HomeMy WebLinkAbout0079 GOOSEBERRY LANE - Health 79 Gooseberry Lane, Marstons Mills
TOWN OF BARNSTABLE `I
LOCATION 6e n 5-.,'3 h' 2 R Y 1,4,v S SEWAGE
VILLAGE Alt' ASSESSOR'S MAP&PARCEL/j7 a2
INSTALLERS NAME&PHONE NO.A24.,$Y S'y 7S' /.?cr
SEPTIC TANK CAPACITY E x rs;
LEACHING FACILITY.(type),) �dS'd1.��i�12Ar ize) 1.2,1dar2s'X�
NO.OF BEDROOMS 3-
OWNER S//
PERMIT DATE: //2 S— 0 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
FURNISHED BY
19
/act; .33 ,
� p
� b
L?
j3o 3y�� ,
No. �,00� ^ 0� I Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
D
0(ppYication for Oigozal �bpaem Con.5truction Permit
Application for a Permit to Construct( ) Repair(�pgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel � j ,g4,-
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
v. 7>-r136 17 7�f 6 A�f 4 S—G z `' 2
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required)) �3 d gpd Design flow provided 3 3 e J gpd
Plan Date J���! �� _ Number of sheets Revision Date
Title
Size of Septic Tank /Is% !® O?J Type of S.A.SW 3 d.S-d 1.v Z-,1rZ-03,72:3
Description of Soil
Nature of Repairs or Alterations(Answer n app�, able)
Date last inspected: v
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 Environment I ode a lace the system in operation until a Certificate of
Compliance has been issued by this Bo Health.
Signe Date S d r�J'
Application Approved by Date —sZ.S'Bd
Application Disapproved by: Date
for.the following reasons
Permit No. P-OO& r 0;1-1 Date Issued / S'o
44
' �. oa o ..
(C( No. � � _ Fee
U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
IZIpprtcattvn for DtgpogaY *_. pgtem (fow5tructton Permit
Application for a Permit to Construct( ) Repair( k Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or L99•t No. / Owner's Name,Address,and Tel.No.
7 GodSS 16(2 f ✓ /2�� V,,/Y
Assessor's Map/Parcel 5.Z �� ✓� i�
- Installer's Na e, ddress,and Tel.No. Designer's Name,Address and Tel.No.
Sol7�S' 1362 7 75i 36 °�/.�—q S�c� 3 G .� 2`7 :2
Type of Building:
Dwelling No.of Bedrooms -3 Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures ,
Design Flow(min.required) 3 gpd Design flow provided 3 3 gpd
Plan Date �/ Z Number of sheets Revision Date
Title
Size of Septic Tank t�' s to P Type of S.A.S. f! � 3 dS�0 1 ,IT112 flies
Description of Soil
Nature of Repairs or Alterations(Answer when-applicable)
c� al ble)
l /f7
Date last inspected:
r
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 ea th.
Signed.% / �— Date fy S f rrJ
Application Approved by / Date
Application Disapproved by: Dated
`for the following reasons 4
Permit No. pooO - .o;L' Date Issued=
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( X Upgraded ( )
Abandoned( )by,
at �)t> 6eO5 / /— / 'I,`'r/f has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 2-00 q -o : 1 dated } ^0
Installer /-/ Designer ,Q!= +' /1?
#bedrooms Approved design flow 3 -3 sv,,/�_V_ gpd
-<--� r� /! r
The issuance oft i/s/ee it/shaRonot be construed as a guarantee that the system will function Jas designed. / //
Date /�/i l C���' Inspector f I'!In 7P,
�L/
—=—=----- ---=--—U�--------== r/------ -
No. U r V 1 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
Iigpont �§pgtem Con5truction Permit
Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ), Abandon ( )
System located at
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
i
Provided: Construction must qb completed within three years of the date of this permit.
Date ' 5 � Approved bye
\.J
Town of Barnstable
°EVE" Regulatory Services
Thomas F. Geiler, Director
9�pT'& °� Public Health Division
1� Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: Sewage Permit#a?_ A06 , Assessor's Ma
p\Par.cel �l
Designer. 1 4 ►W V) U`
b Installer:
Address: �� Address: A6 x
'a"aiJ .1
On was issued a permit to install a
(da e) // (installer)
septic system at _ C�00S10- 9// IANC on a design drawn by
/L (address) -LI'��dated A
/
(designer)
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box andior septic tank.
I certify that the septic system referenced above was installed with major changes (i.e.
;renter than 10' lateral relocation of the SAS or anv vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow.
OF Mgss
o D RF�N M.
E
(Installer's S'_,nature) o. 114�0
l S4N1 TAR�P�
(Designer's Si_,n tore) (affix Designer's Stamp Here)
PLEASE RETURN TO BARNST BLE PUBLIC HEALTFI DIVISION. CERTIFICATE OF
COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE .1
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU
Q: Health/Septic/Designer Certification Form.3-26-a!doc
1
;Ic cmi� t5.220: P eoaranon of Plans and Svecif eatrons • ri-osv, -i,-'/e V 4"e
The plans and specifications for every on-site system shall be prepared as follows:
(1) Every system shall be designed by a Massachusetts Registered Professional Engineer
or a Massachusetts Registered Sanitarian provided that such Sanitarian shall not design.a
system designed to discharge more than 2,000 gallons per day pursuant to 310 CMR 15.203.
Any other agent of the owner..may prepare-plans'for_the repair of a system.designed to
discharge not more than than 2,000 gallons per day pursuant to 310 CMR 15.203 provided
they are reviewed by a Massachusetts Registered Sanitarian and approved by the approving
,/auoritq;
(2) Evcry plan submitted for approval must be dated and bear the stamp and signature of
the designer,
(3) Every plan for a new system or plan for the upgrade or expansion of an existing system
which requires a variance to a property line setback distance;'must.also reference a plan
which bears the stamp and signature of a Massachusetts. Licensed Land Surveyor in
accordance with M.O.L.c: 112, § 81D;
(4) Every plan for a system shall be of suitable scale(one inch=40 feet or fewer for plot
plans and one inch = 20 feet or fewer for details of system components).and shall include
d 'ction of.
(a) the legal boundaries of the facility to be served;
(b) the holder and location of any casements appurtenant to or which could impact the
s stem;
(c) the location of the all dwellings)or building(s)existing and proposed on the facility
aTkitdentifieadon of those to be served by the system;
�)ee--Iacation of existing or proposed impervious areas, including driveways and
. areas;
location and dimensions of the system (including reserve area);
/f) system design calculations,including design daily sewage flow, septic tank capacity
. (re uiredand provided); soil absorption system capacity (required and•provided); and
w ether system is designed for garbage grinder,
YNorth arrow and existing and proposed contours;
h) location and'log of deep'observation hole tests including the date of test, existing
e e gradlevations ;narked on each test, and the names of the representative of the
4a ovtng authority and soil evaluator,
i)/location and results of percolation tests including the Gate of test and the names of
thy representative of the approving authority and soil evaluator,
i C) name and certification number of the Soiil Evaluator of record;
(k) location of every water supply,public and private,
1. within 400 feet of the proposed system location in the case of surface water
supplies and gravel packed public water supply wells,
2. within 250 feet of the proposed system location in the case;of tubular public
water supply wells, and
3. within 150 feet of the.proposed system location in the case of private water
supply wells:
11) location of any surface waters of the Com monwealth, rivers, bordering vegetated
wetlands, salt marshes, inland or coastal banks. regulatory floodway, velocity zone,
surface water supplies,tributaries to surface water supplies,certified vernal pools,private
water supplies or suction Ines, gravel packed or tubular public water supply wells,
OSsensitiv
ubsurface drains, leaching catch basins, or dry wells; and the location of any nitrogen
c area identified'in 310 CMR 15.215 within which portions of the proposed
sVrstem are located.
( location of water lines and other subsurface utilities on the facility;
observed and adjusted ground-water elevation in the vicinity of the system;.
46) a complete profile of the system;
(p) -a note on the plan listing all variances to the provisions of 310 CMR 15.000 sought
—_----� -conjunction with the plan;
q) . the location and elevation of one benchmark within 50 to 75 feet of the facility
which is not stibj4ct to d{slocadon or loss during construction on the facility;
4/4 (r) when dosing is proposed,'complete design and specification of the dosing system
—propo.sed including but not limited to dosing chamber capacity (required and provided),
U ump curves and specifications,number rif dosing cycles and depth per cycle;
when a Recirculating Sand Filter or equivalent alternative technology is required or
yr sed,a complete plan and specification for the system,including a hydraulic profile;
�a locus plan to show the location of the facility including the nearest existing street,
u the street number and lot number,if any, of the facility; and.
v) the materials of constructi rt.and the specifications of the system.
Town of BAm table P#
Department of Regulatory Services :
i
i Public Health.Division Date
KAM $
s63y �e ; 200 Main'Street,Hy#nnis MA 02601
f hj
i
Date Scheduled { i Time Fee Pd.
oil Suitability Assessrx ent for Sew � e Disposal o
Performed By f" ° `�' ' Witnessed By: t/ �
I
LOCATION& GENERkL IN]FORMAT ON
Location Address'�r� G�S �Y r L,�,1 e Owner's Name
�5� �NN
M ) IS j Address 7 f 64o&-be c La vte
Assessor's Map/P4tcel: !� 1�a I Engineer's Name. ' �oL,^,
�; Sti l 4
NEW CONSIRU�'[ION REPAtR �_ I Telephbne# 13 �J 6
Land Use Slopes(9b) ' �, G ,Surface Stones G
Distances from: Open Water Body y�6U ft Possible Wee Area �Z ft Drinking Water We >Zo�ft
drainage Way � ft. Property Line P. ; ft Other
SKETCH:($Ueet name,dimensiotisbf lot,exact locations of test holes&perc tests,locate wetlands in proximity tholes)
seeZE
_
C
2
i
A �
i
I
i
F I
t
Parent material(geglogic) G �. I Depth to Bcdroek .�---.—.---
Depth to Groundwater. Standing Water in Hole:' i Weeping from Pit Face.._._..
Estimated Seasonal high Groundwater
IV
DItTERM NATION FOR SEASONAL HIGg WATrj R TADLE
Method Used:
Depth dbperved standing in obs.hole: _In. Depth to$Oil tnoitlex: Dn,
Depth toi.weeping from side of obs.hole: ' in, Groundwater Adjuattitent
Index Well#__- Reading Date Index Well tevel o ,,,.a Ac�.factor,,,_r,� Adj.Groundwater l evel.,,,,e,
e PERCOLATION TEST D�tp .'gip' •
Observation i Time at 9" N
Hole#
T .5��t!
Depth of Perc Time at 6" ....-------
Stott Pre-soak Time.@ 12 d _ I Time(9"-611)
End Pre-soak
Rate Min./Inch
Site Suitability Assessment: Site Passed_�_ Site Failed; Additional Testing Needed(YM)
Original:.Public He'#lth Division Observation Hole Data To Be Completed on Back----------
***If percola#6n test is to be conducted within 100' of wetland,you must first notify the
Barnstable C44servation Division at least one(1)wedk prior to beginning.
DEEP OBSERVATION;HOLE LOG Hole# _
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.). (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
/ aConsistency.. %Gravel)
s� Lill' Olt- /Vfq
r
7/1 op
DEEP OBSERVATION'HOLE LOG Hole#
Depth from Soil Horizon Soil Texture soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
t o 1) byg-
DEEP OBSERVATION HOLE LOG . Hole#
�'
Depth from Soil Horizon Soil Texture Soil Color Soil Other �
Mottling Structure
Surface(in.) ( PA) (Munsell) g ( ,Stones,Boulders.
o si to c Gravel)
m -
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
d n ist
Flood Insurance Rate Man:
Above 500 year flood boundary No— Yes _
Within 500 year boundary No Yes
Within 100 year flood boundary No x Yes- `
f
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist,in all,areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring p rvious material?
Certification
I certify that on b jcl,of (date)I have passed the soil evaluator examination approved by the
Departmen .of Enviro `ment I Protection and that the above analysis was performed by me consistent with
the required t ini g,expert se and experience described in 3.10 CUR 15.017.
Signature R Date
Q:\SEPTICVERCFORM.DOC
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFF I-R
a DEPARTMENT OF ENVIRONMENTAL ROTECT�I'O`N
ONE WINTER STREET. BOSTON. MA 02108 617-292.5500
f'
WILLIAM F.WELD O C r 2.4 df TRUDY CORE
Governor 10"Vlvof 99 ,a Secretary
ARGEO PAUL CELLUCCI H�[HD pr,48L, AVID B.STRUHS
Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO ORM Commissioner
PART A
CERTIFICATION G
79 Gooseberry Ln
Property Address: Marstons Mills, MA Address of Owner: Karen McGillis
Date of Inspection: 9—A 'V—07 1 (If different)
Name of Inspector: Wm E Robinson Sr
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000)
Company Name: Wm E Rob-inson Septic Service
Mailing Address: PO Box 1 089 , n prvi 1 1 P r MA 02632
Telephone Number( 0 8 1, 7 7 5—R 7 7 6
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:
Passes
_ Conditionally Passes ,
_ Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature: zu L \ Date: " ` -
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 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:
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
COMMENTS:
B] YSTEM 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.
In irate 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, unless the owner or operator has provided the system inspector with a copy of a Certificate of.t
Compliance (attached) indicating that the tank was installed within twenty (20)years prior to the date of the inspection; or
the septic tank, whether or not metal, is 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.
(saviaad 04/25/97) Page 1 of 10
DEP on the World Wide Web: http:/hwAN.magnet.state.ma.us/dep
Printed on Recycled Paper
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: C
Date of Inspection: � Gill s
SYSTEM CONDITIONALLY PASSE$ (continued)
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass)inspection if(with approval of the
Board of Health). Describe observations:
broken pipe(s) are replaced
obstruction is removed
distribution box,is levelled 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) F RTHER 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 PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or
tributary to a surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well.
_ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well.
The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid).
OTHER
(revised 04/25/97) Page 2 of 10
r '
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: MCGillis
Date of Inspection: 1;1 1`—Q
D SYSTEM FAILS:
You ust indicate ea,;er "Yes" or "No" as to each of the following:
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.
Yes No
Backup of sewage into 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 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 1/2 day flow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped _.
Any portion of the 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 I 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. 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) GE SYSTEM FAILS:
Yo must indicate either "Yes" or "No" as to each of the following:
The'following criteria apply to large systems in addition to the criteria above:
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:
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)
The wner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requir ments of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information.
(revised 04/25/97) Page 3 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: McG'illis
Date of Inspection: .Pa„a V-9, 7
Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following:
Yes No
_ Pumping information was provided by the owner, occupant, or Board of Health.
None of the system components have been pumped for at least two weeks 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.
As built plans have been obtained and examined. Note if they are not available with N/A.
The facility or dwelling was inspected for signs of sewage back-up.
_ The system does not receive non-sanitary or industrial waste flow.
The site was inspected for signs of breakout.
_ All system components, excluding the Soil Absorption System, have been located on the site.
_ 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.
The size and location of the Soil Absorption System on the site has been determined based on:
The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of
Sub-Surface Disposal System.
Existing information. Ex. Plan at B.O.H.
4,� _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is
✓ unacceptable) [15.302(3)(b)j
r
(revised 04/25/97) Page 4 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: MCGillis
Date of Inspection: �_ c j_ ✓J
FLOW CONDITIONS
RESIDENTIAL:
Design flow: .330 g.p.d./bedroorn for S.A.S.
Number of bedrooms: 3
Number of current residents: I
Garbage grinder (yes or no):�o
Laundry connected to system (yes or no):2�
Seasonal use (yes or no):,e4-0
Water meter readings, if available (last two (2) year usage (gpd): 1995 — 34, 000 gals
Sump Pump (yes or no):/Ifc) 1996 — 32, 000 gals
Last date of occupancy: ? 1
CO ERCIAUINDUSTRIAL:
Type o establishment:
Design ow:_gallons/day
Grease t p present: (yes or no)_
Industrial Waste Holding Tank present: (yes or no)_
Non-san'ary waste discharged to the Title 5 system: (yes or no)_
Water eter readings, if available:
Last ate of occupancy:
OTHE : (Describe)
Last a of occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
/g4A!
System pumped as part of inspection: (yes or no)—,d�ed
If yes, volume pumped: eallons
Reason for pumping:
TYPE O YSTEM
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)
I/A Technology etc. Copy of up to date contract?
Other
APPROXIMATE AGE of all components, date installed (if known) and source of information: C&/ t� /!L 61+/�.z
��.4+ X4,i 1-4 C
Sewage odors detected when arriving at the site: (yes or no) "�
(revised 04/25/97) Page 5 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: MCGi l l i s
Date of Inspection: q—,X
B DING SEWER:
(Loc a on site plan)
Depth below grade:
Materi I of construction: _cast iron _40 PVC _,other (explain)
Dista a from private water supply well or suction line
Dia ter
Comm nts: (condition of joints, venting, evidence of leakage, etc.)
v
SEPTIC TANK:
(locate on site plan)
Depth below grade:
Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain)
If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No)
Dimensions: "� L
Sludge depth: /U d /2` ,
Distance from top of sludge to bottom of outlet tee or baffler_
Scum thickness: d� '
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee r baffle.
How dimensions were determined: O "-
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integri , evidence of leakage, etc.) O ,
GREA TRAP:
(locate n site plan)
Depth low grade:
Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain)
Dime sions:
Scu thickness:
Dist ce from top of scum to top of outlet tee or baffle:
Distan a from bottom of scum to bottom of outlet tee or baffle:
Date o last pumping:
Comm nts:
(reco mendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural
integ ty, evidence of leakage, etc.)
(revised 04/25/97) Page 6 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: MCGillis
Date of Inspection:
T T OR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection)
(looat on site plan)
Depth below grade:
Mater' I of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain)
Di ensions:
Cap ity: gallons
Desig flow: gallons/day
Alarm level: Alarm in working order_Yes; _ No
Date f previous pumping:
Corn ents:
(con ition of inlet tee, condition of alarm and float switches, etc.)
DISTRIBUTION BOX:Q�1/
(Locate on site plan)
Depth of liquid level above outlet invert:_
Comments:
(note if level and distributio-i is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) C3•�
PUMP HAMBER:_
(locate n site plan)
Pumps i working order: (Yes or No)
Alarms n working order (Yes or No)
Comm nts:
(note ndition of pump chamber, condition of pumps and appurtenances, etc.)
(zeviaed 04/25/97) Page 7 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: MCGillis
Date of Inspection:
SOIL ABSORPTION SYSTEM (SAS):
(locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number:
leaching chambers, number:_
leaching galleries, number:
leaching trenches, number,length:
leaching fields, number, dimensions:
overflow cesspool, number:
Alternative system:
Name of Technology:
Comments:
(note condition of soil, signs of hyd ulic failure, level of ponding, condition of vegetation, etc.) o
7,0 c, 610
A, v d.
92
CESSP lS: _
(locate o site plan)
Number nd configuration:
Depth-to of liquid to inlet invert:
Depth of olids layer:
Depth of scum layer:
Dimensi ns of cesspool:
Material of construction:
Indicatio of groundwater:
flow (cesspool must be pumped as part of inspection)
Comments:
(note condi ion of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
PRIVY:
(locate on ite plan)
Materials of onstruction: Dimensions:
Depth of so ds:
Comments:
(note condi ion of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
(revised 04/25/97) Page 8 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: MCGillis
Date of Inspection:
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all wells within 100' (Locate where public water supply comes into house)
2
I
Y t
CA
V
a
(revised 04/25/97) Page 9 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 79 Gooseberry Ln, Marstons Mills
Owner: MCGillis
Date of Inspection: ��02 Ll-•c
Depth to Groundwater meet
Please indicate all the methods used to determine High Groundwater Elevation
:
Obtained from Design Plans on record
1/ Observation of Site (Abutting property, observation hole, basement sump etc.)
Determine it from local conditions
heck with local Board of health
Check FEMA Maps
Check pumping records
Check local excavators, installers
Use USGS Data
Describe in your own words how you established iZn�.2igh Groundwater Elevation. (Must be completed)
(revised 04/25/97) Page 20 of 10
LOCATION SEWAGE PERMIT NO.
'VIL4AGE
1'V1 RSST-D`JT 071LLS d21 (oV
INSTA LLER'S NAME & ADDRESS
,
R:UIL01 R OR own ER
Ch -'PsT nj- ..
. DATE PERMIT ISSUED S'e ®9,_
DAT E COMPLIANCE ISSUED 6/is�8/
�. ��R�. O i �Ou SL � ,
it � ,r�,�f
No. ..................
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® F HE TH
C L
Ap iration for Uisp.aoal Vorkii Tongtrnr#ion Frrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
ste a?___.--_.....� . mod :..L lc� � s%� 'jAj GIs_...._•-••• -•••-.•_.. ..._. _.......__•---
//+���• cation,,A�� ess / or t No.
!`<< tr�Li c lq�J ��G2.f."�C7�a�K...!�e, �A,
.... ................•••••. _.........._..•--•---------- _...•••------------- • --_.... ---..........
Owner Address
W
t............ . -_________----._._....------
Instaly Address
ID 706
U Type of Building Size Lot____________________________Sq. feet
�-, Dwelling—No. of Bedrooms____.___.3........................_.....Expansion Attic ( ) Garbage Grinder (►)p)
p,, Other—Type of Building ............................ No, of persons......_..................... Showers ( ) — Cafeteria ( )
Q' Other fixtures ____________________________
W Design Flow............................................gallons per person per day. Total daily flow..............-......;.........................gallons.
WSeptic Tank—Liquid ca.pacity4kc.el.P__gallons Length________________ Width.............. Diameter_;__,__L_______ Depth...._...........
x Disposal Trench—No..................... Width.................... Total Length....... leaching area..._�_:�-__._._,....sq. ft.
Seepage Pit No.___./........... Diameter.__10...____._ Depth below inlet.................... Total leac) ink area_-®Z-�_17...sq. ft.
Z Other Distribution box ( ) ' • Dosing tank ( )
►-' Percolation Test Results Performed by..........................................-...............-........-....... Date........................................
Test Pit No. 1.........._-----minutes per inch Depth of Test Pit...........__..__... Depth to ground water........___.___.........
(s, Test Pit No. 2_................minutes per inch Depth of Test Pit.................... Depth to ground water........_...............
a ..................--........................................................-....----•••••-•••_...••.............-...........................................
0 Description of Soil........................................................................................................................................................................
W
V ------------------------------------------------------•.................................................-.................-............-............................-.............................
W
x .........................-.........................----------------..........-...........................................................----....................................................
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 TITLE: 5 of the State Sanitary Code- The uInkersigned further agrees not to place the system in
operation until a Certiythke
liance has bee e b t1rd of lth.
Sign -- - ......................... .....S__ y..$�_.._
Date
Application Approv _______
Application Disappr�gv,� wing reasons-..........................................................---•-------------
---...------•---Date .........._
................................-........................................................................._...........----•--•---•---------•-..........................................................
Date
PermitNo.. ............................................... Issued_._....:__....------------=--------.....................
Date
No. �� F�s�,�.li...... .
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HE TH
1
� - .........OF...........�J...:...... ........................................
Appliration for Disposal Works Tonstrnrtion Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
s��t �L.---- 9 b .......��............. `..... /.�, ----- .........................
.-cations ye or t No.C
,�le0' f'r'... -4'h. i°t:9 Z�'...............
Address
a �/ � t
T e BUl� Installer Address
d yp Of ding Size Lot____-0-70 ----------Sq. feet
U Dwelling—No. of Bedrooms..........................................Expansion Attic ( ) Garbage Grinder ( )
a Other—T e of Building ............... No. of persons...._................__.__.. Showers — Cafeteria
Q' Other fixtures .-------•--•--•-•-------•-----•• .
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter________-_____ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) '' Dosing tank ( )
aPercolation Test Results Performed by••-----------------•-•••••-•••••-•-••---•--...-•-•-•--•••-•••-•_-•-•••... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
---•--------------------------------------------•-••---.....-------------•_•............--•--.------.........................................................
0 Description of Soil........................................................................................................................................................................
x
U •-••-•........•-----•--••-••--•-••••-•-----••••-•----•-••••-•--••........---•-•-••••••--•--•---•-........•••••-•-•-••-••-•-•••----••-•••-•••-----••••--•-•••-••••••••-•-••--•-•••............•••._....._
W ••-••-•••-•-....••----------••••••••••••••-••-••••-••-•-•-••--------------•-•--•-.._......•••-••--•-----•---...-•-•••••--•••••••----••-••--••••-•-•-•••----•-•-•--.......------••--•---•-----•--------•.
UNatureof Repairs or Alterations—Answer when applicable...............................................................................................
----------------------------•---•--.....---.......-•---------------------------------••••-•-.......•-•-•--•••-•-••••••--••--•-••--•-••-•---•••••---••....••. ...........................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TIT LZE 5 of the State Sanitary Code—The u ersigned further agrees not to place the system in
operation until a Certificate of,C m liance has be e b ! band oftlth.
Sigrio� • _... .
------••--•- .
./� Date
ApplicationApproved B ••-• -----•--------- -- ....=.................................................................. ........................................
Date
Application Disappro.. or'the following reasons:..............................................................................................................
t./{J
/� Date
PermitNo.. ................ ............................ Issued-----!.....----------------------.....................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD; O HEA LX
'!........................OF............ ............... ... .. ......................................
wrtifiratr of Tomptittnrr
IS. 0 R IFY, hat the, Individ al Sewage Disposal System constructed (6/) or Repaired ( )
_. Ld" `',
by. _ �� {:� ...
/�y y. sta
at �l—•--•••_!._— -•.- .__4�/' fin/ �........... C ,—Cf ....
--------------------
has been installed in accordance witl�`tk-fe provisions of T .�'.I�E 5gfYhe State Sanitary ,d s d- cribed in the
application for Disposal Works Construction Permit N __..._. _-........................ dated_ __4;S4 ...................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE...................•--•-••...-•--• I6-I JAI.e ................ Inspector.....................�--%-�-��-----------------------•-------••--
THE COMMONWEALTH O!:!:F MASSACHUS TTS
BOAR OF
,._.._
a "r t''t'tM.... O F.....
No.O�..�. �... ............... FEF_?Z..................
Dios sa -k n i rn rrmi#
Permissio is hereby granted � -•--••......:...............
to`Cons ruct _ or Repair an di;idu Sewage Di 0sal Systemp at No. l ----- 7`� = f�'�! ••-12:k � iZ.r...
Street 3- . r
as shown on the application for Disposal Works Construction `Perms N� _1�.,.?.__:--_• Dated..___......./.:.......................
Board of Health
DATE.....................--•---------....--•---•--•-•-•-------............... .
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS !
0
�.to7` � 5 407 y
w 7-
tJo UU
P�t p�s�
,Gb/d J4Goyi�
/iwk
7,. y d
a
� ti o0
39 �
Sot V)
Y
/U7 • 7J
LEGEND
CERTIFIED PLOT PLAN
EXISTING SPOT ELEVATION Ox0
EXISTING CONTOUR --- p
FINISHED SPOT ELEVATION
FINISHED CONTOUR 0
APPROVED , BOARD OF HEALTH r;i�n, "°,1�'�' „' L
DATE AGENT SCALE: i = 30 DATE = H- 27 - 8l
LDREDGE ENGINEERING CO. -'NCCLIENT MIcKuN-As
i CERTIFY THAT THE PROPOSED
EGISTERE REGISTERED JOB NO. 610 e 2 BUILDING SHOWN ON THIS PLAN
CIVIL LAND DR.BY= PM CONFORMS TO THE ZONING LAWS
ENGINEER SURVEYOR OF BARNSTABLE, MASS.
712 MAIN ST CH. BY" /213
HYANNIS, MASS. SHEET_..L OF z DATE REG. LAND SURVEYOR
E/TNER THE SEPT/C ;rAN/C OR
GEAC/lI/vG P/T A/tE MORE TNA/V /2"BEL.0n/
/O PT M/N. GRAOE� A 24'O/AM ET.ER G'ONCR.FTE COVER
SHALL BF ,9 ROC/G.17* TO 61RA LOE.(�4,V EXTRA
C:ONCRCTE j•�EAYy CA ST IRON CO//�R SHAL Z.Q,E USED
M/N. P/TCN
co IF/N GR/VEJ�/A Y
% MIN. CO/VCRE•TE
/4 :%o: d7�A0E COVER CLEAN SANO
.u_ L/QU/O LEYEL
..• z•LAYER
^' CAST
IRON P/PE o 0 o f 1p • '
'tr M/!V.P/TCN GG G G.�IL. D/ST. ' • • • • •• • �„ /HASHED S7t�NE
V-# Pe�/r n SEPTIC TANK , s • • • • ' • • •
BOX p • • 8 • `• • •• � . o
� e EJ°�ECT/✓E • i
:r i • ° t • • DEPTH • • • • v WASNED STONE
0
_ i a, • • • • . • . • • • o.e•P PRECAST SEEPAGE
!Nl�CR'T CLEYAT/DNS a �•� • • • . � • . • • • a o P/7 DR EQU/✓./NYERT.AT OU/LD/NCI 0 FT
/NCET SEPTIC T,4mK G'5- FT. C CAE //�TION�
04174E7'SEPT/C TANK . G' FT.
INLET DiSTR/Ol/TioN BOX Q FT. GROVNO r41TE/< TiaeLE
O�ITLETD/STR/dl/T/ON BOX ��g FT, SECT/ON OF' "
/NL,ET L.EACNIlVa P/T ��', y �; SEWAGE O/SPO�SA L SY.STE'M TABVLAT/ON
L54CH/1V6 P/T OIMENS/ON A 3 FT.
DES/6/V CR/TE/t/A SCALE : % " _ w 0. Dh1,ENs/oN 8 F'T.
NUMSER OF BEDROOMS 3 D/MENS/ON C—�-FT. Mi
�+
G4R49A4GE D/SPOSAZ.UNI T ��- ' SOIL LOG
TOTAL E.?T/MATED FLOH/��GAL.1DAY SOIL. TEST 0/ SOIL TLCST*2 SOIL TEST NUMBER OF 4rACA(IlVG R173�_ fELEY. 7� G �"EtEY, q G PATE OF SOIL TEST M�2J
SIDE LEACHI/VG PER P/T L'�y$_54t fT. RESULTS N//TNESSED dY
BOTTOM 404C'N/NG PER P/T_ SO. &r AERCOLAT/ON RATAr jP0/ , r M/NCl/NCH
7-0Ti4L LA-ACN/NG AREA �G6 SQ. FT. �`G tw a s �j FE/tCOLroT/oN RATE AL 2 MI w•/!NC'y
A—�
SQ. FT i
RESERVELEi4CNIJV6 ARE
3 o.c : Fey 4
ZN 0 F A•f q 4t;�.
R06ERT<
a
No.22162 a ELOREDGE ENG/NEVR/NG COS/NC.
7/2 MAIN S
,�� T.
/ 9p��SGI �E?v\� t�J NO GROUND Y Ar4wR ENCOU/VTL�REO HY.tNN/O, MASS.
Q GRO JJA/O kVATE.,p AT E54— JOB /VO. F/D Z SNEET-At--OF Z"
1F
LEGENDol
N
PROPOSED CONTOUR ON
® PROPOSED SPOT GRADE wAY �S10E O
—— 98 —— EXISTING CONTOUR 9
+ 96.52 EXISTING SPOT GRADE S m
\• W— EXISTING WATER SERVICE A 9 ppc
��/ r !9 TEST PIT r At 5hubae
o ooi; \\\ \\ O�
Iwo
, I \
\ LOCUS MAP N.T.S:
0.i
�'�\
86, :� \\ \• GENERAL NOTES:
ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
\ -\ BOARD OF HEALTH AND THE DESIGN ENGINEER.
WOW_;
O _;.\� \ `fi 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS.
\'\ \\�0�\ \\� aPi( / \`\ / 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE
\ 6� n Z \• DESIGN ENGINEER.
j \ \ O Z \ 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
ENGINEER BEFORE CONSTRUCTION CONTINUES.
5. ALL ELEVATIONS BASED ON ASSUMED DATUM.
\ \ \ G 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE.
Existing Leach Pit 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED
(See Note 10) O \ \ / \ TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.
9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
L O T 39 \`\ THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
CONSTRUCTION.
\\ �, o-�Oo \ I AREA = 10775 S f rt 10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND REMOVED
11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION
\ \` o b QQI� \\ i �• ±, 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY
<>O-0 1 \/ AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
13. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING
\ \
° 14. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPECIFIED OTHERWISE)
\ \ o0 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW
1C0 FOR THE USE OF A GARBAGE GRINDER
\•\ 216 duo i \�8a" + 16. NO WETLANDS WITHIN 10.0 FT. OF PROPOSED LEACHING
BENCH M (� k<
\\\ SHED a "�
\• �- 86
TOP OF FOUNDATION•
ELEVATION = 84.79
\ BARNSTABLE GIS DATUM
OF ,ygss
DA EN
PROPOSED SEPTIC SYSTEM UPGRADE PLAN
I 11 .79 GOOSEBERRY LANE, MARSTONS MILLS, MA
114 Prepared for: Susan Henn
Sl MAP. 102 Engineering by: Surveying by: SCALE DRAWN JOB. NO.
SURVEY REFERENCE: DARRENM.MEYER,R.S. Zoo—Tech &mvhvjzmenW
NITAR\�' LOT. 192 1"=20' DMM
PLAN OF LAND BY GERALD A. MERCER Se CO., ENG.
PO BOX 981
DEED BOOK.` #11020 EASTSANDWICH MA 02537 (508) 364-0894 DATE: CHECKED SHEET N0.
DATED: OCTOBER 1957 Q(•v�'�� DEED PAGE.• #052 508-362-2922 01/24/08 DMM 1 Of 2
ELEV. TOP
FOUNDATION
(Existing)
86.07 F.G.EL: 86.0 F.G.EL: 86.5 F.G. EL:.86.5 FINISH GRADE= 86.5
MAINTAIN 27 MIN SLOPE OVER LEACHING AREA
:Y COVERS TO WITHIN 6 OF GRADE 6" INSPECTION PORT
:r L - 17' ;? W/IN 6" OF FINISH GRADE
6„ . " 4" SCH 40 PVC ; L = 5'
° o ° ° ° ° ° ° ° ° ° o
= ° Li1 14
0"1 ® S= 1% (MIN.) s S= 1% (MIN.)
(MIN.) TEE'S ARE TO BE " r
:. 4" scH 40 PVC INV.83.62 INV.83.40 ° ° ° ° ° ° ° ° ° ° °
INV.83.20
EXISTING OUTLET
GAS PROPOSED DB-3 ° ° ° ° ° ° ° ° ° ° 10, °
BAFFLE H-10 DISTRIBUTION BOX
AUK
' INV. 83.87
EXISTING 1000 GALLON SEPTIC TANK NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING
PIPE INVERTS PRIOR TO;CONSTRUCTION RLnF F 9" MIN.
2) D-BOX SHALL BE SET LEVEL AND TRUE TO PER TI TLE 5
GRADE ON A
OF ,yqs NCH CRUSHED ESTONECALL BASE,OASACTED E SPECIIFID IN BREAKOUT EL. = 83.65
310 CMR 15.221(2) INV. ELEV.=83.10
DA M. 3) REPLACE EXISTING 1,000 GALLON SEPTIC
' M R -+ TANK WITH 1500 GALLON SEPTIC TANK vouecE 14sNm sr�E
1140 "' IF FAILED, DAMAGED, OR UNDERSIZED. IN I/ER
SEPTIC SYSTEM PROFILE 4) INSTALL INLET & OUTLET TEES AS REQUIRED BOTTOM EL.= 81.10
'PE-15 I--48" 50 8 '
0 »
SAN I TA��a D' ti�, SEPARATION 5.35 Fr. I 146 -
INFILTRATOR 3050 SPECIFICATIONS A BOTTOM OF TH-1 EL: 75.75 SOIL ABSORPTION SYSTEM (SECTION)
SOIL LOGS DESIGN CRITERIA
NUMBER OF BEDROOMS: 3 BEDROOOM
DATE: JANUARY 24, 2008 SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF)
SOIL EVALUATOR: DARREN MEYER, R.S., CSE DESIGN PERCOLATION RATE: <2 MIN/IN
WITNESS: DONNA MIORANDI DAILY FLOW: 110 G.P.D.
DESIGN FLOW: 330 G.P.D.
+ HEALTH AGENT
i GARBAGE GRINDER: NO (not designed for garbage grinder)
INLET END Elev. TH- 1 Depth fi Elev. TH-2 Depth SEPTIC TANK: 330 gpd x 2 = 660 gpd USE EXIST. 1,000 GALLON SEPTIC TANK
(OPEN) 87.01 0" 86.50 0"
A LOAMY SAND A LOAMY SAND LEACHING AREA REQUIRED: (330) = 445.94 S.F.
10YR 3/2 IOYR 3/2 .74
4.5' DIA ACCESS PORT FOR INSPECTION. 86.76 B 4" " 85.83 B D" USE THREE (3) INFILTRATOR 3050 UNITS WITH 4 FT. STONE
LOAMY SAND LOAMY SAND ON THE SIDES & 1.3 FT. STONE ON ENDS: 25' L X 12.16' W X 2'D
10YR 5/8 10YR 5/8
BOTTOM AREA: 25 x 12.16 = 304 SF
F� 84.01 Cl 36" 83.42 C1 37" SIDE AREA: (25 + 12.16) X 2 X 2 = 148.64 SF
f TOTAL SQUARE FEET PROVIDED = 452.6 vs. 445.94 REQ'D
DESIGN FLOW PROVIDED: 0.74(452.6 S.F.) = 334.95 G.P.D. vs. 330 G.P.D. req'd
Ittttt
a
. . e . a o . . . . . PERC ®81.68
MEDIUM MEDIUM PROPOSED SEPTIC SYSTEM UPGRADE PLAN
SAND SAND 79 GOOSEBERRY LANE, MARSTONS MILLS, MA
INFILTRATOR 3050 2.5Y 7/4 2.5Y 7/4
Prepared for: Susan Henny
NOMINAL CHAMBER SPECIFICATIONS I
� Engineering by: Surveying by: SCALE DRAWN JOB. N0.
N.T.S.
76.51 126" 75.75 129" DARRENM.MEYER,R.S. Boo-Tech Environmental DMM
SIZE (W x H x L) 51 " x LBS. IN. ( C HORIZ
/ ) PERC RATE <2 MIN/IN. ("C" HORIZON) EAST x 85.4 PoaoxsesSANDWICH,MA WEIGHT PERC RATE <2 MIN " " ON (508) 364-0894
DATE CHECKED SHEET NO.
NO GROUNDWATER OBSERVED I NO GROUNDWATER OBSERVED 506-362-2922 01/24/08 DMM 2 Of 2