m A .-� --� GENERAL NOTES as - - 0 12' A 7Units@7' = 49' FL a SYSTEM. R OFILE e - Effective VkM , 1. Contractor is responsible for Digsofe notification, Verification of Utilities s loot 3/+-1 1/2" a 9' and protection of all underground utilities and pipes. Not to Sca C) compacted stone a 5 L.5� 2. The septicwtank and distri ution box shall be set NOTE ALL COMPONENTS MUST HAVE RI S TO WITHIN B" BELOW GRADE T$ Effective Length level On 6 of 3/4"-1 1/2" stone. z 4, .3. Backfill should be clean sand or gravel with no W Bottom of Test Hole 1 Elev.- 86.00 SOIL ABSORPTION SYSTEM (SAS) stones over 3" in size. 4. This system is subject to inspection during installation PERCOLATION TEST Groundwater Observed - NONE OBSERVED 3050 INFITRATOR CHAMBER- H-20 by Carmen E. Shay - Environmental Services, Inc. 5. The contractor shall install this system in accordance Date of Percolation Test: DECEMBER 18, 2008 (OR , EQUIVALENT) with Title V of the Massachusetts state code, the approved plan Test Performed By. MIKE 0 LOUGHUN and Local Regulations. Results Witnessed . DONNA MIORANDI-BARNSTABLE BOH NOTE: OVERALL HEIGHT OF INFILTRATOR IS 30" /EFFECTIVE HEIGHT 1S 24" 6. If, during installation the contractor encounters any soil conditions or site conditions that are different EXCAVATOR: Shay Env. Svcs. ( tm"ft.,,, � .c Percolation Rate: Less Than 2 MPI ® 48" .w... md TM BOX FHA ME 00N from those shown on the soil log or in our design SET LEVEL FOR AT LEAST 2 FT. 'r installation must haft do immediate notification be Test Hole Test Hole �}-_••_• made to Carmen E. Shay - Environmental Services, Inc. Tor-Osseo°u,ss"£` No. 1 No. 2 7. No vehicle or heavy machinery shall drive over the DEPTH SOILS ELEv. DEPTH SOILS ELEV. as - • OUTLET 12' INLET septic system unless noted as H-20 septic components. r : s• Lr ' 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. 0 97.00 0 97so ei8O0A1 w�. _ c � 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes. a••n Awn ' 1.7r 10. All solid piping, tees & fittings shall be 4" diameter FILL FILL PROJECT BENCH MARK TOP OF FOUNDATION PLAN SECTION CROSS-SECTION Schedule 40 NSF PVC pipes with water tight joints. 0"-24' 95. 6"-24• 195.50 4 BR HOUSE FLOOR SCHEMATIC 11. Municipal Water is Connected to ALL OF The Residence and Abutting Loamy Bandy (Description Provided By Owner) ELEV. = 100.00 (Assumed) Sand 3 HOLE H-10 DISTRIBUTION BOX Properties Within 150 Feet. 10 YR 4P 10 VR 4/3 24'- 30' Ae 94.50 24•- 30" As 95.00 Sewer Line to be Double Sleeved THE PROPERTY LINES ARE APPROXIMATE AND 10 Feet Each Side of Water Line THYME LANE COMPILED FROM THE SURVEY PLAN BY J. O'Loughlin INC.. ENTITLED Loamy Sand° With 6" SCH 40 PVC. (40 FOOT RIGHT OF WAY SEWAGE PLAN PLAN OF 9 THYME LANE, OSTERVILLE, MA 10 YR s/e 10 YR s/s - - - -�- - ----- - ----- DATED JAN. 29, 2009 _ AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN �•_ �- Bw 93.00 36-- ,4g' Be 93.50 `9��..------- - ----- - �� ( IT SHOULD BE USED FOR NO PURPOSE OTHER THAN FINE FINE . __ ----------------------- I Sand Sand ------- ------- ------------------ THE SEPTIC SYSTEM INSTALLATION. z5 Y 6/4 2.5 Y 6/4 1 EXISTING CESSPOOLS TO BE PUMPED OUT AND FILLED IN PLACE - 132 G •00 48•- 132 c, 86• 1.13.81' VENT r-,, .-, ----------- 1 O / �.._------- `N I NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE ��9 49 �� 1 FROM THE EXISTING CESSPOOLS TO BE DISPOSED q• -_ Failed 1 OF AS PER BOARD OF HEALTH SPECIFICATIONS.E D-Box :..-..•.�:-• . -- .. .-. -:~ Cessp�ol 05 • • • • 1 THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY Perc 11 / "'.; •r,='; 1 \� Depth to Perc: 48" to 66` �`' / =c ':•,-` "�` 20.� I ` Per Rate= CL MPI \ / 4V i NEW �\ ASSESSORS MAP 165 LOT 006 Groundwater Not Observed \ cfl cl 1500 gal. 1 1 No,Observed ESHWT Two Compartment \ LEGEND \ � �k'o 1 O ADJUSTED H2O Elev. = None \ �` b»e i O Septic Tank 2 ' 4" PVC Failed 1 I \ Cleanout Cesspool I T-r I � 1 �• p DENOTES PROPOSED 3-24•aAL1 ACCESS wANNotEs 1 1 I 3: 1 �I 104X 1 SPOT GRADE \ i 2 " 1 I � 1 i Cleano t 1 I 1 X 104.46 DENOTES EXISTING .,�i :• -:= : '' ,:_- - \` _ - MTU1 AL GAS1'NNE ---- 1 E%(STING i` 1 I SPOT GRADE ;e 1 4 BEDR00�[ ^� r' tST HOLE #1 98 f 11 11 = 1 Ev.= 97.00 HOUSE Full Foundation i ) 1 I PL PROPERTY LINE 00 RNET `` 0UWT1Fled if ` 1 9E9 PROPOSED CONTOUR y rp THE ACCESS COVERS FOR THE SEPTIC TANK, ni h DISTRIBUTION BOX AND LEACHING COMPONENT Cespool I 1 1 T tit - SHALL BE RAISED TO WITHIN 6' of ----- -99' EXISTING CONTOUR FINISHED GRADE 1 STEEL REINFORCED PRECAST CONCRETE INSTALL ALL OTUF-TITE GAS UTLET TEE ENINSTALLA�S OR EQUALS 1 i DECK ,,� 1 DEEP TEST HOLE & PLAN VIEW� Failed (gg�► N 1 PERCOLATION TEST LOCATION 3- •REi/0vA8 'Cesspool LE \ 'Cl / + \ 1 1 '*0 \ 1 6 FOOT STOCKADE FENCE mh. 9aEr a•mT r mis. s' ,r easy \ i GARAGE OUTLET 1 , T-� Te. 1 _ s-r P SOT P LAN s ` L1yuTd T.w 1 , 6TOOT ..e.. LI d4th \ TEST HOLD #1 _J ItI; ELF'= 9)�� LOT #51 OF PROPOSED SEPTIC SYSTEM UPGRADE f0061/ fog 22,205 Square Peet +/- ; PREPARED FOR CROSS SECTION END-SECTION lot \ MR. J 0 H N SUNDER LAN D TYPICAL (H-10 LOADING) 1500 GALLON SEPTIC TANK �"� \\ ', AT TWO COMPARTMENT TANK �� \\ \ �1 � � � a' g THYME LANE NOT'TO S`CALE �ij \ OSTERVI LLE, MA Design Caloulatiors o \ `� _ ,, d, of PREPARED BY: \ 1 `. Number of Bedrooms: 4 Bedroom EXISTING �0 � ; �\ - A Garbage Grinder. YES = 440 X 1507E = 660 GPD Q \ t `� 1 35.54, E c� Leaching Capacity Required: 660 Gal./Day (MIN. PER TITLE V) S► \ `.\ so C�, � CARMEN E. SHAY Septic Tank : - 2 x 660 Gal./Day = 1320 USE NEW 1,500 GAL Septic Tank. �� \ ; -• E. -' ENVIRONMENTAL SERVICls'S, INC. SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch '� \ -1 98 Bottom Area: 0.74 gal/sq. ft. x 648sq. ft. = 479.52 gallons \ ��` 0 20 40 50 0 1 o P.O. BOX 627 Sidewall Area: 0.74 gal./sq. ft. x 264 sq. ft. = 195.36 gallonsc�sTE�� EAST FALMOUTH, MA 02536 Providing: = 674.88 gallons �� SgrrirAR�P� TEL/FAX : 508-539-7966 Use: SEVEN (7) 3050 H-20 INFILTRATOR CHAMBERS, HAVING A 2' EFFECTIVE DEPTH, c�� SCALE: 1"=20' SCALE: 1"=20' DRAWN BY: CES DATE: MARCH 17, 2009 (4' W x 7' L) TO BE USED WITH V OF WASHED STONE ON THE SIDES AND 2.5' OF WASHED STONE ON THE ENDS. PROJECT#SD1122 FILENAME: SD1122PP.DWG SHEET 1 OF 1