HomeMy WebLinkAbout0096 CHOPTEAGUE LANE - Health 9 ' hopteague Lane,
r - -- — — -- A4Arston MiIis: q
A O11 - 019
i
TOWN OF BARNSTABLE
9� c'
LOCATION //104TP4�LI� SEWAGE#
VILLAGF ,�rQ�t6✓�,� iJ/� ASSESSOR'S MAP&PARCELJ}/•--
INSTALLER'S NAME&PHONE N0640MYAAC 'Ss�D
SEPTIC TANK CAPACITY /6L�70 q 4JJzo e?
LEACHING FACILITY.(type), r 5 (size) ' /0 "
NO.OF BEDROOMS
OWNER 34e7105
PERMIT DATE: 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
r
C. �!
Town of Barnstable
�SMIE tpy,_ ,
Inspectional Services Department
' BA"MAS gam ' Public Health Division
i679• ,0�
200 Main Street, Hyannis MA 02601
Office: 508-8624644
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7021 0350 0000 1549 3679
May 6, 2021
SANDS, PATRICIA E
96 CHOPTEAGUE LANE
MARSTONS MILLS, MA 02648
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 96 Chopteaque Lane, Marstons Mills was inspected on
04/07/2021 by Chad Hathaway, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Leaching facility with standing liquid level at or above the invert pipe (per
Town Code 360-20 h).
You are ordered to repair or replace the septic system within two (2) years from the date
you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
c PER ORDER OF YHE BOARD OF HEALTH
C
T o s c ean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\96 Chopteaque Lane Marstons
Mills.doc
I
o� Town of Barnstable
I" b $ ,0r Inspectional Services Department
'`b,�'Fp► �. Public Health Division
200 Main Street, Hyannis MA 02601
Thomas A McKean.CI1()
Office 509-862-4644
FAX 508-790-6304
Feb 6, 2007
Rev. 4/26/19
DEADLINES TO REPAIR FAILED SYSTEMS
(Town Code §360-44 and Title V: 310 CM
An "x- marked in the ❑ is the failure criteria and associated repair deadline
T��or
DEADLINE CRITERIA
ponding of effluent to the surface of the ground
❑ pumping more than 4 times during the last year not due to clogged or obstructed
pipe g ed SAS or cesspool
❑ Backup of sewage into the house due to an ov erloaded or clog
❑ Structurally unsound septic tank or SAS
ONE l YEAR DEADLINE CRITERIA
❑ Static liquid level in the distribution box is above the outlet invert due to an
overloaded or clogged SAS or cesspool
❑ A portion of the SAS, cesspool, or privy is below the high groundwater elevation
❑ A portion of the cesspool is located within a Zone 1 to a public well `yell
ter
ply
❑ A portion of the cesspool is located within Thlsest °e passes ifivate the Walter analysis
with no acceptable water quality analysis, ( >
indicates the well is free from pollution).
TWO 2 YEAR DEADLINE CRITERIA
(3 Single Cesspool
systems" (broken cover; relocation of a pi
❑ Any "conditionally passed
pe, relocation
of a driveway due to 11-10 components; etc)
aching facility with standing liquid level at or above the invert pipe (per
Town
Code §360-20 h)
OTHER
Repair deadline:_ -- ---- ----____--
0:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS doc
UI1 -019
Commonwealth of Massachusetts
. : ,w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane .
Property Address
Sands r
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
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:outforms When
fillip out f A. Inspector Information _4�on the computer,
use only the tab Chad Hathaway
key to move your Name of Inspector
cursor-do not Hathaway Septic Inspections
use the return key. Company Name
P.O.Box 151
,Q Company Address
Forestdale Ma 02644
Cityrrown State Zip Code
774 274 2581 12866
Telephone Number License Number
B. Certification
I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5
(310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address
listed above; the information reported below is true, accurate and complete as of the time of my
inspection; and the inspection was performed based on my training and experience in the proper function
and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined
that the system:
1. ❑ Passes
2. ❑ Conditionally Passes
3. ❑ Needs Further Evaluation by the Local Approving Authority
4. ® Fails
4/7/2021
Inspector's Signature Date
The system ins ctor shall s mi copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 of completing this inspection. If the system 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 form should be sent to the system owner and copies sent to
the buyer, if applicable, and the approving authority.
Please note: 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.
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18
Commonwealth of Massachusetts
(o Title 5 Official Inspection Form
I- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteague Lane
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary
Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6.
1) 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:
This inspection is not a guaranteeand applies no warrantyof the described components septic in this
p
report including but not limited to piping structual intergrity of components and life exspectancy of
leaching and described components. This inspection is to describe conditions witnessed at time of
inspection only. Regular tank maintenance and water conservation can prolong life of septic systems
. Information on care and do's and don'ts can be found at town health dept or mass ov
2) 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):
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18
Commonwealth of Massachusetts
p Title 5 Official Inspection Form
' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
2) System Conditionally Passes (cont.):
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
❑ 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):
3) 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.
a. 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:
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. Citylrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
❑ 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
b. 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.
c. Other:
4) 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
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
!Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. Cityrrown State Zip Code Date of Inspection
C. Inspection Summary (cont.)
4) System Failure Criteria Applicable to All Systems: (cont.)
Yes No
❑ ® 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
❑ ® 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 water supply
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 2000 gpd-
10,000 gpd.
❑ ® 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.
5) Large Systems: To be considered a large system the system must serve a facility with a j
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 CA.
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
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18
Commonwealth of Massachusetts
P Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is
required for every Marstons Mills Ma 4/7/2021
page. City/Town State Zip Code Date of inspection
C. Inspection. Summary (cont.)
If you have answered"yes"to any question in Section C.5 the system is considered a significant
threat, or answered"yes"to any question in Section CA above the large system has failed. The
owner or operator of any large system considered a significant threat under Section C.5 or failed
under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner
should contact the appropriate regional office of the Department.
6. You must indicate"yes" or"no"for each of the following for all inspections:
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.
0 ❑ 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)]
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18
it _
Commonwealth of Massachusetts
(o Title 5 Official Inspection Form
' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteague Lane
Property Address
Sands
Owner Owner's Name
information is Marstons Mills Ma required for every 4/7/2021
page. Cityfrown State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions:
Number of bedrooms (design): Number of bedrooms (actual): 2
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220
Description:
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ® No
Does residence have a water treatment unit?
❑ Yes ® No
If yes, discharges to:
Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No
information in this report.)
Laundry system inspected?
❑ Yes ® No
Seasonaluse? ❑ Yes ® No
Water meter readings, if available(last 2 years usage (gpd)):
Detail
Sump pump? ❑ Yes ® No
Last date of occupancy: unknown
Date
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18
Commonwealth of Massachusetts
P Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
2. 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
Water treatment unit present? ❑ Yes ❑ No
If yes, discharges to:
Industrial waste holding tank present?
❑ Yes. ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
Last date of occupancy/use: Date
Other(describe below):
3. 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:
I
I
l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
j['a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
4'
96 Chopteague Lane
Property Address
Sands
Owner Owner's Name
information is
required for every Marstons Mills Ma 4/7/2021
page. CitylTown State Zip Code Date of Inspection
D. System Information (cont.)
4. Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Pr€vy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
I
❑ 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):
Approximate age of all components, date installed(if known)and source of information:
1986
Were sewage odors detected when arriving at the site? ❑ Yes ® No
5. Building Sewer(locate on site plan):
Depth below grade: 1.5
feet
Material of construction:
❑ cast iron 040 PVC ❑ other(explain):
Distance from private water supply well or suction line: 20+
feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
I
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
Commonwealth of Massachusetts
F Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
informationis
required for every
very Marstons Mills
Ma 4/7/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
6. Septic Tank(locate on site plan):
Depth below grade: 1
feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
1000 gal
If tank is metal, list age:
years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 8'6"x5'
Sludge depth: 6"
Distance from top of sludge to bottom of outlet tee or baffle
24"
Scum thickness
2"
Distance from top of scum to top of outlet tee or baffle
4"
Distance from bottom of scum to bottom of outlet tee or baffle 18
11
How were dimensions determined? tape and sludge judge
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 over full do to a clogged tank filter. polylock filter. cleaned filtertank settled to normal level.
inlet tee in place no major decay present
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18
G
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
7. 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
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
8. 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
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 11 of 18
Commonwealth of Massachusetts
p Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is
required for every
very Marstons Mills Ma 4/7/2021
page. Cityrrown State Zip Code Date of inspection
D. System Information (cont.)
8. Tight or Holding Tank(cont.)
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
9,. Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert 0
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.):
Dbox rotted out with heavy decay. H10 Long narrow box with 1 inlet and 1 outlet
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
Commonwealth of Massachusetts
p Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is
required for every Marstons Mills Ma 4/7/2021
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
10. 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.):
* If pumps or alarms are not in working order, system is a conditional pass.
11. Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
camera inspected leach pit through Dbox.encounter water that filled pipe. pushed camera through
water and camera head reached end of pipe into pit and was under water
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:
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
11. Soil Absorption System (SAS) (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
12. 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
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):.
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
96 Chopteaque Lane
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
13. 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.):
t5insp.doc•rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
• � 96 Chopteague Lane
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
14. 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
9.2
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18
• Commonwealth of Massachusetts
(P Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
. � 96 Chopteague Lane
Property Address
Sands
Owner Owner's Name
information is
required for every Marstons Mills Ma 4/7/2021
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
15. Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to nigh ground water: 20+
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:
lot el. 80. low in area.el. 60
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5insp.doe•rev.7/26/2018 Title 5 Official Inspection Fond:Subsurface Sewage Disposal System•Page 17 of 18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
96 Chopteague Lane
V
Property Address
Sands
Owner Owner's Name
information is required for every Marstons Mills Ma 4/7/2021
page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
Complete all applicable sections of this form inclusive of:
® A. Inspector Information: Complete all fields in this section.
® B. Certification: Signed 8r Dated and 1, 2, 3, or checked
Z, C. Inspection Summary:
1, 2, 3, or 5 completed as appropriate
4 (Failure Criteria)and 6 (Checklist)completed
® D. System Information:
For 8: Tight/Holding Tank—Pumping contract attached
For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached
For 15: Explanation of estimated depth to high groundwater included
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
ASSESSOR'S MAP N0. 0 , �) PARCEL °'-
L0 CAT ION SEWAGE PERMIT NO.
LDS V C �Y0P7 EF4 Uf 1V
VILLAGE
f
INSTALLER'S NAME i, ADDRESS
B U I L D E R OR OWN ER
�e 1JJ c r�r f�� �► ,�
DATE' PERMIT ISSUED
DAT E COMPLIANCE ISSUED _ _ �
� �� �i n
1 �
, '
�n�
���
No.---!a:24k. c F ....................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR
......................................OF..../I
Appliration. for Disposal Works onstrurtion rini
Application is hereb made for a Permit to Construct (� or Repair an Individual Sewage Disposal
.System
.......... ...... .. ............ ........M--------W-It....
Lo do Address -..._ No. ..
or Lot........... ..................................
-
..... . . ... .......... ... ............................................. ............................................. ........................:0.....................
Address
...........I---- ------*---------------------------------------**......*--------------- ..................Insialler Address
U Type o Building Size Lot---9XO�L4�.......Sq. feet
Dwelling—No. of Bedrooms. .......................Expansion Attic Garbage Grinder (AO
4
Pk Other—Type of Building ..... -—--------- No. of persons............................ Showers Cafeteria
Otherfixt - ....................................................................................
3----------*---------------------------
nxroo�Design Flow_:.................... per personR;rjay. Total daily�w......... .......0........-"-..gakons.
- g 04 Septic Tank—Liquid capacity.,42Viallons Length.M.f.(.... Width..Yr:�.... Diameter................ Depth__.._._._....
Disposal Trench—No Width....._.._...._...... Total Length............._..._. Total leaching area......... sq. ft.
Seepage Pit No..D�,
!t...... meter._._ ...... .... Depth elow inlet...... ............ Total leaching area.... ....sq. f t.
Z Other Distribution box Dos
Percolation Test Results erformed b ... .......................................a.......................... Date. .. .... .. ...................
r
Test Pit No. I................minutes p i Depth of Test Pit...,/;?........... Depth to ground wat ........................
44 Test Pit No. 2................minutes I Depth of Test Pit.............._.._.. Depth to ground water............_...........
9 .........................................*'*'*....."------------------------*....**'**... *------"-----------------*.....*-------------*---------
0 Description of Soil........................................................................................................................................................................
W
U ............................................................................................................:............................................................................................
W
Z ........................................................................................................................................................................................................
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 MIL LE 5 of the State Sanit y Code—The undersigned further agrees not to place the ys; e in
State t
anl y Code ed p e
e
operation until a Certificate of Compliance ha e issue by the board of health.-
Sig .... ........ ------------------ - ------ ---
Application Approved By.. ..... ..... ............... . 4� I at..
. .......... ..... ................... ............ I ----
Da e
ng
Application Disapproved for the fol reasons:......... ......................................... .........................................................
........................................................................................................................................................................................................
Date
PermitNo......................................................... Issued.......................................................
Date
---------------------------------------------------
1
No......................... Fics.........................._.
r.�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD TH
GLrc.._...................OF. ....
=- ------
` I
Applira#ion for Uiipnoal Workii oustrnrtion Famit
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System
.... .... ..........�a . - - - ........ �4 ------------- ....................
..................._.
E.
ion Address ''' or Lot No.
-- . - v
Address
Installer Address
d Type of Building= Size Lot.... .n.. ......Sq. feet
aDwelling—No. of Bedrooms.. .....................................Expansion Attic .(/0 Garbage Grinder (��
p4 Other—Type of Building ..... .4.....__..... No. of persons............................ Showers ( ) — Cafeteria ( )
aI Other fixtu
-- ................
W Design Flow............. ..........................gallons per person per day. Total daily fl�..........3.3n.....................gallons.
WSeptic Tank—Liquid capacity.Z/ allons Length--!".. Width....`"n.).... Diameter................ Depth-.__--.-.-"._._..
x Disposal Trench—No.__�............... Width............ Total Length......... ...____ Total leaching area....................sq. ft.
Seepage Pit No...n-_'_�_�___-. iameter..... Y; Depth Clow inlet... Total leaching area___ --2.sq. ft.
Z Other Distribution box ( ✓ Dosi�i `
/ ``/ i /
'~ Percolation Test Results .Performed b - .` 1........... ....................................................... Date.. __l�....��?..........._-.
i. Test Pit No. I....... ''"_-.mmutes pe Depth of Test Pit....j-3.......... Depth to ground water.._...lw............
Test Pit No. 2................minutes I Depth of Test Pit.................... Depth to ground water........................
P4 ---------------------•--•-------------•---------------------------............._......-----•----•-••.........................................................
0 Description of Soil........................•------------•-------•-•---.............-•--•-.....-----•---•-------------------------------...........-------------------------••.....-•.•••---
W ----------------- ---------------------------------------------------------------------•-----------------------------------------._....--------------------------------•--•-•--•--•---•---••------------
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
---------------------------•---•---•---------•----•----••-•------------•-----------............................----------------------------..........-•-•-------....------------------..__.._..._..----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIE 5 of the State Sanit y Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance haA 'ee issue y the board of health.
Sign Y
. . tY.
Application Approved By...........................
ate
Application Disapproved for the f of g reasons:.... ......................................................................... -
------•-------•----------------------•---•--•-----...._..._....-•--•---•------•-------.........._.....--•I-------------•...-•-----------------------------------------•-------------------------••-•••••.
Date
PermitNo................................................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD ;OF HE T
Trrfif iratr of Tnntplianrr �...
T TO �Y,(That idual Sewage Disposal System constructed ( or Repaired ( )
by y`�_.�_�?. r:. .�. ---------------
ICJ v:7 t,
In Iler
---------------•----------------•--•---------------------------•--------------•-------_
�.
haF been installed in accordance wit the pro sions of TITITE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No..___ �_'.�j_�.3----------- dated------�3 _ z,_� �...................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. 8
DATE...:.:........ '.-... ...- •b.(. ............................. Inspector._..__'_...�r� fa_...� � �I/Y.A..._.._ ..
.Ji.;SIGN►NG ENGINEER MUST SUPEt(VISt
"1 iNSTAI I64TION AND CERTIFY IN WRITING
+ THE COMMONWEALTH OF MASSACH.USE �
ti Hr= �YSTEM WAS INSTAL,L,Ep 1N STRICT
_ 4
BOARD/ F HE T . CORDANCE TO PLAN,
........................OF.... ./liar. ........:.-:... .._.:...................
...........
No............. ........_. FEE........................
i rn in ndiott prrmit
Permission is h reb granted..( �-...--= �/'`` .....................................................•-............
to Construe or R p?air ( fliv',fiat ew Al's'posal System
atN . ............. .. ^•.-------- --- .....-•-•---".... -�.---- .................'
Street as shown on the application for Disposal Work 'onstruction Permit o-- ------- ---- Dated..........................................
=-
Board of Health
DATE_ ....... .----- --
FORM 1255 A. M. SULKIN• INC.. BOSTON -
i
. � o . p � _ C•E �S/ .ES
s D
� L
K� :°•bEPTic AQ.�9
48 47
SAO
/Z5 00
I
0
3/ L 07 3,3
43
.17
• � � 3 a •
3S� • .I aEORoon N � / � ..
q4,-
/ w
�AVFMt/VT
S '=3d
AL S /
oHN
JACOBI z
1 PPERCAPE-ENGINEERI q No.814
u E► P:O. BOX 616 o
. SANDWICH, MA 02R. ? 4'�'vfAl�t`"
362- r
r _
FL. Rlsrk
OP OF FOUNDATION
CONCRETE COVER
.,` CONCRETE COVERS
4"CAST IRON 12��MAX. E-z-$Isw
. ; OR SCHEDULE40 .'• WMAX, '
P.V.C. PIPE . 4' SCHEDULE 4*0 P•V.C.(ONLY) ..
PITCH I/4'PER,FT. PIPE- MIN.. LEACH .
e.�
PITCH,I/4"PER,FT. PIT. PRECAST
i i J
e
INyER o J LEACHING
y
'•e ELY.3i;:••••• INVERT INVERT % . w �' PIT OR
SEPTIC TANK �c DIST. yZ �� ; • EQUIV.
e EL.YX. ..INVERT BOX .
rt 5'3�3 ��. ...... GAL. INVE T
.I—
INVE T w w :i, 3/4"TO I V,'
-, �....... EL...1.��.y w w
EL,N,{ ,7,Y, �� WASHED
w STONE
,o yo -. :.: �X�y
zz
01. --- /L DIAr—+� y
' PROFILE OF ,(/0- GROUND WATER TABLE
SEWAGE DISPOSAL SYSTEM
n , NO SCALE
S91L LOG WITNESSED BY :
DATE .TIME......' .. .... . :f1�1 � . . . BOARD OF HEALTH
• . .
j .TEST HOLE i. 'TEST HOLE .2 . ENGINEER
V. ys
E
EL : '�a a . . . . . . . . .
ELEV..�S. cry
> . . . . . . .
/f DESIGN DATA :
NUMBER OF BEDROOMS . . .. . . . . . . , .
TOTAL' ESTIMATED FLOW , r3..I,Q • , , GALLONS/DAY
�/3
BOTTOM LEACHING AREA . . . SO.FT./PIT
SIDE LEACHING AREA., . .����. . . . . SO.FT./PIT
GARBAGE DISPOSAL . . :.Alo'. .. AREA INCREASE)
TOTAL LEACHING AREA . a:C .. . . . . SQ.FT
PERCOLATION RATE rCs `. . . . 'MIN/INCH
,/ - LEACHING AREA PER PERCOLATION RATE .. . .;... SO.FT.
.l':O WATER ENCOUNTERED
NUMBER OF LEACHING PITS . .Oy��: . . . . . . . . .
APPROVED . . . . . . . BOARD OF HEALTH ?T�2'. .--/Y �'•_ //3 SF !J ,L/,,j ,/Q7TO�J,
• �°z��e,�:. .�-����<y):.�sos��s)=.3?�- ,six'
DATE. . . . . . . . . • • . . . . T r;� -yig Sr 4/4�
•AGENT .'OR• INSPECTOR s ue'
OF A(4
UPPERCAPE ENGINEERIN ~ 9 :g14�o �
. ex . Alnf 3 P.O. BOX 61d �• ���sT�� ;��
E. SANDWICH ��i p`r'4NATA
PETITIONER: • • • • H R''l
Mq, 253 -- '•' "
. . . . . . . . . . : . . . . . . . . . 362-6281' �' J°/r
No. 25 Fee u /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
ftpYitation for Misposal 6pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade Abandon( ) ❑Complete System Individual Components
Location Address or Lot No. C M ) Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel �/� l 1'1��l l/� 6 njrce��
Installer's Ne,Ad e saki Te / Desiener,s Nd rgsg,andNo.
> _ C=- _
Type of Bui mg: 2 '3
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) gpd Design flow provided gpd
Plan Date G 1 Number of sheets 1 Revision Date
Title
Size of Septic Tank epuctml Type of S.A.S. Z—
Description of Soil�� %("��/� ( �
Nature of Repairs or Alterations(Answer when applicable)
PrT
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 Min in operation until a Certificate of
Compliance has been issued by this r o e th.
Sign _ Date
Application Approved by Date .2
Application Disapproved by Date
for the following reasons
Permit No.,,, ZO Z- 't Date Issued 66A ,P—
� No. Fee
Entered in computer:THE COMMONWEALTH OF MASSACHUSETTS ;..
' .' Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftplicatipo for Disposal *pstrm CoietrUrtion Permit ;
Application for a Permit to Construct( ) Repair( ) Upgrade� Abandon( ) "❑Complete System f®Individual Components = .
Location Address or Lot No. ��� J a;Owner's Name,Address,and Tel.No. {y
Assessor's Ma /Parcel
p
/f
Installer's NarMe Address,ess d Te`l. rp Designer's Name Address and Tel.No.
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)ll gpd Design flow provided gpd
Plan Date (� f�} 7 Number of sheets Revision Date
Title
Size of Septic Tank,,/ � X/t57G(f 4f Type of S.A.S. 2— E J4,n'ft,) c 014L
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
d '
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
i
Compliance has been issued by this Boarddooffi&th. I
Signed,"4 „ _ Date LI�Zvl zo?
,,,Application Approved by ( !!i,.r_ lJ v^a /9 r Date fa 12 ci l A i
Application Disapproved by Cr � Date
for the following reasons
Permit No. Z 01 { Date Issued l l 4'i f X/
-- ------------ - - - - - ----- -- -- - ------• - - - --------- - -----------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
P. Certificate of Compliance
THIS IS TO CERTIFY,
�that
the On-site Sewage
Disposal syy�s-t-e�m. Constructed( ) Repaired( ) Upgraded
Abandoned(
)by
has been constructed in accordance / f
with the provisions of Title 5 and the for Disposal System
-Construction Permit No. ' �� -�S)dated
Installer `, LtIV11, Ow�✓1 � Designer _ �1� �MA
#bedrooms Approved design-fl w -- ""� � gpd
The issuance of this permit shall not be construed as a guarantee that the system will function desi ed. r
Date / J Inspector
No. 3 0) "'_ - Fee Ida .
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Misposal 6p$trm Construction A3,Ermit
Permission is hereby granrteed,to Construct( ) {�Repair( ) Upgrade(,tom) Abandon( )
System located at � '
T"' `+' I i,..^ '^"'�•.�',t• 'l; v,,,/ 1 '�..wi V'�t'-... ` ! aw ns q
!f
l
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.
ti
r
Provided:Construction must be completed within three years of the date of this permit. c
Date 1_ / Gt Approved by
Town of Barnstable
Inspectional Services
i = Public Health Division
t�►etvsrasta,
KASS Thomas McKean, Director
+ ° 200 Main Street,Hyannis,MA 02601
Office: 508-8624644 Fax: 508-790-6304
Installer&Designer Certification Form
Date: 7 Sewage Permit# Assessor's Map\Parcel
Designer: Installer: �W�
Address: i�!� Address:
Za �``�l `� was issued a permit to install a
On ��
date) (installer)
septic stem at '�'t v, based on a design drawn by
p G(a ress)
dated
(designer)
I
m referenced above was installed substantial) according certify that the septic system Y g to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than l 0' 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. Strip out(if required) was inspected and the soils
were found satisfactory.
I certi that the system referenced above was constructed in co a with the terms of
he approval letters(if applicable) J A OF/yq
P
VID
sta urea ME SON cr,
v NO.1066
(D e s Signature) (Affix DesiogaQWRere)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Vtoa\deptAHEALTHISEWER connecnSEPTIODesigner Certification Form Rev&14-13.DOC
4ypp'. _ _ _ - _ M_ITMM.aM•aSTesY:�.,.'?'•r+:,+"St-a.-.Jiilq,�y�'iA�fY�7?'S'.+iiCfe�Ya'6Peor9'K-d.nv�.^ypgp�'%•:.3.�y!'6'.:'S.':'1Ci'«c+::..raq�*M4•'7�s•R4.YY:,+n•+C7Vw+'b'lill:"=�'.�. -<p.-: .. _ - - _ _ ___ ___ _ _ _ _ _.
- _ i� sn }N wiSi the State Environmental Co T� ,,
o�uww
r? -
r � .._ . _._ _ _._. ___ __._..,... -• - .-.---- ' �rt,ard c►f!-}pa€ttt ttfagr�:�t=�=�•
T.
ruco � P' -a !' °septic system as PH:.'s;?CY��6!>R ti''`h s ofan shall not ate ins?aj2►'`d uWi!� #jk r;lS@C�town tl 5tr7iIcT
C � t;
<,e�Jes approval and iin i.ista, atior,permit from the a�pti.a`�Ic� owa�.
�' -
�„ ;:; ?r:ortainsCallarkyr,,f�r�;r'ct3lt�" siiBiE�:.� F wert_
_ft�'� *'�. INt 141
ri the location o. r=ljtii =.se,ric �,sewer fines
—_ � � _W/,.�_._��.7V•.. -- --- . ••:' d eXE5ir septic r Arpot., " PArr Y �' •
A6 tr installation. �#��first G feet 31toL� M 'e1 Wi � V ' Ail gravity sewer
piplrg h4 3r h2i } fit}PVC of .�.
type distribution hoc:shad b e)rvoeL ell#^#{ping connections to be g!:,i:, .
A ; -. trjs septic Design i3lath i,n,';Y= 1 = ,,ti:;�ed for property ling rl *�F rr,iraaiji t, .r for any other
/S✓✓ / } � / Y�rposQ
r other ti::,the � r O system" irstallati c,
: Ptmen# 3iY Ea ef Titv y 5?er3CaEfUR;.� �€ ://
PI $ he,p"ohibjtetf u ie. : $<..V p .- w H2O loaded.
t_&K Alb• ,► �. �, ,,�C 1� •i � � _ .:om i)nr_-rtts urtie;.:i �pC�'�,.t.,sr
�1 !D � r1�irE shall r. } .{ �- ,ri_ ,� ..�.-r e
AT !¢ ( 3', 1# ,existing ieaching or C%��.t�.,r.! _„a'1 be pumped and filled vhth;rFaterjal per Title V
.3h andUriment procedui- 4 ac lei t and cesspool(s)3n[i c�r,Ta�r-Tj*ie�sc;i}s within the
� rapOseci SAS shall be mi 11�J ,..Ec. replaced with clean Sand pk-�j:se t��•l�"CifiCat ons
Septic ccrnY pry nferts are t, � �t r:l r Ouster service'#ins`5ev.er}i4;es r rc..s€ng arat�t}'site�7
l i sleeved with an�� . -�f J^r� � a o P
�:_ s t pr;:��i: j si �:_, ;,, edu}e�P'JC with. rd`;�rC##iert The luster 5e_v.c .
1 2 the septic line 3 4 .. Er .e Rh thesleeve living Wit. ci+l�_.�'
c-r'css}rig the}ine.
garbage riZdtreCiSiS l "G s #w',:ore,it is to be t ' r 'ti c is the septic ,yste.m is not1 dlrsigned to accornr*on :�A zii:, Euzi� gr# der. -
/! � : ±� � ( � �r' 1►ot installer is tewopsi'i�toi cc.'s �i.xtavat€dn around,;!i' .i'i'st9;;C5 ii►:;�1,',;f0�?rii�
dY pfr'oteCtjt? the StrthCTlFa�`it?i?'.+:,•: ?a al!LtruciUres during it:-' s:s=r•�i%:3t#'3!t }=ti cLss'J+t t�septic
�. j , p'_>t ort}�r£'�7re'S@a h 3 - p it " r
9l Ysteri�t an#)e ictstai�_EI nr�zi'� �;r^t"'r:y meeting T}tle
c equirements.
T"i-� property owner�-h„}:' A-�{u dessg;,trite:ia to approve ti=t!total ntrr±€kr•.-pf bedrooms ant=
design flour. Irtsta}la#ic:i;;tit= s.=;,t,,. ��item as propctsr=d al�rl re_nipt c71 �Yad neat for the design►
a:[be deemed appmoval of',iip ddr-i�n criteria by the props-w y o-olner or:ip nt of.
1 G•��i }t !:ta validity oil this plan si a!;expire v ith thr:Pxpiratlon of 0* twvrk if,,stallai*r, permit issued fcI
�:. lze � ��� '7 ti}t;s plan or:he va}id 'i' tY. rlar Srsiti px!�}re firs Me!�xpirx!�r+;,o:i#Y^c{ N!'isriCdt±s of Corilpltn[
'7
issued for-the ins;.aiits . l;f k„ri
r q4
9�1
r✓ HID 5004rK t
"OF
�, '� l�� 1 T �. DAVID
`a B
MASON
R
1 775 d 7 s,
�Q ��T !`tea• til,�Z
Aw
/� r s.scas�e_s•>nca+vt-•�,re•..euresa,�ac .sr..t�e--.-r.cr•.r•-m-�-+�.•r- ..eerrrs.+..n:r•...
iCAU
VIM P
'�flr►1i�n.i.wlslrsX9�aYaxs...'�;G�a-tA+R��. -
T -1
- - ._. _ - -, _�..f�SY34�s'h'xtC:'rs7as:e�&-,�' .-. "•w`:3C+3�'.'_>�"icrr�+:v. -