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HomeMy WebLinkAbout0030 CAMELBACK ROAD - Health 30 Ca elback Road) Marstons Mills A= 064-105 r l TOWN OF BARNSTABLE LOCATION -30 SEWAGE# 2 0 t I v 1 2-1 VILLAGE M.MA` S ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. Copa wtd t r° y f Y Q P8 7) SEPTIC TANK CAPACITY 1-5oo �4,,o LEACHING FACILITY:(type) a Y +ee 3(,t t, !f z u (size) f.1.7 Y Z NO.OF BEDROOMS y OWNER /h! PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility N ti 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 l�d9Wil ee ®r'13y3 LC L Li A3 411 ay R� Al 33 5'l,,i 3Y 31.6 V.z No. D'C) t a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for �N,5pogal i�pgtem Cougtruction Permit Application for a Permit to Construct( ) Repair(V) Upgrade( ) Abandon( ) ❑ Complete System Rv ndividual Components Location Address or Lot No. 3e (261 yv t( �c,Lr 1, P- Owner's Name,Address,anTel.No. q\kvan 1l� �n.�c i,. \ V=( 1 Assessor's Map/Parcel � _ 1U — 3v ev.✓ f_A ad Al, /K- Installer's Name,Address,and Tel.No. 9?-7 7? Designer's Name,Address and Tel.No. U 7 7 IS-3 t4aAtA_t0Lu.1 sf- OYI45 Type of Building: Dwelling No.of Bedrooms Lot Size .131 9 Z sq. ft. Garbage Grinder ( ) Other Type of Building o No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) `l y U gpd Design flow provided �fY 3 gpd Plan Date -Z5-- 1 Number of sheets Revision Date Title Size of Septic Tank 6-0 L) Type of S.A.S. a f/ Description of Soil atte/ r nod /iy 7a 14 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Bo d of Health. Signe Date 'p�7 Application Approved by rh, Date Application Disapproved b Date for the following reasons Permit No. Date Issued No. d V I ( Fee U� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplicatiou for �Digoal 6paem Cow5truction Permit Application for a Permit to Construct O Repair Upgrade( ) Abandon O ❑ Complete System ndividual Components Location Address or Lot No. 6Coxj � YN{.t �joe Ic ��(� Owner's Name,Address,an Tel.No. j Assessor's Map/Parcel 3U o-n,- 1 )�Jj y2�l 1 M, / i 1 ►�c�e Installer's Name,Address,and Tel.No. cJ) 7 7 Designer's Name,Address and Tel.No. a 3 () 7 7 � C'"<,A kek, q"teApV\ b� J(' Phi 1,AA_LA,,Lf /1-3 t4v i A.AcLe_t 51- /In 45 1- I Type of Building: Dwelling No.of Bedrooms Lot Size -0 3, 9 Z sq.ft. Garbage Grinder ( ) Other Type of Building 2 y No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) y 9 p gpd Design flow provided gpd Plan Date 7-5- // Number of sheets / Revision Date Title �J Size of Septic Tank ti-o c) Type of S.A.S. Ore ?(o/ t S/�yj I Description of Soil I Ltal f�v+o/ //YJ 2a `� i Nature of Repairs or Alterations(Answer when applicable) r; Date last inspected: i Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date Application Approved by ,/ Date Application Disapproved b : Date "` E for the following reasons Permit No. y �� �a ( Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance E THIS IS TO CERT/I�FY,that thee'On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by C ✓/'Vic "� 0,1 �(,t�,(4A j at c(� 12V has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. a d/1 �.? dated y' ,2 7-11 . Installer ( txl v V I dt �i �!/r f t Designer J C Xie p 1,.t.( #bedrooms c/ Approved design flow 4/ gpd The issuance of this pe - it sh 1/1 not be construed as a guarantee that the system`wil~1 fu tin s esi ned. Date � / Inspector l ` No. 2 n j Fee / oU THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS 'i5po5al gyp! tem Construction Permit Permission is hereby granted to Construct ( ) Repair (/) Upgrade ( ) Abandon ( ) System located at ,6 L� a-w or� c and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Lh Provided: Constructio must be completed within three years of the date of this it Date - Approved by . (n� r , i �por �im l 1�� 4(f Ce CP a 05/20/2011 13:12 FAX 5084283928 CAPEWIDE Q 005/006 Town of Barnstable Regulatory Services Thomas F.Geller,Director g.� Public Healtb Division 10�¢ Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862.4644 Fax: 508-790-6300 Date: ✓f rl r Sewage Permit# Zdt 1 - I Z 1 Assessor's Map/Parccl io`i / 10 5 Installer&Desiaaer Certification Form Designer: SC En5tneec o.� , -Tin C. Installer: C�gowi& t-nFeefrtscs Address: 2854 tkr+bccrlr ikowU Address: lS3 6&nY�e--(-Wt S# �T w61CV%"n, ¢ta 02539 rA!i,, e1iA- 01-41 so9-Z�3-o;r7 On 'A-Z-I-2o l l C,00�0,4 rtr was issued a permit to install a ate} (�nsta er septic system at 30 camzO back R cad based on a design drawn by (a Tess) C EnScneuc�g ,�,��_ dated AQrc t 2�r zo It (designer) I certify that the septic system referenced above was installed substantially according to the design,which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank Stripout (if required) was inspected and the soils were found satisfactory. 0 I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow, Stripout(if required) ' s ected and the soils were found satisfactory. CW JOMN L. CHURC►OLL ( ler's Si ue i L Ale igner s Sign aOre (Affix Deg f Here) P RETURNT ON. CE CATE F COMPLIANC OTSS L BOTH THIS FORM D AS- BUILT ARE RECEIVED Y THE BARWTAWX-PUR1,1C HEALTH D SION. JHANX YOU. ry:\otrtxfonra�daignereeNfl�,l+04 FoRfl.dee 0 p0 nemm+�oswsr�,rarww....�r.•r;r...v..�...�,,..,.�ar..xyP? +41 . m N CIO 00 /[L N 6`v 00 i In -� 74�; V) M N 0 N O 30 Came) bock Pd.. Harsh Des 05/20/2011 13:11 FAX 5084283928 CAPEWIDE _ j001/006 TOWN OF BARNSTA,BLE LOCATION 3b SEWAGE#, Z a VILLAGE M.M, &S ASSESSOR'S MAP&PARCEL 6 v iris— INSTALLER'S NAME&PHONE NO. WL VAA PS 77 SEPTIC TANK CAPACITY t rtoc .o �t:v�Stin.1 LEACH NG FACILTTY(type) �?y a 3L z L) (size) NO.OF BEDROOMS Y OWNER /h Ek&A,( PERMIT DATE: `f-t'?• it . COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted.Groundwater Table to the Bottom of Leaching Facility —A19 Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 fleet of leaching facility)' _ Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY C44wil Ll� Or9�u _L(,(— A3 441 144 too.-? cos•a q 3Z 3q,o 3' � 83 51 � r r 3Y 3L 8 01 4to TOWN OF BARNSTABLE LOCATION&N��9�nP�lJ.©c SEWAGE # VILLAGE, /gty�0, S / /i//�_ ASSESSOR'S MAP LOT,460—/0JT INSTALLER'S NAME 6z PHONE NO. s ASEPTIC TANK CAPACITY !5-d O i p-,BLEACHING FACILITY:(type) f (size) of —/OOd �NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER L'el DATE"PERMIT ISSUED:9/1 7- � DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ✓✓ �:�.�- } - '��r d 0 �� � . 7 � �a y � .. 1®°f . ��/ ♦� ., a, No ....ta F. ..................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...... 'l .....OF...... Y>. nrlf f.�.... .................. .. ApV iratilan for Disposal Works Tonstrn.rtiun Prrutit Application is hereby made for a Permit to Construct (71j or Repair ( ) an Individual Sewage Disposal System at: 46-so LocqL.ation-Add re s ' or t No. ..C_, I-t? ...�Te��1. .----..•.•.... ..'��! �'Y.1.f11...� ................ W Owner Address a ............ �-� f.0.... / �0..�}f 2:1...1 1. ----- ------•-•-•------- ...`�,1.. t1-`?--.#.......................... Installer Address Type of Building Size Lot , ,gfji�..Sq. feet �-, Dwelling—No. of Bedrooms___-.---_- __ _-_._-_--._-•-__._--Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building a —Type g _V.� q� No. of ersons___..__.._. Showers Cafeteria Other fixture p ( ) -----------------------------�------------------`-------•-•------------------ --------------••--.---- w Design Flow.............. gallons per person perlda`j Total dai�y flopy____--_-_3 D....._.........-__gallon / WSeptic Tank—Liquid capacity_. gallons Length.... . ._. Width._,// /Q Diameter................ Depth..X..,3..__ x Disposal Trench—No. .................... Width...... ............ Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......j........... Diameter........... Depth below inlet........... Total leaching area.441�7..sq. ft. z Other Distribution box ( I ) Dosing tank ( ) ' / — o� aPercolation Test Results Performed by-___ '_11-Yj� f „t�..C.... Date-_--�:._._D.__-•-.�3 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water--- 4-A— � Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water _.__ ____.._....._._- �+' ------------- -------------------••-•---••--• ----- _- ......... Description of Soil Q p l .1. .... v6y---_------- x c, w UNature of Repairs or Alterations—Answer when applicable................................................................................................. ---------------------------•-------------......---••-------------------------------........------•-----•-----------------------------------•----------•---------------------------------...---•....---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hAbeened by the boar of h h.Application Approved By..---•-•-- •--- .......-•-•••---............................ •-- .... Date Application Disapproved for the following reasons--------------•--------•----•--••------------•----------•------------------------------------------.....--_...._ -----.•--•-•-•-._._...•---•-•-------•--•.......----•--•--••--.•-------•-•--------------•--•-.----------... -•-•........_. Permit No.. Date._..••-�--�v-�-----_.... Issued---------------•------------------•----------....------ Date No. -------...... FE4,—?............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............. A-e 0 F..... ................................................................... Appliration for Disposal Works Toustrurtion Frrmit Application is hereby made for a Permit to Construct (/-) or Repair an Individual Sewage Disposal System at: r V..........................................................I ................... .............j6........................................................ ---------------------- , Locapon,Address _K_ / ........................................ .........m...... ... ............ ..... ..... ... ....V.......... .. ......... or Lot No Owner....... Address ................ ........ :t.. _ . ...... ....... ........ ......................w......... ................ ..... ......... ....... ........ ................................... Installer Address - r7 / Type of Building Size Lot � 12 llk;�11'6 Sq. feet ....................... U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder Other—Type of Building �!t;tniv No. of persons..........40......... Cafeteria VV't:;�— .... Showers 04 ............................. Other fixtures Design Flow_____________-Ir ( tU...........................gallons per person periday. Total daily flow............ ....................galfons., 1:4 Septic Tank—Liquid capacity. gallons Length...,�,'� 4 ' Width -1-1,- 46 Diameter................ Depth. W — ­;..... .1.7...... Disposal Trench—No..................... Width.................... Total Length..............._.... Total leaching area--------------------sq. f t. Seepage Pit No......./_--------- Diameter.......... Depth below inlet........../ Total leaching area. �....�...sq. f t. 61 Z Other Distribution box Dosing tank ( ) 1-.4 1 A��P " — C Percolation Test Results Performed by...,.?,r.. Date...:q�............ ........... ...............v­­`­-­-----------------L!------- .... ..... Test Pit No. 1__-------------minutes per inch Depth of Test Pit....__.............. Depth to ground water-_-t...............i---- (Zq Test Pit No. 2................minutes per inch Depth of Test Pit___................. Depth to ground water.14,10 Q/'i 11, ........................ 1:4 ...........................................................­*.................... .................. ------7i��r............. 0 Description of Soil..........11411�' ......... ........ ......... W7­ ........... C17Z�............ U ......................................................................................................................................................................................................... W F4 ........................................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with TITLE IT the provisions of' IEj 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been,issued by the board of healih. Signed.. Date Application Approved By................� ................................................. ...... ........ ....... I Date Application Disapproved for the following reasons:.............................................................................................................. .......................................................................................................................................................................................................... Date Permit No...._ 60 ............................................ IssuedL....................................................... Date ,.THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................... Q....0 F...... .......... ............ TuTrtifirate of Tomplianrit THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed -(i- or Repaired by-------------------------- ................................................ � )W ......... .......................................................................................................... ( Ie,' at......................... ..........I L /.; / It,-- '�- /- '.' k"nstalle r 0 ].......................:�.......................;�.................a............................................................................................. has been instilled in accordance with the provisions of TWIT,, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.-::__...__,e.... ........ dated-_ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.......................�T .....Y-.n....S-7............................ Inspector....... -------------------------- THE COMMONWEALTH OF MASSACHUSETTS -7 BOARD OF HEALTH / ............ ............... ............................... _OF..... No......................... FEE.._.'_::�'. ......... tr Disposal Works Tonstrudion Prrutit Permission is hereby granted. ............... .......... ......... ............ 0%nstruct or Repair an Individual Sewage..Di.sposal...System.................................................................... Street as shown on the application for Disposal Works Construction Permit-No)"9..............'/S7 Dated.._772 . . ad.. ............................. ....................................................................................................... DATE Board of Health FORM 1255 A. M. SULKIN, INC.. BOSTON 4ft x, Al '' s• LoT Ls A , y 4 5ox5 - fR 40 570 b Xp ' �X 4-7>(.7 4 Al+ � • a}µ , LEGEND 3 EXISTING SPOT ELEVATION 0 PROPOSED SPOT ELEVATION of r� �� of : :EXISTING, CONTOUR ---0——— ���� PROPOSED CONTOUR 0o� P A U L cti� o N , `V NOTE:THE LOCATION OF ANY UNDERGROUND SEWERAGE,WELLS, OR OTHER UTILITIES SHOWN ON L E V Y " 9LC4X THIS PLAN IS APPROXIMATE ONLY AS DETERMINED No.10050 O �O 3134i a «� FROM RECORDS AND/OR VERBAL INFORMATION. THE CONTRACTOR IS RESPONSIBLE FOR THE To /sT VERIFICATION OF THE EXISTING LOCATIONS IN THE FIELD. z , _FR9G IST T R vY 61 ELDREDGE ASSOCIAMS,INC. FROM15tv"D PLOT , • 1 ot . CLIENTF ENGINEERS — LANDSCAPE ARCHITECTS JOB. NO.� � .PLANNERS — LAND SURVEYORS BYE M' I N S89 WEST {MAIN S' EET :< CHKD.BY• /4eA15 r4-. j M4 SHEET..,,�,.QF� S+CA,LE 3Q QATE s �` ' CENTERVILLE, MIA. �263 = -- y No /F EI7'N--l� TJ/.E S�f�T/C TAN/rC OR 2O'FT.` M1/if !?iT ARE MORE f _ }�- _ _ �dQ�s�:�. GRA®�,�4 2�'O/AMET.E��' CoyG'RE•T.� COMER sci auf- ,+0' StdAI-1- ®.� ®ROUCaR7' TO 4l?ADeE.6AN FX7°-RA CONC-R&r PVc. P/P0 .. l,►E.4VY CAST IRON Co✓=R Sf/ALL L3�E USED' .�1. O Co/�E/�S M/N. P1TCH IF/N Z>R/✓—=JOVyl /��i9FRFY ali�er. C®NC.�e-l- E Ca AOE C®KE/4 CL EAA! .SA V O ' LJ49JIID LE1/FL s _ . D �• A z L YR , OF 1 SC1rEB�vL�� _ o 1/8' GAL e e e . . a e s e 1 d o� ydlASt/ED SAYE �^ #�Pd*�.,P°�: .�isaP�/� �e�/V'LK D/.S"1' o A 4 f• • . . s . ® 1 • ® o a ,� Day.. 314, WASNA P .ST®NE 1 • ® . ! Doe ! p o 0 s ♦sue® 1 e ®, 0 O . ® I I O p o 1 Ito Is g . E1��'A�"/®yS m a 1:o • e, d1V a ® o o FIT DR EyRl1r/�! o ,, ,r �` • 34.Z lntb✓E. 7' AT &VII-PAVC, 47.20 -Fr, f FT D/Al 1. !/�/.,`E7�' �7>/C T.4A!/t FY, F7: D/AM. C�sEC LII-A71®N> au rl-e7° SEPTlC 7�4A1/C F3: GROVAD 4FV,4TEIT 7AABLE /A1ZiFrPJSYR145&71ON BOX FT. .SEC7"!U/V OF Oc/T4e7-D157-.wa/T1oN BaX4SAC�l�F�* .S� AGE /Ss�dZ A.Lo SY.S'?"�/�'1 /hlL�7'.LEAC1�I14�Cr F'/T F�: ���d,/L.AT!®�1 AlU�•ld.Er� OFS�®1�0®/�9S � ®!ME/�S/AN �a_�_F�: �.•�Ro� ®/s�os�tL U14117 ,�/o1�E .SOIL: Z-00 TZ AL E.17114A -=D F'I- / �� U G.�3L.�0.�� cS0/L TEST I�/ SOl1. JP�STgd�`2 l A/UM �rQ OF L6'•�TCttlh/G P/7 ?J f`FtEI/�R• ,r-EX&r!/ Odd Te ®F SOIL TE57^ 51Z>.E A-OACHIA/G P5R P/Y ESQ. FP. RESULTS 1R/ITNE57S-P BYE CeA&-ail/ eor--o1W L�C.+I1NC p�R mil/ Sd F� TPt P1CRcoz ^�-rloN ieA7-0 Af! Z 1�1 411NCH 7-07AI. L,FOCN//Ylr AREA 40 Z stp rT. PWNCOLA7.1®N RAVE I'2 MliV1/IVC" \A OF MAssf�y �o PAUL. A. SChIE LEVY LEVY & ELDREDGE ASSOCIATES. INC. p ffa 10050 40 ��; j � t—( ?j�• Z, 8B9 WEST MAIN STREET CENTERVILLE,MASSACHUSETTS 02632 TOWN fOF BARNSTABLE LOCATIONA��,B�F' �/4 SEWAGE #SG" VILLAGEzyd�S /7i/� ASSESSOR'S MAP & LOT�Is �^p INSTALLER'S NAME Cz PHONE NO._jLef o C-\oSEPTIC TANK CAPACITY /3'a o i LEACHING PACILITY:(type) P fs (size) NO. OF BEDROOMS y PRIVATE WELL OR PUBLIC WATER �-BUILDER OR OWNER O DATE PERMIT ISSUED: 24Z� - DATE, .COUPLIANCE ISSUED: `i " `y - S 7 VARIANCE GRANTED: Yes No ✓� �7 3 lad q _ 4 Vv- YOU WISH TO OPEN A BUSINESS? 1�V For Your Information: Business certificates{co t$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town_(which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office,.151 FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) x DATE: f-vC� Fill in please: A, APPLICANT'S YOUR NAME; y-' . R BUSINESS YOQR HOME ADDRESS: 2Lvvl2 a OF MS.A� TELEPHONE # Home Telephone Number saF- y�0-5 rr3cl " sc'. NAME OF NEW BUSINESS a a can TYPE OF BUSINESS a S IS THIS A HOME OCCUPATION? YE _NO Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS �36 t�gyri-91 lookc- L �Z-ap, MAP/PARCEL N.UMB.ER When starting a new business thero are several things you must do in order to.be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. —(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1 BUILDING Cdivid OM NER'S OFFI E This in I ha e n ice. ed f ny permit requirements that pertain to this type of business. Au horize ature' COMMEN S: ' /-f Ve-On,, hd"yy _,,4 C Q2. BOARD OF HEALTH This individual has be nformed of the mit re ements that pertain to this type of business. 2 77,zed Sign ur /� COMMENTS: al C(/ c--l/ 1 01 3. CONSUMER AFFAIMCENSING AUT ORITY) This individual ed oft licsing'r quirements that pertain to thistype ofbusiness. natu COMMENTS: c� 3q 63 7,) 33 Date: 3 `/a /•/A?COG TOWN OF BARNSTABLE - TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: °' BUSINESS LOCATION: INVENTORY MAILING ADDRESS: -8'0 aE jw p � Qc L 2oagj TOTAL AMOUNT- TELEPHONE NUMBER: ME- 4w3- �i-i9j!j CONTACT PERSON: rr�L ` k 2 EMERGENCY CONTACT TELEPHONE NUMBER��-8-el'20 90A- MSDS ON SITE? TYPE OF BUSINESS: La�ndlS�Q�� INFORMATION/RECOMMENDATIONS: Fire District: 7o- tk ---A - Waste Transportation: Last shipment of hazardous_waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) LIA _. Misc. Corrosive NEW USED Cesspool cleaners NA Automatic transmission fluid MA Disinfectants Engine and radiator flushes Road Salts (Halite) g Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink A Degreasers for driveways &garages Wood preservatives (creosote) A Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries N Lye or caustic soda Rustproofers Misc. Combustible A. Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, NA Lacquer thinners L (inc. carbon tetrachloride) NEW USED �1' - - Any other products with "poison" labels NA Paint &varnish removers, deglossers (including chloroform, formaldehyde, j Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Q Laundry soil & stain removers (including bleach) OA Spot removers & cleaning fluids (dry cleaners) 6a Other cleaning solvents PA Bug and tar removers Windshield wash /Deg-e—ICIL WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINE APPLICATION "')R PEkCOLATION TEST A14D OBSERVATIO14 PITS •)CATION CAMELOT r[IP 14 NO. "�}7 a,4- ILLAGE MarGtons Mi11q DATE 85 = --- i'PLICANT Cedar ACres Egaltvym_r_ust DDRESS TELEPHONE NO. 9.F3.R51 n (Non-refundable) 25 Great Pond nr_ Sn_ Yarmnt�t h� Ma :]GINEER FOG ATE SCHEDULEDA si ature) O • 4n • �. p • • • O • O • O O O • • • • • • p • • • • • O • • • • • • • • • p • p • • • O O •SOIL / Q ,JB-DIVISION NAME CAMELOT DATE %l �¢ (Uj� TIME :PANSION AREA: YES X NO _ � ItJVNGINEER )WN WATER X PRIVATE WELL BOARD OF HEALTH JJQ2 EXCAVATOR ::ETCH: (Street name, etc• ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes ) NOTES: 10 UO i. gU 1944 WIZI . Ay, ' .emu ':RCOLATION RATE: a van w c Fl flex> HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 2 -- --- 2 _ 3 3 - 4 -- 4 - — - 5 5 _ 6 6 - - - 7 J?% ' i7 7 - -- - 8 8 11 11 _.-- 12 I---- 12 _ 13 -- -- 4w zv✓zJ 13 -___- 14 14 15 _ 15 - 16 _ _ _ 16 ]ITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS_Z LEACHING TRENCHES ]SUITABLE FOR SUB-SURFACE SEWAGE. REASONS : )TE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON. PERC TEST APPLICATION !'.IGINAL: COMPLETED IN ENTTRFTY BY P . F . AND RETURNED TO BOARD OF HEALTH IPY: RETAI14FD BY APPLICAN,r Date: aw 1 ta, TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: 0rd -i BUSINESS LOCATION: ; - . MAILINGADDRESS: ,s ns Mail To: TELEPHONE NUMBER: 50R- Board of Health ��O-�,��� Town of Barnstable CONTACT PERSON: 150. i P.O. Box 534 EMERGENCY CONTACT TELEPHONE N BER: _r)QF, -11(0 ISS Hyannis, MA 02601 TYPEOFBUSINESS: (,QId eA112 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES X _ NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants 5 Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) &soline, f- Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ' NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar 1 hs Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS y- • oft �® BORTOLOTTI CONSTRUCTION,INC. 765 WAKEBY ROAD,MARSTONS MILLS,MA 02648 508-771-9399 508428-8926 FAX: 508428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 64t, . Date of Inspection; Inspector's Name: er's Name arld Address: CYRT[FICA TION STAT MFNT I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true,accurate and complete as of the time of inspection. The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal,systems. The System: 1/ Passes Conditionally Passes Needs Further Ev aa ' n By oval Aproving Authority Fails .. Inspector's Signature: �� Date: The System Inspectof shall submit a copy of this inspection report to the Approving authority within thir- ty(30)days of completing this inspection. If the system is a shared system or has a design ow of 10,000 gpd or greater. the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. IN�TION SUMMARY: A)SYS') 1VI PASSES: 10 I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CIIR 15.303. Any failure criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system,upon comple- tion of the replacement or repair, passes inspection. Indicate yes,nor,or not determined(Y,N,OR ND). Describe basis of determination in all instances. If not determined",explain why not.' The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing sep- tic tank pis replaced with a conforming septic tank as approved by The Board of Health. Sewage backkup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of The Board of Health): -1 �A' x•` SUBSURFACE SEWAGE_ DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of The Board of Health): Broken pipe(s)are replaced Obstruction is removed C)FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 Feet of a surface water Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh. 2)SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: 'The system has a septic tank and soil absorption system and is within 100 Feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D)SYSTEM FAE S: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this.determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invertAu"e to an overloaded or clog- ged SAS or,cesspool: }E a f•s ., .,, 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 -2- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 Feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well: Any portion of a cesspool or privy is within 50 Feet of a private water supply well. Any portion of a cesspool or privy is less than 100 Feet but greater than 50 Feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: - The system is within 400 Feet of a surface drinking water supply. The system is within 200 Feet of a tributary to a surface drinking water supply The system is located in a nitrogen sensitive area Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well. The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Check if the following have been done: y ✓ Pumping information was requested of the owner,occupant,and Board of Health. _None of the system components have been pumped for atleast two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _y/__As-built plans have been obtained and examined. Note if they are not available with N/A. --kLThe facility or dwelling was inspected for signs of sewage back-up. _The system does not receive non-sanitary or industrial waste flow. _The site was inspected for signs of breakout. JLAll system components,excluding the Soil Absorption System, have been located on site. ✓ The septic tank manholes were uncovered,opened,and the interior of the septic tank*as in- spected for condition of baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge,depth of scum. The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods.'' -3- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM PART,B' CHECKLIST(continued) ✓The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART C SYSTEM INFORMATION FLOW CONDITIONS Design Flow: qq0 2allons Number of Bedrooms: 7 Nu ber of Current Residents: Garbage Grinder: Laundry Connected To System: Seasonal Use:&30 Water Meter Readings,if ailable: Last Date of Occupancy: —,,\\ COMMERCLAIANDUSTRIAt._ /01) Type of Establishment: Design Flow: gallons/day' Grease Trap Present: (yes or no) Industrial Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings, If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENERAL INFORMATION ' PUMPING RECORDS and source of information: System Pumped as part of inspection: If yes,volum amped: gallons Reason for pumping: TE OF SYSTEM: _ Septic,Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,attach previous inspection records, if any) Other(explain): AP P$0 TE AGE of all components,date installed(if known)and source of'information: ; Sewag ors detected when arriving.at'the"site: a- _ _4 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) y o SEPTIC TANK: p�� Depth below grade: Material of Construction: concrete metal FRP Other (explain) — Dimisions: o 'x 9-' Sludge Depth: �7 ' Scum Thickness: Distance from top of sludge to bottom of outlet tee or baffle: /y Distance from bottom of scum to bottom of outlet tee or baffle: e Dt� JT Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation f9 outlet invert, structural integ ' ,evidence of leakage,etc. / d P All GREASE TRAP: 4 )d ' Depth Below Grade: Material of Construction: concrete metal FRP Other (explain) — — -- — Dimensions: Scum Thickness: Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees orbaffles,depth of ligtnd level in relation to outlet invert, structural intebrity;evidence of leakage, etc.) TIGHT OR HOLDING TANK: Depth Below Grade: Material of Construction:_concrete_metal_FRP—Other(explain) Dimensions: Capacitv: Uallons Design Flow- gallons/day Alarm Level: Comments: (condition of inlet tee. condition of alarm and float switches. etc.) t DISTRIBUTION BOX: Depth of liquid level above outlet invert:_��1Zd Comments: (note if level and distribution is equal, eviden of solids carryover, evidence of leakage into or out f box,etc.) _ / a PUMP CHAMBER:- w E. T r Pump is in working order:...- Comments: (note condition of pump chamber,condition of pumps and appurtenances, etc.) ' -5 -SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) SOIL ABSORPTION SYSTEM(SAS): V-' (Locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: Leaching pits,number:,,. Leaching chambers, number: Leaching galleries,number: Leaching trenches,number, length: Leaching fields,number,dimensions: Overflow cesspool,number: Comments: (note con 'lion of soil,signs of hydraulic failure level of Nnding,condition of vegetation, etc.) ,4�x 1 A &ZM c6_1 CESSPOOLS: Vo Y �, 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: f Inflow(cesspool must be pumped as part of inspection) 0 Comments: (note condition of soilk, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) PRIVY:�� Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.) -6- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. DEPTH TO GROUNDWATER: Depth to groundwater: Z 3 Feeta Me od of Determination or Approximation: /41901nXfi'�x�� 47 -7- '��. -.. '• �sir`.�".r,* Town of Barnstable P# 3 Departinent of Regulatory Services MAM� Public Health Division tfo h 200 Main Street,Hyannis MA 02601 Date Date Scheduled— r Time _ ---/D _ Fee Pd. l�� Soil Suitabili Assessment or Sewa a f L .f ¢e Performed By: V�G� l t'1� �..�(`�U asposal Witnessed By: �C LOCATION& GENERAL INFORMATION Fadonddress 3 U I nn CA`h e l J�� KC� Owner's Name - 2''�•PY, 1M�i sae �' M�'ll f Address Assessor's Map/Parcel: 06 V - 0_5 Engineer's Name NEW CONSTRUCTION REPAIR �C Telephone# Land Use Res I dent l / Slopes(�o) o- 3 `f b Distances from: Open Water Body0 Surface Stones Q >-----__ft Possible Wet Area >�OU -�__ft Drinking water Well >�_ft Drainage Way 04 ft Property Line 7 /0 -- -_ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes& rc test s,ts,locate wetlands in proximity to holes) Parent material(geologic) IoLd W qS Depth to Bedrock rV o yl Depth to Groundwater. Standing Water in Hole: 0 VI Q Weeping from Pit Fpee N U YI P Estimated Seasonal High Groundwater > 13.1 Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE oIf A- Olose,�ibtu;n Depth Observed standing in obs.hole: 7 13 2 Depth to loll mottles: >i 3 2 Depth to weeping from side of obs.hole-;ell t 3 2 in.liidex'Wi I# - Reading Date: '" level - In' clroulldwaterAdJustment ft. - Adj.factor�.. -.� Adj..Groundwater Level -e FHole# . PERCOLAT�ON'X' +'�"�' batp IS I Thne LOOo.2 A Time at 9"eptof Perc Time at 6" Start Pre-soak Time @ � tsQ:30 Time(9"-61t) , End Pre-soak Rate lvlin✓Inch NJ I n Site Suitability Assessment: Site Passed A/ — _ - Site Failed: Additional Testing Needed(Y/N) /v Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***Ifpercolation testis to be conducted within 100) of wetland,you must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:ISEPTICIPERCFORM.DOC L- DEEROBSERVATIONBOLE LO G Depth from Soil Horizon Hole# J Surface(in.) 5oi1 Texture ,Soil Colc rr S — (USDA) oil (Munsel.1) MottlingU� Fl I I Other ts r (Structure, tg es ravouplders.i to e 6._ 10 1.5 1003 a Nbn 3 M-c Sa �.S Y`1I y nJvn R as �Y �3a c•3 0?.SY613 Alo t DEEP OBSERVATION HOLE LOG Depth from Soil Horizon �go]e# a Surface(in.) Soil Texture Soil Color' (USDA) Soil Other (Mansell) Mottling (Structure,Stones,Boulders, ��ld rl 1 �. — onsis en 9ti ravel w-16 LS 16_3a to 93 a L,S 3a; 7a c S W-96 c� a.sy.y 3 A�o✓l e 63 a.ry�/3 /vel DEEP OBSER Depth from VATION ROLE LOG Hole# Soil Horizon Surface(in.) Soil Texture Sol]Color Soil Other (USDA) (Munsell) Mottling (Structure, ones,Boulders. e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture ' Surface(in.) Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,Stones;Boulders, C i to Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes - - 'Within 500 year boundary - ]vo x, Yes Within 100 year flood boundary No. X Yes D_ enth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? e If not,what is the depth of naturally occurring pervious material? _, Certification ' I certify that on �003 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection.and that the above analysis.was.performed by me consistent with . the required training,ex a tise experi nce described in 310 CMR'15.017. Signature g Si � Date Q:VWT]t1PERCFORM.DOC 4"SCHEDULE 40 PVC MIN.SLOPE 1 % FINISHED GRADE OVER BIODIFFUSERS= 108,0' - 10$,9' GENERAL NOTES T.O.F. EL.= 111.4'± PROVIDE EXTENSION RISER WITH INISH GRADE OVER D-BOX= 108.9 " SLOPE @ 2% MIN. CONCRETE COVER TO WITHIN 6"OF INSPECTION PORT WITH 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OVER INLET&OUTLET REMOVABLE WATER-TIGHT COVER OVER ACCESS BOX TO WITHINACCORDANCE RISER TO WITHIN 6"OF FINISHED GRADE 3"OF F.G. (ONE PER ROW) CODE AND ANY APPLICABLELOCAL RULES.1TITLE 5 OF THE STATE ENVIRONMENTAL',- @ FND. EL.= 1 10.0'± F.G. OVER TANK EL. = 109,rj± 5 DlA. OUTLET(S) 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE FINISH GRADE.. " IDESIGN ENGINEER. 9" IN. PROP. 1.2'WIDE H-20 PROPOSED 4" 9"MIN. 36"MAX. TOP OF SAS/B.O. = 105.93' COUPLING(TYP OF 4) 3• 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL EXISTING 4' PVC SEWER PIPE 36 MAX. SYSTEM UNLESS OTHERWISE NOTED. SEWER PIPE 4. TO PREVENT BREAKOUT THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN �-1 „ _ PROVIDE WATERTIGHT ELEVATION _ ' 6 3 3 DROP MAX 1.33 16„ 40 MIL GEOMEMBRANE LNERISS PLACE AT LEASOT F VE FEET PERIMETER SEAS.AND THE TOP OF UNLESS A „ „ F 9„ L - 13# 2 DROP MIN Mw.s�ore�,% JOINTS(TYP.) 4"PVC IN FROM Q 10" „ (TYP.) „ THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 14" *107.4'± SEPTIC TANK 4 ;PVC OUT TO 0.90, 10.75 (TYP) • LEACHING FACILITY + 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. " " 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. CONTRACTOR CONTRACTOR SHALL 12 6 105.50' -104.60' (laid flat) 2.87 6(34.5")_- OUTLET TEE 106.67 MIN. 106.50 ((TYP-) 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK SHALL VERIFY SIZE 48" VERIFY CONDITION OF 5.0' AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE (TYP.) 5'MIN. 11.5' FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY REQ'D NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 31.2 AND DESIGN ENGINEER. 5 (TYP.) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 110.00' OUTLET DISTRIBUTION BOX ESTABLISHED ON A NAIL SET IN AN OAK TREE AS SHOWN ON PLAN. TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV= < 97.50 BIODIFFUSERS (END VIEW) BASE. FIRST TWO FEET OF OUTLET 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1,500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. BIODIFFUSERS (PROFILE) THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT (BY ADVANCED DRAINAGE SYSTEMS, INC.) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES cRoss SECTION vlEw ARC 36HC #3616BD BIODIFFUSERS rH-201 TO THE DESIGN ENGINEER. �! SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL ` / 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC.STRUCTURES SHALL BE MADE WATERTIGHT. '`CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR NOT TO SCALE TO ANY WORK& NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE T j 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING PIT 1 PA TA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM #30 TEST 133243 T/a APPROPRIATE AUTHORITY. O • '' PERC NO. EX\S EXISTING II INSPECTOR: David W Stanton, R.S. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS SNEO HC-1 4-BEDROOM LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE DWELLING 9 EVALUATOR: Bradley M. Bertolo, E.I.T. ° TOF =111.4'± THEY SHALL WITHSTAND H-20 LOADING. �. C.S.E.APPROVAL DATE: Jul 2003 y EXIST. ZONE 2 �j �._ 3. B WASHED CRUSHED STONE SHALL BE FREE O L DIRT, DUST AND FINES. DECK DATE: April 15,2011 1 DOUBLE WAS SHED F AL TEST PIT#: 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE MATERIAL IN AREA BENEATH AND FOR 5 FT.ON ALL SIDES OF LEACHING FACILITY. 4) ELEV TOP= 108.50' 1 ;O REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, ELEV WATER= <97.50 FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). 29`L HC-2 / LOCUS 1 PERC RATE_ 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN (3 :.fit SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. w t 16. PROPOSED PROJECT IS LOCATED WITHIN: DEPTH OF PERC= _ 3�2 TEXTURAL CLASS: 1 ASSESSOR'S MAP 64 PARCEL 105 0° OWNER OF RECORD: MICHAEL J. &LISA RILEY 2) ADDRESS: 30 CAMELBACK ROAD 0„ Fill 10$.50' MILLS, MA 02648 MARSTONS z 108.00 6" a Loamy Sand A U 10" 107.67' FEMA FLOOD ZONE C 10Yr 3/2 �. SWING-TIES SCALE: 1"=20' ; .� z Sa6nd L 10Yr COMMUNITY PANEL 17. DEED REFERENCE: 388 i REN L.C.C.0 16 DESCRIPTION HC-1 HC-2 = /' Ulf 105.67' 18. PLAN REFERENCE: L.C. PLAN#37712-B(SHEET 4) E OF-P4VEMENr BIODIFFUSER CORNER(1) 45.2' 41.1' * C-1 Sandy Loam BIODIFFUSER CORNER(2) 54.4' 50.T . # 2.5Y 4/3 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. j gp^ 103.50 j a 70. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE THIS PLAN IS TO BE USED ONLY BIODIFFUSER CORNER 3 45.7 71.4 , £ _ O q,.., T A J9�7Pc ANY L1ABILITY FOR SEPTIC SYSTEM UPGRADE. JC1=NG1N7:ERi13�WILL S5\ �' rh � ;; ;, s,,,• .; _ � Medium-Coarse Sa�itl w - , �� � BIODIFFUSER CORNER(4) 34.3' 64.9' i C-2 4 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. MAP 64 \ o \ �� -- �: (200o gravel) 1 0 � • ' �a °1 PARCEL 105 \ O� 84" 101.50 23,892 S.F.t O �9 Ot ' 0 Medium Sand I 90 LOCUS PLAN C-3 2.5Y 6/3 MAP 64 f �� (loose) SCALE: 1"= 1000' PARCEL 98 132" 97.50' o� 7 No Mottling, 9 9 j Standing or Weeping Observed TEST PIT DATA LEGEND DESIGN DATA PERC NO. 13243 j 50xO EXISTING SPOT GRADE BPS o 0 �� INSPECTOR: David W.Stanton, R.S. j #30 3 o "' \� - - 50 - - EXISTING CONTOUR EXISTING f �Ps O `� ) EVALUATOR: Bradley M.Bertolo, E.I.T. 4-BEDROOM \ NUMBER OF BEDROOMS (DESIGN) 4 50 PROPOSED SPOT GRADE ' C.S.E.APPROVAL DATE July 2003 DWELLING \ DESIGN FLOW 110 GAUDAY/BEDROOM TOW =DWELLING � DATE: April 15,2011 50 PROPOSED CONTOUR �108` \ TOTAL DESIGN FLOW ° 440 880 GAUDAY TEST PIT#: 2 ' \ EXIST. ` DESIGN FLOW X 200 /o = GAL/DAY E/T/C EXISTING UNDERGROUND UTILITIES TP 1 DECK ELEV TOP= 109.50' / 70�� ✓ ( 108.5' \ �s USE EXISTING 1,500 GALLON SEPTIC TANK ELEV WATER= <99.50' W EXISTING WATER LINE TRF LP OO �' �- �, PERC RATE_ <2min./inch GAS EXISTING GAS LINE o / ° INSTALL 24 - ARC 36HC (#3616BD) BIODIFFUSERS (H-20) DEPTH OF PERC so"-96" TEST PIT LOCATION REMOVE ALL UNSUITABLE C MATERIAL DOWN TO"C-2"SOIL& TEXTURAL CLASS: 1 REPLACE WITH CLEAN COARSE ti .' / 1 TP 2 SYSTEM CAPACITY LP (TOTAL L.F. OF BIO'S&COUPLINGS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)=GPD Q Q Q EXISTING 1,500 GALLON SEPTIC TANK SAND PER 310 CMR 15.255(3) <o t / 10 .5' , (124.8)(4.8 SF/LF)(0.74 GAUSQ.FT.)= 443.3 GAL. LEACHING/DAY 0" 109.50' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE PROPOSED 1.2'WIDE H-20 COUPLING (TYP OF 4) <iti� EXIST. \ / ir' Fill 10" 108.67' PROPOSED DISTRIBUTION BOX GARDEN � �� PROPOSED INSPECTION PORT WITH _ TOTALS: A Loamy Sand El ACCESS BOX TO GRADE(TYP OF 4) / TOTAL NUMBER OF BIODIFFUSERS: 24 16„ 10Yr 3/2 108.17' [� PROPOSED ARC 36HC(#3616BD)BIODIFFUSER(H-20) TOTAL LEACHING AREA: 599.0 B Loamy 10Yr 5/6 d O PROPOSED ARC 36HC 1.2'WIDE H-20 COUPLING (H-20) PROPOSED TOTAL 24 ARC 36HC(#3616BD)H-20 , ! TOTAL NUMBER OF COUPLINGS: 4 Benchmark t � FIELD CONFIGURATION cn o \- , BIODIFFUSERS IN A F Nail in Oak Tree o ,� TOTAL LEACHING CAPACITY: 443.3 32" 106.83 Elev. = 110.00' r REV. DATE BY APP'D. DESCRIPTION Approx. M.S.L. \ � C-1 Sandy Loam NOTE: 2.5Y4/3 PROPOSED SEPTIC SYSTEM UPGRADE PROPOSED DISTRIBUTION BOX EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE 72" 103.50' PREPARED FOR: DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER Medium-Coarse Sand EXIST. LEACHING PIT TO "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO ADVANCED C 80„ 2.5Y 4/4 102.83' CAPEWIDE ENTERPRISES BE PUMPED AND FILLED S64,S / DRAINAGE SYSTEMS, INC. ON OCTOBER 3,2003 (LAST MODIFIED 3 1 F C o0 / JANUARY 11,2011 TRANSMITTAL NUMBER=W000052. P 96„ `; (20%gravel) 101.50' &ABANDONED(TYP OF w/CLEAN, COARSE D 23 OS p ) LOCATED AT / 30 CAMELBACK ROAD NOTES: EXIST. 1,500 GAL. SEPTIC TANK C-3 2.5Y613 MARSTONS MILLS, MA 02648 TO BE UTILIZED IN THIS DESIGN Medium Sand (loose) 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF MAP 64 ( SCALE: 1 INCH = 20 FT. DATE: APRIL 25,2011 120" 99.50' 0 10 20 40 80 FEET EACH SEPTIC SYSTEM COMPONENT. PARCEL 104 t No Mottling, Standing or Weeping Observed CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF of Mass ��,P`�� ActiGs PREPARED BY: 2 ) THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST RESERVED FOR BOARD of HEALTH USE � �pNN�• `�� JC ENGINEERING, INC. PIT DATA SHOWN ON THI S PLAN. REPORT TO ENGINEER AND LOCAL c " JR 2854 CRANBERRY HIGHWAY BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. �a A �a EAST WAREHAM, MA 02538 508.273.0377 F li 3.) LOCUS PROPERTY IS LOCATED WITHIN THE WELLHEAD PROTECTION SITE PLAN Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.1975 ' OVERLAY DISTRICT AND THE ESTUARINE WATERSHEDS. SCALE: 1"=20' • - - --- -- 1