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0049 CAPTAIN STUDLEY ROAD - Health
49 CAPTAIN STUDLEY ��q to/ Marstons Mills A = 126 - 050 OF I"E Town of Barnstable U.S.POSTAGE>>PITNEY BOWES 0 Public Health Division 200 Main Street o© MASS. �prE01M��0� Hyannis,MA 02601 ZIP 02601 02 IVY $ 006.11 f0001383424 APR. 09. 2013 f 7012 I, 1010 0�00 2850 7664 Steven J. Morris fiPsr 140fiirF %Janice E Maenpaa. said 8 Senee Court Amesbury, Ni XI E 1-15 F E 1 00 08. 1 /23 a 13_r.' _t.R N A f) s F.1Z NOT DELIVERABLE AS ADDRESSED U JABLE TO F OR al:A20"D BC: 0260140+0200 *0369-03798-09-42 026,4'7 Ci4002 111,..tis 1 1 11 11 s %�sY ,..d.:''•'3 Tsssesl $!'s3!slasrss.laiee.lnala,lsfibkc'ata_'l:sas..as.s�.d}�1�..'.!_. ` SENDER: COMPLETESECTION COMPLETE • ON DELIVERY I ■ Complete items 1,2,and 3.Also complete A. Signature I I item 4 if Restricted Delivery is desired. ❑Agent X i ■ Print your name and address on the reverse ❑Addressee i so that we can return the card.to you. B. Received by(Printed Name) C. Date of Delivery I i ■ Attach this card to the back of the mailpiece, I i or on the front If space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No r f P hil'Kw"as61Ck TR %fine Street Realty Trust I. 10,1`0 Waltham Street#D 534 3. Service Type ' Lezin on MA 02421 ❑Certified Mail ❑Express Mail I ❑Registered ❑Return Receipt for Me andi I ❑insured Mail 0 C.O.D.- I — 4. Restricted Delivery?(Extra Fee) ❑Ye. I 12. Article Number 7 012 1010 0000 2850 7 6 6 4 i (rransfer from service labeq PS Form 311,February 2004 Domestic Return Receipt 102595 o2 nn tsao!. r i i i .. -iaa ...r...�TT�. . . :-•---rr -•--------- ..0 c3 �� S O Postage $ ru CertRied Fee Postmark O ReturnReceipt Fee N p (Endorsement Required) CFiere O Restricted Delivery Fee u= Q (Endorsement Required) / (P�� pTotal Postage&Fees $ � Paul Kwasnick TR % Vine Street Realty Trust 1010 Waltham Street#D.534 - I cxinnfnn Mid 02421 Certified Mail Provides: ■ A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: is Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. a Certified Mail is not available for any class of international mail. o NO INSURANCE.COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. a For an additionalifee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ("n If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 Town of Barnstable Barn Regulatory Services Department ' MAS&` � Public Health Division fo 39. 200� 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012 1010 0000 2850 7664 April 9, 2013 Steven J. Morris %Janice E Maenpaa. 8 Senee Court Amesbury, MA. 01913-1010 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 49 Captain Studley Road, Marstons Mills, MA was last inspected on 3/01/2013, by Douglas A. Brown, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: Hydraulic Failure. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH as Mc ean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\49 Captain Studley Rd MM 2013.doc r f Town of Barnstable Barnstable Regulatory Services Department • aAsrrsrast,�, MA83. r Public Health Division i639• 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7012 1010 0000 2850 9354 July 02, 2013 Steven J. Morris %Janice E Maenpaa. -28 Senee Court * F`� - Amesbury, MA 01913 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 49 Captain Studley Road, Marstons Mills, MA was last inspected on 3/01/2013, by Douglas A. Brown, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: Hydraulic Failure. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH -� L o Thomas McKean, R.S. CHO Agent of the Board of Health r Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\49 Captain Studley Rd MM 2013.doc I � Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=8093 ti', '�1` �a r � `° Logged In As: Parcel Detail Tuesday,April 9 2013 Parcel Lookup Parcel Info Parcel ID 126-050 _ Developer LOT 14 Location 149 CAPTAIN STUDLEY ROAD Pri FrontageSe 135 Sec Road OST.-W.BARN. RD Frontage 1185 Village IMARSTONS MILLS Fire District(C-O-MM Town sewer exists at this address No Road Index i02 �I InteractiveI` ; � Map r- K 4r +r Owner Info Owner IMORRIS, STEVEN J ( Co-owner?%MAENPAA,JANICE E Streetl 18 SENEE COURT Street2 City JAMESBURY ._� state M zip 01913 Country I Land Info Acres 0.48 Use I Single Fam MDL-01 zoning RF Nghbd 0105 Topography 11-evel ( Road I Paved Utilities IPublic Water,Gas,Septic I Location, Construction Info Building 1 of 1 Year[----1975 I Roof rGable/Hi Ex Wood Shingle Built I struct p ( Wall g Living F.GIs/C 864 Roof As h/ AC None Area� � Cover_p p m Type Be Style Cape Cod Wal� Drywall �� Rooms F2 Bedrooms Model I Residential Int Carpet Bath 1 Full Floor Rooms . Total Grade Average TypeI Hot Air Rooms 15 RoomsHea Stories 1 1/2 Stories J Fuei(Gas ",FOation Typical Gross 11920 w Area • Permit History._._:_- - -- ---- - -- -.............-. http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=8093 4/9/2013 http://www.whitepages.com/search/FindNearby?street=8+senee+Court&where=Amesbury%2C+MA WhitePages • Address 8 senee Court • City, State or ZIP jAmesbury, MA Submit Query Advertisement:Track your Credit Score «Back8 Senee Ct Claim & Edit J. Janice E Maenpaa > 2. See contact information >> 3. 8 Senee Ct •Amesbury, MA 41 Neighbors 1. Joel S Constantino > 2. See contact information > 3. 31 Adams Ct Amesbury, MA 1. Michael Smith > 2. Robert P Porter > 3. 4 Senee Ct Amesbury, MA 1. Nicole M Brady >> 2. Christopher G Brady > 3. Donna M Brady >> 4. 1 more person at this address, see all in map > 5. 7 Senee Ct Amesbury, MA Loading... View more on WhitePages Neighbors > neighdors Get more information on the people in this neighborhood. View more neighbors > 1. Persia K Lacey >> 2. Lisa L Lacey >> 3. George P Dube > 4. 5 Senee Ct Amesbury, MA 1. Allan B Gates > 2. Matthew J Branconnier > 3. Erik A Gates > 4. 1 more person at this address, see all in map > 5. 11 Senee Ct Amesbury, MA http://www.whitepages.com/search/FindNearby?street=8+senee+Court&where=Amesbury%2C+MA 4/17/2013 l Janice Maenpaa in Amesbury MA WhitePages http://www.whitepages.com/name/Janice-E—maenpaa/amesbury-MA WhitePages f t notcasy'u Janice E Maenpaa 55-59 Years old Senee Ct Amesbury,MA Was in Hudson,MA and 2 other cities Sponsored by InstantCheckmate.com Janice E Maenpaa 6o years old Amesbury,MA Email I Public Records I Phone View full details ©2013 WhitePages Inc.-Privacy Policy and Terms of Use 9/4/2013 �+ W U.S.POSTAGE>>PITNEY BOWES cFINE'Ow Town of Barnstable ti ' � O O Public Health Division BARNSTABLE.n,` dQ MASS. 0 200 Main Street �m Hyannis,MA 02601 <,Ep MP,s L ZIP 02601 $ 006.1.1 o a � 02 1YY 0001383424 APR. 01. 2013. 7012 1010 0000 2850 7541 f Steven J. Morriss„' 8 Senee Court ' ,-08� �-- - Amesbury-nnn, .n1a��z - NIXI.E 01-5 F'E 1 00 04J.G4j.j3 NOT DF) FVFi�A�"s F A� At�t31�1"SSFo3 `` 3C' a32>ss0140020�6,9—Oil-04—a :L-4Z ra��n7 f7mttta� I i11. .4.1.i1 I1. .II.1 91a i� 1 1l1 li. .),1.1 �'_•� •`r' Y I 119 !'ai iota a !a laa atttt53.a as t.t aaaa r. .'j• Mom.- 7 -/ -- SENDER:'COMPLETEr THIS SECTION. . COMPLETE THIS DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee ! so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes ! 1. Article Addressed to: If YES,enter delivery address below: ❑No ! Ste ren J. Morris ! 8:Zenee Court ! 3. Sery a Type .Amesb.ury, MA 01913 i o ertifled Mall q Express Mall J(rf ! ❑Registered return -for rc Ise `•, ❑ Insured Mail ❑C.O.D. r 4. Restricted Delivery?(Extra Fee) Yes 2. Article Number 7 012 1010 0000 2 8 5 0 7541 (Transfer from service-label) . t PS Form 3811,February 2004 Domestic Return Receipt_ 102595-02-M-1540 r=1 .. Ln pOFFICIAL Ln CO Postage $ S MA pa C r Certiffed Fee C3 �Q' Postmark p Return Receipt Fee I die eU 13 t p (Endorsement Required)p -e Restricted Delivery Fee p (Endorsement Required) i p Total Postage&Fees U S'' rz n Steven J. Morris r 8 Senee Court Amesbury, MA 01913 Certified Mail Provides: o A mailing receipt _ 4 m A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years Important Reminders: o, Certified Mail may ONLY be combined with First-Class Mail®or Priority Mails. ® Certified Mail is not available for any class of international mail. a NO INSURANCE'COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ® For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". ® If a postmark on the Certified Mail receipt is desired,please present the arti cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry.-' PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 Town of Barnstable Barnstable �fNE Tp� Regulatory Services Department Fo 39�- MA��� Public Health Division 200 Main Street, Hyannis MA 02601 zoos Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7012 1010 0000 2850 7541 March 28, 2013 Steven J. Morris 8 Senee Court Amesbury, MA 01913 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septicY p Y s stem located at 49 Captain Studley Road, Marstons Mills, MA was last inspected on 3/01/2013, by Douglas A. Brown, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Hydraulic Failure. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\49 Captain Studley Rd MM 2013.doc C* Town of Barnstable Barnstable Regulatory Services Department MUAgg Public Health Division019. I fp AA�n A�� 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F. Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7012 1010 0000 2850 7541 March 28, 2013 Steven J. Morriss 8 Senee Court Amesbury, MA_ 01913 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 49 Captain Studley Road, Marstons Mills, MA �O ` was last inspected on 3/01/2013, by Douglas A. Brown, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Hydraulic Failure. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S. CH0 Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\49 Captain Studley Rd MM 2013.doc Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=8093 ► oIn� +. .I t µ :_:./ ez Logged in As: Parcel Detail Wednesday,March 27 2013 Parcel Lookup Parcel Info Parcel ID I 21 6 050 � Developer LOT 14 l 1 Lot Location 149 CAPTAIN STUDLEY ROAD _ ( Pri Frontage�135 _ __. _-ry Sec Road OST.-W.BARN. RD Sec 185 l Frontage I Village,MARSTONSMILLS Fire District!C-O-MM � �--� - l Town sewer exists at this address I No l Road Index 0242 , � y Interactive Map � Owner Info Owner IMORRIS, STEVEN J Co-owner I/oMAENPAA,JANICE E l Streets 18 SENEE COURT l Street2�� l city JAMESBURY State MA zip W1 91—3 -1 Country Land Info Acres 10.48 l use FSingl�— le Fam—MDL-01 l mZoning I RF Nghbd 0105 1 Topography Level Road Utilities 1 Public Water,Gas,Septic Location ^— Construction Info Building 1 of 1 Year 1975 Roof Gable/Hip _ J Ext Wood Shingle _ l Built Struct Wall Living 864 Roof As h/F GIs/Cm� AC None �� Area Cover r p p Type� s ' 1MAC�r4'� Style Ca Cod IntttD wall Bed �pe l Wall 1 Drywall Rooms 12 Bedrooms ( r w Int! Bath'` Model Residential l Carpet j 1 Full Floor; RoomRf Grade Average l Heat CHot Air l Total 15 Rooms l Type( Rooms Stories(1 1/2 Ston ypic es Heat a Found- Stories i Fuel I ation al Gross 1920 ` Area f Permit History http://issgl2/intranet/propdata/ParceiDetail.aspx?ID=8093 3/27/2013 �� � ��� � , /� r� Commonwealth of Massachusetts Tale 5= Official. Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M SVB 49,CAPTAIN STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out -forms on the computer, use 1. Inspector: only the tab key I � to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. DOUGLAS A BROWN INC Company Name P.O. BOX 145 _ Company Address CENTERVILLE MA 02632 City/Town State Zip Code 508-420-4534 S14297 Telephone Number License Number -B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenanre.,of on-jite sewage disposal systems. I am a DEP approved system inspector pursuantt6 Section .340,of Title 5-1310-CMR 15.000).The-system. 77C ❑ Passes ❑ Conditionally Passes ® Fai — k ❑• Needs Further Evaluation by the Local`Approving Authority ? "= r� 3/1/13 Inspect s Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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 DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time:This inspection-does not address how-the system-will perform-ini the-future-under the same or different conditions of use. 15ins-11110 Title 5 Official?riptinr.:Subsurface Sewage Di sal System-Page 1 of 17 Commonwealth of Massachusetts d Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ,•'< 49 CAPTAM STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. Cityrrown State Zip Code Datebf Inspection 8. Certification {-cunt.)- Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑. 1..have.not-found.any information..which:indicates.that.any of.the-failure-criteria,described. in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: LEACH PIT WAS LOCATED-WITH A CAMERA AND FOUND TO BE IN FAILURE B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will-pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass.inspection if it is structurally sound, not leaking and if a Certificate of -Compliance indicating that the_tank is-less than 2-0 years old is-available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5- Official al Inspection Form, m, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 49 CAPTAINt STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. Cityrrown State Zip Code Date of Inspection B. Certification {Cone.-). B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection.if(with approval-of Board-of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or fepiaced ❑ Y El N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced ❑ Y ❑ -N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) .Further Evaluation.is-.Required by the-.Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety andthe 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Officia t I-nspectio.n Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Y�< 49-CAPTAIN-STUDLEY Property Address MORRIS Owner Owner's Name information is MARSTONS MILLS MA 02648 3/1/13 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification-{cont.)- 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100,feet-of-a surface water supply,or,tributary to a surface.watersupply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes i the welfwateranatysis, performed at-a DEP certified-laboratory; forfecai coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System-Failure Criteria:Applicable.to.All.Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or ®° ❑ clogged SAS or-cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 r - Commonwealth of Massachusetts Title 5, Official Inspection Farm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 49-CAPTAIN,STUDLEY Property Address MORRIS Owner Owners Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. Citylrown State Zip Code Date of Inspection B. Certification (,Cont.)- Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ M. Any portion.of the SAS; cesspool or privy is-below-high ground water elevation, ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of-ammonia nitrogen-and,nitrate-nitrogen is equal-to or Less than-5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000gpd- ❑ 10;000gpd-. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary,to correct the-failure. ` I E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D: Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑. ❑ the system-is within.200-feet of a tributary to.a surface drinking-water supply- ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any,question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large -system considered-a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5- Official, I-rispection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M s 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑, Z Pumping,information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the-previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? El ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? • ❑ Was the site inspected'for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of Iiquid, depth of sludge,and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS) on the site has been determined based on: ❑j ®, Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System -information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 2 DESLGN.flow based.on 31.0.CMR_1.5.20.3.(for example:_1.1.0_gpd.x.#of bedrooms.):. 330 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 r Commonwealth of Massachusetts u r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 49 CAPTAIN-STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. City/Town State Zip Code Date of Inspection D. System Information- Description: A SEPTIC TANK WAS LOCATED AND A LEACH PIT WAS LOCATED WITH A CAMERA AND FOUND TO BE IN FAILURE Number of current residents: 0 Does residence have a garbage grinder? ❑ 'Yes fl No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ❑ No Laundry system inspected? ❑ Yes ❑ No Seasonatuse? ❑ Yes ❑ No Water meter readings, if available(last 2 years usage (gpd)): Detail: HOUSE VACANT Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow.fseatslpersons/sq_fL,.etc_.):. Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged.to the Title 5 system? ❑. Yes ❑, No Water meter readings, if available: t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 r Commonwealth of Massachusetts Tile 5 O_fficiai Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M s 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owners Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. City/Town State Zip Code Date of Inspection D. System Information (coast) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as path of the inspection? ❑ Yes M No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping-- Type of System: ❑ Septic tank, distribution box, soil absorption system ❑. Single cesspool. ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes, attach previous inspection records,.if any). ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑. Tight tank, Attach a-copyof the DEP approval. ® Other(describe): TANK AND PIT NO D-BOX FOUND t5ins.•1 vio- Tide.50MOal lnspection.F=:Subsurface,Sewage.DigmsalSystem-Page_8<of 17 Commonwealth of Massachusetts y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 49 CAPTAIN-STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. CitylTown State Zip Code Date of Inspection D. System Information (corn:). Approximate age of all components, date installed (if known) and source of information: SYSTEM APPEARS TO BE ORIGINAL Were sewage odors detected when arriving at the site? ❑ Yes- 0 No Building Sewer(locate on site plan): Depth below grade: feet Matenai of construction: ❑ cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of jointsi venting, evidence-of leakage-, etc.): Septic Tank(locate on site plan): Depth below grade: 1 feet Material of construction` ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: APPEARS TO BE ORIGINAL Sludge depth: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts w Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owner's Name information is MARSTONS MILLS MA 02648 3/1/13 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): TANK APPEARS TO BE ORIGINAL TO THE HOUSE DUE TO THE SMALL RECTANGULAR COVERS Grease Trap(locate on site plan): Depth below grade: feet Material of construction: 1 concrete E metal. C fiberglass [1.polyethylene . [] other(explain): Dimensions: Scum.thickness. Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-11110' Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10'of 17 Commonwealth of Massachusetts Title 5 Official inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 'F 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owners Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. Cityrrown State Zip Code Date of Inspection D. System informati n tcont: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site.plan.): Depth below grade: Material of construction: ❑ concrete Q metal ❑_fiberglass ❑.polyethylene ❑.other(explain): Dimensions: Capacity: _gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm.level:_ Alarm in working.order: ❑. Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. City/Town State Zip Code Date of Inspection D. Systim Informa#ioit tccjnt.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or our of box, etc.): NONEFOUND Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in.working.order... ❑. Yes ❑. No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption.System{SAS){locate on siteplan, excavation not required): If SAS not located, explain why: NO PLANS OR AS-BUILT CARD SO PIT WAS LOCATED WITH CAMERA AND FOUND TO BE IN HYDRAULIC FAILURE t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 r Commonwealth of Massachusetts Title 5 Official- Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. City/Town State Zip Code Date of Inspection D. System Information (cent)- Type: ® leaching pits number: 1 ❑. leaching.chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: leaching.fields number, dimensions. ❑ overflow cesspool number: ❑ innovative/alternative system. Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): PIT WAS LOCATED WITH CAMERA AND FOUND TO BE IN FAILURE WITH HEAVY SCUM TO THE TOP OF PIT Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration _Depth—top-of iicodto inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts u m Title 5 Official- Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owners Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. Cityrrown State Zip Code Date of Inspection D. System information_{cunt-.} Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site-plan): Materials of construction: Dimensions Depth-of solids- Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5- Official Inspection Fora a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owners Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. City/Town State Zip Code Date of Inspection D. System Inn rma- ion{cant.} Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water.. feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked;.date.of design plan.reviewed:. pate ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. .-t5ins.-1.1/10 Tide 5.Official InspectionForm:-Subsurface-Sewage Disposal-System•Page 16.of-17- e R Commonwealth of Massachusetts u - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 49 CAPTAIN STUDLEY Property Address MORRIS Owner Owner's Name information is required for MARSTONS MILLS MA 02648 3/1/13 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 J 3 � t 1p�r TOWN OF BARNSTABLE LOCATION �} �i� srao z . SEWAGE# 20/3 q/ —�yo VILLAGE`LJJ2rSroN� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.,)'08-y'219-973F ;",f SEPTIC TANK CAPACITY `f'00 LEACHING_FACILITY.(type (size) 32 X 9, y q NO,OF BEDROOMS 3 OWNER PERMIT DATE: >^/—/ COMPLIANCE DATE: 7 Separation Distance Between the: Maximum Adjusted Groundwater.Table to the Bottom of Leaching Facility Feet f Private Water Supply Well and Leaching Facility(If any wells exist on site or within 260 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility). ,y ! Feet FURNISHED BY sg y� &S 13- .7. p �rvy7 p i I S o i � No. Fee /A� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Q 2ppliLatlon for MispoSal 6pstrm ConstrULtion Permit Application for a Permit to Construct( ) Repair(d-)�'fJpgrade(''Abandon( ) ❑Complete System El Individual Components Location Address or Lot No.Yf 60,4640 ril ley Au Owner's Name,Address,and Tel.No. ^sJ ,S�oN S!°yl </3' bof,4E A1P,*4 Assessor's Map/Parcel / 6 _fo YAM-C— I taller's Name,A dress,and Tel.No.V.08 �' 4�3� Designer's Name,Address,and Tel.No,5100^3G2 292IL oseP4 0, �r+►r�� i Somas. C4 Type of Building: Dwelling No.of Bedrooms / 'S�Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) _rpjy,Q�z. 5 ®r' //i AOj 16 20 30 &a Di t-,4u.41---H h 2a mollrS ulA- 41o, ooel �'x7"Care D D, �'a`rro ZW li? 41 ac/AFp 151,5s 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 Board of Health. $k*Z/5�4V/ 'o Date go-Application Approved byDate Application Disapproved ll Date 11/ for the following reasons Permit No. Date Issued - No. _ _ j i Fee D " -7HE.COMMONWEALTH OF MASSACHUSETTS Entered in computer: - �,� -. - � + r � Yes PUBLIC HEALTH DIVISION'-TOWN OF BARNSTABLE,-MASSACHUSETTS r O ` _ 1 ZIpplication for Misposal Opstein Construction Permit Application for_a Permit to Construct( ) Repair(Z-rUpgrade(41-Abandon( ) ❑Complete System ❑Individual Components t Location Address or Lot No.z/9 AV 11" Owner's Name,Address,and Tel.No. rL14rS11104 S APf 4E 41P44 Assessor's Map/Parcel - 570 I staller's N e,b¢dress, d Tel.No.S 08" . -71� Designer's Nam,,Address,and Tel.No 47, fSi4r�v5 l�r'yF/' F SoroS• g/ cA41WA"-4-r//�?w /V /-R"i/s r, Type of Building: cea S;b -;Z x o _ D,welling No.of Bedrooms 3 / " 5 Lot Size sq.ft. Garbage Grinder( ) Other`, Type of Building-. No.of Persons Showers( ) Cafeteria( ) Other Fixtures �'<< Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Descripiion of Soil i1 ' Nature of Repairs or Alterations(Answer when applicable) , 9i110.,rFusr-y' H 2a uHils "Ii)% lil® Sra,�rli m Date last inspected: f. / Agreement: The p\ndersigned 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. i igne Gifu Date _p � v Application Approved by i i' Date Application Disapproved by I Date for the following reasons I I..• Permit No. Date Issued 3. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(C-- Upgraded(G-)-- Abandoned( )by 110.5l�I/ A.- l /�4rl�°✓'U at yr/ r14144 jt J A/=1V K41144, W1 IIS has been cons"Jac as e with the provisions of Title 5 and the or Disposal System Construction Permit No. ated Installer JO,S eo4 Q G 1 14eA-03 Designer 10,_-1/5 r ;5 sakf;r. / #bedrooms Approved desigp flow / /y gpd The issuance of th' erml sha of be construed as a guarantee that the system will' �o'nn a s d-si ed G Date Inspector r✓ ! i/ f? t i �� ------- - - - - -� d-• - - - - - - - r - �p�q IN No. �j� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( 44— Upgrade � ,A�b2anddon System located at y �Llsi�Tl4//1 �rej;L; leen and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constru ti m st b ompleted within three years of the date of this permit. Date Approved by J + Town of Barnstable 1HE Regulatory Services Thomas F. Geiler, Director ( � BARIMABEZ 9�AT, Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-362-4644, Fax: 508-790-6304 Installer & Designer Certification Form Date: -) ,� -3 Sewage Permit# 20 f`3 � V Assessor's Map\Parcel Designer: 1"" A'�`�' d4�" S �In L- Installer: ✓r7� Address: Address: BSI On was issued a permit to Install a (date) ����yy (instaCller) septic system at ` n JTV>fl 0- based on a design drawn by ('address) y (W3 V"v�/ dated (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 till box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or anv vertical relocation or any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF Mgsscy r� A N ✓� I' (In taller's Signature) 1140 SNITW�'� ( esigner's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BA STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNST.ABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Heal th/Septic!Desiper Certification Form 3-26-adoc f i n Commonwealth of Massachusetts Executive Office of Energy &Environmental Affairs Department of Environmental Protection One Winter Street Boston, MA 02108.617-292-5500 DEVAL L PATRICK RICHARD K.SULLIVAN JR. Governor Secretary TIMOTHY P.MURRAY KENNETH L.KIMMELL Lieutenant Governor Commissioner FOR GENERAL USE Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: Infiltrator Systems, Inc. P.O. Box 768 6 Business Park Road Old Saybrook, CT 06475 Trade name of technology and models: BioDiffuser I I" Standard, BioDiffuser 14"High Capacity, BioDiffuser 16" High Capacity, BioDiffuser 15"Narrow (Bio 2), BioDiffuser 22"Narrow(Bio 3), ARC 36, ARC 36HC, ARC 50, ARC 18, ARC 24, ARC 36 LP (3.8 inch-invert), and ARC 36 LP (8 inch-invert) (hereinafter the "System"). Schematic drawings of each model are attached. Transmittal Number: X235253 Date of Issuance: June 3, 2013. Authority for Issuance Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000, the Department of Environmental Protection hereby issues this Certification to: Infiltrator Systems, Inc., P.O. Box 768, 6 Business Park Road, Old Saybrook, CT 06475 (hereinafter "the Company"), for General Use of the System described herein. The sale, design, installation, and use of the System are conditioned on compliance by the Company, the Designer,the Installer and the System Owner with the terms and conditions set forth below. Any noncompliance with the terms or conditions of this Approval constitutes a violation of 310 CMR 15.000. June 3, 2013 David Ferris, Director Date Wastewater Management Program Bureau of Resource Protection This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617-292-6761.TDD#1-866-539-7622 or 1-617-674-6868 MassDEP Website:www.mass.gov/dep Printed on Recycled Paper BioDiffuser and ARC Chambers by Infiltrator Systems Inc. Revised Approval for General Use Issued date: June 3,2013 Page 2 of 8 I. Design Standards 1. The models listed in Table 1 are covered under this Certification. Table 1: Chamber Dimensions Dimensions Invert Model W x L x H Height Inches Inches BioDiffuser I I" Standard 34 x 76 x 11 6.5 BioDiffuser 14" High Capacity 34 x 76 x 14 9 BioDiffuser 16" High Capacity 34 x 75 x 16 11.3 BioDiffuser 15"Narrow Bio 2 15 x 87 x 12 6.87 BioDiffuser 22"Narrow Bio 3 22 x 87 x 12 6.87 ARC 36 34.5 x 60 x 13 7.13 ARC 36HC 34.5 x 60 x 16 10.75 ARC 50 51.5 x 42.75 x 30 22.25 ARC 18 16 x 60 x 12 6.24 ARC 24 22.5 x 60 x 12 6.25 ARC 36LP 3.8-inch invert 34x60x8 3.8 ARC 36LP 8-inch invert 34x60x8 8 ' Only Systems installed with this invert height shall be allowed to use the effective Leaching area associated with this model in Table 2. 2.Only System installed with the inlet pipe entering through the roof of the chamber. 2. The System is an open-bottom leaching unit molded from high density, high molecular weight polyethylene (HDPE) Type III, Class A or B, Category 1 or 3 or Polypropylene Group 03, Class 3, Grade 0. It can be installed without aggregate or distribution pipe as an absorption trench in accordance with the requirements in 310 CMR 15.251 or as a bed or field in accordance with the requirements in 310 CMR 15.252. 3. The total effective leaching area for any Chamber Model shall be calculated by multiplying the Effective Leaching Area per square foot of chamber times the total length of chamber from Side Port Coupler to Side Port Coupler including Side Port Coupler. BioDiffuser and ARC Chambers by Infiltrator Systems Inc. Revised Approval for General Use Issued date:June 3,2013 Page 3 of 8 Table 2: Effective Leaching Area in Trench Configuration for New Construction and Remedial Sites Effective Leaching Effective Leaching Model Area Area (SF/LF) SF/LF BioDiffuser I Standard 6.53 NA BioDiffuser 14"High Capacity 7.18 NA BioDiffuser 16" High Capacity 7.88 NA BioDiffuser 15"Narrow Bio 2 4.00 NA BioDiffuser 22"Narrow (Bio 3) 4.97 NA ARC 36 6.78 NA ARC 36HC 7.79 NA ARC 50 NA 6.71 ARC 18 3.96 N/A ARC 24 4.87 N/A ARC 36LP 3.8-inch invert) 5.79 N/A ARC 36LP 8-inch invert 6.96 N/A 3.Effective leaching area is equal to 1.67(bottom width+(2x invert height)) 4.Effective leaching area is equal to 1.0(bottom width+(2x invert height)) 5.The maximum trench width allowed for calculation of effective leaching area is 3 feet. 4. For new construction, the applicant can size the System in a trench configuration without aggregate, using the effective leaching areas presented in Table 2 above. 5. Systems installed on remedial sites shall be allowed to utilize the effective leaching areas presented in Table 2 above or additional reductions in soil absorption leaching area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. 6. For new construction, the applicant can size the System in bed or field configuration without aggregate, using the effective leaching areas presented in Table 3. 7. The System, when installed in a bed or field configuration without aggregate on remedial sites, shall utilize the effective leaching areas presented in Table 3 or additional reductions in soil absorption system area approved by the approving authority in accordance with 310 CMR 15.284. In no instance shall the reduction in the soil absorption system area required in 310 CMR 15.242 exceed the maximum reduction allowed for alternative systems approved in accordance with 310 CMR 15.284. f BioDiffuser and ARC Chambers by Infiltrator Systems Inc. Revised Approval for General Use Issued date: June 3,2013 Page 4 of 8 Table 3: Effective Leaching Area for Bed or Field Configuration for New Construction & Remedial Sites Effective Model Leaching Area SF/LF BioDiffuser I I" Standard 4.73 BioDiffuser 14"High Capacity 4.73 BioDiffuser 16" High Capacity 4.73 BioD=ffuser 15"Narrow Bio 2 2.09 BioD_ffuser 22"Narrow (Bio 3) 3.06 ARC 36 4.80 ARC 36HC 4.80 ARC 50 7.16 ARC 18 2.22 ARC 24 3.13 ARC 36LP (3.8-inch invert) 4.73 ARC 36LP (8-inch invert) 4.73 6.Effective Leaching area is equal to 1.67 times bottom width only. II Special Conditions 1. The System is an approved Alternative Chamber for use as an Alternative Soil Absorption System.. In addition to the Special Conditions contained in this Approval, the System shall comply with all the"Standard Conditions for Alternative Soil Absorption Systems" ("Standard Conditions"), except where stated otherwise in these Special Conditions. 2. This Certificatior_ is for the installation of a System to serve new construction or an existing facility with a proposed increase in flow, for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the Approving Authority and the site meets the siting requirements for new construction. 3. This Certification also applies to the installation of a System for the upgrade or replacement of an existing failed or nonconforming system,provided that the facility meets the siting requirements for upgrades, as provided in Paragraph 6 (b) in section II Design and Installation Requirements of the Standard Conditions. For the upgrade cr replacement of an existing failed or nonconforming system, Systems installed with approved Alternative Chambers and reduced effective leaching area shall BioDiffuser and ARC Chambers by Infiltrator Systems Inc. Revised Approval for General Use Issued date: June 3,2013 Page 5 of 8 also comply with Deed Notice requirement of Paragraph 18 (d)(ii) in section II Design and Installation Requirements and the transferee notification requirements of Paragraph 2 in section IV Addition System Owner Requirements of the Standard Conditions. The proposed use of the System shall also comply with any other Standard Conditions which pertain wholly or in part to upgrades of existing systems. 4. When installed without aggregate,the System shall be exempt from the minimum inlet spacing requirements of 310 15.253. (Systems installed with aggregate are not exempt from this requirement.). 5. When installed without aggregate,the System shall have a minimum of one inspection port through the top of one of the chambers. The inspection port shall be capped with a screw type cap and accessible to within three inches of finish grade. When installed with aggregate in trench, bed, or field configuration, the System shall have a minimum of one inspection port consisting of a perforated four inch pipe placed vertically down into the stone to the naturally occurring soil or sand fill below the stone. The inspection port shall be capped with a screw type cap and accessible to within three inches of finish grade. When installed with aggregate in accordance with the design specifications of 310 CMR 15.253(1)(a)(c) for Pits, Galleries, or Chambers, the System shall comply with the inspection access requirements of 310 CMR 15.253(3). 6. Whether installed with or without aggregate,when installed in trench configuration,the System must be installed in accordance with the trench requirements of 310 CMR 15.251, except 15.251(5)-(9) which pertain to effluent distribution piping requirements and 15.251(1)(b) which limits trench width to 3 feet maximum. The system shall comply with these requirements: a) Length (each trench) 100 feet maximum (310 CMR 15.251(1)(a)); b) Width (each trench) 2 feet minimum (310 CMR 15.251(1)(b)) - Chambers greater than 3 feet wide, when specifically approved, are subject to other Special Conditions and limitations; c) Effective Depth: shall be equal to the depth of the trench below the invert of the chamber inlet with a minimum of six inches up to a maximum of two feet(310 CMR 15.251(1)(c)),; d) The minimum separation distance between any two trenches shall be two times the effective width or depth of each trench, whichever is greater, or where the area between trenches is designated as reserve area, three times the effective width or depth of each trench, whichever is greater(310 CMR 15.251(1)(d)); e) The effective leaching area shall be calculated using the bottom area and a maximum of two feet(per side) of side wall area for each trench (310 CMR 15.251(1)(e)); BioDiffuser and ARC Chambers by Infiltrator Systems Inc. Revised Approval for General Use Issued date: June 3,2013 Page 6 of 8 f) Trenches shall be situated, where possible, with their long dimension perpendicular to the slope of the natural soil. Where possible they shall follow the contour lines (310 CMR 15.251(2)); g) Trenches constructed at different elevations shall be designed to prevent effluent from the higher trench(es) flowing into the lower trench(es) (310 CMR 15.251(3)); h) The area between trenches may be designated as system reserve area only where the separation distance between the excavation sidewalls of the primary trenches is at least three times the effective width or depth of each trench, whichever is greater (310 CMR 15.251(4)) - Chambers greater than 3 feet wide, when specifically approved, shall be separated by three times the actual width and are subject to other Special Conditions and limitations; and i) Effluent distribution lines exceeding 50 feet in length shall be connected and venting provided in accordance with 310 CMR 15.241 (310 CMR 15.25 1(11)). 7. When approved Alternative Chambers are installed surrounded by aggregate in trench configuration, the effective leaching area required by Title 5 for a conventional system shall apply to the System and shall not be reduced, as provided in the Standard Conditions. The System shall also meet the following requirements when installed with aggregate in trench configuration: a) the maximum effective depth shall be 2 feet, measured from the invert of the chamber inlet to the bottom elevation of the aggregate b) the total maximum effective width, including the width of the chamber plus the aggregate, shall be 3 feet; and c) with the use of aggregate, the minimum inlet spacing requirements (20 feet) of 310 CMR 15.253(6) shall apply. 8. When installed without aggregate in trench configuration, approved Alternative Chambers greater than 3 feet wide: a) shall be installed with a minimum separation distance between any two trenches of two times the actual width of the chamber, or where the area between trenches is designated as reserve area, three times the actual width of the chamber; and b) shall only be entitled to a maximum effective width of 3 feet for the purposes of calculating total effective leaching area. 9. Approved Alternative Chambers greater than 3 feet wide shall not be installed with aggregate in trench configuration and shall only be installed with aggregate: a) in a"bed or field configuration" in accordance with the Special Conditions pertaining to all Alternative Chambers and the Special Conditions which reference "bed or field configuration". No credit for sidewall area is allowed in this configuration; or f BioDiffuser and ARC Chambers by Infiltrator Systems Inc. Revised Approval for General Use Issued date:June 3,2013 Page 7 of 8 b in accordancei the i -with t e design specifications of 310 CMR 15.253 (1) (a) (c), the Special Conditions which apply to such designs, and the Special Conditions which apply to all Alternative Chambers. 10. Whether installed with or without aggregate, when installed in a bed or field configuration, the System may be installed without distribution piping, but must comply with the following requirements in 310 CMR 15.252: a) the use of leaching beds or fields is restricted to systems with a calculated design flow of less than 5,000 gpd per leaching bed or field (310 CMR 15.252(1)); b) the maximum length of chambers in series shall be 100 feet(310 CMR 15.252(2)(b)); c) Separation distance between adjacent beds/fields shall be ten feet(310 CMR 15.252(2)(0); d) The effective leaching area shall include only the bottom area, not the sidewalls (310 CMR 15.252(2)(i)). 11. When approved Alternative Chambers are installed with aggregate in a bed or field configuration the effective leaching area required by Title 5 for a conventional system shall apply to the System and shall not be reduced, as provided under the Standard Conditions. The System shall also meet the following requirements: a) the aggregate base under the chambers shall have a minimum depth of 6 inches and maximum depth of 12 inches. b) the area between chambers shall be filled with aggregate meeting the requirements of 310 CMR 15.247 up to the crown of the chambers with a minimum of 1 foot of aggregate to the outer edge of the bed; c) to prevent the intrusion of fines the System shall comply with 310 CMR 15.247(2); d) the maximum distance between chambers shall be 4 feet; and e) the horizontal distance from a chamber to the outer edge of the bed shall be 4 feet maximum. 12. The System, when installed with aggregate, may be installed in accordance with the design specifications of 310 CMR 15.253 (1) (a)-(c) for Pits, Galleries, or Chambers, which state: a) Effective Depth - A maximum of two feet of sidewall depth below the invert of the inlet of the unit shall be used when calculating the effective leaching area; b) Surrounding Aggregate -1 foot minimum per side. 4 feet maximum per side; and c) Separation Distance Between Units -two times the effective width or depth, whichever is greater. 13. When installed with aggregate and installed in accordance with 310 CMR 15.253(1)(a)- (c),the effective leaching area required by Title 5 for conventional chambers shall apply BioDiffuser and ARC Chambers by Infiltrator Systems Inc. Revised Approval for General Use Issued date: June 3,2013 Page 8 of 8 to approved Alternative Chamber Systems and shall not be reduced, as provided under the Standard Conditions. The System shall also meet the following requirements: a) The Alternative Chambers must be installed on an aggregate base of at least six inches deep. The maximum allowed total effective sidewall depth shall be two feet when calculating the effective sidewall leaching area and shall be measured from the invert of the chamber to the bottom elevation of the aggregate; b) The effective width of the Alternative Chamber or Alternative Chambers in series shall include a:least one foot of surrounding aggregate per side, up to 4 feet per side. The effective bottom area will be increased by two to eight SF/LF with the corresponding addition of one to four feet of aggregate per side; c) The area between adjacent units may not be used as reserve area when the System is installed in accordance with 310 CMR 15.253 (1) (a)-(c); and d) Adjacent units (Alternative Chambers with surrounding aggregate), separated by undisturbed sails of less than two times the effective width, shall be considered a multiple bed configuration and shall not be entitled sidewall area when calculating the effective leaching area. 14. For Systems constructed in fill and installed without aggregate,the System shall be installed as specified in 310 CMR 15.255: Construction in Fill, except the minimum 15 foot horizontal separation distance to be provided between the soil absorption area and the adjacent side slope shall be measured horizontally from the top of the chamber. I Town of B• .,-nstable. P# Dep grlment of Regulatory Services Public Health Division Bate BreBLK Fr�sa ; tbsy tee$ 200 Main Street Hyannis MA 02601 jo A '��Fpt1JtM A. d /� ✓� /�/ Date Scheduled V / Time i Fee Pd. ,Foil Suitability Assessment for Sewage Disposal Performed B DNA, ���/1/i Witnessed By: / n/00� r .� LOCATION & GENERAL INFORMATION Location Address Al. l C"TA t✓1 4 �d 1 e�j Owner's Name M4-E/v,?¢, M 1 i,Is Address A,, Assessor'sMap/P4rcel: t26l o `� I Engineer'sName•J1ar-r A4 e_,I -0-jPl-el NEW CONS1RU�iION REPAIR i Telephone# SOR 3Go.._33./I Land Use � ` Slopes(9'0) 0•/ . • Surface Stones NOyle,, Distances from: Open Water Body 7�0 ft` Possible Wet Area �V ft Drinking Water Well ft i . brainage Way >l DO ft. Properly Line �6ft Other ft s of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) SKETCH:(Street name,dimensiod `Yb UV G S �e YriV�� Sow- � � I Ply i i f,"{ q..,e •4 s .. 9 -• . i I i r'acc� Parent material(geologic) ovtwAst,,� Depth to Bedrock ,,/ -----..-r—^— Depth to Groundwater. Standing Water in Hole: /• /r'1 Weeping from Pit Face,v TAQ_ Estimated Seasonal;Righ Groundwater WIA i. DtTERMINATION FOR SEASONAL HIGH WATEXTABLE Method Used: Depth Observed standing;in obs.hole: __in. Depth td soll mottles: $• in, Groundwater Adjustment Depth toiweeping from side of obs.hole: i Adj,'firoundwater Lsvel.•,,,e• Index Well# _� Reading Date: index Well lev,l __ Adj.Actgr,. _ram ; • PERCOLATION . Date Observation I Time at 9" -- hole# 08N��rl Time at6" Depth of.Perc Time(9"-61 Start Pre-soak Time.@ Jl y i End Pre-soak � Rate MinJInch Site Suitability Assessment: Site Passed � _ Site Failed:_-- Additional Testing Needed(YIN) Original:.Public k:elth Division Observatioti Hole Data To Be Completed on Back-- ***If percolation test is to be conducted within 100' of wetland,,you must first notify the Barnstable C64servation Division at least one (1)wedk prior to beginning. DEEPOBSERVATION HOLE LOG Hole#_� Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel Orl �'' Ant an� 1 Q`�lv 10,7 „' � 10 !tom tr [C, b C2 �.I DEEP!OBSERVATION HOLE LOG Hole#. Depth from Soil Horizon- Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) 3s�f_lov.q C . ���I �� C� ..SaYI. Z• b DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel 3 DEEP OBSERVATION HOLE LOG Hole# A Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consisten ra I .r b _ Flood Insurance Rate Map: / Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100 year flood boundary No_ Yes Depth of Naturally Occurring 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? If not,what is the depth of naturally occurring pe vious material? ' Certification I �� I certify that on 6 (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 require in• g,expertise and experience described in 3,10 CMR 15.017. Signature Date 13 Q:%SEPTlWERCFORM.DOC 2-G OJ V Fps..... ... IZA4,h THEBOARD COMMONWEALTH OF,M�ALTH TS OF............ .... . . . ............. ........ Appliration -for Dii lout Norko Tonfi#rurtion Vrrmft Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ........... Location.Add r or Lot No. ---- --- ----- - -------------------------- ----- ----- O wn�a j Address ------------------------------------------------------------------------------ Installer Address dType of Building Size Lot............_---------------Sq. feet Dwelling 5—No. of-Bedrooms----------PZ............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons_-_____----___-_---.__----- Showers ( ) — Cafeteria ( ) P4 Other fixtures ...................................................... W Desi n Flow---------- ��®g �?_______________________gallons per person per day. Total daily flow....._.__....._ _ ______.........gallons. 9 Septic Tank'-1 Liquid capacity tlIons Length................. Width-----_-----.-.. Diameter................ Deptll.-.------------- xDisposal Trench—No. .................... Width-..-__--_____-_--_-- Total Length_.---____--__-•_--. Total leaching area--------------------sq. ft. Seepage Pit No.._,/-__-_____--__ Diameter/ __S_ODepth below inlet... ._____. Total leaching area------------------sq. ft.' Z Other Distribution box ( ) Dosing tank ( ) d j-. G� — 7S— Percolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water--.:----------------_- (% Test Pit No. 2................minutes per inch Depth of ' est Pit-------------------- Depth to ground water......-.---.---.-_----.. X /-------- 0 ----- ---4- Description oIl r ••--• -------=^----- ---- ------ l/(--- - - V ---------------- -- �� -- ------------------------------- W ------------------------------------- - --------- --------------------- �_ 1--- VNature 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 P P Y_•_-L�C.r ___ _._ . operation until a Certificate of Compliance has been ed r the bo of ealt Igned.--- .-- • •- Date i� Application Approved By... .. ... .... •--•• �� •• --- ���- �--7 4- Date Application Disapproved for he following reasons------------------------ --......_•---•• •-------------------------------•------------------------------------.....-------•--•--•-•-•--•---- ti ` r� Date PermitNo.--••----•-----•---•••-•--••••--•--------•............... Issued. = --- -- -- ------ ... Date --- --- --- - - - ------------------------------------------------------------------------- -------------- lee No...... ..� ... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH, ' . .v............OF............ .... .. . ApVtiratiun -for Uinpunttl Morks Tlanntrnrtinn Vrrnfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: - L U 7A /lif �ri'.-& �--/, / /e 1' ,C ��/,/,- /'��f /r fr .' ��/. I4- Location-Addr l _ r or Lot No- / ....................................................' ` .. r. fi..�•. �� /� ...........................................................1 sm. />�t�e�fs f( -- // /7 Own �------•-•---------•--•------ Address Installer Address Q Type of Building Size Lot___________________________Sq. feet Dwelling L o. of Bedrooms___________ ____________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- --- W Design Flow�______�_v......................gallons per person per day. Total daily flow................ ---------------gallons. WSeptic Tank Liquid capacity--,,-," (*Ilons Length---------------- Width---------- Diameter................ Depth---------------- x Disposal Trench—No_--------------------- Width.................... Total Length____________..--_._. Total leaching area........------------sq. ft. Seepage Pit No.... ............ Diameter,/CC.�O._S_'-)Depth below inlet... ......._.._. Total leaching area------------------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) D/— I S=z v- 7S'— aPercolation Test Results Performed by-------------•---------••-•-•••--•••--•---•--••---••••--•-------•---•--•• Date---------------------------------------- ,� Test Pit No. 1----------------minutes per inch Depth of Test Pit._.________.______-- Depth to ground water._._-_._____.__.__-__--- LL, Test Pit No. 2................minutes per inch D�/est Pit.___.____._________. Depth to ground water_..__________________...• -• ----- - --------- ......•.... ............. . ------.... Descri tion o oil_._ -•-•- � /i.:,i- 4- -:.- - P -- -----U -- ------------- � — �-.----. ----------------------------- i n = try 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 ' ed by the bo of ealt . Igned }, ------ . •-• r'------. _'.. = .------••••-• ••-•••--••---•-•-•-••--•-------- (/�/ �~ Date --� Application Approved By-- --- -�- s �� ............. - Date Application Disapproved for the following reasons------------------------------ ------ -------•-.....•-••---•-•-••-------•••-•••••-•-••••......••--------•----•-- ------------------ Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............OF.......�_-it-G Z........`............................... Trrtifirntr of ITIOm rlittnrr by.�HIS S T , C I�TI That t e IniTi idual wage Disposal System constructed ( or Repaired ( ) -T--.�[_ .,k.. ....�. �, ewe ,/ � . .. Ins ll has been installed in accordance with the provisions of Ar,i le The State State Sanitary Code as described ju-the l application for Disposal Works Construction Permit No S __-_ -----6 CZ..._.._.. dated_._ ___- Q..-.�1 .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector--------------------............................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH 7=,__1 * //� D� ....... .........OF....... .... -------------------------------------------------- FEEI--��`_........ inn dig n, np1rurtion Vr it Permission 's reby granted-------- ---- - --- ........................................... p V kiis�pai ! _-----_to Cons ct ) o Re ai ( ') an I divi 1 Sewage (Sy e_ atNo t ���•---...� v ........................................................ - / as shown on the application for Disposal Works Construction P rrit No.____ ____ _!.__ ted..... .� G> . .. ---=------.......- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �,55 pg LEGEND " MARSTONS MILLS DO C PROPOSED CONTOUR LOCUS: � ® PROPOSED SPOT GRADE RqC 49 CAPTAIN /�/ CgNE EXISTING CONTOUR STUDLEY ROAD S63O6' 65`65.30 ST/ ' + 96.52 EXISTING SPOT GRADE O01F �i� '��. VO W- EXISTING WATER SERVICE o TEST PIT N N O i1 f/ j ` HUBAEL o� OQO I 65.1 O,�]O POND y RQ 65.10 GV LOT 14 N �y AREA=20,851f S.F. \\ �� Q� l 65.8 /' O Q \ /J i� vent LOCUS MAP WOODS `\ / �.q insp ports f \ ,e 12. LOCUS INFORMATION Nv 1 "P i 66.0 PLAN REF: 274/34 16 TITLE REF: 2240/91 Q 12"P EX15T. LEACH PIT PAR EL ID RFMAP 126 PAR. 50 m EX15T. I 2000G NOTE 1 O FLOOD ZONE: "C" SEPTIC TANK TBM: TOP OF COMMUNITY PANEL: 250001-001 5-C DATED:08/19/85 CONC.=68.00 /A � CH W - �o LOT 15 SEPTIC SYSTEM W __- _ 5 FT. 501L REMOVAL REPAIR PLAN LOCATED AT: W ° I TH_1 8-CH TH-2 NOTE 17 49 CAPTAIN STUDLEY ROAD „ I N 49 a$ H GENERAL NOTES: M AR STON S MILLS, MA. W •`. = # -- 12"P 12"P 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL PREPARED FOR TOF=68.00__ (0 BOARD OF HEALTH AND THE DESIGN ENGINEER. J ( ' _ _ - 66.2 CO 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE M A E N P A A LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: / 12"P - 310 CMR 15.405 (1) (B): JUNE 4, 2013 REV: 6/30/13 - CHANGE LEACH' 12"P 1) A 2.96 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING TO BE 5.96 FT (MAX) BELOW GRADE VS REQ'D 3 FT. 65.2 (H20/VENT PROVIDED) 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR Of fJ, / TODESIGN NSPE TI NEER.D APPROVAL BY THE BOARD OF HEALTH AND THE � O WOODS ' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING DA FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. NO. 1140 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6 THE THE CONTRACTORI ORR IS OWNERTTO NOTIFY 9 HE LOCAL BOARD OFOR THE F OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. NITAR0 �� �0 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. Zry 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. S6`3Q6, 9 CONTRACTORIT SHALL BE THE RESPONSIBILITY OF THE FY THE LOCATION OF ALL UNDERGROUND UTIL ES, G PRIOR TO STARTING WORK.r 3S F 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND REMOVED PER TITLE 5. MEYER & SONS, INC. REPLACE W/ CLEAN MEDIUM SAND PER TITLE 5. 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION P.O. BOX 981 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO KNOWN PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING EAST SANDWICH, M A. 02537 8� 14. ALL PIPING TO BE 4" SCH 40 0 1/8-/FT (UNLESS SPEC. ) LOT 20 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW (5 0 8)3 6 2-2 9 2 2 FOR THE USE OF A GARBAGE GRINDER 16. NO WETLANDS WITHIN 150 FT. OF PROPOSED LEACHING 17. REMOVE ALL UNSUITABLE SOILS 5 FT. AROUND PROPOSED SCALE: 1"=20' LEACHING TO EL. 56.50 OR TOP OF "C2" LAYER AND REPLACE W/ CLEAN MEDIUM SAND PER TITLE 5. SHEET 1 OF 2 J 1540 NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:59.84 I FOR A DISTANCE OF 15' AROUND THE �i PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. T.O.F. EL.=68.0 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN.) AND SET TO 3" OF F.G. > TF.G. EL.=66.20f F.G. EL.=66.0t F.G. EL: 65.80t F.G. EL: 65.80(MAX.) �� OF VENT y 9" MIN COVER/ D N 36" MAX COVER L = 20' L = 10'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) No. 1140 0 S=1% (MIN.) EL. = 64.48 0 S=1% (MIN.) 0 S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC " 'GIST 10� 14 s' 11.3" TO SANITAR0a� INVERT INV.=63.40 48"L1oufD INV.= 63.15 INV.= 59.34 t� LEVEL PROPOSED GAS BAFFLE � X INV.=61.80 3 ROWS OF 5 UNITS,AT 6.25'/UNIT + 0.75' WEDGE = 32.0'/ROW INV.=62.0 � SOIL ABSORPTION SYSTEM PROFILE) EXISTING 1.000 GALLON SEPTIC TANK E OUTLET RESTORE VEGETATIVE COVER XISTING SEWER INV.=63.85 BACKFILL WITH CLEAN PERC SAND 75" TO TOP OF CHAMBERS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING BREAKOUT=TOP ELEV.=59.84 PIPE INVERTS PRIOR TO CONSTRUCTION INV. ELEV.= 59.45 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.= 58.51 EXISTING SUITABLE GRADE ON A MECHANICALLY COMPACTED SIX 2 83' MATERIAL INCH CRUSHED STONE BASE AS SPECIFIED IN MIN. A TT 5 ROVE BOTTOM OF 0 310 CMR 15.221(2) T.P. EXCAVATION OR G.W. r" 76"- - 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK (6.01' PROVIDED) EFFECTIVE WIDTH 3 x 2.83' = 8.49' WITH 1500 GALLON SEPTIC TANK IF FAILED, ADJ. GROUNDWATER EL.=52.50 USE 3 ROWS OFF 5-HIGH CAPACITY PROFILE DAMAGED, OR UNDERSIZED. = ADS 1620BD BIODIFFUSER (H20) UNITS-NO STONE W/ CONTOURED WEDGE 4) INSTALL INLET & OUTLET TEES W/ GAS BAFFLE AS REQUIRED SEPTIC SYSTEM PROFILE TYPICAL SECTION 16" N.T.S. q.rs 11� �1.. SOIL LOG P#:14006 DESIGN CRITERIA DATE: MAY 20, 2013 ---34" '-� NUMBER OF BEDROOMS: 3 BEDROOM DESIGN SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE #1614 SECTION - END CAP SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: <2 MIN/IN WITNESS: DONNA MIORANDI, BARNSTABLE HEALTH r,�'` `. DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 330 G.P.D. Elev. TP- 1 Depth Elev. TP-2 Depth 16" HIGH CAPACITY 16208`D H-20 610 IFFUSER UNIT GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 65.70 A LOAMY SAND 0" 65.50 A LOAMY SAND 0" MODEL 16" HICAP SEPTIC TANK: 330 10YR 4/2 toYR 4/2 gpd x 200% = 660 gpd USE EXISTING 1,000 GALLON SEPTIC TANK 65.03 8" 64.83 LOAM 8" LENGTH 76" B NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT 62.53 C LOAMY SANDY 7//22 38" 62 SANDY 7/2 EFFECTIVE LENGTH 75" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. SIDE WALL HEIGHT 11.3" .33 C LOAMY 38" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. SANDY LOAM SANDY LOAM OVERALL HEIGHT 16" DISTRIBUTION BOX: 3 OUTLETS (MINIMUM) 56.70 1oYR s/s 108" 56.50 1oYR s/s 108" C2 C2 OVERALL WIDTH 34" 4640 TRUEMAN BLVD PRIMARY S.A.S. MEDIUM MEDIUM - 13.6 CF 90PUBO HILLIARD, OHIO 43026 (it USE 3 ROWS OF 5 - 16" ADS 16208D BIODIFFUSER H-20 UNITS-NO-STONE SAND SAND CAPACITY AND EXTENDED 0.75' W/ CONTOURED WEDGES PERC TEST 2.5Y 6/4 2.5Y 6/4 (101.7 GAL). ADVANCED DRAINAGE SYSTEMS, INC. BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.73 SF/LF OF BIODIFFUSER) 0 55.0 PROPOSED SEPTIC SYSTEM/SITE PLAN (BIODIFFUSERS) 15 UNITS x 6.25 LF x 4.73 SF/LF = 443.43 SF 52.70 156" 52.50 156" 49 CAPTAIN STUD LEY ROAD, M. MILLS, MA (CONTOURED WEDGE) 3 ROWS x 0.75' x 4.73 SF/LF = 10.64 SF TOTAL AREA = 454.07 SF PERC RATE <2 MIN/IN. SOILS IN ("C2" HORIZON) Prepared for: Maenpaa DESIGN FLOW PROVIDED: 0.74GPD/SF(454.07SF) = 336.01 GIRD > 330 GPD req'd NO GROUNDWATER OBSERVED Engineering and Surveying by: SCALE DRAWN DATE: Meyer ASons,Inc. NTS D.M.M. 06/04/13 1. Darren M. Meyer, R.S., CSE, hereby certify that 1 am currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX 981 REV. DATE to conduct soil evaluations and that the above analysis has been performed by me consistent with the A9A02537 CHECKED SHEET NO. EAST SANDWICH, requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. 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