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0018 APPALOOSA WAY - Health
18 APPALOOSA 'S',J,MARSTONS MILLS A = 174,001 wax YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 rs). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission too a ate.) Business Certificates are available at the Town Clerk's Office, 1 FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) ��� o DATE: -3 B 6 Fill in please: � ��~'� M APPLICANT'S YOUR NAME: I1 tJ_ 6= r e3 s 5 v `n1 BUSINESS YOUR HOME ADDRESS: I�fepti laosc- W c=� k _xmexrstoLn V►2tlls VVIIA p-2- A 4�' TELEPHONE # Home Telephone Number NAME OF NEW BUSINESS eb c vVelssaTYPE OF'BUSINESS , oK ra to IS THIS A HOME OCCUPATION'S YES NO "C4e. ACca'%) W%1% toe 6&AC- &T v" 1^pc.4e .a. I Ilk Have you been given approval front the biailding:division? YES I�IO �4`'t i let SWac.e.at e�a�l�sc� Spay t c�oc-�vsc cue ADDRESS OF BUSINESS APf PARCEL NUMBER j 7 — " T- W%LL 6 �ol loe v"atk tt1St-%gvm-r coumptrjQr: WO jP1t+1keMkS 04W1�Wt lno�Q. When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of `c Barnstable..This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OF This individual has been infor e of any permit requirements that pertain to this type of business. ... , :, Au prized Signa re COMMENTS: O P D 2. BOARD OF HEALTH This individual has b .n infor o the r t quirements that pertain to this type of business. Authorized tignature* COMMENTS: . 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: i �— bob -33 TROY WILLIAMS i SEPTIC INSPECTIONS Certified by MA Department of Environmental Protection (508) 385-1300 19 Hummel Drive South Dennis, MA 02660 COPY COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617)292-5500 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B. STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A �t CERTIFICATION Property Address: 18 4 PP 0. 100 s c. flay Name of Owner Lal rw a H<< f3;11 G ro sS rnj a,% M a r s�o h i AVl,i(1 Address of Owner: l fi A� _/ Date of Inspection: /0 /18 /00 /�1 a. s /a, /`l://s Al0. o L G Name of Inspector.(Please Prim Troy wiliiama i y 8 I am a DEP approved system inspector pursuant to Section 15.340 of Trde 5(310 CMR 15.000) Company Name: Troy Wiiiiams So c Inanoctlona Mailing Address: 19 Hummel,Drive. So. 0annis, MA 02660 Telephone Number: (508) 385-1300 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails II Inspectors Signa ure: Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within thirty(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 Department of Environmental Protection. The original should be sent to ttre system owner and copies sent to the buyer,if applicable, and the approving authority. NOTES AND COMMENTS Although system meets the minimum requirements set forth by the Massachusetts Department of Environmental Protection,certification is not to be construed as a guarantee of future working condition of system,piping or components. This inspection represents the conditions of the system on the Date of Inspection noted above. revised 9/2/98 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 18 Appaloosa Way,Marstons Mills,MA owner: Laura&Bill Grossman Date of Inspection: October 18, 2000 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated,are indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: N/9 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. Indicate yes, no,or not determined(Y,N, or ND). Describe basis of determination in all instances. If "not determined", explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty (20) years prior to the date of the inspection;or the septic tank, whether or not metal, is cracked, structurally unsound;shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled'.or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 revised 9/2/98 Page 2of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 18 Appaloosa Way,Marstons Mills,MA Property Address: Laura&Bill Grossman Owner: Date of hupectkm: October 18, 2000 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: A/ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WTrH 310 CMR 15.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 W A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER revised 9/2/98 Page 3ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) 18 Appaloosa Way,Marstons Mills,MA Laura&Bill Grossman Property Address: October 18, 2000 Owner: Date of Inspection: D. SYSTEM FAILS:/{//9 You must indicate either "Yes" or "No" to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No N Backup of sewage into facility or system component due-to an overloaded or clogged SAS or cesspool. N Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. /V Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. LL Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. A/ Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. L/ Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. N Any portion of a cesspool or privy is within a Zone I of a public well. /V 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: 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: The system serves a facility with a design flow of 10,000 gpd or greater,(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST 18 Appaloosa Way,Marstons Mills,MA Property address:owner: Laura&Bill Grossman Dace of Inspection: October 18,2000 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped,for at least two weeks and-the system has been•receivhT normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. ✓ _ The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions,depth of liquid, depth of sludge, depth of scum. / The size and location of the Soil Absorption System on the:site has been determined based on: _ Existing information. For example, Plan at B.O.H. _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable► 115.302(3)(b)) The facility owner(and occupants,if different from owner) were provided with information on the proper maintananca of Subsurface Disposal Systems. revised 9/2/98 Page 5of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 18 Appaloosa Way,Marstons Mills,MA Owner. Laura&Bill Grossman Date of Inspection: October 18, 2000 FLOW CONDITIONS RESIDENTIAL: Design now: //0 g.p.d./bedroom. Number of bedrooms(design): Number of bedrooms(actual): 3 Total DESIGN flow 33 O Number of current residents:/ Garbage grinder(yes or not: VE S Laundry(separate system) (yes or no):.&o; 1f yes, separate inspection required Laundry system inspected (yes or no) Seasonal use(yes or no)._ . Water meter readings,if available(last two year's usage(gpd): 9 q6� o u o�c[h f Sump Pump(yes or no): A10 ' Last date of occupancy: tlr COMMERCIAL/INDUSTRIAL: N119 Type of establishment: Design flow:_ opd ( Based on 15.203) Basis of design flow Grease trap present:(yes or no)_ Industrial Waste Molding 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: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: SYstem pumped as part of inspection; (yes or no) No If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes, attach previous inspection records,if any) 1/A Technology etc.Attach copy of up to date operation and maintenance contract. Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components,date installed Of known)and source of information: Sewage odors detected when arriving at the site: (yes or no) /V V revised 9/2/98 Page 6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(condriand) Pfop"Address: 18 Appaloosa Way,Marstons Mills,MA Ownw: Laura&Bill Grossman Date of Inspectiort: October 18, 2000 BUILDING SEWER: (Locate on site plan) Depth below grade: A Material of construction:_cast iron_k/40 PVC_other(explain) Distance from private water supply well or suction line N 14 Diameter y„ Comments: (condition of joints, venting, evidence of leakage,etc.) r1 us Ac..t I ;I,.�s t -{ c l c-i f-f- , yC' : M, .o� 1. P ti s., h Iz..I r- is 1, 1 I /, f j.c. d o u �[ �o c� 41) 1-& SEPTIC TANK._/ (locate on site plan) Depth below grade: 1 Material of construction:Zconcrete_metal_Fiberglass _Polyethylene_other(explain) If tank is metal,list age_ Is-age confirmed by Certificate of Compliance_(Yes/No) Dimensions: S Sludge depth: X/P Distance from top of sludge to bottom of outlet tee or baffle: 02�21' Scum thickness: I'' Distance from top of scum to top of outlet tee or baffle: G Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structuroHntegrity, evidence of leakage,etc.) ?//L Ta c 7 y✓ �� M�( ✓ t + / �/ �� A —� �. Wartit, .n� UI^(Itty �e t✓,C1 c,.c o /C 1 .c. y✓ c� w, w 'Ta.�h� A� �( Pit.- GREASE TRAP: ,//, (locate on site plan) Depth below grade:_ 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: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to.outlet invert, structural integrity, evidence of leakage,etc.) revised 9/2/98 Page 7ofIt SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 18 Appaloosa Way,Marstons Mills,MA OW1 : Laura&Bill Grossman Date of Inspection: October 18,2000 TIGHT OR HOLDING TANK:&/a (Tank must be pumped prior to, or 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/day Alarm present Alarm level: Alarm in working order:Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX:_✓ (locate on site plan) Depth of liquid level above outlet invert: ' Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) . «. L✓ork, by or�tr w, n. S 7 PUMP CHAMBER:_&/A (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.) revised 9/2/98 Page 8of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(corrtkweQ Property.Address: 18 Appaloosa Way,Marstons Mills,MA Owner: Laura&Bill Grossman Date of kupection; October 18,2000 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan, if possible;excavation not required,location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits, number:-- 4. r X4 ' Le,,,k P1 } w ti, ,2,f�a Y4 leaching chambers,number:_ leaching galleries,number:_ leaching trenches,number,length: leaching fields, number, dimensions: overflow cesspool,number:_ Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.) Lcr < L + wo.I J w: 7� .3, 7 ' cf wu+ � �.-mirth � �+ /� c �►'.+ u� iK //�� h1 11 S .. LC QGN w j�ol1, .L w ,..�'2,✓ /.c 1�f( N J G t,� �t ti cLC. f� � �r � t Y—w I..r1 r a (...w.3 .� �I�, n 6. < W<✓i 70 v a. A A_ e .. CESSPOOLS- / q (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(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: N/fl (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.) revised 9/2/98 Page 9ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 18 Appaloosa.Way Marston Mills MA Owner: PP Y, Date of Impaction: Laura&Bill Grossman October 18, 2000 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) t34�k. I yy'�'' Ny' 57' Ila 70� revised 9/2/98 Page 10ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 18 Appaloosa Way,Marstons Mills,MA Owner` Laura&Bill Grossman Date of Inspection: October 18,2000 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope ' Surface water Check Cellar Shallow wells Estimated Depth to Groundwatero21)f Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site 1Abutting property, observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators,installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) yJ U L 4.T.�.� U L� ✓1,� �j rV y .� (iV , 7` tr N� YV,.,h V 1 s.4 I l_JS 36 �t Q., o r� �t.. ��, �f i ' wh.� w4 s ao t /o C- f{mot h �i ; r y :..dl- i G�c.��'�)v ti ►� C r �.. q �S 7� 4 0 r t C_ ►�l/( c c� v+. 1 c� L. ?`�v v.� Si C� w f S 0 revised 9/2/98 Page 11 of 11 o 063 TROY WILLIAMS �,��� � � �' so ��, SEPTIC INSPECTIONS - ,.�� Certified by MA Department of Environmental Protection — _ (508) 385-1300 TO'NhJ OF g4gNStgBLE 19 Hummel Drive �"�. c41 TH"r:T South Dennis,MA 02660 COMMONWEALTH OF MASSACHU'SETti -1-1 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS c O DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET. BOSTON, MA 02108 617.292.5500 WILLIAM F.WELD Govcmor TRUDY CORE Sccretary ARGEO PAUL CELLUCCI Lt.Governor B.STRUHSor . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioncr PART A CERTIFICATION Property Address: .T8 App`" °o s4 Rcf. Mash /AI;I I s Address of Owner: --� Date of Inspection: S/y/98 (If different) Name of Inspector: Troy Williams I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) ��• Diu Company Name: Troy Will iams Septic Inspections Mailing Address: 19 HLI If11el DrivP - South Dennis , MA 02660 ba29u3 Telephone Number: T508T385-1300 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 inspection: The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: Passes _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: /�.Ji Date: S�y�9� The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to•the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: AI SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: 81 SYSTEM CONDITIONALLY PASSES: /V1/9 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. Indicate yes, no, or not determined (Y, N,or ND). Describe basis of determination in all instances. If'not determined', explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Heal(h. t—i—d 04/25/97) Pay• 1 of 10 I P ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 18 Appaloosa Road, Marstons Mills,MA Property Address-'John Fassbender Owner: May 4, 1998 Date of Inspection: BI SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced — The system required pumping more than four 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 CJ 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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, 1�APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 18 Appaloosa Road,Marstons Mills,MA Owner: John Fassbender Date of Inspection: May 4, 1998 D) SYSTEM FAILS: /V// You must indicate ei;,.er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 112 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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 frortl a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: /V/4 You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment.program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST 18 Appaloosa Road, Marstons Mills,MA Property Address: John Fassbender Owner: May 4, 1998 Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes, No Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been um See ceceivinf flow rates during that period. large Pumped ines of water haveenotks abeennd h ntroducede system antoetheen rsystem recently or / as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material-of construction, dimensions, depth of liquid, depth of sludge, depth of scum. / The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. _ Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)] (r*v1.*d 0//25/9�) r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 18 Appaloosa Road,Marstons Mills,MA Owner: John Fassbender Date of Inspection: May 4, 1998 RESIDENTIAL: FLOW CONDITIONS Design flow:,g,p•d./bedroom for S.A.S. Number of bedrooms: —3 Number of current residents: O Garbage grinder (yes or no):—!YIS Laundry connected to system (yes or no): S Seasonal use (yes or no): YC S Water meter readings, if available (last two (2) year usage (gpd): 7 = 9 Od0 Sump Pump (yes or no):� Q _� !6�� a d v,;. Last date of occupancy:�L u S i a ti w e- c_ to e,,,% cA COMMERCIAUINDUSTRIAL• AI/ 4 Type of establishment: Design flow: t allons/day 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: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source/of information: / No ih 7U Q 0. t4 I�crrrbl� lYc �( Ahf. System pumped as pan of inspection: (yes or no)LVo If yes, volume pumped: gallons Reason for pumping: TYPE qF SYSTEM Septic tank/distribution boVsoil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) VA Technology etc. Copy of up to date contract? Chher APPROXIMATE,AGE of all components, date installed (if known) and source of information: h� -r— 11_ 1 `C s C' : ,w •. 5-su. Sewage odors detected when arriving at the site: (yes or no) No r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 18 Appaloosa Road,Marstons Mills,MA Owner: John Fassbender Date of Inspection: May 4, 1998 BUILDING SEWER: (Locate on site plan) Depth below grade: Material of construction: _cast iron _ 40 PVC _ other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction: concrete _metal _Fiberglass _Polyethylene —other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions:_ G 6 �G.//Jh Sludge depth:__ Distance from top of sludge to bottom of outlet tee or baffle:a 7 Scum thickness: / // Distance from top of scum to top of outlet tee or baffle: 6 , Distance from bottom of scum to bottom of outlet tee or baffle:[3 How dimensions were determined: /oi-o Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) U L //e i,r I� >� C-r J `r -� ✓ o J 74- WGr.L J o— u // p S T O.- h O h S O <(„� 4 t U.✓ S �c./c V � GREASE TRAP: / �/a (locate on site plan) Depth below grade: 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: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (r.v ..d 04/25/91) " 76 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 18 Appaloosa Road,Marstons Mills,MA Owner: John Fassbender Date of lnspectionMby 4, 1998 TIGHT OR HOLDING TANK:N/A (Tank must be pumped prior to, or 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/day Alarm level: Alarm in working order_Yes; No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOXY (locate on site plan) Depth of liquid level above outlet invert: le—u c Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) 4" t1 r 1.• .tf U✓ k , V j-�k j ✓,, . PUMP CHAMBER: A114 (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.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 18 Appaloosa Road,Marstons Mills,MA Owner: John Fassbender Date of Inspection May 4, 1998 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: bh e X L leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: " Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) 74s fa s�� a S L C_-/?O CESSPOOLS: Lt/�j9 (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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate on site plan) Materials of construction: Depth of solids: Dimensions: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) r•.i•.d 0�/75/971 P`9• 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 18 Appaloosa Road,Marstons Mills,MA Owner: John Fassbender Date of Inspection: May 4, 1998 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 3 � I£3 `6to 2`1' �5 �e)o?U,/ ;r (r—i..d 04/25/93) - P•9• 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 18 Appaloosa Road,Marstons Mills, MA Owner: John Fassbender Date of Inspection:May 4, 1998 Depth to Groundwater = Feet adjusted high groundwatcr Iced Please indicate all the methods used to determine High Groundwater Elevation: / Obtained from Design Plans on record V Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) Cl- K. . .. �; suUo2of ' (JSC� S P.O. 10 of 1� n OWN OF BARNSTABLE LOCATION /4`r 12 " i"V SEWAGE # VILLAGE J� WI-1 ' ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. //„ jw" 111'eIr" ASEPTIC TANK CAPACITY (tLEACHING FACILITY:(type) i� (sue) v % NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER^ 'bBUILDER . ���'d� /,J�l�l�a' �f✓ L_�p� DATE PERMIT ISSUED: ✓'��'"�ij" � DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No //�l/' � C��'' II f i "> "/v" It J No.._��-:M.. FEB.... .�0....._ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .......:%!euE4.....................OF....690144hZe........................................................ Appliratiun for Biopuuaal Works Tunitrnr#iun ratnit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: -••--------------•-------••--•--•-- .. .•••••-----••--•••.................... .....®r.iz�...---....__...---- -•--••-----------...-•---......_......--•- Location-Address or Lot No. ...CrY�,� �cl�d:...'�:jj:...tort------------------------------------------------------------------------------------ ........AP,�Lons,,.---Wag........ - ner Address Ins tar Address dType of Building Size Lot....../A/.242L....Sq. feet U g— (/��►) ,.� Dwelling No. of Bedrooms..__..11�x��____________________.....Expansion Attic A) Garbage Grinder '_lPL4 Other—T e of Building No. of persons............................ Showers — Cafeteria a Other fixtures -----•--•-----•-•------------------•---•--..........- •- W Design Flow.....................................5S.gallons per person per day. Total daily flow......_............_.....a-3-.........gallons. WSeptic Tank—Liquid capacity..10Cagallons Length._St:7a`... Width.- .'.10`... Diameter................ x Disposal Trench—No..................... Width......... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No.....T r.____.._ Diameter.....(._.......... Depth below inlet....fn`............ Total leaching area....Z6.7.....sq. ft. Z Other Distribution box (X ) Dosing tank ( ) '~ Percolation Test Results Performed by..C!:4!jr...5��..t............................................. Date_..... 2 ..�._________...___.... Test Pit No. I....Z........minutes per inch Depth of Test Pit.._..1..��..C.... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.-'------.......... Depth to round wate . . - P P P g Ur 0 Description of Soil------...O_.4T .17..'= (G.------•ICILC'�4V3K1.__IR__ a-. f:-t(�3 JG.. .c' :�i :h.....---............................. .sd• . --•-----------••....._•-•-........ . . 9QItLSQ}1l__....�ef' -------•---_.... U Nature of Repairs or Alterations—Answer when applicable............................................................. N AM6 -------------------------------------------•-------•-------•-----------------------------........--•---.........---•-------------------------------------------------••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syste i a ord It the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compl' ce has been issued b the board of health. Signed ...........::�... .. �..�..'.............-.....-- ----��-- ........--................ ..........� - ---------��--�- �t,. - Date Application Approved By ........ /' V... f. Application Disapproved for the following reasons: ......................................--------------------------------------------------------- ----------------------------- -- ................................................................................................................................................................................... ............... QDate Permit No. ...--.1..., ----.�.�. ..---..._............ Issued ........................ Date....................................... ry No................_....... F1Za............_............._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ------ /a.c��.�. .... OF....��ritS.`! 1� ........................................................ Appftration for Uhipaaal Works Tontitrnr#inn jJantit Application is hereby made for a Permit to Construct (Y ) or Repair ( ) an Individual Sewage Disposal System at: ................_................................................................................ .......................\............................ ... ............. Location-Address or Lot No. ... aka ;r.. /y'�at � L}1r;`� - .................... a Owner ....................................... l�(./S_�l! ....Address...--------........ ......•........ � Installer Address UType of Building Size Lot-----�Aj.7!±.Z......Sq. feet ,-, Dwelling—No. of Bedrooms.....71ice...........................Expansion Attic d, ) Garbage Grinder (Y-1) Other—T e of Building No. of persons............................ Showers — Cafeteria al Other fixtures ------------------------------------------••-- W Design Flow....•...............................;_ ..gallons per person per day. Total daily flow.........................3.30........gallons. WSeptic Tank—Liquid capacity.lj?K�gallons Length__ + t`____ Width.'(_`(6"_.. Diameter______ ______ Depth��_I�...... x Disposal Trench—No. .................... Width.................... Total Length...._............... Total leaching area_........._.__......sq. ft. Seepage Pit No.___ n�._._.... Diameter....rQ...._...... Depth below inlet.._��_........... Total leaching area...Z6.. ......sq. ft. z Other Distribution box (X ) Dosing tank ( ) Percolation Test Results Performed by.(.ru�7...:5�jat-�'............................................. Date...Zl2..�7..•..............._.. a Test Pit No. 1.__.P.........minutes per inch Depth of Test Pit----1_1A. Depth to ground water...................... . ,.a r% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_- -------------- -------------------------------------------------------------------•---------•----•- --------•-• �1 OF. O Description of Soil ��....... 11----�� �„>,_ .._=.0 LJ 5K:. ................•--••---- �-�j•------•-•------•----••--••--•- ..._ x r`,�.....13 �S:l:�a±3_ ?.__ >a6 '4 ._�_sG�^GLi( ...... ........ ..............•••...... AttYft UW -•--•-•................................. ..•----•-------------......----•---•-----------••---•••-•------........... .................................................... WIL.S©u..... Nature of Repairs or Alterations—Answer when applicable................................................................ ...: 16 ----------------------------•---••--••-------------------------------------•-------........-----------------------------------------•---•--------------------------------. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in ac r .the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees noLto p acegh system in operation until a Cer • icate of CkNpl'ance s b n issued by the board of health. 5 - ned - -- ------------------------------------------------------------------ ---------------- Da[e Application Approved By ......................................................... ----------------------------- -------------- ---- ------- -------- --------------------------------- -------------- ----------------- .................D---ate---- ------------- Application Disapproved�/th-e)o17owXag reasons- ------------------------------------------------------------------------------------------------------------------------------------- ----------------------------- ----.......................------------------------- ------------ --...............---........-----------------------------------------------...............---------- ------------.......-----------....... Date PermitNo. ---- ------------------------------------------------------ ----- Issued ------------........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ---------------------------------------------- OF ...................... --.........----.......... ---....--..... ............................ Jam, H a 0,& firate of��(1:�10mytin rt THIS I� T,0TCE$T_.M),, Th^�aldAal age L�Ispos System constructed ( ) or Repaired ( ) by ................................................................................................................... .............VV Installer .....�/..`....�.. .�.............. ....-............-.............-..--........-...--.. at ---------- ------------------------------ - -------- ------ -------- ----------------------------------------------------------------------------- -- ------------ ------------------------------------------------------------ has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ................................................ dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE �f~ ��--, ....''... �------------------------------ Inspecto ......Gf /,:�. ��7....................................... THE COMMONWEALTH OF MASSACHUSETTS /00 BOARD OF HEALTH ...........................................O�F. .....................................................................�.......... No......................... h/� FEE........................ �e Permissionis hereby granted--------------------------------------------------------•-•---•-•---•---•---••--•----•--••......--•-•-...........•--•-•.............-•-•---- to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo...............-......................................................................................-........................................................................................ Street as shown on the application for Disposal Works Construction Permit No______ ________• Date ------------------------------------------ ............................... --- - - ---...-----.------ Board ealth DATE --•---•-------------------•--------•------•------- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS i I i R O 20 MINIMUM OR AS INDICATED ON PLAN (/ NOTES. , o g e� 0 10' MIN.' : O 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.Q.E. Joe Thompson Rd. o' T3 A MASONRY EXTENSION TO 12 TITLE 5 , THE TOWN OF At�lUST_ _���--- RULES AND LOCUS BELOW GRADE /59.p < BACKFIL WITH REGULATIONS FOR THE SUBSURFACE DISPOSAL- OF SEWAGE; TOP'OF FOUNDATION ,Sy•O e 8 MIN. /��.�' CLEAN SAND isy.o MASONRY EXTENS10N TO 12 e AND THE REQUIREMENTS OF THIS:PLAN. BELOW GRADE v 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO Appaloosa Way Z WITHIN 12 OF FINISHED GRADE. ' 4 SCH."40 PVC PIPE . 3. ALL MASONRY UNITS USED TO BRING COVERS TO GRADE ' MIN. PITCH 1/8 PER FT. a 1 4 2 LAYER OF SHALL BE MORTARED IN PLAICE. PER FT FLOW LINE - _ " • 1 a i 2 COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE Holder.Lane 10• TEE / / 4 ALL` COM N ` WASHED STONE %s6.Z. m If OF WITHSTANDING H-10 `LOADING UNLESS THEY ARE UNDER OR s MIN. F GALLON - LOADING ism 7 WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H 20 2 MIN. LEVEL � LEACH 4'-0" o �ss4- I PIT SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR MM. I SS,b 3 4" — 1 1 2' , / I LIQUID WA STON PARKING. F SHED E DISTRIBUTION c� LEVEL is ,o Ma rs t ons Mllls W - -,' S. NO DETERMINATION :HAS BEEN .MADE AS TO COMPLIANCE WITH DEED } BOX , W RESTRICTIONS OR ZONING REGULATIONS. OWNER/APPLICANT SHALL 148,0 APPROPRIATE AUTHORITY. OBTAIN SUCH DETERMINATION FROM THE A ,LOCATION' MAP /oo o N GALLO SEPTIC TANK r / N V RTICAL CONTROL SEE. LEVY- ELDREDGE 2 � _Z z 9 6. HORIZONTAL AND E ' 1 Z 4 I� .L I I ASSESSORS MAP PARCEL & WAGNER FIELD NOTEBOOK _27_�I UOUID DEP* IN SEPTIC TANK DEPTH OF OUTLET TEE BELOW FLOW LINE BOTTOM OF TEST HOLE .� 4 FEET- 141NCHES 14 FEET 19 INCHES OR USGS PROBABLE HIGH WATER LEVEL 6 FEET 24 1NCHES CALCULATIONS r . CURRENT ZONINGINTERPRETATION: DESIGN T' SEWAGE DISPOSAL SYSTEM PROFILE MIN. FRONT :.SETBACK 3b FEET NUMBER OF :BEDROOMS � NOT TO SCALE e- GARBAGE DISPOSAL UNIT MIN. SIDE SETBACK i� FEET 146 I TOTAL ESTIMATED FLOW I '' c ", _ MIN. REAR SETBACK FEET /� GAL./BR./DAY X 3 BR.) -�s.� GAL: /DAY , 148 REQUIRED SEPTIC TANK CAPACITY _ 95 GAL. Pace S q / j ACTUAL .SIZE OF SEPTIC TANK ibd4 GAL. open P PERCOLATION -SOIL TEST P 665Z, LEACHING AREA REQUIREMENTS • � tO W AREA .2.5 GPD.' S.F. BOTTOM AREA �—GPD. S.F. SIDE ALL / / 0 ._ 2 � .0 Sd t, 9 �'7 _ 95 .;, DATE OF SOIL _TEST r� � 0 6 - GAL DAY / SIDEWALL 27T( / /2)C_-)SF X25 GPD/SF _ / Lot 127 C z TEST BY - ru�a -s�eF t� .o ` BOTTOM 7T Lo 2 SF x / GPD SF 78 GAL/DAY 18742 s .ft.f � / ) / r M-rry ,wnr��V%t WITNESSED BY —T I '1" o PERCOLATION RATE � a MIN. INCH Z 6 SF 54 GAL DAY f \. 50 1 UT CALCULATION: .....:TEST PIT 1 TEST PIT 2 BREAKOUT \ _ ' Q V._ V_— X d 5a 30 rc r.� r 1 ELE 1,�s,� ELE �o =0.00 -0.00 / �cJnt f , 146 Lot 126 .0 154.9 — 48 - LEGEND. Flric S*Kd 148 E T 'ELEVATION 00 0 rn EXISTING SPOT ELE X 150 -_- -d -- 00----- � -------- � -- � EXISTING CONTOUR F No 4/a!cr a 152 N �� � � � FINAL `SPOT;ELEVATION 00.0 FINAL CONTOUR TP .n. 152 154 _��. 34 ;, � SOIL TEST PIT LOCATION �,, , � BOTTOM OF TEST HOLE 32 1.-t _ _ • . BOTTOM OF TEST HOLE 8 TT Lot 128 t _�__ OR WATER 43. TOWN WATER W W EL i 3 OR WATER ELEV. o SEPTIC TANK [� i m l DISTRIBUTION BOX 156 154 - \ PRIMARY LEACHING PIT O WATER LEVEL ADJUSTMENT. ti � _ / rR� � \ RESERVE LEACHING PIT ., — 158. \ 158 x id - r, v TEST DATE WATER LEVEL 156 I � INDEX WELL (35/9/91 WATER LEVEL RANGE ZONE 1 INITIAL ISSUE 160 e DEPTH TO WATER LEVEL FOR INDEX WELL NO. DATE DESCRIPTION BY Tel. Elec. 4, k. �.76 FOR MONTH OF: 7 3.22 156 SITE PLAN and SEPTIC DESIGN R=12 - Water HookupWATER LEVEL ADJUSTMENT APPALOOSA WAY x:. _ LET 1�7 WATER:,. ... , o DEPTH. TO HIGH A ER .. TWIT : . - a _ t. ... MASSACHUSETTS 1 O O BARNSTABLE, a ; P ..-. FOR ,. BM on PK Nall . DEVELOPMENT CORP. _ � �TEPHEN GREE�TBRIER D Elev.-157.82 -APPROVED. BOARD OF HEALTH � �� ALLYN ;> n , WILS frsas — .. 1 - 30 1565 1565--127 c No.30216 ' SCALE: JOB N0. SITE PLAN Y DATE AGENT � m 0 INC. LEVY, ELDREDGE & WAGNER ASSOCIATES s �r - aKctlr s L�tDSC0 ARCAITBCYS PLANN%R4 IJum SORvMRS PERMIT a P i 889 WEST MAIN: STREET CENTERVHILE MA 02632 n NEW ENGLAND REPROGRAPHICS REPPOGRAPHICS&SUPPLY CO 20 MINIMUM OR AS INDICATED ON PUN N 0OTES. & Ps 10 MIN. Ra Joe Thomson Rd. 00, `1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.Q.E: p 4 —� MASONRY DXTENSION TO 12• TITLE 5 ' THE TOWN OF 'Z3Azn� T t� -�_- RULES AND cocas BELOW GRADE � z1 L WITH CLEAN CLEAN SAND TOP of FouNOATION REGULATIONS FOR THE SUBSURFACE DISPOSAL` OF 'SEWAGE; 8 MIN. -/s8.,�' /5"g.0 Tf.0 MASONRY ExrENsloN TO 12 AND THE REQUIREMENTS OF THIS"'PLAN. BELOW GRADE 2 ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT. TO Appaloosa way. ' z WITHIN 12" OF "FINISHED GRADE. 4 SCH. 40 PVC PIPE • 3. ALL MASONRY `UNITS USED TO BRIfNG COVERS TO GRADE MIN.'PITCH 1/8 PER FT. a 1 4 PER FT. FLOW LINE 2 LAYER OF SHALL BE MORTARED IN PLACE. 1/8 1/2 4. ALL COMPONENTS OF .THE SANITARY SYSTEM `SHALL BE CAPABLE Holder lane 1Q• TEE w /OOG WASHED STONE }� OF WITHSTANDING H-10. LOADING UNLESS< THEY ARE UNDER OR 2'-0• �i < J55.7 f— -- F GALLON WITHIN I 10 FT. OF DRIVES R IV S 0 PARKING AREAS H 20 LOADING 3• MIN. 2 11IN. LEVEL w LEACH 4'-0. 1!747$ > I PIT < SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR /SG.o MIN. /SS.6 3/4- - 1 1/2• LIQUID (o � WASHED STONE PARKING. DISTRIBUTION LEVEL /5 .o Marstons Mills - Box W 5. N0 DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEED RESTRICTIONS OR ZONING REGULATIONS. OWNER APPLICANT SHALL 148.o OBTAIN SUCH DETERMINATION FROM THE APPROPRIATE AUTHORITY. /000 GALLON SEPTIC TANK �j> LOCATION 'MAP ° i ' z 1 6. HORIZONTAL AND VERTICAL CONTROL SEE LEVY ELDREDGE N 2? ti ASSESSORS MAC' i � 4- PARCEL 1 —33 & WAGNER FIELD NOTEBOOK #------ - UQUD DEPTH IN SEPTIC TANK DEPTH OF OUTLET IU BELOW FLOW UNE BOTTOM OF TEST HOLE 4 FEET _14 INCHES - 14 B. 5 FEET 19 INCHES OR `USGS PROBABLE HIGH WATER LEVEL 6 FEET 24 INCHES CURRENT ZONING INTERPRETATION. DESIGN CALCULATION SEWAGE PROFILE DISPOSAL SYSTEM P A S R E MIN. FRONT SETBACK 2 FEET NUMBER OF BEDROOMS NOT TO SCALE t MIN. SIDE SETBACK 1:5 FEET GARBAGE DISPOSAL UNIT 146 TOTAL ESTIMATED FLO W MIN. REAR SETBACK I FEET GAL./BR./DAY , BR.) o GAL. DAY 14g . ,- REQUIRED SEPTIC TANK CAPACITY 495 GAL a ce _Op Sp , � ACTUAL SIZE OF SEPTIC TANK 'l�c� GAL- PERCOLATION SOIL TEST P 665z. ' LEACHING AREA REQUIREMENTS Z.S GPD. S.F. BOTTOM AREA .0, SIDEWALL AREA / , / GPb./S.F. 0 0 - >2 '. 5. _ _T 0 S0( TEST .- / 9 DA E F L � ►. >o 6 - F 2.5 GPD SF — GAL DAY Lot _127_ SIDEWALL 2Tr( /2)�)S _ x / � / Crary �Lterir z TEST BY , o BOTTOM Tf -�o , 2 SF x / GPD SF — ?S GAL DAY 18,742 s ft.t ( / ) / / q I ' Scrr�.t 'Dvnr�ir�o� I WITNESSED BY ' I PERCOLATION RATE Tug /MIN. [NCH I S, NSF _ 4� GAL/DAY 1 \ 1 I 150 CALCULATION: TEST PIT 2 - BREAKOUTC LCULA 1 � TEST PIT 1 � I # 4\ � ,' — I ELEV.— Isg.� ELEV.= o X lS c� - , 30 ra c.t I -0.00 —0.00 Subs / : l 146, Lot 126 .r,' I54.9 — 48 Flea" Sind LEGEND : 148 N W z 150 EXISTING SPOT ELEVATION 00X'O OD -- EXISTING CONTOUR-------00 ———— 152 N Y No 4/alrr u FINAL' SPOT ELEVATION 00.0 4 — 18� - FINAL CONTOUR --- r, r TP 32' 1 ► , fi? 3 -_— Y BOTTOM OF TEST HOLE BOTTOM OF TEST HOLE 152 SOIL TEST PIT LOCATION Lot 128 _ _ i ,:---- � ' ♦ - £L OR WATER ELEV. TOWN WATER . W W 0 0 SEPTIC TANK C� i `? ' DISTRIBUTION BOX ❑ 154 — G PIT O WATER LEVEL ADJUSTMENT. PRIMARY LEACHIN �r/�/� \ RESERVE LEACHING PIT 158 � �d ; i a -T o v _ , TEST DATE 156 WATER LEVEL INDEX WELL \ WATER LEVEL RANGE ZONE 1 ISSUE ELK � INITIAL 160 • DEPTH TO WATER LEVEL FOR INDEX WELL NO. DATE DESCRIPTION BY ..Tel. Elec. � k. , .76 F O F. OR MONTH 0 3.22 156 _ SITE PLAN and SEPTIC DESIGN R-12 ZQ' / Water Hookup WATER LEVEL ADJUSTMENT _. S WAY . s ,. , ... LOT 127 APPALOOSA DEPTH TO HIGH WATER 158 --- nv r :. . _s a _. a . � - . �. o ... BARIVSTABLE MASSACHUSETTS .. .... Pp w;..... MR BM on PK Nail .- 244�.S" R �l GREENBRIER DEVELOPMENT CORP. Elev.=157.82 APPROVED. BOARD 'QF_ HEALTH .,.l , .� .:� BTEPHEN ,. x ALL 1 30 1565 1565-127 ..,.;� 'GLa P r w�Lsoly SCAL JOB N0. SITE T PLAN T /� �T O �' °" i 30216. di eg ►J 1 l � 1 Ltil V '�f 'DATE AGENT �/(/lam _ '� rS4E : LEVY- ELDREDGE & WAGNER ASSOCIATES INC. MiGM10 11msc0 Mc»= PLANNO » MMo>S m PERMIT 889 WEST MAIN STREET CENTERVU T.E MA 02632 HI NEW ENGCANO REPROGRAP CS 8 SUPPLY CO.