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HomeMy WebLinkAbout0075 CARDINAL LANE - Health 75 Cardinal Lane Marstons Mills A= 013-014 C I I f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 75 Cardinal Lane ` Property Address "Gh Colette Cipullo Owner Owner's Name = 7 information is Marstons Mills '� Ma 02648 1-9-17 required for every page. Cityrrown State Zip Code Date of Inspection Iti Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information 1,2/a 0 on the computer, use only the tab 1. Inspector: key to move your cursor-do not Matthew Gilfoy use the return Name of Inspector key. B&B Excavation rQ Company Name 374 Route 130 Company Address Sandwich Ma 02563 City/Town State Zip Code (508)477-0653 SI 13640 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 sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 1-9-17 Inspector'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 in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 �, a i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. Cityrrown 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: System was found to be in working order at time of inspection. Installation was done in 2011. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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).- El 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 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 water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 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 '/day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 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 ❑ ® 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? ❑NA ❑ 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) _3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d See below 9 ( Y 9 (gP ))� Detail: 2015-82,000gallons 2016-29,000gallons Sump pump? ❑ Yes ® No Last date of occupancy: 2 weeks agoDate Commercial/Industrial Flow Conditions: Type of Establishment: NA 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: l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts N r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 75 Cardinal Lane 'M Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. Cityrrown 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: Owner- last pump unknown 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. City/Town State Zip Code Date of Inspection D. System Information (cost.) Approximate age of all components, date installed (if known) and source of information: 2011 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town feet Comments(on condition of joints, 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: 1000gallons Sludge depth: 6" l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 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 30" Scum thickness 2 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 15" 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.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank is not in need of pumping at this time but should be pumped every two years for maintenance. Grease Trap (locate on site plan): Depth below grade: NA 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 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: NA 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 I 4 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 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 0 11 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 was in working order at time of inspection. 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.): NA * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 ` Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is Marstons Mills Ma 02648 1-9-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 20 ARC 36's ❑ 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.): Leaching was in working order at time of inspection. Leaching was dry when inspected. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °wM 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. Cityrrown 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: NA Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 FRONT ' Al- 'I '6" 81 43*6" A2- 20' �• 47' 3• 5'6" 133-49#611 U $ mot VENT t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection , Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. Cityrrown 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: No GW 132" 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. 11-15-11 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Plan on file with BOH. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 75 Cardinal Lane Property Address Colette Cipullo Owner Owner's Name information is required for every Marstons Mills Ma 02648 1-9-17 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems) completed E System Information—Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BARNSTABLE LOCATION 75-eArdin' AL L"h-G SEWAGE# 2,01l-' 3.6J/ '-VILLAGE MMr.5fOn,1 1As ASSESSOR'S MAP&PARCEL (J/3-0/1 INSTALLER'S NAME&PHONE NO. ,f08-5 D-47 3 8_ �e��loh ��l3i9rsN05 SEPTIC.TANK CAPACITY 1000 LEACHING FACILITY:(type) y naw( i a,4 S' #05 ni e ize) 2,5' X NO.OF BEDROOMS 3 OWNER �f/pcl//D PERMIT DATE: /0—2 r // COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet ; Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �C`Jae/lil/'J� FrOhr _I IJ y P r� 6-vr ,O b Z�Sp c1'�oh PorT S. Fr W; Epl va No._ .U i ^- Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppYication for bisposai 6pstem Construction Permit Application for a Permit to Construct( ) Repair(!4!Upgrade(Abandon( ) ❑Complete System Individual Components Location Address or Lot No. rJS 4mvrV i ii of Owner's Name,Address,and Tel.No. d1wr5mell Assessor's Map/Parcel p/3 - o/ 3,q`y/f Installer's Name,Address,and Tel.No.Sd0-4/2 Designer's Name.Address and Tel. 2 ✓os Gph De- MrYl r -e Sons. -we. .4 ohs i%l Q- Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Z 1 d 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)ZY711 L`� �/ °�du/S OF 6� fl;T" �A/Z�. 3l0 �t21or wl,f-4 /)/a flOy115 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in j 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. Sign Date Application Approved by Date JB-2,$ - f� Application Disapproved by Date for the following reasons Permit No. cam' - � Date Issued It-�f ' No. loll r y �` �� 4w,,. Fee Uf/ THE COMMONWEALTH OF MASSACH SE S, Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTA� E,MASSACHUSETTS Yes ftplitation for Veposal *pstrm Construction 13ermit Application for a Permit to Construct( ) Repair(!Upgrade Abandon( ) ❑Complete System Individual Components Location Address or Lot No. '77 C 14Y,O/4 / G.q/1/_ Owner's Name,Address,and Tel.No. `i 1171- 61razLO Assessor's Map/Parcel ij, Installer's Name,Address,and Tel.No. 5-- " S'2 q 73`' Designer's Name,,Address,and Tel.No._�_U -3G 2- g 2 Type of Building: eb j Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building\ „ No.of Persons Showers( ) Cafeteria( ) Other Fixtures 3� Design Flow(min.required) � !) gpd Design flow provided gpd R� Plan Date Nuri&r of sheets Revision Date i Title I� Size of Septic Tank Type of S.A.S. Description of Soil I ` Nature of Repairs or Alterations(Answer when applicable) y'r^j 4' S- /4, /9 gG .3 G 6W/7 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in e _ 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. Signed-, /�J. �ci1/�Pr✓i Date Application Approved by f�,: Date /0 ?,$-- i Application Disapproved by Date for the following reasons Permit No.�o �/- Date Issued /o----------------------------------------------------------------------------------- Zr / __- ------------ THE COMMONWEALTH OF MASSACHUSETTS t BARNSTABLE,MASSACHUSETTS Certificate of Comp[iante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( �)— j Abandoned( )by ,ld. -_d 6 /%-! k?`l�lJ; at�f �/' Ql/-)k?C G.ys�i= Yv9. /1h,/�5 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. D 0 It 3 dated 10 Installer ✓05 1,,/r /1 /�<�f v^J_f Designer yJi�/;G//,!� S S'a�75.. ✓IC, #bedrooms 3 Approved design flow 3 3 U gpd The issuance of this permits all j.of be construed as a guarantee that the system will` c de igned. Date rl rl I I Inspector --------------------------------------------------------- i 7! No. 3�� - G Fee IOU - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal bpstem Construction 'ermit i Permission is hereby granted to Construct( ) Repair( Upgrade( U) Abandon 1 d ( ) it System located at e` L 14 l 4/a Z' Z 1441: I 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. i Provided:Construction must be completed within three years of the date of this permit. r Date / 0 -:2 Approved by . I . . I Town,of BL-mstable. . P# Department of Regulatory.Services loql �) -� Public-Health Di ion Date 20o Main Street;,Hyannis MA 02601 3 RFD µA't r , �� / / 'Time l© Fee Pd. Date Scheduled I oil Suitability Assessment for Se age Disposal t Witnessed y Performed By. Y B ; LOCATION&.GENERAL•INE.ORMATION LocationAddress'.�S (�1�—Q✓ ( ��. Owner's Name Y('(,Lb Address kALAssessor's Map/P4ree1: O�. f Engineer's 0 1 Name Oa:�(1(�i l(l. ��—�( 3 ,. Zv NEW CONSTRU�`i;tON REPAIR Telephone# Land Used f1y Slopes(9b) o Surface Stones Distances from: Open Water Body lob ft. Possible Wet Area -,--Zoo R Drmhng Water Well �Zod ft prainage Way X ft. .Property Line 7 I OO ft Other ft i SF TCH:(tree[name,dimensiods'of lot,exact locations of test holes&perc tests,locate,wetlands in proxitnity to holes) 1 I — ___t ;•_ � �_ _ - - - — — _ Z y � o < s - 44 S { o 0,J „. / $ i U G 1 1 ' (�t.� Q � (� 1(,t I- ' Parent material(geologic) � K Depth to Bedrock _f Depth to GroundwaNr. Standing Water in Hole: i Weeping from Pit FAee Iv Estimated Seasonal;$gh Groundwater r i' Dt�A1'ION FOR SEASONAL ffi(;H WA �+ `T• LE Method Used I in. Depth to sell mottles: In. Depth Clb;�erved standing'in obs.hole in, ©roundwater`Adjuetttlent fy Depth toiweeping from side of obs.hot& Adj,OTundwater Level.,,.,e, Index Well# Reading Date: Index Well 1061 -- A4:faetoC, PERcoLATiON TESx . Dr;a Thne .�.. Observation l I ..,. .. - Tittle at:9'= t L.;:;--- Hole# i Depth of Pere 31 -53 Time at 6" :�..� ,...... Start Pre-soak Time.@ End Pre-soak Rate MnJlnch Site Suitability As Site Passed Site Failed Additional Titling Needed • Original•.Public k;e$Ith Division Observation Hole Data TO B e Completed-on Back . ***If P ercola#on test is to be conducted within 100' of wetland,-you Must first notify the Barnstable C64Servation Dirtzsion at least one(1)wedk p1jor to beginning- DEEP OBSERVATION HOLE LOG`' Hole#. Depth from Soil Horizon " `Sotl Texture• Soil Color Soil ' :<Other,.. Surface(in.) (USDA) (Mansell) Mottling •(Structure, tones,Boulders. • - Consistencv.,4'o'Gravel — l Z` LA I ,a,; a d b V-k- N q 13 44 . hit DEEP OBSERVATION HOLE LOG` 'Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA), (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel) .4 Said �lv . !�2" G A1w. la-4 DEEP OB NATION HOLE LOG Hole# NIA Depth from' Soil Horizon oil Texture Soil Color Soil Other Surface(in.) ( A) (Munsell) Mottling (Structure,Stones,Boulders. Cons istencv.%Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from So-1 Horizon Soil Texture Soil Color Wl Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consistency. ra I .t Flood Insurance Rate Map: • Above 500 year floodboundary'No Yes _-_— Within S00 year boundary. No ` Yes�.- . .. Within l00 year fl Yes cod boundary No X Dentk of Naturally OccurrineTervious Material Does.at least:four feet of naturally occuuring pervious material exist:in all areas observed throughout the area proposed for the soil absorptioti'system? yew If not,what is the depth of naturally occurring pervious material? Certification. I certify that onII (date)I have passed the soil evaluator examination approved by the Department of Envi onmental:Protection,andjhat the.above analysis was performed by me consistent with the required ing,expertise and.experience described`in 3;10 CNII2`15.017 Signature "" Date v 1 Q:ISEPTICIPERCFORM.DOC I Town of Barnstalble '"E' i.� Regulatory Services, Thomas F. Geiler,Director • BAMBrABLZ INAn Public Health Division �A i6�q• �e ram '' Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 503-362-4644 Fax: 503-790-6304 Installer & Designer Certification Form t tl Date: 11 1111 Sewage Permit# lall—Y-Gf Assessor's Map\Parcel Designer: t Installer: �90,s ew`a51 Address: !�' Address: LZd�i3��.� � On was issued a permit to install a (date) (installer) septic system.at 75 C AI�_ th-t, based on a design drawn by M (address) _f� ' ` - � dated 10 (designer) c 1 W, cs3 _ I certify that the septic system referenced above was installed substantially according to �; — the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. LL_ C.) -= I certify that the septic system referenced above was installed with major changes (i.e. greater-than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF D E . I M, yam, staller's Sianatur) ram ) 1�,4 S�FGISi t NITA 1 (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CONIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form 3-26. 4:'doc " CAT ION SEWAGE PERMIT NO. PILLAGE 1# �w 5 G s 5 613 INS A LER'S NA E i ADDRESS . v BUILD R OR On NER �G� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 3X i10 _ f/ ql i N. l� FEs.....��.e............... No:._._.�...---�----- THE COMMONWEALTH OF MA'SACHUSETTS BOARD (O�OF HEAL 'H .1..O.W.N..................0F.7.1N.R3SrkA.r L Z....-...... Appliration for Uiupusttl Workii Tuuutrurtiuu Vverutit Application is hereby made for a Permit to Construct ( 5i� or Repair ( ) an Individual Sewage Disposal System at: _ iV .................................... .... ................ Location-Address (+ P4 A^I or Lot NoL ........... ..__. . ........... ............................................. ........................•----. ..... ............_ ........-----........_._..._..... ��..........................Own ------........................... ...'Y1 PQ S���� Ad, '{ J -•----••-••...........................................•---------...... Installer Address d Type of Building Size Lot_2•....-.}.Q.t�Sq. feet -a Dwelling—No. of Bedrooms........................................ P ( )Showers g Cafeteria ( ) p, Other—Type of Building ............................ No. of persons nsion Attic Cafeteria e Grinder ( ) 04 Other fixtures .......... �,, ----.•-••........................... W Design Flow...................5..................gallons per person per day. Total daily flow..........�.�-----•------•-.----.-....gallons. WSeptic Tank—Liquid capacity1.Sl.gallons Length.g,5..... Width... ,_�` Diameter................ Depth_, .Q__. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......}_.-.,____--- Diameter............... Depth below inlet............... Total leaching area.-?�.-©.,......sq. ft. z Other Distribution box ( ) Dosing tank ( ) '~ Percolation Test Results Performed by...... .1.9,3AN.�r..................... Date.••'$• ..__......._.. Test Pit No. 1...Z,,....._.minutes per inch Depth of Test Pit..Vgt3......... Depth to ground water....... Test Pit No. 2....�..._minutes per inch Depth of Test Pit.....A.%........... Depth to ground water...U.QNC-___- --------------------------------••---------•--.........--............-••----- •----.............._...--------•---•-•-....---•---•••••-••--------•-.......... O Description of Soil �A P fic �}�rQ� /�-. �------•-------------- x W ........:................•••---•--•••-•-••••••••-••••----•---••••••••••••-•-••••••••••••••••-•---.....•••••••••••••••••--•••••••--••-•••-•--•-••••••••-••••••••-•-••••-•••••••......•-•••---•--......_.. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ----------------------------------------------------------------------------------••--.............-----.......----------------------------•----------•-------------------------------...._._.......... Agreement: The undersigned agrees to. install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance as been issued by the board of health. rfoll:owing n dd ...................................................•---•--.....................••. ........-.... A lication Approved B ..( . _ Z/.�� PP PP Y � Date Application Disapproved reasons-----------------------------•--•------------•------........-----------------------•......•=-••••.........------ ---------------------------------••---------•--------------•-•-•-----------....------•--•-•---•--------.........----•-•--•-•----------------------------------------------------....-••--•••-••-...----•- Date PermitNo......................................................... Issued.................................... Date NO.../......rn:1r` Fx$..........'`................... • THE COMMONWEALTH OF MAnSACHUSETTS —}-� BOARD OF HEALV`H Appliration for Biipniittl Workii (Snnitrnrtiaan Prrmit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: Location-Address C ^ n IQ, A,,,) N`.. or Lot No.( (A ........................ .......................................................................... ....................._.........---...............T........--...(.................•..........._..... W Owner t Y ti S T V rV Ad d 1 Vj a •--.._. ....•-•...............•---.....---.......---...............................••--•-•-----•. --••-----•-•-•-•----••----....•-------•---•---...............................................•.... Installer Address UType Cy Size Lot... _a_. q. feet Dwe1 ing—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- --------------------------•-... W Design Flow....................5.................gallons per person per day. Total daily flow....................... 1 ._................gallons. WSeptic Tank—Liquid capacity.6.�= gallons Length_:_:' .____ Width... -_�' . Diameter................ Depth... ......... x Disposal Trench—No. .................... Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No........ __.-,______- Diameter.........!:.:_...... Depth below inlet.......... ...... Total leaching area--:r_... sq. ft. Z Other Distribution box ( ) Dosing tank ) ` y '~ Percolation Test Results Performed by t�_...._a.k..c�. / .L�.................... Date..-!�.... .................... ,aa Test Pit No. 1-__.�' ....... per inch Depth of Test Pit....'�Q......... Depth to ground water...NQ'\j _._.- Gi, Test Pit No. 2_..._.2 _•..._minutes per inch Depth of Test Pit...... ........... Depth to ground water-__ ----------------------------------------------ti--...........•----------..........••--.._:_... ................................. . x 14 ...•-------------------------•---•-•••••-•--•••----••--•-•••--------•---------------•-•------------•-----•---•---•----------•-•----•--•-••••---•--•-•---•------------------••......----•-......--...... 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. gned ------------------------------•-----•--------------•-••-••--------..........-- _---- Application Approved B Date Application Disapproved for following reasons----------------•----•-----......----•-....------------•--------------------------••-•---- ..........••------------------•-•----•---....._.....--••---------•--••---•-••-----------••••••------•--.............-•-------•-------•-••------•-----•-------•---•-•--•--•------••-•------•----•-•-•----- Permit No......=.................................................. Issued- // --• Date i- ------•--•---•---•---------- l' THE COMMONWEALTH/OF MASSACHUSETTS 1 BOARD ,OF HEALTH ............... ......................OF.....r.............................................................................. Trrtifiratle of Tuntpliatta THIS *S,--T CER FY That the.Individual Sewage Disposal System constructed ( ) or Repaired ( ) by...... .... . .. . ..--•--.......J -•-•- ............. .......................................................................................... . ----------Inst �.. at = f� �z = '-v�fr ----------------------------------------------- - has bee instilled in accordance with the provi ions of TI� 5 of The State Sanitary Code s Xerbed in the application for Disposal \'Yorks Construction Permit No.-___ _�_-.lf���.._._....... dated_ . _ __ _-�s- .................. THE IS UArtu CE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED GUARANTEE THAT THE SYSTEM L CTION SATISFACTORY. DATFs.� .1 ...0............... Inspector---•-- ........ •-•---....---..•-----•--•-••----......_.....---.........---...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... G/O No..... FEE.......................... �i���a��t1 �r '� �trnrtilan .rrntit Permission is hereby granted....... ,� ; ,.. _.. .............................................................. to Construct ( ),,of Reg�fi ) an In ' al Se gagrD� sal" tem at No. � r fir- j ----------- _.. ___._.d•c__ __________ __ ______ .� .-_.__...............---- _-__............._..... Street as shown on the application for Disposal Works Construction Permit No.___._ _._ _ .......................................... r lPl :_..__... ------------ ---•-••---••--------------------•----......... oard of Health DATE �� -•------------•-•------•---------------------- , FORM 1255 A. M. SULKIN, INC., BOSTON - MARSTONS MILLS S Ro LEGEND GG 5 P Msr� cR PROPOSED CONTOUR ® PROPOSED SPOT GRADE �2s 00 EXISTING CONTOUR L O T 76 f\ + 96.52 EXISTING SPOT GRADE 2 0 AREA = 20000 sf +— W EXISTING WATER SERVICE \ TEST PIT �P LOCUS 98 96 I BENCH MAR /' I LOCUS MAP / / I 90 I TOP OF DRAIN GRATE 100 / 92 I LOCUS INFORMATION ELEVATION = 92.35 /' � I i BARNSTABLE GIS DATUM �� / I ,\ lI I yE0 I I TITLE REF: 4265/343 S i I PARCEL ID: MAP 013 PAR. 014 100 II ESTUARIES ZONE PROPERTY IS IN ZONE / EXIST. 1000 GALLON / / I , ,' I SEPTIC SYSTEM 5EPTICTANK ; ' 4�� REPAIR PLAN GENERAL NOTES: LOCATED AT:75 CARDINAL LANE - / II / 88 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 00 BOARD OF HEALTH AND THE DESIGN ENGINEER, M A R S TO N S MILLS M A / / I 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS aQp/ / / I OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE PREPARED FOR i 0 / i LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: T I - 310 CMR 15.405 (1) (B): C I P U L O 1) A 1.07 FT. VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING ' I TO BE 4.07 FT (MAX) BELOW GRADE VS REQD 3 FT. OCTOBER 15, 2011 2S 20 ft TOp ``�/� /� (H20/VENT PROVIDED) � / V SCALE: 1" = 20' 0 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR �hN ° 0' 0 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE FA/10 JI 98 I 0 DESIGN ENGINEER. V 1 S� I 4. ANY FROM THOSEOSHOWNOHEREONDSHALLNBECREPORTEDOTO THEEDESGN OF �qs' / j I ENGINEER BEFORE CONSTRUCTION CONTINUES. 98- �nyp• - Q I 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. o DA L�N M _ J/ s� 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF f M �Yf 96 0 --- -___ C�/ I THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF ------ TP-2 / HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. O. 1140 TP 1 / 1 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. W Q 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED STE � 1;1 ,/ / J 9� TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. SANITAR�aa � ) j) N 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 0 w THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING / Q CONSTRUCTION. / 3 10. EXISTING LEACHING PIT TO BE PUMPED, CRUSHED AND FILLED PER TITLE V. li + 72 ^� ,/ r LOCATION OF LEACHING IS UNKNOWN, REMOVE AND REPLACE IF NECESSARY. I S'00 Pt i O / 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION MEYER & SONS, INC. / Q 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY. E 0 - 94 .1 1 �� _ AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY P. O. BOX 981 \ 13. NO PRIVATE WELLS WITHIN 100 FT. OF PROPOSED LEACHING / OF A 92 Q ' 14. ALL PIPE TO BE 4" SCH 4001 8" FT UNLESS SPEC. OTHERWISE) /V/� VE�,j 1 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW M A. 02537 FOR THE USE OF A GARBAGE GRINDER EAST SANDWICH, t 16. NO WETLANDS 100 FT. OF P D L 17. INSTALL 40 ml POLY LINER AS SHOWN, FROM ELEV. 67.50 - (5 0 8)3 6 2-2 9 2 2 63.50 TO PREVENT BREAKOUT. PAGE 1 OF 2 r NOTE: TO PREVENT BREAKOUT THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:92.93 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. 41 SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. T.O.F. EL.=98.15 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. OF F.G. EL.=96.50t F.G. EL.=96.Ot F.G. EL:96.50t F.G. EL: 97.0(MAX.) ��Q��� �qsV D R r M. VENT �! �R 9" MIN COVER/ ` O. 1140 L = 40't 36" MAX COVER j L = 10' L = 15'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) ® 5=1� (MIN.) ® 5=795 (MIN.) ® S=1:� (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC S1 to• 6 10.75" TO SOI TAO 14" INVERT \INV.= 94.68 48'LIQUID INV.=94.43 0I LEVEL PROPOSE INV.=93.55 4 ROWS OF 5 UNITS AT 5'/UNIT 25'/ROW " Da-5a 2 INV.= 92.50 INV.=93.75 0) SOIL ABSORPTION SYSTEM (PROFILE) EXISTING 1,000 GALLON SEPTIC TANK EXISTING OUTLET RESTORE VEGETATIVE COVER BD" BACKFILL WITH CLEAN PERC SAND TO TOP OF CHAMBERS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION - ;• `'�•' ->' "' 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BREAKOUT=TOP ELEV.=92.93 GRADE ON A MECHANICALL COMPACTED SIX INV. ELEV.= 92.50 INCH CRUSHED STONE BASE, AS SPECIFIED IN BOTTOM ELEV.= 91.60 EXISTING SUITABLE PROFILE 310 CMR 15.221(2) 2.88' MATERIAL 3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK 5' MIN. ABOVE BOTTOM OF WITH 1500 GALLON SEPTIC TANK IF FAILED, T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH =' 4 x 2.88' = 11.52 DAMAGED, NOT H2O LOADING, OR UNDERSIZED. (6.92' PROVIDED) USE 4 ROWS OF' 5-ADS ARC 36HC 4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL.=84.68 -_ (H20) UNITS -I NO STONE GAS BAFFLE AS REQUIRED SEPTIC SYSTEM PROFILE 's TYPICAL SECTION 1o.7s" N.T.S. N.T.S. SOIL LOG P#: 13435 I� 34.5"-� END CAP DESIGN CRITERIA DATE: OCTOBER 7, 2011 SECTION NUMBER OF BEDROOMS: 3 BR DWELLING SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE. #1614 WITNESS: DON DESMARAIS. BARNSTABLE BOH SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: <2 MIN/IN Elev. TP- 1 Depth Elev. TP-2 Depth ADS - ARC 36HC CHAMBER (H20 LOAD 95.68 0" 96.10 0" DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 330 G.P.D. O/A O/A MODEL ARC 36HC GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) L IOOYYR 3/2° L OAMY IOYYR 3/2° LENGTH 63" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SEPTIC TANK: 330 gpd x 200% = 660 gpd USE EXIST. 1,000 GALLON SEPTIC TANK 94.68 12" 95.10 12" EFFECTIVE LENGTH 60" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. SIDE WALL HEIGHT 10.75" LOAMY SAND LOAMY SAND OVERALL HEIGHT 16" DISTRIBUTION BOX: 5 OUTLETS (MINIMUM)(H20 LOADING) 10YR 6/8 10YR 6/8 4640 TRUEMAN BLVD OVERALL WIDTH 34.5' PRIMARY S.A.S. 92.59 C 37" 92.92 C 38" 10.7 CF HILLIARD, OHIO 43026 USE 4 ROWS OF 5 - ADS ARC 36�'UNITS-NO STONE CAPACITY (80.0 GAL) ADvANCED DRAINAGE SYSTEMS, INC. PERC 0 91.10 MEDIUM SAND MEDIUM SAND BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF CHAMBER) 2.5Y 7/3 2.5Y 7/3 PROPOSED SEPTIC SYSTEM SITE PLAN (CHAMBERS) 20 UNITS x 5.0 LF x 4.80 SF/LF = 480.00 SF 84.68 132 85.10 132� 75 CARDINAL LANE, M. MILLS, MA TOTAL AREA = 480.00 SF PERC RATE <2 MIN/IN. ("C" HORIZON) Prepared for: Cipullo DESIGN FLOW PROVIDED: 0.74GPD/SF(480.OSF) = 355.2 GPD > 330 GPD req'd NO GROUNDWATER OBSERVED Engineering by: Surveying by: SCALE DRAWN MEYER&SONS,INC. Boo Tech rwr. NTS D.M.M. • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 pO BOX 981 (508) 367-8097 DATE: CHECKED to conduct soil evaluations and that the above analysis has been performed by me consistent with the EASTSANDWICH,W02537 SHEET N0. requirements of 310 CMR 15.017. 1 further certify that 1 have passed the Soil Eval. Exam in October, 1999. 508-362-2922 10/15/1 1 D.M.M. 2 OF 2 L. r� SECTION - SEWAGE ' y 10 - SEPTIC TANK - S "D"BOX I o LEACH TOP OF FDN �(MSL)x "2"OF Its TO 1/2,, '"'.�- c !"'��' F^ `'i"'^ :}'��8'i�r''f. �'f...; 5; y' »a �.e I.e•.. .. ,��a''^w .cs •. T.s'.y w +§'z'?:• •�'.�;,,;,. WASHED STON . �_ __ '1'� ,l OF R+�, , GR�Oa. � y; S y ram • l " IN OUT IN OUT IN. 12 SEPTIC , `• \ 3 y( i, O ,7 TANK EL ELEV. ELEV. ELEV. ELEEV. ELEV. p' + ,. 4 d� fcc.1/2 . 1 WASHED STONE 1 s + 7 i �Cglp: '5 k3v_ ris 12L_ ( , +. TEST- HOLE LOG TEST BYE, %lLZ IJV-PE., ..�� .J,�3L �,H D+� WITNESS $ i TEST DATE 7�t 1 j�8 3 DESIGN — 5 BEDROOM HOUSE T.H. * 1 T.H. # 2 yL ELEV.105.3 ELEV.,OS,4 NO v �# low BOO' ' DISPOSER DISPOSER I PERC RATE C MIN/IN. y "$waso Io2.8 30 • ,� FLOW RATE74(Al .JO(GAL./DAY) vC = t t r IUI. 3 SEPTIC TANK 53 O (I `7 � Ner(Fv "'�r REQ'D SEPTIC TANK'SIZE 1 0C'>CD T6 SgF.�r LEACH FACILITY �o4rsP SIDE WALL lFBI''n% �,_ 1 SOI> ( Z,S► = 31�{ G/D. Snh•1 �1'+avr BOTTOM 1 4M w 50,3 ( 1 ) S"0.3 G/D, TOTAL 20i . I G 4-Zl-3 ClA_) USE: "`) —LEACHING LEACHING I I Gam+ ���.I? �y 8171A . `.. - � � • WATER ENCOUNTERED r NOTES: (UNLESS OTHERWISE NOTED) ' r 1. DATUM(MSL).+TAKEN FROM-----__---_------------_-,_......._QUADRANGLE MAP , { 2.MUNICIPAL WATER___ � ......................AVAILAB.LE �+ 3. PIPE PITCH: +/4"PER FOOT q 4. DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO.- -44 tn, DISTANCE AS CERTIFIED 5;MIN.GROUND COVER OVERALL SEWAGE FACILITIES: (a) FT. F 1 6.PIPE JOINTS 1,;HA4,L BE MADE WATER TIGHT ' RICHI�RD ��•� 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. I C4 1 HEREBY CERTIFY THAT l HE BUILDING _ SITE PLAN STATE ENVI RONMItNTAL CQDE TITLE 5 16 SHOWN ON THIS PLAN IS LOCATED ON THE 1 + �I ? LOCUS: 1 2-1- "1 Gu C A ro�I�iO �. A� u�-S V+`c. +3t,ss, I-\® ���s` C.a CYav►J( k X�S? i 2 / GROUND AS SHOWN HEREON&THAT IT t N�l�iZs'S cam►l N1 l lrl S MA 1 T � CONFORM TO THE ZONING BY LAWS OF THE �+,� ��. .�I twit j? �. t�• [ '��•, _ + N I o' Q�y o�� '1�+1�.•l,.>¢-F`C�.1 a._�.Ss.�w P.a to #�..R,�� '� �e -$ � .,ti -- TOWN OF -•- - 1-- , : , $1 5..ON. INEER WHEN CONSTRUCTED. DATE REF; esFp1 ------ ��'i� �O�✓II C6,00 eJ7,gl?eef1 l f PREPARED FOR: r • `+ -,,• M1 �I CIVIL ENGINEERS . 0+.1 �41c.LS � ' f LAND -R -�AN- • BOARD OF HEALTH r n SURVEYOR (EXISTING)t c ~ ---------- CONTOURS �, � (3t.� MA Yarmouth&Orlgans,MA T PATE (PRaPt15ED).—O O'Q�O— APPROVED. EATEN. TA Y I