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0033 BARBERRY LANE - Health
c f i .3� TOWN OF BARNSTABLE LOCATIONEa6:K�,)fLSEWAGE VILLAGE W-:!S6 (��:� � ASSESSOR'S MAP & LOT/dam,-l24"7 INSTALLER'S NAME & PHONE NO'lsk (, _ SEPTIC TANK CAPACITY �L. LEACHING FACILITY:(type) (size) ,� S NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: (ty DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No o� hE a Li LOCATION � ' J SECW ,� G, Lr.. PERMIT N)O- g e- VILLAGE Al I N S T A LLER'S NAME i ADDRESS ' Assam c (,A7e 1 Y L o u 4 Gc BUILDER OR OWNER DATE PERMIT ISSUED }� -74 DATE COMPLIANCE ISSUED 12 i3 -7� s ) 9 I3 � Add � d^�\ E � s k Town of Barnstable 39. Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 John Norman,Chairrrnan FAX: 508-790-6304 Donald A.Guadagnoli,M.D. F.P.(Thomas)Lee,P.E. Daniel Luczkow,M.D.Alt March 7, 2022 Mr. Joseph Henderson Horsley Witten Group 90 Route 6A, Unit 1 Sandwich, MA 02563 RE: ` 33 Barberry Lane, Marstons Mills Dear Mr. Henderson, During the public meeting of the Board of Health held on August 24, 2021, the Board voted to remove your original request to increase the wastewater discharge flow from three to four bedrooms at 33 Barberry Lane, Marstons Mills. Thus, a request for an innovative system designed for three (3) bedrooms (330 gpd) flow was reviewed. You are granted permission on behalf of your client, Carol Weston, to construct and utilize a NitROE secondary treatment unit with advanced nitrogen reduction technology designed for three (3) bedrooms at 33 Barberry Lane, Marstons Mills, Massachusetts. This permission is granted with the following condition: • The variance request and engineering plans shall be revised to show three (3) bedrooms, You are reminded the following requirements are provided within the MA Department of Environmental Protection (DEP) Provisional Use Approval Renewal letter for this particular technology, dated May 12, 2020: (1) Thirty (30) days prior to submitting an application for a DSCP, the Company or its Authority a certification signed b the representative shall provide to the Approving y g y owner of record for the property to be served by the unit, stating that the property owner: a) has been provided a copy of the Provisional Use Approval and all attachments and agrees to comply with all terms and conditions; b) has been informed of all the owner's costs associated with the operation including power consumption, maintenance, sampling, recordkeeping, reporting, and equipment replacement; KleanTu NitROE 2K Provisional Approval, May 2020 Page 11 of 15 Technology: NitROE® 2KS & 2KM WWTS c) understands the requirement for a contract with a company approved operator and has been provided a current list of all approved operators; d) agrees to fulfill his Q:WP/Henderson 33BarberryLane NitROE Approval August 2021.docx responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10) and the Approval; and e) agrees to fulfill his responsibilities to provide written notification of the Approval conditions to any new owner, as required by 310 CMR 15.287(5). (2) Prior to the issuance of a Certificate of Compliance by the Approving Authority: a) In accordance with 310 CMR 15.021(3), the System Installer and Designer must certify in writing that the System has been constructed in compliance with 310 CMR 15.000, the approved design plans, and all local requirements, including any local approving authority site-specific requirements; (3) Prior to issuance of the Certificate of Compliance and after recording and/or registering the Deed Notice required by 310 CMR15.287(10), the System Owner shall submit the following to the Local Approving Authority: (i) a certified Registry copy of the Notice bearing the book and page/or document number; and (ii) if the property is unregistered land, a Registry copy of the System Owner's deed to the property, bearing a marginal reference on the System Owner's deed to the property. The Notice to be recorded shall be in the form of the Notice provided by the Department (4) Prior to the use of the System, the System Owner shall enter into an O&M Agreement with a qualified contractor and submit the Agreement to the Approving Authority and the Company. The Agreement shall be at least for one year. (5) The wastewater effluent shall be sampled and analyzed/tested quarterly if this facility is utilized year-round. Sampling shall include pH, BOD5, TSS and Total Nitrogen, unless otherwise stated. Flow shall be recorded at each inspection. [Note: a) Year-round facilities shall be inspected and effluent sampled quarterly; b) Seasonal properties shall be inspected and effluent sampled a minimum of twice per year, with at least one annual sample taken 30 to 60 days after seasonal occupancy and a second sample taken no less than 2 months after the first sample; and c) After 12 rounds of monitoring, sampling may be reduced to TN only quarterly. Reduced sampling shall also include Field Testing of System wastewater when determined necessary by the operator, see DEP Field Testing Protocol at http://www.mass.gov/eea/docs/dep/water/laws/i-thru-z/testsamp.pdfl (6) A copy of the wastewater analyses, wastewater flow data, field testing results, and System Operator O&M reports and inspection checklists shall be maintained by the Company. It is recommended the System Owner also maintain copies of these items. The above list is not all inclusive; all of the other conditions listed in the MA Department of Environmental Protection (DEP) Provisional Use Approval Renewal letter to KleanTu LLC dated May 12, 2020 will need to be adhered to. This permission is granted because the proposed plan appears to meet the maximum feasible compliance provisions of the State Environmental Code, Title 5, and the Town P of Barnstable Board of Health Regulations. It also appears to meet the nitrogen loading restrictions contained within the State and local regulations with no increase in sewage flow requested at this property at this time. jSi,ncgerqy yours, I ohn Norman, Chairman Q:WP/Henderson 33BarberryLane NitROE Approval August 2021.docx t �lime DATE: $95.00 FEE*: LA t � = Town of Barnstable rrtaes. $' REC.BY: � 1639- &gym Board of Health 3CHED.DATE: 200 Main Street,Hyannis MA 02601 Office: 508-862A644 John T.Norman FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Paul J.Canniff,D.M.D. F.P.(Thomas)Lee,Alternate VARIANCE REQUEST FORM LOCATION Property Address: 33 Barberry Lane-Marstons Mills Assessor's Map and Parcel Number: 102/147 Size of Lot: 0.44 acres Wetlands Within 300 Ft. Yes 250'+/- Business Name: Subdivision Name: APPLICANT'S NAME: Joseph Henderson(Horsley Witten) Phone 508-833-6600 Did the owner of the property authorize you to represent him or her.? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: Linda J Martin Name: Joseph Henderson(Horsley Witten Group) Address: 33 Barberry Lane Marstons Mills Address: 90 Route 6A,Unit 1 Sandwich,MA 02563 Phone: Phone: 508-833-6600 EMAIL: jenderson@horslywitten.com VARIANCE FROM REGULATION(lncl.Reg.code a) REASON FOR VARIANCE(May attach separate sheet if more space needed) Installation of I/A system. Additional bedroom NATURE OF WORK: House Addition House Renovation LJ Repair of Failed Septic System Lj Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as S collated packets. _ A. Five(5)copies of the completed variance request form _ B. Five(5)copies of MA DEP approval letters for innovative/Altemative septic system(when proposing an I/A system or secondary treatment unit(S.T.U.). C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health(4town.bamstable.ma.us *(Pool Plan—5 hard copies) D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version. A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or PLS. Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). Fee Submitted•$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1)Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance"). Variance request submitted at least 15 days prior to meeting date 'r VARIANCE APPROVED John T.Norman NOT APPROVED Donald A.Guadagnoli,M.D. REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. Q:\Application Forms\VARZREQ Rev Jan 1-2020.docx a MAIL-IN REQUESTS Please mail the variance fee amount of $95.00 (if applicable), along with the documents listed below, to the following address: Checks payable to: Town of Barnstable. Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 For septic system variance requests, each of five packets must include: 1) Variance Request Form, 2) Letter for the Board with further information on the reason for the septic variance request (Optional), 3) MA DEP Approval letters for proposed Innovative Alternative (I/A) septic system or a proposed secondary treatment unit (S.T.U.) 4) Engineering plans, 5) Floor plans. In additional to the five septic packets above, include one copy of the seven (7) page checklist, the authorization letter, copy of abutters notice, and fee, if applicable (see checklist below). Please send one electronic submission using a PDF or .jpg of the engineering plan and floor plans to email: health town.barnstable.ma.us. (Total email must be less than 10 megabytes.) For grease trap variance requests, each of five packets must also include a full menu. (see checklist below). Checklist - Please submit rrst four on list as 5 collated packets. A. Five(5)copies of the completed variance request form - . B. Five(5)copies of MA DEP approval letters for Innovative Alternative septic system(when proposing an 1/A or , secondary treatment unit(S.T.U.). C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health@bamstable.ma.us D. Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version submitted to email: health@town.bamstable.ma.us A completed seven (7) page checklist, confirming all required items are on the engineered septic system plan submitted by engineer or registered sanitarian. Signed letter stating that the property or business owner authorized you to represent hhTAer for this request - Applicant must notify the abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only) Fee Submitted *595.00 for the following variances: 1)New construction,2)Septic repairs with increase in flows,3) New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic. repair without an increase in flow and variances granted at the counter. 2) Monitoring Plans, and 3) Temporary Food(this.is not a variance). Variance request submitted at least 15 days prior to meeting date: For,further assistance on any item above, call (508) 862-4644 Email: health(@-town.barnstable.ma.us Back to Main Public Health Division Page i t s p' I ram . a a� 11 , r — _-- dam �► v n. 6-d row _ �oorr, I ram, bad- . n' ------- AgVY VC) cz �a �D v ro r Commonwealth of Massachusetts Executive Office of Energy &Environmental Affairs Department of Environmental Protection One Winter Street Boston, MA 02108.617-292-5500 Charles D.Baker Kathleen A.Theoharides Governor Secretary Karyn E. Polito Martin Suuberg Lieutenant Governor Commissioner PROVISIONAL USE APPROVAL RENEWAL, Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: K1eanTu LLC. 300 Old Pond Road, Ste#206 Bridgeville,PA 15017 Trade name of technology and models: NitROE® Waste-Water Treatment System (NitROE® WWTS) with unit sizing for design flows up to 2000 gpd (NitROE® 2KS WWTS and NitROE® 2KM WWTS) (hereinafter the `System' or the `Technology'). Owner and Operator manuals, installation manual, schematic drawings illustrating the System models and the technology inspection checklist are part of this Certification. DEP Transmittal No.: X285590 Date of Issuance: May 12,2020, Expiration date: May 12,2025 Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection (hereinafter "the Department") hereby issues this Provisional Approval to: Klean Tu LLC, located at 300 Old Pond Rd., Ste 206 in Bridgeville, PA (hereinafter "the Company"), NitROE® 2KS WWTS and NitROE® 2KM WWTS (hereinafter "the Technology" or "System") for use in the Commonwealth of Massachusetts subject to the conditions herein. Sale and use of the Technology is subject to compliance by the Company, the Designer, the System Installer, the Operator, and the System Owner with the terms and conditions herein. Any noncompliance with the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000. _May 12, 2020 Marybeth Chubb, Section Chief Date Wastewater Management Program Bureau of Resource Protection This information is available in alternate format.Contact Michelle Waters-Ekanem,Director of Diversity/Civil Rights at 617-292-5761. TTY#MassRelay Service 1-800-439-2370 MassDEP Website:www.mass.gov/dep Printed on Recycled Paper K1eanTu NitROE 2K Provisional Approval,May 2020 Page 2 of 15 Technology:NitROEO 2KS&2KM WWTS I.PURPOSE Subject to the conditions of this Approval and any other local requirements, the purpose of this Approval is to allow installation and operation of at least 50 on-site sewage disposal systems utilizing the technology in Massachusetts in order to conduct a performance evaluation of the capabilities of the Technology during the first 3 years of operation of each system, in accordance with Title 5 — 310 CMR 15.286 (7),Provisional Approval of Alternative System. The specific goal of the Performance Evaluation is to determine if the Technology is capable of consistently meeting the concentration limits for total nitrogen (TN) of less than 11 milligrams per liter (mg/L) for installations with design flows less than 2,000 GPD in the effluent discharged to the soil absorption system. In areas subject to nitrogen loading limitations, increases in the discharge rate per acre may be allowed when the nitrogen concentration discharged to the soil is reduced. The Company is responsible for oversight and sampling of the systems during the Performance Evaluation. The System Owner has responsibility for continued oversight and sampling of the system if the property served was allowed to increase the discharge rate per acre above 440 gallons per day per acre (gpda) in an area subject to Nitrogen Loading Limitations. The System Owner will be required to repair, replace, modify or take any other action as required by the Department or the local approving authority, if the Department or the local approving authority determines that the System is not capable of meeting the required reduction in nitrogen in the effluent. With the other applicable permits or approvals that may be required by Title 5, this Approval authorizes the installation and use of the Alternative System in Massachusetts. All the provisions of Title 5, including the General Conditions for all Alternative Systems (310 CMR 15.287), apply to the sale, design, installation, and use of the System, except those provisions that specifically have been varied by this Approval. H. GENERAL DESCRIPTION OF THE TECHNOLOGY The NitROE ® 2KS or 2KM WWTS (the `System') is installed in series between a Title-5 system septic tank and a soil absorption system constructed in accordance with 310 CMR 15.100 — 15.279, subject to the provisions of this Approval to accommodate design flows of less than 2,000 GPD. The System is comprised of two-unit processes which are sequentially performed in two different chambers. The first chamber is aerated, via an external air pump and airline header/hose arrangement, to achieve both organic carbon reduction along with the biological conversion of ammonia-N to nitrate-N. From the Aeration Chamber, the wastewater then gravity flows into a Denitrification Chamber where, in the presence of natural organics from wood chips, bacteria mediate the conversion of nitrate-N to inert N gas that exits to the atmosphere via the Title 5 system vent piping. Depending on.design flow and availability of local tank structures, the sequential Aeration and Denitrification process steps can be performed in the same single tank, which is NitROE® 2KS WWTS, or each process could be performed in its own separate tank with the overall NitROE® WWTS comprised of multiple tank combinations, which is NitROE®2KM WWTS. The use of the Technology under this Approval requires: • Disclosure Notice in the Deed to the property; • Certifications by the Company,the Designer, and the Installer; • System Owner Acknowledgement of Responsibilities; K1eanTu NitROE 2K Provisionai Approval,May 2020 Page 3 of 15 Technology:NitROE®2KS&2KM WWTS • A certified operator under contract for periodic inspection and maintenance; • Periodic sampling; • Recordkeeping and reporting; and • An external power supply III.CONDITIONS OF APPROVAL A. Basis for Conditions 1. The term "System" refers to the Technology in combination with any other components of an on-site treatment and disposal system that may be required to serve a Facility in accordance with 310 CMR 15.000. 2. The term "Approval" includes the Special Conditions, Standard Conditions, General Conditions of 310 CMR 15.287, and the approved Attachments. 3. Items required by this Approval include: a) Performance Evaluation Plan (PEP) with sampling and analysis requirements and approved by the Department. The PEP must be submitted to the Department for review and approval within 60 days of issuance of this Approval and meet the requirements of the Department's Guidance for the Preparation of Performance Evaluation Plans <2,000 GPD; b) Minimum System installation requirements; c) Company schematic drawings and specifications; d) Owner's Manual, including information on substances that should not be discharged to the System; e) Operation and Maintenance manual, including but not limited to, operator qualification requirements, inspection requirements, sampling and analysis requirements, recordkeeping requirements, and/or reporting requirements; and f) MassDEP Operation and Maintenance (O&M) checklist and I/A technology inspection checklist. B. Special Conditions 1. Department review and approval of the System design and installation is not required unless the Department determines on a case-by-case basis pursuant to its authority at 310 CMR 15.003(2)(e)that the proposed System requires Department review and approval. 2. System installations must meet the specific siting conditions for Provisional Use provided in 310 CMR 15.286(4) and the facility must meet the siting requirements of this Approval. 3. Any System for which a complete Disposal System Construction Permit Application is submitted while this Approval is in effect, may be permitted, installed, and used in accordance with this Approval unless the Department,the local approval authority, or a court requires the System to be modified or removed or requires discharges to the System to cease. 4. The System Owner shall provide access to the site for purposes of sampling the System in accordance with the Company's technology Performance Evaluation Plan approved by the K1eanTu NitROE 2K Provisional Approval,May 2020 Page 4 of 15 Technology:NitROE®2KS&2KM WWTS Department, in addition to providing access for performing inspections, maintenance, repairs, and responding to alarm events. 5. The System Owner shall ensure that no permanent buildings or structures, other than the System, are constructed in the area for the installation of all the components of a fully conforming Title 5 system with a reserve area. The area for a fully conforming Title 5 system with a reserve area shall not otherwise be disturbed by the System Owner in any manner that will render it unusable for future installation of a fully conforming Title 5 system. 6. The Department has not determined that the performance of the System will provide a level of protection to public health and safety and the environment that is at least equivalent to that of a sanitary sewer system. If it is feasible to connect a new or existing facility to the sewer, the Designer shall not propose an Alternative System to serve the facility and the facility Owner shall not install or use an Alternative System. When a sanitary sewer connection becomes feasible after an Alternative System has been installed,the System Owner shall connect the facility served by the System to the sewer within 60 days of such feasibility and the System shall be abandoned in compliance with 310 CMR 15.354, unless a later time is allowed in writing by the Department or the Local Approving Authority. 7. The control panel including alarms shall be mounted in a location accessible to the System Operator. 8. For any System that does not flow by gravity to the SAS, the System shall be equipped with sensors and high-level alarms to protect against high water due to pump failure, pump control failure, loss of power, or system'freeze up. The control panel including alarms and controls shall be mounted in a location always accessible to the operator (or service .contractor). Emergency storage capacity for wastewater above the high level alarm shall be provided equal to the daily design flow of the System and the storage capacity shall include an additional allowance for the volume of all drainage which may flow back into the System when pumping has ceased. Instead of providing emergency 24-hour storage, an independent standby power source may be provided for operation during an interruption in power. With any interruption of the power supply the source must be capable of automatically activating in addition to manual start up capability. The standby power must be sufficient to handle peak flows for at least 24 hours and sufficient to meet all power needs of the System including, but not limited to, pumping, ventilation, and controls. Standby power installations must be inspected and exercised at least annually and all automatic and manual start up controls must be tested. Standby power installations must comply with all applicable state and local code requirements. Provided that a standby power installation complies with these requirements, no variance is required to the provisions of 310 CMR 15.231(2). 9. System unit malfunction and high water alarms shall be connected to circuits separate from the circuits to the operating equipment and pumps. 10. All-System control units,valve boxes, conveyance lines and other System appurtenances shall be designed and installed to prevent freezing per the Company's recommendations. K1eanTu NitROE 2K Provisional Approval,May 2020 Page 5 of 15 Technology:NitROE&2KS&2KM WWTS 11. Any System structures with exterior piping connections located within 12 inches or below the Estimated Seasonal High Groundwater elevation shall have the connections made watertight with neoprene seals or equivalent. 12. In compliance with 310 CMR 15.240(13), a minimum of one (1) inspection port shall be provided within the SAS consisting of a perforated four inch pipe placed vertically down into the stone to the naturally occurring soil or sand fill below the stone. The pipe shall be capped with a screw type cap and accessible to within three inches of finish grade. Operation and Maintenance 13. Inspection, operation and maintenance (O & M), sampling, and field testing of the System required by this Approval shall be performed by a System Operator with the following qualifications: a) is an approved System Inspector in accordance with 310 CMR 15.340; b) has been trained by the Company and whose name appears on the Company's current list of qualified operators; and c) has been certified at a minimum of Grade Level IV (four) by the Board of Registration of Operators of Wastewater Treatment Facilities, in accordance with Massachusetts regulations 257 CMR 2.00. The name of the Operator shall be included in the O&M agreement required by paragraph B (14). 14. Prior to the use of the System, the System Owner shall enter into an O&M Agreement with a qualified contractor and submit the Agreement to the Approving Authority and the Company. The Agreement shall be at least for one year and include the following provisions: a) The name of the qualified Operator that appears on the Company's current list of Service Contractors; b) The System Operator must have the qualifications specified in paragraph B (13); c) The System Operator must inspect the System in accordance with the Approval and anytime there is an equipment failure, System failure, or other alarm event; d) In the case of a System failure, an equipment failure, alarm event, components not functioning as designed or in accordance with the Company specifications, or violations of the Approval, procedures and responsibilities of the Operator and System Owner shall be clearly defined for corrective measures to be taken immediately. The System Operator shall agree to provide written notification within five days describing corrective measures taken to the System Owner,the Company, and the local board of health; e) The System Operator shall determine the cause of total nitrogen effluent limit violations if they occur and take corrective actions in accordance with the approved O & M Manual; and f) Procedures and responsibilities for recording quarterly or monthly wastewater flows must be defined, see paragraph B (32)"Flow Metering". 15. At all times, the System Owner shall maintain an O&M Agreement that meets the requirements of paragraph B (20). 16. The System Owner and the System Operator shall properly operate and maintain the system in accordance with this Approval, the Designer's operation and maintenance requirements, and the requirements of the local approving authority. K1eanTu NitROE 2K Provisional Approval,May 2020 Page 6 of 15 Technology:NitROER 2KS&2KM WWTS 17. Upon determining that the System has failed, as defined .in 310 CMR 15.303, the System Operator shall notify the System Owner immediately. 18. Upon determining that the System has failed, as defined in 310 CMR 15.303, the System Owner and the System Operator shall be responsible for the notification of the local approving authority within 24 hours of such determination. 19. In the case of a System failure, an equipment failure, alarm event, components not functioning as designed or in accordance with the Company specifications, or any violations of the Approval, the System Owner and the System Operator shall be responsible for the written notification of the local approving authority and the Company within five days describing corrective measures taken. 20. Within 60 days of any site visit, the System Operator shall submit an O&M report and inspection checklist to the System Owner and the Company. The O&M report and inspection checklist shall include, at a minimum: a) for a System failing, any corrective actions taken; b) wastewater analyses,wastewater flow data, and field testing results; c) any violations of the Approval; d) any determinations that the System or its components are not functioning as designed or in accordance with the Company specifications; and e) any other corrective actions taken or recommended. 21. By September 30th of each year, the System Owner and the Service Contractor shall be responsible for submitting to the local approving authority all monitoring results with all ' O&M reports and inspection checklists completed by the System Operator during the previous 12 months. 22. By September 30th of each year, the Service Contractor shall be responsible for submitting to the Company copies of all O&M reports including alarm event responses, all monitoring results, violations of the Approval, inspection checklists completed by the Service Contractor, notifications of system failures, and reports of equipment replacements with reasons during the previous 12 months. 23. A copy of the wastewater analyses, wastewater flow data, field testing results, and System Operator O&M reports and inspection checklists shall be maintained by the Company. It is recommended the System Owner also maintain copies of these items. 24. The System Owner shall notify the Approving Authority in writing within seven days of any cancellation, expiration or other change in the terms and/or conditions of the O&M Agreement required by Paragraph B(14). 25. The System Owner and the Service Contractor shall maintain copies of the Service Contractor's O&M reports, inspection checklists, and all reports and notifications to the LAA for a minimum of five years. 26. The System may only be installed to serve facilities where a fully conforming Title 5 system with a reserve area exists on-site or could be built on-site in compliance with the design standards for new construction of 310 CMR 15.000, and for which a site evaluation in KleanTu NitROE 2K Provisional Approval,May 2020 Page 7 of 15 Technology:NitROE®2KS&2KM WWTS compliance with 310 CMR 15.000 has been approved by the Approving Authority. A fully conforming Title 5 system may include other approved alternative technologies in accordance with the conditions imposed on the alternative technologies. 27. Subject to the provisions of this Approval, the Technology shall be installed in a manner which neither intrudes on, replaces a component of, or adversely affects the operation of all other components of the System designed and constructed in accordance with the standards for new construction of 310 CMR 15.200 - 15.279. Effluent Limit and Monitoring Requirements, 28. For the new construction, unless the facility meets a TN effluent limit of 11 mg/1 or less, the system shall not be designed to receive more than 440 gallons of design flow per day per acre (gpda) in an area that is subject to the Nitrogen Loading Limitations of 310 CMR 15.214. If the facility does not meet with the Nitrogen Loading Limitations pursuant to the aggregation provisions of 310 CMR 15.216, the System Owner shall repair, replace, modify or take any other action as required by the Department or the local approving authority to meet the total nitrogen concentration limits in the effluent. Violation of the TN concentration in the System effluent shall not require notifications as required in paragraphs B (18) and(19). 29. Prior to Department approval of the Company's Performance Evaluation Plan, the Company shall be responsible for the following monitoring requirements for all System installations that are subject to a total nitrogen concentration limit in accordance with paragraph B (28). Sampling shall include pH, BOD5, TSS and Total Nitrogen, unless otherwise stated. Flow shall be recorded at each inspection, see"Flow Metering" section below. a) Year-round facilities shall be inspected and effluent sampled quarterly; b) Seasonal properties shall be inspected and effluent sampled a minimum of twice per year, with at least one annual sample taken 30 to 60 days after seasonal occupancy and a second sample taken no less than 2 months after the first sample; and c) After 12 rounds of monitoring, sampling may be reduced to TN only quarterly. Reduced sampling shall also include Field Testing of System wastewater when determined necessary by the operator, see DEP Field Testing Protocol at htW:11www.mass.govleealdocsldeplwater/laws/i-thru-z/testsamp.pdf. Properties occupied at least 6 months per year are considered year-round properties. Properties occupied less than 6 months per year are considered seasonal properties. 30. During the Performance Evaluation period, the Company shall follow the monitoring requirements specified in the Performance Evaluation Plan for installed Systems. 31. After the three (3) year Performance Evaluation period by the Company and approval by the Department, and until this Approval is modified, terminated, or superseded by a General Use Certification, the System Owner shall comply with the following monitoring requirements if the System is subject to a total nitrogen concentration limit in accordance with paragraph B? (28)• K1eanTu NitROE 2K Provisional Approval,May 2020 Page 8 of 15 Technology:NitROE®2KS&2KM WWTS a) Year-round properties shall be inspected and sampled for at least the TN parameter a minimum of twice/year, at least 5 months apart and with at least one sample taken between December 1 and March 1 of each year. Field testing shall be completed as determined necessary by the System operator, see DEP Field Testing Protocol at http://www.mass.gov/eea/docs/dep/water/laws/i-thru-z/testsamp.pdf. Water meter readings shall be recorded at each inspection, see"Flow Metering"below. b) Seasonal properties shall be sampled for at least the TN parameter a minimum of twice/year. At least one annual sample must be taken 30 to 60 days after each seasonal occupancy. A second sample must be taken no less than 2 months after the first sample. Field testing of the System shall be completed as determined necessary by the operator. Water meter readings shall be recorded at each inspection, see "Flow Metering" below. 32. Flow Metering - At a minimum, for all systems installed prior to this Approval, water meter flow data shall be recorded each time the system is inspected and sampled by the System Operator. For systems installed after the effective date of this Approval, wastewater flow data shall be recorded each time the system is inspected and sampled by the System Operator and may be based on: a) actual metering data of wastewater flow to the system; or b) water meter data for the total facility with metered non-wastewater flows, if available, subtracted from the total facility water usage. 33. Field Testing: Turbidity, pH and Apparent Color - Turbidity, pH, DO and apparent color shall be measured and/or recorded in the field when when determined necessary by the operator. See applicable sections of the Department's Field Testing Protocol at http://www.mass.cov/eea/docs/dep/water/laws/i-thru-z/testsamp.pdf. 34. At a minimum,the System Operator shall inspect the System: a) two times per year; b) in accordance with the approved O&M manual, the Designer's operation and maintenance requirements, and the requirements of the local approving authority; and c) any time there is an alarm event, equipment failure, or system failure 35. The System Operator shall collect samples and obtain analysis results from an approved lab, perform field testing required by the Approval and submit results within 60 days of the site visit to the System Owner. 36. If the Company successfully demonstrates the effectiveness of the System to reduce nitrogen loadings during the Performance Evaluation period, a minimum of three years, the System Owner shall operate the System subject to the requirements of the General Use Certification, if issued, for this technology. C. Special Conditions Specific to the Company 1. The Approval shall only apply to model units with the same model designations specified in this approval and meet the same specifications, operating requirements, and plans, as provided by the manufacturer at the time of the application. Any proposed modifications of the units shall be subject to the review of the Department for coverage under the Approval. f K1eanTu NitROE 2K Provisional Approval,May 2020 Page 9 of 15 Technology:NitROEO 2KS&2KM WWTS 2. Prior to submission of an application for a DSCP,the Company shall provide to the Designer and the System Owner: a) All.design and installation specifications and requirements; b) An operation and maintenance manual, including: i) an inspection checklist; ii) recommended inspection and maintenance schedule; iii)monitoring(i.e. water use and power consumption)and sampling procedures, if any; iv)alarm response procedures, if any, and troubleshooting procedures; c) An owner's manual, including proper system use and alarm response procedures, if any; d) Estimates of the Owner's costs associated with System operation including, when applicable: power consumption, maintenance, sampling, recordkeeping, reporting, and equipment replacement; e) A copy of the Company's warranty; and f) Lists of Designers,Installers, and Service Contractors. 3. The Company shall implement the Performance Evaluation Plan, as submitted and approved by the Department, and shall be responsible for all data collection and submissions to the Department until a final determination on the Performance Evaluation has been made by the Department. 4. Until a final determination has been made by the Department on a completed Performance Evaluation, the Company shall submit to the Department an annual report by February 15th of each year that includes the following: a) a table of all sample data collected for all systems installed to date and all information required by the Department as part of the approved Performance Evaluation Plan; b) status of preparation of a Performance Evaluation Plan if not yet provided to MassDEP, or any recommended changes to the approved Performance Evaluation Plan; c) a list of pending applications for system installations which have been submitted to local approving authorities; d) identification of any System after start-up in violation of the Approval or not in compliance with any performance criteria at the time of the annual report, the reasons for the noncompliance and the status of any corrective actions that are needed; and e) any recommendations and requests for changes to the system monitoring and reporting plan or the performance criteria of the Approval. The report shall be signed by a corporate officer, general partner or the Company owner. (Service Contractor records submitted to the Company should not be included with the annual report to the Department, but shall be made available to the Department within 30 days of a request by the Department.) 5. The Company shall institute and maintain a program of Installer training and continuing education that is at least offered annually. The Company shall maintain and annually update, and make available the list of qualified Installers by February 15th of each year. The Company shall certify that the Installers on the list have taken the training and passed the Company's training qualifications. K1eanTu NitROE 2K Provisional Approval,May 2020 Page 10 of 15 Technology: W NitROEO 2KS&2KM WTS 6. The Company shall institute and maintain a program of Designer training and continuing education, as approved by the Department. The Company shall maintain and annually update, and make available the list of qualified Designers by February 15th of each year. The Company shall certify that the Designers on. the list have taken the training and passed the Company's training qualifications. 7. The Company shall institute and maintain a program of Operator training and continuing education, as approved by the Department. The Company shall maintain and annually update, and make available the list of qualified Operators by February 15th of each year. The Company shall certify that the Operators on the list have taken the training and passed the Company's training qualifications. 8. The Company shall not sell the Technology to an Installer unless the Installer is trained to install the System by the Company. 9. Prior to its sale of any System that may be used in Massachusetts, the Company shall provide the purchaser with a copy of the Approval with the System design, installation, O&M, and Owner's manuals. In any contract for distribution or sale of the System, the Company shall require the distributor or seller to provide the purchaser of a System for use in Massachusetts with copies of these documents,prior to any sale of the System. 10. Within 60 days of issuance by the Department of a revised Approval, the Company shall provide written notification of changes to the Approval to all Service Contractors servicing existing installations of the Technology and all distributors and resellers of the Technology. 11. The Company shall provide written notification to the Department's Director of the Wastewater Management Program at least 30 days in advance of the proposed transfer of ownership of the Technology for which the Approval is issued. Said notification shall include the name and address of the proposed owner containing a specific date of transfer of ownership,responsibility, coverage and liability between them. 12. The Approval shall be binding on the Company and its officers, employees, agents, contractors, successors, and assigns, including but not limited to dealers, distributors, and resellers. Violation of the terms and conditions of the Approval by any of the foregoing persons or entities, respectively, shall constitute violation of the Approval by the Company unless the Department determines otherwise. IV. CERTIFICATION AND NOTIFICATION REQUIREMENTS 1. Thirty (30) days prior to submitting an application for a DSCP, the Company or its representative shall provide to the Approving Authority a certification, signed by the owner of record for the property to be served by the unit, stating that the property owner: a) has been provided a copy of the Provisional Use Approval and all attachments and agrees to comply with all terms and conditions; b) has been informed of all the owner's costs associated with the operation including power consumption, maintenance, sampling, recordkeeping, reporting, and equipment replacement; K1eanTu NitROE 2K Provisional Approval,May 2020 Page 11 of 15 Technology:NitROEO 2KS&2KM WWTS c) understands the requirement for a contract with a company approved operator and has been provided a current list of all approved operators; d) agrees to fulfill his responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10)and the Approval; and e) agrees to fulfill his responsibilities to provide written notification of the Approval conditions to any new owner, as required by 310 CMR 15.287(5). 2. Upon submission of an application for a DSCP to the Approving Authority, the Company shall submit to the Approving Authority, with a copy to the Designer and the System Owner, a certification by the Company or its authorized agent that the design conforms to this Approval and that the proposed use of the System is consistent with the unit's capabilities and all Company requirements. The review shall include evaluation of the need for installation of water meter(s) at each facility. An authorized agent of the Company responsible for the design review shall have received technical training in the Company's products. 3. The System Designer shall be a Massachusetts Registered Professional Engineer, or a Massachusetts Registered Sanitarian provided that such Sanitarian shall not design a system with a discharge greater than 2,000 gallons per day. 4. Thirty30 days prior to delivery of the treatment unit to the site for installation the ( ) Y P rY , Company shall provide to the Approving Authority a copy of a signed contract for a minimum period of one year with a Company approved Operator and the initial Owner/Occupant of the property. 5. Prior to the commencement of construction,the System Installer must certify in writing to the Designer and the System Owner that (s)he has taken the Company's training, passed the Company's training qualifications, and is listed on the Company's list of Installers. 6. Prior to the issuance of a Certificate of Compliance by the Approving Authority: a) In accordance with 310 CMR 15.021(3), the System Installer and Designer must certify in writing that the System has been constructed in compliance with 310 CMR 15.000,the approved design plans, and all local requirements, including any local approving authority site-specific requirements; b) In accordance with 310 CMR 15.021(3), the Designer must certify in writing that any changes to the design plans have been reflected on as-built plans which have been submitted to the Approving Authority by the Designer; c) As a condition of this Approval, the System Installer and Designer must certify to the Approving Authority in writing that the System has been constructed in compliance with the terms of this Approval; d) An authorized agent of the Company must certify to the Approving Authority in writing that the installation was done by a qualified Installer approved by the Company and the installation conforms to this Approval. The authorized agent of the Company responsible for the inspection of the installation shall have received technical training in the Company's products; and e) Prior to signing any agreement to transfer any or all interest in the property served by the system, or any portion of the property, including any possessory interest, the System Owner shall provide written notice, as required by 310 CMR 15.287(5) of all conditions contained in the Approval to the transferee(s). Any and all instruments of transfer and �I any leases or rental agreements shall be included as an exhibit attached thereto and made K1eanTu NitROE 2K Provisional Approval,May 2020 Page 12 of 15 Technology:NitROE®2KS&2KM WWTS a part thereof of a copy of the Approval for the System. The System Owner shall send a copy of such written notification(s) to the Local Approving Authority within 10 days of such notice to the transferee(s). V. STANDARD CONDITIONS 1. The provisions of 310 CMR 15.000 are applicable to the design, installation, use and operation of a System utilizing an approved or certified alternative technology, except those provisions that specifically have been varied by the conditions of this Approval. 2. The design, installation, and use of the System must conform to the terms and conditions of the Approval and the Department approved attachments. 3. The facility served by the System and the System itself shall be open to inspection and sampling by the Department and the local approving authority at all reasonable times. Standard Conditions Applicable to the System Owner. 4. This Approval shall be binding on the System Owner and on its agents, contractors, successors, and assigns. Violation of the terms and conditions of this Approval by any of the foregoing persons or entities, respectively, shall constitute violation of this Approval by the System Owner unless the Department determines otherwise. 5. The System Owner shall obtain all necessary permits and approvals required by 310 CMR 15.000 prior to the installation and use of the System in Massachusetts. 6. The System is approved for the treatment and disposal of sanitary sewage only. The System Owner shall not introduce any wastes that are not sanitary sewage into the System. The System Owner shall dispose of wastes generated or used at the facility that are not sanitary sewage by other lawful means. 7. Prior to issuance of the Certificate of Compliance and after recording and/or registering the Deed Notice required by 310 CMR15.287(10), the System Owner shall submit the following to the Local Approving Authority: (i)a certified Registry copy of the Notice bearing the book and page/or document number; and(ii) if the property is unregistered land, a Registry copy of the System Owner's deed to the property, bearing a marginal reference on the System Owner's deed to the property. The Notice to be recorded shall be in the form of the Notice provided by the Department. 8. The System Owner shall at all times have the installed System properly operated and maintained in accordance with the most recent O&M provisions of this Approval for the alternative technology and in accordance with any additional requirements of the Approving Authority. The most recent O&M provisions of this Approval for the alternative technology are available from the Department. 9. The System Owner shall furnish the Department any information that the Department requests regarding the System,within 21 days of the date of receipt of that request. Standard Conditions Applicable to the Designer K1eanTu NitROE 2K Provisional Approval,May 2020 Page 13 of 15 Technology:NitROEO 2KS&2KM WWTS 10. The Designer shall be a Massachusetts Registered Professional Engineer or a Massachusetts Registered Sanitarian, including when designing systems for repair, provided that such Sanitarian shall not design a system to discharge more than 2,000 gallons per day. 11. Prior to the application for a DSCP,the Designer shall provide the System Owner with a copy of this Approval. Standard Conditions Applicable to the Company 12. This Approval shall be binding on the Company and its officers, employees, agents, contractors, successors, and assigns. Violation of the terms and conditions of this Approval by any of the foregoing persons or entities, respectively, shall constitute violation of this Approval by the Company unless the Department determines otherwise. 13. The Company shall include copies of the Approval with each System that is sold. In any contract executed by the Company for distribution or re-sale of the System, the Company shall require all vendors, distributors, and resellers to provide each purchaser of the System with copies of the Approval. 14. The Company shall make available, in printed and electronic format, the approved Attachments and any approved updates associated with the Approval, to the System Owners, Operators,Designers,Installers,vendors,resellers, and distributors of the System. 15. The Company shall submit to the Department for approval any proposed updates or changes to the Attachments to the Approval: 16. The Company shall notify all System Owners, resellers, and distributors of changes to the Approval within 60 days of issuance by the Department. 17. The Company shall notify the Department's Director of the Wastewater Management Program at least 30 days in advance of the proposed transfer of ownership of the Technology for which the Approval is issued. Said notification shall include the name and address of the proposed owner containing a specific date of transfer of ownership, responsibility, coverage and liability between them. All provisions of the Approval applicable to the Company shall be applicable to successors and assigns of the Company, unless the Department determines otherwise. It. The Company shall furnish the Department any information that the Department requests regarding the Technology within 21 days of the date of receipt of that request. 19. If the Company wishes to continue the Approval after its expiration date, the Company shall apply for and obtain a renewal of the Approval. The Company shall submit a renewal application at least 180 days before the expiration date of the Approval, unless written permission for a later date has been granted in writing by the Department. Upon receipt of a timely and complete renewal application, the Approval shall continue in force until the Department has acted on the renewal application. Reporting K1eanTu NitROE 2K Provisional Approval,May 2020 Page 14 of 15 Technology:NitROE®2KS&2KM WWTS 20. All notices and documents required to be submitted to the Department by the Approvalshall be submitted to: Director Wastewater Management Program Department of Environmental Protection One Winter Street- 5th floor Boston, Massachusetts 02108 Rights of the Department 21. The Department may suspend, modify or revoke the Approval for cause, including, but not limited to, noncompliance with the terms of the Approval, non-payment of any annual compliance assurance fee, for obtaining the Approval by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Approval, or as necessary for the protection of public health, safety, welfare, or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to the Approval and/or a System utilizing the Technology against the Company,the Designer, the System Owner,the Installer, and/or the Operator of the System. Vl. GENERAL CONDITIONS Title 5 Regulations 310 CMR 15.287: "General Conditions for Use of Alternative Systems Pursuant to 310 CMR 15.284 through 15.286" "The following conditions shall apply to all uses of alternative systems pursuant to 310 CMR 15.284 through 15.286: 1. All p p g plans and specifications shall be designed in accordance with 310 CMR 15.220. 2. Any required operation and maintenance, monitoring and testing plans shall be submitted to the Department and approved prior to initiation of the use. Monitoring and sampling shall be performed in accordance with a Department approved plan. Sample analysis shall be conducted by an independent U.S. EPA or Commonwealth of Massachusetts approved testing laboratory, or an approved independent university laboratory, unless otherwise provided in the Department's written approval. It shall be a violation of 310 CMR 15.000 to omit from a report or falsify any data collected pursuant to an approved testing plan. R 3. The facility served by the alternative system and the system itself shall be open to inspection and sampling by the Department and the Local Approving Authority at all reasonable times. 4. The Department and/or the Local Approving Authority may require the owner or operator of the system to cease operation of the system and/or to take'any other action necessary to protect public health, safety,welfare and the environment. 5. The owner or operator shall provide written notice to any new owner or operator that the system is an alternative system. Such notice shall include notice of the general conditions and any special conditions applicable to the system and its owner. K1eanTu NitROE 2K Provisional Approval,May 2020 Page 15 of 15 Technology:NitROE&2KS&2KM WWTS 6. The owner or operator, or the proponent of the alternative system, shall obtain and provide the Department with a determination from the board of certification of operators of wastewater treatment facilities established pursuant to M.G.L. c. 21, § 34A as to whether a certified operator is required for operation of the alternative system. The Department shall waive this requirement if it has on file a determination for the alternative system, and shall notify the owner, operator, or proponent of the determination. 7. It is a violation of 310 CMR 15.000 to install, construct, or operate an alternative system except in full compliance with the written approval and 310 CMR 15.287. 8. The Department may require the issuance of a groundwater discharge permit pursuant to 314 CMR 5.00 (groundwater discharge program)for any alternative system. 9. The system owner shall maintain an operation and maintenance contract with a Massachusetts certified operator where one is required by 257 CMR 2.00, or otherwise with a person qualified to operate and maintain the system in accordance with the Department's written approval. 10. Prior to obtaining a Certificate of Compliance for installation of a new or upgraded system, the system owner shall record in the chain of title for the property served by the alternative system in the Registry of Deeds or Land Registration Office, as applicable, a Notice disclosing both the existence of the alternative on-site system and the Department's approval of the system. The system owner shall also provide evidence of such recording to the Local Approving Authority. 01� No....................... FE a� .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEAL, H OF............. ... . .: .. ... .. . .............. . .................. Apphratiun -for Biiipwial Works Tonstrurtiun Prrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at &r �7G/r'dPrr� J-0n� /�q r - ---•-----••••• • ••--------------------------------------•--------------- ... ..----- ................................................................... Location-Address or Lot Jqo. Ail W — -----•------- �5- / --•-- .._......... dress.j.1/�r`5'vrs l.!LY.e- �` /�;Install��� Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms._.--Z4 Q& -----Expansion Attic (4b) Garbage Grinder (VO-) aOther—Type of Building ___________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures y`e d W Design Flow............................................ per person per day. Total daily flow..............................._------------gallons. WSeptic Tank—Liquid capacity_____-_-___gallons Length------_------- Width................ Diameter---------------- Depth_---__._-_---- x Disposal Trench—No- ____________________ Width.................... Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth belo ).— inlet......... _ g 1. Z Other Distribution box ( ) Dosing tank ( ) � .�G Total leaching trea....__-_.____.__sc ft. aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- Test Pit No. I................minutes per inch Depth of Test Pit--------------------- Depth to ground water...----.-_-____-_--_--.. fX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ a --- n O Description of Soil ? ---------------------------------------------------------------------------------------------------------- ...................................................... ---------------------------- 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 Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has&isedhheboar of health. I"�'-.��-------------------------• ---��!•-Z0'6------- Date Application Approved BY ......... '�� --•--•---- •--•• ,��-''Z`l- 7.----•-. Date Application Disapproved for the following reasons:................................................................................................................ ----------------------------•-----------------------------------------------------------------------•---••••---•---•...•---.._..-•--•--•-------•-•-•----••-•----------------------••-...-•----------•--- Date PermitNo......................................................... Issued........................................................ Date � iy THE COMMONWEALTH OF MASSACHUSETTS r _ BOARD OF; HEALTH OF. � .�...J ,. Appliratiuu -fur Uii s C�vuiitti arkuustrurtiuu PPrutit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: VU /v v7— /?IF 7- /_?ji . l;-f / Location.Address or Lot No. /i'i/y //i r' r, /-/vE • //J• r riYir:;l✓T�e {%l ••-•----------- --------•- -•••---•-•----•-•-•••••..........•--••-•--•--. .................................................. �Xz�Owne• Address T /s�1 IAA v' o fir........... Installer Address UType of Building Size Lot............................Sq. feet r-, Dwelling—No. of Bedrooms.--___ -----___-._-.-----Expansion Attic Garbage Grinder PH Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures -•-----------------------------------------•-- •-------•----------------------------•-----•--_-.------------.------..------•------------------------- W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. 1:4 Septic Tank—Liquid capacity------------gallons Length---------------- Width_.............. Diameter-----_----.--- Depth_--.----...--- xDisposal Trench—No_ ____________________ Width-------------------- Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No..................... Diameter-------------------- Depth below inlet.......... _.._ Total leaching area._._..-._-._.___-_sq. ft. z Other Distribution box (. ) Dosing tank ( ) Q�j_ /�6 — aPercolation Test Results Performed by-------------------------------------------------------------------------- Date-------------------------------------- ,� Test Pit No. 1----------------minutes per inch Depth of Test Pit____________________ Depth to ground water...-_..._-__------_ -- (4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water._.--.-..--.--.._-_--__. 9 ------------•------------------- Descri tion of Soil - �n-------- --- -� �d5% r : P U ! . .-- r� V �A .- u V ______________ .. _ : S_1�....1...�d�______ F__ _._ ..J.cy�._ '__ ----••----------------------------------------------------------------------------------------------- ---••----------------------------------------------------------------------- .................... 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ued by the board of health. � f 91 Date Application Approved By---------------- =•• .. --.......... ------- -y'-'-7(------- Date Application Disapproved for the following reasons:.................................................................................••--------•--•---------•------- .................•---------••-----•-•-----._..-_......---------•.....•------------•----•-•----••••--•-•--------------........---........-•-•-------•---- ------•---•••-------------------------------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH . ...........OF......... . ... .. . .............................................. Trrtifiratle of f"umptlitture THIS I T Th the Inds idual 'Sw Disposal System constructed ( �r Repaired ( ) by-----•- ------ ... y Q ( Installer ilrCk GG�l �_. _...117r7 / f" .. — 41 .4.t-. ...•... has been installed in accordance with the provisions of Ar e XI of The tate Sanitary ode as described' in the application for Disposal Works Construction Permit No.. 1 -------------------- dated__l_.'. __ _ ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE© AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ;.1 .. DATE "-• ` LJ --------------- Inspector-------=`------- - �.v ..., --...................... THE COMMONWEALTH OF MASSACHUSETTS 7G BOARD O :HEALT No. / .......... ..L 'G�...... ...OF........ .: ..G . .................... FEE f •... Dinvulitt1 1=13 1i ' u udbuu rrmit Permission is ereby granted--- -- ! --- - --: --.. .. j. . . to Constr cA ( ) o�ea ) an I di dal Sewage Disposal,SS tem at av r Street as shown on the application for Disposal Works Construction P t N Dated___ _--- 7G u- •------------------------- _ DATE....... (l�^ BoarcT of Health/ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS F 1 _ 98•c' _ �g.00 _ FAQ n (1 t ; h V L f O Q TLL .Gc�7- 13 8 5e /3 9 `. '09 s <f> Ll 98 00 98•vc> f 7'E.s�-ycaGE GaG �9s p�TEE.'�•'liNEd by ,�r9GG- /s-!U/GE'•�1�/ � � ___ - - I SO/� Bv'K1.E'O o� /`� AG-TN i'94E•�'7-" poi L- /g'- 0y L/GN7-G✓2A!/E�- 154< -/Z-0"A?,E tO. To G/4yE2-s oFs�9vp i ( G Q PLOT i- !.. /"i (\7 CRAIG �� 5�'d�.5 /Y//GG.S o RAYMOT m �- O C A r i 0 Nt U SHORT , 1 S C to L 1� � '3 U DATE' ©CT. Z 8, �97�0 .o �No. 274830 E N C C : G3 /••✓G G ca TS /.3 8f� /3 9 f S ss/ONALoe E��'\ .0 E: G oA2oE ��B� E'S/STi9/3LE S 7/2>/ 5� ®���5 /N ,vL �9..i C3oo,� /38 .o��E Z 5 A T + i ICRCIIY CERTIFY THAT THE BUILDING l. ANO 5UI4 :' : a :< OCJN ON THIS PLAN IS LOCATED ON I NU GROUND ASS+ SHOWN HEREON AND ' + l�G1 S aF V THArw IT CONFORM TO THE KUNING QY - LAWS OF THE r o w N OF I ''q A WHEN CONSTRUCTED . v JOSEPHM. I I � MONAHAN,1R. ti ' �'r (� /� /� TES � 13660 10 IN C ' t PEGISTERED ENGMEERB 8 LANO SURVEYORS ® su���y fAID -CAPE OFFICE BUILDING - 1265 RO UTE Z,6 SOUTH YARM O UTH, MASS. 02,664 1 98. ,:7)v V ,COT 77 . x o , /00 . . Tr=T• �iT � G G /9iPUc'Nd 98 ao - - - 98 00 - •\L Q. To �c�.i�- L�yFr1 1 .=- .� ��> <i;/o ��7'�: E• �Cc�t�N-t-EDJc i P L .0 T P L e SHEET OF SHEETS SHOWING PROPOSED CON ST R C ON L O C A T 10 N SCALE' __ _ DATE l E . LAND SURv OR . REFERENC E : -G-'��'`�G �oT�= 13S 8 y �O /39 D A T E OF MAssgc` .47 JOSEPH C M S ASSOCIATES, INC . MONAHAN,JR. H 0 I REGI5TERED ENGINEERS a LAND SURVEYORS � 'GIsTE�yo� MID_CAPE OFFICE BUILDING - 1265 ROUTE 25 NpSURV G SOUTH YARM. OUTH., MASS . 02664 FEB APPRWE0 THE COMMONWEALTH OF MASSACHUSETTS Ba ,scabt�Con�rvati�CapartR BOARD OF HEALTH TOWN OF BARNSTABLE Apphratt°oI't for Di-aipoottl Works Tomitrnrtion Urrmit ��3 Application is hereby made for a Permit to Construct ( ) or Repair ((/�an Individual Sewage Disposal System at: _._ :45*: /�.-R... 0 5fQry M<<• l ----•-•- -------------------------------------------•-- ---- --------•-•-•. Locatip --i\ddress or Lot No. , 1.C\ ..�.... ---------------%_ ......_. O er ddre s Installer Ad ress UType of Building Size Lot............................Sq. feet F. Dwelling— No. of Bedrooms---__- -------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- -------------- .......................-...................... W Design Flow.....................................r.`.t.t...gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.�� .gallons Length---------------- Width---------------- Diameter---.------------ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.---.---_-_-----.-- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 14 Percolation Test Results Performed by...................-...................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water--------------------- C3, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a, ----•-•-•-----------------------------------------------------•---•--------------•-•---..........----...........---•--------•-•------=......---------------- ODescription of Soil....................................................................................................................................................................... x U ---------------•-----------•------•-------...._......•---•-------•-•-•-•--•-•----•---•--------•--------••------•--------------------•----•---------•----•----------------•---------------•-------•------ ------------------ --------------------- --------------------------------------------------I Nature of Repairs or Alterations—Answer when applic ble._._.... t... _ a. .....�X .................. --- -�C----=`-----i ` '` '�"------.... ....._ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli ce has been issue 7oealth. Signed ....... .: .... .......... C .........:...... to Application Approved By ------------------- ---'.......1-.. L ^f- .............. . . ............. ........-------- Date Application Disapproved for the following reasons- -------------------- --------------------------------------------------------------------------------------------------------------- - ------------------------------------- - `� t/ Permit No. Issued ��' ............... Date I! 1417 No.... FEs..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Divi-Vui3Ml Murky Tomitrurtiun Funtit _ ''"Application is hereby made for a Permit to Construct ( ) or Repair (L/f an Individual Sewage Disposal System at r��• ea• �'`cr540 rh( ..U-�.. 3 .............................•-----------•----------- -- - -. Locatiol--i\ddress or Lot No. L.c\ .Cs....M ram ` .(...r�----------------------------------- =�ov ..... ...... 01 Installer Ad•dress Type of Building Y, Size Lot............................Sq. feet I—I Dwelling— No. of Bedrooms......... ..........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons________-___--__.__--_-... Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------------------------ ------------------------•-------•--•----•-•-----•-•-----•-•-.......-•••----- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.�M_galIons Length________________ Width---------------- Diameter—------------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total'leaching area....................sq. ft. Seepage Pit No---------------------- Diameter-------------------- Depth below inlet-................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date..------------------................... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to gl-ound water........................ ----•---•-------------------------------------------------------•--------------......--••-•--......•-•••-•--•••••-•••-••••••---............................ DDescription of Soil----------------------•-•-----...---•-•••••----•---......-•......•----------•----------------------•---------------•••-----••---------------------•---........_-•----• x �. c, x --------------------------------------------------------------------•---------------------......--- ,,jj�� X ................. _U Nature of Repairs or Alterations—Answer when applicable_.__-jvL___ kCMS.(_Q.CI..... ? _.. .....e r^..t- ^----C�-..------`......�`'`----------.-.... �s 4,�/,'e� '--------------------------------------------------- ----------------- Agreement: A ' The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been isscue 'ofrhealth. Signed ......�. ......_ - -----"�-- - - - ............... 511.�... . .y.. Date Application Approved B PP pP Y - i ....................................�.�....�.............................................. ..................................... �f Application Disapproved for the following reasons: ... ................................... ... --- . ...................... ........... .------------------- ------------------------------------------------------------- ----------------------------- --- ------------------------------------------------------------------- -------------------- ------------*--------- --- A" Date// Permit No. .>�� -----------._. Issued ............. `.. �..' - � r Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE A Trrti1firate of TIImpliairirr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ----. SS----- _ - -------.-C_or'.s ---------.--S'C_Q.tN-7- - ----........-----------------------------........_---..-------------------- ---------- h,t:diet at .._... - r �`'"-. _ .........---------- ----------------------------------------........-----------..........----------------------------- has been installed in accordance wiA the provisions of TITLE-5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ...... ,+ �� dated ...A� �"' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE - ........ Inspector - ...._..- •- - - -------------------------------------- ------------------------------- I ` THE COMMONWEALTH OF MASSACHUSETTS If .. BOARD OF HEALTH F TOWN OF BARNSTABLE No... .._ '!" FEE.............. ..... 14npupttl urk Tunutrnrtuan Wrutit Permission is hereby granted--- M G S �Gt��L--... d --------------------------------------------------------------------------------- to Construct ( ) or Repair ) an Individual Sewage Disposal System atNo.--------c _ ._:._ �f ��= 'r �f �'�� .....•__A- ------------------• ------------------------------------------------- ------ _, Street 1 V o� `�. . z as shown on the application for Disposal Works Construction Permit No.�.�� ,�`_ �D��e�.•;��.'-_ -----•... w oard of Health ! / / DATE..............-=3 --- f' �r'� --- i- FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS XIX `33 TOWN OF BARN LOCATION STABLE VILLAGE SEWAGE ,�r5� M. I( c ASS ES.SORB HAP INSTALLER'SLOT/�2,.1 NAl`E 6 PHQNE Nol SEPTIC TANK CAPACITYwo SS LEACHING FACILITY:(type) P1 NO, OF BEDROOMS ._PRIVATE WELL OR PUBLIC WATER v BUILDER OR OWNER isr\es n DATE PERMIT ISSUED: DATE CpNpLIANCE ISSUED• VARIANCE GRANTED: Yes No J ceC 4F— 9� ' h1 a G� J s . � i t A" v 'e I I e s x ZONING & RESOURCE PROTECTION NOT E 1. PARCEL ID: 102/147 LOT SIZE:0.44 AC v �a , - - 2. OWNER OF RECORD:LINDA J MARTIN �� W ,„ s t. 0 N780 05' 25"E 3. ADDRESS: 33 BARBERRY LANE,MARSTONS MILLS � o- a , v, c 100.00' = 4. THE LOCUS IS IN LOCATED IN FLOOD ZONE X(AS SHOWN ON F.LR.M.MAP 25001 C0542J DATED JULY 16,2014). s s .. - t Mn .2'5. fn 5. THE SITE IS LOCATED IN A WELLHEAD PROTECTION DISTRICT. � �:;' ,•. .. sue'y.., ,.:. b ' -"� �. ' - g � � t� M t7,�s".' ;,'%r`''. - � WASTEWATER INSTALLATION INSPECTION NOTES 1. THE CONTRACTOR SHALL PROVIDE A MINIMUM OF 24 HOURS ADVANCE NOTICE TO THE ENGINEER AND LOCAL BOARD OF W HEALTH FOR ANY INSPECTION. s; v » ' }r „ w _ , 2. ALL WASTEWATER COMPONENTS SHALL BE BY THE ENGINEER AND THE LOCAL BOH REPRESENTATIVE PRIOR . N m TO BACKFILLING. AT A MINIMUM THE FOLLOWING ITEMS SHALL BE INSPECTED: 2.1. SYSTEM COMPONENTS BASE AND INSTALLATION PRIOR TO BACKFILL 2.2. LEAKAGE TEST ON SEPTIC TANK MIN.24 HR 2.3. START UP TEST OF SYSTEM WITH ALL COMPONENTS INSTALLED AND FUNCTIONING AS DESIGNED 2.4. FINAL INSPECTION OF BACKFILLED SYSTEMIM r $mot .:" . • ,. = 3 THE CONTRACTOR SHALL BE RESPONSIBLE TO MAINTAIN UP-TO-DATE AS-BUILT DRAWINGS AND NOTES INDICATING THE HORIZONTAL AND VERTICAL LOCATION WITH TWO TIES OF ALL SYSTEM COMPONENTS INSTALLED. THESE AS-BUILT DRAWINGS AND Nil � ;, Y -� z, ..• t <:, NOTES WILL BE UTILIZED BY THE ENGINEER FOR THE PREPARATION OF RECORD PLANS. „ WASTEWATER NOTES PROPOSED AIR PUMP EXISTING WATER SERVICE 16. THE CONTRACTOR SHALL PROVIDE A DEWATERING PROTOCOL PRIOR TO CONSTRUCTION IN ACCORDANCE WITH CONSERVATION COMMISSION ORDER OF CONDITIONS. V y m FINAL LOCATION TO BE 1. ELEVATION,PROPERTY LINE AND EXISTING CONDITIONS ON THIS PLAN ARE BASED ON A _ w FIELD DETERMINED w SURVEY CONDUCTED BY THE HORSLEY WITTEN GROUP,INC.ON NOVEMBER 20,2020. 17. UNSUITABLE SOIL MUST BE REPLACED WITH TITLE 5 SAND AS SPECIFIED IN 310 CMR .� 15.255(3). ANY ADDITIONAL AREAS THAT ARE FOUND TO HAVE UNSUITABLE MATERIAL O p` o m 2. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE REPORTED TO THE ENGINEER. C SHALL BE IN ACCORDANCE WITH THE STATE ENVIRONMENTAL CODE AND THE RULES AND N W W W (.0o REGULATIONS OF THE LOCAL BOARD OF HEALTH. 18. ALL SEPTIC COMPONENTS SHALL BE INSTALLED WITH MAGNETIC WARNING TAPE. OL a Y W NITROE 2KS 2,000 U) :E 3. THIS PLAN IS INTENDED TO ADEQUATELY PROVIDE THE INFORMATION NECESSARY TO 19, ALL SEPTIC TANKS SHALL BE APPLIED WITH 2 COATS OF DAMP PROOFING OR BITUMINOUS r DECK GALLON TANK LAYOUT AND CONSTRUCT THE PROPOSED SEWAGE DISPOSAL SYSTEM REPRESENTED ON MATERIAL. C m o IT AND SHOULD NOT BE USED FOR ANY OTHER PURPOSES. .i.� •�. INV. IN=53.89 12.8' G = C.4 k EXISTING TREE 20. THE CONTRACTOR SHALL RESTORE ALL SURFACES EQUAL TO THEIR ORIGINAL CONDITION 00 O INV. OUT=53.64 (TO BE REMOVED) 4. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE ENGINEER AND/OR THE LOCAL AFTER CONSTRUCTION IS COMPLETE. AREAS NOT DISTURBED BY CONSTRUCTION SHALL BOARD OF HEALTH(BOH)STAFF. BE LEFT NATURAL.THE CONTRACTOR SHALL TAKE CARE TO PREVENT DAMAGE TO m d o in o SHRUBS,TREES,OTHER LANDSCAPING AND)/OR NATURAL FEATURES. WHEREAS THE ` O .�eto p ) N \ 5. PRIOR TO CONSTRUCTION,THE CONTRACTOR SHALL COORDINATE WITH THE PROPERTY PLANS DO NOT SHOW ALL LANDSCAPE FEATURES,EXISTING CONDITIONS MUST BE = O v.ch ch 16.06' Qt 1W OWNER AND ENGINEER ON THE CONSTRUCTION SITE ACCESS AND MATERIAL STOCK PILE VERIFIED BY THE CONTRACTOR IN ADVANCE OF THE WORK. i w •C O "a oMo Go Q AREAS. y _ a�Q o0 00 12,0' O O 21. ALL UNPAVED AREAS DISTURBED BY THE WQORK SHALL HAVE A MINIMUM OF 4-INCHES OF _ y y too 4" SCH 40 PVC 6. TRENCH SAFETY SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR INCLUDING ANY LOAM INSTALLED AND BE SEEDED WITH GRMSS SEED AS SHOWN ON THE PLAN AND/OR c` LOCAL AND/OR STATE PERMITS REQUIRED FOR THE TRENCH WORK. THIS WORK MAY BE DIRECTED BY THE ENGINEER. THE CONTRACTOR SHALL BE RESPONSIBLE FOR WATERING cn L=28', S=1.0% REQUIRED TO TAKE PLACE OUTSIDE OF NORMAL HOURS OF OPERATION FOR THE ANY LOAM AND SEEDED AREAS UNTIL LAWN(GROWTH IS ESTABLISHED AND APPROVED BY J CCF' O G7 FACILITY.THE CONTRACTOR SHALL PLAN ACCORDINGLY. THE ENGINEER AND/OR OWNER. 4" SCH 40 PVC _ L-9', 5=1.0% 7. THE CONTRACTOR SHALL REPORT ANY DISCREPANCIES FOUND IN SITE CONDITIONS FROM 22. AN INNOVATIVE&ALTERNATIVE TREATMENT SYSTEM IS PROPOSED FOR THIS SITE. THE THOSE SHOWN ON THE PLAN TO THE DESIGN ENGINEER. SYSTEM MUST BE INSTALLED AND MAINTAINED IN ACCORDANCE WITH THE DEPARTMENT W 33 BARBERRY LAN OF ENVIRONMENTAL PROTECTION(DEP)PROVISIONAL USE APPROVAL. EXISTING TREE STUMP � Q p A �I 8. FAILING TO PROPERLY INSPECT OR PUMP THE SEPTIC TANKS AND TREATMENT SYSTEM 4 BEDROOM HOUS ' (TO BE REMOVED) OR CHANGES TO EFFLUENT FLOW,GRADING,OR LANDSCAPING,EITHER ON-SITE OR D ROO n'VI DESIGN SIGN 4 g ' p 1 I ADJACENT TO THE SITE,MAY RESULT IN IMPROPER FUNCTIONING OF THE SEPTIC AND Q J V'V (1 LEACHING SYSTEM(S). W \ / 5.3 RISER TO WITHIN 3"OF \ / PROPOSED 9. CALL"DtGSAFE' AT LEAST 72 HOURS PRIOR TO COMMENCING CONSTRUCTION AT 4" SCH 40 PVC ✓ ! 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES TO FIELD VERIFY LOCATIONS OF FINISHED GRADE W o DISTRIBUTION BOX EXISTING UTILITIES. \V �/ �/ �® \,i//EL.156.150�\t/ � �/1 : 7 L=18', S-1.0/o L -, 0 INV. IN =53.36 - :LOAM AND SEED=i I I- - - - J� a 0 / INV. OUT=53.19 10. THIS ON-SITE WASTEWATER TREATMENT SYSTEM IS NOT DESIGNED FOR USE WITH A - = __. -EL.54.28 _ = < GARBAGE GRINDER. - CLEAN - y /f EXISTING =-BACKFILL - - - -- �/� �- I DISTRIBUTION BOX 11. THE OWNER SHALL INSPECT AND PUMP THE SEPTIC TANK ONCE EVERY 2 YEARS. - _ _ _ _ _ �- - - - - _ _ v� TO BE ABANDONED - � Cn U) 12. PROVIDE WATERTIGHT SEALS BY USE OF NON-SHRINK GROUT AT ALL POINTS WHERE - FLOW r - - O 4" SCH 40 PVC G PIPES ENTER OR LEAVE ANY CONCRETE STRUCTURES. - - FLOW - - '- z Q L.L 0) ..------- - I ----- _ - 6"OF 3/4" CLUE O � O �HW L-19', S-1.0% 13. USE SCH.40 PVC PIPING WITH WATERTIGHT JOINTS UNLESS OTHERWISE NOTED ON PLAN. - _ _ EL.52.69'. - - - e _ COMPACTED L n/ \ ALL PIPE SHALL BE PLACED ON A COMPACTED FIRM BASE. _ CRUSHED 14. ALL STONE TO BE DOUBLE-WASHED AND FREE OF DIRT,DUST,AND FINES. -I f I I I STONE BASE J �- UJ 2 °H w < ry W OHW 15. THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING OPERATIONS AND MAINTENANCE I I P I W Q I Q ry INFORMATION FOR THE SEPTIC SYSTEM TO THE ENGINEER, IF NECESSARY. _ M i NOTES: U J O 1 PROVIDE 3 OUTLET DISTRIBUTION BOX INSTALLED ON LEVEL � W _ STABLE BASE 2. BLOCK ONE OUTLET. z 3. INSTALL FIRST 2 FEET OF OUTLET PIPES LEVEL. GC m 4. INSTALL SPEED LEVELERS(OR EQUAL)ON OUTLET PIPES. cM PROPOSED, H-10 DISTRIBUTION BOX DETAIL m W N EXISTING ACME PRECAST OR EQUIVALENT, EXISTING 1,000 o GALLON SEPTIC DRIVE NOT TO SCALE N TANK TO REMAIN = Q INV IN =54.32 a a INV OUT=54.07 GENERAL NOTES: 153" 1. NITROE 2KS TANK TOP TO HAVE THREE-24",TWO-12"HOLES AND- 3 O TOTAL TANK LENGTH MULTIPLE 4"HOLES WITH RISERS AND COVERS FOR MAINTENANCE (t3 _ OUTSIDE WALL TO OUTSIDE WALL OUTLET TROUGH(OT) AND SAMPLING. Q EXISTING OVERHEAD 2. FOR THE 24"HOLES;PROVIDE 24"DIA.ADS PIPE(CORRUGATED) co ELECTRIC TELEPHONE WITH POLYLOK(OR EQUIVALENT)COVER(OR EQUIVALENT , e A a. ,�. t. .... TANK WALL Y w CONCRETE RISER AND COVER)TO 12"BELOW GROUND SURFACE & CABLE SERVICE THICKNESS Z a F- AND SECURE TO TANK TOP. C: V AT TOP T •. ~ .� 3. FOR THE 12"HOLES;USE ADS PIPE(CORRUGATED)AND POLYLOK CU rn •� _ (3"TYP) O U' (OR EQUIVALENT)COVERS TO 12"BELOW GROUND SURFACE AND N ,'r CIO tU ¢ MIDDLE 40 w 0' SECURE TO TANK TOP. V N RAMP ROUGH w INLET J 4. PROVIDE FOUR 4"DIA,SAMPLING PORT(1"BELOW GROUND N (D o N Cn G7 O .r.• TWO EXISTING LEACHING PITS TO REMAIN o v, EFFLUENT TROUGH SUE RGED ( ) DENIT CAT( Q' SURFACE)WITH 6"PLASTIC ROUND BOX AND COVER TO BE FLUSH o -O !✓ Cl)CC) ,� ME 00 MT '- 0 WITH GROUND SURFACE. LL CU O _ LO o 6' DIA.X 6' DEEP SURROUNDED WITH 2' STONE �Z FROM SEPTIC (IT) A N HAMS -� .= N (U 0 TANK CIA B ®C `: 5, FOR(EXISTING SEPTIC TANK;PROVIDE 2"DIA.SAMPLING PIPE THAT m _ co o •Z45 LOWER INVERT g1 )" z 0 ( ) IS CEMENTED OR ANCHORED TO THE TANK TOP AND EXTEND 2 Q Co �` m ? o to s C) O w = = N J BELOW THE TANK TOP AND BE POSITIONED 6-12"FROM THE EDGE p` m U o0o a O a P1 INV. IN 53.09 U O EFFLUENT'TO OF THE OUTLET END OF THE SEPTIC TANK OR IN THE SEPTIC TANK `n P2 INV. IN=53.00 = "Y Q Q DBOX CONCRETE OUTLET COVER.ON THE TOP SIDE OF THE SEPTIC TANK, EXISTING GAS MAIN NO w THE 2"DIA:SAMPLING PIPE SHOULD EXTEND TO 2"BELOW THE m co ui + GAS SERVICE TO HOUSE o o GROUND SURFACE AND HAVE A 6"DIA.PLASTIC ROUND BOX AND N r TANK WALL - COVER AT GROUND SURFACE. r THICKNESS AT BOTTOM a (may (4 1/2"TYP) �.., •.a PROJECT BENCH p MAG SET EL.= 55.52 N tl9 N O O •p 6"PLASTIC BOX AND COVER WITH 4" ` i SEE NOTES 3 AND 4(TYP) (� SEE NOTES 3 AND 4(TYP) MONITORING PIPE;SEE NOTE 2 AND 4(TYP) M � o 0 Y SEE NOTE 2(TYP) l .� C Cs � N GROUND SURFACE TYP EL.56.75 55.8 MIN 24"ACCESS HOLE WITH COVER SEE NOTE 2(TYP). °° �' o M <? m SEE NOTE 2(TYP) a Q o � 111 P (D 0 0 o =M 5 1/2"TANK TOP(TYP) ABSORPTION SYSTEM i 6 TO SOIL I Z � 1 EL.55.06 I(SAS) Z O c o Cc Cc N rn a 4 r in Z CD Cc ILLL.. o �. r EFFLUENT FROM SEPTIC a + Registration: (n TANK FZ- as srnncwnTeaoEPni EFFLUENT 9 o O W o _ N n I �� SUBMERGED DENITRIFICATION CHAMBER _ 0 � Q w C O o > + AERATION (DC) 1 a ft - L Q. �- p _ CHAMBER 0 w Z W z , 0 o (SAC) Z Lu k , ~ LO rx w w O B O CD H iN w v Z N o � l o {_ N780 05'25"E / z- 0 ( 100.00 1 .a•. . :: Project Number: Sheet GRAPHIC SCALE 17EL.49.31 - - :. . : . • KleanTu LLC -� TANK 10 0 5 10 20 40 TH CKNESSBOTTO4M 12"CRUSHED AGGREGATE OR APPROVED 20112 1 of 1 MAT-ERIAL;ON LEVEL,COMPACTED AND STAIBLE BASE TANK WALL THICKNESS AT BOTTOM(4") O Sheet Number: TANK WALL THICKNESS AT TOP(3") (in feet) NItROE 2KS 2,000 GALLON WASTEWATER TREATMENT SYSTEM (WWTS) �FT u 1 INCH = 10 FEET N-ASST20M-H10 WW - NOT TO SCALE CU --------- --.