Loading...
HomeMy WebLinkAbout0179 CURTIS ROAD - Health Curtis �MaYStOriS Mills A= 042-005-' dQr� L 1 1 I 1,� ]�S6f//► J TOWN OF BARNSTABLE OP / l/ d LOCATION �of a. c�e,Q�/ �� SEWAGE # ,!5;— l 9 VILLAG ASSESSOR'S MAP & LOT `f L as INSTALLER'S NAME&PHONE NO. 9-g 9 9 SEPTIC TANK CAPACITY ��o LEACHING FACILITY: (type) r l-o l�� c�saC'S �`� (size) NO.OF BEDROOMS J BUILDER OR OWNER � PERMITDATE: COMPLIANCE DATE: - - 7-7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist >Sa Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ' 1 -`� L4J f t No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for IDi!5pogal *pztem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. I / D - e/' is �,(� Owner's Name,Addressf d T�No. 0 Assessor's Map/Parcel A�TONS �/ � /Z t �/ n�/1 Installer's Name,Address,and Tel.Np, Designer's Name,Address and Tel.No. \J-o ,� M4G-G/O Type of Building: Dwelling No.of Bedrooms y Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the constructimLand maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title Envir ental Code and not to place the system in operation until a Certifi- cate of Compliance has been is ed by -of SignedV Date Application Approved by ® Date _ Application Disapproved for the following rea ns Permit No. Date Issued -- TOWN OF BARNSTABLE 1 I.00AtTON 7`? C r l •S SEWAGE # VILLAGE Rlb7?�S �. S ASSESSOR'S MAP&LOT T INSTALLER'S NAME&PHONE NO_ oo SEPTIC TANK. CAPACITY .5-aD LEACHING FACH=' (type) No.OF'BEDROOMS 3 BUILOER.OR OWNER pERMITDATE: COMPLIANCE DATE: Separation Distance Between tbe: 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 2tm f--_�t of leashing facility) ; Edge of Wetland and Leaching Facility(If any wetlands exist within 3100 feet leaching facility) Feet Furnished byeiG�n /Ll ��9y� �� G r 1� �� rat J . .. ' /� �' r,G1} ,j, g . ,, R �r �� ►� � � � � ,, � 1 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 179 Curtis Rd Property Address Bank Owned (Contact David Holt @.Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19A 1 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. A. General Information �. 1. Inspector: `- Shawn Mcelroy ' ► Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10-19-11 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the `w report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer; if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Se j ge Disposal System•Page 1 of 17 J Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: i ® 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: System is in good working order with o y g k g n sign of failure. 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 t t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM ' 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. City[Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the.Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No P sewage into facility or sys tem component due to overloaded or Backup of p ❑ ® 9 clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins•11/10 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �Y °M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of,a tributary to a.surface drinking water supply ❑ 0 the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. CityfT'own State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes"or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® Determined in the field (f any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): 330 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. City1rown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Well Detail: Sump p um ? ❑ Yes No P Last date of occupancy: 10-2011 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) -Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A 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) (f yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (f known) and source of information: 1997 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 14" 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.): Good condition. Septic Tank(locate on site plan): Depth below grade: 8"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: yearn Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal Sludge depth: 12" t5ins•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' ,M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. CitylTown 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 20" Scum thickness 0 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Tape 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 is in good condition with baffles installed and no sign of leakage. I 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): Good condition with water at working level and no sign of back-up from field. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4-flodiffusers ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Flodiffusers in good condition with no sign of back-up into d-box or surrounding stone. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments note condition of soil signs of hydraulic failure level of ondin condition of vegetation, ( 9 Y p g, g , etc.): ti t5ins•11110 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 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 �pILI V` lid �. C Wr i t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 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: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 179 Curtis Rd Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-19-11 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 SOIL EVALUATOR& PERCOLATION TEST FORMS �1HE Town of Barnstable Page l of4. ' eAaMASSS. t Department of Ilealth, Safety, and Environmental Services �A &619. "$ Public Health Division 367 Main Street, Hyannis MA 02601 OMcc: 508-790-6265 FAX: 508-775-3344 ORIGINAL Sol SLIT tl billl y Assessment 16' r Se Kage Disposal ASSESSORS MAP K, PARCEL NO. Date: t o — o-ci Cc Performed By: ���= yr j =� --Z> Date: Witnessed By: �-Av. -_32 Location Address Owner's Name Lot q: t_._oV ^ Address,and Z i o F;= GHcz�•�S `�-o a�� T cz"J �r-.�►11= �1 Assessor's Map/Parcel: yZ _. J o _ Telephone H 0 1 / �A0 z:;7'i NEW CONSTRUCTION ✓ REPAIR Office Review Published Soil Survey Available: No Yes Year Published Publication Scale loo nnn Soil map unit Q m y Drainage Class Soil Limitations `t1rL �T Surficial Geological Report Available: No Yes ✓ Year Published tC�v75::� Publication Scale Geologic Material (Map Unit) ��Iz> t��►L�►��<<Po>�T S Landform Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No / Yes Within 100 year flood boundary No 4 Yes Wetland Area: National WetlandAnventory Map(map unit) L, /A Wetlands Conservancy Program Map(map unit) M /A Current Water Resource Conditions(USGS): Month o C-- t_ Range: Above Normal Normal Below Normal Other References Reviewed: CNfE u,; �6.4m,; Lot-J�-„t 1 — L f,- DEP APPROVED FORM- 12/07/95 .— w ,r . FORM 11 - SO11. EVAIXATOR FORM Page 2 of 4 Location Address or Lot IJa. 11-site Review Deep Hole Number ( Date: o o\(., Time: \o'•vo p-M Weather Location (identity on site plan) Slope %) Surface Stones "o Land Use 5 ( Vegetation Landform Owe \)AASN mow` Position on landscape (sketch on the back) Distances from: Drainage way /)L. feet Open Water Body 1/A feet Possible Wet Area �a�A teat Property LineO ly � teat � 30' ' { feet Other 2d�� }... �a�-��t 'R✓o� Drinking Water Well 11U ��r► Foy N,U.`� t7t=�i��C=D L 0 • ( +6�G S��r Y \\DEEP OBSERVATION HOLE LOGS Other Soil Coor Soil Depth from Soil Horizon $O(USDA) a Mun elll) Mottling (Structure, Stones,G uldeaveljrs, Consistency, °� Surface (Inches) \ �- 3I L Z/, L�oSt✓ t�\o Sf01.+�=- oft �o4��E2S IO,IR l �oS�= SA KJ \1-10 MIS Lonts�E� l \z0y L �IHt✓SnN \OyR 'i'3 L Z� t_�o sue_ L���� t'\tyt� Swr.\\� 1 '3/ �- L�' LooSC I�o z:o1.1i= oft I�uv��IZS �i lZI A/r SL_ o�llL \\ - Z'' FtL\I.c3L;_ -10—'1z" l L S 10'1Q L/ L_ Z 11 Luos�- shVil (5-lo tr M Cot:0��=5, 17- — Iz0 z— trHc_SALAD 1oy� 7/3 \�\� ���*`D_ Depthtoaedrock: Parent Meteriel,lgeologlcl 1— —_ Weeping from Pit Face, tl o tvi� Death to Groundwater: Standing Water in the Hole: Estimated Seasonal High Ground Water: f_ - �O ~ UEP APPROVED F0101• 1210719S DORM 11 - SOI1, LVA'LUATOR NORM Page 3 of 4 Location Address or Lot No. Lam -L C,. w7 Det easonal High Water Table Method Used: ❑ Depth observed standing in observation hole ... �i4 inches ❑ Depth weeping from side of observation hole Y/1- inches ❑ Depth to soil mottles )�/A- inches ❑ Gr and water adjustment_ et v�ATi'c-rL ��1,"I-lTo t ���0 Index Well Nomber ---- Reading-Defte ......... . Index well level . Adjustment factor Adjusted ground water level .. SCF_'. LhP1_ L.r7 �`�•.-.,iSlvr�.�, W\h3'C"c.,L �11TS1.�c �YT�.iiL N V�� '• �!�_\� \A�F L- 14r a%> �Q oT V=-L k 0 N �,►1i=�1S Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? —4r:;--S If not, what is the depth of naturally occurring pervious material? Certification I certify that on 3 (date) I have passed the soil evaluator examination approved by the Depar ment of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature � �- Date DEP APPROVED FORM• 12/0719S FORM 12 - PERCOLATION TEST Page 4 of 4 Location Address or Lot No. COMMONWEALTH OF MASSACHUSETTS Massachusetts Percolation Test` Date: Time:, i • 3.0 � � Observation Hole # Z Depth of Perc Start Pre-soak 1 �', 3 5, 1'Z •. U Cb� . End Pre-soak Z.A z 4 - LA l Time at 12" Time at 9" i Time at 6" Time (9"-6") Rate Min./Inch Minimum of 1 percolation test must be performed in both the primary area AND reservee area. Site Passed U Slte Failed ❑ .........................................................................................................................._......-......... Performed By: -- Witnessed By: 1�1 �_ li -�Pf-�rtc Comments: DEF APPROVED rORM•121"05 ' '�� TOWN OF BARNSTABLE LOCATION kOf Lis SEWAGE # VILLAGE ASSESSOR'S MAP & LOT ` LalS,� INSTALLER'S NAME&PHONE NO. •A 4/17MU SEPTIC TANK CAPACITY LEACHING FACEL TY: (type) r l_oud us-PS (size) XV NO.OF BEDROOMS BUILDER OR OWNER d4 l�C as' 6,41e tWt9& PERMUDATE: �/ - `I 9 7 COMPLIANCE DATE: - - Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private.-Water Supply Well and Leaching Facility (If any wells exist 150 Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by L/ I-- s L 4J � � �, 04-9 � o1a-No.- -------- Fee---------- BOARD OF HEALTH TOWN OF BARNSTABLE Applitation1brVell Con0ructionpermit Application is hereby made for a permit to Construct A), Alter ( ), or Repair ( )an individual Well at: -------0-`-- -- Q M ------------------------ Location — Address Assessors a and Parcel y/J �/V�� Owner Address Installer — Driller Address Type of Building Dwelling J�J - ,� --------------- Other - Type of Building--------------------------------- No. of Persons-------------------------------------------------- 11 Type of Well Capacity 1-t Capacity---------------------------------------------------------------------------- Purpose of Well d-- Agreement: The undersigned agrees to install the aforedes dividual well in accordance with the provisions of The Town of Barnstable Board of Health Priv a Protec on Regulation - The undersigned further agrees not to place the well in operation until a Cert' a .o om nce has b n issued by the Board of Health. Signed —= - - ---- - - - -- --- -- date Application Approved By- ------ -- - ---------------------------- date Application Disapproved for the following rea s:------------------------------------------------------------------------------------------- ------------------------- -- ---- - - ---- - - -- -- -- --- - - ---------------------- —— date Permit No. - ------—---------------- Issued ----��- ------------ ---------- --------- ------------------- owl ------------------------ --------------------- date BOARD OF`HEALTH TOWN OF BARNSTABLE (fertif irate (Of Compliance THIS IS O CERTIFY, dividual Well Constructed (x), Altered ( ), or Repaired ( ) bY-------- — - ------------------------ -----------------@--------------- - 7, at------� l-f tA� �`' M/213------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of ealth Private Well Protection Ql- Regulation as described in the application for Well Construction Permit No, - / Dated------------------------ 1. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------— - - - - ----- -- Inspector--------------------------------------------—- - ----------- 4 BOARD OF HEALTH TOWN OF BAR-NSTABLE � t Certificate Of Compliance THIS IS O CERTIFY, dividval Well Constructed,( 1), Altered ( ), or Repaired ( ) by------ �� - -- .r'- - -- - - - _ c -- iV --------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection "'Regulation as described in the application for Well Construction Permit No.(V �7 -Dated------------------------- / � m THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. i DATE--------- --—---- — - ------ -- Inspector----------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Ivell Con!5truct ion Permit No. --- Fee---------_-_---- Permission'i hereby granted--- +! ---- - ----------------------------------------------------------------- -------------------- to Const u Alte/r ), r Repai ( D Indi ii u I Street as shown t appli ati n for a Well Construction Permit sue, No. - - Il/ --- --- --------------------- Dated l ------------f y-- --------- - -------------------- -©- --- ------- - UJ lth /I Board ealth DATE—�t — ---- -- -- --- ----— y V �!/ <, , -- -- - �i No.-------- ----------- - Fee- -- ---- -- BOARD OF HEALTH TOWN OF BARNSTABLE�;, Tipp[icat ion for lVell CongtructionVermit Application is hereby made for a permit to Construct (. ), Alter ( ), or Repair ( )an`individual Well at: -----1-2-9=------C-cm�-- -J'Q- T�_x�r!r/,�s_ . _5� --------Q "%-o-o----------------------- Location — Address — Assessors Map and Parcel �Owwn^'e�r Address ` 4 1 ----- ------------------------ ...... = --------'-'V -------------- Installer Driller Address Type of Building Dwelling - r1�.� --------------- Other - Tye of Building------------—------------------ No. of Persons---------------------------------------------------- It I Type of Well—-- -- VG Capacit ----------------------------------Purpose of Well----- !Y A�!-TZ- L Agreement: The undersigned agrees to install the aforede oibe�"'i'�idividual well in accordance with the provisions of.-The M. Town of Barnstable Board of Health Privat el Protec on Regulation — The undersigned further.agrees not to place the well in operation until a Cert' a .o Com nce has�been issued by the Board of Health. Signed—= - --- — - - ---- --- date -- - -- i! f date Application Approved-By '�--- ----=-------— -- ------------------------- AV date Application Disapproved for the following reaLSI:----------------------------=---------------------------------------------------------- - — -- --- -- — — ------------------------------------------------- --------------------------------—---------------- .�'T� date Permit No. -��! ---1L/ -------- ----------- Issued---------------------------------------------------------------------------- date rL -No. THE"COMMONWEAL-TH OF MASSACHUSETTS 'E�t"rep in c mputer� M Yes PUBLIC-HEALTH DIVISION 2 TOWN OF BARNSTABLE,, MASSACHUSETTS 01ppYicactiou for Oigpo!5al�6p!5tem .Cou,5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. / Owner's Name,Address and Tel No. ��� p d ; Assessor's Ma/Parcel cok/S PW �2.ws n IN 'ISM_ ' . , �n-.5ra�s Installers Name,Address,and Tel.Np, Designer's Name,Address and Tel.No:, F - \J—o E & RGG%O y-7 -7 - Qp 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title t Size of Septic Tank Type of S.A.S. Description of Soil s� r S M _ ,Nature of Repairs or Alterations(Answer when applicable) Date last inspected:' Agreement: `l r The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in acco dance with the provisions of Title 5 Enviro mental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss ed by t of a t Signed '� Date Application Approved by Date IM� Application Disapproved for the following re ins ° Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS " Certificate of Compliance � THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(Repaired( )Upgraded( ) Abandoned( )by g at 'has b constructed in accordance, with the provisions of Title 5 and the for Disposal System Construction Permit No. q dated Installer Designer The issuance of this permit shall Clot be construed as a guarantee that the syste wil fu�n&tion.as designed. Date 12 Inspector --------------------------------------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS Mi5po5ar',416p0tem Cou9tructiou Permit Permission is hereby granted to Construct( )Re air( )Up radeo(. )A a on( ) G System located at -, A jT and as described in the above Application for Disposal System.Construction Permit.The applicant recognizes 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. Date:__��— Approved by THE COMMONWEALTH OF MASSACHUSETTS � MASSACHUSETTS �kpplirattivn for Disposal Sgztem (uuns#ru.c#ion Vermit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. CiA'�tl.ot ,i. t?0.�I�� Installer's Name,Address,and Tel.No. Designer's Name;Address and Tel.No s .."Type of Building: Dwelling No. of Bedrooms Garbage Grinder( ) Other Type of Building No. per Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow -gallons per day. Calculated daily flow 444- gallons. Plan Date Lam-. 7-6 IRS(- Number of sheet Revision Date Title e L%z. I Im L t,Description of Soil Nature of Repairs or Alterations(Answer when applicable) II °=;Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the aforedescribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date 'k :Application Approved by Date ..Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS MASSACHUSETTS (1Tertifirate of (gomplialare THIS IS TO CERTIFY, that the On-site Sewage Disposal System installed ( ) or repaired/replaced'( )on by for at has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Use of this system is conditioned on compliance with the provisions set forth below: The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. This :Certificate expires on DATE Inspector THE COMMONWEALTH OF MASSACHUSETTS No. , MASSACHUSETTS FEE Pispusal �$Vstem (1lonstru.c#ion Ilermit Permission is hereby granted to to construct( )or repair( )an On-site Sewage.System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. « %7ftN'!!hTQQ ymm of The date Wow. Approved by ' �oViM i36ffi .3h95 A.M.SULI d CO.•®o8TON.MA 7&_- 0---- .riRcluiaTs':nTER ANALYTMC .L gNVI%CTECK 508 71;a 1.�75; :! 4 ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (OCIPID/ELCD) Lab I0: 15349-01 field 11): E12339 Batch ID: VGZ-0977-W Project: Aqua Jet Sampled: 12-24-96 Client: Envirotech Received: 12-26-96 Coat/Prsv- 40m1" VOA Via1JHC1 Cool analyzed- 12-27-96 • Matrix: Aqueous \ CONCENTRATION REPORTING LIMIT PARAMETER (u9!'I� tug/Ll BRL 5 Dichlorodifluoromethane BRL 5 Chl aromethane 5 Vinyl Chloride BRL 5 N Bromomethane BRL 5 Chloroethane BRL 1 Trichlorofluoromethane BRL 1 1,1-Dichloroethene / BRL 1 Methylene Chloride 8RL I trans-1,2--Dichloroethene 1 1,1_Di chloroethane BRL 1 cis-1,2-Dichloroethene * BRL BRL 1 Chloroform BRL 1 1,1 ,1-Tri+chloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL l 1,2-Dichloroethane BRL 1 ' Trichloroethene BRL I 1,2--Dichloropro ane BRL I Bromodichloromethane BRL - 5 2-Chloroethyl Vinyl Ether BRL 1 cis-1,3-�Dichloropropene 1 1 Toluene BRL 1 trans=1 ,3-Dichloropropene BRL 1 1,1,2-Trichloroethane BRL 1 Tetrachloroethene ORL 1 Dibromochloromethane BRL 1 Chlorobenzene ORL 1 Ethylbenzene I meta-and ara-Xylene * BRL ortho-Xylene * BRLBRL 1 Bromoform, BRL 1 1,1,2,2-Tetrachloroethane BRL 1 1.,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene BRL t 1 1,2-•Dichlorobenzene QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY ' 4C LIMITS a,a,a-Try fl uorotol uene 30__ 29 98 B7 - 113 % 1 ,2-Dichloroethane-d4 30 25 85 96 83 -- 117 % et compound. ►Iethod R;f c.er Method 601 :c�a. - 4tfrgeabl e ii.tne <6er� -el Mefhnri M2 Purgeat?e Aromatics, 40 C.F.R. 136, A.pperdix A (1W). ' .powwow,Fihl�—]. . --al' hti iha ] 2 '27 EhJ'v'I F:CiTEC:N Li-+�.._ . LAID oRATORIES, MA Cert, No,: M-MA.063 449 Rtc. 130 ° Sandwich, MA 02563 (508)888 ' 1-0(,)()-339-6460 (508)888-6446 kou)c r Y O ATTON: Curtis Rd- CLIENT: Aqua Jet Marstons Mills MA M)DRESS: 135 Route 130 Mashpz,e MA 02649 SAMETE DATE: 12-24-96 COLLEMB BY: Chuck DATE RECEIVED: TIME_ N/A LAB I.D. #: E12339 JOB 7YF'E: 4d2wT well SAMPLE I.A. #: E12339 WELL SPECS. : N/A RESUM OF ANALYSIS: Parameters Units Recor�nded Limit Result Coliform bacteria/100ml (4 Method) 0 06.54 x pH units 6.0-8.5 i 1' S0{1 4a C . onductanc-e mg/mg/L LS/C3ll 26.0 8.7 Sodium 10.0 LT 0.04 Nitrate-tl/Nitrite-N mg/L 0.3 2.0 Iron rQ/L 0.104 Manganese mg/L 0.05 Volatile Organic Compounds See attached report EPA Method 601/602 1000.0 1.0 Toluene ug/L cOrMENTS: Iron and Manganese are not a health hazard, but MY cause taste, staining, and odor problems. YES WATER IS SUITABLE FOR DRINKING pMPOSES 16 OR PARAMETERS T xxx Date l 3 � Ronald J. ari Laboratory Director JJP = L�yss Than y .T--'3T h1��N 1 EFJ':+I RLtTECH Lt1BS - S-`1. =:�.: E.446 —�� 44 � o' ro Lam`` PROPOSED WELL SITE • + bNyr; •� �`- ASSESSORS MAP 42 — 005•— C00 - • RECORD OWNER: CARLOS I. MARISCAL �S P.O.BOX 145 PROVIDENCE. RI 02901 `\ Lovel i , ` V�� s. ) ZONING DISTRICT: RF - Pox RELOCATE I`r,; „ tI•- Er : A SETBACKS: `� `� EXISTING WELL FRONT - 30" SIDE 15' _. •"' `� ♦+ '� REAR >s 15' .` - NO MUNICIPAL WATER AVAILABLE W E USGS LOCUS 1: 25.000 OVERLAY DISTRICT: WP ` \ i FEMA DATA: ` LOCUS DOES NOT LIE IN A FLOOD HAZARD ZONE r SEE BARNSTABLE FIRM PANEL 15C REV: AUGUST 19. 1985 ` lilt b 'IT ce r S 88*08*23" E------- ---- --------•-- 38.82 50 --- - S`8 28 f N 13- At 44 \ �•.__ \ 50,374 sq.ft. \ PROPOSED 10' / - DRIVEWAY CL J . 74 E)OST1NG DWELLING USE , era , \\ \ \ 1< �1 D TO BE ABANDONED AND ��\ STRUCTURE SHALL REMAIN \ \ �.• _• ►• ► + _ FORt'1nRAGE OUTBUILDINGAl \ / CB , EXISTING GARAGE ) , i ' ` I \\��\ \ FND \ 23.44' �. / i \ 1 EXISTING SHEDS 4 - 1-3 ONO. 23971 Av \ \ 5 SHEET 1 OF 2 t( J � ` Z SITE PLAN OF LAND GRAPHIC SCALE OF 12 10 20 40 Do SCALE: 1' 20' DATE-`OCTOBER 28. 19% ( IN FEET ) 1 inch 20 !t STEPHEN J. DOYLE AND ASSOCIATES 42 CANTERBURY LANE EAST FALMOUTH. MASSACHUSETTS 02536 TELEPHONE: 508/540—2534 GENERAL CONSTRUCTION NOTES 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 I AND THE TOWN OF � �,L�rrst..� RULES AND REGULATIONS FOR PROFILE OF SEWAGE DISPOSAL S Y S IT TEM THE SUBSURFACE DISPOSAL OF SEWAGE. 2. AT LEAST ONE ACCESS PORT OVER TANK TEES SHALL BE ACCESSIBLE NOT TO SCALE WHITHIN SIX INCHES OF FINISH GRADE WITH ANY REMAINING ACCESS PORTS BROUGHT TO WITHIN TWELVE INCHES OF FINISH GRADE. 3,. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' TOP FOUND. EL 7S.C) OF DRIVES OR PARKING. H-20 LOADING SHALL BE USED UNDER OR WITHIN 10' OF DRIVES OR PARKING UNLESS NOTED. 4.' THE EXCAVATOR/CONTRACTOR SHALL VERIFY THE LOCATION OF ALL SITE UTILITIES PRIOR TO ANY EXCAVATION. r- - ---- ---- — . _.— _ __.__ _4..`___ 51. SEWER PIPES SHALL BE 4" SCHEDULE 40 PVC LAID AT 0.02 SLOPE. 6. ANY MASONRY UNITSUSED TO BRING COVERS TO GRADE SHALL BE ' INV. EL -to.-r. ? MORTARED IN PLACE. WATER TIGHT COVER FLOW LINE ` 7. FINISH GRADE SHALL HAVE A MINIMUM SLOPE OF 0.02 FEET PER FOOT. ttY MIN 19' INV. EL �9.8 r——s' LEVEL ---� 10' MIN. 4' UQAO OEM MIN. Ltd INV. EL / _ _., INV. EL 4 •co EL 4gA, -INV. - 2"MIN. - 1/8 TO 1/2- WASHED STONE 1500 GALLON PRECAST REINFORCED CONCRETE SEPTIC TANK 4' x e' PRECAST Flow DIFFUSOR PRECAST REINFORCED CONCRETE ® ® G MINIMUM CONSTRUCTION MATERIALS PER 31.0CMR 15.226(2) DISTRIBUTION BOX TEES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND Zy SHALL EXTEND A MINIMUM OF 6' ABOVE THE FLOW LINE INSTALL ON A LEVEL BASE OF THE SEPTIC TANK AND BE ON THE CENTERLINE OF THEtie SEPTIC TANK LOCATED DIRECTLY UNDER THE CLEAN-OUT MINIMUM WALL- THICKNESS 2" 3/4" - 1 1/2' WASHED STONE (2' MAX DEPTH) MANHOLE MINIMUM INSIDE DIMENSION = 12 THE INLET PIPE ELEVATION SHALL BE:NO LESS THAN 2' NOR INV. EL 1�� ` AC" 'rt � c»0'.E �' OFTHE OUTU.: 7 INVERTS SI-;ALL BE EQUAL T31 EACH OUTLET PIPE.' -OTHER AND AT 2*-MINIMUM BELOW S; =ET INVERT. w THE DISTRIBUTION LINES FROM THE DISTRIBUTION BOX S.A.S. _ALONG x.1_WIDE x Z- EFF.- DEPTH SEPTIC TANK SHALL BE INSTALLED LEVEL AND TRUE TO GRADE DETERMINED BY FLOODING < . ON A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY SHALL ALL HAVE EQUAL INVERTS A,. s COMPACTED AND ON TO WHICH SIX INCHES OF CRUSHED STONE THE DISTRIBUTION BOX TO THE HEIG+IT OF THE DISTRIBUTION SEE PLAN VIEW FOR DIFFUSOR LAYOUT �as►��u� HAS.BEEN PLACED TO ENSURE STABIUTY AND TO PREVENT LINE INVERT AFTER ALL LINES HAVE BEEN SEALED IN PLACE. INVERT ADJUSTMENTS SHALL BE MADE BY FILLING WITH DURABLE s'Oi�S SETTLING. AND NON-DEFORMABLE MATERIAL PERMANENTLY FASTEND TO THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 . LINE OR RECONSTRUCTING THE LINES UNTIL ALL INVERTS ARE OF EQUAL ELEVATION. c%-. Or-Z Z.o' THREE 20" MANHOLES WITH READILY REMOVABLE IMPERMEABLE COVERS OF DURABLE`MATERIAL SHALL BE PROVIDED WITH ACCESS PORTS BEING PLACED AT THE CENTER AND OVER THE INLET AND OUTLET TEES THE OUTLET TEE SHALL BE EQUIPPED WITH GAS BAFFLE. REFERENCE MAP: SOIL OBSERVATION DATA: C - - jhj� CAPE COD DESIGN DATA: WATER TABLE CONTOURS AND PUBLIC WATER SUPPLY STRUCTURE ES • 3 �J o `M Of ,1� p TEST DATE 10- x -ql. TYPE r NO. BEDROOMS GARBAGE DISPOSAL ss $ I WELLHEAD PROTECTION AREAS STs�CaEwt v sEPT>a+eoR tt�ws DESIGN FLOW 3 X, 110 33Q_ � �• p SOIL EVALUATOR --P L = � Estill B.O.H. AGENT Mom. G-� T_ w"cup sSION WSOURCES OFFICE M0. 2397To EXCAVATOR -�._— S►QN41 - PERC/RATE Z 1A AA to t.A- -J?�0 k Zoo�' � t.LD{AST= t5 oc GAL_t.g SEPTIC TANK 1 SHEET 2 OF 2 As+SE s>;o�sQ : fit-.o0 5' Cc0 » �c AWE AT'LEACHING-FACILITY '12.0 �o�RVz �►. E ►0-1 tt'q x N �r1ai Y � �e.T-a - Z•p - G '('�' Z_ l5 $ 7ZAuSo a. lo`fttLJ� C. lb-(V ry4 cL -- SCALE: AS SHOWN DATE: 10-Z5•-5l, LS SAO L_S 17L to-m �1�3 to`ltt`t� STEPHEN J. C Z, 1*i Wt T- YLE AND ASSOCIATES 42 CANTERBURY LA FALMOUTH MA. 0253fi `,t TELEPHONE: 508/540-2534 SwrD ``-,, S'salD u �p W I►TF1L 1Zo" �a WA►T�tL Lzo