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HomeMy WebLinkAbout0050 BISCAYNE DRIVE - Health 50 Biscayne.Drive(Marstons Mills) A=012-013 -002 . i WARREN REID 1-888 248-2468 , o � �1 TOLL FREE INCORPORATED Building'&Title V Insp'ections,' Residential&'Commercial - P.O.BOX 134.•NORWOOD.MA 02062 .$ Gyp I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owner's Name information is required fot MARSTONS MILLS MA 02648 APRIL 16 2009 every page. citylrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way- Important:When filling out A. General Information forms on the I computer,use 1. Inspector. 4 only the tab key to move your WARREN F. REID cursor-do not Name of Inspector use the return key. ALLABOUT THE HOUSE INC. Company Name tlit Q4 P.O. BOX 134 Company Address NORWOOD MA 02062 Citylrown State Zip Code 781-255-8839 pZ D 97 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16.340 of Title 5(310 CMR 15.000).The system: t ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority F{ APRIL 24 2009 i✓ - Inspector's Signature Date r n The system inspector shall submit a copy of this inspection report to the Approvin Autho%(Baard of Health or DEP)within 30 days of completing this inspection. If the system is a s ared s em 9 has a design flow of 10,000 gpd or greater,the inspector and the system owner s 11 submit the report to the appropriate regional office of the DEP. The original should be sent to. `e system owner and copies sent to the buyer, if applicable, and the approving authority. ""This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Lo 50 BISCAYNE MILLER-0308 Title 5 096aeJ Irupection Form:Subsurface Sewage Disposal System-Page m of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owners Name information is required for MARSTONS MILLS MA 02648 APRIL 16 2009 every page. City/Town State Zip Code Date of Inspedion B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: THIS STYSTEM SHOWS TO BE OPERATING AS INTENDED,THERE WERE NO SIGNS OF FAILURE AT THE TIME OF INSPECTION B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined(Y, N, ND)in the❑for the following statements. If'not determined,"please explain. ❑ The sep9c tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. NO Explain: N/A ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 50 BISCAYNE MILLER•03M8 T&-5 Official hVectim ins Suitmffftw Sexege Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner owner's Name information is required for MARSTONS MILLS MA 02648 APRIL 16 2009 every page. City/Town State Zip Code Date of Inspection B. Certification (coat.) B) System Conditionally Passes(cunt.): ❑ distribution box is leveled or replaced ND Explain: N/A ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: N/A C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a`surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 50 BISCAYNE MILLER-03M Title 5 Offnal Loon Form:Subsurtace Sewage Disposal System-Page 3 of 15 I C Commonwealth of Massachusetts Title 5 Official Inspection r Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner owner's Name information is MARSTONS MILLS MA 02648 APRIL 16 2009 required for every page. city/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health(cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply weir*. Method used to determine distance: NIA *`This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: N/A D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than Y2 day flow ❑ ® Required pumping more than 4 times in the last year A/or due to clogged or obstructed pipe(s). Number of times pumped: ❑ Any portion of the SAS,cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 50 BISCAYNE MILLER 03M Title 5 official Wmpecbon Fort;Submasface Sewage Disposed System-P29e 4 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owner's Name information is required for MARSTONS MILLS MA 02W APRIL 16 2009 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cunt.) D) System Failure Criteria Applicable to All Systems(cunt.): Yes No Q ® Any portion of a cesspool or privy is within a Zone 1 of a public well ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails_The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ® the system is within 400 feet of a surface drinking water supply ❑ ® the system is within 200 feet of a tributary to a surface drinking water supply ❑ z the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 50 BISCAYNE MILLER•03= Tills 5 Of=al Inspec&on Farm:Subsudaoa Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Tide 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP& LOT 12-13-2 Owner Owners Name information is required for MARSTONS MILLS MA 02648 APRIL 16 2009 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? Y p ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid,depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] 50 BISCAYNE MILLER-03108 Title 5 Official Idnspmclian Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner owner's Name information is required for MARSTONS MILLS MA 02648 APRIL 16 2005 every page. Cityfrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes Z No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d NORMAL FLOW 9 ( Y 9 (gpd)): Sump pump? ❑ Yes ® No Last date of occu anc : PRESENTLY P Y Date Commercial/lndustrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/AGallons per day(gpd) Basis of design flow(seats/persons/sq.ft,etc.): N/A Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: N/A Last date of occupancy/use: N/ADate Other(describe): N/A 50 BISCAYNE MILLER•03108 Title 5 official tnspactiore Foam:Sclasfaos Sere Oisposei System-Page 7 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owner's Name information is required for MARSTONS MILLS MA 02648 APRIL 16 2009 every page. Cityyfrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: NONE PRIOR TO THIS DATE Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: N/A gallons How was quantity pumped determined? N/A REQUIRED PUMPING BY OWNER AFTER Reason for pumping: INSPECTION FOR MAINTENANCE Type of System: ® Septic tank,distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Altemative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed(if known)and source of information: 2001 Were sewage odors detected when arriving at the site? ❑ Yes 0 No 50 BISCAYNE PRICIER-031138 Tdle 5 Ofraial trtspecti.Form:Subswtace Severe Disposal System-Pam 8 of 15 f Commonwealth of Massachusetts Tale 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owner's Name information is!required for MARSTONS MILLS MA 02648 APRIL 16 2009 every page. City mown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: NIA feet Material of construction: ❑cast iron ❑40 PVC NIA ❑other(explain): Distance from private water supply well or suction line: N/A feet Comments(on condition of joints,venting, evidence of leakage, etc.): N/A Septic Tank(locate on site plan): Depth below grade: 22 INCHES feet Material of construction- 0 concrete ❑metal ❑fiberglass ❑ polyethylene ❑other(explain) THE SYSTEM WAS UP GRADED IN 2001 N/A If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ® No ------------------------------------------------------------------------------------------------------------------------- Dimensions: 5 X 5 X 8 H-10 Sludge depth: 6 INCHES Distance from top of sludge to bottom of outlet tee or baffle 22 INCHES Scum thickness 61NCHES Distance from top of scum to top of outlet tee or baffle 41NCHES Distance from bottom of scum to bottom of outlet tee or baffle 16 INCHES How were dimensions determined? TAPE STICK 50 BISCAYNE MILLER•OW08 TWO 5 Oofial kmpectim Farm Sub&zface Sewage Disposal System-Page 9 at 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner owner's Name Information is,required for MARSTONS MILLS MA 02648 APRIL 16 2009 every page. Cityrrown state Zip Code Date of lnspedion Q. System Information (cost.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): AFTER THE INSPECTION THE SYSTEM WAS PUMPED VIA THE OWNER FOR MAINTENANCE, THIS WAS PERFORMED BY BCI AS WAS TOLD TOME Grease Trap(locate on site plan): Depth below grade: N/A feet Material of construction: ❑concrete ❑ metal ❑fiberglass ® polyethylene ❑other(explain): N/A Dimensions: N/A Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping: N/A Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: Q concrete ®metal ❑fiberglass ❑polyethylene ❑other(explain): N/A 50 BISCAYNE PAILLER•03MB Tale 5 ommm kmpectm Form:&oswtane sewsw Dmposai system.Page to of 15 Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owner's Name formation is quires forMARSTONS MILLS MA 02648 APRIL 16 2009 every page_ C►hdTow n State Zip Code Date of Inspection D. System Information (cunt.) Tight or Holding Tank(cont.) Dimensions: N/A Capacity: N/A gallons Design Flow: N/A gallons per day Alarm present: ❑ Yes ® No Alarm level: N/A Alarm in working order: ❑ Yes ❑ No Date of last pumping: N/A Date Comments(condition of alarm and float switches,etc.): N/A *Attach copy of current pumping contract(required). Is copy attached? ® Yes ❑ No Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert AT BASE LINE OF OUTLET Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): THE BOX IS LEVEL AND SHOWS TO BE FUNCTIONING AS INTENDED,ZERO SIGNS OF CARRYOVER PAST OR PRESENT, NO SIGNS OF FAILURE Pump Chamber(locate on site plan): Pumps in working order. ❑ Yes ❑ No Alarms in working order. ❑ Yes ❑ No 50 BISCAYNE MILLER-03108 'rile 5 O&W 9ispedmn Fome SuInwbco Sw age Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,. 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owner's Name information is required for MARSTONS MILLS MA 02648 APRIL 16 2009 every page. Cityrrown State Zip Code Date of inspection D. System Information (cunt.) Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): N/A Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: SYSTEM LOCATED BUT NO NEED TO UNEARTH AT THIS TIME Type: ❑ leaching pits number. ® leaching chambers number: 4 ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/aitemative system Typeiname of technology. N/A Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): IN THE LOCATION OF THE LEECH FIELD NO ABNORMAL GROWTH HAS APPEARED, NO SIGNS OF HYDROUC FAILURE, NO CARRY OVER IN D-BOX 50 BISCAYNE MIU.ER•0" Ttlb 5 Oftsall knpachm Fo m:Subsurface Sewage Omposel System•Page 12 aQ 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal Systern Forme-Not for Voluntary Assessments s ` 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address Owner GREGORY&GLORIA MILLER MAP&LOT 12-13-2 information is Owner's Name required for MARS-ONS MILLS _ MA 02648 APRIL 16 2009 every page. cityrrown State Zip code Date of Inspection D. System Information (cont.) Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration N/A Depth—top of liquid to inlet invert N/A Dearth of solids layer NIA Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.is N/A Privy(locate on site plan): Materials of construction: NBA Dimensions N/A Depth of solids N/A Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.'* N/A 50 BISCAYNE MILLER•03M8 Title 5 4tridal Irmpection Form Sdmolece Swage Disposal system-Page 13 of 16 Oornmonweafth of Massachtmetts Title 5 Official Inspection Subsurface Sewage Disposal System Form-(dot for Volunntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owner's Name information is required for MARSTONS MILLS MA 02648 APRIL 16 2009 every page. Cityrrown State Zip Code Date of In spection D. System Information (cant.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. - 1 CK C-AR 1 �B v e 50 BISCAYNE Wlr11LLER•0308 rMe 5 Official Inspection Forns&tswfaas Sewage Disposal System•Page 14 of,15 Commonwealth of Massachusetts b Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 BISCAYNE DRIVE MARSTONS MILLS MA 02648 Property Address GREGORY&GLORIA MILLER MAP&LOT 12-13-2 Owner Owner's Name information is MARSTONS MILLS required for MA 02648 APRIL 16 2009 every page_ City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: > 12 FEETfeet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked,date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: ELEVATION OF PROPERTY, LOCATION TO SURFACE WATER, THIS AREA SHOWS TO BE SANDY SOIL AND ELEVATED, NONE SHOWN ON PERMIT OF 4-18-2001 50 BISCAYNE MILLER-WIM Title 5 Official Inspection Form:Sulmarace SswaW DLVosal System-Pe4s 15 oY 15 TOWN OF BARNSTABLE LOCATION t d 'Fi -LVIA /t- SEWAGE # ZW Z3I VII_LAGE /ACAA, ' VL--) I I ASSESSOR'S MAP & LOT I Z—13—Z INSTALLER'S NAME&PHONE NO. I SEPTIC TANK CAPACITY 0 0 LEACHING FACILITY: (type) y R/AA,Vr,-J (size) 3 x//X Z NO.OF BEDROOMS BUILDER OR PERMITDATE: r-01 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 300 feet of leaching facility) Feet Furnished by . �_�..: v �s ,,,,,� '3., `.a f` ` Q 0 0 �D�ti ` � �► �' -@,�� �S ��e � ��1g ..YLi.' No.,gob I-C;F� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes PUBLIC HEALTH DIVISION -TOWN OF_BARNSTABLES MASSACHUSETTS 0[pphration for Mi9;po!6a1 *p.5tem Cow6truction Permit Application for a Permit to Construct( )Repair V,)*U*'pgrade( )Abandon( ) ❑Complete System )R:kndividual Components. `z+ Location Address or Lot No. Q Owner's Name,Address and Tel.No. Assessor's Map/Parcel Ins Ike,Address,and Tri.(io. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title _ Size of Septic Tank S iiwtc— (L1 Type of S.A.S. + ! 1 UQS Description of Soil �iv�an Nature of Repairs of Alterations(Answer when applicable) �vlC t t L i t�-� o OL—� l/ 9 4 2. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has e Signed Date 7�/ �ell, Application Approved b Date O Application Disapproved for the following reasons Permit No. �_JCn 'o f Date Issued /� i TOWN OF BARNSTABLE LOCATION �O �►SC.&VfA �+- SEWAGE # Z—t3 -Z /1I�Gt.�.)� l� ASSESSOR'S MAP & LOT VILLAGE ��U INSTALLER'S NAME&PHONE NO. O 4 ne— SEPTIC TANK CAPACITY O00 LEACHING FACILITY: (type) (size) 33 X//XZ NO.OF BEDROOMS BUILDER OR 'LJ ri ' PERMITDATE: ` / r"0 / COMPLIANCE DATE: rf 2- . Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility. Feet ! Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by • s , I _. I �' a r: No. cg o� —,;a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppfication for ni.5po.5al 6raem Construction Permit Application for a Permit to Construct( )Repair(j upgrade( )Abandon( ) ❑Complete System Didndividual Components Location Address or Lot No. 6t0 j j5 ,�� y Ito �i t g<�? Owner's Name,Address and Tel.No. Assessor's Map/Parcel /�1 _/�12_ O Oj r i�j7 Inst e,Address dress and Designer's Name,Address and Tel.No. Type of Building: f, Dwelling No.of Bedrooms t Lot Size sq.ft. Garbage Grinder( ) Other Type of Building - No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /`� 4 F. gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title � t _ Size of Septic Tank ! 5�i_I tA- �j 7 Type of S.A.S.` +.t" s � r Description of Soil 11tvt6 <�; o Nature of Repairs or Alterations(Answer when applicable) Z Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- i cafe of Compliance has been-issued-by-this-Boaarr dff'Health' `f Signed /� Date 7�� o/ Application Approved'by je- � Date I8 O1 Application Disapproved for the following reasons Permit No. _J()3 I o�� Date Issued c� Q_�tx THE COMMONWEALTH OF MASSACHUSETTS 005 P BARNSTABLE, MASSACHUSETTS Slertificate of (Compliance THIS IS TO CERTIFY',that he On-site Sewage sposal System Constructed( )Repaired ( )Upgraded Abandoned( )by 101, r at © i a4.a �1sL r 1 fhas been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. A 1'd31 dated Installer Designer The issuance of thip perm' shal n�be construed as a guarantee that the systean ,ill fu Et n s designed. Date �� 9 ®� Inspector Q.v� , rr I / --------------------------------------- _ No. 00 1 Q�2 J Fee Z) THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS / U Mizpogaf *p,5temCongtruction Permit Permission is hereby granted to Construct( Repair( Upgrade( )�Abandon �t. ( ) ,System located at '7 F� 4C-6'N.. r._ 3 J«t and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. ` Date: �� Approved by j(eQ4 Ajen I 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I ` , hereby certify that the application for disposal works construction permit signed by me dated `7�" ���� , concerning the property located at �C��)SG �,�.✓E�Q�„c� �- '%��l meets all of the following criteria: L.-1--"This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. Z- The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. t There are no wetlands within 100 feet of the proposed septic system There are no private wells within 150 feet of the proposed septic system here is no increase in flow and/or change in use proposed • %There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation.,[Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation (using GIS information) qoi B) G.W. Elevation i +the MAX. High G.W. Adjustment. L DIFFERENCE BETWEEN A and B J' SIGNED : _ J DATE: " p [Please Sketch pr osed.p an of system on back]. iVOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert :� . 2�c.� �� 3�I�y�� :, c.-f 50 TOWN OF BARNSTABLE LOCATION_�' ,� 7.S G aay Alb I)t�'Ue, SEWAGE # ?7 VILLAGE .fit.a(flf;�'U 5 M lllf ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. 0 4<sGotl f 5-0 d SEPTIC TANK CAPACITY LEACHING FACILITY:(type) "Ck T, (size) a NO. OF BEDROOMS RIVATE`WEL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 0 1 VARIANCE GRANTED: Yes No v'' � � • �, aa (8a Y � ,v �� �� S 3� ��� _, � . �, �4 - '. - �� �- i � � I � �� y` ��r No... ...... ' .I P THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH -------..... ........0F.........�� 7Q�4JSST ................•----....... Applira#ion for Disposal Works Tonstrnrtiun Permit Application is hereby made for a Permit to Construct ()() or Repair ( ) an Individual Sewage Disposal System at: ...AaT -.. Ve ........................................... ocation•Address � or t N Ir wner f Address Install£ Address Type of Building Size Lot....44,.-M---Sq. feet U Dwelling—No. of Bedrooms___....................................Expansion Attic Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers a YP g ---•-----•----------------•• P ( ) Cafeteria � ) 04 Other fixtures .---•-•--•••--- •••-•...---•--------•-•----•---....--.----•••-•-•...-------•---•-••••-•-••••......-•------•--•-----•••••.... W Design Flow..........................5_5�-------gallons per person per day. Total daily flow....................... WSeptic Tank—Liquid capacity._A .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 ( ) ~' Percolation Test Results Performed by '.1...����!�� 14 ��ate........................................ W L 4 Test Pit No. 1;`.._..../Z...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 ground water::---__................. O Description of Soil--------•---)- - �------------- P.... .....�� r--�SC 1 - -------------- -----------------•--------_-- x -------------------------------------- 6.':.. ._i. , ''_.-•-- - ...-..Cvv ......5KI�........-------•--••------•---••-•--••-•---•--•----•-•. U W UNature of Repairs or Alterations—Answer when applicable_____________________________•-__-________---•-_---______-____-___-______---___-•-------------. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T:'." 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until.a Certificate of Compliance has been issued by the board of health. Signed /�-- ------------------- ----------- 7 � .---- at Application Approved BY--..--"follo --•------ -- ----------------------------------•--------------• ............. to Date Application Disapproved for reasons--------------------------------------------------•--------------•---•-----------------------------------------•. --------•..._....•••........................••---•--------•...--------•------•----------•--•-•---•------•--------..........-•---•-----------•-•---•----------•-------•--•-•-••-------------•-------•---- Date PermitNo........................................................... Issued........................................................ Date A NO.....,..........� .., ! C Fps......................... M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH flQ ..........oF......... .: .. ............................ Apo nation for BiBpoii al Works Tons rnrtiun Pormit Application is hereby made for a Permit to Construct ( ,) or Repair ( ) an Individual Sewage Disposal System at .... .. ocation Addr ss or Lot No. t ) �_ e>n%... { _f 3 G�'� .11._C_. . ......................................... W �ner Address ....fJ5 ....................•- ---- ------ ---.......-------•--•---•-•----------•---••-..............---••-•.....----••......._...--•---..... Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms... ........................ .Expansion Attic (,Vf) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other.fixtures . . -•---...-------------•---•------•-•----•-•---•-------•-•-•--•-•----- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity............gallons Length.............•.. Width................ Diameter---------------- Depth................ 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 ( . ) _ aPercolation Test Results Performed by--- ' _._ __ : .4�_� ' . A.-6. Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fZ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-•-----••--••-•----•---••---••--•------••................................••---•-•-•....•----•----•-...........---._............................-••---....... 0 Description of Soil........................................................................................................................................................................ x V ---••-•••-••--•----•••-•-•--••-•--•----•--•-----•---•••------•--•----•-----•--•-----•-------------------••----••-•-•._......•-----••••••--•-•••------•.......•••-•-•--------••-•----•---••-•-•---••-•••. 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'T" y g g p y 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed-----------•... - -------•......:........... _._.. ---------/ �---•...................•-•----------------------....--------------•-- ate Application Approved BY ............................................ —/ate ��'� Application Disapproved for the f oll i g reasons:------•--------------------------•------...------------------•------------------------------------------------- Date PermitNo....................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........�W. .........oF..... _ 1 �4) .::�.�.4:F..................... Tatif irFa#r of Tuntpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed O or Repaired ( } by...... :._., V,f 1_ e)C� ,..... •-- ----- ------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of TiTIZ 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No__��__—�... ............... dated-------- -------Q............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS ., V1 BOARD OF HEALTH _ .......: . .. 5......0F..... ` m. • ... -1' IT ) ..,,� �O.. ...................�.. FEE.... ....A........... Bispoiil arks T�un #r on amit ' ,. � ..Permissio is hereby granted-•-- • ......- ..... - .. ------------------------------------- •-------•-•----------......................... em o at �Toonstru!I _f Rep �t C' a f IndividualSewage� D.sp ..-Sys f ............................................... yy as shown on the application for Disposal Works Constructi•n Permit Street . �-. � Dated..__``..t_. .:_. �............ f f Board of Health DATE......... .............--------------•••-•---••--------- FORM 1255 HOBBS & WARREN. INC. PUBLISHERS Massachusetts Water Resources Commission/Division of Water Resources WATER WELL COJMPLETION REPORT ) WELL LOCATION Address L-pl- CwiL) City/Town ",4ytz M l f kipG.S.Quadrangle MapGrid Location Owne[ Address 80 WELL USE CONSOLIDATED WELL Domestic R Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones METHOD DRILLED 1) From To Rotary(type) 14V 9-Re-- Cable ❑ 2) From To Other 3) From To 4) From To 40 CASING Depth to Bedrock Length 4 _Diameter esI n Type love- UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface '!�+ Sand: fine❑ medium❑ coarse Date measured �-v '�Y7 Gravel: fine❑ medium❑ coarse❑ Screen: 'GRAVEL PACK WELL Slot#/0 ength 3 from to Yes ❑ No W Split Screen(or 2nd screen) WATER QUALITY TESTS MADE Slot# length from • to Chemical ' Biological Depth To Bedrock PUMP TEST Drawdown feet after pumping days hours at GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To o d n' Q114sAnd I .3 " DRILLER a /s -- Firm ,a weft Di&.g 3 Address ���•� X 430 �� ` City S0. :w , Registration No. .2 4hy Operator's Signature -Please print firmly 1OM-8/81-164843 L Number: 76 cotui�ottle # E856 'Date: 8-7-87 SAlW,► BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT SUPERIOR COURT HOUSE v BARNSTABLE, MASSACHUSETTS 02630 AS$ DRINKING WATER LABORATORY ANALYSIS PHONE: 362-2511 - Ext. 337 Client: Green Briar Derel . Cori_ Collector: Davis Chappell _—_— Mailing Address: Box 510 Affiliation: Well Driller Centerville MA 02632 _ Time & Date of 8-5-87 Collection: 4. Telephone: Type of Supply: well -__-- Sample Location: Lot 13 Well Depth: 632 -- BiscaVnp Date of Analysis$_&R7 _12-G0 Marsi�nns Mills PARAMETER SAMPLE RESULT_ RECOMMENDED LIMITS - Total Coliform Bacteria/100 ml 0 1 0 H 5.2 Conductivity (micromhos/cm) N 84 i 500.0 Iron ( m) <.1 i 0.3 _ Nitrate-Nitrogen ( m) 2.0 10.0 Sodium ( m) _ 7 i 20.0 i I . X Water sample meets the recommended limits for drinking of all above tested parameters. II . Based only on results of the parameters tested for this sample, the water is - suitable for drinking but may present the problems checked below: A. Water sample has higher than average levels of Nitrate. Future monitoring is recommended (2-3 times per year) to establish any upward trends. B. The low pH of the water may shorten the useful life of the house's plumbing. C. Water may present aesthetic problems (taste, odor, staining) due to D. Water sample has high levels of sodium. Persons on low sodium diets should consult their doctor. III. Due to one or more of the reasons ,checked below, this water sample is unfit for human consumption: A. High Bacteria B. High Nitrates _Ith „nd Environmental i, REMARKS: stateme " , The Barnstable Coun endorse nny anyone Department shall not conclusions made by sent. interpretations Or results without written con else concerning these CC: B rnstable Board , f Health Cc: C)i fford WA I Driel 1 ers Laboratory Director 1 /7/85 r _ r 9 I) � 46 Explanation of Test Results Total Coliform Bacteria Coliform bacteria are an indicator of the sanitary quality of a water supply. Water supplies may become contaminated from malfunctioning septic systems, cesspools and surface runoff. A total coliform count of zero indicates that your water supply is safe and approved for human consumption. A total coliform count of greater than zero is most often the result of accidental contamination of the sample bottle through improper sampling methods. For this reason, it would be advisable to retest any well water that is not approved. pH pH is the measure of acidity or alkalinityof the water. On the pH scale, the number 7 is neutral, less than 7 is acidic and more than 7 is alkaline. The pH of water on Cape Cod tends to be acidic in the range of 5.0 to 6.5. Conductivity Conductivity is a measure of the dissolved salts in solution. Amounts in excess of 500 micromhos/cm are generally considered unacceptable and may have a laxative effect upon users. Iron The presence of iron in water in concentration of .3 ppm or greater may: give the water a bittersweet.astringent taste, cause an unpleasant odor, often gives the water a brownish color and cause staining of laundry and porcelain. The average concentration of iron in Cape Cod's water is .2 - .6 ppm. Although the presence of iron in water may cause the problems listed above, it is not considered deleterious to health. Iron may be removed by use of an iron removal system. Nitrate-nitrogen The Massachusetts Drinking Water Regulations have set a maximum contaminant level for nitrates at 10 ppm. Excessive-concentrations may cause methemoglobinemia (an infant disease) and have been suggested to form potentially carcinogenic nitrosamines. Contamination sources include fertilizers, cesspools and industrial wastes. Copper Due to the acidic nature of the water on Cape Cod, copper tends to leach from pipes. This normally does not present a health hazard; however, concentrations in excess of 1.0 ppm may cause a metallic taste and/or a bluish-green stain on porcelain fixtures. Sodium A concentration of sodium over 20 ppm is only of concern to people who are on a low sodium diet. If the water supply has more than 20 ppm sodium,it is up to the people who are on such a diet to find another source of drinking water,or•c`ontact their,doctor to determine if consuming the water is advisable. Concentrations exceeding 50 ppm indicate}that there may be ocean water or road salt runoff water getting into the well. 20 FT. MIN. TOP OF FOUND. SOIL. TEST EL. z - 78-6 10 FT. MIN. DATE OF SOIL TEST CONCRETE WITNESSED BY 4 SCH 40 P C PIPE CLEAN SAND PERCOLATION RATE -- MIN. INCH COVERS MIN. PITCH I/8�v PER FT. CONCRETE OBSERVATIO N HOLE I OBSERVATION HOLE 2 2" LAYER OF ELEV. = ELEV.= 4" CAST IR N PIPE 12 COVERS FOR EQUAL,) MIN. \ 1/8"— 1/2" WASHED -r, ;; -7, s... PITCH 1/4 PER FT. STONE 110 VIrNT 114" MRtw z me c�tioM FLOW LINE ro E L = MIN.10 EL.= 2'0" 7 - EL = LEVEL EL= _ E L a w DIS T E_ _ BOX o v o w Li WATER AT EL.= WATER AT EL.= o „ > 3/4"— 1 I;2,. v •v° c a t GALLON WASHED STONE o ° ° � J001 DESIGN CALCULATIONS SEPTIC TANK 0 EL = PRECAST LEACHING NUMBER OF BEDROOMS BASIN OR EQUIV. GARBAGE DISPOSAL UNIT 0 _ 6' DIAM. TOTAL ESTIMATED FLOW SEWAGE DISPOSAL SYSTEM PROFILE c GAL /BR. /DAY x BR.) GAL /DAY NOT TO SCALE - REQUIRED SEPTIC TANK CAPACITY GAL. — - - —_ - - ACTUAL SIZE OF SEPTIC TANK GAL- PE4t. BOTTOM OF EST HOLE OR USGS PROBABLE WATER TABLE EL= LEACHING AREA REQUIREMENTS OBSERVED WATER TABLE / / ) EL.= 14/; SIDEWALL AREA 7. GAL /S.F. BOTTOM AREA _ GAL./S.F LEACHING CAPACITY ( BOTTOM+ SIDEWALL) 4 4 C GAL. ` 1 LEGEND: RESERVE LEACHING CAPACITY 4 � GAL EXISTING SPOT ELEVATION OOxO EXISTING CONTOUR — -- - 00- --- !�o ' L / FINAL SPOT ELEVATION NOTES FINAL CONTOUR 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E Q.E. SOIL TEST LOCATION TITLE 5 AND THE TOWN OF RULES AND r UTILITY POLE -d- REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE . TOWN WATER W ��=W 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO CATCH BASIN ® � WITHIN 12 OF FINISHED GRADE . ` 3. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE SAME. 5<y ! 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABILE OF WITHSTANDING H— 10 LOADING UNLESS THEY ARE UNDER OR! WITHIN 10 FT OF DRIVES OR PARKING AREAS. H -20 LOADING MIN. FRONT SETBACK SHALL BE USED UNDER OR WITHIN 10 FT OF DRIVES OR PARKING. 1 1 MIN. REAR SETBACK �.5. 5. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE MIN SIDE SETBACK SHALL BE MORTARED IN PLACE. 6. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER /APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. r 1 R��. - -� �4�; , � -�^ , �t. �., ._., � '�'��.,,, APPROVED : BOARD OF HEALTH W � w !n � \ DATE AGENT � � ? mod.9 i Q <.� ; — PROJECT LOCATION ? u- r- � 3 3 � S C� YNF 2 � g / , , cc /} _,�S _ I / Q APPLICANT O Z _ LEVY, EL DREDGE, D lIILAGIVER ASSOC �l C ENGINEERS - LANDSCAPE ARCHITECTS PLANNERS - LAND SURVEYORS 889 WEST MAIN STREET •, U NTERVILLE, MA 02632 LOCATION MAP Jt38 Ko.` . �7 SHEET OF --- 1 d¢ 2v FT. RAIN. M TOP OF ND. SOIL TEST EL. : 10 FT MIN. GATE OF SOIL TEST ZUn. I S, T CONCRETE WITNESSED BY Z �N COVERS 4" SCH. 40 p�yC PIPE CLEAN SAND PERCOLATION RATE_ MW. IN H -+F VAIN PITCH 1/e PER FT. i OBSERVATION HOLE I OBSERVATION HOLE 2 4N CAST IRQN COt. 2" LAYER OF ELEV. _ ELEV.= t2 - � ------ (Oft EAUALJ PIPE MIN. m 1/0"- 1/2" WASHED PITCH 1/4 PER FT STONE rl 3v VENl Tww Mgt►+ ' "ftLv'I JH+T FLOW LINE ME o�ter• r— s E EL _ MIN. ---- EL = - -f ' LEVEL M E L; —_-- - r ! �7� ��DIST. /D C 75- _ - �• • o W WATER AT . EL.= �-� WATER AT N EL = N !" BOX 4. y 4 ---1--- -- 14J L : , .T L E r7r ENS 3/4"- 11/2" GALLON WASHED sTor, oo ,rC7-U,IL AS 8U L7- T U.W o ° = =, �o. DESIGN CALCULATIONS �_ SEPTIC TANK e o EL. DU U - C L E VA 710!V PRECAST LE - AG NUMBER OF BEDROOMS ,4 c T L)AL AS 1= BASIN OR Eta� GARBAGE DISPOSAL UNIT y O 6 DIAM. ! TOTAL ESTIMATED FLOW / �' GAL./BR./DAY x 8R.) --�y--3-�-GAL. DAY ,E'Ev/ siO�.i AcTc1./}L SEWAGE DISPOSAL SYSTEM PROFILE � ' REQUIRED SEPTIC TANK CAPACITY 9r'=NOT TO SCALE GAL. ACTUAL SIZE OF SEPTIC TANK - 00 GAL- Bert il,N EE L. E v/. S;;r2✓C Y L? -:/e' BOTTOM HOLE OR USGS PROBABLE WATER TABLE EL- LEACHING AREA REOUIREMENTS �d� 2i7- 2 . j OBSERVED WATER TABLE ( / / ) EL.= I* A SIDEWALL AREA "A S 4AL./S.F. BOTTOM AREA 1 0 GAL./S F �a.�wti/ B.r •4 5 7 LEACHWG CAPACITY ( BOTTOM+SIDEWALL) --- -- ...__. i 3 � 4 JX V K � x Q� f /Z h � r ;y x Y �• � GAL. y L EGE NHS' RESERVE LEACHING CAPACITY Q GAL 1E X IST WG SPOT ELEVAT ION OOxO —'—" r�T EXISTING CONTOUR — -- -00---- G FINAL SPOT ELEVATION NOTES FINAL CONTOUR SON TEST LOCATION 1. ALL WORKMANSHIP AND MAT ERIALS SHALL COWORM TO OQE.O.E. -a. TITLE S AND THE TOWN OF C,4A1l1STAH�-g RULES AND UTILITY POLE % I PfGULATIONS FOR THE SUGSLRFACE DISPOSAL OF SEWAGE. / >g TOWN WATER W r`=W 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO CATCH BASIN `S I WITHIN 12" OF FINISHED GRADE . 3. EXISTIING' AND FINAL GRADES SHALL REMABN ESSENTIALLY THE SAM. 9� z 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE \ OF WITHSTANDING H- 10 LOADWG UNLESS THEY ARE UNDER OR WITHIN 10 FT OF DRIVES OR PARKING AREAS. M-20 LOADING A4N. FRONT SETBACK 3c� SHALL BE USED UNDER OR WITHIN 10 FT OF pRr&S OR PARKWG. IMN REAR SETBACK �S. S ANY MASONARY UNITS USED TO BRING COVERS TO GRADE MW SIDE SETBACK SHALL BE MORTARED IN PLACE. / I 6• NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH i.AC 1.1 DEEDED OR ZONING REGULATIONS. OWNER /APPLICANT IS TO (-� ^ OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. APPROVED : BOARD OF HEALTH 50 ILA DATE AGENT 0 3 S PROJECT LocxTIONI A$ , �'-- /-rE /1 Aj D �l�G.•�Y/.i,�" Jam'/V�"' tg�l k�.�� 7--1f3 L E . Mi4 Cbl APPLICANT ° r , E46 N K 3 L E_IVY EL DREDGE, 8 WAG41ER ASSOC /NC ENGINEERS - LANDSCAPE ARCHITECTS r-LANNERS - LAND SURVEYORS 689 WEST MAIN STREFT C-ENTE RVILLE, MA 02632 • . I at4? t \ ?®N 1 N to GL L r 4 `1 � 1 ;? PAUL A. LEVY JOE No. - No. 1051.' LOCATION MAP ! Cl L -7 [SHEET OF