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HomeMy WebLinkAbout0120 BLUEBERRY LANE - Health 120 BLUE®ERY LANE, MARSTON MILLS A = r T OF B ST CLE LOCATION C, SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. ,ZA ^iI SEPTIC TANK CAPACITY LEACHING FACILITY: (type)r.&2 (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: 6 COMPLIANCE DATE: Separation Distance Between the: j 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 i f. v © ti Al A L Q17l 43 Commonwealth of Massachusetts is Title 5 Official Inspection Form , s Subsurface Sewage Disposal System Form Not for Voluntary Assessments 120 Blueberry Lane Property Address , Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 page. City/Town State Zip Code Date of Inspection �15 .IJ 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. Important:When A. Inspector Information filling out forms on the computer, use only the tab Sean M. Jones key to move your Name of Inspector cursor-do not S.M.Jones Title V Septic Inspection use the return Company Name key. 74 Company A Lane Co Company Address Centerville Ma 02632 City/Town State Zip Code 508-658-3456, 774-2484850 SI 4522 sean@smjonestitle5.com License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property 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 4/11/2019 Inspector's Signatur 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 i� Commonwealth of Massachusetts Title 5 Official Inspection Form ±' is Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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: The dwelling located at 120 Blueberry Lane Marstons Mills is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box and 3 Cultec 330. The system was found to be in proper working condition at the time of inspection. 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 Title 5 Official Inspection Form 0 Subsurface Sewage Disposal System Form - Not for voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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 ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ 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.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts 0� Title 5 Official Inspection Form <� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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 �9 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 page. CitylTown 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 1/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the 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: 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 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form <� Subsurface Sewage Disposal System-Form - Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 page. City/Town State Zip Code Date of Inspection C. Inspecfon 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? ❑ E Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 0 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 page. Cityrrown State Zip Code Date of Inspection b. System 'Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd Description: Number of current residents: 0 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: unknown 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 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries . Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 page. Cityrrown 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: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts g Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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.(tote-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: system installed 9/13/1999 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2 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.): Joints ok, no leaks or blockages. Vented through roof t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c � Commonwealth of Massachusetts Title 5 Official lnspecti®n Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 page. Cityrrown State Zip Code Date of Inspection -D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 1.5 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: 1500 gallons Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 3 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 11" How were dimensions determined? opened covers and tookmeasurements 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 does not need to be cleaned now but should be done soon and again every 2 years for proper maintenance. water level was even with outlet, tank was not leaking and was structurally sound. t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts to Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name informatifor every on is required Marstons Mills Ma 02648 4/11/2019 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 inspection) (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 Title 5 Official Inspection Form Io Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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 0" 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.): Distribution box was level and in good condition with no rot. Water level was even with outlet invert with no signs of past backup. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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: 3 Cultec 330 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form la Subsurface SewageDisposallSystem Form --Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 page. Citylrown 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.): s.a.s. consists of 3 Cultec 330 chambers in a 29'x12'trench. Leaching facility was video inspected and found dry with no signs of past hydraulic overloading. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System form -Not for Voluntary Assessments � 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 page. Cityrrown 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 Commonwealth of Massachusetts .Title 5 Official Inspection Form I j Subsurface Sewage 'Disposal System Form -Not for Joiuntary Assessments �ww 11�` 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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 r,. LJ drawing attached separately CS 2 A( 3f � �( 17'6 AZ 3► `6 13ab ,A3 11'b BI 32'� t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts Ot Title 5 Official Inspection Form Subsurface Sewage DisposaFSystem Form -Not for Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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: Groundwater elevation was established by accessing Town of Barnstable groundwater contour maps. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for-Voluntary Assessments 120 Blueberry Lane Property Address Lori Humphries Owner Owner's Name information is required for every Marstons Mills Ma 02648 4/11/2019 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 T OF B ST LE � AOV30/®0 LOCATIONOZQ &&&V 1 t-9-306 LA5 SEWAGE # VILLAGE ASSESSO�R''S MAP & LOT INSTALLER'S NAME&PHONE NO. t 6 k9A `-� SEPTIC TANK CAPACITY �5<22 LEACHING FACILITY: (type)�!—It (size) .` NO.OF BEDROOMS 3 BUILDER OR OWNER 0V { PERMITDATE: 512�fi,fCOMPLIANCE DATE: ' �&271 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 cp Q� �7-7 ' L4 3 �`f � 43 No. OVA * FEE COMM�l1�lY �'�Y EAL ® � ACIVIUSETTS Board of Health, ga f n SfcAl MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct(4-1 repa:r( ) Upgrade( ) Abandon( ) - R-C-o'niplete System ❑Individual Components Location ;?,�) Blue 13",A A VE Owner's Name L OR I /1v W%r Nye 1 es Map/Parcel# 1'O a Jul Address 6 r7 r ry ncw- l,qz,; e ?,em 6m,,ee ,- Lot# J J Telephone# ZO Installer's Name ©/� Ow /,�1 Designer's Name Address (� � jn Address L�oB 1h-IvSTv Telephone# Telephone# Z --00 $ Type of Building I AM Lot Size 101 AOt) sq.ft. Dwelling-No.of Bedrooms Garbage grinder V b Other-Type of Building No.of persons Showers ( ),Cafeteria( ) Other Fixtures Design Flow (min.required) ;eL. gpd Calculated design flow Design flow provided 3 7 8 gpd Plan: Date J'17- 7 8 Number of sheets Revision Date Title S t'f,C+ S.e,2't;r- /o),I N.) Description of Soil(s) Ser- 421#4 q Soil Evaluator Form No. <l 1 93 Name of Soil Evaluatorlsr'x'e G-. h WIP141 Me of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees t not�plae tem in operation until a Certificate of Compliance has been issued by the Board of Health. SiLyned � � q Ins Tons PIA ,640 qt � " r-v?7 FEE ;, .11 i • _ " e�o,-Tv�e; M�['l[ T OF MASSAC14USETTS Board of Health, I Jet n S�C4,�If MA. APPL BATON FOR ➢ ISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct(��epair( ) Upgrade( Abar�ii on( ) - C�'�plete Syste" m U Indivi�mponents Locati?pt A30 1 ve J L A �C� Owner's Name L O P,) Map lcll eI# 10 a e Address '� t ��,�yW hc&l J Ax e ?Pw,br.,ee fN�l- si Lot � //S Telephone# 1 Installer,s Name /" � ��°f?e�` Designer's Name ,9 rp ,jt,,RVe CaASUC7 A N-tS C l Address Address 1/08 Ala s1S n�� 11 Telephone# Telephone# Type of Building cPA44 Lot Size 10, a'�� sq.ft. Dwelling-,No.of Bedrooms _ Garbage grinder Vb ,O,tther-Type of,Building t No.of persons Showers ( ),Cafeteria O Other Futures • - Design Flotw (min.required) 2 � gpd Calculated design flow ® Design flow provided 3 gpd ,,Plan,. Date S Number of sheets " 4 / f Revision Date Title S 11C.+ Se iC- I N p"r A Description of Soil(s) Soil Evaluator Form No. y3 Name of Soil Evaluatort� Q� (`t N`/ ate of Evaluation S $ r 8 DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above,described Individual Sewage Disposal System:in accordance with the provisions of TITLE 5 and further agrees to not to place e em m operation until a Certificate of Compliance has been issued by the Board of Health. r 7 Signed. �x / Da* Insp ns No. Q6 `• i FEE�� COMMONWEALT14 ®F M/ASSACHUSETTS Board of Health, MA. 1 k CERTIFICATE OF COMPLIANCE Description of Work: ❑Individual Component(s) U�C*mplete System The undersigned hereby certify that the /Sewage Disposal System; Constructed (L�epaired ( ),Upgraded ( ),Abandoned ( ) by: �'��©4© at has been in ccor ance �th the provisions of 310 CMR 15.00 (Title 5) an•�d the approved design plans/as-built plans relating to application No. d A dated Approved Design Flow 3,17 (gpd) Installer • _ ® Q ( 'n WI IU, I Designer: y4Nkee S�nxCWt$oI19N7SInspector: /la � /�� iii Date:The issuance of this permit shall not be construed as a guarantee that the system/will function as designed. t No. q,Q_-- � FEE COMMONWEALTH OF MASSAC14USETTS Board of Health, Ja-r"Sy MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( pair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at 1 J ue)Yc v✓ L A N67 s as described in the application for Disposal System Construction Permit No. / (/,0�dated / Provided: Construction shall be completed within three years of the date of this rmit. All local conditio s mu Lb met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date A .• rd of Health s �_�" — 1 — 1 - 'J 9 '�F 1 1 _ 04 �p�OFTHETp�o TOWN OF BARNSTABLE a OFFICE OF Z Be$a9 : BOARD OF HEALTH .� rne& e 0ip, 0 MAY a�s0 367 MAIN STREET HYANNIS, MASS.02601 May 4, 1999 Wallace Parton 80 Lakeside Drive Marstons Mills, MA 02640 Lot 115 Blueberry Lane, Marstons Mills A=102 - 115 Dear Mr. Parton: Your request for a variance to construct an onsite sewage disposal system for a proposed three bedroom dwelling at Lot�Blueberry Lane, Marstons Mills, is not granted. Al However, you are granted permission to construct a septic system at this property designed to handle only a two (2) bedroom dwelling. The permission is granted with the following conditions: (1) The applicant shall submit a revised floor plan showing a maximum of two bedrooms for this site. Dens, study rooms, finished attics, sleeping lofts, ` and similar-type rooms are considered bedrooms according to Massachusetts Department of Environmental Protection. `0 (2) The septic system plans shall be revised to show a proposed two bedroom design. (3) The applicant shall record a deed restriction at the Barnstable County p Registry of Deeds concerning the two bedroom maximum allowed at this property. parton ,. r r C 1 'i S 3 9704 t f (4) The applicant shall submit revised floor plans, revised septic system plans, and a copy of the deed restriction to the Health Agent prior to obtaining a disposal works construction permit and building permit approval. Sincerely yours, Susan G. ka6k R.S. Chairperson Board of Health Town of Barnstable SGR/bcs BARN COUNTY REGISTRY OF DEEDS A�7 UE COPY,ATTEST JOHN F.MEAD E+�E6f3#£�—.-. BARNSTABLE REGISTRY OF DEEDS parton 8LE COUNTY REGISTRY OF DEEDS •JOHN F . MEADE , REGISTER ER RECEIPT # : 1991 15369 ED :. WED '5/ 19/99• 1 1 : 0`5 : 33 Ri; 170R / , OMER : N/A BATCH : 8435 1 PAGE : OOK-PAGE: 12277 174 ,INSTRUMENT # : 39704 RECORDING FEE : 10 . 00 RECORDING DATE : WED 1999 -05- 19 11 : 04 POSTAGE : . 33 ADDRESS : 115 BLUEBERRY LANE MARGINAL REF FEE : , 00 COPY FEE : . 00 TOTAL AMOUNT DUE : STATE EXCISE : „ 00 PAID BY : CASH COUNTY EXCISE : . 00 _-.--_.-._......-.-_-__ -.,_ 'a C�Fi GTEE GROUP : 00 1 - "_..- TOWN : BARN BARNSTABLE .INSTRUMENT: N NOTICE OR, CAVEAT CONSIDERATION : STATE EXC CONSID : . 0c. . 00 GRANTOR : COUNTY SONSID . OG DESCRIPTION : BLUEBERRY LN GRANTEE : MARGINAL REF BOOK--PAGE : GRANTORS : PANTON WALLACE (&O) HIUMPHRIES LORI •J (&O) BARNSTABLE TOWN OF (HEALTH &0) GRANTEES : NONE RECORDED -- - - - - _. _ -..--- ---.. -.-.-.....-- _- -....--..---..-._. ....-...-_..... - -_._._ -- -._-.- . __.. e _urn ,_ddRE'SS : WALLACE PANTON -_. 80 LAKESIDE DRIVE MARSTC'N'S MILL: MA. 02640 (4) The applicant shall submit revised floor plans, revised septic system plans, and a copy of the deed restriction to the Health Agent prior to obtaining a disposal works construction permit and building permit approval. Sincerely yours, Susan G. Ratk R.S. Chairperson Board of Health Town of Barnstable SGR/bcs parton oFTHe Taw TOWN OF BARNSTABLE OFFICE OF HAHa9TOBL i BOARD OF HEALTH MAS& vo i639. � 367 MAIN STREET CFO MPY tr. HYANNIS, MASS.02601 May 4, 1999 Wallace Parton 80 Lakeside Drive Marstons Mills, MA 02640 Lot 115 Blueberry Lane, Marstons Mills A=102 - 115 Dear Mr. Parton: Your request for a variance to construct an onsite sewage disposal system for a proposed three bedroom dwelling at Lot 115 Blueberry Lane, Marstons Mills, is not granted. However, you are granted permission to construct a septic system at this property designed to handle only a two (2) bedroom dwelling. The permission is granted with the following conditions: (1) The applicant shall submit a revised floor plan showing a maximum of two bedrooms for this site. Dens, study rooms, finished attics, sleeping lofts, and similar-type rooms are considered bedrooms according to Massachusetts Department of Environmental Protection. (2) The septic system plans shall be revised to show a proposed two bedroom design. (3) The applicant shall record a deed restriction at the Barnstable County Registry of Deeds concerning the two bedroom maximum allowed at this property. parton 'OF rHE 1p� DATE: /r' FEE: BARNSCABLE, y MASS. g RE . BY 1� �p t679. A�0 'F°^ter Town of Barnstable SCHED. DATE:4/, �` Board of Health C 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Susan G. Rask,R.S. FAX: 508.790.6304 Sumner Kaufman,M.S.P.H. Ralph A. Murphy,M.D, VARIANCE REQUEST FORM 8 LOCATION A Property Address: Lot .115 Blueberry Lane M r 1� Assessor's Map and Parcel Number: 102 / 115 Size of Lot: _.23 f r o ��_ Wetlands Within 300 Ft. Yes Subdivision Name: Sand Shores 5 199 9 ., No X e ,� � Business Name: APPLICANT CONTACT PERSON - Name: Lori J. Humphries Name: Wallace Panton Address: 57 Furnace Lane; Pembroke,MA Address: 80 Lakeside Dr. , Marstons Mills, MA 02359 02648 Phone: 781-293-6820 Phone: 508-428-7886 FAX: FAX: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) relief from 310 CMR 15.214 Tit 1 P V SEE ATTACHED SHEET ,T z C(tgcklist 0o be completed by office staff-person receiving variance request application) V Four(4)copies of plan submitted (including septic system plans and/or restaurant floor plans) V Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (,'or Title V and/or local sewage regulation variances only) VFull menu submitted (for grease trap variances only) I/ Variance request application fee collected inn fee for hfeyvard modification renewals,grease trap variance renewals(same ownedleasee only 1,outside dining variance renewals(same owner4easee only).and variances to repair failed sewage disposal systems lonly if no expansion to the building proposed)) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED _ Susan G. Rask, R.S., Chairman NOT APPROVED Sumner Kaufman, M.S.P.H. REASON FOR DISAPPROVAL Ralph A. Murphy, M.D. Q:/WP/VARIREQ ATTACHED REASON FOR VARIANCE FOR LOT 115, BLUEBERRY LANE, MARSTONS MILLS, MA 02648. For my family size a one bedroom or two bedrooms home would not meet my needs. Other homes in the neighborhood, Sand Shores, have at least two bedrooms and many have threebedrooms. I purchased this lot thinking I could build a reasonably sized three bedroom home. I have now been informed that I need to apply for a variance. I do not feel that a detriment to the environment will occur as a result of the granting of a variance without strict application of this provision under 310. The lot in question is about 850± feet from a body of water and had an acceptable perc test on 5/17/98. Without the variance I, as the applicant, will be deprived substanially of all my benficial use of the property. 3po "Town ol' Barnstable P# Department of Health, Safety, and Environmental Services TM Public Health Division Date 367 Main Street,Hyannis MA 02601 i anaxaTAatA _ M TFD► +�`� Date Scheduled �� Time l4 Fee Pd. /6d p w1 Soil Suitability Assessment for ►sewage Disposal Performed By: I-'Yy�e G. U R P / Witnessed By: J-G ry,�A DV 110 l h Ct LOCATION & GENERAL INFORMATION Location Add ygs, Y( n� Owner's Name Lori. T, � n �n Address 5 - {—U(Y)C1,C LG� it Y l Q rs'l�n Assessor's Map/Parcei: 10 j 15 �I �� Engineer's Na�in�""" bra�, GtnkPC Sur✓ey�'�su/fa.,t5 . NEW CONSTRUCTION 11 REPAIR Telephone M Land Use W Slopes(%) Surface Stones _ Distances from: Open Water,Body _ft Possible Wet Area ft Drinking Water Well ft "Toe,utV Drainage Way n Property Line ft Other ft SKETCH: (Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) 100 Parent material(geologic) ►A9—Uek „„ NN Depth to Bedrock Depth to Groundwater: Standing Water in_Hole: Iy"NC Weeping from Pit Face 1-�•14 Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs,hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: V Iin. Groundwater Adjustment ft. Index Well p Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST Date S-$'q8 Time I0 Observation Hole N Time at 9" t Depth of Pere Time at 6" Start Pre-soak Time© !0-�1 _ Time(9%6") End Pre-soak j j'v6 Rate MinAnch L 5 Ng4�l�S Site Suitability Assessment: Site Passed V Site Failed:_ Additional Testing Needed(Y/N) Original: Public Ilealth Division Observation Hole Data To Be Completed on Back---� Copy: Applicant I DEEP OBSERVATION HOLE LOG Hole # -�— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulderes. % y,_ g,r 5"°Goywt 1o7k3 3 S 1-7Y wt )oyRY(� 644 k 'till Jo yR o wr4lrR. i DEEP OBSERVATION HOLE LOG Hole # 2 Dcpth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulderes. Consistchcy.%Gravel) 0-�,� O 0 kG-A 10 YR 3-3. 1� 4 S14N,bY L✓ -8 A Lva4 r� royR 3-3 14 M 10yR5=� 3; + {Ccrl WeS5AN1 1oyR A ----------- r DEEP OBSERVATION HOLE LOG ole # Dcpth from Soil I lorizon Soil Texturc Soil Color Soil Other Surface(in.) (USDA) (Munsell.). Mottling Structurc;Stones,Boulderes. % i DEEP OBSERVATION MOLE LOG Hole # Depth from Soil Ilorixon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes e DEEP OBSERVATION HOLE LOG Hole # Depth from Soil Horizon Soil'Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. i % a HO USE MARSTONS MILLS 0 ' RACE A a LANE LOCUS 'Y I MISTIC LAKE c° HUBAEL p E I A.M 10 1114 POND �I A.M. 1021134 MIDDIL I I E POND POND S87 00'00'E 100. 00 ti 12 0' 10 LOCUS MAP PROPOSED BEIATCHMARK I _ _ _ DRI VEWA Y 1 TOP OF CATCH BASIN ° ELEV=100.0(ASSUMED) 98 26.0 0 i Wo ° o PLAN REF 138125 RES. ZONE. "RF" is J TP i o FLOOD ZONE. "C" \. PROPOSED ; — = W I 3-BEDROOM 42 0' ' zo I . \ l HOUSE �ti i A.M. 1021133 I _ I / 12, 0' l T- m :. . — _ J ,�. I TO.F 101.0 ICI j I O PROJEC T LOCH TION I 98 0 I W O v A.M. 1021115 BLUEBERRY LANE I PROP/ I_ __ — 19g MARSTONS MILLS, MA. O I O DECK �. I �O 99 24.0' LOT 98 APPLICANT A...:f 1021115 loo =- O O ARE': =10,200 S.F. LORI J. HUMPHRIES i YA NKEE SUR l/E Y CONSUL TA N TS = I S87 00'00, 100. 00 P. O. BOX 265 UNIT 5, 403 INDUSTRY ROAD MARSTONS MILLS, MA. 02648 I (VACANT) PH. (508)428—0055 — FA X(508)420.— 3 555 A.M. 1021132 A.M -102/116-1 _. _ SCALE.-. 1 "=20' DA T1 5117/98 REV. ' REV. 51570A- - . ._ SHEET I OF 2 � h A _ e} .f V EL. = 101_0 TOP OF FOUNDATION 20' MIN. 10' MIN. CONCRETE COVERS 4" SCHEDULE 40 P. V.C. MIN. PITCH 118 PER FT. CONCRETE COVER ?'LAYER OF ,, EL = 100 118"-112 vent .Y 6" MAX , . . . , EL.=98.5'. WASHED STONE 4" CAST IRON PIPE (OR EQUAL) MINIMUM PITCH 114 PER FT. CLEAN SAND 9" 77\ FLO W LINE MIN. 10" 1MIN. EL=93.5' INVERT 14" EL.=98.0, INVERT -- GAS �6" SUM LEVEL o 0 0 °o°° ° INVERT BAFFLE EL.= 97 5' INVERT INVERT o°a o ®o° EL.= 97 75' EL.= 96_75' D EL.= 96.5'_ ° ° ° EL=91.0' (TO BE PLACED ON FIRM BASE) DISTl LIB UTION 4 �—SPLASH PAD 4' MECHANICALLY COMPACTED OR 6" OF STONE BOX 3 CULTEC H-20 REGARGER 330 1500__GALLONS TO BE WATER TESTED �OIL X 29' TRENCH FORMATIONSEPTIC TANK IF MORE THAN ONE OUTLET PLACE ON 6" STONE314" TO 1-112" ABSORPTION PROFILE OF WASHED STONE S YSTEM (SAS) SEWAGE I S P 0 S A L SYSTEM BOTTOM OF TEST HOLE OR USGS PROBABLE WA TER TABLE ELF V. = 870 _ NOT TO SCALE NO OBSERVED WATER TABLE (515198) ELEV= 870 OBSERVATION HOLE I EL _98_0 = PERCOLATION RATE �5 _ MINI_INCH AT ._42'_ INCHES OBSERVATION HOLE 2 EI, 98.o_ DEPTH �HORIZ TEXTURE COLOR MOTT. OTHER FDEPTH jHORIZ TEXTURE COLOR MO TT. OTHER 0-4" 0 ORGANIC 110 YR3-3 0-4" 0 ORGANIC _ 4-8" A SANDY LOAM IOYR3-3 . , �10 YR3-3 - SANDY LOAM 10 YR3 3 = 8"-36" B SILTY LOAMY IOYR5-6 8"-3' B SILTY LOAMY 10YR5-6 GENERAL 1 PTO TES 36"-60" C1 MEDIUM-SAND 10-YR5-8 PERE 36"`=60", Cl MEDIUM; SAND IO YR5=8 3 •„ AND COBBLES AND COBBLES ' 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 60"-126 ' C2 MEDIUM SAND 10 YR7-3 60"-132 ' C2 MEDIUM SAND 10 YR7-3 _ TITLE 5 AND THE TOWN OF _EA_RNSTABLE-___ RULES AND NO WATER ENCOUNTERED NO WATER ENCOUNTERED REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO P#9143 WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST 515198 SOIL TEST DONE BY BRUCE G. MURPHY, R.S. ALL C.OMPONF,NTS OF THE SANITARY .SYSTEM SHALL BE CAPABLE OF WITNESSED BY: JERRY DUNNING WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 5 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE DESIGN CA L C ULA TIONS USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL NUMBER OF BEDROOMS . 3 BE MORTERED IN PLACE. TOP LOAD 3 CULTEC H-20 RECHARER 330 GARBAGE DISPOSAL . . . . . . . . NO 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH 4' STONE SIDES AND ENDS TOTAL ESTIMATED FLOW DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO 12' X 29' x 2 ( 110__GAL./BR./DAY x 1___ BR.) 330 GALIDA Y OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. INSTALL IN "C2" HORIZON REQUIRED SEPTIC TANK CAPACITY 1500 GAL 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR O.F MEDIUM-SAND IS TO CALL 'DIG-' SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS SOIL CLASSIFICATION . 1 PRIOR TO COMMENCING I;'ORK ON SITE. DESIGN PERCOLATION RATE . . . .. < 5 MIN./IN. - 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS.." __� �` - - - = EFFLUENT LOADING- RA TE . 74 GALIDA Y/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. � LEACHING CAPACITY (AREA X RATE) 378 GALIDA Y 8) PARCEL IS IN FLOOD ZONE "C t RESERVE LEACHING_ CAPACITY . 378 GAL/DAY - _ , .ti:. (29X12X. 74)f(294-09f 12f 12;x 74 X 2) . ... ; . 9) LOT IS SHOWN ON ASSESSORS M AP _102_ AS, PARCEL _115__ fx - 4 .. ---------- ��.: : JOB NUMBER- `�'.4 - 5157 A HO USE - r MARSTONS MILLS RACE ilkw LANE l` c LOCUS MISTIC LAKE wl HUBAEL C A.M. 102/114 POND l / �I SHED A.M. 1021134 U POLE I 5'8 00'00'E' 10000 , POND I O p 99 o - g� - - --c�- - - - - - 12. 0' 10, LOCUS MAP PROPOSED BENCHMARK: _ _ _ _ _ _ DRIVE WA Y TOP OF CATCH BASIN — w ELEV=100.0(ASSUMED) I W 98 26.0 \ 00 o PLAN REF: 138125 RES. ZONE "RF" ® Tp#1 I FLOOD ZONE "C" / I O \ PROPOSED / 20 Ip' o 3—BEDROOM 42 0' Q)O I 1 HO USE/ 12 o A.M. 1021133 T0.F=101.0' T I / / ® -13d.ol�i 32 0, o I I I�I � ,o° / PROJECT L OCA TION A.M. 102 115 BLUEBERRY LANE 98 0 W / I O PROP j � — — — 19g MARSTONS MILLS, MA. I / DECK O 99 -- 24.o' L:OT 98 APPLICANT. f)XU'CE 1 AREA 1002001 S.F '. G. �;` ' I Io0 o LORI J. HUMPHRIES MURPHY Nv.749 {' i S8 700 WEE SUR VE Y CONSUL TAN TS 100. 00 YA'00 E /TAB P. O. BOX 255 I UNIT 5, 405 INDUSTRY ROAD i MARSTONS MILLS, MA. 02648 .. , I (VACANT A.M 102/132 PH. (508)428-0055 - FAX(508)420-555,3 A.M. 1021116-1 SCALE.' 1 "=20' DA TE.' 5117198 i A. RE V. REV. JOB NO. 515 70A SHEET �JOF_ 2 _101.0_ TOP OF FOUNDATION .4 Cl y 20 MIN. 10' MIN.A CONCRETE CO VERS 4" SCHEDULE 40 P. V.C. EL = 100 MIN. PITCH 118 PER FT. CONCRETE CO VER 2"LA YER OF ven t 118"-112" / / /6 WASHED STONE.. MAX i i / t EL=98.5' 4" CAST IRON PIPE PITCH 1/4 ' PER FT.M CLEAN SAND 9 FLOW LINE /` EL=93.5' MIN. INVERT 1 10 14 7 98 0' MIN. EL.=_9 -- INVERT 2.E GAS �6" SUM LEVEL ol ° °o °oo° o INVERT BAFFLE EL.= 97 5' INVERT INVERT o ° °° °®° 75' - 96 75' ° ° (TO BE PLACED ON FIRM BASE) DISTRIBUTION 40 ===]- -SPLASH PAD 4 MECHANICALLY COMPACTED OR 6" OF STONE BOX 3 CULTEC H-20 REGARGER 330 1500 --GALLONS TO BE WATER TESTED �OIL X 29' TRENCH FORMATION SEPTIC TANK IF MORE THAN ONE OUTLET PLACE ON 6" STONE 314" TO 1-112" ABSORPTION PROFILE OF WASHED STONE S YSTEM (SAS ,i SEWAGE DISPOSAL SYSTEM _ BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELEV=_8_7.0__ NOT TO SCALE NO OBSERVED WATER TABLE (515198) ELEV=-_ 87.0 OBSERVATION HOLE I EL _98-0 PERCOLATION RATE <5 MINI INCH AT _AZ" INCHES OBSERVATION HOLE 2 EL 98.o_ DEPTH HORIZ TEXTURE COLOR MO TT OTHER DEPTH HORIZ TEXTURE COLOR MO TT OTHER 0-4" 0 ORGANIC I0YR3-3 0-4" 0 ORGANIC 10 YR3-3 4-8" A SANDY LOAM I01R3-3 4-8" A SANDY LOAM I0YR3-3 8"-36" B SILTY LOAMY I0YR5-6 8"-36" B SILTY LOAMY I0YR5-6 GENERAL NOTES 36"-60" Cl MEDIUM SAND 10YR5-8 PERC 36"-60" Cl MEDIUM SAND 10YR5-8 AND COBBLES AND COBBLES 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 60"-126 ' C2 MEDIUM SAND I0YR7-3 60"-132 ' C2 MEDIUM SAND I0YR7-3 TITLE 5 AND THE TO WN OF -BARNSTABLE____ RULES AND NO W 4 TER ENCOUNTERED NO WATER ENCOUNTERED REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO P#9143 WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" DATE OF SOIL TEST 515198 SOIL TEST DONE BY BRUCE G. MURPHY, R.S. 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN WITNESSED BY: JERRY DUNNING 5 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE DESIGN CAL C ULA TION, USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL NUMBER OF BEDROOMS . BE MORTERED IN PLACE. TOP LOAD 3 CULTEC H-20 RECHARER 330 GARBAGE DISPOSAL . . . NO 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH 4' STONE SIDES. AND ENDS TOTAL ESTIMATED FLOW DEEDED OR ZONING REG ULA TIONS. OWNER/APPLICANT IS TO 12' X 29' x 2 ( 11 __GAL./BR.IDA Y x 3___ BR.) o GAL/DA Y OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. INSTALL IN "C2" HORIZON REQUIRED SEPTIC TANK CAPACITY 1500 GAL 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR OF MEDIUM SAND IS TO CALL "DIG- SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS SOIL CLASSIFICATION . . . . . . . . 1 ' PRIOR TO COMMENCING WORK ON SITE. DESIGN PERCOLATION RATE . . . . . < 5 MIN./IN. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS EFFLUENT LOADING RATE . . . . . . . 74 GAL/DAY/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. LEACHING CAPACITY (AREA X RATE) 378 GAL/DA Y 8) PARCEL IS IN FLOOD ZONE __"C" , RESERVE LEACHING CAPACITY . . . 378 GAL/DAY 9) LOT IS SHOWN ON ASSESSORS MAP _102_ AS PARCEL _115 , (29X12X. 74)f(29f29f12f12 X. 74 X 2) JOB NUMBER__ 51570A______