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HomeMy WebLinkAbout0019 CAPTAIN BAKER ROAD - Health CAPTAIN BAKER ROA J �MARSTONS MILLS _039 No. 4210 1/3 YEL ESSELTE „ J " 10% O ® ® O ���a�� 5 7 ' Commonwealth of Massachusetts ` Executive of Environmental Affairsr 0 F� DEP 90 Department of .11'L161 Environmental Protection SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - - PART A CERTIFICATION /0 d Apr Z 4*a4. PARCELNO: Property Address: Jkx` V5��t� , Address of Owner. (if different) D ate of I nspection: Name of Inspector: Michael DeDecko Company Name, Address and Telephone number: Atlantic Environmental P.o Box 2384 - Mashpee Ma 02649. Tel: (508) 4771420 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection . The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. The system ---- Passes ---- Conditionally Passes -�Needs'further evaluation by the local Approving Authority Inspector 's Signature: t L/ Date: I1 The system Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or 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 or the Department of Environmental Protection. The original should be sent to the system owner and copy sent to the buyer, if applicable and the approving authority. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 32r z Owners : sPr.-;r-os Date of Inspection : INSPECTION SUMMARY: Check A, B. C,or D A)SYSTEM PASSES: ---- I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CM 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 completion of the replacement or repair, passes inspection. Indicate yes, no, or not determinate (Y,N, or ND). Describe basis of determination in all instances. If "not determinated",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 septic tank is replaced with a conforming septic tank as approved by the Board of Health. ---- Sewage backup 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). ----- broken pipe(s) are 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 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address : 32 Cp--- vT Owner : Date of Inspection : r� L` to C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: — .Conditions exist which require further evaluation by the Board of Health in order to de-- - termine if the system is failing to protect the public health ,safety and the environ- ment. 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 of water ---- Cesspool or privy is within 50 feet of a bordering vegetated wetland or a small marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNC- TIONING 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 within 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 analy- sis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate notrogen is equal to or less than 5 ppm. D)SYSTEM FAILS: Av 'Al 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 cor- rect the failure. 14 ackup of sewage into facility or system component due to an overloaded or rra cb%pd SAS or cesspool. 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 32 C;�% Owner: Date of Inspection : D) SYSTEM FAILS (continued) "�Tisaharge or ponding of effluent to the surface of the ground or surface ++paters "endue to an overloaded or clogged SAS or cesspool. •-- Static liquid level in the distribution box above outlet invert due to an over= loaded or clogged SAS or cesspool. --- Liquid depth in cesspool is less than 6" below invert or available volume is less than 112 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation. --- Any portion of cesspool or privy is within 100 feet of a surface water supply ortributary 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 ana- lysis. 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. k• SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: '2 C-t_vr %f vA rL- Owner: ,,,� Date of Inspection : E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above : The design flow of 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. Th e owner or operator of any such system shall bang the system and facility into full compli- ance 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. r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 32 Cc-4Ta004. t­ Owner: S� s Date of Inspection: Check if the following have been done : -x Pumping information was requested of the owner , occupant and Board of Health. --x None of the system components have been for at least two weeks pumped and the system has been receiving normal flow rates during the period. Large volumes of water have not been introduced into the system recently or as part of this inspection. --x As built plans have been obtained and examined. Note if they are not available with N/A. --x The facility or dwelling was inspected for signs of sewage back-up. --x The system does not receive non-sanitary or industrial waste flow. --x The site was inspected for signs of breakout. -x All system components, excluding the Soil Absorption System, have been y P 9 P y located on the site. ---x The septic tank manholes were uncovered, opened and the interior of the sep- tic tank was inspected for conditions of baffles or tees, material of construc- tion, dimensions,depth of liquid, depth of sludge, depth of scum. --x The size and location of the Soil Absorption System on the site has been deter- mined based on existing information or approximated by non-intrusive methods _x The facility owners and occupants if different from owner were provided with information on the proper maintenance of Subsurface Disposal System. I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 3Z C� f-7 Owner: ,,,�5 Date of Inspection: RESIDENTIAL: Design flow: 330, gallons Number of bedrooms Number of current residents: 02 Garbage grinder (yes or no) : t- c Laundry connected to system (yes or no): yc5 Seasonal use (yes or no) : t--xD Water meter readings, if available: Last date of occupancy : COMMERCIALANDUSTRIAL : Type of establishment: Design flow : gallons/day Grease trap present: (yes or no) Industrial waste holding tank present (yes or no) : Non-sanitary waste discharged to the Title 5 system (yes or no) : Water meter readings,if available : Last date of occupancy : Other: (Describe) ............................................................................................................ Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information : N2ccW �_ System pumped as part of inspection (yes or no) :.....NCB........ if yes, volume pomped : ..............:..... gallons Reason for pumping :................. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 3Z CQ.R- (IettA-t_�_ Owner: C,,,-r2�j Date of inspection: 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) -X 0 Cher (explain). .'+c.... u, �c. ..1 ... 4... .P. ................. APPROXIMATE AGE of all components, date installed (if known)and source of information . ............................................................................................ ................................................................................................................................................ ................................ Sewage odors detected when arriving at the site : (yes or no)...r�1p. SEPTIC TANK : ... (locate on site plan) Depth below grade: ...f ��. Material of construction: ..k.. concrete ......... metal........ FRP ........ other (explain) ................................................................................................................................................ Dimensions: Sludge depth :...'..�..`!...... Distance from top of sludge to bottom of outlet tee or baffle:.......:3!.................. Scum thickness :....A.'.'........... Distance from top of scum to top of outlet tee or baffle: i 0 `�....................................... Distance from bottom of scum to bottom of outlet tee or baffle :......1.0.'............. Comments : (recommendation for pumping ,condition of inlet and outlet tees or baffles, depth of liquid level' relation to outK in rt, struc leakage,tural integrity,evidence of leak etc.). , f.....: .. V.IlY.1 ..................... ............................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: ,z� Date of inspection: GREASE TRAP : ......0.0.... (locate on site plan) 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:....................................... Distance from bottom scum to bottom of outlet tee or baffle:............................... Comments: (Recommendation for pumping condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.)........................ TIGHT OR HOLDING TANKS:.....f :. (locate on site plan) Depth below grade:............... Material of construction:........concrete........metal.........FRP..........other (explain).......... 6.............................................................................................................................................. imensions:............................ Capacity:....................gallons Design flow:...............gaflons/day Alarm level:............................. Comments: (condition of inlet tee, condition of alarm and float switches, etc.) 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 3z c,--fT' Owner: N`ZS Date of inspection: DISTRIBUTION BOX:.1.40 (locate on site plan) Depth of liquid level above outlet invert:................... Comment: (note if level and distribution equal evidence of solids carryover, evidence of leakage into orout of box,etc.).................................................................................................................. .................................................................................................................................. .................................................................................................................................... PUMP CHAMBER:...N.�7... (locate on the site) Pumps in working order: (yes or no)............... Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.).................... ................................................................................................................................................ ................................................................................................................................................ SOIL ABSORPTION SYSTEM (SAS):...�C ...... (locate on site plan,if possible; excavation not(equied, but may be approximated by non- intrusive methods) if not determined to be present, explain: ................................................................................................................................................ .....................:.......................................................................................................................... leaching pits, number: .P%\ leaching chambers, number:........ leaching galleries, number:........... leaching trenches,number ,length:..................... leaching fields,number,dimensions:................... overflow cesspool, number:.......... Comments: (note ndition of soil ns hydraulic failure level of po ding, con iti {egetation etc. .. 1.�.. u . .m.S. . .. � . , !-'�-�.,..�� Q.l. .�.. . .. ...... ...fix r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property address: 32 C�4 &4 -e - Owner: Date of inspection: i 1 .i y hi. CESSPOOLS:....... (locate on site plan) Number and conficuration: .................................... Depth-top of liquid to inlet invert: ........................... Depth of solids layer: ............................................... Depth of scum layer: ............................................... Dimensions of cesspool: ...................... Materials of construction: ..................... Indicator of ground water: .................... inflow (cesspool must be pumped as part of inspection) ................................................................................................. ................................................................................................. Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) ................................................................................................................................................ ................................................................................................................................................ PRIVY: ......�(..�.... (locate on the site) Material of construction: ................................... Dimensions: ....................... Depth of solids: .....I........... Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.). ................................................................................................................................................ r SUBSURFACE SEWAGE DISPOSAL SYS TEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address : 32 Owner: V' tt-3 Date of inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate at wells within 100' n v DEPTH TO GROUNDWATER: Depth to groundwater: �AO..feet Method of determination or approximative: .......................................' ar,................................................................................................. .................... ...................................... ................................................................................................................................................ TOWN OFgBAIRNSTABLE 4 9 LOCATIONlo 4� SEWAGE# 01 VILLAGE 'V[ SO 'S MAP&PARCEL INSTALLER'S,NAME&PHONE NO. �i SEPTIC TANK CAPACITY � 4 LEACHING FACILITY:(typ ) (size) NO.OF BE ROOMS OWNER PERMIT DATE: It> COMPLIANCE DATE: J141D 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 w V& 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 IR ® . No. Dl�' 0 2- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppgicatiou for �Bi5po5al q§p5tem Con0truction permit Application for a Permit to Construct( ) Repair(Upgrade(Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No! jc% Cb,%01, � ��"gip O'w jer's Name,Address,and Tel.No. ,�pp Assessor's Map/.Parcel -®Vl t11 CA Installer's Name,Address,and Tel.No.A0047_ )(c#,Ar Designer's Name,Address and Tel. Type of Building: Dwelling No.of Bedrooms Lot Size ZA. sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) AALO gpd Design flow provided A;'A gpd Plan Date %.J Z Number of sheets Revision Date Title Size of.Septic Tank iob . Type of S.A.S. CIA/��—�►`Rr� ��� �'� Description of Soil ��sa& S®t(„��� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: ,------- The undersigned agrees to ensure the const n and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of t nvir al Code and not lace the system in operation until a Certificate of Compliance has been issued by this Board ofI. Signed Date !3' Application Approved by JQDate Application Disapproved by: Date for the following reasons Permit No. ,q10/ D 9 Date Issued -- 2 v ----- ----- No. ..2 D/() 19 �" ''`"yews _ �., Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ti 2pplication for Thgogar *pgtem Con0truction Permit Application for a Permit to Construct( ) Repair V Upgrade V Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. 'q GA�l�; � ✓.e.ZIP. OW W eL Name,Address,an`dKTe1t�No. r Assessor'sMap/Parcel �12�,� � Yt'�• Mr�I�S ?,,►^T&A4 Pd Installer's Name,Address,and Tel.No.*C"Kj �Xlf���Q�l� Designer's Name, ddress and Tel.No. Lr 4-2 Type of Building: _ p } Dwelling No.of Bedrooms Lot Size Z41 �`� sq. ft. Garbage Grinder ( ) Other Type.of Building No.of Persons 1 Showers( ) Cafeteria Other Fixtures Design Flow(min.required) AtAto gpd Design flow provided 4 S A gpd t Plan Date V—AA,-,l 'L(# . 1610 ,N/umber of sheets p Revision Date [ Title ' "='C�c G, 11`iOY.n[tA1�6- 11 At ..� _'Att \ CAr,-e �►1/ ' . ZP►, Size of.Septic Tank t th) Type of S.A.S. CAA AA--Ale—W_ -of'MlCA-A LN'k* Description of Soil _'C,t�.�%� t7L,Q, S 0%(..., Lou C, r Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and"R�a maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the�Enviirropme tal Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. / w Signed --"�- r Date /n g Application Approved bye/(� „_ ,L).Q I!n f. Date A f' Application Disapproved by: N Date for the following reasons Permit No. 0�y '��- Date Issued LlD r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ('I ) Upgraded ( ) Abandoned( )by at „Z/ �' AA• �� 5 has been constructed in accordance with the provisions��l'tle 5 and the for Dispo al System Construction Permit No. 2,01 Q- /§iL dated E�Ag I Instal er4� _ ,/ Designer , #bedrooms Approved design flow A/7 o r gpd The issuance oofithi(s`pe/rmit shall not be construed as a guarantee that the system will fun'c o/as/designed. e Date D I� I Inspector t �t/ 4 /a i 1 No. U�0 � ��- Fee /SV THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS &.5pogal 4p5tem Construction Vermit Permission is hereby granted to Construct ( ) Repair ( ) J Upgrade ( ) Abandon ( ) System located at 9 r t gg- tip r. +M. M and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Constr ction Pust be completed within three years of the date of this.peerrnib A, �S Date h )-K#0 Approved by r aVe r t/Q a�Ju��- 1uwer,� �nrl�prA �✓��e �� N-/o �`S � 1�n�ecf 08/27/2010 10:42 5084574444 FALMOUTH PRINTING PAGE 01 Town of Barnstable Regulatory Services Thomas F. Geller,Director Public Health Division Thomas McKean,Director 200 Main Street,ECyannis,MA 02601 Office:.50&862-4644 Fax: 508-790-6304 Installer&Designer Certiification Form Date: $ LLB l D Designer: Ad o Li Installer: 1 -- Address: , Address: 6 (Z$q On was issued a (date) (installer) permit to install a septic system at based on a design,drawn by (address) dated (designer) ' a c 'fy that-the septic system referenced above was installed substantially accordin t e design, winch may include minor approved-changes such as later relocation of the Stiibution box and/or septic tank. I certii�Cd at the septic system referenced above was ins • a ��' ' changes'(i:e, greater t =n 0' lateral reloea4bn-of the SASS or-any.veW.cal'it�1'bo ion-of any compoaeipf• of the•septie"��ystem)but in aoeordaace with State &I+.ocal;itegti�ations. 1'�lan revisign of cued as-biltby er follow. � AAA 1' � 4 Vt OF Mas��� ' y3► ,'bgVID S Ignatnre) S- G STEPHEN �49ASON Cn N&M6B' D3 v A ,o SgN!TAR%P�! ` (D er s Signature) '` Aexc �• P. ) c T S LI. rrEAir D IO R B :'CCz -Nd UED'� T C. TE 'i�4 STAGE P D Q:HoaltUSepticlDesigr�erCerlification Form �:S•:;i,!. � `' r 1 • E . Ao\-, G>5 >✓� Town ofyBarnstable P`# $ Department of Regulatory Services xg tt c.:s Y Y.. w. '• ii.►>stvssisr Public Health:Di<vision Date �- 1 10> MAB3_: 200 Mam>Street,Hyannis MA,02601 �> 4 Date Scheduled Time Fee Pd Soil`Suita'bi�'ity Assessment for Sewage sposal Performed By:_ 5 Y� 11 t 1i� 1—1�? Witnessed By:` nS LOCATION& GENERAL INFORMATIO Location Address ` Owner +4i"waa r.4 a'.✓�'a-s i gY"t ,�I/ flw:r'» � v+ __' dCIMS Assessor,'s Map/Parcel yl.(9 6 Engineer's Name J NEW CONSTRUCTION REPAIR Telephone# Ladd�Use f=�f✓ ri L f '�( t Slopes.(9h) � Surface Stones w x Distances from: Open Water Body G l}/ ft Possible.Wet Area!�1-00-ft Drinking Water Well �nio ft Drainage Way ft Property Line - ' [eft Other ft SKETCH'(Street name,dimensions of lot, locations of test holes&pert tests,locate wetlands In proxim,ty to holes), O' Z �t (- C)` 7: �s ., 0 s 'ht ° a -`' r Parent material(geologic) t_ Depth to Bedrock Depth to Groundwater.Standing Water in Hole: Weeping from Pit Ree Estimated Seasonaf High Groundwater ... DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: A�A Depth Observed standing in obs.hole: — in, Depth to soil mottlm: Depth to weeping from side of obs hole: in., Orisundwater Adauritinenk fr. Index Well# Reading Date: Index Well'levei____��,._., AdJ. ctor AdJ.C3rtaundwnterhevet 'PERCOLATION TEST . D to i-� } Thne. t Observation Hole# Time at V. 7.777777 Depth of,Perc Time aN 6' Start Pre-soak Time @ �D/ (� �+�.: '15me(9"6„) End Pre-soak {-i`: y i l`•.l$ Vt-?ti%S Loks Rate Min.Anch Site Suitability Assessment: S' sled Site Failed Add itional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed_on Back - ***If percolation test is to be conducted within 1001,of wetland,you mast first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:ISEPTICIPERCFORM.DOC . DEEROBSERVATION HOLE LOG Hole# t. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. ConsktencV. Gravel)— L el ,.) t^S to`�2 q rnc`ZJp� DEEP OBSERVATION HOLE LOG Bole# Z Depth from Soil Horizon Soil Texture Soil Color Soil - Other Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones,Boulders. ri ' enc %Gravel) • 1GS�!�i. ,,,I . L. D •- t DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Can ' e c G vel E= DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color 8 11 Other Surface(in.) (USDA) (Munsell) Mottling (structure,Stones;,Boulders. Cons' en 4� L. lv 3 � tit ✓ " �D ` t� � ------------------- Flood Insurance Rate Man: 2 Above 500 year flood boundary No Yes Within 500 year boundary No Yes,.. within 100xyear flood boundary No. Yes Depth of Naturally Occurrine Pervious Material Does at least four feet of naturally occurring pervio material exist in all'areas observed throughout the area proposed for the soil absorption system? If:not,what is the depth of naturally occurring pe ious material? Certifiication I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environ ental Protection and that the above analysis was:performed by me consistent with the required`training,expe tise and"experience described in 310 CMR 15.017. Signature Date Q-. EPTICIPERCFORM.DOC :Towtn of Barnstable P# Department of Regulatory Services Public Health:Division Date, n-� r6�9 200 Main�Street,Hyannis MA,02601 '°lfD MA't A Date Scheduled o� +�.~ Time 01fil Fee Pd. PP Soil`Suitdhifi Assessment or Sew a is osal �3' .f, Performed By:_ s�1�% 11 t�i 1� i� 1��i : Witnessed By: LOCATION&GENERAL INFORMATIO N Location Add �i ress 1 rA.l�1: �b. i 11P er s s �� � j Own ame z:. Assessor's Map/Parcel ~l.(� b ,` Engineer's Name ti NEW CONSTRUCTION REPAIR Telephone# Landltlse f-. %i L E 't�l •��'4� Slopes(�Yo) ,Sutface.Stones Distances from: Open Water.Body }/ ft 'Possible Wet Area r ft Drinking Water Well }ly ft Drainage Way ft Property Une _ft `,Other ft SKETCH:(Street name,dimensions of I6G locations of test holes&perdtests,locate wetlands in proximity to holes), c1 \ 71 M Parent material l De th to Bedrock (geologic) P Depth to Groundwater Standing Water Hole: l!`� Weeping from Pit Page in Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER FABLE Method Used: Depth Observed standing in obs..hole: —_ __ in, Depth to soil mottles: in. Depth to weeging from side.of obs hole: itt ©rnundwateeAd�ustinent ft. Index Well# Reading Date: Index Well levci -- Adj..h for, AdJ.Gt^auitdwaier hevel.- PERCOLATION TESL'. Dgte i Thne t Observation Hole# Time at 9" i Depth of.Perc _` Time ttt ti' Start Pre-soak Time @ :O i] - .� ��+ : Time.(V V) 77777 End Pre-soak' Vt`N4w isLlk Rate Min./Inch '�'' LCGi , Site Suitability Assessment: S' as"sed Site,Failed ,,.Additional TesUpg Needed(Y/N) Original: Public Health Division 0liservation Hole Data To Be Completed-,on Back -- ***If percolation testis to be conducted within 100' of wetland,you must first notify the Barnstable Conselrvation Division at Least one(1) week prior to beginning. Q:\.SEPTICVERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# - Depth from . Soil Horizon Soil Texture Soil;Color Soil Other Surface On) (USDA) (Munsell). Mottling: (Structure,Stones;Boulders. Coi�kten6v.% ravel 51.E Iocf:C. 3 k"'t'Ao rift i✓ .. y 2, - . y DEEP` BSERVATION HOLE LOG Hole# Z Depth from Soil.Horizon Soil Texture Soifcolor. Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. . Consistencv.%Gravel) 1 DEEP OBSERVATION HOLE I,'OG .Hole# 3 Depth from Soil Horizon Soil Texture Soil Color :Soil % Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders: Con ' e Gravel) tS•--w -S �° tZ-� `Z (/ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon_ Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Munselq Mottling (Structure,Stones;Boulders. Co s' 0� �— to 3 Flood Insurance:Rate Man: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes. within loo year flood boundary No,�.� Yes Depth of Naturally Occurring Pervious Material Does.at least four feet of naturally occurring pervio nlatertal exist m all'areas observed throughout the area proposed for the soil absorption system? If:not;what is the'depth of naturally occurring pe ious material? Certifiication . I certify that on r (date}.I have passed the soil evaluator examinarion approved by the Department of Environ ental Protection and that the above analysis was'performed by.me consistent with : the required`training,expe 'se and experience described in 310.CMR 15.017: Signature Date Q:\SBPTICTERCF0RM.D0C Commonwealth of Massachusettsto 0 awl a° . Executive Office of Environmental Affairs ,`- Department of Environmental Protection Nov 5 Wpllam F.Weld P<Trudy Cox* Gotwtnor '4w` "`8-"A-V Argw Paul Celluccl ti David B.Struhs. LJ.tiorrtrtor � GommlNbent' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A - J� C/9 CERTIFICATION �F- Baker Rd. property Address; Mars tons Mills Address of Owner. Date of Inspection: //—/" ei cr (If different) Edmund Santos Name of Inspector. W.E. Robinson SR Company Name,Address and Telephone Number. ( 5 0 8 ) 7 7 5-8 7 7 6 W.E. Robinson Septic Service P.O. Box 1089 Centerville MA CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: 4,4es _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority Fails Inspector's Signature: e�l(j `� Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or 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 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. INSPECTION SUMMARY: Check A,B,C,or D: A] SYS PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 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 completion of the replacement or repair,pastes inspection. Indies yes, no,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 septic tank is replaced with a Fonforming septic tank as approved by the Board of Health. (r vised 11/03/95) 1 One Winter Street is Boston,Massachusetts 02106 * FAX(617)556.1049 a Telephone(617)292-5500 ' i Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 32 Captain Baker Rd. , Marstons Mills Owner. Edmund Santos Date of Inspection: ��,_�_9 / B]SYSTEM CONDITIONALLY PASSES ES (continued) Sewage backup 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): broken pipe(s)are 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) THER 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) YSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A 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) JYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE) JAFE RMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND TY 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 within 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:Prom that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 3R (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 32 Captain Baker Rd, , Marstons Mills owner. Edmund Santos Date of Inspection DI7his FAILS: ve determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the re. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 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 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. El LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 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 U 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.. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST PropertyAddrsaa: 32 Captian Baker Road, Marston Mills Owner. Edmund Santos Date of Inspection: Check if the following have been done: ping information was requested of the owner, occupant,and Board of Health. Tone of the system components have been pumped for at least 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. _vAs built plans have been obtained and examined. Note if they are not available with N/A. Y The facility or dwelling was inspected for signs of sewage back-up. jelAe system does not receive non-sanitary or industrial waste flow L'1'he site was inspected for signs of breakout. I/All system components,excluding the Soil Absorption System, have been located on the site. _Ldofhe septic tank manholes were uncovered, opened,and the interior of the septic tank was inspected for condition of bales or tees,material of construction, dimensions,depth of liquid,depth of sludge, depth of acum. 1/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. r/The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION PropertyAddresa 32 Captain Baker Rd. , Marston Mills Owner. Edmund Santos Date of Inspection: FLOW CONDITIONS RESIDENTIAL.• Design flow , 0 Alone Number of bedrooms: 3 Number of current residents: Garbage grinder(yes or no): Laundry connected to system(yea or no): X?5 Seasonal use(yes or no):_ Water meter readings, if available: 1994 — 6 8, 0 0 0 g a l s 1995 - 67 + 000cla1G _ t•n 61g6 _ gq ., nn dais Last date of occupancy: COMMERCIALANDUSTRIAL: Type of establishment: Design flow:_ gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OTHER(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: `p System pumped as part of inspection: (yes or no)_ �— If yes,volume pumped: gallons Reason for pumping: TYPE 9JKSYSTEM Septic tank/distribution box/soil absorption system Single Cesspool Overflow owspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Other(explain) APPROXIMATE AGE of all components, date installed(if known)and source of information: / —Of ALL I Sewage odors detected when arriving at the site: (yes or no)A,b (revised 11/03/95) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) prop.rtyAdd 32 Captain Baker Rd. , Marstons Mills Owner. Edmund Santos Date of Inspection SEPTIC TANK: (locate on site plea) Depth below grader // Material of construction: ✓isncrette_metal_FRP—other(explain) Dimensions: ! Shulge depth: 0 Distance from top of sludge to bottom of outlet tee or baffle: Scum thicknees: 6 y � Distance from top of scum to top of outlet tee or baffle:, S Distance from bottom of scum to bottom of outlet tee or baffle:- Comments: (recommendation for pumping,cond_tion of inlet and outlet tees or baffles, de th of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) d C .6 GREASE TRAP:_ (locate on its plan) Depth belo grade: Material of nstruction:_concrete_metal_FRP_other(e:plain) Dimensions Scum ess: Distance m top of scum to top of:outlet tee or baffle: Distance to bottom of scum to bottom of outlet tee or baffle: Comm ts: (rem �dation for pumping,condstion of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) (revised 11/03/95) 6 _i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAddr+eas: 32 Captain Baker Rd. , Marstons Mills Owner. Edmund Santos Date of Inspection: // / -7 4, T149#T OR HOLDING TANK_ ( on site plan) Depth low grade: Material construction:_concrete_metal_FRP—other(explain) Dimensi no: Capaci gallons Design ow: ¢allona/dEy Alarm 1 1: Commea : (conditio of inlet tee,condition o`alarm and float switches,etc.) DISTRIBUTION BOX- ( locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) 'd'z��Zx"' PUM CHAMBER:_ (locate n site plan) Pam in working order:(yes or no) Comme to: (note tion of pump chamber, condition of pumps and appurtenances,etc.) n (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) PropertyAddrees: 32 Captain Baker Rd. , Marston Mills Owner. Edmund Santos Date of Inspection: / SOIL ABSORPTION SYSTEM(SAS): 1✓ (locate on site plan,if powl1e;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: leaching Pita, number: leaching chambers, number:_ leaching galleries,number leaching trenches,number,length: leaching fields, number, dimensions: overflow oesspool,number: Comments: (note condition of soil,signs of hydraulic failure, level ofponding, condition of v -/ b & � � G egetation,etc.) a 3 Z�- .► C POOLS:_ (locate n site plea) Number configuration: Depth-top of liquid to inlet invert: Depth of lids layer. Depth of layer: Dimensio of cesspool: Mate ' of construction: Indicat' of groundwater: inflow(cesspool must be pumped as part of inspection) Comments: note condition of soil,sign of hydraulic failure,level of ponding,condition of vegetation,etc.) PRIVY: (locate o site plan) Materials f construction: Dimensions: Depth of lids: Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.) (revised 11/03/95) g I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Address: 32 Captain Baker Rd. , Marstons Mills Owner. Edmund Santos Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' o. S d e O � d DEPTH TO GROUNDWATER Depth to groundwater.j-J).1t feet method of determination or approximation: B '' l t.',5 ��n S (revised 11/03/95) 9 TOWN OF BARNS LE LOCATION �� 'V� SEWAGE # ) IILLAGE_ ASSESSOR'S MAP ,( ^ INSTALLER'S NAME&PHONE NO. PSO��Mgz-� 'Z°7 S T77, SEPTIC TANK CAPACITY m7 _ n ` LEACHING FACILITY: (type) 16 �T� c� �� f*'nQ4size) 0�C.� NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: I I COMPLIANCE DATE: Separation Distance Between the: Maximum Adjr"W 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 ' t a � /ge 4AC 30 aP�a�N /34kot-. t?gAP r - e N0. Fee $5 0 . 0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIPPricatio igogar *pitem Conotruction Permit Application is hereby made for onstruct( )or Repair( x)an On-site Sewage Disposal System at: Loc tion Address or Lot No. Captain Baker Rd. Owner's Name,Address and Tel.No. Edmund Santos Mills 42873087 Assessor's ap ce 32 Captain Baker Rd. , Marstons Mil Ls Installer's Name,Address,an .N6. —7 7 J-V 7 6 Designer's Name,Address and Tel.No. Wm.E.Robinson Sr. , Septic Srv. P.O. Box 1089 , Centerville Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder(no) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Description of Soil sand Nature of Repairs or Alterations(Answer when applicable) Septic repair, D-box, 1 , 000 gallon stonepacked leachnit. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board ofpalth. 4 Signed ell �� � d=�- Date/ Application Approved by Date �/- Application Disapproved for the following reasons Y � �. Permit No. � Date Issued ,/^ ——————————————————————————————————————— k � ti t ' r No. Fee $5 0.0 0 "A THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS 01ppricatio i5pogal *pztem Construction Permit Application is hereby made for onstruct( )or Repair( X)I an On-site Sewage Disposal System at: Location Address or Lot No.(",,/Captain Baker Rd. Owner's Name,Address and Tel.No. Edmund Santos `lhlax tong Mills , 428.=3087 , Assessor's Map arce 32 Captain Baker Rd. , Marstons Mil s Installer's Name,Address,and Tel.No. 7 7 5—8 7 7 6^yJ Designer's Name,Address and Tel.No. r Wm.E.Robinson Sr. , Septic Srv. P.O. Box 10 8 9 Centerv&i&e ? , Type of Building: Kirl( o) Dwelling No.of Bedrooms 3 / / -' Garbage Grmd Other Type of Building T No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallop day. Falculawd/dai y'flow E gallons. Plan Date Number gf sheets- - ' x Revision Date Title Description of Soil—sand'"'w t Nature of Repairs or Alterations(Answer when applicable) Septic repair, D—box, 1 ,000 gallon stonepacked 1!eachpit. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the°provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of�pal,th. _ — o� Signed�e� , . �%.�.�1 Date Application Approved by Date /gR Z Application Disapproved for the following reasons ~^ Permit No. / Date/Is uea one--- — ————— THE COMMONWEALTH OF MASSACHUSETTS a BARNSTABLE, MASSACHUSETTS Santos QCertifirate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced(x )on by Installer Wm.E.Robinson Sr. , Septic Srv. at 32 Captain Baker Rd. , Marstons Mills has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction ermit No 5— dated -Z l Date `.... Inspect_r .� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. ��" ,;`J ---------——————-- No. ----a— Fee $5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION . BARNSTABLES MASSACHUSETTS Santos 33tgo5al *p.5tem (Con.5truction Permit Permission is hereby granted to Wm.E.Robinson Sr. , Septic Service to construct( )repair( an On-site Sewage System located at No.# 32 Captain Baker Rd. MaRSTONS Mills Street and as described in the above Application for Disposal System Construction Permit. — No. r r� The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction`must be completed within three years of the date below. Date: Approved by B d'of Health i y � CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) I,William E. Robinson, Sr.,hereby certify that the application for disposal works construction permit signed by me dated��"�� ,concerning the property located at 32 Captain Baker Road,Marstons Mills,. meets all of the following criteria: * There are no wetlands within 300 feet of the proposed septic system. * There are no private wells within 150 feet of the proposed septic system. * The obseved groundwater table is 14 feet or greater below.the bottom of the leaching facility- * There is no increase in flow and/or change in use proposed. * There are no variances requested or needed. SIGNED: C� DATE LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 42 (Attach a sketch plan of the proposed system. Also if the licensed installer proposes a certification plot plan,this plan should be submitted). 4 y �O I - �`� � f.4 1 A .�2A c� L AivE AC— NON o N 'I jNf 1 q.QE�9 I 0 L oqM!��eCroii.. c["W �✓/ry.P.�4VEL i coq,Q,sF sq.vo 1 C�.ei9✓EL . 7'4-S7- �/7- O,97-lq Ati tilAVALFS Tom/ ^of L S E B�/�l/CJ .C.CT L3 .�� S1s'OLt/iC.J �- Fs$./i.................... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH ..... �.0. VA,I ...........OF........ ... 9 i✓S/ L4'....... .................... Appliratinn -for 4:1Rpnnttl Marko Toni#rnr#ion Permit Application is hereby made for Permit to Construct ( V(or Repair ( ) an Individual Sewage Disposal System at: Location-Address yyJ or LotN9. /AL f.-•_L.P. .—2' ,5W----rQi_'_x-----------------•--•---_____- ----.. ..... ._ own el Address a A..... wiz ....-ti1--,Qr ,r ................... -•--------------------•--._............--------.....---------......-•-•--.....----••--•--- Installer Address d Type of Building Size Lot._Adv._ay .....Sq. feet U Dwelling—No. of Bedrooms.................. _.._._.___........__.Expansion Attic (rlv) Garbage Grinder (/o) aOther—Type of Building ............................ No. of pet ........................ Showers (/) — Cafeteria ( ) a Other fixtures _______________________________ ___ W Design Flow._____-_...S�__________________••____..gallons per pet•son per r d��. Total daly fl�w.._.._."ADO..........................-•--gallonti.y WSeptic T.ink—Liquid capacity_e�0'_.gallons Length.__"_6. . Width..4..11..d.. Diameter................ Depth....f!4..-.6 x Disposal Trench—No..................... Widt1i�......�........... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..... ............. Diameter._�_._:i?sT Depth below inlet_.Tz__.......... Total leacllittg :trea_a ......sq. it. z Other Distribution box (✓f Dosing tank `" Percolation Test Results Performed by.... 4y4FO...._RI�...____.____ Date....... /31.7_'r.._....... aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.................... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ................. .. .............................. --•-•-••-••••--••-•--••---•••••••••••-•••••••-••-••-•--••••-•••••••••••-••••••••-•-•••-•-••--••--•---.. O Description of Soil_...,rr ......�9!�G ! ._..__ L�n1 ___--- V -----------------------------------------------------•-----•---------•---....-•-•----------....---•--•-•--•----------------•----•-•---------••--•-------------------•--------..._.._._...•-•-•••---..... 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of lth. Si -�� 7 g / Date Application Approved By.......rl _ / (,C'tl''L �..6p -/..�..Ts -----••- Application Disapproved for the following reasons__________________________ ___________________••---••----•••••.-...----•-••--•-•-•.........Da.ate............... .................................................•-------•••...._•---•-•--•--•---••••••-••-•-•••••••...__....__••••••-••-••-..__.••••••---.._..---•-••-••-••--•_..__._.._._.._..._•••----••••-•--•••••--- Permit No. Issued..... Date .�.._. Date Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ll..... I..........OF.......... .... .. ............. Trr#ifira#le of (Compliaurr ;THI IS T/� EP7IFY, That"the Individual Sewage Disposal System constructed ( or Repaired ( ) by ._ ., `"�,r�= /............................................................... _ r->H<l !- Uy�-'............ ...... fInstall r _ has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--------••-•---•---------------------•-•--------=-----•---------._._....._...... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS f� BOARD )OF HEALTH K !1..................O F.....lC�.............. . �) iJ No.......s••G-•••-•-•- FEE.,Ia............... Permtsston is hereby granted••` �� '` d t! ,�.--- --------------------------•-----____-_-__- to Construc: ( or Repair (� an I tyidual�wjeDisposal Sy�ters, at No.___ �_ — ,�f� 1 � ... � = .. �i.� U-�� Xs�----�---•------•---•- Strcet � as shown on the application for Disposal Works Construction mit N :.. /' 7S� ---••••• Dated.. ..-.•- ............................. �_ Board of \Y DATE...:...........:......�.......--•--------------....-----...-----•--------_ / FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 111up ........ . y� SE•PTIC SYSTENN I?ty:RT 13E ge'Permit number .............. ............................ 15TALL ,t1 4::; f::;'.:..=;TH .IA,'�.Cf �QyOFTNErp�O TOWN OF BAR1'4B E'E,T "' EMSTMM i DMYae� ... BUILDING INSPECTOR APPLICATION FOR PERMIT TO / 5 TYPE OF CONSTRUCTION ./.a ..,..c5'T.orE��Y.......rrvmP.+% ...w rat W.Q....... l41_�;... .......................... — .............................054.11 ..192j.. -----TO-THE INSPECTOR-OF•BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...., Qf.... ............. ....,.loe; ..........07`�O. Ott..e..1.4ere..... vv�6.7a, tX.Arlozj ProposedUse .......... !.........................................................................................................................I......................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner G,P ...............Address ...�1'1�..�!i.��+��Y.. ...........� % ir'6trGYs.Til-�.. Name of Builder ....r.-.. 4o.�w,05111 ,IwAO........Address ................... ................................................... Name of Architect ......... rlr�,s ,Gr'.....................................Address ..................:94..�AIW.C................................................. /�. Number of f.--Rooms .....t. ................ Foundation ....o.49......... W.r.eml..... .ctr. . ......... Exterior lA.....�R�P�ldt�t4?P ...aT�i�...t...��jP�arr . .Roofing .......... ? G?/.. ................................................ Floors .........<.li .?-1....................................................... Interior ...........�IV V..t. la//............................................. Heating ...,t:as... ......�4?7`.. 1/,�T..................Plumbing ....................................................... ....................... Fireplace ....rl s!.....1 .�`1�ie4' < ?....................................Approximate Cost ...............��•I.SOU.................... . ....... Definitive Plan Approved by Planning Board ___���,2�_;n_______19 Area ........ -'.A .t... ........... Diagrarr� of Lot and Building with Dimensions / . Fey.. ......................./.............. SUBJECT TO. APPROVAL OF BOARD OF HEALTH 17'/4 4 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......... ...�t..r�.. f � .. rq' 3.e Fsic.l ..�..... THE COMMONWEALTH OF MASSACHUSETTS - ��'- EOARD-QF HEALTH 7. ;. Vn> ......._....OF........ .5 ?e,✓ / &AC" .._._......................_--- Applira#ion for UiBpoii al Workii Tomitraartion Vamit Application is hereby made for a Permit to Construct ( ✓�or Repair ( ) an Individual Sewage Disposal System at: /r! (r1f er 64 kep_ Location.Address or Lot N4. lrix �', zE ry '.eae, ---------_------------------ ------ ?e ......rrl2 fs-. ------------------------------- Own Address --------------------------------•---........-----------------------------------------•--••------ Installer Address Q Type of Building Size Lot. j__C -__-_Sq. feet U g— -Expansion Attic (40) Garbage Grinder ¢io) Dwelling No. of Bedrooms................ ....._.__..______.__ PL4 Other—Type of Building ............................ No. of persons............................ Showers (/) — Cafeteria ( ) Q' Other fixtures ------------------------------ -- W Design Flow------------ ..........................gallons per person per day. Total daily flow__._._. ��.-__--_----______...._._._gallons. WSeptic Tank—Liquid capacitv_l�'�gallons Length.__"_`___. Width..4.7:0.. Diameter---------------- x Disposal Trench—No. .................... Width._-_---------_-_-- Total Length.................... Total leaching area---------------•....sq. ft. Seepage Pit No-----e:------------- Diameter__K__:*2_S3' Depth below inlet..Z ........... Total leaching area:�4_04------sq. ft. Z Other Distribution box (✓f Dosing tank a Percolation Test Results Performed by._._ -C.._. -1l, 44 .9......lel.AJ............. Date------1A412 '_----------- Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water-----------............. f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ ---------------- -----------•-------••-----------: -------------------------•----••--•---...-----......................................................... 0 Description of Soil__.-_--Z ...... .......9 " U -••-------------------------•------- -----------------------------•------------------.--------------------------------------------------------------.-----•----------------------_---------•--- U Nature of Repairs or Alterations—Answer when applicable-----------------------------------------------------------------------------------------------. ----•---•-----------------------------------------------------------------------------•----------.------•-----------•-------•--•-----------.-.-__--.-------•--------------------•--•------------------- Agreement: , The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article \I 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 olth5alth. f (....= -_-._ r / Date Application Approved By------- ... ---- . . . ----------------- 7+ Date Application Disapproved for the following reasons------------ ------ -- -----••-•------...............-------------------------------•--------------------•-- ....................................................... •--•------------......._.........-----•---•-----•.....------•--•----•••------...-•-•--•--------------..........----------......------------.----- Date PermitNo......................................................... Issued...... -------•7-'S.................. Date Date No?,_I S - FEa. T�.. ..... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD QF HEALTH ..w. J..... .......OF.......;•t/......{2/✓.Si!....G�L..*�------------------ Appliratiaan -for Di,spaaaial Warkii Cnutuitrurtiaan Vrrmit Application is hereby made for a Permit to Construct ( vl�or Repair ( ) an Individual Sewage Disposal System at: /-� Location-Address or Lost 7No. / Owner Address FM-1 Installer Address UType of Building Size ._._._Sq. feet �-, Dwelling—No. of Bedrooms...............:..-_____.-_-.__...--__-_-Expansion Attic (>0) Garbage Grinder (>u) a`4 Other—Type of Building .__._______________________ No. of persons............................ Showers (/) — Cafeteria ( ) Gl, Other fixtures -------------------------------- ------------------------------------------------------------------------------------------------------------------- W Design Flow............. ...................... P1 Septic Tank—Liquid capacity!.'.:`.".gallons Length.�-_'_E____. Width..4�:._n-q.- lliameter_----...._..... Depth_--_�_-'.--. xDisposal Trench—No_-------------------- Width.................... Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No....!............. Diameter..E___r Depth below inlet_.ZG............ Total leaching area_­20�_.--_.sq. ft. z Other Distribution box (✓) Dosing tank ( ) a Percolation Test Results Performed by._... =-..%1!?��� � .<%_.....Y�'��J_____________ Date.......`1 :� 7%�-........... Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water.-_.___-.-__----_------- !14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__._--.-._____._-_-_-. - 9 -----•...••---- -------------------------------------------•-------•----•-•--•-•----•--....-----•----•...---------------•-••------•-----------------•------ D Description of Soil------ =_------- ......./—)4,9,-✓ x --•---. ----- -- U ---------------------------------------------------------------------------•------•--------------------------------------------------------------------------------------------------------------------- W -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable.-.................•-----_-___-_._._-___-_-._._-.-..----___-___:-_-__-___.------__---__----.-... -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board o�f -ealth. Si d. '� ' .- /� Date Application Approved By----- �i _._44--&1_CGs '- l_ 7 i -4.... .1... Date Application Disapproved for the following reasons:......................... .... ...-------•-----------------------------------------------------------------•---------------------------.---•------•----------------•--•--••---•--•-•----•-----•---------•------•••••------------------- Date PermitNo......................................................... Issued........................................................ Date } THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...��..........OF.......... . ...1 ........... . Tertif iratae of 051,11.mpliatta ,T II IS T,oLI RRTIFY, Th the Individual Sewage Disposal System constructed ( or Repaired ( ) ----- Install at. ...... .j has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..................:...................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. I DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEA TH /'t-t 'j...,...............OF........................ . ........................ No.- 1 S............... FEE-/D............... %spll�tlrvfr�, �a ,a trurfi Prrmit Permission is hereby granted °'fie � Q �%r � .._ . . . _. ......................................... to Construc ( or Repair an I i,idual wa Disposal Sy�t �.p -- Street �� ---------------- Xr_ as shown on the application for Disposal Works Construction mit N Dated..( ...................................S`--� . .......................... _ DATE--- Board of&�tb Z �-----�-©-�'S�.............................................. \\a�l FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 1 Awe } S �e3' 0�'�5".>�--�- .•_• 'SLp.5�8� -... .... A= B�L52" �.-.t�sZo.00' 'vo" TANy. k V nn <V V\ Z ,LoT Z Lo7- T P.e�fl�tSE+O .�•/Oo0 ��1r9L. SEP7-iG • rt, `V w/2'JroN� Ace o�sT °.•ExPAnisio� .PO�/.v0 •••.. BoX 1.9.QE.9 t ® T T / �•� 25�df//oE ACCESS _ I �+ •.- -r-/t/ �3: o�'�S" ems/ /�8.37' ---• L o•T /z L oT // LoT /o 0 ,�oqM f.SueCso�.c..�c/o T-E �hVoaocogM� CL AY'�✓��,PA{/EL � CP ly.eA✓EL TEST 1`/7- 1`4 0 7- P,c- A/ syowi�cic, P,2oPos�O Go�t/S T,2tJc Tio/C./ LocvTio/�/ 4/IA,0SToN WlLL_S I IN �2E.oE,e�/l/CE- BG/�/y LDT -3 f7� S�YO`t/N oN f L/9ti./ ,eKO.E.C7E'o .97- ,Bi9.e/�/STigf3L•1= 01,9 IZ/-/.5 77/9 BL,— S U,e V 4'- Y C o/�/S�/,C 7 ,49 A-/TSB /it/c. Jt S 114 OF,ygs� r o �+ GEORGE yN v LOW,JR. svRVEy aG!/N�=.P ' .�/.2S 7- CE N TU.2 S� TOP FOUNDATION SYSTEM PR l 1 1 ®l O �j� T-L-E � LE ��j ]� T• T. S. EL. 51.9 FINISHED GRADE EL. 50.6'f 1/8" TO 1/2" DOUBLE WASHED STONE ® 3" THICK OR GEOTEXTILE FABRIC _c' �� , OST. o 0 MflyMff6" ACCcn CHARCOAL VENT SET 36^ ABOVE GRADE �L \ _ \ \ W. BARN. RD. LA cp it RISER FINISHED GRADE EL. 50.5't FINISHED GRADE EL. 50.5't WHEN MORE THAN 3' OF S.A.S. COVER /'�`_ J�`�nYR �„�i3 x -'� LOCUS o < ~ 6„ lllll lllllllllllllllllllllllllrllllllllllrl llllllllllllllrll llllllllll �r � �. s+� �. D e < INV. OUT RISER I-- 8.5' -� RLssm '' �'1 ( \�� �l t��' \, R w � a. aoa aaa d nI 1 0// qCE LANE LJ ccnn U INV EL a a =L. 44.55' IN EL 1 0� 1� IN EL INV EL e z Q a Below Flow Line GAS �ums. INV EL -48" 3/4" - 1 1/2" `�$" REMOVE ALL UNSUITABLE MATERIAL FIVE FEET SHUBAEL Q m Liquid Level Line BAFFLE 47.15' DOUBLE WASHED STONE AROUND THE S.A.S. DOWN TO THE C HORIZON 6" Stone (EL. 41.6') AND REPLACE WITH CLEAN COURSE POND w Q J o 33.5' a SAND PER310 CMR 15.255 - AS REQUIRED., o DISTRIBUTION BOX PROPOSED CHAMBER TRENCH Of< ~ EXISTING 1000 GALLON TANK TO REMAIN U 0 N CAPT. BAKER D U o < BOTTOM OF TEST PIT EL. 36.6 Sj 60, ROUND(3 a) (n :2 SEPTIC TANK NOTES: POND � NO GROUND WATER OR ' ~ � < REDOXIMORPHIC FEATURES OBSERVED w THE INLET PIPE ELEVATION SHALL BE NO LESS THAN 2" NOR MORE THAN 3" �' o L_ OCLJ � M AFC ABOVE THE INVERT ELEVATION OF THE OUTLET PIPE. I THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 12", WITH TWO 20" MANHOLES HAVING READILY REMOVABLE IMPERMEABLE COVERS �---- 12.83' -i • r P OF DURABLE MATERIAL SHALL BE PROVIDED WITH ACCESS PORTS. TANK TEES SHALL BE INSPECTED AND BROUGHT INTO COMPLIANCE 34^ •'d e m p•'• 24 48 ae^- AS MAY BE REQUIRED. 58" x S7•9S, NUMBER OF TRENCHES = ONE N 4 51.6' OP DISTRIBUTION BOX NOTES: NUMBER OF UNITS = THREE 63, 04 INSTALL ON A LEVEL STABLE COMPACTED BASE PROPOSED LEACH TRENCH-END VIEW MINIMUM WALL THICKNESS = 2" INSTALL THREE 500 GALLON UNITS S�0`�✓ MINIMUM INSIDE DIM. = 12", WITH WATERTIGHT COVER WITH FOUR FEET OF DOUBLE WASHED STONE ° AT ENDS AND AT SIDES '°q(/F• , OUTLET INVERTS SHALL BE EQUAL TO EACH OTHER AND AT S' 2" MINIMUM BELOW INLET INVERT. SYSTEM DESIGN DATA: x 51x5' RFSTR/ 51.5' THE DISTRIBUTION LINES FROM THE DISTRIBUTION BOX SHALL � CT� x FOUR BEDROOMS = 4 x 110 GPD = 440 GPD REQUIRED FLOW 50.8 �. ON ALL HAVE EQUAL INVERTS AS DETERMINED BY FLOODING THE �gSFM o DISTRIBUTION BOX TO THE HEIGHT OF THE DISTRIBUTION LINE USE CHAMBER TRENCH 12.83'W x 33.5'L x 2' EFF. DEPTHCA SIDE WALL: [33.5+33.5+12.83+12.831 x 2.0 = 185 SF x ~ FNT S2s0, INVERT AFTER ALL LINES HAVE BEEN SEALED IN PLACE. W BOTTOM: 12.83 x 33.5 = 429 SF LOT 3 RELOCATE GAS LINE 50.8' d INVERT ADJUSTMENTS SHALL BE MADE BY FILLING WITH 614 x 0.74 = 454 GPD TOTAL DESIGN FLOW PROVIDED o; AS REQUIRED C z DURABLE AND NONDEFORMABLE MATERIAL PERMANENTLY �' �.�ESS x 7i FASTENED TO THE LINE OR RECONSTRUCTING THE LINES NO GARBAGE DISPOSAL ALLOWED 241097± S. /' 50x8, - \ 51.8 > o UNTIL ALL INVERTS ARE OF EQUAL ELEVATION. G ca r x r z x 51.2' GENERAL NOTES: 512, 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO DEP AND Z PROPOSED S.A.S. THE TOWN OF BARNSTABLE RULES AND REGULATIONS FOR THE SUBSURFACE P L A N LEGEND oo CHAMBER TRENCH VENT AS DISPOSAL OF SEWAGE. EXISTING UTIL/POLE �� 12.83' x 33.5' % REQUIRED 2. ACCESS PORTS OVER TANK TEES SHALL BE ACCESSIBLE WITHIN 6" ti l �� f1�/ OF FINISHED GRADE. ----U BURIED GAS BM: TOP FOUNDATION /f x 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF W- BURIED WATER ELEV. 51.9' 3 4 0 50.7 WITHSTANDING H-10 LOADING UNLESS OTHERWISE NOTED. EXIST. LEACH PITS oo DATUM: ASSIGNED 4. THE EXCAVATOR/CONTRACTOR SHALL CALL "DIG SAFE" AND VERIFY THE LOCATION PER AS-BUILT DATA OF SITE UTILITIES PRIOR TO ANY EXCAVATION, AND SHALL BE RESPONSIBLE FOR x 51 51.2'2� x o- / ALL MATTERS RELATING TO ELECTRIC AND/OR GAS EASEMENTS. , SPOT GRADE EXIST. & PROPOSED �, � �"' x �X- o0 5. SEWER PIPES SHALL BE SCHEDULE 40 PVC. (4" DIA. UNLESS OTHERWISE NOTED) .2 51.1' 6. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE �co 0 50.4 z o MORTARED IN PLACE. ASSESSORS MAP 126 PARCEL 039 w Y < 0 7. FINISH GRADE SHALL HAVE A MINIMUM SLOPE OF 0.02 FT. PER FOOT. x 0 �o o z 0 0 0 8. EXISTING SYSTEM COMPONENTS - IF ANY - SHALL BE ABANDONED PER 50.4' �cZh REFERENCE DEED: 21343-328 0 < w TITLE 5 REQUIREMENTS. 9. THE EXCAVATOR/CONTRACTOR SHALL BE RESPONSIBLE TO CONTACT DOYLE ZONE qp O �' � F- < J AND ASSOCIATES 24 HOURS PRIOR TO ANY REQUIRED INSPECTIONS. Wp �'/ REFERENCE PLAN: 274-34 0- 10. ALL COMPONENTS SHALL BE MARKED WITH MAGNETIC TAPE OR � <</10 0 50.5' o 0 o m x �o z z COMPARABLE MEANS IN ORDER TO LOCATE THEM ONCE BURIED. x LOCUS DOES NOT LIE IN A FLOOD o < Q z 11. WHERE WATER SERVICE IS LOCATED CLOSER THAN 10 FEET FROM 51.0' ¢ /9 �o x HAZARD ZONE. < o SEWAGE COMPONENTS, SERVICE LINE SHALL BE SLEEVED IN PVC. 0 o < < � 50.5 ZONING DISTRICT: RF p �_ � Q 12. ANY AT-GRADE COVERS SHALL BE SECURED TO UNAUTHORIZED ACCESS. OVERLAY DISTRICT: 0 � - :2 13. S.A.S. INSPECTION PORT SHALL BE BROUGHT TO WITHIN 3" OF FIN. GRADE. 49.61' x w \ x 50.6' � � . � ZONE II, WP AND RPOD � 50.3' EXISTING 1000 49.85' GALLON TANK TO REMAIN �N OF j , � 49.85�` x ���, ass9 o 49 3 49.8 ABANDON EXISTING DAV1D r w (0 J 2S' 49.84' / LEACH PITS & D/BOX B. _ Q N o FAG wjo� ,\ GRAVEL PER TITLE 5 REQUIREMENTS MASON v o 0 SOIL DATA: qC DRIVE 9�No.1'066 a 0 TEST DATE: 02-24-10 CFSS .. c� E� w (- SOIL EVALUATOR: S. DOYLE APPROVED 3/95. Fq y \ WITNESSED BY: DAVE STANTON SFM w sq I < < � to TEST PIT #1 TEST PIT #2 TEST PIT #3 TEST PIT #4 TO \01- 49.9 z a PERC <2 M/INCH PERC <2 M/INCH PERC <2 M/INCH PERC <2 M/INCH j CqA x Q D v1 r7 EL. 50.8' 0„ EL. 50.8' 0„ L. 50.6' 0" EL 50.6' 0„ �83�0 Tq/N \ 5�0./►1.A®t W 0_ < N SL 10YR 3/2 "A" SL 10YR 3/2 "A" SL 10YR 3/2 "A" SL 10YR 3/2 Bq ' 1���I`jN OF ' •�� „A„ �y T 0 6" 6 6" "B" LS OYR 5/6 S63e pgVF FR RO � _ \ \ ; �� P��Is F9Fo,>';;�s o � ? � "B" LS 10YR 5/6 Bw LS 10YR 5/6 w q0 q o STEP J. > N o 0 "Bw LS 10YR 5/6 w 60"(EL. 45.8') 60"(EL. 45.8') �6 •� DOYLE " � � � ( PERC ®66^ C 108(EL. 41.6') 108(EL 41.6') `�SDQo 50.1 8 MED. MED. 2.5Y 6/4 C MED. PERC 0 110" C MED. F c 37a g 1• Z � SAND 2.5Y 6/4 SAND SAND / •♦ 9�F �� fi W / SAND 2.5Y 6 4 2.5Y 6 4 0 20 40 w U) = 8' EL 36.6' EL 36.6' ► W w 132" 168 WEL. 39 EL 39.8' " NO G/WATER OR NO G/WATER OR NO G/WATER OR NO G/WATER OR _j w REDOXIMORPHIC FEATURES REDOXIMORPHIC FEATURES REDOXIMORPHIC FEATURES REDOXIMORPHIC FEATURES 50.12'