Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0057 DEBBIES LANE - Health
57 DEBBIES LANE, MARSTONS MILLS -- - -- - -- - - --- - A � II f � �i Commonwealth of Massachusetts �d Title 5 Official Inspection Form X, 1. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments sy�l 57 Debbies Lane v Property Address ° Patrick Dunlea Owner Owner's Name information is required for every Marstons Mills ✓ Ma 02648 3-29-19 page. City/Town State Zip Code Date of Inspection N. Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information f 3�q� filling out forms on the computer, Brett Hickey use only the tab key to move your Name of Inspector cursor-do not B&B Excavation use the return key. Company Name 374 Route 130 Company Address Sandwich Ma 02563 City/Town State Zip Code rr�cv (508)477-0653 S113747 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: . 1. ❑■ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Brett Hickey °m'g�°O en""" 3-29-19 -a1e:ZO19.q.0199.4901-0090 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 has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 1 B f C Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane u Property Address Patrick Dunlea Owner Owners Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ❑■ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: The system was in working order at the time of inspection. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts �e Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 57 Debbies Lane Property Address Patrick Dunlea Owner Owners Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 I c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well*". Method used to determine distance: *'This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ Q Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 c Commonwealth of Massachusetts �- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ 0 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ El Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ a Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ 0 Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ Q Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ 0 Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ 0 Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ El 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.] ❑ 0 The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ 0 The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 i Commonwealth of Massachusetts 1p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane u Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered"yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no" for each of the following for all inspections: Yes No 0 ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ El Were any of the system components pumped out in the previous two weeks? E ❑ Has the system received normal flows in the previous two week period? ❑ Q 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) ❑ El Was the facility or dwelling inspected for signs of sewage back up? El ❑ Was the site inspected for signs of break out? El ❑ Were all system components, excluding the SAS, located on site? El ❑ 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: El ❑ Existing information. For example, a plan at the Board of Health. ❑ 0 Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc-rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 cam, Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 3 Number of bedrooms(design): Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330/gpd Description: 2 Number of current residents: Does residence have a garbage grinder? ❑ Yes No Does residence have a water treatment unit? ❑ Yes 0 No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes No information in this report.) Laundry system inspected? ❑ Yes 0 No Seasonal use? ❑ Yes Q No Water meter readings, if available(last 2 years usage(gpd)): See below Detail: 2018- 30,000gallons 2017- 34,000gallons Sump pump? ❑ Yes ❑■ No current Last date of occupancy: Date t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: NA Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner- last pumped 2 years ago Was system pumped as part of the inspection? ❑ Yes ❑■ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . v 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: 0 Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: New SAS added to existing leaching in 2013 Were sewage odors detected when arriving at the site? ❑ Yes W No 5. Building Sewer(locate on site plan): 1 rnn Depth below grade: feet Material of construction: ❑ cast iron ❑■ 40 PVC ❑ other(explain): Town water Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts i� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments �a ,u 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 911 Depth below grade: feet Material of construction: ❑■ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 1 Dimensions: 000gallons 591 Sludge depth: 3119 Distance from top of sludge to bottom of outlet tee or baffle 1" Scum thickness 611 Distance from top of scum to top of outlet tee or baffle 1511 Distance from bottom of scum to bottom of outlet tee or baffle measured How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was in working order at the time of inspection. The tank is not in need of pumping at this time but should be pumped every two years for maintenance. t5insp.doc•rev.728I2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts ,z Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane V Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): NA Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):' Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 57 Debbies Lane V Property Address P Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be opened) (locate on site plan): o„ 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.): The d-box was in working order at the time of inspection. t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form f' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane v Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information cont. y (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): NA * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: (10)Hi Cap infiltrators FX] leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts �- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The leaching was in passing condition. Infiltrators were dry when viewed. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): NA Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): iMaterials of construction: NA Dimensions I Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑■ hand-sketch in the area below ❑ drawing attached separately Rssis"sing,A�Bui}t.Cards; vur:Arr5�� iUe�11.a nssssc s rnxct r:'-.r5 �s' zrasrAts PIMrro.. ra.�3�� ssr_ndr�rnc.C'A''FAMY L ACHL*rCrFACTL?rY 41YP�)���� ►± is 3 z t J7%'^ . ERwrbAml G i Ct i tlaNGEDr1IE. l w4rP'Cr� Sap4txRoa 2 B+mwmen rLe: .. : � .. �ttm�mm 3�l�atod :TahIe to>�c BMaeai oEl:gachsag�sy 'd�"'�'lC Fect' Privase Wjdet S>y�jr`&et! T:uacbSng;F�ailEY tLt aa�weUs'exlet,atr ' aik oz anchi¢2oo tens of#eachmg fru�treyj �,,,�feN� oti S�e6mg YarltrtY(uy wnGa a>dnt witl 3t79.fcutng ficifil5)` l cst =.3W �I� E 13c�y iv�i's'u y t5insp.doc•rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 r Commonwealth of Massachusetts �o ,z Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane V Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑■ Check Slope FW Surface water ❑■ Check cellar ❑■ Shallow wells Estimated depth to high ground water: No GW @ 120"feet Please indicate all methods used to determine the high ground water elevation: F Obtained from system design plans on record 6-11-13 If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) I ❑ 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: A plan on file with the Board of Health was used. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Debbies Lane Property Address Patrick Dunlea Owner Owner's Name information is Marstons Mills Ma 02648 3-29-19 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ❑■ A. Inspector Information: Complete all fields in this section. ❑■ B. Certification: Signed& Dated and 1, 2, 3, or 4 checked ❑■ C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed ❑■ D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 } TOWN OF BARNSTABLE LOCATION S7 bt�S �A3 SEWAGE# 9_0 1.3 —-.2-1 0 /,;VILLAGE &grr, AA)) S ASSESSOR'S MAP.&PARCELO&I C) INSTALLER'S NAME&PHONE NO. i �alGt � ex.�ae� 1 n,e SL7F4 2/2t9 -YS 3 SEPTIC TANK CAPACITY L'x f S h nV S i LEACHING FACILITY:(type) ;C�Jfda�bAS (size) G S %/PNa4- NO.OF BEDROOMS -I OWNERc�ccs�c QA PERMIT DATE: & 1 13 F COMPLIANCE DATE: 6f 3 Separation Distance Between the: e"r-ovN+elec) Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility CZF !�./c Feet Private Water Supply Well and Leaching Facility(If any wells exist or►`.- 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 BYY� :32 — ;V5 .. 3ci Deck �WNd�v� r No. 2© ®� Fee v``U� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppl Lation for VspoBal *pBtrm ConstCUttlon prrmit Application for a Permit to Construct( ) Repair(i<Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location.Address or Lot No. • 7 DOO b t`5 (. Owner's Name,Address,and Tel.No. &e"s Irc,?VS /kv1�5 cGd110C ►'1 1 Assessor's Map/Parcel 011 —O 1 S Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. F"'51-j&e. L-�jS LovrICS - 00-7/ Type of Building: Dwelling No.of Bedrooms 3 Lot Size W,000 sq.ft. Garbage Grinder( ) Other Type of Building h oo g,C No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) "3'3� gpd Design flow provided 3&y ,5- gpd Plan Date G "i Number of sheets 2— Revision Date Title Size of Septic Tank Z�5F�5-f 5 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable)7�g, fG // ly r cJ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si " A-Z—, Date 6115 / Application Approved by R Date Application Disapproved by Date for the following reasons Permit No. 10 Date Issued �� I No. U -2 V \ Fee 16, THE COMMONWEALTH OF MASSACHUSETTS Entered in compute: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftplication for disposal 6pstent Construction Permit Application for a Permit to Construct( ) Repair(V<Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 De14)0i t-S G Owner's Name,Address,and Tel.No. ,tit&,-S �C,"s �,l�s L cch�vc � , .• Assessor's Map/Parcel O 1-5-- Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. �a�S1GS A �alc>wr✓ =n-c trv5 ,��ri '..g Wc�f1C3 -L/00- 7/ Type of Building: v Dwelling No.of Bedrooms' -3 Lot Size 2CJ,e-�e�7 � sq.ft. Garbage Grinder( ) Other Type of Building Vn o 0 5 V- No.of Persons Showers( ) Cafeteria( )' Other Fixtures Design Flow(min.required) o gpd Design flow provided 36 gpd Plan Date Number of sheets 2 Revision Date Title Size of Septic Tank �T_���,� 5 Type of S.A.S. Description of Soil i Nature of Repairs or Alterations(Answer when applicable) 1 Nam,f, // .N r Date last inspected: °p Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. ., Signed lam- Date G / Application Approved by Date / Application Disapproved by Date for the following reasons / Permit No. o ? r 2 U Date Issued / THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( I,"- Upgraded( ) Abandoned( )by `> �����S (caw 7- at 5-7 i7�1nh�w N tvl`,�cs. ,g 'l�T has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. d -21U dated / Installer 1 bQ,Nr_!6 A =;vc Designer '(- #bedrooms Approved de Ifun w J G�(, S gpd The issuance of this permit shall not be construed as a guarantee that the system willi on as designed - - Date -��/'=5]� I�- - Inspector 91 i --------------------------------------------------------------------------------------------------------------------------------------- No. ( I - 2 0 Fee OO THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposai *pstem Construction Permit Permission is hereby granted to Construct( ) Repair( f/� Upgrade( ) Abandon( ) System located at 1�_7 D-g43 V), S L /�a✓S't G�v tUl, c 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:Const- ction ust be completed within three years of the date of this permit. Date 6 1 7 / Approved by 06/17/2013 16: 19 5084775313 ENGINEERING WORKS PAGE 01 Town of Bnrnstabit Re eery Services Thomas F. Geller,Director Pub& HeXM Divi Qom Thomas McKean,Director Zoo MOW Street, Hyann*MA 02601 MOW sob.862 4644 Fax: 308-790-6304 Date: 1 Sewage Permit# Assessor's Maplpaml Q 1 Ind 1 .11er&Designer CeW tins Form Designer: - —�"—a. � Installer: )_2a A, ,a-t �✓'� Address: 2 Address: 0, ms M ,4 On •1' ` j'`'{- was issued a permit to install a (date) (mst$.iler septic system at 57 based on a design drawn by dated (de finer) I certify that the septic system referenced above was installed substamially according to the desi,qn, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater th m 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Platt revision or certified as-built by designer to follow, Stripout(if required) wa . ted and the soils found satisfactory. Aw OF PETER T. or's Signature) �ENTEE CIVIL No,3a40s 2r-. (Designer's Signature) (Affix Design ST E F COMMANCE WrLL NOT BE ISSUED UNTIL BOTH THIS F RM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTA.BLE PUBLIC HEALTH DIMS ON IHAU.YOU q:W500 JXM9\ 3igne Utffioation fbmdoc ,�' � DeparW>Lent of Regulatory Services i! Public Health D><vison Hate �2 )3 h 200`Main Street,Hyannis MA 02601 Da � � 1 C to Scheduled V Time Fee Pd. Soil. ' itab >lity Assess: eat far Sewage D' s�osal Perfo,med,$y: � Witnessed By: LOCATION&;GENERAL:INF(?.RMITI) T. Location Address r Owner's Nisme Az 6� . eS fL Address S 7. �e S aNhrs � �..�1 M Y3 (�Z 4. Assessor sMap/Parcel: 1 Engineer's Name S NEW.CONSTRUCTiON REPAIR _� . Telephone# 67 73-7--y 7 Q $` Land Usc I o'er„ t c, Slopes M Z Surface Stones Distancesfrom: Open Water Body.N ft Possible Wet Area�_ft Drinking Water Well ( ft Drainage Way N f A- ft Property Line S0�f� ft Other SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands?T!p oxlmityto`holes) C� R.5c 57 Parent material(geologic) "" Depth'to Bedrock Depth to Groundwater. Standing Water in Hole: �0 Weeping from Pit Face NcH - Estimated Seasonal.High Groundwater `� / � DETERNIINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: _____- In. Depth to Boll mottles: Depth:a acepiug ibufa side:of obs.hole: In. Groundwater Adjustment ft. Index.Well.4 Reading Date: Index Well level Adj factor' Ac({;'(7roufldwater'Level,,,,� PERCOLAMN TEST bate..,. Thm Observation Hole# Pe f e. &LA 1=; t.e.Time at 9" Depth-of Perc P-5 1 S- Time at 6". Start Pre-soak Time @ �./ ✓l. Time(9"a6") ,,r End Pre-soak Rate Minainch 2 Site Suitability Assessment: Site Passed. '� Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:ISEPTICVERCFORM.DOC r DEEFOBSERVATIONbOLE LOG Depth from Soil Horizon " Soil T:cxture SoiYColor Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;do Boulders: t ' M-C 5c1 . 15 � DE Hole# P OBSERVATIbN HOLE BOG �-- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in) (:USDA) (Munsell) Mottling (Structure,Stones,Boulders Consistency.96 61orell_ Z / 5 DEEP OBSERVATIWHOLE`LOG Hole# Deptii`;froni- . Soil Horizon Soil Texture Soil.Color. Soil other. Surfai a(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. - -, DEEP OBSERVATION HOLE LOG. Hole# Depth".from Soil`fiorizoa. Soil Texture Soil Color Soil ► Other + Mottlin Structure,Stones;:Boulders. i ` S.urface'(in. (USDA) (Munsell) g Flood I7n�urance Rate Map., Above 500 earflood'boundary No_ Yes. Y Wittiia S00 year boundary. No Within 1o0 year flood boundary No. Yes Death of Natiuraliy'Occurrini=Pervious:M__teriai 8 .. . Does==ah least four ft;6t of naftirally occumng pervious material exist in a1f areas observed throu out , e,_ - area proposed for the soil abgorpdbn system? If not,what is the depth.Of naturally occurringpervious<matorlaf? Ce ratio I certify thati©n _19 t0.a� , .(date),I;havepassed:theaoil-evaluator examination approved by?the . Department of Environmental Protecrion and that the above analysts was performed by me consistent with the required`traimng I;xpeittise and_experience.described in 10 CMR 15;' 7. • �- Date � (C ( • • Signature_., Q:ISEPTIC�PBRCFORM.DOC Commolnweatih of Massachusetts .John Grad Executive Office of Envirtv orrlerrtal Affairs D.E.P. Tit ector Department of Environmental Protection a et,Mn 0253 r _08) 56 C44 CE/VEQ MAR 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM f, TOWN OF 1 1997 PART A HEq(SAS pSTAB(E CERTIFICATION Property Address: 57 Debbies Lane Marstons Mills Address of Owner: 6 Date of Inspection:2127197 (If different) Name of Inspector:John Gracl Doyle Company Name, Address and Telephone Number: CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: X Passes This inspection is based on criteria defined in Title V Conditionally Passes code 310 CMR 15.303.MV findings are of how the system is _ Needs F rthq Evaluation B the Local Approving Authority performing at the time of the Inspection. a lInspectlon does Y PP 9 ty not Imply any warranty or guarantee of the longevltV of the Fails septic system and any of its components useful life. r Inspector's Signature: /� Date: 319197 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. If the system is a shared system or has a design flow of t0,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A, B,C,or D: A] SYSTEM PASSES: x I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,passes inspection. Indicate yes,no,or not determined(Y, N,or ND). Describe basis of determination in all instances. If "not determined", explain why not.) The septic tank is metal, cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 11/15195) One Winter Street • Boston,Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 57 Debbles Lane Marstons Mills Owner: Doyle Date of Inspection:2127197 _ Sewage backup or breakout or high static water level observed in the distribution box is due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced The system required pumping more than four 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 obstruction is removed 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. _ The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria volatile organic compounds indicates that the well is free from pollution for that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm. 3) OTHER D] SYSTEM FAILS: _ I have determined that the system violates one or more of the following failure.criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Backup of sewage in facility or system component due to an 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 cesspool. SAS is in hydraulic failure. (revised 11115195) 2 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 57 Debbles Lane Marstons Mills Owner: Doyle Date of Inspection:2J27197 D] SYSTEM FAILS(continued) 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 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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 privyls 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria: _ The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 11115195) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 57 Debbles Lane Marstons Mills Owner: Doyle Date of Inspection:2127197 Check if the following have been done: X Pumping information was requested of the owner,occupant,and Board of Health. X None of the system components have been pumped for at least two weeks and the and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined. Note if they are not available with N/A. X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout. X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge, depth of scum. X The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. I (revised 11115195) , 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 57 Debbles Lane Marstons Mllls Owner: Doyle Date of Inspection:2127197 SEPTIC TANK: X (locate on site plan) Depth below grade: 1' Material of construction:X concreate_metal_FRP_other(explain) Dimensions: L8'6*h5'7'w4'10" Sludge depth:1" Distance from top of sludge to bottom of outlet tee or baffle: 26" Scum thickness:0 Distance from top of scum to top of outlet tee or baffle:6" Distance form bottom of scum to bottom of outlet tee or baffle: 0 Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) Septic tank and all components are structurally sound.Recommend pumping system every two years for maintenance. GREASE TRAP: (locate on site plan) Depth below grade: Na Material of construction: _concrete_metal_FRP_other(explain) Dimensions: n1a Scum thickness:n1a Distance from top of scum to top of outlet tee or baffle:n►a Distance from bottom of scum to bottom of outlet tee or baffle:n1a Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) n1a (revised 11115195) 6 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 57 Debbie$Lane Marstons Mills Owner: Doyle Date of Inspection:207197 FLOW CONDITIONS RESIDENTIAL: Design flow: 440 gallons Number of bedrooms: 4 Number of current residents: 1 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings,if available: nla Last date of occupancy: n1a COMMERCIAL/INDUSTRIAL: Type of establishment: n1a Design flow:0 gallons/day Grease trap present:(yes or no) No Industrial Waste Holding Tank present: (yes or no) No Non-sanitary waste discharged to the Title 5 system:(yes or no) No Water meter readings,if available: Na Last date of occupancy: n1a OTHER: (Describe) n1a Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System was last pumped two years ago by Ace System pumped as part of inspection:(yes or no)No If yes,volume pumped: 0 gallons Reason for pumping: n1a TYPE OF SYSTEM X Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source information: 1980 Sewage odors detected when arriving at the site: (yes or no) No (revised 11115195) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 57 Debbles Lane Marstons Mills Owner: Doyle Date of Inspection:21Y7197 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: n1a Material of construction:_concrete_metal_FRP_other(explain) Dimensions: n1a Capacity: n1a gallons Design flow: n1a gallons/day Alarm level: n1a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n1a DISTRIBUTION BOX: X (locate on site plan) Depth of liquid level above outlet invert: liquid levelwlth bottom of pipe. Comments: (note if level and distribution is equal,evidence of solids carryover, evidence of leakage into or out of box etc.) Distribution box Is structurally sound. PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber,condition of pumps and appurtenances, etc.) Na (revised 11115195) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 57 Debbles Lane Marstons Mills Owner: Doyle Date of Inspection:2f2719T SOIL ABSORPTION SYSTEM (SAS):x (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: n1a Type: leaching pits,number: 1,000 gallon leach pit leaching chambers,number:n1a leaching galleries,number: nfa leaching trenches,number,length: nfa leaching fields, number,dimensions:nfa overflow cesspool,number:n1a Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) The leach pit is structurally sound and functioning properly.It was 112 full at the time or the inspection. CESSPOOLS:_ (locate on site plan) Number and configuration: nfa Depth-top of liquid to inlet invert: nfa Depth of solids layer: nla Depth of scum layer: nfa Dimensions of cesspool: nfa Materials of construction: nfa Indication of groundwater: nfa inflow(cesspool must be pumped as part of inspection) n1a Comments:(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) n1a PRIVY:_ (locate on site plan) Materials of construction: n1a Dimensions: n1a Depth of solids: n/a Comments:(note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation, etc.) n1a (revised 11115195) 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 57 Debbles Lane Marstans Mills Owner: Doyle Date of Inspection:2127197 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' iAA( U' 0 AEI 1� AB 30� AC 0 aA 3`I� DEPTH TO GROUNDWATER Depth to groundwater:12 feet method of determination or approximation: USGS Maps and Charts (revised 11115195) 9 i t GA T C P.7CL °lACO81 1 .c_.--- d .:'-___ __. ..ACC t__.. -.._.._,_ _ ._ .. _- ,. •_ ._._� -- - .. _ - h ' 1 AI wET l 1 vAce At 7- pq. _ - - - x CD Ul �_ l' 44 _ -7) 1 � 1 t ( f �Ay •]t , '� t t u44 � 1 ' i i -- - _ i yip •yam ; GfVEERi G f _+.._-.- _ .... f - 190t -C,IPPERCAPE:ECV HOB 3� - i , � P 0 i � 6-16 i 1 �®WIC IVIA 425} 281 114 Li 1 P f : 1 as bra/ ST I TOP OF FOUNDATION "•'1 - CONCRETE COVER CONCRETE COVERS f �(?,SER. � 4' CAST IRON 12"MAX.. T T 'rm»r•r`- 6 O ' I' OR SCHEDULE 4.0 12"MAX. P.V.C. PIPE 4 SCHEDULE 40. PVC.(ONLY) — PIPE - MIN: 7 44K!,,i , PITCH 1/4"PER.FT LEACH A ''PITCH 1/4PET PIT o ,, PRECAf \—INVERT /0' lk ,6 . ' ^LEACHIP EL.YsX,3..... IIJVERf — INVERT o . a PIT OR SEPTIC TANI( 4„ e INVERT EL YSXD . . F�ODC' EL.YyI!Y.. >_._ EQUI1 DI T /D . . .. .. GAL . INVERT , :AL•µ:.° c� L-:LY't INVERT w w O g° 'r• 3/4 .t0 I ELY,4 L �' WASHE; /0 �/ w �: STONE r-t f3 ;II:;• 6 DIA. DIA. y ^1' PROFI LL. OF GROUND WATER TABLE SEWAGE DISPOSAL .SYSTEM I NO SCALE r' S D! COIL LOG WITNESSED BY ZATE /07A�. .... TIME. . . . . . . . . . . �: . ITE�7✓. BOARD OF HEALTH TEST HOLE I TEST HOLE 2 UPPERCAPE ENGINEERING ENGINEER p ... ELEV. 0.0 P.O. BOX 616 6,' ,, Eo SANDWICH,- MA -02537 r s o_ s 362-o2ftSIG(V DATA NUMBER OF BEDROOMS TOTAL ESTIMATED FLOW . GALLONS/DAY 0OTTOM. LEACHING AREA // 3. � . SQ.F1-. /PIT � SIDE LEACHING AREA . . . SO.FT./ PIT' GARBAGE DISPOSAL_ . -ALP 50. . °/a AREA INCREASE) l0I_AL LEACHING AREA SO.F'f — _ — — — PERCOLATION RATE �4 5.5. Z . . MIN/INCH LEACHING AREA PER PERCOLATION RATE . . . . . . . SQ.FT. ..P .WATER ENCOUNTERED PJUP.40ER OF LEACHING PII E?/liL! • . . • , . . . . • AP�'ROVED . . . . 130ARD OF HEALTH TTR .=.3,/y`3G 113 --,//3 CPO DATE . . . 1` AGENT. OR INSPECTOR 7/ NAL Sq a JOi�N . UPPERCAPE ENGINEERING No Q .Fy. . : . . P.O. BOX 616 T E {TIOPJcf� P > �`P . 0 F E. SANDWICH, MA 02537 YEALV .- .---- 362-rig S jJ f , Upper Cape Engineering P.O. BOX 616, EAST SANDWICH, MASSACHUSETTS 02537 (617)362-6281 Sept 26 86 Board of Health Town of Barnstable Hyannis, Klass i RE: Lot 108 Debbies Ln Dear Sir : This letter is to inform you that the septic system was installed in compliance with the plans submitted by this office . That well to septic distances meet or exceed those shown on the plan . Than you —_G o Jacobi �'`` LP CATION � EWAG E PERMIT . NO. V L A G E 4INSTA,LLER-S NAME ADDRESS �1co aco b l S UILDER OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED r -. -- �` 'i �� ..k I ��,6' � � ,� � o • �, 3N�6 ;A ^� \`T c.�e ►� ------ __ r THE COMM0NWEAcs1=H OF MASSACHUSETTS BOAR® H _...................OF. :. ........--....................--.....................-- Appliratiun for Disposal Igork Tonstrudion Frrutit licati is hereb made f r a Permit to Construct ✓' or Repair an Individual Sewage Disposal AP ( ) P ( ) g � Sys t: ocation-Address or Lot No. ... .. — .. ... ........................................ ............................................. .._.. — Address a - ---------- --•-•------------------•---- --•-------.....-.......-------------------•-•---•---------- -------------........ -............. nstall-r Address Typ of Building Size Lot.ko.A.71.�..........Sq. fee U Dwelling—No. of Bedrooms..... ............s_.._.__._....._......Expansion Attic (��. Garbage Grinder Other—Type of Building .......__. No. of persons............................ Showers — Cafeteria Other fixtu WW Design Flow.............. _-......................gallons per person ay. Total dal flow.... 0.........................gallons. WSeptic Tank—Liquid'capacity/A4.P..gallons Length.Ve Y.._ Width.9r ..... Diameter................ Depth-_ _-. Disposal Trench—No.............. . x p Width�--------. Total Length.................... Total leaching area........... sq. ft. Seepage Pit No._©1 ...._ ameter....�........... Depth below inlet-. Total leaching area......_ ...sq. ft. Z Other Distribution box (✓� Dosin ( ) � - Percolation Test Results Performed .... ........................................ .. Date ' ....�......___.... Test Pit No. 1................minutes per i epth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per ' c Depth of Test Pit.................... Depth to ground water........................ Q+' -• --------------------------•--••----- --.....-•----•-•----•---...................----------•-----•--------••--------•----••--•---------..... 0 Description of Soil........................................................................................................................................................................ W V ....------•-------•-••---•............................•-•-------..._....__.....---....•----••-•---•----••...-------------•----------•----•------.............••--••....._........._....._...-•••--••----- W ......--•------------•-•-•----•-----------------------------•-------------------------..............-••-........--•---•-••••--------...•--•--••-••....-----••----•................•-•-•-•----------••--- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... -•--------------------------•--------•------•-----•------•-•--------•------.........--------........-----...----------------------•------•------------•--•---•--------•---..............--•--------._••- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITI,I 5 of the State Sanitary Code—The ndersigned further agrees not to place the system in operation until a Certificate of Compliance Feasons: ued e board of health. Sig Date Application Approved BY �= --. ----•_------ Co. [_2 �=..--- Date Application Disapproved for the follo 'ng .................................................................................•...._...._....._.____.. ...................•----••-----------...-----•-••----•------------•-------------.....----------•---..........--•-•-------....-----•---•-••--•----..........................--•-•---------------••--•-•--- Date PermitNo......................................................... Issued........................................................ Date z- �Na'.+..r t_r..`S 6 6 Fzic............................. THE-COMMONWEALTH OF MASSACHUSETTS 4 BOAR® O7 H ,W �� ...................OF. .................................... Appliration for Dispasal lVorksZonotrurtion ramit 7" A licati is hereb made for a Permit to Construct (I'') or Repair an Individual Sewage Disposal Syst at: .......... .................... ................................................................................................... ocation-Address or Let No. ............................................. ................................................................................................. Address '4Z.............................................. .................................................................................................. Installer Address Type of Building Size Lotlrzo,�A�.,!................Sq. feet U� :3 6arbage Grinder Dwelling—No. of Bedrooms---- -Expansion Attic (A14 Other—Type of Building ....... .......... No. of persons............................ Showers 7— Cafeteria PLI I—-****----I---------_ Other fixtu ......................................... lie -------------------------------------------------------------------------------------------------------------- Design Flow..............S'd......................gallons per person per.day. Total daily flow....X.jO............................ga!lons. 9 Septic Tank—Liquid capacit/iM._gallons Length.Ree�Y____ Width ...... Diameter................ Depth.Z" W ;P---- osal Trench—No.. ------- Disp ................... Width.................... Total Length..____.......__.____ Total leaching area.___._..___ '_�. sq. ft. 14. '70-� -------- Y,..'.'sq. f t Seepage Pit No..QA14r,------- Diameter..../............ Depth below inlet...../------------ Total leaching area.......e. .... Z Other Distribution box Dosing 0-4 . - 4 - Percolation Test Results Performed 1�511 .... .................................................... Date �-4 Y-, ,el�,��.i Z??'�............. Test Pit No. I................minutes per i I: epth of Test Pit_........_._...._.._ Depth to ground water..__....._.............. 44 Test Pit No. 2................minutes per 'niche Depth of Test Pit.........._____..__. Depth to ground water._..._......._...._._... 9 -------------------------------------------------...*-------------------------*-----------•------------------**...................."...**...*----------- 0 Description of Soil........................................................................................................................................................................ ......................................................................................................................................................................................................... ................................................................................... .................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .................................................................I...................................................................................................................................... Agreement: The undersigned'agrees to install the aforedescribed Individual Sewage Disposal System in accordance with M ;?'n t; tc � the provisions of T I TIZ- 5 of the State Sanitary Code—Theendersigned further agrees not to place the system in operation until a Certificate of Compliance h...s be issued he board of health. SiSi .. .. ......... ........................... ..................... .......................... t%X.................Gj Application Approved By.................... ....... .... ............... !...... ........ ate Application Disapproved for the follo ng easons.ons:. ............................................................................................................... ........................................................................................................................................................................................................ Date PermitNo......................................................... Issued....................................................... 'Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEA6TP/ ........... .. ..................................0 F....... ................................... Tntifirate of Tompliana �s is -the Individual Sewage Disposal System constructed (,-<Or Repaired �p....................................................................................................................... ................... _1114 Installer .................................................................................................................. at......... f....../ .... ........ . haF been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code a escribed in the application for Disposal Works Construction Permit No.... <26 .... ... ............ .... ...... dated................ ...1_�: THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR TE E THE SYSTEM WILL FYNCTION SATISFACTORY. DATE............4Lzntgl-n................................... Inspector.................................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD��F HE T................ ... .... . .........................OF ... ... ......... .......................... FEE......7�s War. hAffir IM19it Permission k1'e'reby gr te ei�l Y_,L. ...... --------............................................. to, ConstuofA air ndi idu!lA Z,age Di osal System j at . ........ ............ ........... ......... .................................................................................... ...... Street as-shown on the application for Disposal Works Construction Permit I—----- No........ .. at e d.............. ............ ................................... Boar of Health . DATE.................. .. . ........ . .... . ............ FORM 1255 A. M.4ZELKI .., INC., BOSTON\ � I , lc EXISTING SEPTIC TANK LEGEND A,e� PB 272/PG 92 (TO REMAIN) ——98 ——EXISTING CONTOUR ��° g c� N TOP OF TANK, EL.=58.54 x 100.98 EXISTING SPOT GRADE Gr°Q �e� Ao• Qo /] IN V.(OUT)=57.21 t ° oa `O6 + W EXISTING WATER SERVICE 6Q, P �� es fO�P BENCHMARK SET EXISTING LEACH PIT G EXISTING GAS SERVICE F 57,50 OUTSIDE COR./BULKHEAD TO BE PUMPED & FILLED —O:H:W.— OVERHEAD WIRES 56 EL.= 60.16 (Assumed Datum) W/SAND AND ABANDONED TEST PIT BENCHMARK S ur Ln 3 r a Pat Wild 3c (LOT 108) 145'f LOCUS s o� 59,65 d APN 011 -015 �� x 20,000 S.F.t r— x you ` x 59.17 58.62 , — �- -� t x s9 50 LOCUS MAP / 0 LE ' x 58.64 x 59.12 1 SHED �—� I f GENERAL NOTES: 7/ 5 .64 0 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL ( X SPIKE BOARD OF HEALTH AND THE DESIGN ENGINEER. I 58.62 P-1 ♦ 59.38 2, ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 0 +� OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE r'x 58,20 6POS25 59,52 *� LOCAL RULES AND REGULATIONS. w J /� -c x 59,21 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. O 01 0,_/ 59,49 O TP-2 J 13' 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING PO ( FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 1 59.41 O '80 `� 01 W l ENGINEER BEFORE CONSTRUCTION CONTINUES. x DECK 60,10 O � 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. Z I Un 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF I x 59,68 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF I x HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 58,18 i 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. I EX/STING 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. i 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS HOUSE(#57) x 59,73 x 59�6 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE T.O.F.=60.9f / DIRECTED BY THE APPROVING AUTHORITIES. x 60.4 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING OF �qs CONSTRUCTION. 60.06 �P��� S9C� 1 1. WHERE REQUIRED, CONTRACTOR SHALL REMOVE .ALL UNSUITABLE SOILS PB00IN THE AREAOF REPLACE WITHB CLEAN HSAND AAND �RSPECOIFIEDL N S310S MR THE IN S. AND 59,61 59,80 60 1 60,106 .'.. McENT EE CIVIL 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE INSPECTED BY DESIGN ENGINEER PRIOR TO QACKF.ILL. � 8.54 1 No. 35109� / >. ... 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND x 58,74 DRIVEWAY:' o�oF £�/Sj���� NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. 14 USAGE OF THE OF THE BOARD EXISTING IS LING SEPTIC TANK IS SUBJECT TO THE APPROVAL 6d,13 ; I xLAMP, .�`, ' 15. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC x 8,61 I WS❑ 6 19,;: i>. :'.,.`..., x 60J8 (Al t�� So 143,00 SYSTEM COMPONENTS NOT SHOWN ON THIS PLAN. UTILITY P❑LE ��,Iv 03°24'55" w _ PROPOSED SEPTIC SYSTEM UPGRADE PLAN 57 82 edge of pavement 59,92 ��4— 60,20 61,22 catc%asin 57 DEBBIES LANE, MARSTONS MILLS, MA 60.10 Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 �T� OWNER OF RECORD Engineering by: SCALE DRAWN JOB. N0. 1.4 _ 1� r BACCHIOCHI, KIM M Engineering Works, Inc. 1"=20' P.T.M. 162-13 57 BEBBIES LANE 12 West Crossfield Road, Forestdale, MA 02644 DATE I MARSTONS MILLS, MA 02648 CHECKED SHEET (508) 477-5313 6/11�13 2 P.T.M. 1 Of 2 I NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL.=56.83 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SPIKE SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL WATERTIGHT RISER & INSTALL 2 INSPECTION PORTS (MINIMUM) OUTLET AND SET TO 6" OF FINISH GRADE COVER. SET TO 6" OF GRADE T.O.F. ��� P`� 62,Jr, EXISTING F.G. EF.=59.5f ROPpSEO� `�2 F.G. EF.=59.5f � F.G. EF.=59.5t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. ' L = 23' L = 2' INSPECTION PORT , S=1% (MIN.) ® S=1% (MIN.) (1-MINIMUM) DEC 46.9 4"SCH40 PVC 4"SCH40 PVC 8" io°I TO a^ EXISTING 48" LIQUID INVERT LEVEL I - 4ADD INV.=56.67 EX/STING .0. GAS BAFFLE - - ITS A T 6.25'/UNIT = 6 2.5' HOUSE(#57) INV.=57.21 t D BOX INV•INV.=5 6.44 1 ROW OF 10 UN EXISTING SOIL ABSORPTION SYSTEM (PROFILE) T.O.F.=60.9f EXISTING SEPTIC TANK ESTABLISH VEGETATIVE COVER BACKFILL WITH CLEAN NATIVE OR PERC SAND TO TOP OF CHAMBERS NOTES: BREAKOUT EL.=TOP EL. :�.;:' '�-'.': ';; S.A.S. LAYOUT 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP ELEV.=56.83 INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=56.44 '.:; f� 75" ►{ 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.=55.50 II GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED 5' MIN. ABOVE BOTTOM OF 2.83' IN 310 CMR 15.221(2). T.P. EXCAVATION OR G.W. 3) INSTALL INLET & OUTLET TEES AS REQUIRED. EXISTING SUITABLE 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM OF TP, EL=49.4 - MATERIAL AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. NO GROUNDWATER ENCOUNTERED 76" 1 ROW OF 10 - 16" (H-20) ADS BIODIFFUSER UNITS I PROFILE SEPTIC SYSTEM PROFILE WITH NO SEPARATION BETWEEN EACH ROW & NO STONE TYPICAL SECTION N.T.S. N.T.& 16" 11 t.2" rN i DESIGN CRITERIA SOIL LOG 34"- m. - NUMBER OF BEDROOMS: 3 BEDROOMS DATE: JUNE 11, 2013 (REF#13,937) SECTION END CAP SOIL EVALUATOR: PETER McENTEE PE(SE#1542) SOIL TEXTURAL CLASS: CLASS I WITNESS: DON DESMARAIS R.S. HEALTH AGENT 16" HIGH CAPACITY (H-20) BIODIFFUSER UNIT DESIGN PERCOLATION RATE: <2 MIN./INCH ELEV. TP- 1 DEPTH ELEv. TP-2 DEPTH MODEL 16" HICAP UNITS MUST BE 'STAMPED H-20 DAILY FLOW: 330 GPD 59.4 A 0 59•5 A 0 LENGTH 76" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT DESIGN FLOW: 330 GPD SANDY LOAM SANDY LOAM TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY 58�9 GARBAGE GRINDER: NO 10YR 4/2 6., 59.0 1 10YR 4/2 6„ EFFECTIVE LENGTH 75" SIDE WALL HEIGHT 11.2" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. B B EXISTING SEPTIC TANK: 1000 GALLON CAPACITY SANDY LOAM SANDY LOAM OVERALL HEIGHT 16" PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLET (MIN.) 10YR 5/8 10YR 5/8 OVERALL WIDTH 34" 4640 TRUEMAN BLVD 56.9 C 30" 57.0 C 32" 13.6 CF ® HILLIARD, OHIO 43026 LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF CAPACITY (101.7 GAL) novANceo oRaNacE srs7EMs, INC. .74 GPD/SF SOIL ABSORPTION SYSTEM PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE ADS 16"HC BIODIFUSER UNITS IN STONELESS TRENCH CONFIGURATION M-C SAND M-C SAND HIGH CAPACITY INFILTRATOR UNITS MAY BE SUBSTITUTED 2.5Y 7/3 2.5Y 7/3 57 DERBIES LANE, MARSTONS MILLS, MA (GENERAL USE APPROVAL FOR 7.88 SF/LF IN TRENCH CONFIGURATION) 15% GRAVEL 15% GRAVEL (7.79 SF/LF FOR HIGH CAPACITY INFILTRATOR SUBSTITUTE) Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 1 TRENCH WITH 10 UNITS @ 6.25' PER UNIT = 62.5' Engineering by: SCALE DRAWN JOB. NO. 62.5' x 7.88 SF/LF = 492.5 SF(486.9 SF FOR HC INFILTRATOR) 49.4 120" 49.5 120" Engineering Works, Inc. NTS P.T.M. 162-13 DESIGN FLOW PROVIDED: 0.74 GPD SF 492.5 SF = 364.5 GPD PERC RATE <2 MIN/IN. (P75815, 4/29/86) / ( ) ("C" HORIZON SOILS CONSISTANT WITH PERC ON RECORD) 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 0.74 GPD/SF(486.9 SF) = 360.3 GPD (FOR HC INFILTRATOR) NO GROUNDWATER ENCOUNTERED (508) 477-5313 6/11/13 P.T.M. 2 Of 2