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HomeMy WebLinkAbout0158 ASA MEIGS ROAD - Health l 158 ASA MEIGS,A MARS TONS MILLS A= 031 001-WL` i, i i Town of Barnstable °AWE Regulatory Services Thomas F. Geiler, Director BULMABLL All Public Health Division � Thomas N[cI{ean, Director - — 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: `� o 0 Sewage Permit# t Assessor's Map\Parcel /00 Designer: >r Installer: (V&LJ 4 i 01A)G Address: Ra ' + �p Address: 2&T,j:( S — 61 37 On O ! 'as issued a permit to install a (date) (installer) pp septic system at � � ITS1A �(�(�� 1�D� based on a design drawn by (address) �1t�Qi✓� t9"l dated (designer) I certify that the septic system referenced above was installed substantially according to the desian, which may include minor approved changes such as lateral relocation of the distribution box and/'or septic tank. I certify that the septic system referenced above was installed with major changes o,reater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. ARRE '�4 MEY R ( nstaller's Signatu 1 1140 RfG/S1E � SANITAR�I'� e7 DCesigner's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTA E PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORitiI AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form 3-26-04.�doc P TOWN OF BARNSTABLE LOCATION A�-A L IGC5 R 1D SEWAGE# VILLAGE I p►Il /��SSESSOR'S MAP&PARCEL 6 INSTALLERS NAME&PHONE NO.1UA h I 9; SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ZJ O 5 (size) NO.OF BEDROOMS OWNER PERMIT DATE: O, 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&'Within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within.300 feet of leaching fa0l' ) Feet FURNISHED BY %�J C OUS - A-1 - 41? /4-3- Sys �v t t TOWN OF BARNSTr�IlLE C— p Li7C t,7;I0N✓46 Z09;E,, 6 SEWAGE # 77 —M3 VIfigGEArr 10 A r /�e/ ASSESSOR'S MAP & LOT 63i•dQ • INSTALLER'S NAME&PHONE NO. .�(�C������°� _ i�M�/a SEPTIC TANK CAPACITY rI � S9�" M e��' CSC(i%� �1�i 56 l /4 LEACHING FACILITY: (type)/�Ci��T/��� ---,(size) NO.OF BEDROOMS � � BUILDER OR OWNER �Vcd PERMITDATE:�� /B�� COMPLIANCE`DATE: /®®a-7 4 9 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (ref any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by a' Pnc o�a=CA ' 1 l 0 1 3 16' '37 i� e ve t OZoZ ,38 T '3cy as�> No. C " —5 1 1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippYication for �Btgponl *pgtem Con0truction 3dermit Application for a Permit to Construct( ) Repair(grade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. /5'9 ASft [AF_r C-G S AD--O-ner's Name,Address,and Tel.No. J/)//7-* 44P,;�u fM1jJ_S Assessor's Map/Parcel A 4Q 03 4ffr ©D /0B Installer's Name,Address,and Tel.No. bo t;L.%.jAw 61M64gZ Designer's Name,Address and Tel.No.P/¢UF_/V 16WEk a6 iaNr1. C sT /� n'��i �O> oX P/SY " ANDwlc{f o_q5?7 o Type of Building: Dwelling No.of Bedrooms Lot Size 30 r 2��t=sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 1'1 V gpd Design flow provided d gP Plan Date Number of sheets Revision Date Title Size of Septic Tank �5 0� Type of S.A.S. t/f/ � TD�S �_ D�0 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 of Health. cc�� Signed 1/ j Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. 2"0 '�� Date Issued O`� —p '°--� ------------------------------------ 1 Fee No. -, THE COMMONWEALTH OF MASSACHUSETTS :Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes + 21pprication for JMis;pos;ar 6pq;tem Cons;truction Permit ' Application for a Permit to Construct O Repair(yil"Upgrade O Abandon O ❑.Complete System ❑Individual Components Location Address or Lot No. �50 As� ' 'S Owner's Name,Address,and Tel.No. 5- 17—7 +C14QSTolV Wij-oLs Assessor's Map/Parcel /VAF 031 LIT ©o loo:L_ a, Installer's Name,Address,and Tel.No. (b 1�-/./A 11m � Designer's Name,Address and Tel.No.,P-4UZjV 6 /T/AC CT" IyA 0,;L6o J °• TeX 9' �¢�vLtvIcff _o _ n Type of Building: Dwelling No.of Bedrooms, AW - Lot Size r 2 rsq.ft. Garbage Grinder ( ) Other Type of Building � � / No.of Persons Showers( ) Cafeteria( ) Other Fixtutesk Design Flow(min.required) r� j�� gpd Design flow provided sim mc:�o gpd Plan Date ° v Number of sheets Revision Date # Title ,,,;,Size of Septic Tank �� ���� Type of S.A.S. e_7 101r/L-FIQAT4DI Description of Soil ' 1 ' Nature'of Repairs or Alterations(Answer when applicable) r Date'last inspected: `'V Agreement: _ The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in•, accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date 0 0 Application Disapproved by: Date for the following reasons Permit No. 20 0-7 `S q y Date Issued ^ O — —————————————————————————————————————————- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( tl< Upgraded ( ) Abandoned( )by at / �4C , /f � (J has been constructed in accordance with the provisions of Title 5 and t"Disposal Sy-ggLp Construction Permit No. 2 6 d q ^5 y of dated Installer Designer %A�VVL-(L =0 -C #bedrooms Approved de i, flow gpd The issuance of this ermit s n t be� strued as a uarantee that the s stem fu ct on as de i ned. U� U C r Date p ) g InspectorNo. �g �o ' FeeTHE COMMONWEALTH OF MASSACHUSETTS ��'" - �• PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Minvoar 6p5tem Cott!6truction Permit Permission is hereby granted to Construct ( ) Repair (v1-r Upgrade ( ) Abandon ( ) System located at T145Affl '—C pe) .Q and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty j to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date 2 0` — d t Approved by s bo t r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments N 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. City/Town Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key l to move your MICHAEL DEDECKO (� f�3 �O oC cursor-do not Name of Inspector use the return key. COMPASS REALTY DEV CORP Company Name P.O. BOX 2384 Company Address MASHPEE MA 3 02649 Cityrrown State ? Zip Code: 508-221-5003 Telephone Number License Number a v •E I B. Certification I certify that I have personally inspected the sewage disposal system at this address and That then information reported below is true, accurate and complete as of the time of the Inspection.(The irspection 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 tolSection 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 9/11/07 Ansector's ignature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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. ****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. 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. Cityfrown B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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 r pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 r Commonwealth of Massachusetts ta Title 5 Official Inspection Form System Form -Not for Voluntary Subsurface Sewage Disposal r/Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. Cityrrown B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fall 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. 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Junta Ass essments � A Subsurface Sewage Disposal System Form Not for Vo ry w 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. Cityrrown B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ® ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® 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 El 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. 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. City/Town B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply El ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. CitylTown C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components 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? ® ❑ 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: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)1 158 ASA MEIGS-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. City/Town D. System Information Residential Flow Conditions: Number of bedrooms(design): 5 Number of bedrooms(actual): 5 1 .203 for example: 110 d x#of bedrooms): 550 10 CMR 5 DESIGN flow based on 3 ( p 9P 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No N/A r readings, if available last 2 ears usage(gpd)): Water mete g , ( Y Sump pump? ❑ Yes ® No N/A Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): 158 ASA MEIGS-08106 Title 5 Official Inspection Form:Subsurface sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. Cityrrown D. System Information (cont.) General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ 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: N/A Were sewage odors detected when arriving at the site? ❑ Yes ® No 158 ASA MEIGS•08106 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. Cityrrown D. System Information (cont.) Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ❑ cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town waterfeet Comments (on condition of joints, venting, evidence of leakage, etc.): joints tight, yes vented, no sign of leakage Septic Tank(locate on site plan): i Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) El Yes ❑ No ------------------------------------------------------------------------------------------------------ 1500 GAL Dimensions: 3" Sludge depth: 31" Distance from top of sludge to bottom of outlet tee or baffle 1" Scum thickness Distance from top of scum to top of outlet tee or baffle 11" Distance from bottom of scum to bottom of outlet tee or baffle 14" ' MEASURED How were dimensions determined? 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. Cityrr vn D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): NO NEED TO PUMP,TEES INTACT,STRUCTUALLY SOUND,LIQUID EQUAL WITH OUTLET INVERT,NO LEAKAGE Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): 158 ASA MEIGS•08/06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. Cityrrown D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert EQUAL WITH OUTLET INVERTS 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.): D-BOX IS LEVEL AND DISTRIBUTION NOT EQUAL, YES SOLID CARRYOVER, NO LEAKAGE,LEACH PIT#3 IS BACKING UP AND LEACH PIT#4 HAS A CLOGGED PIPE Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 158 ASA MEIGS,-08108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 2/6X6 ❑ leaching chambers number: ❑ leaching 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.): SOIL SAND,YES SIGNS HYDRAULIC FAILURE IN LEACH PIT#3, NO SIGNS OF HYDRAULIC FAILURE IN LEACH PIT#4 , PONDING DRY, NO DAMP SOIL, VEGETATION NORMAL, 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 158 ASA MEIGS-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 't 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is required for MARSTONS MILLS MA 02648 9/11/07 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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. i �Ze a�" i � 6 ® y IN 3-'45 B3 37 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 158 ASA MEIGS RD Property Address C/O TODAY REAL ESTATE DAVID HOLT 1533 FALMOUTH RD CENTERVILLE MA 02632 Owner Owner's Name information is MARSTONS MILLS MA 02648 9/11/07 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells +106.81' Estimated depth to ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: BARNSTABLE GIS You must describe how you established the high ground water elevation: BARNSTABLE GIS 158 ASA MEIGS•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 TOWN OF BARNSTABLE C- LOCATION 53 ArA c� SEWAGE # 99-6Y-3 VILLAGE Z"740%aa n f h</i ASSESSOR'S MAP & LOT Q:3i•de •oe�L INSTALLER'S NAME&PHONE N0. /7�C^^���� yG�:<510 9 SEPTIC TANK CAPACITY rrl��.20,S9 �� �" ( M a c C cX ;%�r —)gq 1 LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDEROR OWNER LVcd PERMTTDATE: /4 r�Br�'! COMPLIANCE DATE: l D -�)-7 -99 Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 s . 0 V � / i1 C) f y.. No.—J� La � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0[pplication for �Digpoal *pttem Congtructton Permit Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./S8 9509 Ile-/fi Owner's Name,A dress and Tel.No. Assessor's Map/Parcel rs ht`s S RD/ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. g Z�i o.�o ,S T• Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 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 Nature of Repairs or Alterations(Answer when applicable) //a-C ex s i iK, yen i t-c Rat rya /0 IF, ,ie�-.� Avo,%li-,7 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 Certifi- cate of Compliance has been iss d by this Bo d of H h. Signed . Date®e7: �/8,/ Application Approved by115" Date /G¢ Application Disapproved for the following reasons Permit No. 7 '° Date Issued /Z:T — 14' Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS ZIppricatiou for Migpogal 6pgtem Congtruction Permit Application for a Permit to Construct( )Repair(v Upgrade( )Abandon( ) ❑Complete System El Individual Components ' Location Address or Lot No.IS -9SJ /94/fJ IeW Owner's Name;?address and Tel.No. Assessor's Map/Parc) �/ cep 1 es h z S Rol ( Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ` 31 r cc tl0"cc P �S c��:ltt Lf �8`55 C, Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow r` 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 a Nature of Repairs or Alterations(Answer when applicable) //U"C CX E s i t'_ 5enirt S0•1,�,- 70 /a iF, ''' % 1 i r �w oo,/Id i 7 1 -10 f 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 Certifi- cate of Compliance has been iss d by this Bo d of H Signed Date OCT /81/� Application Approved byoe- Date e4 --I.Fr Application Disapproved for the following reasons + Permit No. '' Date Issued //.-T e9' -------------------------=a---=--------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( t/jUpgraded( ) Abandoned( )by E�,,cc 1rt C,.0 C,t t:a c at 1 S 8 1 +l h c:k S k( " +1. h:t 4 9 has been"constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated /0 ` 8 Installer Designer The issuance of this permit shall not be construed as,a guarantee that the system will function as designed. Date 3 n _ til s Inspector ---G�--/------------------------------ --- No. 7 Q/ ^ P' Fee L✓ T THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS MigPogal bpgtem Con5tructiou Permit Permission is hereby granted to Construct( )Repair(V,)Upgrade( )Abandon( ) System located at 1 $8 A s s;,\ h R,4- 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 wit 'n three years of the date of ' e t. Date: `� GJ Approve%t✓ 116199 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, 'I ,,z- hGe(a- —,Icr hereby certify that the application for disposal works construction permit signed by me dated /o /3 -/9 F concerning the property located at /S8 A5A / /c-rrJ k-o— /`l- ✓`t���� meets all of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, 'F7 ��� JL Please complete the following: X1J �j , 2em�� A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation +the MAX.High G.W. Adjustment . _ DIFFERENCE BETWEEN A and B SIGNED DATE: [Sketch proposed plan of system on back]. q:health folder:cert 70 T COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS _ ' ►4 DEPARTMENT OF ENVIRONMENTA �PRokkz N ONE WINTER STREET. BOSTON. MA 02108 617-2��5500 TQW/V 4 lgg � NFgI H�P TAB1 f 8 �zt WILLIAM F.WELD j TRUDY COXi Governor 6 yt. Sccrcuu, ARGEO PAUL CELLUCCI DAVID B.STRUH Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commission( PART A CERTIFICATION 001 158 Asa Meigs Rd Dave Ayres Property Address: M rstons Mills Address of Owner: Date of Inspection: -5 oZ 7—,,'Vr (If different) Name of Inspector: Wm E Robinson Sr I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Wm E Robinson Septic Service Mailing Address: PO Box 1 089, C_Pnt ervi 1 1 e r MA 02632 Telephone Numbers 5 0 8 ` 7 7 9_8 7 7 6 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: _✓Pas/ses _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: Date: 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 owne and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SY3TEM PASSES: 1 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: B] YSTEM CONDITIONALLY PASSES: One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, up( completion of the replacement or repair, as approved by the Board of Health, will pass. Jnd ate 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; the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tan 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 Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:llwww.magnet.state.ma.usldep C.1 Printed on RecyGed Paper i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 158 Asa Meigs Rd, Marstons Mills Owner: Ayres Date of Inspection: S-,L 5—9 F BJ 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 C))URHER 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. SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM 15 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 vyithin 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 APPROPRIATE) DETERMINES THAI THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE NVIRONMENT: 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 tha 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) )OHER (revised 04/25/97) page 2 of 10 i i I SUBSURFACE,SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A t CERTIFICATION (continued) 1.. Property Address: 158 Asa Meigs Rd, Marstons Mills I Owner: Ayres e Date of Inspection: i D) SYSTEM FAILS: ` Y:r I You PN 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 or this determination is identified below. The Board of Health should be contacted to determine what will be`necessary to correct j he 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 civerloaded or clogged SAS or 1 cesspool. 1 _ _ 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 tit day floe. Y a 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. _ An», 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. - r El LA E SYSTEM FAILS: You ust indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: i 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: t t 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 11 of a t public water supply well) The o ner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requir ments of 314 CMR 5.00 and 6.00 Please consult the local regional office of the Department for further information. } (revised 04/25/97) Page 3 of 10 - i i jr SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 158 Asa Meigs Rd, Marstons Mills Ayres Owner: A y Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: t Yes/. No. t/ 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 receiving normal flow 'iates 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. i - ✓ - The site was inspected for signs of breakout. r 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 theproper maintenance of ' Sub-Surface Disposal System. i// 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)1 r i 7 (raylaad 04/25/97) page 4 of 10 :• . f - i � J SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION ( Property Address: 158 Asa Meigs Rd,Marstons Mills :w.. Owner: Ayres . Date of Inspection: FLOW CONDITIONS +. .#.::;..�E,°•. RESIDENTIAL: Design flow:G G D a.p.d./bedroom for S.A.S. Number of bedrooms: _/ Number of current residents: 2� Garbage grinder (yes or no):A-O Laundry connected to system (yes or no)��3 i Seasonal use (yes or no):_j O Water meter readings, if available (last two (2) year usage (gpd): 96 — 71 OOOg Sump Pump (yes or no):,,,-_v 97 — 81 , 000g Last date of occupancy: S:7-$_9 T ,, y.? ;;+_ •r COM ERCIAUINDUSTRIAL: Type establishment: _.._ Design low: gallons/day Grease ap present: (yes or no)_ _ Ind.ustri Waste Holding Tank present: (yes or•rio)_ Non-san tary waste discharged to the Title 5 system: (yes or no)_ Water eter readings, if available. Last d e of occupancy: OTH ( scribe) , Last dV of occupancy: ,• P GENERAL INFORMATION Y PUMPING RECORDS d source of information: t � �- System pumped as part of inspection: (yes or no) " If des, volume pumped: gallons _ G Reason for pumping: TYPE OF STEM Lof Septic tank/distribution box/soil absorption system. Single cesspool ( Overflow cesspool -n Privy - - } Shared system (yes or no) (if yes, attach previous inspection records, if any),. I/A Technology etc. Copy of up to date contract? Other j APPROXIMATE AGE of all components, date installed (if known) and source of information: (3 N) Sewage odors detected when arriving at the site: (yes or no) R 1 ' (revised 04/25/97) Page 5 of 10 r SUBSURFACE; SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 158 Asa ,Meigs Rd, Marstons Mills Owner: �.Ayres J . ' Date of Inspection: ^a 9-,g d S'r BUIL ING SEWER: (Locate on site plan) } Depth low grade: .. .�. Materi of construction: cast iron _40 PVC_other (explain) Dista ce from private water supply well or suction line is r Dia ter Com cents: (condiuon,of joints, venting, evidence of leakage, etc.) SEPTIC TANK: (locate on bite plan) Depth below grade:— Material of,construction: concrete _metal _Fiberglass _Polyethylene _other(explain) i • If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: Sludge depth:_S + �► Distance from top of sludge to bottom of outlet tee or baffle_ Scum thickness: 3-LV r baffle: to to of outlet tee or ba _ to of scump from Distance p Distance from bottom of scum to bottom of outlet tee or baffle:� How dimensions were determined: / f�'�- Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet inv structural integrity, evidence of leakage, etc.) -e� �L (-+ a • [� o j•- �= —M GREASE RAP (locate on ite plan) Depth belo grade: Material of c nstruction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: _ Scum thick ess: Distance f m top of scum to top of outlet tee or baffle: Distance m bottom of scum to bottom of outlet tee or baffle: Date of last umping: Comments: (recommend tion for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evi ence of leakage, etc.) (revived 04/25/97) Psge 6 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 158 Asa Meigs Rd,Marstons Mills Owner: Ayres Date of Inspection: I TI HT OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (Iota on site plan) Depth below grade: Materi I of construction: _concrete _metal_Fiberglass_Polyethylene _other(explain) Dime sions: f Capa ity: gallons Design low: gallons/day Alarm le el: Alarm in working order— Yes; _ No Date of revious pumping: i Comme ts: (conditi n of inlet tee, condition of alarm and float switches, etc.) t ti DISTRIBUTION BOX: { (locate on site plan) Depth of liquid level above outlet invert:_ Comments: (note if level and distribution is ea!, evidence of solids carryover, evidence of leakage into or out of box, etc.) L PUMP C MBER:_ t (locate on ite plan) Pumps in orking order: (Yes or No)— Alarms in w rking order (Yes or No) Comments: (note conditi n of pump chamber, condition of pumps and appurtenances, etc.) g r (revised 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) L Property Address: 158 Asa Meigs Rd, Marstons Mills 'Owner: Ayres Date of Inspection: i SOIL ABSORPTION SYSTEM (SAS):_ (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If no(cletermined to be present, explain: Type - leaching pits, number:_ 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.) CESSPOOLS: _ (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: .. 4 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: Dimensions: Depth of solids-__ Comments: (note condition of soil,.signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Page 8 of 10 r f f f I , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART C SYSTEM INFORMATION (continued) Property Address: 158 Asa Meigs Rd,Marstons Mills Owner: A res Date of Inspection: 02 9-4 ! 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) _ i cR _ t (A/ GJ i i 4 1 ( `I i ! � I I (revised 04/25/97) Page 9 of 10 V , T INSPECTION -,SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART C SYSTEM INFORMATION (continued) Property Address: 158 Asa Meigs Rd, Marstons Mills Owner: Ayres Date of Inspection: s a S Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: i/Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) r 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) (revised 04/25/97) Page 10 of 10 L -CA T N ;, ;q �,, � SEWAGE PERMIT NO. VILLAGE "INS TA LLER'S NAME i ADDRESS R. UILDER -OR OWNER DA T E P E R M I T ISSU E D DAT E COMPLIANCE ISSUED i s ry � 9 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH �.............OF........... 11 N _-:.._... .��..�F..._...._........ T Appliration for Uiipoii al Works Tonitrurtion "prod# Application is hereby made for a Permit to Construct (Xj or Repair ( ) an Individual Sewage l Disposal System at: .--•... �....ME.�s. �..........................•-- -----•...............���•----� ......................................... -•- ... Location-Addre r Lot No •--•••.............••---- •-- -•-•- --••..... ------•... wner ''�S dress W v� 4.__.f °��\ ' ''` -------------- .......-...t.....1'�-rZH►�.-•---•------------ Installer ��i� 6� Address �. Type of Building Size Lot_ 7-.— -A....Sq. feet U Dwelling—No. of Bedrooms---___________¢.........................Expansion Attic ( ) Garbage Grinder ( ) `k Other—T e of Building No. of persons............................ Showers — Cafeteria Other fixtures -------------------------------------------••••--- ---• W Design Flow............... w...................gallons per person per day. Total daily flow............. .. -0................ lons. WSeptic Tank—Liquid capacity/40.Z?.gallons Length Width_"..... Diameter________________ Depth-....'5k----_-- x Disposal Trench—No.11. ................. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No....... Diameter..... �.. Depth below inlet...... _..._._... Total leaching area tiiz ._ __:scp'ft. Z Other Distribution box ('(� Dosing tank ( ) AA `4 Percolation Test Results Performed by._L - ..... .... w -�:FI�...__1�C. Date_.__,[....................2-1 __.__.._.. aTest Pit No. 1.�_. -____minutes per inch Depth of Test Pit__ _4_..._.._ Depth to ground waterP_97 ......E )e-CV'+ T- (i Test Pit No. 2__C.y...minutes per inch _Depth of Test Pit.. 4_4_`'.... Depth to ground water__ ........... - -----------------------------------------•---------------•---.--........... O Description of Soil---------------�-EF.�------A.7.�__��=G��------ -�.f Al------------------ -------.............................. v -- . -----•----------•-•-------------•------------------•----••-----------------------.....---•----•--•-----------•-- U Nature of Repairs or Alterations—Answer when applicable_.`,; t> � ?a.. B�r� .leu-a _. ,ti..�-. --------------•----------------•---•----•---•-•-•-•------------.._.......--•--...---................------------------------------------------------................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of THTHE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. h .C .... .....__ ..>� .. ...................... Signed---- ----- t Application Approved By..... ! /�l .. 11{ e------- .... Date Application Disapproved for the following reasons:................................................................................................................ ------•....................••---•--------•-•----------------------------...----•--••---------------------------------------------------•-•-------•-----•-----•-------- ............................... Date PermitNo......................................................... Issued....................................................... Date r No........................ FEB.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' 1 � 7 .OF....... � LE1... :� �. .--.... ......................... -' Appliration for Dispnsttl darks Tonstrnrfinrt Vamit Application is hereby made for a Permit to Construct (/6 or Repair ( ) an Individual Sewage Disposal System at: ... ..... Location-Addres �r Lot No. ......CCp).. K A2. n.y....•=..-•�.e��... ............... ! Lr/�.-�/�' �=r�r.. -' .... --"�'; ..1 :. sll. ........ O ner Address ..}- a /Installer Address %Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............ ..............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q, Other fixtures .--••-•----------------------- . Q .......... .......... W Design Flow................<5�-...._...._.._...gallons per person per day. Total daily flow.................. ..�b.............._..gallons. WSeptic Tank—Liquid capacity/.G:?�<lgallons Lengthl4_.'.4a':.. Width-_S__."e.'Diameter................ Depth_.•..��...... x Disposal Trench—No .................... Width.................... Total Length...........T........ Total leaching area....................sq. ft. Seepage Pit No.... --_�-_.. Diameter.......1Z:..�. Depth below inlet....... .......... Total leaching area.I/1z:2_s4.4t=G?.,P Z Other Distribution box Dosing tank ( ) 0-4 Percolation Test Results Z Performed by...... � L___ C:. Date...2-Zz.--El-_------. ,4 Test Pit No. 1---4_ ..minutes per inch Depth of Test Pit.../_. 4.... Depth to ground water✓I.1Q.T-.-..t (i Test Pit No. 2...C Z .minutes per inch Depth of Test Pit.14.1'.".. Depth to ground water..✓. v. W --••--......---••-••--••-•••---=--•--•--•-••-•.....................................• O Description of Soil...................... ........ i.: [fG.12-•-•---p G:..9......-------•---------------•-•-•-•------------ x W UNature of Repairs or Alterations—Answer when applicable............................................................................................... --------•-------------------•---•----•-••---.....--•-----------------------------.......---•------------•----------•----------------•------------------•-••---------....---......_..........._.......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of p of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i ed by.th bo rd of health. f nedy ApplicationApproved By••.....--•-----•--••---------------•-----....... .......................................... ........................................ Date Application Disapproved for the following reasons-------------------------------------•------------------•-----------------------------•----•--••......-•-•---•--- ....................•-•------•----••-•--............----------------------.._.._..........-----------•-•---------------------------------------------•-•-------•----•-----------------•-----•----._...-- Date PermitNo....................•-----•----••......-•••-----.._..... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............:............................OF......................................I.............................................. Trr#ifiratr of Toutp atirr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (&4/or Repaired ( ) by........................192. .........1. --?-'4' -------------------------------------•..----------------------------------....------....----------.........................---- Installer has been installed in accordance with the provisions of TI%1a�A* i State Sanitary 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 SATISF CT RY. DATE.........................................n...... .:..� ?- :..... Inspector.............1%A z.'"_---•-------------•-•------------•••---•._...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH .....:. ...OF................. ................. ...................................... No......................... FEE........................ Disposal Works Tunmitrnr#inn frrmft Permission is hereby granted..........A`f........'1_e. '40! -----•----------------------------------•---------..._........-•---..................---•-•--- to Construct ( ) or Repair ( ) an Individual Sewage Disposal Systet�I at No........••------.6 --•- f---I- f� ,4 /�1 r,G 5 ;ZC/ '.4�s/n±s 4, . ......................•-----• --- ----•--............_..-------------•----................ Street as shown on the application for Disposal Works Construction Per it No.....__ Da f:.' :.'�-/--.--- ...................... •------•----••-•---•--•-• . ------------------....------......_....._......---- �,. _ Board of Health DATE --------••---------•---------•--••--••--••---.....--- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS j: BOARD OF WATER COMMISSIONERS CENTERVILLE-OSTERVILLE FIRE DISTRICT OSTERVILLE, MASS. 02655 September 25, 1981 Mr. Joe Loud Robinson Supply C. I. T. Road Hyannis, Mass. 02601 Dear Mr. Loud: At the present time, the Centerville-Osterville Water Department is preparing contract documents to install town water on Asa Megs Road in the village of Marstons Mi?,1s. Our schedule- is to have water available in your area by the end of this year. If you have any questions, please do not hesitate to call. Very ly y urs V Supt. Donald F. Rugg o WIN Y NE LA S 6 i- LEGEND SW N BF o�04f c� LED: UQ- i. LA AM K Ch'!y0 / ,s " G RD( h i• — PROPOSED CONTOUR O �0 A LA 9® PROPOSED SPOT GRADE- HOB IVY ' Is WAS m EXISTING CONTOUR eFA Y sly /� MEIGS RD y \ 9 + 96.52 EXISTING SPOT GRADE \ - - W— EXISTING WATER SERVICE 1 L O T 2 ` - ' TEST PIT \. AREA = 50,175 sf +— _ — — _ � Z �y / � O "400, 0 .I r � g0.20 O �FSHORE ca cc " Q a \ srgeCe — LOCUS MAP N.T.S. 1 Existing Cesspool 1 (See Note 10) 1 ` — f1-- IOs i \`\ 5 FT. SOIL REMOVAL �`,(�� �� �J �� / ``\I _`` \ (see note 1A�)_/ ti _/ / `�<<? I cis LINE \ O NE Existing 1560 Gallon __- \ Septic TQnk '\ ,��� r• \� I = - - _ _ 1 -- ��•, L �& < I `'l DAR EN M. tiF MjR� rH_2 � I HE tIt i ( -__ h.:. 0Ri�E%,1A r o. 1140� 107 -—_4 \ L----J _ 'J c.n i 1 I' !/r �,— 1H—t 107 - _-- '� I l qFG/SiE��Q I GENERAL NOTES: --- -- ----- BENCH MARK 1 FAINT SPOT ON ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL ins I BOARD OF HEALTH AND THE DESIGN ENGINEER. DECK CORNER _ —___ X 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS ELEVATION OF THE STATE ENVIRONMENTAL CODE, TITLE-V, AND ANY APPLICABLE BARISTAKE GiS LOCAL RULES AND REGULATIONS. — -- 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND REMOVED SURVEY REFERENCE: TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION DESIGN ENGINEER. 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY PLAN OF LAND BY FRANK CONERY, SURVEYORS 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY DATED: NOVEMBER 5, 1979 FROM THOSE SHOWN HEREON SHALL BETI REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. 13. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 14. ALL PIPING TO BE 4" SCH 40 0 1/8-/FT (UNLESS SPECIFIED OTHERWISE) PROPOSED SEPTIC SYSTEM UPGRADE PLAN 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW s THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF FOR THE USE OF A GARBAGE GRINDER 158 ;4SA MEIGGS ROAD, MARSTONS MILLS, MA HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 17. PROPERTY IS NOT LOCATED IN A ZONE OF CONTRIBUTION. Prepared for: Smith TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 18. POTENTIAL REMOVAL OF ALL UNSUITABLE SOILS 5 FT. AROUND.LEACWNG TO MAP.• 031 Engineering by: Surveying by: SCALE DRAWN DATE 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY EL 102.9/101.32 OR TOP OF C1 LAYER AND REPLACE WITH CLEAN IAEDIUM LOT.0011002 DARRENM.MEYER,R.S. Dao—Tech ESavhwameatal 1"-30' DMM 1 1/20/07 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING SAND. DEED BOOK.- 20766 P0 BOX 981 (508) 364-0894 REV. DATE: CHECKED SHEET NO. CONSTRUCTION. DEED PA GE.- 71 5006-3 229D2 SANDWICH,MA02537 1 2/02/07 DMM 1 of 2 ELEV. TOP FOUNDATION vent required (Existing) \\ 109.17� -F.G.EL: 107.25 F.G.EL: 107.0 F.G. EL: 107.0 FINISH GRADE= 107.0 - ^-`I " MAINTAIN 2% MIN SLOPE OVER LEACHING AREA Ai n. lJAli�i.�irTYI✓ 1.+� iJrYS. lis� A �J COVERS TO WITHIN 6 OF GRADE 6" INSPEcTIorJ PORT °• . L = 36 ,' W/IN 6" OF FINISH GRADE 6" . w 4" SCH 40 PVC _ L = 5' ° 1 0"1 ° ° O ° ° ° ° ° ° ° ° ° C� S= 1 7 (MIN. 6 (MIN') TEE'S ARE TO BE t4 @ S= 1% (MIN.) :r 4" scH 40 PVC INV.103.73 INV.104.09 INV.' ° _ EXISTING OUTLET GAS PROPOSED DB-3 ° ° ° BAFFLE H-10 DISTRIBUTION BOX INV. 104.34 EXISTING 1500 GALLON SEPTIC TANK NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING ---- -'-- -"- PIPE INVERTS PRIOR TO CONSTRUCTION JcXR FABRI. Sat 9" MIN. 2) D-BOX SHALL BE SET LEVEL AND TRUE TO PER TI TLF 5 OF GRADE ON A MECHANICALL COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN A BREAKOUT EL. = 103.40 y DA / 310 CMR 15.221(2) INV. ELEV.=102.90 E o "`C 3) REPLACE EXISTING 1,500 GALLON SEPTIC /s._ ti TANK WITH 1500 GALLON SEPTIC TANK novBies S' 24" .30.5" No. 1140 IF FAILED, DAMAGED, OR UNDERSIZED. IN VER r SEPTIC SYSTEM PROFILE 4) INSTALL INLET & OUTLET TEES AS REQUIRED BOTTOM EL.= 100.90 "-- NITAR��`� SEPARATION 5.10 FT. 9 46INFILTRATOR 3050 SPECIFICATIONS BOTTOM OF TH-1 EL: 95.90 SOIL ABSORPTION SYSTEM (SECTION) -(Fj2Q) SOIL LOGS DESIGN CRITERIA NUMBER OF BEDROOMS: 4 SEDROOOM DATE: NOVEMBER 16, 2007 SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) SOIL EVALUATOR: DARREN MEYER, R.S., CSE DESIGN PERCOLATION RATE: <2 MIN/IN ° WITNESS: DONNA MIORANDI DAILY FLOW: �G.P.D. HEALTH AGENT DESIGN FLOW: �!qC� G.P.D. - GARBAGE GRINDER: NO (not designed for garbage grinder) INLET END Elev. (OPEN) TH-1 Depth Elev. TH-2 Depth SEPTIC TANK: 550 gpd x 2 = 1,110 gpd USE EXIST. 1,500 GALLON SEPTIC TANK 107.32 A LOAMY SAND 0" 106.90 A O 0" (440) = 594.59 S.F. tOYR 4/1 LOAMY SAND LEACHING AREA REQUIRED: . 74 4.5'DIA ACCESS PORT FOR INSPECTION. 106.32 B 12" 105.90 e/c1 / t2" USE FOUR (4) INFILTRATOR 3050 UNITS (H2.0) WITH 4 FT. STONE SANDY LOAM LOAMY SAND ON THE SIDES & 2 FT. STONE ON ENDS: 33.8' L x 12.16' W x 2'D tOYR 6/4 10YR 6/4 BOTTOM AREA: 33.8 x 12.16 = 411 SF r' 103.32 Cl 48' 102.90 48" SIDE AREA: (33.8 + 12.16) X 2 X 2 == 183.84 SF SANDY LOAM C1 TOTAL SQUARE FEET PROVIDED = 594.84 vs. 594.59 REQ'D ° ° ° ° ° ° 2.5 Y 7/1 DESIGN FLOW PROVIDED: 0.74(594.84 S.F.) = 440.18 G.P.D. vs. 440.G.P.D. req'd ° ° ° ° ° °1 1° ° ° ° PERC ®100.90 � ®"a 101.32 C2 MEDIUM 7z" PROPOSED SEPTIC SYSTEM UPGRADE PLAN -- --.-. MEDIUM SAND , INFILTRATOR 3050 SAND 158 ASA MEIGGS ROAD, MARSTONS MILLS MA 2.5Y 7/4 ._ 2.5Y 7/4 Prepared for: Smith NOMINAL CHAMBER SPECIFICATIONS -- - - Engineering by: Surveying by: SCALE DRAWN „ „ 97.32 120" 95.90 132" DARREN M.iWEYER,R.S. Eco-Tech Envimament&I N.T.S. DMM l l 26 J67 SIZE (W x H x L) 51 x 30 x 85.4 Po eox ssI (506) 364-0894• -- WEIGHT 80.0 LBS. PERC RATE <2 MIN/IN. ("C" HORIZON) PERC RATE <2 MIN/IN. ("C" HORIZON) FASTSANOWICH tvIA02537 Rc✓, CHECKED SHEET NO. NO GROUNDWATER OBSERVED NO GROUNDWATER OBSERVED 508-362-2922 f'Z 2 07 DMM 2 Of 2 � ��� I ­7 c' Cx d f-7 e--4 .4 HOMIZ. r_ljq .91 r_- _ /O ,0-0 tC�'t-o SCHE-o o P. v c, o-ro zu b-7 S 77 5, / If--o IA A Z_. C 7 q 5/7&_'v/ .T e 7-7- 5 :7 / /, 0 7_o us e 0 0/*' 9/ e,,5 7 B Ir n 7 tl 7 AJ e. /-Ir 17 --------q 7 f-: 6)S ,E: �5 HOL 76-67- Ho ILo r q 4q,4-7-,-q 4�0,9., j K OO& 14 7 J�_IC�46 AE!7 gy, e 0 O S ::� 0 AJ� 7 o 7H 0 ei�_ig 0'o e .3 5 H 0 LAV AJ 0 A./, is / le?Al Z�0 6- s S 7-_c_cl>;k/ 0 e/t-? 7-0 4e�U C> -5-H C-e 0 5: 75 0 7 tJ'r 0 W/I-/ 0 A= S 7 5 4- 6=4::;, SL,=-r z5 og c OLUI"e 'r _7 AE! C OAJ7 9 7- C-C- oq -lit C V r 4r ee, + —7 (7 q T�-/o r7