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0035 CARDINAL LANE - Health
35 Cardinal Lane MarstonsM_ills P A = 014 022 F E I� i I �y LOT .84 �Q to I t- Io .z oh TEST PIT#i Q PRESERVE APE:A • - nryyyY• , .'�,„P 9 90 , .1 � TEST PIT# -a.d+n. b 4; deep. " LEACHZ PITWIth ' / O � 2'of washed stoNe N oI I around. • 0 p 8i Dlsr�BUTIou Box 56.30 I /t(� �� loon GAL. II ` ? a SEPTIC TANK 2 V,IoV2 Lo-r 80 J� Z '` t /yo � y>^ SLOT -18 stone. g � 02 19� °201 — ° io FoUNDA-r'lop( D(QA'N$ •..... I I 10'wIDe DRIVEWAY 91.80 WITH LEAGHINGi � ,xl1l LO-r 79? BENCH / = t TN REUi � MARK EXISTI-NG WELL' �X15`�EG I� �� 4 23,E 451 S.F. LL- town, ELEV. 5Z.0± =8 3Z�E /7'� LnI I I�1_ •••• T Ip of�BANK-'-' 5. EDGE of PAVEMENT , W,ae) CARDINAL LANE �Pfz1VATE� �� Ic. - TION. L CgMFY W -ME �UILOINC 15 LY-AT� 1 fI P( T)�A�f 111 E 5JILp)Nu !S 11XA� SCE a� 11NowN AMD THAT THE ILo TION CON- OW FL -D ZC NF � AS � �VU ON FILY�D FORI�'ts Tv TWE: ti11N11.1U 1 f �I�s OF INS - � pp c..�NukN17`( _F:w4 OF C J NW9EER 250001 0005 A AND RcnD �E 5EP( 2, 1980 >: IS ?.YET. fh 1IA D �AZPdZD � ) TEM. IBIS 444%tJRVE`fr52 �T 2 r 9eL �'► ' / LT H 60 r z 11*0 APP Uu�t l► I bV >#� cazfl '17cNs J�Sit tNS > DATE DESCRIPTION Drawn by Checked-by REVISIONS PLOT PLAN OF PROPOSED SEWAGE DISPOSAL SYSTEM —. FOR JOSEPH POLCARO 'LAN OF LAND IN . ?, X•._ Ih MARSTON MILLS,BARN STABLE,MA. E, MASS. DE.- SCALE: I'�=.40' DATE: JUNE 18 1980 '- .-• ►WELL AND TAYLOR holmes and mcgrath,'inc. civil engineers and land surveyors 301 main street falmouth, ma.02540 Checked by Plug CIV ENa NEER` a. T 14-22. 548-3564Drawn y,�744. JOS N° 80133 DWG. Ne A-978 SHEET I OF 3 . �' ,, , ('� .._�_...�._..__._,_..._......_.:.�_ _... N,�_�._._,..�_ -.�._. �,.� .__. _,. _v_�_ ��.. ._,Y..�,., � f .�..__.e.__.______._ � ,� _� �� x � ,. i q `� �� - � � I f ____ ^�. 3 � 7 „' .•g ,. � `��: ,_,.,��_....:.�. Nr...�.,._,..._�.,._--t___... �,,...._�� ter- �� wv_�__.._.......�_..,.......:...u,._. �._._. � � ..___.... , LQCATION .•-� SEWAGE PERMIT NO. �'A /yr l RAJ, VILLAGE INSTALLER'S NAME AND ADDRESS BUILDER OR OWNER 777 DATE PERMIT ISSUED DATE COMPLIANCE ISSUED %f��51Sb s i GZ cc-rw - �.�,►c�L �r t i1 ��llgq]] al. m Ilk ' /7/(d t � • � 3 9,4m . > 77 Nd........... -...1....: TA^ _............... THE COMMONWEALTH.OF MASSACHUSETTS BOARD OF HEALTH /..[2..W1if..............OF....... ..•,----•---............ Appliration for Dispusdl Morkii Tonstudion ramit Application is hereby made for a Permit to Construct (A") or Repair ( ) an Individual Sewage Dis osal System at ........: . ... :.,�, ./_tiff L....L�r4N 7 ... ..... ..... Locati Add Lot No. �i�:....0' Q -fA_:47-_T1---------------- �/�11 `----------------................ _.._....... Owner dre if Installer -Address /�� 2yy I' Type of Building CC ize Lot-S—T-/_ J................-Sq. f Dwelling—No. of Bedrooms.............. 4/Y._._._..__.._..Expansion Attic ( v) Garbage Grinder Other—Type of Building No. of persons............................ Showers — e Otherfixtures ••--••-••--•••--------------•••---•-...•---•-----•---•.-••-•...------•-------•-----•-•---•--=-•----------•-••-•--•-•-•-•-....:-•. ..................day. ..... Ions. W s �r r' WSeptic Tank—Liquid capacityjM.;allons Length__ .._._ Width._.y._._ Dia eter....... ....... Depth..-- ...1M.!iVr x Disposal Trench—No. ... Width.................... Total Length..... Total leac mg area....................sq. ft. Seepage Pit No.........../...... Diameter......1.0. .... Depth below inlet._..... .... Total leaching area. .Z9_.s ft. z Other Distribution box (� Dosing to ( ) n (ite�M�*M¢j .4Ariy� Percolation Test Resul ............----- per inch Depth of Test Pit...../-;---__.... Depth to ground water.W-0,I/Ix r ... - - - • - __......- ------•_.... o Description of Soil........O_col... - x •---••-------------------------••----------------••••---------•-----.----------••••-••------•--•-••------•-•-----••••••-•...-----••------------••-•••-------•------•----•---......••----------••-•-•--•- 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 iITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board f h th. / Sig /ffo Da e Application Approved By----- ;, -------------------- -••••-. ...��----- Date Application Disapproved for the following reasons:-----•.................. ._..._•-•--------------------••••-------------•---•-•------- ----....._.._. Date PermitNo......................................................... Issued.-•------•---------------....._....-•--.....--------_.. I Date No ........I.... FE;�.s . .......... .............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ Applirttlion for Dispoo al Works C ontitratrtion ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: Looatio -Addres Lot.No.. ............ ........................ Owner Add re .• .................. 1. !, Installer Address f 1 Type of Building ize Lot. .__k._._;j................Sq. feet Dwelling—No. of Bedrooms______________ _..............Expansion Attic ( Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers A`" r — Cafeteria 0.1 YP g P ( ) ( )4. , Q' Other fixtures ..................... r W Design Flow.•...........:... _ ._ gallons per person" of day. Total daily flow........ { __ . ° r ---------- - ----- -�------`" ------- Ions. WSeptic Tank—Liquid capacrt _�d.gallons Length__ _...(.. Width._ ..:_. Diameter._.__.._.___.__'Depth_:._..... !t_! x Disposal Trench 4rN,o. ......___IA.._ Width........ Total Length.._. ._ Total leaching area:... x_ .__ sq. ft. .� 'i Seepage Pit No.......... ....... Diameter_.._... _____. Depth blow inlet__. .... Total leaching area.! '�.... _s . ft. M Other Distribution box VT Dosing to ( ) � �°���,� d-/W Percolation Test Result Performed by._...... , 3�fi•4; • _ .... Date.... Q_ P . __ .. d....... minutes per mch Depth of Test Pit ti � Test Pit No; 1_._._� p p �`..__.. Depth to ground water''___.4A6 _. f3, Test Pit No.;2._.._ ......minutes per inch Depth of T�st Pit----4....___... Depth to ground water.A-_#_A/, ___. _ r ............... r --•----------- .............. ... .,... Descri on of Soil -a�#t�7" s! C� -:... ... G4:$/ rY �.r G, y / �W 'v� �A S1!�. 0 } �i.......--••• l .. ,0 --------- UNature of Repairs or Alterations—Answer when applicabl'e__---_•-----------------------------------------,............................................................ ) --------•-------------------•-------------------•----------•------...------------------------.......•----•-•--•----------•--•----•••----•••----••••.:....•--•--.........--•-•----•---••-----•-----•--•. Agreement The undersigned agrees to install the aforedescribed Individual"�ewage Disposal-System in accordance with the provisions of TIT?..;;` 5 of the State Sanitary Code--L The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is/sued b the board f h th. Sig -d t, _.. __ �t. !l. a _ /Q DD e Application Approved By.••••-- •-•-- , ..._.�' • ' ------------------ Y L ' SP l .. Issued-•••--==•---••-------•--- Permit No...................••-• Date...... Date THE COMMONWEALTH OF MASSACHUSETTS g BOARD O HEALTH Wit...........oF........ . . ..... ..........................•••••--••-••....... rWIn ' Mtr of ToutpliFaata THI�S,�S TO CERTI Y Th theual Sewage Disposal System constructed ( ) or Repairedb .. - ------ ... y --. I stal .• at ,P .... �44 has been installed in accordance with the provisions of TI 1`�o T e State Sanitary Code as described. in the application for Disposal Works Construction Permit No... .. ......J_ 7. ......... dated_..:._.`.-2.. .:"t d 1 THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED. AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � t DATE................ � a.`�.......................................... Inspector__(24.19..._ } THE COMMONWEALTH.OF MASSACHUSETTS .dv ' BOARD F" HEAL, f ..... �ly(! '1............0 F.....................................4 % ......................... ? r� No...........3 �.. FEE..Y.................. Dispa �rk� aaat ' n rani Permission is hereby granted....... .: :...._...... ...-_---- to Const ct ( Rep r an I v'dual ge spasal s AM _at No..s��-�--�1 .��_r }'r'f:_. t . \ ...... --- ....... Str t as shown on the application for Disposal Works Construction Pe No.... .�/...... .................. --------------------- Board of Health DATE /8 FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 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 to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name P.O.Box 763 Company Address Centerville Ma. 02632 City/Town State Zip Code (508)428-4028 S14454 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 maintenance of on site " ; rv7 sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Q ez�, Title 5 (310 CMR`15.000). The system: ce ®`. Passes i ❑ Conditionally Passes ❑ Fails c U � El ,Needs Further Evaluation by the Local Approving Authority o ( 12/31/2009 Inspect rs 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 in the future under the same or different conditions of use. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 I a Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. 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 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is Marstons Mills Ma. 02648 12/31/2009 . required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 J Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 i every page. City/Town 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 water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for 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 El ® 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 El ® or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/z day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M ,•''V 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town 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: ❑ ® 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 CM 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. 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town 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 ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ' ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ ® Existing information. For example, a plan at the.Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M ,•''v 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town State Zip Code Date of Inspection D. System Information Description: The septic system consists of a 1000 gollan septic tank,D-Box and leaching pit. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d Well Water 9 ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 12/1/2009Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 i i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 a every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 1980 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line. 20'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: 14"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years M Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) El Yes ❑ No Dimensions: 1000 gallon Sludge depth: 4" t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 I I Commonwealth of Massachusetts W Title 5 Official_ Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town 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 28" Scum thickness 0" Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every two years.lnlet and outlet tees are in place.No evidence of leakage.tank appears structurally sound. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts L W Title 5 Official Inspection Form �j Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 ❑ 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Box is Ievel.Box has one outlet Iateral.No evidence of solids carryover.No evidenc eof leakage. 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 site plan, excavation not required): If SAS not located, explain why: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 112 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): Sandy dry soil.No signs of hydraulic failure.Leaching pit was dry at time of inspection.Stain line obsreved 32" below invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 I f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 - I Map Page 1 of 2 Town of Barnstable Geographic Information System Parcel Viewer I Custom Map Abutters Map Size ■ ■ Zoom Out i l l 1 1 1 1 1 JIn L K R A � + I i � . I t ♦ j I 3 ISO � 3�/ 3 9' , 7 3 O 0'•,, 20 Fe f, -77 Set'. Scale 1" = 20 I Aerial Photos I MAP DISCLAIMER !'n—rinht 9Mr-')0n0 Tn,./n of Rornetohlo hAa All rinhtc rocnno Commonwealth of Massachusetts f Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is required for Marstons Mills Ma. 02648 12/31/2009 every page. City/Town 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: Bottom of LP 60' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: As-Built ❑. Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 35 Cardinal Lane Property Address Laura Appleton Owner Owner's Name information is Marstons Mills Ma. 02648 12/31/2009 required for 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 6' t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 I .T 133� MAP ® 14- PARCEI, ; ®Z Z...,....�.. COMMONWEALTH OF MASSACHUSETTS PA . EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS A Z = DEPARTMENT OF ENVIRONMENTAL PROTECTION cupy w � � d A� yt v�Y TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner's Name: MR. MORNEAULT Owner's Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Date of Inspection: 6/2/03 RECEIv�� Name of Inspector: (please print) JOHN GRACI,INC. 2Q�3 Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 SOW HEALBH pEP P� Telephone Number: 508-564-6813 FAX 508-564-7270 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 the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes _ Conditiont ses _ Needs Fualuation by the Local Approving Authority Fails Inspector's Signature: Date: 6/2/03 The system inspector shall submit opy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspect' n. 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. Notes and Comments SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEMS USEFUL LIFE. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR.MORNEAULT Date of Inspection: 6/2/03 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a 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 _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a 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 _obstruction is removed ND explain: n/a Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR.MORNEAULT Date of Inspection: 6/2/03 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 and the environment: _ Cesspool or privy is withir_50 feet of a surface water _ Cesspool or privy is withir_50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance n/a "This system passes if the well water analysis,performed at a DEP certified laboratory,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 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: n/a Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR.MORNEAULT Date of Inspection: 6/2/03 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/z day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped SYSTEM WAS PUMPED TWO YEARS AGO.. _ X Any portion of the SAS,cesspool or privy is below high ground water elevation. _ X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _ X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X 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 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 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.] NO (Yes/No)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. 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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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. a Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR. MORNEAULT Date of Inspection: 6/2/03 Check if the following have been done.You must indicate "yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site? X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum? X _ Was the facility owner(arid 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: Yes no X _ Existing information.For example, a plan at the Board of Health. X _ 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(3)(b)] 5 Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR.MORNEAULT Date of Inspection: 6/2/03 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Number of current residents: 2 Does residence have a garbage grinder(yes or no):NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings,if available(last 2 years usage(gpd)): n4— O Z� W?l 000 Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIALANDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/,sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no):NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings,if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: SYSTEM WAS PUMPED TWO YEARS AGO. Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X 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) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1978 BY OWNER Were sewage odors detected when arriving at the site(yes or no): NO � �I Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR.MORNEAULT Date of Inspection: 6/2/03 BUILDING SEWER(locate on site plan) Depth below grade: 18" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 12" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000 GALLONS" Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle:33" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 17" How were dimensions determined: MEASURED Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR.MORNEAULT Date of Inspection: 6/2/03 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): D-BOX IS STRUCTURALLY SOUND. PUMP CHAMBER: _(locate on site plan) Pumps in working order(yes or no):NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a u I Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR. MORNEAULT Date of Inspection: 6/2/03 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. SYSTEM SHOWS NO SIGNS OF FAILURE.PIT HAD F OF LIQUID IN IT AT TIME OF INSPECTION.STAIN LINES INDICATE PIT HAS NEVER HAD MORE THAN 1' OF LIQUID IN IT. BOTTOM IS AT 10 FT. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a U Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR.MORNEAULT Date of Inspection: 6/2/03 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. ti. Net da L �9r4 t�L � c in � Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 CARDINAL LANE MARSTONS MILLS,MA 02648 Owner: MR.MORNEAULT Date of Inspection: 6/2/03 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12 feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from syste&design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: HAND AUGER- 12 FT. 11 prv � 7 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION TORM Address of property Ca.r'A; K K I L owne 's name Date rof Inspection POLL,, l QI�C��U�If�D yl°�y/ g 5 PART A MAY 2 6 1995 CHECKLIST KEAl1N fP'L Check if the following have been done: TOWN OF BARNM%E Pumping information was requested of the owner, occupant, and Board of Health. None 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. As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The site was inspected for signs of breakout. All system components, excluding the SAS, have been located on the site. The .septic tank manholes were uncovered opened, .and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. V The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS.' 1r ♦ �1 .v' i..�7 FF! ..1� '.. x. ��� F SUBSURFACE SEWAGE DISPOSAL SYSTEM 'INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential .2 number of bedrooms d number of current residents to garbage grinder, yes or no .a5 laundry connected to system, yes or no MD seasonal use, yes or no If nonresidential , calculated flow: Water meter readings, if available: /C& = o241 U O ° 17? -1 _ aye e0c> & I . Last date of occupancy GENERAL INFORMATION Pumping records and source of information: o 42--h 42 Al 0 �b System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: of system Typ 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) • Other (explain) Approximate age of all components. Date installed, if known. Source of information: O io" e— J a lyO Sewage odors detected when arriving at the site, yes or no I 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B f SYSTEM INFORMATION continued SEPTIC TANK: (locate on site plan) depth below grade:_/ material of construction: concrete metal FRP other(explain) dimensions: X2 X a p s. u sludge depth _L�J"distance from top of sludge to bottom of outlet tee or baffle 9 " scum thickness G" distance from top of scum to top of outlet tee or baffle distance from bottom of 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, recommendations for repairs etc. ) Co lry c.Y c TC- 1 N e 4- Cr►� o u T /<- -i-GG s ,.J yI t/ r :n C.J y✓ k r v► r. dc.- ` 7 k o � 2 b � S � �v� a L O w1 h't t w L.l J H.. /� v� i h S tJ ✓'C l.cn✓`© �/` -.r..�v✓ l/1 c. Vr�e✓ . DISTRIBUTION BOX: V (locate on site plan) e u tr'A 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, recommendation for repairs, etc.) D- 2_0 x .,Lt� J �.! y G / � G .c a PUMP CHAMBER: (locate on site plan) pumps in working order, yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs,etc. ) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : V (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. leaching pits and number 6h c 6 �— leaching chambers and number &J leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) V / '_J ! co, ✓1 &? (.� o S i #4r 0 1 wJ '• o/ ✓o S ' cu L CESSPOOLS (locate on site plan) number and configuration depth-top of liquid to inlet invert depth of solids layer depth of scum layer dimensions of cesspool materials of construction indication of groundwater inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,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, recommendations for maintenance or repairs,etc. ) i 11 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L:SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' , � 3 w ° yo 6x a's��t . DEPTH TO GROUNDWATER depth to groundwater 6,4e-s o method pf determination or approximation: f • 1: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C { FAILURE CRITERIA Indicate yes, no, " or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined" , explain why not) Backup of sewage into facility? Discharge or ponding of effluent to the surface of the ground or surface waters? Static liquid level in the distribution box above outlet invert? Liquid depth in cesspool <6" below invert or available volume< 1/2 da) flow? Required pumping 4 times or more in the last year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? �/ Is any portion of the SAS, cesspool or privy: L below the high groundwater elevation? within 50 feet of a surface water? within 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt marsh (cesspools and privies only, not the SAS) ? N within 50 feet of a private water supply well? 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 analy for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. a 13 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector / „ ' ( ;U S Company Name / YV y 6A)! l / Yam! S �Q�T7 G --:z Company Address �/lj a 14 B4s S C � _,,, /< ,JoJ-r� O� -� ; S 10 dab 6 � Certification Statement I certify that I have personally inspected the sewage disposal- system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and manitenance of on-site sewage disposal systems. Che3zk one: I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15. 303 . Any failure criteria not .evaluated are as stated in the FAILURE CRITERIA section of this form. f I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15.303 . The basis for this determination is provided in the FAILURE CRITERIA section of this form. Inspector's Signature S Date Original to system owner Copies to: Buyer (if applicable) Approving authority t Finish'grade above and adjacent shall•i blDk a min.of 2%away from system �,� f 4 diam. cast iron or Schedule4OPVC pipe (tight joints). Lo-1- 84 20'min. distance ( building to edge of leaching system) ' 1 7 IO'min.dist. to 101.28" t TEST PIT#I PRESERVE AREA � TEST PIT#2 �� ' ' 1 .(o din. b !o deep i yy LEACH IIUG PIT w Ith ; BUILT UP BRICK AND 2'of washed i6ro1Qe First Floor Elev.= 104.00 PROPOSED MORTAR MAN ROLE _ u+ of I ncound. 0. 02.5 PROPOSES 0 n ; Q h •016TR1®uTION Box o,a S= , OZ• Removable4eye Removable = O 3�" MAX '-j.Jr' \ SEPriot TANK p 2 $ G ,1: Clean bockfillLiuid level 2"layer of "to I/2" LoT 80 �41 i' '' .�` \ \ 51 J LOT 78 °v °o 0 0 0 0 0 0 0 0 b washed stone.0 to il) e o0 0 00 o mu u c c Q ; c W b 0 0 0 0 0 0 0 ® 0 > c � \ HoUSE0 0 - SEPTIC TANK Q(� �,VVV 1000_..GAL. _ °I V, a: �o0, t'> �. • Effective ° t° ° o __ y '. , i y > d H > �� o Depth 0 rs Of 60 r.-i d ;,N v F'oUNDATIoI,1 DKAINS �� lo'wIDC DRIVEWAY d w Precast concrete o �n t > d> JI S Wlrli LEAOHIhIdi Lot �� BENCH 5 'c 'c _C o c LEACHING PIT. d ,° L V = 91.150 T_RF 1 MARK 9EE FOUNDATION DRAIN 1..-2ft. Eft. diameter 2ft. EXISTING WELL PROPOSED 50 23,�45t S.F. PROFILE 2 ft.alt3/4"ta II/2"washed stone + t� WELL 10l ` DETAt L_• s Not to scale oTi—around precast pit providing on � -rcJoWn� ELEV 5Z.0- ��8, oo}' of l I K DESIGN CRITERIA effective diameter of IOft. Ira ��994 100 _—— NUMBER OF BEDROOMS 3�equivalent to 330 gals/day). GARBAGE DISPOSAL UNIT NONE GENERAL NOTES �_--Ec>GE of PAVEMENT - ArO W1de) LEACHING AREA-CAPACITY REQUIRED 330GALS/DAY. CA' `DI NAL LANE �PRwAT� I)NO CHANGE TO THIS SYSTEM SHALL BE MADE UNLESS SIDE AREA PROPOSED 16701 SQ. FT. APPROVED?IN WRITING BY HOLMESand McGRATH, INC. B C e BOTTOM,AREA PROPOSED 78.5 SO. FT. 2)SUBJECT TO INSPECTION DURING CONSTRUCTION BY THE BOARD OF HEALTH AND HOLMES and McGRATH INC. PROPOSED LEACHING CAPACITY45S GALLONS/DAY. 3)HEAVY CONSTRUCTION EQUIPMENT SHALL NOT TRXVEL OVER DISPOSAL SYSTEM DURING OR AFTER CONSTRUCTION. WATER SUPPLY WELL 4)DISPOSAL SYSTEM TO BE CONSTRUCTED IN ACCORDANCE PRECAST CONCRETE UNITS, H-I0LOADING. WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE. 5)A COPY OF THESE PLANS MUST BE KEPT ON THE SI T E DURING THE TIME OF CONSTRUCTION. 6)A COPY OF THESE PLANS MUST BE FURNISHED TO THE 0 L LOG NTRACTOR CONSTRUCTING THE DISPOSAL SYSTEM. FORE BACKFILLING THE CONTRACTOR SHALL NOTIFY N° 1 N 2 2 ,v ,�1 OLMES and MCGRAW INC. AND THE BOARD OF HEALTH )`il AGENT TO INSPECT THt SYSTEM AS CONSTRUCTED. Depth Solis El-ev. I Depth I Soils Elev. l ) FLOOD PLAIN HAZARD ZONE C c102.(o0' Iv2&r9) ZONING DISTRICT RD-2 LOAM Lo�M HOUS DATE DESCRIPTION Orawnby Checked by 21 SUBSOIL 100.4 z1 sUB5011-.100• • N° REVISIONS �.00SE { 1 LoosE 9a , BENCH MA ASSIGNED ELEV. 100.00 TOP of G.B. "B" _ PLOT PLAN 4pti�� o b �RA*vSL OF PROPOSED SEWAGE DISPOSAL SYSTEM .� /~ �k 61 SOIL TEST TITLE REFERENCE : PH11111P yc CI_AY FOR JOSEPH POLCARO fir,IN €,4"rL�tyRt�t I � cLAY 9l0.10� DATEOFSOILTEST JUNE 17, 1980. SUBDIVISON PLAN OF LAND C ts:'+t:;gg ��, TEST TAKEN BY PHILIP D. H- S. MARSTON MILLS,BARNSTABLE,MA. NU IN BARNSTABLE, MASS. �E- SCALE: 111=401 DATE: JUNE 18 , 198 of ^�o-•� COARSE COARSE RESULTS WITNESSED BY PAUL HURRAY v� SAnID SAND PERCOLATION RATE 2 MIN./ INCH. SIGNED 13Y CROWF-LL AND TAYLOR hOlrrle,5 and rnC9fath, lI'IC. civil engineers and land surveyors GROUND WATER NONE ENCOUNTERED CCRf- SCALE I —100' 301 main street falmout.h ma.02-540 Checked CI V EN G N E E RG b 12� 90. ' 1z' 9o•ro ASSESSORS MAPN� 14-22 548-35,64 '. rawru. y, 'cc. No 80133 DWG N2 A-978 ' SHEET I OF 5 I 8 - 6 Al I outlet pipes from the distribution box shal I KnockoU'ts Outlet be set level for at least 2 from the box. Al I access Manhole covers for Septic Tank, N r / '� o Distribution pox and/or Leaching Pits set fILET OUTLET INLET OUTLET — more than 12 below finished grade shall Lm — 'o I raised to within 12"of finished grade. 14 -I Outlet r Metal frame &cover or concrete cover Knockouts over.".T's" where required. Concrete block masonry 2'_O" I -2 STEEL REINFORCED, PRECAST CONCRETE — or Brick .masonry Removable covers 3 'f Concrete-. `a 2 - — <, 211 Conc.-"cover,. a '_ n- s INLET -.�,,� 8••-3�min.clearance required.--`��� 13 .�INLET��'' �� - L , a -2 min.inlet to outet 6 min. ,• t��Iquid level OUTLET INLET-�. �',���/ Kno ko is ' - yOutlet FU10 min. 14 `J OUTLET b 2 min. Knockouts- min. — - ,. E oCL _ ` 6 min. -- 6— ;� _! ;q 6min. Cr TYPICAL DISTRIBUTION BOX SCALE: I = 1 -0 TYPICAL 1000 GALLON SEPTIC TANK f SCALE* 3/8" = I'- 0" ta- DATE DESCRIPTION. Drawn..by Checked by REVISIONS; `j PLOT PLAN -- DETAIL SHEET .44, OF PROPOSEDSEWAGE DISPOSAL SYSTEM 'R FOR JOSEPH POLCARO MARSTON MILLS,BARNSTABLE,MA. s 1 p�c14 1 SCALE: a shown DATE:_JUNE 18 . 1980 } 4 holrnets:and mcgrat h,,inc. civil engineers and land surveyors z N 301 main "street Checked b ..I ENGIN Lot 79folrnouth, CARDINAL :LANE 548-356ma.02540 Drawn b :TLc. JOB NQ :80 133 OWG.N° A-978 SHEET 2 OF 3 ' f r tumrnaus Coating o� _ �'ln cIA7 rad¢ 2 n�mum Slo °'A. � Jzxcavafion de4n' VdrIes -fill � 4 A . \/pLF 6o1,d Pic �lar�e5 o; ,c-wp 4o rpe p 8 LF 4'per�orafed Sc+tb 40�lG p' or �rtuminous Fit-�,er Pipe 6' Ka 2 1°Yers 151b ° •• .a.e� 'd. 'a 9►avcl -�¢l+ Pali-r 2 to yens ISIb. c�er pants -�clt pa par 0 .Q D '.e 6 2 2 asca yttx:» 4 perforated min. �; I Z,-644P 40 Pvc p pe l2 boo .• .9, 2 4 4o I%2 w45h¢d naO io �cdlQ �4 �o l2 w4sh¢� ° - Sfion e , Od 0000 u°°o'°000 4' Pee Pr pe rated 1.0.0 p� Crock �2c�►oh Date DESCRIPTION Drawn by lChecked by REVISIONS { DETAIL SHEET OF FOUNDATION DRAIN for < JOSEPH POLCARO In MARSTON MILLS, BARNSTABLE, MA. 1.0 f° •+�, t`�,�, Scale : as shown Date'. June 18, 1980 � = � holmes and mcgrath , inc. ter;:•; "--� ° " civil engineers and land surveyors ' 301 main street , 6 Lot 79 CARDINAL LANE falmouth, Mass. 02540 Checked by CI L ENGINEER 4 548- 3564 1 Drown by :;(:c.c. ,J B N° 80 133 1DWG N°.A -978 1. SHEET 3 OF 3 NO TE� 1WId Y! A) r f an �d/V#N fow PZ �Z: 17�io S f f u f " ��4V. ve lf ' f x6W 4WD J 1 b , `i r GJ//ip(W �mov,Es�oK cavcr��s��� ram. Al/0471 116//" 21vv Zc l � ' <G'�X1SilN GY�J GJl'�o 1t/ o/Npa6d Nak✓ �ooF jar/ ' g ��t'1ST/ail� /LIAjTCFIr�S �-c'�STf,v Gf I , ,u,44) e-4V,.sN4 -I S /U6j se�a c_#r I Ei A)AI 1 �Z Xvom �116V N44) Xplrv� (LooF S1�o� �-ce ss f fs: , IRIDGE BEAM RAFTER ® 16" O.C. - O O O O O O O O 2.6 COLLAR TIES 16" O.G. O O V� .�//rt/�'v OLJ GJG�/7)._./Z./. �L Gf��L��.� -��� �•e /C UG� oo 142.5 O EA. RAFTER NOTE, e ° RIDGE STRAPS ARE NOT o� REQUIRED WHEN COLLAR TIES OF ._ 2/�+ /�, n p// / �7 �j o - - NOMINAL 2x6 LUMBER ARE o-�_ ���C.�C�J l.L�G/ GC.J \ o o TOP PLATE LOCATED IN THE UPPER THIRD -- OF THE ATTIC SPACE AND I ATTACHED TO RAFTERS USING 5)I0d NAILS EACH END p pl[ -;v - ® RAF-("ER TO PLATE CONNECTION - RIDGE COLLAR TIES. OD� l�l�C,r.J o /[/ �[, p�� SCALE, N.T.S. /V'/ C..0 l.S%//L�j^ lV SCALE. N.T.S. —2 y X/o TO 4% GEf !STi " I _ DOUBLE ROW STAGGER NAILING + INTO BOTH PLATES - 2x6 DBL TOP PLATE VERTICAL STRUCTURAL PANEL - - NAILED ad COMMON ®3" O.G. EDGE AND 12" IN FIELD - JOINT DESCRIPTION NUMBER OF NUMBER OF NAIL SPACING VERTICAL COMMON NAILS BOX NAILS DOUBLE ROW STRUCTURAL PANELS .+ STAGGER NAILING BREAK ON SECOND FLOOR INTO BOTH PLATES RIM JOIST ROOF FRAMING t 2x6 DBL TOP PLATE BLOCKING TO RAFTER (TOE NAILED) --2-Bd 2-lOd EACH END RIM BOARD TO RAFTER (END NAILED 2-16d 3-I6d EACH END WALL FRAMING TOP PLATES AT INTERSECTIONS(PACE NAILED) 4-I6d - 5-I6d AT JOINTS STUD TO STUD (FACE NAILED) 2-I6d 2-I6d 24"O.C. SECOND FLOOR HEADER TO HEADER (FACE NAILED) I6d I6d 24" O.G. ALONG EDGES VERTICAL RIM JOIST .STRUCTURAL PANEL. VERTICAL STRUCTURAL PANEL ® FLOOR FRAMING NAILED ad COMMON NAILED ad COMMON ®3" O.C.' EDGE JOIST TO SILL, TOP PLATE GIRDER (TOE NAILED) 4-Sd 4-lod PER JOIST FIELD BLOCKING TO JOIST (TOE NAIL AN3" O.C: EDGED 12" IN FIELD AND 12" 'N ED) 2-Sd 2-IOd EACH END - BLOCKING TO SILL OR TOP PLATE(TOE NAILED) 3-I6d 4-16d EACH BLOCK LEDGER STRIP TO BEAM OR GIRDER(FACE NAILED) 3-16d 4-I6d EACH JOIST JOIST ON LEDGER TO BEAM(TOE NAILED) 8-5d 3-IOd PER JOIST BAND JOIST TO JOIST (END NAILED) 3-I6d 4-I6d PER JOIST BAND JOIST TO SILL OR TOP PLATE(TOE NAILED) 2-16D 5-I6d PER FOOT ROOF SHEATHING DOUBLE ROW DOUBLE ROW WOOD STRUCTURAL PANELS STAGGER NAILIN ,'I INTO BOX AND SILL I STAGGER NAILIN INTO BOX AND SILL RAFTERS OR TRUSSES SPACED UP TO 16" O.C. ad lod 6" EDGE/6" FIELD ' 1 RAFTERS OR TRUSSES SPACED OVER 16" O.C. ad lod 4" EDGE/6" FIELD k I I I I GABLE ENDWALL RAKE OR RAKE TRUSS w/o GABLE OVERHANG ad IOd 6" EDGE/6" FIELD GABLE ENDWALL RAKE OR RAKE TRUSS w/STRUCTURAL ad IOd 6" EDGE/6" FIELD ` OUTLOOKE.6 'GABLE ENDWALL RAKE OR RAKE TRUSS w/ LOOKOUT BLOCKS Brl,. IOd 4" EDGE/4" FIELD CEILING SHEATHING n GYPSUM WALLBOARD ad COOLERS - 7° EDGE/IO" FIELD ' WALL SHEATHING WOOD STRUCTURAL PANELS STUDS SPACED UP TO 24" O.C. ad IOd 6" EDGE/12" FIELD R2" AND 2%2" FIBERBOARD PANELS ad - 5" EDGE/6" FIELD Y" GYPSUM WALLBOARD ad COOLERS - 7" EDGE/10" PIELD - FLOOR SHEATHING WOOD STRUCTURAL PANELS ®FULL 1=IEIGHT SHEATHING —SINGLE FLOOR - ®FULL HEIGHT SHEATHING —MULTI FLOOR 1"OR LESS ad IOd 6" EDGE/1" FIELD SCALE+ SCALE: N.T.5. GREATER THAN I" IOd I6d 6" EDGE/6" FIELD