HomeMy WebLinkAbout0253 ASA MEIGS ROAD - Health 253 Asa Meigs Road, Mar=Mills
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Commonweafth of Massachusetts w '
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Executive Office of Environmental Affairs
Department of
Environmental Protection
�'bo 1 .
Willlam F.Weldt?, V
3ovemor
Trudy Coxe
Seemary,EOEA
David B.Struhs
Commhsloner ;
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address:e �3 4-SO- /'r�� CeA5-TO Q
129,1,j�, Address of Owner: o25S3 7�/�5
Date of Inspection:/D (If different)
Name of Inspector"—
,Company Name, Address and Telephone Numbe��oc°
V11742r76/ ok
�)ae�
CERTIFICATION STATEMENT
Oc;?&P? V-AF 0 5oPG
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:
V Passes
_ Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature: Date:
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 copiez, sent to the buyer, if applicable and the approving authority.
INSPECTION SUMMARY:
Check A, B, C, or D:
AJ SYST M PASSES:
I ha
ve a 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.
B] SYSTEM CONDITIONALLY PASSES:
One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,
passes inspection.
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,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 Health.
(revised 8/15/95)
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Ow Wlnbr strut a Boston,Massachusetts 02108 a FAX(611)888.1049 a TiNphone 4417)2i2M0tp
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address:� 3 ` �e/JS G � // /Gf S kps
Owner:/?kAtlI-e&l?
Date of Inspection: /O
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
s inspection if with approval of the
pipe(s) or due to a broken, settled or uneven distribution box. The system willpas pest ( aPP
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
CI 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.
1) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT
THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
_ The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply of tributary to a
surface water supply.
_ The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well.
_ The system has a septic tank and soil absorption system and is within 50 feet'of a private water supply well.
_ The system has a septic tank and soil absorption system and 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•
DI SYSTEM FAILS:
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.
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.
(revised 8/15/95)
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
/CERTIFICATION (continued) ,�y�
Property Address �i�PG�—�ei5 S' y►(plc.d m�r.S &?,3 �//i
Owner.I'U l eo J4 --rr
Date of Inspection:
D]SYSTEM FAILS(continued):
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 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
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 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:
The following criteria apply to large systems in addition to the criteria above:
The design flow of system is 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:
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.
(revised 8/15/9S) 3
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART 6
CHECKLIST
Property Address:�,j� l—/ %CAS' d/ /✓/���'u �I%
Owner: rnacl e e q
Date of Inspection: /0
Check if the following have been done: - -
Pumping information was requested of the owner, occupant, and Board of Health.
/None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates
during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
vAs built plans have been obtained and examined. Note if they are not available with N/A.
K The facility or dwelling was inspected for signs of sewage back-up.
,,,"The system does not receive non-sanitary or industrial waste flow
Vhe site was inspected for signs of breakout.
t_-All system components, excluding the Soil Absorption System, have been located on the site.
t'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 or
approximated by non-intrusive methods.
�he facility ov.rcr !and occupants, if differen! from owner! were provided with information on the proper maintenance of Sub.
Surface Disposal System.
(revived 8/15/95) 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORM•�A—TIO,N, �
Property
Owner: /7.C,4/r&j
Dale of Inspection:
RESIDENTIAL: FLOW CONDITIONS
Design flow: 3rz2 allons
Number of bedrooms:
Number of current residents: 3
Garbage grinder(yes or no): / b
Laundry connected to syste��jJ (yes or no):des
Seasonal use(yes or nokz o
Water meter readings, if available:
Last date of occupancy:
COMMERCIAUINDUSTRIAL:'A/�
Type of establishment:
Design flow: aallons/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,MRDS and source of information: _
'� 19 O;
System pumped as pa►t of inspection: (yes or no Q
If yes, volume pumped: gallons
Reason for pumping:
TYPE OF TEM
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)
Other(explain)
APPROXIMATE AGE of all components, date installed (if known) and source of information: o.
Sewage odors detected when arriving at the site: (yes or no)
(revised 8/n/95) S
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property A�jd.�ress: o�� �q-/7U' S 6qd, �arskw IV,11T
Owner:
Date of Inspection:
SEPTIC TANK:
(locate on site plan)
Depth below grade:L
Material of construction: k-concrete _metal _FRP —other(explain)
Dimensions:
Sludge depth: J
Distance from top of#dge to bottom of outlet tee or baffle:3
Scum thickness: AIVll
Distance from top of scum to top of outlet tee or baffle:_
Distance from bottom of scum to bottom of outlet tee or baffle:_Q_
Comments:
(recommendation for pumping, condition of inlet and outlet tees or affles, depth of liquid le in relation to outlet invert, str du I
integrity, evidence of leakage, etc.) 5
/i tj^ C
q
GREASE TRAP:
(locate on site plan)
Depth below grade:
Material of construction: ,_concrete `metal _FRP —other(explain)
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom t- bottom of outlet tee or baffle:
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 0/15/95) 6
I
r
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .
PART C
SYSTEM INFORMATION (continued)
Property Address:ca�s3
Owner:
Date of Inspection:
TIGHT OR HOLDING TANK;[V1,4
(locate on site plan)
Depth below grade:
Material of construction: _concrete_metal _FRP—other(explain)
Dimensions:
Capacity: gallons
Design flow: gallons/day
Alarm level:
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:, 2,,4'
Comments: /
to if level and distrib io^ is equal, evidence of solids car over, vide ke of leakage tgor out of b etc. yC
i
PUMP CHAMBER:��L'" �--
(locate on site plan)
Pumps in working order:(yes or no)
Comments:
(note condition of pump chamber, condition of pumps and appurtenances, etc.)
(revised 9/15/95) .7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued) /
5�Property Address:o) ' ��� /S
Owner i' /�CGUon!�'/? ���
Date of Inspection:
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._(
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:
S Q, /000-
Co merits: (note ondition.of s 'I, si ns of hydraulic failure, level of po�din , condition f vegetation, O
CESSPOOLS:
(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)
failure level of ondin condition of vegetation, etc.)
Comments: (note condition of soil, signs of hydraulic p g, g i
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 OAS/95) 8
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:.�s"3
Owner: 1&G`�t?4
Date of Inspection:/O �S—
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100'
t
0 3�
DEPTH TO GROUNDWATER
Depth to groundwater._.LLfeet
method f d erminatio or approximation:
(revised 6/15/9S) 9
t}
TOWN OF BAMSTABLE
LOrATIONo�Qiga/714,4 -�)0o N SEWAGE #
VILLAG&92rsk 12,-A�' ASSESSW MAP&/LOT
ZN ==W, NAME&PHONE NOar-Adl'd
SEPTIC TANK CAPACITY/007 qT//�ar
LEACHING FACILITY: (type) (size) /O DO.92 P/,T
NO.OF BEDROOMS _� v
BUILDER OWNER
PERMITDATE: COMPLIANCE DATE:
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 3 et of leaching fac' ' ) Feet
Furnished f a C.
0
31 '
LOCATION SEWAGE PERMIT NO.
VILLAGE
INSTALL R'S NA,ME i ADDRESS
0
• UILDE R OR OWNER
DATE PERMIT ISSUED . /®
DATE C0MIPLIANCE ISSUED s- �5�
d
J4
0 9
Noe.- Fmc..Z ..............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 6-i A TH �_�
........ ........OF........ ... ..... .......... .........---
Appliration for Diipoottl Worko Tontrnrtion frrmit
Application is hereby made for a Permit to Construct ()() or Repair ( ) an Individual Sewage Disposal
cyst M
. - .:a�. .. ........... .......
..
LLoc Lion -re
84 ~� Owner% Add? s
W -
........ ...... ...............I •--•--......: 11�1?�4�2.............. 2S�'1-------.-.-----•-•--•---.--.
Installer Address
d Type of uilding Size Lot.21��........Sq. feet
U Dwelling—No. of Bedrooms................ .........................Expansion Attic ( ) Garbage Grinder d
Other—Type of Building No. of persons............................ Showers
a g P ( ) — Cafeteria ( )
Otherfixtures --------------•------------------•--------••----------.....-----•-•--------•----------------•----•---•--......•;_•--• •-----
w Design Flow......... .....................gallons per person pe>r day. Total daily flow........:K74 ....................gallons.
WSeptic Tank—Liquid capacity��.....gallons Length.... .._..... Width...- ....... Diameter................ Depth...e.-".r....
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.--......e......... Diameter......!V....... Depth below inlet.. :-�...--.... Total leaching area... -Z ...sq. ft.
Z Other Distribution box ( ) Dosi
~" Percolation Test Results Performed by. ....v.!` . ----------------------
Date........................................
14 Test Pit No. I................minutes per inch Depth of Test P' .................... Depth to ground water.....................--.
Test Pit No. 2................minutes per inch Depth of Test Pit---................. Depth to ground water.....--.................
----•-•----------------------•-•---•------------.....------•---•---..........-•-•---•------------•--------•-•-•---....-----.......-••--•-----------•---..••.
0 Description of Soil...............•-•----------------.......................---•--.................--------------------•-•--------------••-----------------•--•----•-......•...........•---
x
c.,
w
U Nature 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 TITLE 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 t`-3 oar f health.
•... ..... • .... .•----••- - ----- ---------•----......Application Approved Beigne
•. ............ ...... ...............•-•-..----••----...---•----- ...... 8. Date
Application Disapprovedg reasons:-------••---•---------•--------•----•-------------------------••---•---------------------- ............----..
.................................•----------------------------------•••--.....--•-•-•---•................---..............••----••-•-----•-•-•-••-•-••-----------••----•••-----•------------••----------
Date
PermitNo......................................................... Issued........................................................
Date
- --------------�
No..g. 0/ Fmc.............................
THE COMMONWEALTH OF MASSACHUSETTS 7a
----------- BOAR HEALTH
.. ........................•-----.._...........
Appliration for Diopoiittl Works Tomitrurtion Prmit
Application is hereby made for a Permit to Construct (y) or Repair ( ) an Individual Sewage Disposal
System-at- _, _
4 `l'( 4.. .: _�..-• ...--`� .:....... .............. ....
., (/ Loc�t�on / py(ot.No.
//
-kid 1L.[J�4
Owner` Addr'sJ,�/
W . R ,. .....4/.etdt ?!t..r �!1 �f..... ........__..
.........•---- ........ Z�w
Installer Address
d Type of wilding _ Size Lot.._.__:.�!.................Sq. feet
U Dwelling—No. of Bedrooms...............:_...._........_..._____..Expansion Attic ( ) Garbage Grinder (46
Other—Type of Building No. of persons............................ Showers
QI g -------------------•-------- P ( ) Cafeteria ( )
QI Other ...........
fixtures -----•-•-------•-•-----•------....
-----------
.........Design Flow........... ...... gallons per person per day. Total daily flow......._ J_. ._. .,,.. ...gallons.
W .........
WSeptic Tank—Liquid capacity.&6 .agallons Length-_-_4....... Width..."{ _r-_......Diameter-, `_..:jDepth....G._................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching.,area. ................sq. ft.
r . , /W
Seepage Pit No.....__.�..______. Diameter...... ..._.._. Depth below Inlet._4`�______________ T.bfal leaching area_._..._/.....__.....sq. ft.
Z Other Distribution box ( ) Dosi
Percolation Test Results Performed by.... !------- _.--- .------ _------.-- Date........................................
aTest Pit No. I................minutes per inch Depth of Test Pi .................... Depth to ground water........................
GX, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a •-•-•-••-•...---•-•••••------••------•••.....••••----•...........................................••..................................----......._....----.--..
0 Description of Soil-------------------------------•---------•----•---------•-•------------•--••-•------------------------•-----------------•---------------------..........--•-----•----•--
x
U •--••-.....-•------•-------------------•----••••••--••-•-••••--•---------••-•-••---•••....................•-•---------•--------------•-•'-•••-------••--••-•••--•----......--•-----........---'---------
w
----------------------------------------------------------------------------------------------------------------------------------------------------------------------•---........--•----••---•----•--
U Nature 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has be issued by the boar f health.
igne .•-• --- .......... ..../�Vat
Z
A lication A roved B
_PP PP Y /G ...,
Application Disapproved r e f ollowing reasons:..............................................................................................................
....................................................--------------•--••--•--••---------........----•-..........--••-----•---•--------•-•------------•--•••••----•-•--------•----•----•-•--••-•-•-'•.....
Date
PermitNo......................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF.....................................................................................
Trrtifirair of (��antlilittnrr
T 0 CERTIFY, That the Individual Sewage Disposal System constructed (r 4-0f"Repaired ( )
by-------- - - -----• •-•--- -----.. -------
-----• --•--- ......
......................
..............._._......
- �..... /. Ins er
at
has been installed in accordance with the revisions of TITLE 5 of The State Sanitary Code des abed in the
application for Disposal Works Construction Permit No, _' r.. ................ dated/�._ .z2..............
THE ISSUAN E OF THIS CERTIFICATE SHALL NOT BE CONSTRIDE AS A GUARANTEE THAT THE
SYSTEM 1Al - UNCTION SATISFACTORY.
DATE.. Inspector ...........................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�/ .....................................................................................
No. �� 3 l O F FEE.y12...............
intro arks n��rurtion "permit
Permissio hereby ranted---••- -•- -r-t�
to Constru ( or Repa' dividual Sewage Disposal System
atNo -<f, L..... ---•- ........ -•----------------•----•'••-•-•--.------------------------------•-------•---. ..............................................
—-- Street
as shown on the application for osal Works Construction Permit .... ......... Dated..........................................
.............••• ........ --•---•-•-------•••••----•-•---•••-•......-•-•--•---•-•-••-•......----------
Board of Health
DATE................................................................................ c7
FORM 1255 A. M. SULKIN, INC., BOSTON
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J4� �®3nSS1 0.NslldW03 3lva
0,/ 03nSS1 11W43d 31v0
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SS3voov ! 3wv " S,M : 1T.vIsNI
j 39v111A
'ON lIWv3d 39vM3S _9V NOlIV301
►JO GAkBAGE GwNDEQ-
IDia��Y FLOW z 110 x 3 = 73oG.P. Q A,:,
SEPTIC, TA►JK = 330x15�% = �49%G.Po 30. /9-
U5>G- 100o GAL. ° Fare
Dt5Po5AL PIT D5E lvo0 GAt_. o, TEE s.r•
5�DD•�At.� A2Cta = I�o S.F. t.� Per �i c i
150
BOTTOM AREA= .. 5O S,F. P .✓R '
�
'ToTAI- DESIGN = ,g-25 6.PD• 9 I'
-TOTA4 DA 1 330 G.Po 19•7 a
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N
PEPZCOL.AT{ON RATE . C'{N 2Mln.I ot`1_E55 98o N ,(( i
97.6 N
�,,{OF AQ SM Of OWAc,
per' WILLI,AM G� 02 ALAN �
2 C. W.
N Y E y 10 ES
No. 19334�0 .0 25100
STO' QQ` T �` 14
ND SURS
/z 5-ao
I
T6`�T TOP FNU = 1oo.0
INV.
-su8�icr 17%ST. Io0,U. lN�
Z
INJ' -CiEPrIC. 978
O�X a G�YcL {Uo0 I►J�I, /,G TANK
Got .
3 Lcacu 9Jo
PIT
WITu . 97'z 97 y
113/4-III U i
.t;;QN,D WASNGD �
6TvNE I
G�>~T11=1GC� Pt-C,T PLAN
PRv P I L�
L o c A-T 10 N
►.�O SCALE
p L-p,N R t=F E 26►� c.E
I cREON Gor�Pt_�(5 Y� To1 otN �4YN
N .L oT
E S
Auk 5E6Te4GK 26R�►R.EMEN7'� of �N� 8`2-,�9 �6 7�
'ja W N p F:;: 03AV- AZ L& AND I S
L0C rE P ►N
DATEA';�
BAxTE�Z.t NYE INS•
REG 15�f�Q6'D I-A►•1 D'S u IZV E`(ae5
TW:5 PLati ► � NET 4n5c n a� N C7STE2VILLJ✓
lu5'1"R-JMENT 5�2Ve -TNE n_ ►=F>F - Suou►,D -
►Jn-r {UF- ��S - pTC7 C7ETER/^I).lE L.oT 1- Ip-lE�j APPLICP.tJT 5�c•�f 1. -qsS�:.�/a/G
�jI►.1GLL- Fp,'nnII.Y - BGDRooM
1.10 6At'zBAGE 6wr.1DE2.
D�,Ly F�-owN IID A 3 = -7)3o G P. A0 y .i
SEPTIC TAQK = 330x15o% ' �9 jGpq
u51; 100o GAL. }: 3� •'�F o
o15Po5AL PIT U5E 1000 COAL.
5%DcWALL Ae.Ca
t5o s.F x = 375 G.?o
BOTTOM AREA=
So 5.F x t- o 50 —
•3 !'
-ToTP.I- DESIGN
i
-roTAL pA I ►-Y FLOC/•( - 330 6RD.
N ,
PE2GOLAT►ON RATE I'�iN 2MIN a�LES�i 98 o N
97•6 N
V N
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