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HomeMy WebLinkAbout0141 WIANNO AVENUE UNIT #B - Health (2) ll a h a n 0 e " TOWN OF BARNSTABLE G I'OCATION dot/ SEWAGE#J,009-/1(y,7. ILLAGE_QSAEC-1 rn& ASSESSOR'S MAP&PARCEL N INSTALLERS NAME&PHONE NO. ,3 e r 7 SEPTIC TANK CAPACITY fl��✓' / LEACHING FACILITY:(type) -5 O c �/ L�- (size) NO.OF BEDROOMS -7?4—K(3 2- ' OWNER .-�✓ PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY —Lo�— rr J-;-oo iz.9-15 -I&v 3g —6® o TOWN OF BARNSTABLE LOCATION �y Q W IAM 0 IT V C. SEWAGE # j. p S 'trvAUL ASSESSOR'S MAP &LOT V SAGE LYSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY a CZ S S p Y%I S LEACHING FACILITY: (type) 4- CQ S S VD is (size) NO.OF BEDROOMS-9— BUILDER OR OWNER At' i'rA��Or\ PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leacng facility) Feet Furnished by �it fntV�1 U^ rote 8 y .e w�1s I.S c� D u 00 s —� Fee �® THE AMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zipplication for Missp0$ar *pztem Conmrurtton 3permtt Application for a Permit to Construct(941 Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. �/�' / �o I/ /���f�D ¢�p O/w`ner''s Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �— Type of Building: Dwelling No.of Bedrooms l Lot Size 10 Z sq.ft. Garbage Grinder (41!;t7 Other Type of Building 0 Ce No.of Persons Showers( ) Cafeteria( ) Other Fixtures �J)� Design Flow(min.required) 1 `7 O gpd Design flow provided 44�;—Z7s t gpd Plan Date ` 4�9 7 Number of sheets Revision Date Title 51& 5 r I evl Af/Q'��� Size of Septic Tank e7 Type of S.A.S. Description of Soil • W Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o alt . Signe ' Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. �/6 L4- Date Issued No. —�lr C� r `" �A=A < 1 � ' 4( i Fee THE C MMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes r. ZippYication for,Migpogar 6pztem Cott!5tructfon Wermit x4 Application for a Permit to'Construct(W Repair( ) Upgrade( ') Abandon( ) C Complete System ❑Individual Components Location Address or Lot No. /Y 1 ,6 &)`olleD azp Owner.'s Name,Address,and Tel.No. 7�/ , I —D,5—,f / / Assessor's Map/Parcel D,> f Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �©a? Type of Building: ¢ Dwelling No.of Bedrooms / Lot Size '0!910 5 Z sq. ft. Garbage Grinder (4!rp Other �^ y:pe;of,BiiildingR��$/ �'I�G�' No.of Persons Showers( ) Cafeteria( ) OtheNixtures,/ 2 Design Flow(min.required) 7 gpd Design flow provided gpd Plan Date /7'`/ C Number of/sheets f Revision Date "- Title �7 J Gr✓O cJ�' �!�'�'l r 5�1 Size of Septic Tank Type of S.A.S. 3 j 'Q/ a �M►� Description of Soil Nature of-Repairs or Alterations(Answer when applicable) 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 o -ealt / Kkti �� Signe f�� Date /z-3 Application Approved by Date Vb-4/ U'7 Application Disapproved by: Date t for the following reasons Permit No. Dcc / '�6 C91' Date Issued f G� t THE COMMONWEALTH OF MASSACHUSETTS w BARNSTABLE, MASSACHUSETTS - -- r Certificate of Compliance THIS IS TO CERTIF that the On-site Sewage Disposal System Constructed (✓ ) Repaired (. ) Upgraded ( ) Abandoned( )by at � � GU1C�flf9l� �(/Z`' �✓ has been constructed in accordance f with the provisions of Title 5 and the or Disposal System Construction Permit No. dated Installer Designer #bedrooms !� Approved des.iga flow �f y � � gpd The issuance of thiss,p}e its II hot b onstrued as a guarantee that the system will function as de igned. C@ Date `'J �/ Inspector �,/�Jr %� ————————— 1--,--------------- -- —L——————————— No. "—Aa,;?, Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS =i5po5al *patent Construction Permit Permission is hereby granted to Construct Repair ( ) Upgrade ( ) Aban on ( ) System located at l 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: Constructio ust be •ornppleted within three years of the dale-of this pe Date d © / Approve ,by - I� 7 2`7_,97 09:59 F i .-T!"T 5P 8 4 2 9 Town. of Barnstable Regulatory Services Thomas.F Geiler, Director Public Health Di'Nislon Thomas McKaun,Director 200 Main Street., Elyannis,i1VtA 02601 Office: SC8-8621-4644 sta'lCr &Designer Certification Form 7 Sewage Permit# Date: Assessor's Map\Parce! Designer: G1cti^C ce5 Instatier: Ao/ Address: Address: On Y ZI_07 was issu*d a p:rrnit to install a ,e0o by saptic sys"CAR 31 y�4�6aw� —_-based on a deign drawn (addresss), dated I certif-y that the septic system referenced above was installed slULstantia1y acc ing t� the design, wbich -,ray include mirlor approve.', changes such as lateral relocation of the distribution box and/or septic tank, St-ripout (if required) was inspected and the soils 'A'ere found 31n:sfacrorv. r. certify hat the septic system referenced above was installed with major changes (i-t greater than 10' lateral relocation of the SAS or any vertical relocation of lay compaLnenc of the septic system) but in accordance with State & Locall Pegulatlons 1?1arl revision or certified as-built by desiper to folloNv. StriPOUt of Mquir ected and the soils were found satisfacto,,,, 'A� OF DANIEL E. BRAMAN o STRUCTURAL 11 t r's ignamre No 3905 aft - WSignature Here) �esign,..-'s ture) PLEASE W-TMN1 , TO BARNSTABLE PUBLIC tTEALTH DIVISION.-CER ATE M, COMP-111A.F, WILL NOT ISSUED AI—NP AS- UVILT CARD ARE RECEIVED BY THE IIA-MSTABLE PUBLIC HEALTH DIVISIQN. TRANX YOU. cerification Form Rev 03-09-06-dor E � Y 1 I .0' N Lo Ln I I O' lu w r 2 F. 0 O IL m Q (L 0 N W (n Q �\06 0� O LOT 2 0, P-1 1 20077.5 S.F. b VQ O I BUILDING LOCATION PLAN FOR 141 B WIANNO AVENUE OSTERVILLE, MA PREPARED FOR GLENN * 5HEILA TO DIN OF 5CALE: DATE: DRAWN BY: TEVEN W 111 = 40' 07-09-2007 TMW M JOB NUMBER: REVISION: 5HEET NUMBER: 35 91 07-009 CPF-2 R�FESS WELLER * ASSOCIATES qN� SUR� I G45 FALMOUTH RD., SUITE 4C -- P.O. BOX 4 1 7 CENTERVILLE, MA 02632 2 WINDY WAY, #232 NANTUCKET, MA 02554 1 ,1 uv1 TEL.; (508) 775-0735 -- FAX: (508) 775-0754 EMAIL: tri5Weller@COMCa5t.net COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION C). 0 TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY AS ESSMENT SUBSURFACE SEWAGE DISPOSAL SYSTEM FO -- .� PART A CERTIFICATION Property Address: 141-B Wianno Avenue Osterville. MA 02655 Owner's Name: Gail Trafton Owner's Address: 11 Bayberry Road �Vj N. Ouincv. MA 02171 Date of Inspection: October 5. 2005 Name of Inspector: (Please Print) James.M. Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: . October 13, 2005 The system inspector shall sub a copy of this inspection report to the Approving Authority(Board of Health.or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****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. Title 5 Inspection Form 6/15/2.000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 141-B Wianno Avenue Osterville, MA Owner: Gail Trafton Date of Inspection: October 5. 2005 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over.20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 141-B Wianno Avenue Osterville. MA Owner: Gail Trafton Date of Inspection: October 5, 2005 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 CAM 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that t g p he well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to.or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued). Property Address: 141-B Wianno Avenue Osterville MA Owner: Gail Trafton Date of Inspection: October S 2005 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well.. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 141-B Wianno Avenue Osterville. MA Owner: Gail Trafton Date of Inspection: October 5, 2005 Check if the following have been done: You must indicate"yes or"no"as to each of the following: Yes No ✓ _ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? n/a 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(SAS)on the site has been determined based on: Yes No ✓ _ 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(3)(b)]. 5 f Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 141-B Wianno Avenue G'sterville MA Owner: Gail Trafton Date of Inspection: October S 2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 example:for ( p 110 gpd x#of bedrooms): 220 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:__ The cesspools were pumped after the inspection for maintenance Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: _gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool 162) Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank - Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation unknown Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFO TION(continued) Property Address: 141-B Wianno Avenue Osterville MA Owner: _ Gail Trafton Date of Inspection: October 5 2005 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC otheq(explain): Distance from private water supply well or suction line II Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) (Cesspool acting as a septic tank) Depth below grade: Material of construction: concrete _metal —fiberglass _polyethylene ✓ other(explain) Cesspool block If tank is metal list age: Is age confirmed by a Certificate of stem Compliance es or no certificate) S #1 p (y ) (attach a copy of y (back) System#2(side) Dimensions: _ 5'W x 5'T x 7'bottom to grade 5'W x 5'T x 8'bottom to Qrade Sludge depth: 101, ]off Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 6" 6„ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Measurinje stick Measurinv stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): The back cesspool 01 had]'of li uid on the bottom. The cove was 10"below zrade. No outlet tee was resent. The side cesspool(#J2 had 2'ofliauid on the bottom The cover was 12"below grade A tee was present The cesspools were pumped after the insl2ection. GREASE TRAP: None ,(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglas polyethylene ,_other (explain):_ I - Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 r Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 141-B Wianno Avenue Osterville, MA Owner: Gail Trafton Date of Inspection: October 5 2005 TIGHT or HOLDING TANK: None (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: allons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: None (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: - None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 141-B Wianno Avenue Osterville, MA Owner: Gail Trafton Date of Inspection: October S, 2005 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: . leaching trenches,number,length: leaching fields,number,dimensions: ✓ overflow cesspool,number: 2 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): The back system 01)over was S'W x S'T x 9'bottom to Qrade and was dry, The scum line was 1'up from the bottom The cover was to Qrade. The side system 02)overflow was S'W x 7'T x 10'bottom to grade and was dry, The scum line was 1 5'un rom the bottom. The cover was 10"below grade There did not appear to be anv signs of failure in either of the overflows, CESSPOOLS: None (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 or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 t. Page 10 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM,INFORMATION(continued) Property Address: 141-B Wianno Avenue Osterville, MA Owner: Gail Trafton Date of Inspection: October 5. 2005 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. s Y a �' b ,D l3Ask sysiLV�. .a t a A yg q° 10 \\\ I , Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 141-B Wianno Avenue Osterville, MA Owner: Gail Trafton Date of Inspection: October 5, 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30+/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maw_ Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours maps the maps were showing gpproximately 30'+/ to ground water at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. i 11 A N N fit• N COas O 72'-0" 6 6 .-0.. 6(Y 10'-O" T-73/4" I 19-10 114" 6'-2 5/8° 5'-9 3/&' 1P 4' 4'-51/4" 4'-0" 4'-0" '-0" ,.. Tl;UOH �211 5'-7 3!4" 24 LUD 4 q1D 4 4 CUDH2 24/3 CUDH 424 o- _ R 4 �{I 1/2 VrsATN O \ III 11 0) N 400 I WALK INCLO P°I, raieoWaIIIAWe`"5"I fl I w N1lrEN IYWwvI MSER PATH 1I1I O (2)15/4".II1/B^ III L'BNtIRf III . AV rOt R00f Be.W —�' III y b 1 u ((r_� . Mic 4080 T to III P III III � 2000 5'-8— 2'-6" —5'10" 8'31/2" zsBa MIJI9ROOM ENTRY N N a MS WN.L roINVt 11 65NPie III VVV G NING ROOM b"oc.ecrswwBNa/vw Ne 2 pl - - GU H 2 24/36 CU 2 24/3 f MASTER OE WOM � �p� �1{ VW/VYI A5f AWA tt; C - to G - iR . .•N � rOYBle BIur NS P « - N o(J CO T N T n / '-81/2" 0" 5 3, 5.3"_,t`5'4 3/4" H O 5 r•`' 4' � N V • � utsewva aaasr _ _ BeN015tAf f0 ' T CUDH DUGH 4/3 A0g0 2 24/36 CUDH 2 24/36 3 2 rnrAerua owrtwNeolnaex smow/rxnnsoMarx - � -0" d" 6'-0" 6'-0" 5'-0" 2'�^ —.1p-0 � _ R —5'11 112"--R`——T-0" 5'-1 1/4" P S _ LIVING ROOM e PIP O q € - II I I F.LI 'I �w!urolwve2Ybsnv,. DEYJaPfION LODE MMIFPLtl9�ft COMME Ib"OL.F02 R.W...IG/�01rNG F1,OOI� 07INEN50 r, 242R MNNIN n iPi 24"X23 I/8" 25X23 5 8 ANMING LL1IMATE DOIAI-E N1NG. LUGN 302R 36 MPIA4N 293 8"X56 3/8" 30 3/8X56 7/8 LL11MAT DOIDI.E N1NG LUDH 2424 MNN N BATE �7�I.IE 15 - 6 I 29 3/8"X68 3/8" 30 3 8X68 7/8 LLt1MA1E DOJfA-E N1NG O1G1'I 2424/36 MWZ`/IN FINAL . I I 36"X48" 36X48 �40 A iEMPE� 4/11/O7 I I I 58 3/4"X68 3/8" 59 3 4X68 7/8- MLLLED UWf-PINEIk"C'A) CllDN 2424 36 4 �N 2 33 3/8"X48 3/8" 3R 3/8X98 7/8 LLfIMAtE DOIDI-E H1NG O1GN 2820 1 GUDH 3 4/36 - ' 2 34 3/8X56 7/8 LL11MAfE V.LUA E FI1NG O1GYI 2829. MAk/IN fe a - 000H 3 /3 , II 2 33 3 8"x96 3/8" O1DI'12824 MP1Z`AN 8"X56 3/8" 34 3 6X56LLiIMA1E DOLE FI1NG LUI71,12820 MNZAKI _ ' 4'-6" 3 33 3/8"X48 3/8" 34 3/Sx48 7/8 LL11MA1E DOIYiLE N1NG nip " ' I 29 3 8"X68 3 8" 30 3/8X68 7 8 LL11MAfE DADIE N1NG OJDFI 2R24 36 IMA9VIN SCALE UNLESS A 41'-0" NOTED COVEMP PORCH mRWISE IST JL L®®� ��t�l a PAGE# v \ N � N T CUP1524LUDH 824 _ v N f KOOM#4 N < 66B V N lh N L>CN 1'SIIPAER Nry'r � 3 �. OATH ? [ t7R00M#3 � N m G Iry 2666 666 . 1 LNFN 4.%low W. N 4' WALK IN 0L05Ef PAIN#Z A N N PRfM1Ra O. � r\�] F� g' PePR00M#2 f .. SRWa0uf - _ PIP FO.1 g • _ W WoW 50•ERL PLi1B�R COMMENTS W . °1 I Ofl' PI.00ft DIMENSIONS R 0 DESClZ� ON '4 58• 6-31/2" 6-21/6" WAKINGLO%f0II1I f1)1>/1YII] . 12 I 24"%231/8" 2 ANMING UCI1VRvN1�241244 hb MMNNPT//INN 363/8%687 8 ILIIMATED01P:9'EFII�" WNN]0R1/4"(MW0lx Izs) I 293 8"%563/8" 303 BX567/8 MMAKM D01IDLE HIND O1DH 2424 MN2V N astom ru oya LMNaD%r ----iu roRau�uaN"/°°'4 6 I 29 3 8"X68 3/8"- 30 3 8X68 7 8 LLfIMAfE DOUfiLE `g N1NG CIY.112424/36 MNZ/I .. sa66 - --- m � � I I - 58 3/4"X68 b 8" 59 b 4%68 7 8 MLLLED UNf-PINEIkC DO) LUGN 2424 36-2 MN2VIN �MPE�D w - � un d• -- w � ^ 2 2 33 3 8"X4B 3 8" D4 3 8l(48 7/8 LLfIMA1E DODLE H1NG 01GYI 2820 MPKVIN A 3/8' 34 3 8X56 7 8 LL11MAfE DOUDLE H,INa Q112824 MAR/IN tEMPEF.ED O v awwoat 00 �n -I. 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PAUI ,MAllOCA (508) 428-9854 30ch 2446 I I I I � I I � I I N I � I I � C I i I I , I: I A 21 A 21 13 4 g Of HA a T a Su Su v O p �_ Z z y z (z, z ZC� z v O z O a >Vkl x, N o o D 71 � Z v o o zs z x m m m V1 O O N 1 . \ z z nt?AO 6 39 JAY M. CAP 141 `Y VI ANNO .A ' www,caddes�gns,blz n�51GN5 OSTERVIEL LE, v 79vl�x 41 12 � -,, 3: y GCI BUILDERS INC. ---------------- MR FAI MAZZaA <508) 428-9834 MM D � N �EEP OP 5 ERVATI O N HOLE LOGS w N Lu DATE: 03-28-2007 � cz, y PIPE TO BE LAID LEVEL FOR TEST BY: M. O'LOUGHLIN, CSE cV 2' OUT Of DISTRIBUTION Box WITNE55: D. DE5MARAI5 (13ARN5TABLE HEALTH INSPECTOR) 0 4" 5CH 40 PVC PIPE 2" LAYER OF 3/5" PEA5TONE OVER PERC RATE: < 2 MIN. / INCH � T.O.. O 3/4" - 1 1/2" DOUBLE WASHED STONE 0 Marty 5TUET L. TOP e EL. 31 .7 m Wt5T BAY DEEP OBSERVATION HOLE #I EL. 35.0 z wi 33.00 la 23 {3) 500 GAt PREGA5T DRYWELL5 (H-20) v �NNo 32.00 INSTALLGA5BAPFLE 31 .40 BOTTOM e EL. 29.00 DEPTH 501E SOIL O :NOUTtZTTe�--� 31 .57 SOIL COLOR SOIL 31 .00 HORIZON TEXTUi� I w o �—LOCU5 31 .75 � SUROACE OTHER � (MUNSELL) MOTTLING CV (B p 5' 0" - 5" A LOAMY SAND I OYK3/4 5" - 22" B LOAMY SAND I OYR4/G Q BOTTOM TH #4 EL. 24.0 22" - 1 20" C VERY FINE SAND 2.5YGIG 5EPTIC 5Y5TEM PROFILE DEEP 0135ERVATION HOLE #2 EL. 35.0 DEPTH 501L 501L 501L COLOR 504L FROM HORIZON TEXTURE OTHER SURFACE (MUNSELL) MOTTLING O" - 5" A LOAMY SAND 1 OYR3/4 5" - 20" B LOAMY SAND I OYR4/G DESIGN DATA GENERAL NOTES 20"- 1 20" C VERY FINE SAND 2.5YG/G DAILY FLOW: (4) BEDROOMS x 110 GPD = 440 GPD 1 . CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION SEPTIC TANK: 440 GPD x 200% = 880 GPD OF ALL UTILITIE5, ABOVE * UNDERGROUND, PRIOR TO U5E: 1500 GALLON PRECAST SEPTIC TANK ANY EXCAVATION OR CONSTRUCTION. DISTRIBUTION 13OX: 2. SEPTIC SYSTEM 15 TO BE INSTALLED IN COMPLIANCE U5E: DB-G WITH 3 10 CMK 1 5.00: TITLE V. DEEP OBSERVATION HOLE #3 EL. 3G.0 501L ABSORPTION SYSTEM: 3. TH15 PLAN 15 NOT TO BE U5ED FOR PROPERTY LINE DEFT 501L 501L 501L COLOR SOIL OTHER USE: (3) 500 GAL. DR LINED w/4' OF DETERMINATION. DOUBLE WASHED STONE ALL AROUND 4. ALL DISTURBED AREAS ARE TO BE LOAMED if SEEDED. 5URPACE HORIZON TEXTURE (MUNSELL) MOTTLING 5. CONTRACTOR TO PROVIDE 48 HOUR NOTICE FOR ANY CAPACITY: REQUIRED INSPECTIONS. 7" - 7" A LOAMY SAND 1 OYR3/2 S G THIS SYSTEM I5 NOT DESIGNED FOR THE USE OF A 12 7" - B LOAMY SAND I OYRG/4 . SIDEWALL AREA: 93 x 2 x 0.74 = 137.G GPD 24" - 0" C VERY FINE SAND 2.5YG/6 BOTTOM AREA. 13' x 33.5' x 0.74 = 322.3 GPD GARBAGE DISPOSAL. 459.9 GPD DEEP OBSERVATION HOLE #4 EL. 35.0 DEPTH 501L 501L 501L COLOR 501L FROM HORIZON TEXTURE OTHER SURFACE (MUNSELL) MOTTLING O" - G" A LOAMY SAND I OYR3/2 G" - 22" B LOAMY SAND I OYKG/4 22" - 132" C VERY FINE 5AND 2.5YG/G NOTE: NO GROUNDWATER ENCOUNTERED IN ANY OBSERVATION HOLE , +;37.G 4 C v R [ 1 V 3G \ 3G \ LOT 2 `\ \ 20082 5.F. \ TBM = EL. 37.0 NAIL SET IN TREE 34 SITE 5EWAGE FLAN �► `�'�.<�` ��` '�cF /j, 34 FOR 1415 WIANNO AVENUE 05TERVILLE, MA WTH #4 PREPARED FOR \ -fTh #,`., , 'P�'��P GLENN 5HEILA T013IN <1 SCALE: DATE: DRAWN BY: TH #2`��` Q1 M � OFM4ssq 1 " = 20' 04- 17-2007 TMW DA m JOB NUMBER: REV151ON: St1EET NUMBER: TE EN tiG RAMA 07-009 5P— I ' MBA `^ ° CA / ,(O 57 No. WE LEER A550C I ATES 19k7NAL �� I G45 FALMOUTH R.D., SUITE 4C — P.O. BOX 417 CENTERVILLE, MA 02C32 2 WINDY WAY, #232 NANTUCKET, MA 02554 TEL.: (508) 775-0735 -V FAX: (508) 775-0754 EMAIL: trl5wellerecOmca5t.net PROFE5510NAL ENGINEER5 * LAND SURVEYORS