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0031 BLACKBIRD ROAD - Health
31 B1ackbi;d Road Marstons Mills. A= 151-008-016 TOWN-.O/F ABLE . � . ��� ..SFWAOE#. . LOCATIQI`t... -. VMLAt;R Gt r5 s Il TALLER` .NAME PHONE N'O SEI�'iZC TANK I.l~.ATING FACT 'tom) -(sue) `6 NO OgBEDROOMS EU=SR OR flWi ER-777-77 PERAhITDATE CobfPLiANM DAM Sapatat�on Distance Between fhe . Feat Maxim AdUusted Caoundwater Table to tLe Bottom of Lsact ing Fac itty pnv&ta�Yater Supply felt andLeac3�ng Fes► E�€aaY ors exisi feet. an:sits ct unthxn 20fl feet of Ieachucg fa3 Edge:of V�l�t�aad and°I.eaclurig faaltty(I€any wetlands exist ,MtWi jW;feet of teaeh ng lactlitY) Famished by '••���" A � a o � -/- 3.3` -� •3 - 3? lb TOWN OF BARNSTABLE LOCATION 3l ��b1 0 SEWAGE# 2'017 - VILLAGE �2g L/�l�S ASSESSO y'�S MAP&_Y�kRCELJ51- INSTALLER'S NAME�&PHONE NO. SEPTIC TANK CAPACITY D LEACHING FACILITY:(type) `I ize) NO.OF BEDROOMS p OWNER -I IX PERMIT DATE: l l COMPLIANCE DATE: 1! c Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site 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 B g �� Al-16 Y, vtz��' �3 yam. J � i ��JJJJ�� i No. C >6 /0 r {.�. + Fee /00 TKE'COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye 2pprication for �Bigozal *p.5tem Cou5tructiou Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 3� ,t fo �/� Owner's Name,Address,and Tel.No. Assessor's Map/Parcel /jam- Z)' Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �YF,_4a �LAJ ;Jq6-29010 Cz) , Type of uilding: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building .90 vs e— No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33� gpd Design flow provided p gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank /i()G7Q Type of S.A.S. �6 /7/gdl C°�bv �il�j�fi�g- ems Description of Soil r / Nature of Repairs or Alterations(Answer when applicable) / eoy f .lPyG`ii Date last inspected: Agreement: The undersigned agrees to ensure-he construction and maint nce of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental d and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H th. Sign Date Application Approved by Date (j Application Disapproved by: Date for the following reasons Permit No. �; ©jo T d Date Issued � ) ' v No. Fee 7 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: - PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye ZIppYication for Di5pogal *p5tem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3/ /t�k�//Z'� () Owner's Name,Address,and Tel No. Assessor's Map/Parcel Ile 0 oil y ZS t7/6 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Twc— ity/¢rlr�2 e Z-f ,,/sCLl4l�ey Co . 1 Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building /-/p 1/1 e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 33D gpd Design flow provided ?3 y gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 4200 Type of S.A.S. Ito Description of Soil Nf Ir'epairs or Alterations(Answer when applicable) �{�G/ /�nX .CP G`ii.�� /� atu a o 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 c�'ode and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hp a,th. Sign9 4 Date // / O Application Approved by Date d Application Disapproved by: Date " for the following reasons �/ Permit No. ��Q 7� Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( Upgraded ( ) Abandoned( )by /J�,y z�j- at X1,9ce1,p ,e p has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated /) )' Installer ��i/�r/ 1-7S4 e-2 Designer #bedrooms .• Approved design flow 3 gpd The issuance of this perm t sh 11 not be construed as a guarantee that the system will func ' n a designed Date 7 h Q Inspector No. / " _. .., Fee l --_ . THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5po5ar 6p5tem Construction Permit Permission is hereby granted to Construct ( ) Repair ( �) Upgrade ( ) Abandon ( ) System located at 31 /0/r4C/4' and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions.. Provided: Construction mu t be completed within three years of the date of this p t. ' Ii � l Date l0 Approved by 11/04/2010 13:08 5088626339 POPEJOHNPAULII HS PAGE 01/01 Town Of Barnstable Regulatory Services Thomas F. Geiler,Director x .. Public Health Division Thomas McKean,Director 200 Main Street,Dyannis,MA 02601 Office:,508-862-4644 Tax: 508-790-6304 Installer&D•esin r Cert if canon Form Date: dv. / 2��'a MAg Iter: j ° Installer:• ` Addxess: . - oe oe ��1( __ Address: 14/d on ([fate) was issued a permit to install a (installer) . septic system at ed On a design drawn Ly addres.-91 ` dated 1 c.� jCU certify that the septic system referenced above was imstahed substantially acc6rdiing•to deszm wbkh may include miJaar approved-change tdbution s such as lateral.relocatioxi of the dls x and/or septic tank. .a. flat the 5 ••c.y,' ., I cez.& y septic system referenced above was instated with'. 'inuior,c]�g0s-(iwe greaten't} 0 lateral relmati 6h o;f the SAS or-,any vertical'r��o�ti��n£�y compoteant cothe.sephfied as- em)but in aecoxdance with State.&Local;Ro ceztied as- `hY desier t�`follow. gtil.�tions. Plan revision or �. . f4�lIDy v ,N (ns s Sign true} � �. �yCZ .-MASON � a; 1 Nafb6s . J s . (D ex s Sigdature) (Affik. PMT. 56X'is.Sfaotp Here) PLEASE ■may■.tea■�f . T�{�yy�ry•� ��yy N y}�.rylry .IC ':�AL��y[ .1JF�S1<01 'JTB TJrL 4 �:V.-'wu\.WA/ l.Slllil-'A��' �:lM+f�Y� � a' ilO 11 ���[�y FC■ VY ,rypT j TWA ry��!T�y��[ .k STL L�•� l WJr ..MI . PY yyy. Q Roo,&Septic/Designe'r Cc ca Oj Fomj •1 c; s, Town of Barnstable P# f 3 lo 2 Departlinent of Regulatory Services Public Health Division Date �U o )toes 200 Main Street,Hyannis MA 02601 Date Scheduled o 2 r Time / � . = l/( Fee Pd. /.0 Soil Suitability Assess " ent for Sewage Disposal Performed By: , t : .Witnessed By; f LOCATION& GENERAL INFORMATION [NEW ation Address �� Owner's Name 1vQrs� `� tJl ;�— M�� s . OA II C Address / ssor's Map/Parcel: f J�� d C7 �Gi Engineer's Name D�V e_ /yyj��" CONSTRUCTION REPAIR �� e .�h� v4 Telephone# Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line —.—�_f[ Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) to w� Parent material(geologic) Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE Depth Observed standing in obs.hole: Depth to weeping from side of obs.hole: in. Depth to sell mottles; in, In• Index Well# Reading Date: Index Well level Groundwater Adjustment f[. �a Adl,factor- Adj.droundwaterLevel o �{_� Observation PERCOLATION TEST bate Tittle ,1' Hole# � Time at 9" Depth of Perc Time at G" Start Pre-soak Time @ imc(9"-6") End Pre-soak Rate Min./Inch 1 V/T- Site Suitability Assessment: Site Passed Site Failed: nal ing Needed ) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:\SEPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. on istenc %Gravel) 0 O z l F � � Pom DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Cgnsigency,% el DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con i to c Gravel) , DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. I F1.,)d Insurance Rate Man: Above 500 year f!o^d boundary No- Yes Within 500 year boundary No Yes Witldn 100 year flood boundary No. Yes- Depth of Nahlrally Occurring Pervious Material Does at least four feet of naturally occurring pervi u 4 final exist in all areas observed throughout the area proposed for the soil absorption system? If not,what i s the depth of aturally occurring pervi us material? Certificatio,.i t } I certify that on (date)I have passed the soil evaluator examination approved by the; Department of Enviro me tal Protection and that the above analysis was perfor d by me consistent with the required training,a erti n perience described in 310 CMR 15.01 Signature t Date Q:\.SEPTICV'ERCFORM.DOC -7 4 °'', Commonwealth of Massachusetts r� Title 5 Official Inspection Form hi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Or 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information 'j#. (ae9g Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S 13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.01 have personally inspected the sewage disposal system at theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 6-19-19 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form I'll � Subsurface Sewage Disposal System Form -Not for Voluntary Assessments U 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: System is in good working order with no sign of failure. 2) 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts ,i. Title 5 Official Inspection Form Zi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ Y El ❑ ND (Explain below): ❑ obstruction is removed ❑ Y El ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑Y ❑ N ❑ ND (Explain below): ❑ 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 ❑Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts r� 6 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r U `>r 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for 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 must be attached to this form. c. Other: 4) 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 t5insp,doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ? ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the 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. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) Large Systems:T'o 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 CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 � N Commonwealth of Massachusetts - ,. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments - 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe 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)] t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 s Commonwealth of Massachusetts Title 5 Official Inspection Form i�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments >r 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 (Assessors 2) DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 5 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 6-2019 Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I� w:, ,�A YID► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments e ,A1: 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner---pumped 2-3yrs ago Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 ., Commonwealth of Massachusetts ' Title 5 Official Inspection Form ,ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) 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: 2010 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 30" feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts y Title 5 Official Inspection Form V it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments V . . 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 24"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign leakage. Recommend pumping for heavy solids. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface.Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of i nspecti on)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form �i I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 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.): Good condition with water at working level and no sign of back-up from field. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form �-r w. YI�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments / 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 16-Infiltrators ❑ leaching galleries number: '❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts ,w. Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach field in good working order with no sign of back-up into d-box or surrounding soils. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts �1 Title 5 Official Inspection Form hI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is Marstons Mills MA 02648 6-19-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 It� Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately L�j 33 3 .r - t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts rill Title 5 Official Inspection Fors 116) Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection D. System Information_(cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts il Title 5 Official Inspection Form ri Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Blackbird Rd Property Address Roy Mckenzie Owner Owner's Name information is required for every Marstons Mills MA 02648 6-19-19 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form!Subsurface Sewage Disposal System-Page 18 of 18 TOWN OF BARNSTABLE t LOCATION \ p� ' \(o � -gZSEWAGE # VILLAGr `cam ASSESSOR'S MAP & LOTIS INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY O O Q„c LEACHING FACILITY:(type) (size) a NO. OF BEDROOMS- PRIVATE WELL OR�UlSLIC WATE BUILDER OR OWNER DATE PERMIT ISSUED: D �o DATE COMPLIANCE ISSUED: S -x v 91% VARIANCE GRANTED: Yes No GN 41 X ` i_ r THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH yl-............. O F.............. �nQ rlirFa#ion for Diapati ai Works Tonstrnr#iun ramit Application is hereby made for a Permit to Construct ()ejor Repair ( ) an I'tidual Sewage Disposal System at: '31 5L_,9C &R-b je6 �„lM " e (� - L t �s ` ........ .................................. - -------d ".....`.`.......---•---_.. ................._...._.....-•----•- r--- o ti ress o. �..ram.. _� ........... ....................... ............ 1./��iD° -------------------.............---------- n r Address .................... -- `� Installer Address Type of Building Size Lot... __.S.G..!WSq. feet Dwelling—No. of Bedrooms................. ___._....._..__.........Expansion Attic --- Garbage Grinders-� Other—Type of Building o. of persons.......(................. Showers Cafeteria—t---Y Q' Other fixtures ......__.__ W Design Flow........................%5 --------gallons per person per dy. Total daily flow--------- .c3_. ..............gallons. WSeptic Tank—Liquid capacity.l°qkgallons Length Width__4-.(.!'"'Diameter................ Depth.,6.._...__... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------[----_____. iameter..... -�..... Depth below inlet.... ,�_.J�_ Total leaching area....3.�_Asq. ft. Z Other Distribution box (, Dosing tajikc- a Percolation Test Results Performed by.... _ ____ .! '�'��� M Test Pit No. I.._.•_--..2-minutes per inch Depth of Test Pit..... Depth to ground water.._........Z�..` ' 44 Test Pit No. 2....4-.z-minutes per inch Depth of Test Pit------ Z_�-__, Depth to ground water....../--.Z....�. a ------------- --- ----------------------------------- -- (f-------------------------------------------.---------- -� Descriptionof Soil............... ..-� K)..----- ...•... .................................................................. Z x W --•---•-----------------------------------•---------------------•---••---••--...•-----------•-•••----•-•--------•-----•---•--•••------------------•--•-----•--------••-•••......•-•-••......-•--••.••••. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -----------------------------------------------•-•---------------------------------------•--•----•-----•----------------------------------------------•--------------------------------•--••-•-•••..... Agreement: The undersigned agrees to install the aforedesc ' ed Individu Sewage Disposal System in accordance with the provisions of TITI.% 5 of the State Sanitary CT T e u e lg urther agrees not to place the system in operation until a Certificate of Compliance has been issu y t r iealth. Signed,X-- -- -•-• ----------------------- �1 ApplicationApproved By.... ---------` ................................ .. ................................ Date Application Disapproved for the following reasons-------------------------------------------------------••---------------------------------------------------•.. ...-•----••----------•-------•--••-•-----•--•--•-----•---._...---•-----•--------------------••-•...---••-•--•-------------------•---------•-•--••-••----•-------------------••-•-----------------•---•-- Date PermitNo........ .-- ...... ...... Issued....................................................... Date N ....... ?..�/ FEB THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...-----W./���.�1V1V..OF.......'--a�`7 .7 l J t7.3 L� .................................................................•- Appliratiun for Disposal Murky Tonstrurtion Prrutit Application is hereby made for a Permit to Construct (V) or Repair ( ) an Individual Sewage Disposal System at: - I ---•_.. ......=.....-. .} /? l p j? 1 .� , •r'. ) i :� / • -..G _ - c-- -' ` ----•----------------------•-------------• ..... --- .....__. w l / f ��JJ' ••�---- Lo ati • --•r=ss-•-•. / r Lo o. • ,. 1.:..G? 1...1. - .2 ..... ............................. --•---....7_l�l/ 1`/��'/ ........................................... Address •------•--•--•------•-- --•--•---•-- Ct ......... -1----........................................................... Installer Address d Type of Building Size Lot___.. ....................!.Sq. feet aDwelling—No. of Bedrooms___.....T.... .......................Expansion Attic (- ) Garbage Grinder (—) WOther—Type of Building J----- �'-No. of persons......t:.................. Showers ( ) — Cafeteria ( ) Otherfixtures .. ::-•---•-----------•---•--•---•-----------------------------•---•---•--•--•-•-•------•-••----•---•-------•--------•----------------••------------ W Design Flow..........................�?. .........gallons per person per day. Total daily flow.___.._..-'...-�..�.......__..._..gallons. WSeptic Tank—Liquid*capacity)C'4 v..gallons Length_�'___�_ -- Width_`��---_--_-:___ Diameter________________ Depth�:?__...�. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------- ----------- Diameter....1_.!- ..... Depth below inlet..__: .__- ___. Total leaching area.._......_1..4.sq. ft. Z Other Distribution box (2/) Dosing tank•(i)' '-' Percolation Test Results Performed by.... .....'`_..."•-� __ _iy�_ _rr' : .. ,.a ., Date_.....7........................., Test Pit No. I..... __-mint.tes per inch Depth of Test Pit... _.....__ Depth to ground water...... ........... 44 Test Pit No. 2...............minutes per inch Depth of Test Pit...._/.._.2---..... Depth to ground water._.._ _z._................. PI' O Description of Soil......... --) ) __..'?...C- -=�' ca � r+. I V ....------••----•-•--•--•--------••-•-•------------••----•-•----•---••••-••-•----•-•---••••....-----•--••-•------'-------•-•-----•-•••---•------•••-------•-•-••-•-••••---•....---•-••---••-•--•---•-•-. W UNature of Repairs or Alterations Answer when applicable................................................................................................ -•------------•=---------------------------•---------------•--------------------------••--------------------••--------------------------------------------------------------------------------••-•-----. Agreement: The undersigned agrees to install the aforedesc ' ed Individu Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary C e T e u de ig further agrees not to place the system in operation until a Certificate of Compliance has beem issu y t e' r o health. VIP. Signed.''--I- _-•- t` ------------ ............. Application Approved By----------L Date Application Disapproved for the ;ollowing reasons:-----••-------•------•-•-•-••-••-•--•----•-•---•------••----•••••-•--------•-•---•-••------••--•--•------------- ......-•-......•••--.....-••--•--•-•-•------•----•-••------•---•-•-•-•-•--•------••----•-....-•------•••----•-•--------•-------•--••----------------------------------------------------------------•--- �- Date PermitNo.------� r` '--...:---- _ ------ Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....0.✓✓..^/.......0F... ....................................-T- ....7...Z. ..T-----� .3.......... < �. Tatifirate of Tuutplinure THIS IS T CERT I/EVat rhinVid1 age Disposal System constructed (I-)r Repaired ( ) Installer at-•---• /� c� o ' --(9 t f c� ! 4 . . C, f s-,� ----•--- -----•------- -------------------------------------------------•-----------------•---------------____---------------- has been installed in accordance with the provisions of TI R 5 of The State Sanitary Code s desc *bed in the application for Disposal Works Construction Permit No.__ �2.....�Yl... dated__..�_�/-�_- `;* (.............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................... ... ... ------------------ Inspector.............................-- -_-------------_____-________---------- - � THE COMMONWEALTH OF MASSACHUSETTS BQARD OF HEALTH J ..✓A✓0F........=''....... ' Z,r.' _ No._::- ........... FEE.......� � �t��t11� nr � Cnunu ttr�iun �erutt# _ __- � Permission Is hereby granted --------- --------------------1 /_ to Construct ( L-)'or Repair ( ) an Individual Sewage Disposal System = ...................................................................... ---- - ----- --------••-•-••- Street r" as shown on the application for Disposal Works Construction Permit Noz:E` �('_Y� Dated.._..`� �" / -1-- `�.. .ter `DATE G ..•--___ Board of Health FORM 1255 A. M. SULKIN, INC., BOSTON REC'EIV�b JUL u 51986 holmes and me rath, enc. civil engineers and land surveyors 200 main street, room 201 falmouth, ma. 02540 54873564 July 3, 1986 Mr. Douglas Lebel Lebel-Sollows Corp. 131 Old Route 132 Hyannis, MA 02601 Dear Mr. Lebel: Re Fieldstone Estates Our Job No. 85,310 Enclosed please find the following: l. . Topographic Plan of Land; Dated July 30, 1985 2. Subdivision Plan of Land (3 sheets) ; Revised June 26,1986 3. Subdivision Plan of Land .(Sheet 2 of 3) ; Revised May 12, 1986 4. Results of Percolation Tests witnessed by Barnstable Board of Health. The Subdivision Plan of Land; Revised June 26,: 1986 (enclosure 2) is the plan approved by the Barnstable Planning Board on June 30, 1986. The Planning Board is in possession of .the signed copy of the plans. I have enclosed the Subdivision Plan of Land (sheet 2 of 3) ; Revised May 12, 1986 (enclosure 3) , because the test holes were located according to this plan. (Lot 1 on this plan corresponds to Lot 1 on the test report and Lot 2 on this plan corresponds to Lot IA on the test report) . Due to the redesign. of the lots during the testing procedure, the test reports .them.selves do not accurately reflect the final lot numbering. Adjustments should be made according to the attached sheet. If you have any questions, please call or write. Yours truly, HOLMES AND McGRATH, INC. obert A.' urgmanri Vice Preyident RAB/dcl cc: William Haney TEST REPORT FINAL SUBDIVISION PLAN Lot 1 Lot lA Combined into Lot 1 Lot 2 Lot 2 Lot 3 Lot 3 Lot 4 Lot 4 Lot 5 Lot 5 Lot 6 r Lot 6 Lot 7 5 Lot 7 Lot 8 Lot 8 Lot 9 Lot 9 Lot 10 Lot 10 - -- Lot 12 . Lot 11 Lot 13 Lot 12 Lot 14 Lot 13 Lot 15 Lot 14 Lot 16 Lot 15 Lot 17 Lot 16 Lot 18 Lot 17 Lot 19 Lot 18 Lot 20 Lot 19 Lot 21 Lot 20 Lot 22 Lot 21 Lot 23 Lot 22 irk #Q PROPOSED DISTRIBUTION BOX IN APPROXIMATE PROPOSED INFILTRATOR LOCATION OF EXISTING DISTRIBUTION BOX . CHAMBERS IN FIELD LOT 15 CONFIGURATION EXISTING LEACH PIT WITHOUT AGGREGATE EXISTING 1000 GAL. TANK + 132.89' TO REMAIN N 85° 41 E rn ; _ — —a G-.-OR x-111.1' !o I p � _ o � 2 � BENCHMARK: TOP OF FND1 5.2ft I u ° e a �eo 1 x=111.8 ELEVATION: 112' DATUM: BARNSTABLE GIS f Q ° i W ➢; rn rn ,,,,,,//,,, 10.9ft _ — — --=- Aft :-. W 0 Feet /,,,,,,,,,,,,,/,/,/,„,,/,,,,,,,,,,,,,,,,,,,,,/,/,,,/ , •: ... •2 EE GENERAL17.6ft ft x= . NOTE #11 G WLOCUS MAP .t PLAN REF 426-68 //////////////////////////// •R'y .'r. #31;;;;;;;,,,,,,; G ;.;._� ' T DEED REF.- 7150-258 , ,,,,,,;;;;;;;;;;;;;;;;;;;;;;, ..* x, _:,,..,• . ASSESSOR'S MAP. 151-008-016 r 0 ZONING.. RF SETBACKS. 3 G ;.•.,; :. ;. .:`: N N ��� FLOOD ZONE- C PANEL NUMBER- 250001 0015 C E DATED.- 08/19/1985 OPEN ,,,,,,,,,,,,, 00 ,,,,,, OVERLAY DIST. RPOD SPACE I ///„/, : . ......... PLOT PLAN OFLAND /,„,,, .00 e LOCATED AT o R \ 31 BLACKBIRD ROAD 0 32.7ft 1 9.9 ft MARSTONS MILLS, MA z 10.5ft LOT 16 P hl 1 o PREPARED FOR: 4� og �' LOT 17 LEGEND ANN Q UINLAN / REMAX S 61 --- OCTUBEl>' ,fib; ,2010 SPOT ELEVATION x=111.5' e � iN F�qs� UNDERGROUND ELECTRIC LINE —E— REV - 1 DABVID 9G ®°�o�'va P�G�S_EP �� ®q UNDERGROUND GAS LINE —G— REV MASON STEPHEh UNDERGROUND WATER LINE —gyp/— REV nio.toss y ® pO�E ® YANKEE LAND SURVEY *'� �� s = o e s aR ®®`Aw0 S ��y®�° CO., INC. l(D 2,9 � o ,�® GRAPHIC SCALE 119 ROUTE 149 20 0 10 20 40 MARSTONS MILLS, MA 02648 NOTE: EXISTING SEPTIC COMPONENTS ARE DRAWN YTEL' 508-4 -0055AWT 0� sr-55 oar PER TOWN OF BARNSTABLE AS—BUILT CARD. 1 inch = 20 ft. SHEET 1 OF .1 JOB # 54675 SH e y n ' � 4 S EWAG E SYSTEM PROFILE VIEW N . T . S . T.O.F. EL. 112' FIN GRADE = 111't co RISERS FIN GRADE = 111t 20" 20" INV EL. DIA DIA. C PVC INSPECTION PORT WITH SCREW CAP 109' RISER FIN GRADE = 111 t GEOTEXTILE FABRIC TO WITHIN 3" OF FINISHED GRADE (4 TYP) SEE PLAN VIEW. INV EL 10" MIN. LUNE INV EL. INV EL. L108.00' 108.66' �� 108.41' INV EL. MIN. 6" INV EL.BELOW 107.6T e e ° ° e °r ° ° °° o ° e ° ° �0� E=lLIQUID 108.16' SUMP 107.96' 16„ a°° ° o ee e° e e GAS BAFFLE 6 STONE ° e e' ' o \' , ° ° °o 0 . DISTRIBUTION BOX ° t-106.67' EXISTING 1000 GALLON TANK 34 _� ° ° ° CLEAN MEDIUM SAND 6"PRECAST REINFORCED CONCRETE DISTRIBUTION BOX SEPARATION BETWEEN ROWS (TYP.), TEES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND SHALL EXTEND A INSTALL ON A LEVEL BASE WITH WATERTIGHT COVER 1 3.83 MINIMUM OF 6" ABOVE THE FLOW LINE OF THE SEPTIC TANK AND BE ON MINIMUM WALL.THICKNESS = 2" THE CENTERLINE OF THE SEPTIC TANK LOCATED DIRECTLEY UNDER THE MINIMUM INSIDE DIMENSION = 12" USE FOUR ROWS OF (4) HIGH CAPACITY INFILTRATOR CHAMBERS In CLEAN-OUT MANHOLE. OUTLET INVERTS SHALL BE EQUAL TO EACH OTHER AND AT TOTAL CHAMBERS = 16 THE INLET PIPE ELEVATION SHALL BE NO LESS THAN 2" NOR MORE THAN 3" 2" MINIMUM BELOW INLET INVERT. ABOVE THE INVERT ELEVATION OF THE OUTLET PIPE. THE DISTRIBUTION LINES FROM THE DISTRIBUTION BOX SHALL ALL HAVE NOTE: PERFORM 5' STRIPOUT DOWN TO C2 HORIZON. SEPTIC TANK SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL, EQUAL INVERTS AS DETERMINED BY FLOODING THE DISTRIBUTION BOX TO STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON WHICH THE HEIGHT OF THE DISTRIBUTION LINE INVERT AFTER ALL LINES HAVE BOTTOM OF SOIL PIT = EL. 101.1' 6" OF CRUSHED STONE HAS BEEN PLACED TO ENSURE STABILITY AND BEEN SEALED IN PLACE. NO GROUND WATER OR TO PREVENT SETTLING. INVERT ADJUSTMENTS SHALL BE MADE BY FILLING WITH DURABLE AND REDOXIMORPHIC FEATURES OBSERVED SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9" NONDEFORMABLE MATERIAL PERMANENTLY FASTENED TO THE LINE OR TWO 20" MANHOLES WITH READILY REMOVABLE IMPERMEABLE COVERS RECONSTRUCTING THE LINES UNTIL ALL INVERTS ARE OF EQUAL ELEVATION. OF DURABLE MATERIAL SHALL BE PROVIDED WITH ACCESS PORTS. MIDDLE ACCESS PORT SHALL BE 8" DIA. MINIMUM. THE OUTLET TEE SHALL BE EQUIPPED WITH GAS BAFFLE. DESIGN DATA: SEPTIC TANK CAPACITY: THREE BEDROOMS REQUIRED — 330 GALLONS AT 200% 3 X 110 = 330 GPD REQUIRED FLOW EXISTING — 1000 GALLONS USE 16 HIGH CAPACITY INFILTRATOR CHAMBERS IN FIELD CONFIGURATION WITHOUT AGGREGATE FIN GRADE = 111't (16 X 6.25) X 4.72 SF/LF = 472 SF EL.108.14' 472 X 0.70 = 330 GPD TOTAL DESIGN FLOW ° °° o ° o MED MED GENERAL NOTES: RESERVE FLOW = 0 GPD SAND SAND 1. ALL THE WORKMANSHIP AND MATERIALS SHALL CONFORM TO DEP GARBAGE DISPOSAL NOT ALLOWED e s° ° s° TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS 25 FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2. ACCESS PORTS OVER TANK TEES SHALL BE ACCESSIBLE WITHIN 6" 26' OF FINISHED GRADE USE FOUR ROWS OF (4) HIGH CAPACITY INFILTRATOR CHAMBERS 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF TOTAL CHAMBERS = 16 WITHSTANDING H-10 LOADING UNLESS OTHERWISE NOTED. T.P. #1 PERC 6 M/INCH T.P. #2 PERC 6 M/INCH 4. THE EXCAVATOR/CONTRACTOR SHALL CALL "DIG SAFE" AND VERIFY THE LOCATION OF SITE UTILITIES PRIOR TO ANY EXCAVATION, AND SHALL BE RESPONSIBLE FOR EL. 111.8' o" EL. 111.8' o" ALL MATTERSRELATING TO ELECTRIC AND/OR GAS EASEMENTS. LOAMY 10 YR 4/2 LOAMY 10 YR 4/2 5. SEWER PIPES SHALL BE SCHEDULE 40 PVC. (4" DIA. UNLESS UTHERWISE NOTED) "A" SAND „A» SAND , 6. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE SANDY 10 YR 7/6 SANDY 10 'YR 7/6 SOIL DATA: MORTARED IN PLACE. "Bw" LOAM 37 "Bw" LOAM 37" TEST DATE: 10/21/2010 7. FINISH GRADE SHALL HAVE A MINIMUM SLOPE OF 0.02 FT. PER FOOT. EL. 108.7' EL. 108.7' SOIL EVALUATOR: DAVID B MASON 8. EXISTING LEACH PIT AND DISTRIBUTION BOX SHALL BE ABANDONED PER „C1" SILT 10 YR 6/3 "C1" SILT 10 YR 6/3 APPROVAL DATE: 10/94 TITLE 5 REQUIREMENTS. LOAM LOAM 9. THE EXCAVATOR CONTRACTOR SHALL BE RESPONSIBLE TO CONTACT YANKEE 78" 7s„ HEALTH AGENT: DAVID W STANTON / "C2" FINE 10 YR 6/4 "C2" FINE 10 YR 6/4 SURVEY 24 HOURS PRIOR TO ANY REQUIRED INSPECTIONS. SAND SAND 10. ALL COMPONENTS SHALL BE MARKED WITH MAGNETIC TAPE OR EL. 101.1 128" EL. 101.1 128" COMPARABLE MEANS IN ORDER TO LOCATE THEM ONCE BURIED. NO G\WATER OR NO G\WATER OR 11. WHEREVER WATER SERVICE LINE IS CLOSER THAN 10' TO A SYSTEM REDOXIMORPHIC FEATURES REDOXIMORPHIC FEATURES COMPONENT SAID WATER SERVICE LINE SHALL BE SLEEVED IN PVC. SHEET 2 of 2 JOB NUMBER__ 54675 I BENCH MARK : 40 ,� I � LEv. ar33 , 9z w•�, � ,t,. TEST HOLE RESULTS P ,� � �. • _ DATE • 11 WITNESSED BY T/e C�M �"7 . ) f� •.40� e3 ; C'7, h� 7•" 4 P q Cry J P H ;Z✓ F J2 O M ,E/v L,r92 G, " H r t7 L.AllS Ile) e?/� 7-H e s*V C. r D 7/3 c7,✓E3 5' 7-- , co 0 , '� a F_'L o � � L © 7-• / ,3 D OIL /V O T O �Z e-=/ 1�/ L _ - _ S" i � N 0 v I I c p � 's , I , I / , K 2 t_ f / lam\,,, '► e w )•4.9,> E L • 10 2, G 3 \ 9E '�'.� h ,�•A!!��G � /�/© G• T� :D C e /�/ 'T� 8 \ F MANHOLES . AND COVER TO BE BUILT TO ti � N I E � 23 �� co ELEV. TOP OF v ca�.L '�..'. '�• :..• � WITHIN 12 OF FINISHED GRADE t� ., FOUNDATION CrP • ` Zoo . -�•'" e � ,x��. si t•�' - FINISHED GRADE " MIN. 2% SLOPE 4 DIA. --•- -w-- q DIA. PIPE 20 FIRS 2MI --- �► � o 7- / v ��• - Ma H r . 2 LA YER R OF P lP E M N L T � �� N M N c I PI TCH LE4/E I NN. � F S» T. .:.; . PEASTONE T.lNk �8 2 2 MIN. PITCH i�'•Mw. 4P t _ � • L , v 4 rc� INVERT s sue '-INVERT • • d� •. - INVERT .. GALLON - cn to • 9 SEPTIC TAi� n \\ ► t ) INVERT I /Q.Qo c� •,. } / •.� IN \jERT •.• _ :• 80X o• WASHED STONE •!� t ''�PLACE ON IN,l�ERT �'i �� ©,: ALA. AROUND � FIRM BASE �--�----� �---� �•-lo � BOTTOM AT ELEV./ oG.S'•o Ia. , M IN . -. 1 10 -s crs� 1 t .Zo = 0•. 0 GARBAGE. MIN 4' R , w, 2 - GRINDER S 0 , l T►� 2i' ,I'3cO7, eat 7;t-eC�z�� ELEV. /oo. o a GROUND WATER TABLE � R FILE OF L P 0 SANITARY DISPOSAL SYSTEM ( NOT ;.TO SCALE ) t� DESIGN DATA h L VIC � �' °"" • CONSTRUC TION OFSANITARYDISPOSAL BEDROOMS R OOMS _ A to SYSTEM SHALL CONFORM TO THE MASS. •, ;- , wr► . i ��.,,� DESIGN FLOW 3 3 0 o G A L �D A Y ENVIRONMENTAL CODE TITLE r LEACH RATE MIN./INC HREVISE0 • 7- I-77� AND T-HE TOWN OF Cl 330 REQUIRED ED LEACHING CAPACITY : R R H T A Q G- HEAL H R E G U L TIONs. e T A_ • ll� ,a• 2 • SEPTIC TANK, DISTRIBUTION BOX AND LEACH- PROPOSED i ' '_GAL/DAY. r ING UNIT TO BE OF REINFORCED Ctl_.NCRETE . 2.S 3.s7re4') ti.077~ (7) 4 Posa � E . 30 0 0 , IN. CONCRETE STRENG HP. I To00 MREQUIRED SEPTIC TANK : i cAn MIN. STEEL STRENGTH * 20,000 P. S. I. 2 s. r MIN. DESIGN LOADING : H � PROPOSED SEPTIC TANK• /oovL. I I 1 ,� SYSTEM DRIVEWAYS NOT TO BE LOCAa ED OVER I � J . I I UNLES S . H2O DESIGN LOAD114G IS USED I • A E G ALL PIPES AND FITTINGS S TO BE WATERTIGHT T HEALTH AGENT APPROVAL- DATE AND TO BE OF CAST IRON OR APPROVED P.V.C. I . SITE P ' AN SHOWING PROPOSED CONSTRUCTION f ZONING LOCATION :DATA LEGEND _ 0 ` 'F R DATE ZONE � f' •*�s'_ _ � fin/ 1 TEST HOLE LOCATION 4- REFER E N C E �, �-- `�--� C.,v da) s ..15 e_I wiy @ REV I S I O N S 8 /?-/a 47 REQUIRED AREA * _ /��-,�� a� eP,89 � � EXISTING SPOT ELEVATION 176 ��'� °FCRAIG s —�•• ,f" f 0 37 S s , _ /0 EXISTING CONTOUR 16 � REQUIRED F ONTAGE R � z298� 4 O �' a s a 3 3 REQUIRED FRONT SETBACK C ,� PROPOSED CONTOUR --� : 3 3 $ E` SCALE / ., ' REQUIRED S1DE SETBACK . PROPOSED WATER SERVICE W �S/ONAte�REQUIRED . REAR SETBACK : /5 �S PROPOSED GAS SERVICE G- i g � f4 PROPOSED ELEC. -Br TELE E aT 7 CRAIG R . SHORT , P. E . PROFESSIONAL CIVI L EN G I N S E `R BU L NG SPEC'TOR APP ROVAL DATE 131 OLD ROUTE 132 HYANN IS . 'MA. 02601 FILE NO. / t D I I �l r ( •r_-z_�r e, 7 � a 2 - 94 �e SHEET I OF I II I i I I