Loading...
HomeMy WebLinkAbout0031 ACADIA DRIVE - Health i 31 Acadia Drive Marstons Mills A =058 013 004 \ t I CO-MMON W---A—LTH Off`.ivL SACHSE'1-S xEcuTivE OFFICE OF E-NT'IRONTMENT-AL.AFFAIRS ' DEPARTMENT OF EN-WR.OI`MENTAL PROTECTION s� TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION z7 O/3 Od Y Property Address• i p # Owner's Name: ` fn w 1 CD f Owner's Address: Date of inspection: Nance of Inspector:sqjease print Company Name: Mailing Address• .slP� IhS�GrCa�S aa6 yi `" Telephone Number: ��� _ ?� _ r 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: 06 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of i 0,000 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 liow the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of I I OFFICLkL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMEIM SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: aj i 4 ok Ve a!S Owner: 2 a Date of Inspection: p Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X03 I havemot found any information which indicates that any of the failure criteria described in 310 C'biR or in 310 CMR 15.304 ex ist.Any failure criteria not evaluated are indicated below. Comments- & 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 Bo of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following state is.If"not determined"please explain. The septic tank is metal and over 20 years old' or the septic (whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiitration or tank is imminent System will pass inspection if the existing tank is replaced with a complying septic tank as ved by the Board of Health. *A metal septic tank will pass inspection if it is "sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is a 'able. ND explain_ Observation of sewage backup reak+out or ingh static water level in the distribution box due to broken or obsiructed pipe(s)or due to a brok settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)anereplaced obstructim its reinoved distriliirtiod bent is Ie tirerled or replaced ;bT13 explain,:. system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass ,ection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain. 2 Page;of"I OFFICIAL INSPECT ION FORM-NOT FOR VOLUNTARY ASSES&ViEN I S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: /¢ i& �rt lJ2 Owner: Date of Inspection• D C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Heal order to determine if the system is failing to prote(it public health,safety or the environment. 1. System will pass unless Board of Health determines in acco nee with 310 Ch1R 15.303(1)(b)that the system is not functioning in a manner which will protect lic health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface wat _ Cesspool or privy is within SO feet of a borderin egetated wetland or a salt marsh 2. System will fail unless the Board of H Ith(and Public Water Supplier,if any)determines that the system is functioning in a manner that p otects the public health,safety and environment: The system has a septic tank soil absorption system(SAS)and the SAS is within I00 feet of a surface water supply or tributary o a surface water supply. — The system has a septic and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a se p c tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a ptic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply ell".Method used to determine distance "This system p es if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and vol ile organic compounds indicates that the well is free from pollution from that facility and the presence o ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure trite ' are triggered_A copy of the analysis must be attached to this form. 3. Oth page 4 of t 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE D91WO&AE:;YS'y'EM INSPECTION FORM �A PART.A- C1ER L IFICATION(continued) Property Address G t C4- Qwmer• t �$ Date of Inspection: D. System Failure Criteria applicable to an systems: You must indicate`yes"or"no"to each of the following for all moons_ Yes No A' BackLT 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 is 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'/z 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.(nis system passes if the well water analysis, performed at a DEP certified laboratory,for bacteria and volatile organic-co 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 S ppm,provided that no other ffilln re criteria are triggered.A copy of the analysis must be attached to this form.] es.No(Y )The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CN R 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: yTToo b�a considered a largZ,,,, system must serve agility with a design now of 10,000 gpd to 15,000 g _- "6 _You must indicate either "to each of' ollowing;following criteria ap systems in dition to the criteria above) yes nothe system is we a surface drinking water supply the system is wet of a tributary to a surface drinking water s•�rpply the system is toitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped 7.one iI of a p fic water supply well If you have answer "yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section above the large system has failed.The owner or operator off large system considered a significant under Section E or failed under Section D shall upgrade the system in accordance with 310 ChIR 15.304.The, em owner should contact the appropriate regional office of the Department. 4 r Page 5 of I I OFFICIAL,INSPECTION FORM—NOT FOR VOLUNTARY ASSESS. °T'S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 3 i C. a; Owner: .� '< f -4G�-,,ram. l•� Date of Inspection: , /n V lD( Check if the following have been done.You must indicate"yes"or`to"as to each of the following: _ Yes No Pumping information was provided by the owner,occupant,or Board of Health Were any of tie system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? a Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as NIA) 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? 1 _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition o the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scim? 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 held(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 Page 6 o,11 OFFICIAL LNSPECTION FORM-NOT FOR VOLUNTARY ASSESSMEIN"TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: %a a)I' - tS Owner: Date of Inspection: a D PLOW CONDITIO1vS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): s DESIGN flow based on 310 CMR_)5.203 (for example: 110 gpd x#of bedrooms):5 S C� Number of current residents: �( Does residence have a garbage grinder(yes or no):J!'; Is laundry on a separate sewage system es or no):,&V (if yes separate inspection required) Laundry system inspected(yes or no): Seasonal use:(yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): AV Last date of occupancy: G 0 filed- COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 06a 15.203 • --sd Basis of design flow(seatslpersons/ ,etc.): Grease trap present(yes or no):____ Industrial waste holding .esent(yes or no): Non-sanitary waste disc ged to the Title 5 system(yes or no):_ Water meter readings ,available: Last date of occu cy!use:_ OTHER(des ibe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): If yes,volume pumped: �alions—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM K Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool _Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology,Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval ^Other(describe): Approximate age of all components date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): 6 I Page?of I i OFFICUL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSIMEWS SIBSI ACE SEW-AGE DISPOSAL SYSTEM INSPECTION FOR- PART C � SYSTEM INEGRI'�I+TIGN(continued) Property Address: 0( A CZJ%0L k4.00I/4J-e owner: De 6!�Ma � ]Date of Inspection: BUILDING SEWER(locate on site plan) . Depth below t t ep grade: oZb Materials of construction:_cast iron 0(40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: Of (locate on site plan) Depth below grade:� Material of construction:_Kconcrete_metal-fiberglass,J)o!yethylene _other(explain) _ If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Imp P,e4- Sludge depth: - Distance from top of sludge to bottom of outlet tee or baffle: 30 Scum thickness: 3" Distance from top of scum to top of outlet tee or baffle: w Distance from bottom of scum to bottom of outlet tee or ffle:_y How were dimensions determined: M em La!!:eA Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related t outlet invert,evidence of leakage, GREASE'TRAP: (locate on site plan) Depth below grade:_ Material of construction_concrete,metal uberglass__polyethylene other (explain): Dimensions: Scum thicknesXMidence Distance fromtop outlet tee or baffle: Distance from ttom of outlet tee or baffle: Date of Iasi pu Comments(onmendations,inlet and outlet tee or baffle condition,structural integrity,liquid Ievels as related to oence of leakage,etc.): 7 Page 8ofil OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: tC2. /+f✓� Owner. Date of Inspection• TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fibs glass_polyethylene other(expl2in): Dimensions: Capacity: X—alarm Design Flow: slday Alarm present Alarm level: g order(yes or no): Date of last puComments(co switches,etc.): i DISTRIBUTION BOX: LY (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.): `f � c a PUMP CHAMBER: (locate on site pl Pumps in working order(yes or no Alarms in working order(yes o): Comments(note conditio pump chamber,condition of pumps and appurtenances,etc.): g Page 9 of l l OFFICIAL. INSPECTION FORM—NOT FOR VOLUNTARY ASSESSME 1 S S€ BSUPZFACE SE*AGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) � Property Address: .31 L Di Owner: Date of Inspection: ��' SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number_ _r teaching chambers,number: teaching galleries,number. leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): 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 laver. Depth of scum layer: Dimensions of cesspool Materials of constru on: Indication of fro dwater inflow(yes or no): Comments(n condition o€soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.). PRIVY: (locate on site:pl Materials of constructi Dimensions: Depth of solids: Comments(no condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): g Page 10 csf 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORK![ PART C SYSTEM INFORMATION(continued) Property Andress: Wz Owner: Rs Q . Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sew-age 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. sn Page l l of I I OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMEN1S SUBSURF kCE SEWAGE DISPOSAL,SYSTEM INSPECTION FOR. PART C SYSTEM INFORMATION(continued) Property Address: 3 `Vf 1 1 © e F Rateto of of Inspection- SITE EXAM Slope 049. Surface,water 00 Check cellar ' w Shallow wells 140 Estimated depth to ground water�p 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: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground ware elevati c v-e1 a . o. 2!/z' 0 7/ Fee$/M THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓�/ V PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppIttatton for MigozaY *pztem Cow5tructtun Verna Application for a Permit to Construct(V)Repair( )Upgrade( )Abandon( ) 1916mplete System El Individual Components Location Address or Lot No. 3! IlCof b/A ZY2. Owner's Name,Address and Tel.No. T2/— l Q 40 A/Lt1S Assessor's Map/Parcel 5-,f-T 0 13140 /�)4 q S/b E: 76, L�6- IWC .Installer's Name,Address,and Tel.N T Designer's Name,Address and Tel.No. '7 7 S—L0 7—3 5— Type of Building: Dwelling No.of Bedrooms Lot Size Y3,56A sq.ft. Garbage Grinder Other Type of Building j�4b FX09 No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flower 0 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil At> PER 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 t Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued s oar of Health. Signe ,.gyp Date tzw Application Approved by c'• Date S /(7— y Application Disapproved for the following reasons Permit No. 'z/—Z'/ Date Issued �-�I o—a / r - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Yes 2pplication for Mig ogaY gtem Congtruction Permit Application for a Permit to Construct �Re air )Upgrade( )Abandon( pp ( ) p ( ) pg ( ( ) NC;omplete System El Individual Components 1 � Location Address or Lot No. 3 Owner's Name,Address and Tel.No. /[ L5 _, Assessor's Map/Parcel 5� Q /3 (J�y />4`/S/Z)E L/�6. /,JC Installer's Name,Address,and Tel.NJ Designer's Name,Address and Tel.No. 7 7 5 '- D7 3 \). F. /' , o y GULL L i�2 v SOU C Type of Building: Dwelling No.of Bedrooms _ Lot Size q3. s�d so.ft. Garbage Grinder(N� Other Type of Building/.I&ID F94 1¢G No of Persons Showers( Cafeteria( ) Other Fixtures I Design Flow U gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Q UQ ��LCD z(/S Type of S.A.S. Description of Soil //5 )41 R A-, r .-Nature of Repairs or Alterations(Answer when 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 oft Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued _y_this- oar of Health. Signed, ,Y _ Date Application Approved by Date /U- o Application Disapproved for the following reasons r Permit No. /- Z> Date Issued J /0-U --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( V )Repaired( )Upgraded( ) Abandoned( )by K lc A,t(/, r)�� at -3 / 4C A I►-1 /1 - M - l U 5 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Z/V 1-2-7( dated -�/y-G / Installer Designer The issuance of this permit sh 11 not be construed as a guarantee that the syst• will fu ."ction as dd ligned. Date I� �� �? - Inspector rn.,11 4" V v --------------------------------------- No. Z 71 Fee / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS &.5pool-b- pgtem Congtruction Permit Permission is hereby granted to onstruct( v)Repair( )Upgrade( )Abandon( ) System located at 3 ( /�C,4 b �> • ✓Yl . M/L - S and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this pet. Date: Approved by ' TOWN OF BARNSTABLE LOCATION 3 I SEWAGE# °t nn 65s- 61 000 ASSESSOR'S MAP \LOT caT3 INSTALLER'S NAME&PHONE NO. ��' z4z �D�1.�G�'�-�DS� SEPTIC TANK CAPACITY P I size) LEACHING rACILITY: (type) NO.OF BEDROOMS �/ / , J BUILDER OR OWNER PERMITDATE: u 2 ® COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) exist Edge of Wetland and Leaching Facility(If any Feet within 300 feet of leaching facility) Furnished by g t 1 I � BAR o D1 t l qd Oq yge��ar� TOWN OF BARNSTABLE LOCATION 31 fly'[. gZa 1260 ' SEWAGE # 6� VILLAGE �A LS GnS ��_ASSESSOR'S MAP PLOT60<< L T 3 INSTALLER'S NAME&PHONE NO. h®& SEPTIC TANK CAPACITY X' 0__O u ,11 P/D LEACHING FACILITY: (type)T f'O©C44f G/rVW_) ,/ size) Ll-� X Ill NO. OF BEDROOMS BUILDER OR OWNER17 l PERMITDATE: Cl Z ® COMPLIANCE DATE: v Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet O 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 r .. I 6 aR 1z` - .�a �v� Town of Barnstable P# C� Department of Health,Safety,and Environmental Services � > Public Health Division Date S(, 367 Main Street,Hyannis MA 02601 • eNwareBLA 16 Ep y►� Date Scheduled J�f 12e_ 13 , 02006 Time 104 v Fee Pd. ti'"i 2 ki.0 4,.t Soil Suitability Assessment for Sewage Disposal _ Performed By:'V l tAY&LI ZC,7hq,/A0_r9.2A .Zhe- Witnessed By: I `k 0 e 0 LQCATIQN& GENERAL INFORII�IATIQN Location Address Owner's Name ftr Try rfid_rJ7F09,f ��l Address OSfery / S Assessor's Map/Parcel: /� Sa 0/3_'engineer's Name fie-1 l SUll/ VCI--'! pt NEW CONSTRUCTION 'REEPAIR Telephone# Sokf -yAIF- 3 3 yy /C Land Use -eS/de/ih�L Slopesf(°/.)" 6 -3f°1,O Surface Stones NO�C Distances from: Open Water Body �300 t ft Possible Wet Area l fi ft Drinking Water Well 106 rft Drainage Way (_30(5 11 Property Line Q 2 ft ,Other N/W ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ACA01A �2 i 3 .4 C�O^c Parent material(geologic) G Ge'Tlo n& �L Depth to Bedrock ®" P1/(/ Depth to Groundwater: Standing'Water in Hole: q ,, Weeping from Pit Face Estimated Seasonal High Groundwater L 2� APP2pk r� L=-C-©1z1( 6Z;PDZ; .. .. .. ........ DETE 1ATYQN E{� SEAS()NALHYGIT'VVATR TLE> <:..:::<:>:><:" .`:':' Method Used: l 9�2 'Ih�LC—ice tM t L( ` Vt'10 0 G—c_. Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: 91t in. Groundwater Adjustment ft. Index Well#__._...._. .Reading Date: Index Well level., Adj.factor Adj.Groundwater Level_ ....::......:..:. .. . pli RCUL TI£7N T ST.::. .`. >':iiat;ti<> ::E. .::::r� " . . ........................ Observation _ Hole# 1 '� I Time at 9" Depth of Pere 2g Time at 6" Start Pre-soak Time® 2 S trl�O t�S V" Time(9"-6') End Pre-soak 1 VN Rate Min./Inch Z r`` V\)/`P Site Suitability Assessment: Site Passed Yam— Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back Copy: Applicant DEEP OBSERVATION' IOLE LOG HDI�e## 1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° 23-i l2(0 Ci eo #,-As� loy Qs/S DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % p O ����1., tc. 4\'t-A.r 12-28 5A h40 s/ 4 2Q,-120 C Vbu 2 s/S DEEP �B$ERVATIpl11 (�I,E LOG: Dole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.o DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency. Gravel) Flood Insurance Rate MM Above 500 year flood boundary No_ Yes 1< Within 500 year boundary No�1 _ Yes Within 100 year flood boundary No 1C 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? �ES If not,what is the depth of naturally occurring pervious material? APr Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature2.,E' O Date 6 14 WO F')ap TEST HOLE LODATE: DUNE 13, 2000 P-9762 SOIL EVALUATOR: P. SULLIVAN, PE WITNESS: D. MIORANDI, BOH PERC RATE: < 2 MIN/IN . 66.0 0" 66.5 0" ORGANIC ORGAtiZC / 65.8 SA 3" 66.2 4" 71-LO]WY ND ]1�I.O711a[ SAI® / r / 10YR3/1 10YR3/1 65.2 10" 65.5 12" � 7.SYAS/4 7.SYRS/4 63.5 30" 64.2 28" I IZ/ X O-COARSK SAND O-COARSE SAM /� �� 1 10YR5/5 / 1 NA• //✓ TifzGE, 55.5 126" 56.5 120" y� �Po540 NO WATER ENCOUNTERED DESIGN DATA DAILY FLOW: (5) BDRMS. x 110 GPD = 550 GPD SEPTIC TANK: 550 GPD x 200% = 1100 GPD 000 /o \ � USE: 1500 GALLON PRECAST SEPTIC TANK \� LEACHING FACILITY: USE: (4) 500 GAL. PRECAST DRYWELLS (5' x 8.51 ) I LINED w/4' OF DOUBLE WASHED STONE tJ CAPACITY: N �o� SIDEWALL: 110 x 2 x 0.74 = 162.8 (p BOTTOM: 13 x 42 x 0.74 = 404.0 TOTAL: 566.8 GPD N MINIMUM BUILDING SETBACKS 1 1 FRONT: 30' SIDE: 15' REAR: 15' 1 I ' OF o`L DANIEL I. yG INAMAN N p CIVIL V No.32686C ~ ^l N (JI;/zC NOTES: �,Tr 2. PIPE PTOE TO BE 4 H0 BE LAID LEVEL FOR29 OUT COF DISTRIBUTION �f"'ONAL���� 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN -(1C) ^�D�L 6" OF FINISH GRADE. 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A ' GARBAGE DISPOSAL. 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED ` ON A 6" LAYER OF STONE. 6. INSTALL GAS BAFFLE IN OUTLET TEE. ii 2" LAYER OF 3/9" PEASTONE OVER DOUBLE MSHED STONE ........... i ALL AROUND3, TOP OF FOUND. @ ELEV. Of.O z losc> 1 3. 5 G3.as S SEPTIC SYSTEM PROFILE SG-� SITE SEWAGE PLAN GENERAL NOTES FOR 31 ACADIA DR. , MARSTONS MILLS, MA 1. CONTRACTOR TO BE RESPONSIBLE FOR TB8 LOGTION ASSESSORS MAP 58 PARCEL 13-4 OF ALL UTILITIES, ABM AND UNDERGROUND, PRIOR TO ANY EXCAVATION OR CONSTRUCTION. PREPARED FOR 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH 310 CMR 15. 00: TITLE V. BAYSIDE BUILDING CO . 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE DETERMINATION. DATE : MAY 7 , 2001 SCALE : 1" = 4 01 4. ALL DISTURBED AREAS TO LOANED AND SEEDED. AuU.22� ZonZ 5. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY REQUIRED INSPECTIONS. WELLER & ASSOCIATES 1645 FALMOUTH RD. - SUITE 4C P.O. BOX 417 CENTERVILLE , MA 02632 TEL: (508) 775-0735 FAX: (508) 775-0754 APPROVED BY: L•��s �,�' TEST HOLE LOG DATE: JUNE 13, 2000 P-9762 SOIL EVALUATOR: P. SULLIVAN, PE WITNESS: D. MIORANDI, BOH / PERC RATE: < 2 MIN/IN 66.0 0" 66.5 0" IORGANIC ORGANIC 65.8 3" 66.2 4" A.LOAMY SAND OAMMUr 10YR3/1� 10YA3/1 65.2 10" 65.5 12" B.SAND 11-SAND 7.5YR5/4 7.5YR5/4 ��— D�/ 63.5 30" 64.2 23" �X C-coarse SAND C•00ARS9 SAND 10YRS/5 / 55.5 126" 56.5 120" NO WATER ENCOUNTERED y, D� DESIGN DATA CA FLOW: (5) BDRMS. x 110 GPD = 550 GPD r SEPTIC TANK: 550 GPD x 200% = 1100 GPD I 000 \ USE: 1500 GALLON PRECAST SEPTIC TANK LEACHING FACILITY: USE: (4) 500 GAL. PRECAST DRYWELLS (5' x 8.51 ) I LINED w/4' OF DOUBLE WASHED STONE e�1 CAPACITY: �1 SIDEWALL: 110 x 2 x 0.74 = 162.8 BOTTOM: 13 x 42 x 0.74 = 404.0 (pIQ TOTAL: 566.8 GPD N MINIMUM BUILDING SETBACKS 1 I FRONT: 30' REAR: 15' /Z 1, Cv 0 s9 y9, IL �P�,1N OF ry 4 O OANiEI t. 'SG ,RAMAN N pCIVII �.� r No.32d86C ~ ^ ` N NOTES: �•( C. 1. ALL PIPE TO BE 4" DIA. SCH 40 PVC. �ss' E�G� ��, 2. PIPE TO BE LAID LEVEL FOR 2' OUT OF DISTRIBUTION �NAI BOX. 3. RAISE ALL APPLICABLE MANHOLE COVERS TO WITHIN 15 C(-C) 6" OF FINISH GRADE. 4. SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A GARBAGE DISPOSAL. 5. SEPTIC TANK AND DISTRIBUTION BOX TO BE INSTALLED i ON A 6" LAYER OF STONE. i !� 6. INSTALL GAS BAFFLE IN OUTLET TEE. 2" LAYER OF 3/8" PeASTONE OVER i "-1h" DOUBLE WASH® sTt>ZiE (��,Z (max oen. { ALL AROUND 3, TOP OF FOUND. @ ELEV. G9 O .::::::�:::::: — 6z_ 7 _. . s SEPTIC SYSTEM PROFILE SG.� SITE SEWAGE P GENERAL,NOTES FOR 31 ACADIA DR. , MARSTONS MILLS, 1. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION ASSESSORS MAP 58 PARCEL OF ALL UTILITIES, ABOVE AND UNDUMOUND, PRIOR 12(% ( - n� I TO ANY EXCAVATION OR CONSTRUCTION. PREPARED FOR 1 2. SEPTIC SYSTEM TO BE INSTALLED IN COMPLIANCE WITH 310 Clot 15. 00: TITLE V. BAYSIDE BUILDING CO . 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE DETERMINATION. DATE : MAY 7 , 2001 SCALE : 1" = 401 4. ALL DISTURBED AREAS TO LOAMBD AND SEEDED. AuU.Z7� ZooZ 5. CONTRACTOR TO PROVIDE 24 HOUR NOTICE FOR ANY REQUIRED INSPECTIONS. WELLER & ASSOCIATES 1645 FALMOUTH RD. SUITE 4C P.O. BOX 417 CENTERVILLE , MA 02632 TEL: (508) 775-0735 FAX: (508) 775-0754 APPROVED BY: I ' � _ '10' x.l 2'__.PrLESgU2G. TREAT EO I ° °�0�/4 i 59 '�4 1`1000 ❑GCIL �. iLAIL. __-. _ � d � I !n PCc 25s9_ L L w _-STEPS To C,rLlar7c TO o,eco v, .t �•.J p ETE tZ1n 1 N G n o n1 S I T E 10.14 u I �o�v5j` / Yl_. ru P cA zza-LaxIx- QtNYL o_trnrtc> -oEN 0I { v N I d o - i t O' Oj — I _ pHo,-lE err PET. !L s• III moo• o' In I TIL r Q19 ,C 1w,,[A N h. j at j0 V�I CP2FCA I _t_AVIL o o k 17 Pcc 2s¢� t_ -} lo'-d! I O _E'. 0 3' Co' ' 0! G z5 a4x4 / a4 I ? V w,? LP, I V vl r� V�N/L. �� _• �, ^ � I ♦] ! R.A.. �• CCC 1515-'S xV � tom. I m _ -<�AIrL1Lp �'� v L —� I •8, Rcc 25 S.9•� I N :O ! �IS 1/t _ 1 aNSuwT� STG� Y41 Division Tow 84o 5 blgaansa POBox534 ! " ts02.6 1 Massachuse Hyannis, __. I Qo 775-3344 'S)ia)�1 C-A2AGEoc�F Gri. Fax(5081 _ iiV 4��Cor:rccz.: 5wg � �I: 503)790-6265 te 0 -Pt r+-. 2.- To-:o ao-M phone( _1�•�/dr < a� ��4 i p I Pcc 2sa, rz- -- i.cc.:.-1 4 -.z . 6E D 2Ac2/n 3 Rom•EO.tZ00%/�-'2- i rf I G "�i.. ... I i. i I QI a - t'L vaUUrcr-) GE.IL-kaL 01 I � i .pNOrJG � � /�. •I I I d' I I � �l i � - i I cz_P.`..ti1= -r o L_I�l I tit c- rz.n 1 `L'-lv�\C1 i P c G 294-7 7- 15CCot.» F-Lr. i 1 L 0 v 4 " I C.�.I<_IhLCa l_EV�L —_._. ..� � .,,_ i •I ' GR O �~ — —� c�' � I I— tf �� 1/^ c — IEll Lp 0-JQ- ..LIS-re0 FtrLS-T ELQ --� ' W A Lt-C-US Am -TrNfSH.-F.LGC2:• I P -� 19 I� � 14 � ••./ N j I � 1 Gam'-�'• i _' - . _ I vs S'Z.0 t O GL.n� �LO<^i� Pc.. 294-7 Co.o.Co I sa '•/a x 4 7 "ram GAl-Z,;JEi I � jAt-fcnNr--_ I i 6Y� — .. -'• I I -SGLE: :CF- :01- .OATEN S .LJ .