HomeMy WebLinkAbout0087 CHUCKLES WAY - Health 87 Chuckles Way
---ons Mills
A= 101-134
TOWN OF BARNSTABLE
LOCATION_ C �, C y I-e-5 k SEWAGE# .r2 O2I_OSO
/� MAP&
VILLAGE �- AS�SESSOR'S &PARCE �G
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY /S__0y +'
LEACHING FACILITY:(type) �— << 6 (size) ,e /0
NO.OF BEDROOMS JJ
OWNER Z C9 IU
PERMIT DATE:, COMPLIANCE DATE: 1—S-Z/
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 - l G4 I,. e"v v'o
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C�114, w
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TOWN OF BARNSTABLE
LOCATION C A �. f U r`�S `� SEWAGE# 2 L z I
G(•- f ,
VILLAGE ASSESSOR'S MAP&PARCEL I f
INSTALLER'S NAME&PHONE NO. I ���'`y �Ai'y Q fc`
SEPTIC TANK CAPACITY S�d�
LEACHING FACILITY:(type) << 6 (size)
NO.OF BEDROOMS ?OWNER 2. Id'
PERMIT DATE: C / 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 BYeQ
n
r r
W N` c w
' No. � Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Oille
Zo2,(Rp�pfitation for Misposal *pstrm Construrtion Permit l
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Adddr ss or Lot No.T7 6.4 c r_V)eS' f/"47" Owner's
Name,Address,and Tel.No. (pi /
Astessorls Ma /Parcel
Installer's Name,Address,and
�Tel.
sNo./s'('S 9.7 C V yP SF 7 Designer's Name,Address,and Tel.No.
c�l•J t+t_ C3 <a�^+w �"1/K �f(��@� !�f� •iI f��lr ' 2 C
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) gpd Design flow provided /l�. E/ gpd
i
Plan Date 2 �-z Number of sheets �Z Revision Date
Title
Size of Septic Tank lG'o Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) XG/:�Yc C G e e L 4
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 the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Signed Date 2 l?'?/
Application Approved by �s Date — 3-
Application Disapproved by Date
for the following reasons
i
17��
Permit No. o Date Issued
/ T
`«,.;;y,�W.. "�;. w � � D C�•�;,.ram r V�/
No. J Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2 -2 202 t
21pphfatiou for disposal *pstrm Construction Permit e�
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.T7 G.4 c•c G('/ef fNAy" Owner's
Name,Address,and Tel.No.
Assessor's M p/Parcel -`- tc!'
Installer's Name,Address,and Tel.No.n �'/ Ic, .��Pf 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) 0 gpd Design flow providedf'�, �/ gpd
Plan Date f Number of sheets �- Revision Date
Title
Size of Septic Tank � �'� Type of S.A.S.. e-
Description of Soil
i Nature of Repairs or Alterations(Answer when applicable) G 1�71C L Gee•C 4 , C,
r
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 dace the system in operation until a Certificate of
Compliance has been issued by this Board of Health. .��Y
Signed Date
Application Approved by [A,,A }7. �� Date
� s
Application Disapproved by Date
for the following reasons
Permit No. Q T Date Issued 3 " 2 1
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO,,rrCERTI Y,that the On-site Sewage Disposal syste Constructed( ) Repaired( X' Upgraded( )
Abandoned( )by 01 "t 0 `� T✓/ .
at 17l �� r1/,10'r$1 has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.; 0150 dated ?�
Installer ? G 0-X/ /,i i 1y `w ' `'' Designer
#bedrooms _2 Approved design flow 7?34 gpd
The issuance of this permit shallll`Aot be construed as a guarantee that the system will fun^'ct designed.
Date �' /' Inspector`
___-_-_. - :0____.___._.__._____.__._._.____.__._-_______ _.__-_ _______
No d G r Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Bisposal 6pstem anstruction Vermit
Permission is hereby granted to Construct( ) Repair(✓ Upgrade( ) Abandon( )
System located at
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:Construction must be completed within three years of the date of this permit.J ,gyp Q <`
Date ` r�r) Approved by �A"� i
V
Town of Barnstable
°4`"E l° Regulatory Services
Richard V. Scali,Interim Director
9� MASS Public Health Division
1 .
ATfDntats Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 503-862-4644 Fax: 503-790-6304
Installer&Designer Certification Form
Date: 3/ 1 Sewage Permit# -02- - Assessor's Map\Parcel
Designer: L�q ,' Xe�� n L�7c r(,c5 �vtC Installer: Z� ��L`''z J-3,
Address: 12 Wi Cr gssP-Oc/ RJ Address: V1 Can
On z 146/E�- L as issued a permit to install a
(datef (installer)
septic system at i;15- C u C trt based on a design drawn by
(address)
��i r1.2e(c�r'1 1Nc;,&sr lkt( dated
(designer)
L/ I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral.relocation of the
distribution box and/or septic tank. 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 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State& Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed in with the terms
of the I\A approval letters(if a able) ��
(Installer's Signature) CtVtu
typ.3g1t19
(Designer's Signature) (Affix Desigtie ere)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLI_ANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:'Septic+.Designer Certification Funn Rev 8-14-13.doe
Engineers note:This certification is limited to an as-built inspection of system components as installed prior to backfill.The
engineer did not supervise construction of the system.The installer assumes responsibility for all materials,workmanship,backlilling
to specified grades with proper compaction and setting riserslcovers as shown on the design plan.
<� TOWN OF BAI(NSTABLE
LOCATION_
VILLAGE_ LA $CaSOIt'S MAP 6s LOT
INSTALLER'S NAME & PHONE NO. � .�f�fG, LL 7?/./U�U
-SEPTIC TANK CAPACITY L
7W-
--- - ---
LEACHING FACILITY:(type)
NO. OF BEDROOMS PRIVATE WEI.l- R UBLIC WA.fEItI-s_
9
BUILDER OR OWNER VC./j
DATE PERMIT ISSUED: /
DATE COLIPL.IANCE ISSUED::
VARIANCE GRANTED: Yes No
T
J
f A / 3t
No- �....... f F ,n.. ........._.............
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
........ 0W1.11..........OF..........;F�Ln�.t?T e ........................................
Appliratiun for Rapa'sal Works Tunitrurttun tIrrmit
Application is hereby made for a Permit to Construct ( V�or Repair ( ) an Individual Sewage Disposal
System at:
................-........_...e4... ...... ....................... .........................&t.••--..... ...............................
Lo iation- r s I cc or No.
... ...... ... .=L..1..... _..... •---•................................
Owner Address
........................................................... ....................... .....................................................
Installer Address
Type of Building Size Lot......1S,1..Q"P_ ___Sq. feet
Dwelling—No. of Bedrooms............. .........................Expansion Attic ( ) Garbage Grinder ( )
.............. No. of ersons.._.___..................... Showers — Cafeteria p., Other—Type of Building ............. � p ( ) ( )
Q' Other fixtures ------------------------- ---• .
w Design Flow........................�.5..........gallons per person per day. Total daily flow...................... .......gallons.
WSeptic Tank—Liquid capacity/0ZEkallons Length................ Width................ Diameter_............. Depth................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No............. ...... Diameter.......... Depth below inlet.....6.......... Total leaching area... .sq. ft.
Z Other Distribution box ( Dosing tank ) ,/
Percolation Test Results Performed by............. A- .j'Z� ..._. __._.__i!�4F._... Date_._.....Z��?9' P.........
a
Test Pit No. 1......�Zff----minutes per inch Depth of Test Pit------- Depth to ground water------_____-..........
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to groundwater........................
a •-•---•-•---.....-•-•••----•-•-•--•••••....--••--•----••--------------------------------------------........................................................
0 Description of Soil-------- ......................... ........ . . .......• ---- .-----------------•--•---•------
x �`-x --------Q ... . ,�-------�--------- = �---------------------------------
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 TITLE 5 of the State Environmental Code—The undersigned further a es not o place the
system in operation until a Certificate of Compliance has been issued y the boar he
Signed .......... .............. ..... .............--- . ....... . .. .-- ......../-Z. . ..............
9 re
Application Approved By ... I'd. ........ ...... .. - ------- ----- .. .. ................ .... . _01
[e
Application Disapproved for the following reaso ..... ........... . .. .................................................. ................................................
-----------------------------
Dace
Permit No. . ---- QQ.'' Issued .
U f
Dace
Gy
r `./ (_/ /�.. Fx3.. ./......._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD -•OAF HEALTH
............./.rJ.1��4..........OF.......... f?, 1, .?%, > ...........................................
ApPration for Diipnsal Works Tontitrurtiun ramit
Application is hereby made for a Permit to Construct �or Repair ( ) an Individual Sewage Disposal
System at:
..... ----•_._...•••..._...�::,/l..YlG.(._c'5 ���Ft� f7/
n .....Location-Address-•-•-•-,--•---•--•---•-------^• ----..../---------------------------•-•--or Lob No... .........................._.
.....__....-....._........... T
........a_..._.._-__ --••--••-•-----------------
r �✓ ) i
�Owner �•J/ _---71��� ��i/ Address
. ....... ....................••-•--•----...........--•.---••----•••- --•..•-• /...........
Installer Address
dType of Building Size Lot...... feet
Dwelling—No. of Bedrooms_____________ '..........................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons____________________________ Showers — Cafeteria
Q' Other fixtures„
d ,--- ----------•---------------------------------------------------------------------- •--
........ •----------
W Design Flow...............
........._> _T________ _gallons per person per day. Total daily flow..___._...____.________��_______0___..__gallons.
WSeptic Tank—Liquid ca.pacityl gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No ________________ ....................Width of Length--------•----------- Total leaching area_____y._.__......sq. ft.
Seepage Pit No............. ------ Diameter.___.._.__..... Depth below inlet____!.......... Total leachin area sq• ft.
Z Other Distribution box ( Dosing tank_( ) I
Percolation Test Results Performed by................ ___________�.r.=-__-_._____________.-.�--_'_-____ Date........................................
Test Pit No. 1_._.__z'.._.minutes per inch Depth of Test Pit-------E_r-_.... Depth to ground water........ ...........
C3. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a •-•-----•----•-------------------•-•---••----------•---•--------•-•---•--•-----•---..._-•------•------•--•-----..._.........----•--•--._..._.._..--•--__----
ODescription of Soil............i�-...........................................l.......... ..................................I=------...---•-----•---------._.._..---------
v ---•--•--------•-•-----------------------._:.... l.fl dt tJ f �hr E ... .� .. eJ)....................•------------
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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has, een issued by the board of health.
Signed G� "N `i �%.' 12, i `----
------------
.i n - �-------------------------- ce
Application Approved By .... ... 4114-1.----- a-- d �� .. ......................... .... .��-- --
j Date
Application Disapproved for the following reaso . ...................I.......................................-------------------------..-........---------------------.-------------.....
---------------------------------------
..................................�400
Permit No. ..............'' Issued ...-/
............................r Date ...--.....-..--Date......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..............................Llt J/.�....... OF ............................... e;:...*/�I: ....------. ---...........
CITertifiett$e o ompliattce
THIS-IS TO /CERTIFY, That the Individual Sewage Disposal System constructed ( f) or Repaired ( )
b I ` r C _
at ------------------------------------------------------------------- -- .. --------...........--------------------------------------='--------------------------------------------------------------------------
has been installed in accordance with the provisions of TITLE 5 f The e ironmental Co e crib d in
the application for Disposal Works Construction Permit No. ...- Q.- -.. dated ....�-. .( --------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARA TiE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-----'.��...... .9-"... ----------------------------------------- Inspector -.... ... .
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF........:`/. r71i��71:: ,�?✓,.................. / D .
No..... -----------•. FEE..... .. ..........
ila1 Marko Ounnitrndiaan Opirrutit
Permission is hereby granted_.._______! j.__:_____.__r..!'.--rSC G( L
-
to Construct or Repair ( ) an Individual Se)&rage Disposal System
at No.--- l Cifvs__.....<-t-; %1 .�;� .. . r;- r --•-••
Street
as shown on the application for Disposal Works Construction Permit No. �_ _ Dated_ __ _._ ._._. _ ._._._....
-----•-•---------------------•----------------------------------------------------------•------_--_.._._
Board of Health
DATE...............................................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
Information is
required for every M���s Mills Ma 02648 12-1-12
State Zip Code Date of Inspection
Inspection results must be submitted on this form.Jnspecaon forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When A. General Information
filling out farms �N►tUnUlrHyi�
e only the tab 1.on the computer,
OF�gy
use
key to move your Inspector �f ```\?: :py
cursor-donot James D Sears 'o�' JAMES ,us '
ke the return Name of Inspector
y Capewide Enterprises.LLC � T►{�Ec ����
bf lo► I I Company Name
�y 153Commercia►Street ' S JNS?
Company Addms '���ngnuunn�p�o��`
Mashpee Ma 02649
City/Town state Zip code
50BA77-8877 S1623
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 Q Fails
❑ Needs Further Evaluation by the Local Approving Authority
AlilYr�.�� d� 12-1-12 --_ C-)
ltffpector's Signature Date
to �'
The system inspector shall submit a copy of this inspection report to the Approving Authority(Bo rd
of Health or DEP)within 30 days of completing this inspection. If the system Is a shared syst rn
has a design flow of 10,000 gpd or greater,the inspector and the system owneri shall submit theme
report to the appropriate regional office of the DEP.The original should be sent`to the system ojpr
and copies sent to the buyer, if applicable,and the approving authority. ' r--
""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.
inns.1910
Titla 5 al iornr Laoe s�S seem•P t or�7 SeWeas� Y �
Dec 02 12 08:03p p.3
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Ownees Name
information is Ma 02648 12-1-12
required for every Marstons Mills
page. Cityfrown 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:
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not
determined, please explain.
The septic tank is metal and over 20 years old'or the septic tank (whether metal or not) is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass
inspection if the existing tank is replaced with a complying septic tank as approved by the Board of
Health.
' A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•11110 Titte 5 omciel inspection Form:Sutrsinfaae Sewage Disposal SySWM-Page 2 of 17
Dec 02 12 08:04p p.4
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
information is Marstons Mills Ma 02648 12-1-12
required for every
page. Cityfrown state Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cant_):
❑ 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£valuation 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-MID T1Ue 5 Offldd Inspection Fore:SubsW&12 Sewage oigmsi system-Page a of 17
Dec 02 12 08:04p p.5
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form.- Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 12-1-12
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier,if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
This system passes if the we11 water analysis, performed at a DEP.certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must
be attached to this form.
3. Other.
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes"or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth ink/7;T is less than 6'below invert or available volume is less
than 2 day flow
t5ins.11110 Title 5 O trial Inspection Form:Subsurface Sewage Disposal System•Page 4 o117
Dec 02 12 08:04p p.6
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
information Marstons Mills Ma 02648 12-1-12
required for every
page. citylrown State Zip Code " Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® 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 colifonn bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than S 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
tf 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•11M 0 Trde 5 Official klspedion Farm:subsurface sewage oisposai system-pop 5 or 1 T
Dec 02 12 08:05p p.7
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Flame
required fb is Marstons Mills Ma 02648 12-1-12
required forevery
page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done.You must indicate"yes"or"no"as to each of the following.
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ID 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 NIA)
® ❑ 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?
0 ❑ 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): na Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203(for example:.110 gpd x#of bedrooms):
330
t5ns•11f10 Tide 5 Official Inspection Forth:Subsvdaoe Sewage Disposal System•Page 6 of 17
Dec 02 12 08:05p p.8
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
information is required for every Marston Mills Ma 02648 12-1-12
page. CitylTown State Zip Code Date of Inspection
D. System Information
Description:
The System is a 1000 gal Precast Tank D Box and Pit
Number of current residents: 1
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage d 2010-69,000-gat
g y g (9P ))' 2011-39,000-9al
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: present
Date
Commercial/Industrial Flow Conditions:
Type-of Establishment
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seatsfpersonslsq.ft.,etc.):
Grease trap present? ❑ Yes Q 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•1 MU Tdfe 5 Ofloal Inspection Forth:Subsurface Sewage D13posel System•Pege T o117
r
'Dec 0212 08:06p p.9
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner owners Name
information is required for every Marstons Wils Ma 02648 12-1-12
page. City/Town State Zip Code Date of Inspection
D. System Information (cost.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: 4/9109
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/Altemative 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):
15ins-11110 Tttie 5 omaai mspectlon FafTm subsurface sewage Disposal system.Page a of 17
Dec 0212 08:06p p.10
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 12-1-12
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed(if known)and source of informmation:
1990 Permit#90-538
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 40"feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Pipeing is 4" pvc sch 40
Septic Tank(locate on site plan):
Depth below grade: 32"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
1000 gal precast
Dimensions:
Sludge depth: 2
L%ns•11110 Time 5 Official tnspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Dec 02 12 08:06p p.11
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
information is Ma 02648 12-1-12
required for every Marstons Mills
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont)
Distance from top of sludge to bottom of outlet tee or baffle
28" i
Scum thickness
Distance from top of scum to top of outlet tee or baffle
12"
1 711
Distance from bottom of scum to bottom of outlet tee or baffle
How were dimensions determined? Asbult Tape 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 and outlet cover at 32"below grade w/inlet cover at 6"Tank at working level wl outlet baffle no
sign of leakage or overloading
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins•t 1/t0 Title 5 Of idal lnspecticri Form:Subsurface Sewsp Dispose(System•Page 10 of 17
Dec 02 12 08:07p p.12
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Ownet's Name
information is Marstons Mills Ma 02648 12-1-12
required for every
page. Cityrrown 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 M 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? Q Yes ❑ No
t5ins-11110 TBIe 5 Otfical Inspection Fam:SubsuAees Sewage oisposat SysOem-Page 11 of 17
Dec 02 12 08:07p p.13
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
87 Chuckles Way-
Property Address
Donald Thomas
Owner Owner's Flame
information is
required for every Marston Mills Ma .02648 12-1-12
page. Citylrown 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
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
D Box is 4' below grade Box is dean and solid no sign of oveloading or solid carry over w/one line
outr
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 silte plan, excavation not required):
If SAS not located, explain why:
t5ins•WIG Title 5 Official Inspechm Form:Subsurface Seerage Disposal System-Page 12 of 17
Dec 02 12 08:07p p.14
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 12-1-12
page. Cityrrmn State Zip code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number.
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovativelaltemative system
Type/name of technology:
J
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leaching is one 1000 gal precast Pit.Pit is 52"below w/cover at 20" Pit has 20"water w no high stain
line. no sign of overloading or solid carry over
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
f Materials of construction
i i In d Caton of groundwater inflow ❑ Yes ❑ No
t51ns-1 MO Tifle 5 ORdal Inspedicn Form:Subsurface SewW Disposal System•Page 13 of 17
Dec 02 12 08:08p p.15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owners Name
infortr►ation is Marstons Mills Ma 02648 12-1-12
required for every
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins.1 U10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Dec 02 12 08:08p p.16
Commonwealth of Massachusetts
MUM Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
informationeicedo is every Marston Mills
required for eve Ma 02648 12-1-12
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building.Check one of the boxes below:
® hand-sketch in the area below
❑ drawing attached separately
O O
� of
t5ins•t 1/1D Title 5 Official hspegron Foam Subsurface Sewage Disposal System-Page 15 of 17
Dec 02 12 08:08p p.17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
87 Chuckles Way
Property Address
Donald Thomas
Owner Owners Name
information is required for every Marstons Mills Ma 0264B 12-1-12
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
Estimated depth to high ground water:
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 propertylobservation 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:
Auger Hole 12' no water Auger Hole 2' below bottom of Pit
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal Syslem•Pape 16 of 17
Dec 02 12 08:09p p.18
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
9 P Y rY
87 Chuckles Way
Property Address
Donald Thomas
Owner Owner's Name
information is required for every Marstons Mills Ma 02648 12-1-12
page. cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
0 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
thins-11110 Title 5 Of tidal Inspection Form'Subsurface Sewage Disposal System-Page 17 of 17
,A
--64-- EXISTING CONTOUR
x 60.98 EXISTING SPOT.GRADE _ `FM;
-W EXISTING WATER SVC. 9
-G EXISTING GAS SERVICE
-tiGW- UNDERGROUND WIRES �cP 405496
TEST PIT ..
BENCHMARK
st
LEGEND
. .� Wap Maraa¢GLAz ' S
' K
S
(� ( fro».,. '''•.
O S
5 38�2's4'• w LOCUS MAP
xj 27'
LOT 15 111.03
15,863t S.F.
x 110,50
109.63 BENCHMARK
109.5x6
x COR./BULKHEAD
f EL.=105.54
110.37 109,29
x 11).22 0x
109A0 EXISTING LEACH PIT
TO BE PUMPED, FILLED
109.12
E a 105.38 109,12 x 108.82 WITH SAND & ABANDONED
EXISTING SEPTIC TANK 0G
TOP OF TANK, EL.=102.88
INV.(OUT)=101.55E 310 + 108.4�
9.12 105,43 ` i/ \ 107.24 -
105.40 105.96 x `D
a>
04
C3F 0
x 105.41 I VENT
z BM 0
105.59 105.54
a)
x DECK N
10516.T.'DFPLUS.14 BH 105A5 O ;;i_v _0)
1 � 1 `O 04
r Q'
107.71 �. . �. pI2 iz
1EXISTING
Q O: :I 104.8
GARAGE HOUSE(187)
T.O.F.=106.2E
f--10'--I
107.03 • X. 105. 4 PROPOSED S.A.S.
105.0 a 5 LC-6 UNITS SURROUNDED
�t' ..: ':•. `.:` .' WITH 3.5' OF STONE, ALL SIDES
04.87 �: :- :w�. x I /
. , 104.94
104.55 104,59 0 .12
PAVED. /
DRIVEWAY::
G� PLANTINGS '
J x 100.55
103.17 LANTI GS
103.13 . '
L=100.58' 99,8
R=18 c�
' 100.27
103.03 102.10 edge •
of
101,29 Pavement
100.14
CATCH BASIN PK SE 100.18
/~HUCKL
RIM=99.81 100.00
�'S WA y
O F
® 99.85 / 0 ( -
Mgss9c
� y
o PETER T. �, PARCEL ID: 4
McENTi
PROPOSED SEPTIC SYSTEM UPGRADE PLAN
No.. IL
35109 35
Rfc�s� ° 87 CHUCKLES WAY, MARSTONS MILLS, MA
Prepared for: DiBuono Sewer & Drain, 35 Content Ln, Cotuit, MA 02536
-Z,1 OWNER OF RECOED Engineering by: SCALE DRAWN JOB. NO.
H2G HOLDINGS LLC Engineering Works, Inc. 1"=20' P.T.M. 120-21
40 COCHESET PATH 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO.
WEST YARMOUTH, MA 02673 (508) 477-5313 2/15/21 P.T.M. 1 Of 2
t�
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE < EL: 100.5
FOR A DISTANCE OF 15' AROUND THE
PERIMETER OF THE S.A.S.
SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S.
INSTALL RISERS & COVERS OVER INLET & INSTALL RISER AND COVER INSTALL RISER & COVER OVER ONE CHAMBER(MIN.)
OUTLET AND SET TO 6" OF FINISH GRADE SET TO WITHIN 6" OF FINISH AND SET TO WITHIN 3" OF FINISH GRADE TO SERVE
T.O.F.=106.2t GRADE AS AN INSPECTION MANHOLE.
F.G. EL.=105.2f F.G. EL.=105.4t F.G. EL.=106.4t F.G. EL.=104.2 to 106.8t
EXISTING CHARCOAL VENT
L = 36' L = 28'
® S=1% (MIN.) @ S=1% (MIN.)
4"SCH40 PVC 4"SCH40 PVC
6• w 2" LAY;
R OF 1/8"
U-ilo"I 6 I®0 E3 TO 1/2 DOUBLE
14" 12" WASHED STONE
EXISTING 48" LIQUID INV.=101.55 (OR APPROVED FILTER FABRIC)
LEVEL INV.=100.50 3.5' 3' 3.5'
PROPOSED 3/4"-1 1/2"
D-BOX EFFECTIVE WIDTH = 10' DOUBLE WASHED
•BAFFLEGAS ... INV.=100.67 H-20 RATED INV.=100.00 STONE
EXISTING SEPTIC TANK USE 5 LC-6 LEACHING CHAMBERS IN SERIES WITH
3.5' OF DOUBLE WASHED STONE ON ALL SIDES
H-20 RATED
NOTES:
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP CONC. ELEV.=100.83 -- -- -BREAKOUT
INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=100.00 ®®®0®®® ELEV.=100.5
2) D-BOX SHALL BE SET LEVEL AND TRUE TO
GRADE ON A MECHANICALLY COMPACTED SIX mm�o -
BOTTOM ELEV= 99.00
INCH CRUSHED STONE BASE, AS SPECIFIED IN 3.5' 5 x 6' = 30' 3.5'
310 CMR 15.221(2). 4' OF NATURALLY OCCURRING
3) INSTALL INLET & OUTLET TEES AS REQUIRED. PERVIOUS MATERIAL EFFECTIVE LENGTH = 37'
4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE 5' (MIN.) ABOVE G.W.
AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. BOTTOM OF TP, EL=93.5 = LEACHING SYSTEM SECTION
SEPTIC SYSTEM PROFILE
N.T.S.
GENERAL NOTES:
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOG
BOARD OF HEALTH AND THE DESIGN ENGINEER. DATE: FEBRUARY 12, 2021 (REF#TPT-21-028)
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SOIL EVALUATOR: PETER McENTEE SE#1542
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE WITNESS: DAVID STANTON R.S. HEALTH AGENT
LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: ELEV. TP- DEPTH ELEV. TP-2 DEPTH
-310 CMR 15.405(1)(b): LOCAL UPGRADE APPROVAL
1) A 5' variance, S.A.S. to cellar wall, for a 15' setback. 105.2 A 0 105.0 A 0"
2) A 3' variance to the 3' maximum cover requirement, for up to SANDY LOAM SANDY LOAM
6' of cover over the S.A.S. 10YR 4/2 10YR 4/2
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 104.5 B 8^ 104.3 B 8"
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. LOAMY SAND LOAMY SAND
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 101.7 10YR 5/4 42" 101.7 10YR 5/4_ 40"
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN C PERC C
ENGINEER BEFORE CONSTRUCTION CONTINUES.
5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. 25"/43" ,
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF FINE SAND FINE SAND
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 2.5Y 6/6 2.5Y 6/6
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE 93.7 138" 93.5 138"
DIRECTED BY THE APPROVING AUTHORITIES. PERC RATE <2 MIN/IN. "C" HORIZON
10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY NO GROUNDWATER ENCOUNTERED
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
CONSTRUCTION.
11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS r-- a'K
IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND NOCKOUT
REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). I 20'Ow. COVER
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE I I
INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. - 10
I4'KNOCKOUT 4•KNOCKOUTI �
13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. I I
14. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC L------ 4' KNOCKOUT
SYSTEM COMPONENTS NOT SHOWN ON THE PLAN
72" 'l
DESIGN CRITERIA PLAN VIEW
• NUMBER OF BEDROOMS: 3 BEDROOMS ® ® ® ® ® ® ® z2'
SOIL TEXTURAL CLASS: CLASS I
DESIGN PERCOLATION RATE: <2 MIN/IN INVERT I ® ® ® Ea ® ® ® I I I
DAILY FLOW: 330 GPD
DESIGN FLOW: 330 GPD I 72' 36• 7
GARBAGE GRINDER: NO-AND NOT PERMITTED WITH THIS DESIGN SIDE VIEW END VIEW
LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF WIGGIN LC-6, H-20 LOADING
.74 GPD/SF LEACHING CHAMBER
EXISTING SEPTIC TANK: 1000 GALLON CAPACITY
PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS, H-20 RATED N.T.S.
USE 5 LC-6 LEACHING CHAMBERS IN SERIES WITH PROPOSED SEPTIC SYSTEM UPGRADE PLAN
3.5' of DOUBLE WASHED STONE ON ALL SIDES 87 CHUCKLES WAY, MARSTONS MILLS, MA
SIDEWALL AREA: (10.0' + 37.0') x 2 x 1' = 94.0 SF Prepared for: DiBuono Sewer & Drain, 35 Content Ln, Cot uit, MA 02536
BOTTOM AREA: 10.0' x 37.0' = 370.0 SF Engineering by: SCALE DRAWN JOB. NO.
TOTAL AREA:........................................................... 464.0 SF Engineering W�r Orb, Inc. N.T.S. P.T.M. 120=21
12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO.
DESIGN FLOW PROVIDED: 0.74 GPD/SF(464.0 SF) = 343.4 GPD (508) 477-5313 2/15/21 P.T.M. 2 Of 2