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HomeMy WebLinkAbout0031 CHINE WAY - Health 31 Chine Way Marstons Mills A = 097 014 I r ! CP No.t Fee ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for Misposal *pstem Construction Vermit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Addre or Lot No. j 1 G% ,a'a c�c�7 Owner's Name,Address,and Tel.No. V+ G Assessor's Map/Parcel ® `7 ,(9p Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size `315 y('5— sq.ft. Garbage Grinder( ) Other Type of Building d'eS IDCN• l No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3 E-1¢3 ,-7 gpd Plan Date 7- 7 r) 5 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. 2 soo Description of Soil Nature of Repairs or Alterations(Answer when applicable) `AoSk4 �� C) bor '2 S OCd cAa IbN ('vlGft�(bt'fS e G 5 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ed Date J Application Approved by Date &Zcl / Application Disapproved Date for the following reasons Permit No. Date Issued Fee l�. � 1•' •� � k THE-00MM0NWEALT4 OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF'BARNSTABLE, MASSACHUSETTS Yes ""'i" in for Disposal *pstrm Construction PPrtttit A lication' for armitfto Construct Repair U rade Abandon Complete System Individual Components PP ( ) P (�Pg ( )4 ( ) ❑ P Y ❑ P Location Addrey or Lot No. I i G l &.se Wo 7 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 0 a'7 .-0/ �I GAS S,I/ /L b✓� �,. Installer's Name,Address,and Tel.No. �� Designer's Name,Address,and Tel.No. i �agl as A T'3 'E f "V Type of Building: Dwelling No.of Bedrooms 7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building eie S I DeNi i 0. No.of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow(min.required) gpd Design flow provided 73 e-18 ,-7 gpd Plan Date -7—_7 j S Number of sheets Revision Date Title ` Size of Septic Tank y, F ;r, Type of S.A.S. ? 1[`,N r p✓4j Description of Soil Nature of Repairs or Alterations N 2 SCR rations(Answer when applicable) t S�G �l C-)- boX O r\ GG( IbN C'�tGn�t�jr'✓S vV (l 1 D't Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si ned\ Date s Application Approved by Date y �/ r Application Disapproved Date for the following reasons Permit No. ��y (p Date Issued lr THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Crrtifiratr of Compliatirr THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( graded( ) Abandoned( )by 10 j C,% "T-^r at 3 i ( �i N-e t.�3 ek i has been constructed in accordance >, with the provisions of Title 5 and the for Disposal System Construction Permit No.?e�- Z6b dated O l2f)l Installer _ p ro_ ,T ,,, Designer N> I roe' &d&NS W le S #bedrooms _1 Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will functi fi a designed. Date I ► V 1 Zlt I (Y Inspector �, V IhN lZ,. f- go No. r �O� Fee%loo THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstet�Const urtiott 3pPrtnit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at ( C N e, o• and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constru tion must be completed within three years of the date of this permit. Date l�j ;� f ti Approved by Town of Barnstable fVE� � Regulatory Services o* Richard V. Scali, Interim Director 44 �g P MASS, 1� Public Health Division Thomas Mclean,Director 200 lain Street,Hyannis,MAA 026,01 Fax: 508-790-6304 office. 508-862-4644 Installer D si er'Certifi&tion Form Date ) 1_5'�'Sewage Permit4 2LrtS-'DL C- Assessor's Map\Parcel t Des2.': �=✓l cj. il�C? ; Vic„ — /� e.� 1 Address: V �0. 1� I S� A d ; ess 1 Z l�U � 5�. 3'z MA 8 ��� �. •� 1 ►'�On was issued a permit to install a (installer) +;date) C� v-,k vJ ck M l4 d lba.sed on a design drawn by sept c system at (address) �— r — L C-6111 1 i dated 71-7 ),, IS- (de iper) acco ing to I certify that the septic elude minor app ovtem referenced o e was d changestalled ubsta such as ateral rlel cati not-the the design, which may distribution box and/or septic tank. Strip out (if required) was inspected and the Bolls were found satisfactory. I certify that Vile septic system referenced above was installed With major ch«nges (i.e: I eater than 10' lateral relocation of the SAS or any vertical relocation of any r-ainpondnt of the septic system) but in accordance with State & Local P�egulaiions. Flan revisaQn of Strip out(if required) was inspedted dr:d the:soils certified as-bolt by designer to follow, were found satisfactory. I certify that the system referenced above was constructed is cgjXg1aaajce with the terms of the IAA approval letters(if applicable) staller s Signature)01 (Designer's Signature) (_f ffix DesignoN�v� nap Here IlLEASE RETURN TO BAR1STAB1GE ' CTED fTlt'Tf, TH THIS FoiAS- l I ColPLSA CE WL NFICATE QT 1E ISS ILT CARD N RECEIVED BY T BARNSTABLE PUBLIC A 'I r�� THAl� voU. jnh�. eptic\Designer Certification Form Rev 8-14-13.doc oF� Town of Barnstable P# Department of Regulatory Services Public Health Division Date - I's XAS&� 4..,,,,200 Main Street,Hyannis MA 02601 n 9 �n Date Scheduled Time Fee Pd. 4( `CP) Soil Suitability Assessment for Sewa e D sposal Performed By: ?6tr�. -sy2 Witnessed By: LOCATION & GENERAL INFORMATION Location Address : Owner's Name - 1 S AA t ( Address 0' ��X Z 1 Cu" O Assessor's Map/Parcel: Cen U CT-7_6 1 1 Engineer's Name NEW CONSTRUCTION REPAIIt �c 99 Telephone# 5 o a—Z 3- 4-7.tpo _ Land Use i�2 S t r�Q h��m Slopes(%) I . Z Surface Stones N 0 Distances from: Open Water Body 7 3oo ft Possible Wet Area -ft ft Drinking Water Well S_ ft Drainage Way A— ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) _ 1 2 J 00 CC) FS- Parent material(geologic) d V�� Depth to Bedrock ? Depth to Groundwater. Standing Water in Hole: If 0, _ Weeping froln pit Face /\J 0 V\A- Estimated Seasonal High Groundwater �i 3Ft ' 71 .'>`l1.'.R>•,ATi�J A TT(a1�7 FOR E`T'A C"fl Oj A lr ;TX Y,r lip A rr,"V!N' m i xtr :._..J. .u17NJA YON a R �J-L1 A C�..=.0:i�L 111,1511d�.lJLr.I:U Method Used: Depth Observed standing in obs.hole: _ __in, Depth to soil mottles: in, Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: Index Well level— A41,factor— Adj.Groundwater Level PERCOLATION TEST Date Thne. Observation Hole# Time at 9" - Depth of Perc ✓ Time at 6" Start Pre-soak Time @ .` r Time(9"-6") End Pre-soak " 1 �� Rate:Min./Inch. �Z ✓l $l v�l- �.7 �r Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation.test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. 1 Q:\SEPTIC\PERCFORM.DOC �J' DEEP.OBSERVATION HOLE LOG Hole# 1 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, r vel Z-13 C DEEP OBSERVATION HOLE LOG Hole# z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (lviunsell) Mottling (Structure,Stones,Boulders. Consistency,% ray F-30 26Y6t G DEEP OBSERVATION HOLE LOG Hole# - Depth from Soil Horizon Soil Texture Soil Color Soil .• Other Surface(in.) (USDA) , (Munsell) Mottling (Structure,Stones,Boulders. 1 Cnsistency,%Gravel) C i DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consist nCy. Flood Insurance Rate Man: Above 500 year flood boundary No x_ Yes Within 500 year boundary No(? Yes Within 100 year flood boundary No Yes Depth of Naturally Occurrine Pervious Material Does at least four feat of naturally occurring pervious material exist in all areas observed throughout the area pro posed for the soil absorption system? P If not,what is the depth of naturally occurring pervious material? - Certification I certify that on tqq�l (date)I have passed the soil evaluator examination approved by the. Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, ertise and experience described in 310 CMR 15.017. r Signature' Date 3 Q:\SEPTlC\PERCFORM.DOC APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS s , LOCATION LD-F �{ gu ��� �D. 1ILLLAGEO�fSE {Z I-fi I LLS WESTS O � r V Ii t= N0. _rj��� DATE - PPLICANT D/N V I D W ��E N FEE 3S. A E)DRESS ��� 1= S N I�vU I C1 N0. -_ TELEPHONE ���-��(Non refundablE e-11G INEER LAN-7-EJZ�( A S SDC 1 Q1 TELEPHONE N0. FJ uS`'�LAL/I�� q ��� �� U ,D4TE SCHEDULED - (Applicant signatur, • • • • • • o 0 0 0 0,0 o • o 0 0 • o • • o o • • • o • o• 0 0 0 • • • • • • o • • • o • • • •.• • • • • • • • • • • • • • • o • o • • • o o • o • • • • • 9 7- �- - SOIL LOG 311B-DIVISION NAME DATE__ TIME YPANSION AREA: YES NO ' —LA NT-E.�Y ASSC)C/�T� ENGINEER �T�QWN WATER/ _PRIVATE WELL_ t D1"1 MG KE01`�I BOARD OF HEALT, L) EE C-4 PF B U 11 P5 EXCAVATOR 'S/CSTCH: (Street name,t etc. ,dimensions of lot percolation , exact location of test holes and ests, locate wetlands in proximity to test holes ) NOTES: NDT DRAW MCA L it ti Tr1 77 u: I� 0 PERCOLATION RATE: LESS -r-4 f4 -Z ,y 1 1 IyCN SST HOLE N0: ELEVATION. I ' TEST HOLE N0: _ ELEVATION MCP23o1i . 2 1 S�k r!�` S 1 L, 2 3 . 4 ..� $RD.vU/� MEN-COA4SE 4 _ -- SA?-(D 6 9 LIG4T 9 10 �. 10 MF-:D-COAL 11 '— 13 13 14 No H 0 14 5 --- 15 16 ---- 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS H V LEACHING TRENCHES U14SUITABLE FOR SUB-SURFACE SEWAGE. REASONS: OTC: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ,IGINAL: COMPLETI,E) IN ENTIRETY 13Y P , F_ AND RETURNED TO-tiOARD 0_F HEALTH ppyI RETAINED B.Y APPLICANT r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 31 Chine Way Property Address Estate of Floyd Galler _ Owner Owner's Name information is Osterville Ma. 02655 9/9/2010 required for .. 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 k 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 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 9/9/10 Inspe or's Slgna ure 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 r- Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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: 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): Pump and repair leak on bottom of tank from (weep holes) t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 I , Commonwealth of Massachusetts _ - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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 r I i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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 aseptic 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: Septic tank had 20"of water at time of inspection.Tank may be leakaing through weep holes on bottom of tank and should be cemented. 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 El ® 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �nM 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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 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. 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 i r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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): 33 Number of bedrooms (actual): 3 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 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 every page. City/Town 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? [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 2008:125,000 g ( y g (gpd))' 2009:135,000 Detail: Sump pump? ❑ Yes ® No Last unknown date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(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 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface sewage Disposal System Form - Not for Voluntary Assessments ;M 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Csterville Ma. 02655 9/9/2010 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: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 26"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ 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): 18„ Depth below grade: 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: 1250 Sludge depth: 6" t5ins•09/08 Title 5 Official •Inspection Form:Subsurface SewageP Y 9 Disposal System Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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 14" Scum thickness 6" Distance from top of scum to top of outlet tee or baffle 28" Distance from bottom of scum to bottom of outlet tee or baffle 1" 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.Tank shows evidence of Ieakage.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 l5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° 31 Chine Way 'M Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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 lateral.No evidence of solids carryover.No evidence of 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•09/08 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 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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.Pit was dry at time of inspection.Stain line observed 26" 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 31 Chine Way M Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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 � 9 ✓� * C'Y it�� ti 4t tt� � T� f ,F 1 n ri Y f i f t r :3^ryk�r a� c T t ' a rn o t,t ikK tdf ,A }. v 4 / 3 r d!3 1} � a x „l y 5 f'r,t ,t� �s✓4.� 1 fi � RS Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �nM 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 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 26' 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: ❑ 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 annaul ranges of groundwater elevations. 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 Commonwealth of Massachusetts r W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 31 Chine Way Property Address Estate of Floyd Galler Owner Owner's Name information is required for Osterville Ma. 02655 9/9/2010 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file i t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 L0 C A T ION S W A E PE RANT . N17. z o / y 6� I Ze ��Y Pu m 2►c SS(o — 7 SY �T, ll LACE INSTA LL £ R' NAME Z ADDRESS S7�ge I� I U 1. LDER i3 A 0 W. NE3 Dof�/ �En DATE PERMIT ISSUED OAT COMPLIANCE ISSUED 9j1V z 5 z h i S ASSESSORS MAP NO: No... -----Z - I Fmc.. ....._............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ......... .....oF.......... ..................! .............. Appliration for Disposal Work. Tonitrnr#ion Prrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: .�� .. ...�o..��-----��................. - � ��. t.�_. -. .�. �=- WAY. Location-Address ................. _.. .....c �Ct11_... � :.... -s.�.A !:� --•---......... W ow Address --- ..... Installer ,` r�........... Address d Type of Building Size Lot..-.1_310< .........Sq. feet U Dwelling No. of Bedrooms......... .....Ex Expansion Attic �••+ g— •-----•---•--••--•-•-•---- p ( ) Garbage Grinder ( ) a` 1 Other—T e of Building No. of persons........................... Showers YP g ---------------•-----------• P - ( ) — Cafeteria ( ) dOther fixtures ----------------------------------------------------------------------------------------------------------------------------------------••---........ W Design Flow.............................................gallons per person per day. Total daily flow------------A3®.......................gallons. WSeptic Tank—Liquid capacity.l'L'Ogallons Length......!R`..... Width.... ....._.. Diameter................ Dept h...51 i1. x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No..........i.......... Diameter......OB......... Depth below inlet..... _........... Total.leaching'area.... ®... sift' q�s Z Other Distribution box Dosing tank '-' Percolation Test Results Performed by_ .A.&? .y___.! Sil ......... Pate...... 1 f�i..._..._t -.......... _._,.a Test Pit No. 1.....t.Z---minutes per inch Depth of Test Pit.....1+ .....:Depth to ground wa er..Mo....14.1i?... (_, Test Pit No. 2..__ ...minutes per inch Depth of Test Pit.....J :::..... Depth to ground water..00...Re o---. ----------------------------------------------------------------------------------------------- ------- -.•••-•-------•----- O Description of Soil.... . . -�-Z.l. T S..A sA! p. .p :. %6_-, "7 - '�cNev ��.r-�'5--- -- --------j-- ------------ / � -. SaAt S`'� ---•� ,� ••..titd-'-�.G!�IZ.? .._L. L. �I"D .... �...:�.... r. .... / U UW -•------------------------------ Z�= ! '...::.�De .�-C _�s 1+ ......SAN.P.................................................................................... 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 iITI U 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until.a Certificate of Compliance has been i ed by the b r of health. Signed . .y . ---•-------- ................................... ...... _.... Application Approved B .....•--...•• ..• - Application Disapproved for the following r ons •-•-••-•••-•-••-•••-----•-••..--.Date ......�...(.-..�.? .........•••-•••-•••-•••••---•--•...-•---........•••--••--•..._..•-••-•-•-•-•••••---••---•••••-..................•••-•-•-•-------....•-••••--•--•...•••--•••••-•••••-••••--•-•-••--•••-•••••---••-•••--- Date PermitNo------ -----------------•---- ---------------------- Issued........................................................ � Date ..,��a_���• r 017 - O) 4. No.........'........`.�.� Fss.. .. ._....._.. . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. .............OF......... 'v.S : ............! Apli iratiaan for Dispuotti Works Tomitrurtiaan Frruat Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: _ �. ocation-Address .l�!1�. a.!� 1� .... ►Q.�.tl,.�NG !�.............. ....x �.p �....A�!. . �?... P ,Muat......_._..... Owner t Address W t .....-• - ....�.:.: i4:,�EP�._..- ! .....................................Z......................... Installer V .,�„_ -� Address 3 s UType of Building Size Lot..__..... � !�-..._..Sq. feet 1--1 Dwelling—No. of Bedrooms...........3.............................. Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g --------------•--...._........------...... P ( ) — Cafeteria ( ) Otherfixtures . .. ---.--••..........................•------...........••-•--...--•••-•••- W Design Flow.....................5.r................ per person per day. Total dail7 flow............. 3 0....___.........._._..gallons. WSeptic Tank—Liquid capacity.A?$9gallons Length......! �.... Width..... ........ Diameter................ Depth....5..1!a.... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No...........I......... Diameter......l.SI 1........ Depth below inlet------?........... Total leaching arm.... sq Z Other Distribution box Dosing tank ( ) "4 Percolation Test Results Performed by....! F!T �.�1...ASSo�......p.-5 4........ Date.....-.to-. .� 8 �1 _......... ►a •- 4 Test Pit No. I......—.Z,..minutes per inch Depth of Test Pit......I ........ Depth to ground wa er...NOL.... .t .. 44 Test Pit No. 2.._.4.&..minutes per inch Depth of Test Pit......t l-._..... Depth to ground water..IJQ... C?-_.. ---------------------------- --•-•---------..-...................••-••-•••-••-•-.-----------.....-----------------•--------•----------- ._.-----------•-- Description of Soil.......1.....P�2 ........ -Y_i4 M.+ticl.-..3.sr.!�Q L!#t_Stl.�b_...---... U ,.... VNature of Repairs or Alterations—Answer when applicable................................................................................................ -------------------------------•-•-........----•-•--------•--.........-•------............-----•---•---------•----------------------•----........----•-••------............................-•••-•..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITA IE 5 of the State Sanitary Coder .The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. � w ----------• -•---- ....... ate Application Approved By... ----........••..... ..... � - ... Y... .�1.5? Date Application Disapproved for the following re ons:.............................................................................•..----. •-•-•-•----- -•....•••••-•-•-••-••••-•••-•-•••-••----•-.......••-•--••.........--•--•••••••-----•••......-•••••.............•••••••••-••-••......••-----•••--•••----•......................•••----••••---•---••....._ Permit No.. ......... Date . 1.. . .................._ Issued....------...........--••................. ...._ Date THE COMMONWEALTH OF MASSACHUSETTS OF '..................�.:"......8 OFRD��.\+�.... H. L .............. (9rdif irate of Gautplianrr THIS IS TO CE�R,, LLL ;-Th t t_he Individual Sewage Disposal System constructed (X) or Repaired ( ) by ....... = r- --...------•....................................................................... ._...._ at•---•-..L.P•1---.................................................. � `t-1�..........................Instal •.°r �• / L - -- — -.r........................................ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the ,application for Disposal Works Construction Permit No......................................... dated......--.--... ............................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................... U PI •....................•--• Inspector....../�...................................................._.............. +THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �- _ Z. ._._ � 1 h� \ - 1...1..a ................OF...... 1-. O No......................... S Fgs..... S.:..----- DispiluFt 3 �(u fr inn >er . ..._. Permission 's hereby granted.... ,r ----------- �----_•-______._. to Construct ( or Repair ( ) an Individual Sewage Disposal Sysem at No. Z.CJ..._ ..I. �.L... .:........��. A U•••l_.... ' Street as shown on the application for Disposal Works Construction Pep 't No..................... Dated.......................................... r2.,.A .......................... _ rBoard of Health DATE.....-•-•`n .S .lr-- ff FORM 1255 A. M. SULKIN. INC.. BOSTON �" f A O N r a / Rd o z a 90 N VtY Felicity In fi sOGf� ,Jb`�oloP n m o •44.06 T%Y ia • 42.50 o Ln 42.52 o. e°cps LOCUS Rd ass s � az.eo LOCUS MAP of NOT TO SCALE 0"'' �� 43.00 43.75 3�r :• - 97--EXISTING CONTOUR ?p4s 00'y 41 o� x 100.98 EXISTING SPOT GRADE ;48 97 PROPOSED CONTOUR :` 43.37 W ' EXISTING WATER SERVICE G EXISTING GAS SERVICE U UNDERGROUND WIRES OVERHEAD WIRES TEST PIT �� �`� 44.73 .,QEL\V; �0 1�0 BENCHMARK LEGEND x 44 44.7344.49 46.22 ';$'6 \\ x 43.32 / 46.18 / 1 / M �F gsSq� x 43.24 1' y o PETER T. M cEN TEE CIVIL ��--48 _ o. 35109 __ 6 /x 44.03 48.45 \`\\ / EC/STFR�``O�._6�� 48.47 50.04 x 48.98 - 5-8 \ 49.7 ,.50.84 50.39 � \♦- BENCHMARK 'SHE[L \� EXIS77NG SEPTIC TANK OUTSIDE COR. STEP // s TOP OF 1♦ANk, EL.=50.°9 DRIVEWAY;.' .. ' \ EL.=53.74 ' 51.25 TP 2 0 ` \\ INV.(OUT)=49.66E 52.05 b ♦ O. 52.06 - ' P- ?5• --5�- fit.? Q \ 52.70\ �\ EXISTING LEACH PIT �GAR,4GE 4-, 90 . �\ \ \CONTRACTOR SHALL PUMP, 2.6 m +52.35 x 52.43 o f ` `\ FYkL W/SAND & ABANDON � \ \ y1 // 52.68 // Sys; S• �_\ +52)1�2 ` x 46.32 40 // BREEZE :52.57 1 + �.61 \ 1 \1 ry0' ,' WAYS ♦_� \ 11 h - 1 / DECK LAWN IRR1GAnO4 -- ` 1 1 of SYSTEM 52.92 11 \\ / BH 52.30 \ \ EXISTING S/yR�B +52.64+52.58 HOUSE(#31) T.O.F.=533± 1 �... 52.6 \ LOT 4 \\ °� .... x 52.6 / 097-014MBL x 51.1 \1 .SHELL '` 38,515 ±SF(CALC) 51.7 x / o :DRIV. 9.71 1 1 13 00 / / x 51.2 // 47.10 L=256.91' 1 ,' R�07.77' 1 0 /�. A� /`0, o' 1i1 ' Paveme Q. �oLL 11 edge �� _�>%f 1 Ps -IpO� �� �" OWNER OF RECORD x 52.1 54.1 KOURI, JOSHUA A & HRYNKO, ALEXIS M 31 CHINE WAY OSTERVILLE, MA 02655 %SYLVESTER, PAUL A & KATHLEEN M Engineering by: SCALE DRAWN JOB. No. PROPOSED SEPTIC SYSTEM UPGRADE' PLAN Engineering Works, Inc. 1"=30' P.T.M. 164-15 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET No. 31 CHINE WAY MARSTONS MILLS MA (508) 477-5313 7/7/15 P.T.M. 1 of 2 Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:49.00 SEPTIC TANK FOR A DISTANCE OF 15' AROUND THE INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S.A.S. AND SET TO 6" OF FINISH GRADE. PROPOSED D-BOX PROPOSED S.A.S. PROVIDE ACCESS TO GRADE OVER OUTLET COVER INSTALL WATERTIGHT RISER & PROVIDE TWO ACCESS MANHOLES TO WITHIN 3" T.O.F.=53.3t COVER SET TO 6" T GRADE OF FINISH GRADE FOR INSPECTION PURPOSES F.G. EL=52.5t F.G. EL.=52.4t F.G. EL.=52.0t F.G. EL.-51.8t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. . , L = 20' L = 5' ® S=1%% (MIN.) @ S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 6" 1 " as as 14 0"I ` 6 686aeBB EXISTING 48" LIQUID aaaaBaa LEVEL kD �GAS BAFFLE 4' 4.8' 4' INV.=48.77 PROPOSED INV.=48.60 INV.=49.66t D-BOX EFFECTIVE WIDTH = 12.8' . (FIELD VERIFY) INV.=48.50 EXISTING SEPTIC TANK 2-500, GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN H-10 RATED TOP CONC. ELEV.=49.3t BREAKOUT ELEV.=49.00 NOTES: INV. ELEV.=48.50 ease Law ease ease eases 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE ease eases INVERTS, PRIOR TO INSTALLATION. BOTTOM ELEV.=46.50 4' 2 X 8.5'=17.0' 4' 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE 4' MIN. OF NATURALLY OCCURRING EFFECTIVE LENGTH = 25.0' ON A MECHANICALLY COMPACTED SIX INCH CRUSHED PERVIOUS MATERIAL STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN. ABOVE GROUNDWATER LEACHING SYSTEM SECTION 3) INSTALL INLET & OUTLET TEES AS REQUIRED. BOTT. OF TP-2, EL.=40.1 - 4) CONTRACTOR SHALL INSPECT EFFLUENT FILTER ON 3/4" TO 1-1/2" DOUBLE OUTLET TEE AND REPLACE IF NECESSARY. I WASHED STONE 3" LAYER OF 1/8" TO 1/2" SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE (OR APPROVED FILTER FABRIC) SOIL LOG 4 25' _ DATE: JUNE 23, 2015 (REF#14,727) SOIL EVALUATOR: PETER McENTEE PE(SE#1542) o� i ROP. S.A.S.1 WITNESS: DAVID STANTON R.S. HEALTH AGENT `� 1 00 3•Z 38.0 T ELEV. TP-1 DEPTH ELEV. TP-2 DEPTH o 51.8 q 0" 51.6 q 0 ai9 M _ SANDY LOAM SANDY LOAM_ N 51.1 10YR 4/2 8" 50.9 10YR 4/2 8„ GARAGE - B B SANDY LOAM SANDY LOAM 49.1 10YR 5/6 32„ 10YR 5/6 BRZ. C 1 49.1 30" DECK Cl WAY B PERC 32"/50" EXISTING MED. SAND MED. SAND 2.5Y 6/6 2.5Y 6/6 HOUSE(#31) T.O.F.=53.3f SEPTIC LAYOUT 40.3 138" 40.1 138" NO GROUNDWATER, PERC RATE: <2 MIN./IN. GENERAL NOTES: SOILS IN "C" HORIZON ARE CONSISTENT WITH 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL REFERENCE PERC TEST, 6/18/86, (P-5854) BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE LOCAL RULES AND REGULATIONS. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR DESIGN CRITERIA TODESIGN INSPECTION ER D APPROVAL BY THE BOARD OF HEALTH AND THE 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING NUMBER OF BEDROOMS: 3 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN SOIL TEXTURAL CLASS: CLASS I ENGINEER BEFORE CONSTRUCTION CONTINUES. DESIGN PERCOLATION RATE: <2 MIN/IN 5. ALL ELEVATIONS BASED ON ASSUMED DATUM (BARNSTABLE G.I.S.t). (0.74 GPD/SF LOADING RATE) 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF DAILY FLOW: 330 GPD THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. DESIGN FLOW: 330 GPD 7. WATER ..SUPPLIED BY TOWN WATER SERVICE. r GARBAGE GRINDER: NO LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS .74 GPD/SF AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE EXISTING SEPTIC TANK: 1250 GALLON CAPACITY DIRECTED BY THE APPROVING AUTHORITIES. PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY USE 2-500 GALLON LEACHING CHAMBERS IN SERIES THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES CONSTRUCTION. 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 471.2 S.F. 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE TOTAL AREA:.............................................................. INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. Engineering by: SCALE DRAWN JOB. NO- PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. N.T.S. P.T.M. 164-15 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. 31 CHINE WAY MARSTONS MILLS MA (508) 477-5313 7/7/15 P.T.M. 2 of 2 Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 '�• - .. -. .._. Ir. r. - - K_. ri ter.., r OE S 10, /V SINGLE FAMILY D wE[LL//VG WIZ) B�,eooMs j O GAReAGE DIS.aosn DAILY FL-Dw -- /10 x G. P. D. S� �rlC 7-At-/K ( VOL . Rf- i?'D ) 53Q . . G.P. 0 , x /.5 = `.95 GA LS. GAL . -FA 1\1K.- O,-K. t DISPL75AL P/ T - EFFECYIVE DEPTH = G_•,O a CA P''T Y : Ir X .LU x kA-T i AC 1 11^D BEET TOTA L CAPACITY = 55Q GALS. S l T'E PL A A/ FIN.FLOOR "^ TEST PI 7.s f- PVRC TEsr- �ASSUMEd� - ` . SCALE: l i/ _ � -foPOFWALL J FIrM.GR.�L.a�o .Ex1STll`IG C�.EL.go � EG2A�E_ GZ 970— 4"PVC �°�`� P•ISERS fiS N1=COED HARRY N r L INV. �� \� � LAN R h(V 4zo'-I I / $+ZDWN 65 I NV.;► � GAL. �- --6. ) x � P.C.G 0 ri CELLAR FLooR - io mit4.--> Pc.CONG INp_ ❑ IS PO-SA L P(T SEPTIC SANK � qq W '�I of .3! " -ro 1 �z:'I MAD_ � SEWAGE DISPOSAL SYSTEM DESIGN `t FbR- W s AS P E b S-rn- N Fa i z : - �' 2 I s1n� DAV 1 U v,./AY ALL APDDHD 1 LI E •�HT, I ��U-1 � �� SCALE ' LAYER PCAS7'pNE !_L. �zP•o— - - -.� ao nV .i'f-Kc. r-Is_�-cag oN TOP. VE KT l I LOT -4 1 PUMA R ivIL k RD , s rn► INS z- ri - I OYSTEi�' �-1 I L LS W t- ST ' PRDFILI: nF UI � PD'r-\,('\ L SYSTEM 0.77TEF V) L. L_L-. ; MA NOTE : DISPOSAL � ,..,YTE BE TO GONSTRUCTED fN STRICT moo— NoNrC� ��� — gip L A NTEPY A S SDC. AccORDANCI=. CIF G�Mh'I . OF (`��ASS. E. t`Iv� R0N. GDbE- TIrL.E_ :fi E. � �TESTED:_Co IS �'>.(r, CONSULT, E-N&k E..SANU.) MA . U �--l-.K ''. "`,i" LUI Lli'__ '� DA.TL %. 7_l.i:.l..l.°�-La_ DWG. '.I i`. i� . l_1 1 rL�- 06.CSQ yo i V N 'NOTE! U-K\j E-Y DA-T A 15TA KEZ w E`f OT4- .R S. -- Qrp=- - O ep y 1 SITE. FL AM nCA LE: y 2 . I" OF k OF Mq<". • a ss „�;�,r ash. o` ALLAN HARRY � AN 'KINGSBURY .2 O p�.#261010 SS�ONAL bN�\ Hp.S �i LS ITS '" 1 FD '• • ��v » w�zRE�y . sa w cu, A, - aN -LOT 4 BUMPS \VET L� OST�R\/ I L L E MA , .S rlDw c 1� MA. I A. ,��; +.��z1�. 1 .; ......�. ... 5 ©l - J TOWN OF BARN STABLE LOCATION Y f C t a SEWAGE#VI I'�1P � VILLAGE f ASSESSOR'S MAP&PARCE - f INSTALLER'S NAME&PHONE NO. �c)GS P, foWrJ ,•A`-C SEPTIC TANK CAPACITY 1--4 S O i5 LEACHING FACILITY: (type) �00 Q. KEN C6�S (size) NO.OF BEDROOMS 3 OWNER KOv( I PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: NVro Nn�CBvraJ!-� 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 j vj,3 lD 2- OUT ZG 3e, G oc 16i 31 A �1("At P A