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HomeMy WebLinkAbout0150 FLINT STREET - Health 150 Flint Street Marstons Mills P - - - - - -- - - - -- -- - A = 123 004001 TOWN OF BARNSTABLE 151bCATION /Sa o -T-4X _J SEWAGE # VILLAGE / lYSleas ^ 0-3 ASSESSOR'S MAP & LOT tS 'S NAME& PHONE NO. A021--alt t pAc4w-] SEPTIC TANK CAPACITY / 5:-�o dA/ -,;; LEACHING FACILITY: (type) /n,4 J-4 (©ze) NO. OF BEDROOMS -3 BUILDER OR OWNER6 PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �y� Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) So Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r 6 , s� c��'� lfrAiws Commonwealth of Massachusetts w r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information Q forms on the Q computer,use 1. Inspector: only the tab key to move your DOUG BROWN cursor-do not Name of Inspector use the return key. DOUGLAS A BROWN INC Company Name P.O. BOX 145 Company Address CENTERVILLE MA 02632 City/Town State Zip Code 508-420-4534 S14297 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and th5t--the information reported below is true, accurate and complete as of the time of the inspection. The insp, ction was performed based on my training and experience in the proper function and maintenance of ors ite sewage disposal systems. I am a DEP approved system inspector pursuant to Section 45.340of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ,, ❑ Needs Further Evaluation by the Local Approving Authority 2-5-14 Inspe 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 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments wM > 150 FLINT ST Property Address MAZO Owner Owner's Name information lis required for MARSTONS MILLS MA 02648 2/5/14 every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: AT TIME OF INSPECTION SYSTEM MET PASSING REQUIREMENTS .FUTURE PERFORMANCE UNDER THE SAME OR INCREASED USE CAN NOT BE DETERMINED. NO OBSERVATION PORTS WERE FOUND ON THE S.A.S SO INSPECTION WAS DONE FROM THE D-BOX 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. El Y ❑ N ❑ ND(Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °,M s 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 I Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Citylrown 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 ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title' 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Cityfrown 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 groundwater elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 f Commonwealth of Massachusetts G . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not, available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: r Number of bedrooms(design): 3 Number of bedrooms(actual): ? DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 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 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: ACCORDING TO PERMIT#99-668 SYSTEM CONSISTS OF A 1500 GALLON TANK D-BOX AND A THREE BEDROON SAS CONSISTING OF 4 INFILTRATORS SURROUNDED WITH STONE Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ❑ No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Detail: 2012----247 GPD 2013-----156 GPD Sump pump? ❑ Yes ❑ No Last date of occupancy: 2013 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3h 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts 4 v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 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 M 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) ' Approximate age of all components, date installed(if known)and source of information: ACCORDING TO PERMIT#99 668 SYSTEM WAS INSTALLED IN APRIL OF 2000 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 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.): Septic Tank(locate on site plan): Depth below grade: 1.5 feet Material of construction: ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 PER PLAN Sludge depth: VARYING/LIGHT t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Citylrown 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 Scum thickness TRACE CLUMPING Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? WOODEN PLOE 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 LOOKED FINE AT TIME OF INSPECTION RECOMMEND PUMPING EVERY 2-3 YEARS 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•3/13 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. GM , 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ 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•3/13 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 s 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Cityfrown 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.): BOX LEVEL NO SIGNS OF FAILURE AT TIME OF INSPECTION Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): " If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: NO OBSERVATION PORTS FOUND ON INFILTRATOR UNITS t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts w v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Cityrrown State Zip Code Date of Inspection D.System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4INFILTRATORS ❑ 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.): NO SIGNS OF FAILURE AT TIME OF INSPECTION 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page_ Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: >120"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: PERMIT#99 668 ATTACHED Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ��M s 150 FLINT ST Property Address MAZO Owner Owner's Name information is required for MARSTONS MILLS MA 02648 2/5/14 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Are No..�11... -`� Fxs. .....`................ E COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiou for Ropm al Workg Toustrurtion ramit Applica 'on is her de a P t to Construct (�/) or Repair ( ) an Individual Sewage Disposal System c5 .................................................. -----•-----------------•--... " �c:. �" r ..... .................................................... ... ....._ ... Location-Address or Lot No. ...----•.............._.....-•-------------•--•----.........--•---............................... ----------...................-----.............---••-............•-----........................... Owner Address Installer Address Type of Building Size Lot........... .............Sq. feet Dwelling—No. of Bedrooms.___.____._. _._-_•____________________Expansion Attic ( ) Garbage Grinder ( •-�� LI Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 4 Other fixtures T Design Flow.....................4/.t/.0.............gallons per pepper clay. total daik qpw----............... ...........gall?ns, Septic Tank—Liquid capacity` gallons Length...... Width--_ _... Diameter______________/eVi....Disposal Trench—No. ..__...._l_...__.._. Width_....._....I.(.... Total Length...__...7.4i.... Total leaching area �"_ ..sq. ft. Seepage Pit No---_-------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Other Distribution-box ( ,f� Dosing tank (, ) � � -' Percolation Test Results Performed by------- �- ___________________ .. te............................./......... aTest Pit No. LL��__.minutes per inch Depth of Test Pit._ _y. Depth tc ground water..__ 44 yt 4 Test Pit No. 2................minutes per inch Depth of.Test Pit--- ------ Depth tc ground water___:r_/Z•©._u Description of Soil--...... - 4 •-••-••--••-....-•-----•-----•-•---•---...-•••--•----•------•--------•-----•--•-----•------- jNature of Repairs or Alterations—Answer when applicable.------------------------------------•---_--_-______----:---_-_•--:-------•------_-------------. •---------------;---------•---••••-•----•--••--•------•-----•---•----------•--•----•----••-------•--•-•-------•--......-•----------------•--•------•-----------•-------•-----••• ...................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposa- System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of.Compliance has be n is ed by the board of health. Signed Dare Application Approved By �. _ ,�' , �---------------------------------------------------------------- ---- o ff z 9 Date Application Disapproved for the following reasons- ------------------------------------................................------.......................................................... ��°, Dare PermitNo. — .....ill/ -- ---- -------- Issued ................................................ -------- ....................... ----------Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Trdifieazte of Tompliance TJIS IS TQ CERTIFY, That the Individual Sewage Disposal System constructed ( fr ) or Repaired ( ) ............... at ll ,s �.'� "( l t, to I,.. r /4 -I�sl.tl�et f� '� /6 L ----- ............. - _ - -... has been installed in accordance with the provisions of TITLE 5 g e S at ironmental Code as described in the application for Disposal Works Construction Permit No. ...................� . . dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C :NSTR D AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ( � � 1 1 1. DATE ... .... . �- ----- -------- -- - Inspec.orfl. :.. .......: - .--- ------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No........j f . •---.. FEE---....-----•-•--....... Permission is hereby granted............ _.._..... - ' to Corf§fr ict ( .,)�ior.Repait-j ) an Individual Sewage Disposal System ,. atNo----------------'- _`E ............--- -..� ......•. ......---.........._ Street l l as shown on the application for Disposal Works Construction Permit No�;K__-__=r__.._. Dat�Ted,.__...._::.*_.___.=:_�r:..:..........•.. per, � s. Board of Health _ DATE------------------ ' :: r FORM 36508 HOSES&WARREN.INC.,PUBLISHERS I Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION 54AA J SEWAGE# v LLAGE M*Ales A,(Li ASSESSOR'S MAP&LOT 'S NAME&PHONE NO.ACOwa ,v,Aalw�3 77/-3P_ SEPTIC TANK CAPACITY /—<,b */ �A LEACHING FACILITY:(type) b2 /env +,� (size) NO.OFBEDROOMS —3 BUILDER OR OWNER &15 f L!SA 5C­103 PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist 6�fi on site or within 200 feet of leaching facility) Feet Edge of Weiland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by s �� 6A I if M1Lr. tti tne l+rAiwS http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=123004001&seq=1 2/11/2014 —OWN OF BARNSTAt L; LGI—ATIO: r SEWAGE # , / VILLAGE Z±PrZ1-('6kt �`�fs ASSESSOR'S MAP & LOT- INSTALLER'S NAME&PHONE NO. b,Vt S• J5]kcA.vo1 t,�,`.— SEPTIC TANK CAPACITY �v Cho LEACHING FACM=: (type) �f rm'1n S (size) $43le NO.OF BEDROOMS_ BUILDER OR OWNER Lo PERMTTDA T E: COMPLIANCE DATE: Separation Distance Between the: Mazimurr.Adjusted Groundwater Table and Bottom of Leaching Facility { Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 2(i)feet of leaching facility) _t &t.�- Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of eac ' facility) Feet Furnished by 6 Id 0 • 4. yn 1. TOWN OF BARNSTA.BI LOCATION SEWAGE # 1 VILLAGE rS-66 kts �ls ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.gn ki S SEPTIC TANK CAPACITY f goo / LEACHING FACMITY: (type) ��m'f..gs (size) f/ $4?� NO.OF BEDROOMS BUILDER OR OWNER, C A Lo S PERMPT DA T E: COMPLIANCE DATE: Separation Distance Between the: Maximum Adiusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or Within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet ofleaching facility) Feet - Furnished by i I� o COMMONWEALTH OF MASSACHUSETTS Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS r DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED 9M SVe� JUL 3 1 2002 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 150 Flint Street Marston Mills Owner's Name: Bob and Lisa Sculos Owner's Address: Same Date of Inspection: 6/13/02 Name of Inspector: Timothy Lovell Company Name:Accurate Inspections MAPZ3 Mailing Address: 550 Willow Street W.Yarmouth,MA. PARCEL L�...�..■r�■r Telephone Number: 508-771-3700 LOT 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 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: X _Passes Conditionally Passes \ Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signatur _ Date: 6/13/02 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****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. f Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6/13/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _x_I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: _N%A 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. _N/A 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 infiltration 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. ND explain: N/A 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 Obstruction is removed Distribution box is leveled or replaced ND explain: N/A 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 Obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6113/02 C. Further Evaluation is Required by the Board of Health: _N/A 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: _N/A_Cesspool or privy is within 50 feet of surface water _N/A 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 any)determines that the system is functioning in a manner that protects the public health,safety and environment: _n/a_ 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. _n/a The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. i _n/a The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. n/a_ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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: �I Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6/13/02 D. System Failure Criteria applicable to all systems: You must indicate`yes"or"no"to each of the following for all inspections: Yes No _x_Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _x_Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _x_Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _N/A _Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow _x Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _x Any portion of the SAS,cesspool or privy is below high ground water elevation. _x_Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _x_Any portion of a cesspool or privy is within a Zone 1 of a public well. _x_Any portion of a cesspool or privy is within 50 feet of a private water supply well. _x_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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.] _No (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 1515.303,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: N/A To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No _The system is within 400 feet of a surface drinking water supply _The system is within 200 feet of a tributary to a surface drinking water supply The system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered Gyes"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. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6113/02 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _x _Pumping information was provided by the owner,occupant,or Board of Health _x Were any of the system components pumped out in the previous two weeks? _x _Has the system received normal flows in the previous two-week period? _x_Have large volumes of water been introduced to the system recently or as part of this inspection? _x_ _Were as built plans of the system obtained and examined?(If they were not available note as N/A) _x_ _Was the facility or dwelling inspected for signs of sewage back up? _x_ _Was the site inspected for signs of break out? _x _Were all system components,excluding the SAS,located on site? _x _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? _ _x_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: Yes no _x_ _Existing information.For example,a plan at the Board of Health. _ _x_Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) 1310 CMR 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM, PART C SYSTEM INFORMATION Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6/13/02 FLOW CONDITIONS RESIDENTIAL 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 Gallons Number of current residents: Does residence have a garbage grinder(yes or no):_no_ Is laundry on a separate sewage system(yes or no):_no_ [if yes separate inspection required] Laundry system inspected(yes or no):_n/a_ Seasonal use: es or no): no_ Water meter readings,if available(last 2 years usage(gpd)): 1-0" Sump pump(yes or no): _no_ Last date of occupancy:_Current COMMERCIAL/INDUSTRIAL N/A, Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: owner Was system pumped as part of the inspection(yes or no):_no_ If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _x_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) Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 4/18/00 Were sewage odors detected when arriving at the site(yes or no):_no_ Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 150 Flint Street Marstons Mills Owner:Bob and Lisa Sculos Date of Inspection: 6/13/02 BUILDING SEWER(locate on site plan) Depth below grade: 27" Materials of construction:_cast iron _x_40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): No evidence of leakage joints look tight venting is ok SEPTIC TANK:_x (locate on site plan) Depth below grade:_19" Material of construction:_x_concrete_metal_fiberglass_polyethylene_other (explain) If tank is metal list age:_Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 1500 Gallon Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 4" 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:_14" How were dimensions determined: Infield Measurements Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Tee's are in place no evidence of leakage structurally tank is fine recommend pumping every 2 years water level is at invert out. GREASE TRAP: N/A (locate on site plan) Depth below grade:_ 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6/13/02 TIGHT or HOLDING TANK: N/A (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:_x (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.): Box is level liquid level is at inverts out no evidence of leakage PUMP CHAMBER:_N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6/13/02 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type Leaching pits,number:_ _x_Leaching chambers,number:_4 Infiltrators_ 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.): No evidence of hydraulic failure no ponding vegetation normal no damp soil CESSPOOLS:_N/A (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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY:_N/A (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6/13/02 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. Rear Of Home Rear Of Home 30.6 15 31' 46' "D"Box Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 150 Flint Street Marstons Mills Owner: Bob and Lisa Sculos Date of Inspection: 6/13/02 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_14+_feet Please indicate(check)all methods used to determine the high ground water elevation: _X_Obtained from system design plans on record-If checked,date of design plan reviewed:_1999 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: According to o design plan there was no water found at 12'design plan is located at the Barnstable Board of Health � �� � �� �� � � ������� ©� ���. �. �� _ � �y � �� � _ _ _ __ WINDOW/EX-T. DOOR SCHEDULE m m o MARK OTY. PART NUMBER ROUGH OPENING REMARKS U DHI 8263,1 DOUBLE HUNG II " " ¢ I U - ",� � 2 I DH2 2826 61 I/2" X 61" DOUBLE HUNG I �x ,e-�• DHI 2019 26 1/9" X 3l"2 DOUBLE HUNG z- rn rn _ n Z � - 9 2 DHI 3219 38 1/9" X 31" DOUBLE HUNG h1 9 ch 04 8'-0• h 4'-, 3 8" 2. OR 262 38 1/2" X. 83 1/2": INS. STEEL DOOR i� w o 1 F02 1820 -13" X 80 1/8" FRENCH DOOR ^ SI 3 SKY LITE LESS THAN 2'-6" WITH BRAND SPECIFY BY OWNER Q I KITCHEN IC' X 14' 3'-10 /8 W O O z �V \ I 7 \ � Y \ ' o U co 8' L�-7 3 8• 8'-4 S 8" 4'-9• 4'-3• I M Cn LLJ M I OOP HELOUI `T, BEDROOM 92 II O BC x BC' 13' X 10' 8'-738' 8'-45 8° 4'-B' 4'-9' 3 2/4z= - - - - - - - - - - - - - II 2/8 2/8 I I DINING ROOM h /0 IC' X 11' CLOSET DOWN A BATH 0 2/8 b is m N I SKY I JI I SKY' G I LITE 1 2/8 I LITE �o N LIVING ROOM + I _ -1 _ O O IC X 19' Oi 2/8 - BEDROOM al U1 c . iO MASTER BEDROOM DOWN ` Q 13' X IS' 8/0 R IS' X 21' c OPEN TO BELOm uj � ? �u FOYER i� ^ w m I KY I V z 2/4 IMI 1p I LITE I 3 Lu a �s s. �s_ s - �s- �s_ I _ _I x m 0 0 0 p � 8'-7 3 8" W-4 S 8' S'-7" 4'-1 S 8' - M IL — — — — — — — — — — — — — — — — — — — — — — — — — — — — — II O FIRST FLOOR PLAN SECOND FLOOR FLAN � I I � � 0 C. -2 . ao Z Q rnI C, Z CV O U) I- w w w H Q Z w y OIL TOP OF FOUNDATION _ _ 20 FT. MINIMUM FROM CELLAR TEST -�� 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE DATE OF SOIL TEST ELEV. _ �,�Ci_ 10 FT. MINIMUM — CLEAN SAND SOIL TEST DONE BY CONCRETE WITNESSED BY COVERS LOAM AND SEED 4" SCHEDULE 40 PVC PIPE OBSERVATION HOLE 1 ELEV.= MIN. PITCH 1/8" PER FT. 2' LAYER OF PERCOLATION RATE < MIN./INCH AT INCHES -- — 1/8" TO 1/2" DEPTH HORIZ TEXTURE COLOR MOTT. OTHER WASHED STONE + -"— 4" CAST IRON PIPE I VENT �levf i'll� rMG (OR EQUAL) MINIMUM NOT REQUIRED �� PITCH 1/4" PER FT. z 1 CU. FT. OF CONCRETE a 4'"' y �f,�t/ -- ANCHOR -- FLOW LINE rn _ _ ELEV. 6' _ r...._ 'j c x MIN. --ELEV. LEV. .>7 7 L VOEL ° ° 10' ELEV. EL.EV. _ ' GAS 6" SUMP BAFFLE ELEV. _ -- ELEV. _ DISTRIBUTION ELEV. LIQUID OUTLET CAPACITY INFILTRATORS WITH j � _•1 _ /Zy� - �� '�"- � ]� TEE (TO BE PLACED ON FIRM BASE) BOX STONE IN AN HIGH I' 4 FEET 14 INCHES TO BE WATER TESTED j 5 FEET 19 INCHES IF MORE THAN ONE OUTLET "TRENCH FORMATION II 'WELL 7 FEET 29 INCHES GALLON (TO BE PLACED ON FIRM BASE) ZONE SOIL ABSORPTION � WATER ENCOUNTERED AT ELEV. 18 FEET_ 34 INCHES SEPTIC TANK 3/4" TO 1 1/2" INDEX - WASHED STONE SYSTEM (SAS) ADJUST_ _ OBSERVATION HOLE 2 ELEV.= I USGS PROBABLE WATER TABLE ELEV. _ PERCOLATION RATE < MIN./INCH AT INCHES 1 SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. _ _ _ DEPTH HORIZ TEXTURE COLOR MOTT, OTHER TT NOT TO SCALE BOOM OF TEST HOLE ELf_V. J LEGEN D: '•' Alf �� I ,`��` 3'' EXISTING SPOT ELEVATION EXISTING CONTOUR 00 00x0 1 FINAL SPOT ELEVATION ~ v FINAL CONTOUR --LO - -- SOIL TEST LOCATION (9 .+, UTILITY POLE TOWN WATER =W--_-W CATCH BASIN GAS LINE CLEAN OUT _ ` CESSPOOL C.P. 0 t v WATER ENCOUNTERED AT — ELEV. I I DESIGN CALCULATIONS ` NUMBER OF BEDROOMS GARBAGE DISPOSAL UNIT NO TOTAL ESTIMATED FLOW I l' ( 110 GAL/BR.,/DAY X BR.) GAL./DAY REQUIRED SEPTIC TANK CAPACITY GAL. ACTUAL SIZE OF SEPTIC TANK GAL SOIL CLASSIFICATION 1 Oro, � r'''r�r DESIGN PERCOLATION RATE < MIN./IN. �.a•1 4 EFFLUENT LOADING RATE GAL/DAY/S.F. LEACHING AREA `' SO. FT. Il • ! (f• � /f LEACHING CAPACITY (AREA X ?ATE) � • GAL/DAY RESERVE LEACHING CAPACITY GAL/DAY NOTES: 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. { r TITLE 5 AND THE TOWN OF T RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. ' 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6' OF FINISHED GRADE. 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN yr ; 10FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE t USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER / APPUCANT IS TO `J r OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. A", 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR f IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. . CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS r ! SI'E CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION r( >< IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER r� IMMEDIATELY. 8. PARCEL IS IN FLOOD ZONE _ I j 9. LOT IS SHOWN ON ASSESSORS MAP j AS PARCEL 1 vj. f,. � t\ (",- - .tee["1 ("! t� t - '•� / `-4 a s+' 14 T. s , f rmfks # APPROVED: BOARD OF HEALTH nA AGENT �- PROPOSED SEPTIC DESIGN I FOR LOCUS -- �• � PROJECT LOCATION S WEETSER ENGINEERING 235 GREAT WESTERN ROAD �►�' 508— P. 0. BOX 713 398-3922 SOUTH DENNIS, MASS. 02660 SCALE 4. 20' REVISED — JOB NO. LOCATION MAP R" D [SHEET 1 OF 0 1999 SWEETSER ENGINEERING