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0057 JASPER ROAD - Health
57 JASPER ROAD Marstons Mills A = 047 - 030 / \ I TOWN OF BARNSTABLE LOCATION ,S 7'Tmsycr Li l SEWAGE# +ZOZo - 22O VILLAGE M OA,'115 ASSESSOR'S MAP&PARCEL 9 1-30 INSTALLER'S NAME&PHONE NO. E)teoulaAr on y�l'1- OLS3 SEPTIC TANK CAPACITY 15-00 oa_l LEACHING FACILITY:(type) p- cam- (size) ZX3 X 33 NO.OF BEDROOMS 3 OWNER u'ib( N014 f PERMIT DATE: 71-20. 2O COMPLIANCE DATE: 717 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 Al- 24'y " 431 - ILI AZ- Zo Bz, 1`1 ' 03-7 7Nr��r s Ara W)"a " r•r A4' Bq -GO'9 " i v;-0 No. ` Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliLation for -Misposal bpBtem Cunstruttion Permit Application for a Permit to Construct( ) Repair(,./ Upgrade( ) Abandon( ) ❑Complete System [Individual Components Location Address or Lot No.$� 745 f&C 9%c o ct Owner's Name,Address,and Tel.No. 0m-J;d Ao t+ MQ,rstnnS l' iks Assessor's Map/Parcel H'7 0 $1 TAsegr 0,00.A Mpcs{O,-4 mats Installer's Name,Address,anJ Tel.No.1�t Q, IixCAoaAjur+ Inc, Designer's Name,Address,and Tel.No. Flphst tnu;ro. 3Ttl 0�00kc, 130 5andv+io" 570 •4;-f•0(053 96b0% 331 H6r id, Ma, 1-74-C1gLi• If(o!o Type of Building: Dwelling No.of Bedrooms 3 Lot Size 20, 000 sq.ft.' Garbage Grinder(Uo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided Lill gpd Plan Date 7 ( It.'20 z 0 Number of sheets 2 Revision Date Title Size of Septic Tank 1500 Type of S.A.S. (1)"T rcmht S Description of Soil SG4, O►enS Nature of Repairs or Alterations(Answer when applicable) I nsyosa re LJ SAS ( % T rt nChes an6 ci—box CoOnntoivn% �0 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date -711-712-02.6 Application Approved by Date — Z i Application Disapproved by Date for the following reasons Permit No. �� Date Issued No. 1 �a� m Fee—too THE COMMONWEAL H OF MASSACHUSETTS Entered in computer: t/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for ]Disposal apstetn Construction 30ertnit Application for a Permit to Construct( ) Repair(v Upgrade( ) Abandon( ) ❑Complete System [6ndividual Components Location Address or Lot No. $ } p,a f*r (�p c�c+ Owner's Name,Address,and Tel.No. Oc.0�o H«4 Mn(51V IY}"i1's Assessor's Map/Parcel H-I 30 Installer's Name,Address,and Tel.No. 0j t f,;a c-y(a:,ejk' n {nc, Designer's Name,Address,and Tel.No: {cn he 3'11 1�tutrFe !�U �jcinr�,;(1., �4a 'Oto '3 P4 f ax 3Z1 HasvjgV-, Type of Building: Dwelling No.of Bedrooms Lot Size { 10, C!U 0 sq.ft. /- Garbage Grinder(Wo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �>'3 Q gpd Design flow provided 91 ?i gpd ,A1" .:, Plan Date -7 Z Number of sheets 'L Revision Date Title Size of Septic Tank 1500 Type of S.A.S. 2) Description of Soil S e*. n ton 5 Nature (Answer of Repairs or Alterations(As!wer when applicable) 1j Y1`,{at 1 Y1P u) 5A5 i is nc l,ec, tar,(+ C c)y-fn e 0-,c1 C '�l? Q jt":a T i�Cn C1Q(.'t l�. r 4'/�Y..• U Date last inspected: , Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sig ��, Q� Date -7 7 o7.C_� Application Approved by 1,,,� IJ_ y Date �'/+ 2.©' Application Disapproved by Date for the following reasons Permit No. o o-'U` 9-9-0 Date Issued -�y THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(./) Upgraded( ) Abandoned( )by '� �) C a vr� �c�n h1 c , =� -at J -7:a Swa.p r 9)oa d has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.�2��0- 7 20'dated -'�rj J Installer- Q.*�, �; �.XCn.�n ��. �nr. , Designer �AcV.or4,. #bedrooms 3 Approved�design flow 1wr ��j(� gpd The issuance of this�permitFshall not be construed as a guarantee that the system will function ads,tdesi' p-d. "T o '� ' °"j Date / Inspector No. 2 o Fee ._ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstetn Construction Vertnit Permission is hereby granted to Construct( ) Repair( f) Upgrade( ) Abandon( ) System located at 9cuac{ i and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Const-ruction must be completed within three years of the date of this permit.,,<� Date fi d '' Approved by p { Town of Barnstable Inspectional Services Public Health Division 1ANWARM NAM Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certification Form Date: •3 1- ZO Sewage Permit#2020• Z.ZO Assessor's Map\Parcel qJ-a Designer: FJQ.kcr Aw Ens; Installer: �� .� £XemQ01-4ionl, Address: P p Qox 331 Address: 114 kLP,01C lk �or-cs- del On !1 •Zo• ZO II R EXco�Ljtj i on. was issued a permit to install a (date) (installer) septic system at 6n TQZper Lam, based on a design drawn by T (address) Flo h=-y-AsA dated 'j- I G -Zo (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 and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic stem referenced above was installed with major changes (i.e. p greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed i Forme with the to rms of r. the RA approval letters (if applicable) f DAdID D. �m� F!AFiF ,y JR. s 4 r (I tall er's 1 Hato �� � 'r21:t r. esigner's Signatur (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. \\toa\depts\HEALTMSEWER connect\SEPTICMaigner Certification Form Rev&14-13.DOC r �sto�ti Town of Barnstable Inspectional Services Department b�: ,�� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 0978 October 23, 2019 US BANK TRUST NA TR 13801 WIRELESS WAY OKLAHOMA, OK 73134 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 57 Jasper Lane, Marstons Mills, MA was inspected on 10/05/2019 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360—20h). You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\57 Jasper Lane Marstons Mills.doc Town of Barnstable i • BARNSTABLE, Inspectional Services Department rfD MA'S� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) Veaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts Title 5 Official Inspection Form '�A %l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) r. Owner Owner's Name / information is MarstonS Mills ✓ MA 02648 10-5-19 required for 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. A. Inspector Information Ay/80 Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 16.340 of Title 5 (310 CMR 15.000);1 have personally inspected the sewage disposal system at theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ® Fails 10-5-19 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form w,- i�b. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2) System Conditionally Passes: ❑ One or more system components as described in the "ConditionalPass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y El ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 r Commonwealth of Massachusetts 3 Title 5 Official Inspection Form rl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln .1- Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Marstons Mills MA 0264 - - required for every 8 10 5 19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y El ❑ ND (Explain below): ❑ obstruction is removed ❑ Y El ❑ 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 El ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts 3 Title 5 Official Inspection Form ll i wa i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 r Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ® ❑ 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 '/Z 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 SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 2000 gpd- 10,000 gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone 11 of a public water supply well t5insp.doc-rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r a 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ❑ ® 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? ® ❑ Wasthe 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 I Commonwealth of Massachusetts ,w Title 5 Official Inspection Form cl�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: UnknownDate t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts rr ;w Title 5 Official Inspection Form c�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 r Commonwealth of Massachusetts w Title 5 Official Inspection Form } k1► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �.,_•T,;:•, 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known) and source of information: 1978 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 12"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts 3 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: 6"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: 1000 gal Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 0 Distance from top of scum to top of outlet tee or baffle roll Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed. t5insp.doc-rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form �'l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Traplocate on site plan): ( P ) Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scam to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 i Commonwrealth.& Massachusetts Title 5 Official Inspection Form 01 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments f' :,_T,,;•;> 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): `Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened)(locate on site plan): 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.): D-box had signs of back-up with stain lines above outlet. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1.1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Z, 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments > .�._� 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit had stain lines above inlet invert. 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form } :i0 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David Holt Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form bi Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _.. 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. 'Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately - 40 1 r C2 rel CPS 14 -d - Oil / . ? 74C13, 3 , `r a ? 6 6 -41- 77 .1 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 c Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 57 Jasper Ln Property Address Bank Owned (Contact David,Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 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: USGS and town maps show groundwater at greater than 20'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp,doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts w Title 5 Official Inspection Form iCl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,lc 57 Jasper Ln Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Marstons Mills MA 02648 10-5-19 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 _ I COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS v DEPARTMENT OF ENVIRONMENTAL PROTECTION a d �s TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 o Jcc, ( � . Owner's Name: MARY HINNERS Owner's Address: 156 HOOPHOLE RD MASHPEE MA 02649 Date of Inspection: 11/26/01 Name of Inspector: (please print) JOHN GRACI RECEIVE® Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 DEC o 6 2®�� Telephone Number: 508-564-6813 FAX 508-564-7270 TOWN OF BARNSTABLE HEALTH DEPT. p 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 t i inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes }' _ Conditionally P sses Needs Furtl r valuation by the Local Approving Authority Fails Inspector's Signature: Date: 11/26/01 The system inspector shall submit 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 SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG SYSTEM'S USEFUL LIFE. nS j r 3 ****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 systeiu will perform in the future under the same or different conditions of use. , 1 I _ ' Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: 11/26/01 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: SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG SYSTEM'S USEFUL LIFE. 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. t: ,7 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 4 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 ;u , that the tank is less than 20 years"old is'available. ND explain: n/a z 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 ,i_:, Health): _ broken pipe(s)are replaced ..r E, •";> _ obstruction is removed h _ distribution box is leveled or replacedw=t; ND explain: n/a 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: n/a vs Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: 11/26/01 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 F 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the r 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 tankand SAS and the SAS is within 50 feet of a private water supply well. h _ 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 n/a Ay "This system passes if the well watef 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: :. n/a .r- ;Y 'i Page 4 of 11 F . OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION,(continued) Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: 11/26/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for alLinspections: E 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 E.T SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z 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 n[a. 'f X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool br'privy'is within 100 feet of a surface water supply or tributary to a surface water supply. f; X Any portion of a cesspool or,pr►vy is within a Zone 1 of a public well. s 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 3w,r 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 yt: less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be r ; attached to this form.] _ (Yes/No)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. 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 X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply i, r X 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 aYq system question in Section E the s stem is considered a significant threat,or answered Y Y "yes"in Section D above the large system,has failed.The owner or operator of any large system considered a significant threat r . under Section E or failed under Section D shall upgrade the system in accordance with 310 CM 15.304.The system owner °. should contact the appropriate regional office of the Department. Y 0 eta xW SR;. l ' I Page 5 of 11 t f OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 57 JASPER RD.MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: 11/26/01 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 1 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 �F } baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? s' 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 u ,•., unacceptable)[310 CMR 15.302(3)(b)] " • , _s a f. ' 7 _ _V, 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: 11/26/01 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 Number of current residents: 0 4 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): NO Seasonal use:(yes or no): NO '• -;•4 Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: 10/1/01 COMMERCIALANDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMRd 5:203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO i - Non-sanitary waste discharged to the Title 5 system(yes or no): NO ? s ' Water meter readings, if available: n/a y �. Last date of occupancy/use: n/a ,.; OTHER(describe): n/a GENERAL INFORMATION ' Pumping Records Source of information: n/a '; }Tlj Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a 5s Reason for pumping: n/a r`' 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) t,f; ',< _Tight tank Attach a copy of the'DEP approval Other(describe): n/a W Approximate age of all components,date`installed(if known)and source of information: 1976 r <k Were sewage odors detected when arriving at the site(yes or no):NO f Page 7 of 11 ,f OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: 11/26/01 BUILDING SEWER(locate on site plan) ` t Depth below grade: 12" ° Materials of construction:_cast iron _40 PVC Xother(explain):20 PVC , Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X locate on siteplan) Depth below grade: 6" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a g g Y P (Y ) ( PY ) Y a it If tank is metal list age: n/a ]s age confirmed b a Certificate of Compliance es or no : NO attach a co of certificate) 1000G L 8' 6" H 5' 7" W 4' 101''11 Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle:33" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle:24" Distance from bottom of scum to bottom of outlet tee or baffle:0" r How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): ' SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/n Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.); n/a r Page 8 of I I 4 ` OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: I1/26/01 TIGHT or HOLDING TANK: (tank must be pumped at t line of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_po!..ethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day .` Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locrnte on site plan) Depth of liquid level above outlet invert: LEVEL WIT I I:OT'L'OM OF PIPE Comments(note if box is level and distribution to outlets (;.ial, any evidence of solids carryover,any evidence of leakage into or out of box,etc.): D-BOX IS STRUCTURALLY SOUND. ' PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition ot'jnunps and appurtenances,etc.): n/a i At } t. Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: 11/26/01 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: nla n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: nla n/a F innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.PIT HAS I 1/2FT OF LEACHING LEFT IN IT AND THE BOTTOM IS AT 10 FT.RECOMMEND RAISING COVERS. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow es or no): NO E Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): n/a } PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,sign3 of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a 'l ; r sr n Page 10 of 11 OFF 'ECTION V O1 (— !;OT FOR VOLUNTARY ASSESSMENTS CE SEWAG 1 . 1 1_, t.' SAL SYSTEM INSPECTION FORM 1'. 11T C SYST1?\'1INF( ,N4ATION(continued) Property Address: i s RD MARSTON.S ;)11'.' 't, NIA 02648 Owner: MARL' Date of Inspect SKETCH OF SF POSAL SYSTr.m Provide a sketch ..sposal system ii;,_I;i,'ini, ' ,it least two permanent reference landmarks or benchmarks. Locate all wells Locate where public tipply enters the building. . i 0 OeC IL Wb* C AA 3� 00 s A hAy Ho 6 gA { f Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 57 JASPER RD MARSTONS MILLS,MA 02648 Owner: MARY HINNERS Date of Inspection: 11/26/01 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 13+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators; installers-(attach documentation) YES Accessed USGS database-explain: n/a ; You must describe how g you established the high round water elevation: Y g GROUNDWATER DETERMINED FROM HAND AUGER-NO WATER ENCOUTERED AT 13'-BOTTOM OF PIT AT 10' w :. SARNSTABL LOCAIrION: S7 Jcz Si /1 &,1 SEWAGE VILLA Gi�S A,! GIs: SEsSSOIZ'S M"SG L4T XSTALLS S NAME&PHONE NO. E G TANK CAPACrrY .— p LEAt��iG 1F+1►i,C#Q.1TY's,(�Q} � (size) ...., ._.. M.C)Fv5 0oms . tuXt. oR DER i�}3RSUdfT. DATL' ,. cdWL"C»E Dm AM34. ISOpsuratio l9tstsna Bstv�een tl7o aMoxlmumAdjustet.Cod idwaterTableta the&tttarnofX 020119 focility ..., P&Y tt wotGr Supoly i 4111wd L�thing Faailat Of eery VIa1ls exist aw►eit ac wlthin?AR feet of te MY) Mo.,ii f WetAand and Les►dMos 0i Ally.(k str y:wetlands exist vltlals1 300 Aidof leda}tits PuriACry}.. urnlsb©d.by c r � 1 17 3 7- -7 P v LO+CATION SEWAGE P RMIT NO.: VILLAGE INSTA LLER'S NAME & ADDRESS B UItDE R OR OWNER Ind �- `�/ % �►i ci2�'��s 2 C © ATE PERMIT ISSUED J_ OAT E COMPLIANCE ISSUED �Z ,.= �Caih2 �2 Fps._ 2S� No............ :...... ... ............... THE COMMONWEALTH OF MASSACHUSETTS I BOAR® OF HEALTH 7C�"UJ"►7...- ___...OF........RaM� ..��.. 41......................................... ApplirFation for Disposal Works Tnnitrartiun ramit Application is hereby made for a Permit to Construct W15 or Repair ( ) an Individual Sewage Disposal System at: y�- . J ............. _ � . d_-_...Nje)--..................---•--......---- ..............................................................t No Loc 'o`�- dre or ...... �. _ ��...... .�� !L „ { ..........•_........Y.VN-/�JZj.1.S.................................................. Owner Address a ........................... . ............................................. ...........................a .-.------------------------------------------------------- Installer Address QType of Building Size Lot__&sPP ........Sq. feet UDwelling—No. of Bedrooms____-_•_•__.3...........................Expansion Attic ( ) Garbage Grinder aOther'—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ---------------------------••••••-_D.. ••• •••••...........•------------------------------------------------------••-••••---------------- W Design Flow.........f_.10........................._gallons per V per day. Total daily flow.............:33.4.)..................galjonf WSeptic Tank—Liquid*capacityl6l)A-•gallons Length_&k..... Width_.5.-Q_•_.. Diameter________________ Depth.... �.._. x Disposal Trench—No_____________________ Width+..__.._..__.___._ Total Length.___..__.._..__..._ Total leaching area....................sq. ft. Seepage Pit No.......J------------ Diameter...IC.#:_.... Depth below inlet.....K_D._._. Total leaching area.U.7_.....sq. ft. Other Distribution box (i� Dosin tank ) '� Percolation Test Results Performed by_ "�:_ ..:AQ y!S�_-•__.•.............•____-• Date_S,6?.& 419 ....... aTest Pit No. l.12_.......minutes per inch Depth of Test Pit•._48_......... Depth to ground water__/V�;E._.......... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to gr i ........................ rx ..............--•••...................•-...•••••-••-•-•-•••••...............................••-........_-. �". QE �. ................... O Descript n of Soi - _ • o�.�•-••••••-•-•-•••sqc� ................ W B. Q. CHAPNMAN•-_---N ------------- UNature of Repairs or Alterations—Answer when applicable.____________________ _ ______________ __A _*o:-2-7&54-a_._._. ............... ----------------------------•---•----------------------•-•-----------------•-----•------•----•----...-••---------------------- -•••-- -• •-••• �pz F � � ................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal c rdance with the provisions of TITf.% 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signe ._._ ..... -- •.................••.........----------•----••-•--•-•-••....._. .......................... •.•. Date Application Approved By---•-- r � !l L �'2�P `7_ .:.... Date Application Disapproved for the following reasons_________________________________________________________....................................................... ...-----.•.......----•-------•---•------•-•--------------------------------•------------------------------•••••••....•••-••••••••-•---•••••••----•-•-------•-•••••-•••-••••---••----••-••-••••••-------- -.. � .-.-.Date Permit No.......................................................- Issued_.- �` ^��.. Date i __1 No................_....... Fes$............._............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF........ r, 6 ......... Appfiratiun for Disposal- Works Tonstrnrtinn Vrrmit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at: I LQ !� Loc •on-A res or t No. V Owner Address ............................................ -------------------------- ..__._:°1J....................................................... Installer Address dType of Building Size Lot...&,42?........Sq. feet U Dwelling—No. of Bedrooms..........._�...........................Expansion Attic ( ) Garbage Grinder (✓f Other—T e of Building No. of persons............................ Showers — Cafeteria Q+ Other fixtures ..----------••......••-••-•--••- W Design Flow........./J.6..........................gallons per ` n per day. Total daily flow.............334)..................gallons. WSeptic Tank—Liquid'capacitylgAP..gallons Length.lQ_6._... Width_..10..... Diameter................ Depth.... x Disposal Trench—No.-------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.......'............ Diameter...fI?.+- ".... Depth below inlet.....4. l?'._.. Total leaching area. 47_....sq. ft. Other Distribution box (✓f� Dos in tank, ) Percolation Test Results Performed` r___________________________ Date. :___ Test Pit No. l.1o_3.........minutes per.inch Depth of Test.Pit...4B•....... Depth to ground water..Y�`A(:............ (s, Test Pit No. 2.................minutes per•'inch Depth of Test Pit..................... Depth to ground water........................ 0 Deai n-ef z��e OF ..........................Mgs�ti x v --------•-•-----•--•---------- -------- Reravcie�r-- � ... WB:......•••-•- ' -•--•-........•- UNature of Repairs or Alterations—Answer when applicable...................................... spa...... HAPMAN...._.. .._............_. ----•-•---•-•---...---••----•------••----•-----•-•---•----•------•----•-•-----.:-----•--•--•...............•-•......---.._.....••-• ••...... ��'P :.2 6 ....._-•--•-•••. 54 p Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposa ordance with the provisions of TITTLE 5 of the State Sanitary Code—The undersigned further agrees no top ace the system in operation until.,a Certificate of Compliance has been issued by the board of health. r Application Approved By.................................. ...Y.......................... ........................................ Date Application Disapproved for the following reasons----------------•---------------.........----------------------•------------------•---•-••--•••...........------ ....--•---•---•-•...............•--........_-•--.....--••••••-_---...........-•-••---•-------•-••--•••••.--•._.......•--•-••--••-••-••-••--••-••••-•--•--••••----•••••---••-------•••••---•--._....----- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS OARD HEA ..........................................OF.............Q..`../............................... Y............?.............. Trdifiratr of fl�untpfianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal-System constructed ( ) or Repaired ( ) by........................................................R,--,YY644.4.....--------------------...---------...-------------------------.-....--------......_.....----....----------•-- Installer at....... ---A-f .............. •f) - ---------- ----------- G has been installed in accordance with the provisions of T JoGTho,State Sanitary V(tdgaOttes it d ,n the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILLj F NCTION SATISFACTORY. d DATE............. .. ......... ---•-- ..............................-••••-........._•-----....._.. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD ...........................................OF..................................................................................... No......................... _ - FEE........................ Disposal Works Tuno#.ratiun frrutit Permission is hereby granted......... ......--•-----------------------------------•---...........-•--•...........-_•----...... to Construct!�. ) or Repair ( ) an Individual Sewage • osal System atNo...1.....�y... •-....._. }. 2` y( .: --------��0..;................... .4 's cr --- ----------------------•-----------•---•-••---••-•................. as shown on the application for Disposal Works Construction P t Dated.................... ......'__._........:. Cam: . ------------------•----•----•-------__- ��► Board of th DATE---/ -----------------------------=------------------- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS SOIL LOG p / ... / \Xx 111.1 U><1�\V i vv-,✓M ter/i .,c,t r I����t1i��i x h:�J 0 5 . !` r 2'IPEAS TO N6f LOAM a FILL 12"MAX.It 1 4 C.I. DIST a �;° ° of BOX If °• ° °' o ( _ /O'MIN. I�O� -j °29"OIN.° ° 1000— GAL. °a� �F,12C 7'�T L?4}.S GAL. j o, °• PRECAST OR ° ° °I Y611ow ✓e+Eo, SEPTIC 6' ° ° ° • BLOCK TANK ��°,° ° ° .' ;.SEEPAGE PIT o° °°o 133 S a'e° S� '.j .W.Area= 1 BB.'SF ° I ° n° o 20' MINIMUM ° 0 7otill = 267 FOUNDATION i y»r+a Co4ou6 !-L4 S 1 %z WASHED STONE -T� I fiC'i �y c�r>�i' fhaf�°�� rzre�: �r� Shorvrr on 1Jec.1Q, 1977snd con{arms w,fh Me Z�)1711) I o B� 75wo07 Rgro-s A)3-5 �. ,,✓ L/e ^ 0�1./ cS( � t � ,(w1'Jh G1-Gr-lhdsr) TEST BY: I }; 4F Aq ,c9 L ° TOWN INSPECTOR f`�y' *^y~e� �y any BACKHOE OPERATOR : 3 u ►/A,s e . DANA \N� I TEST MADE ON 1 ii'7 I ; ARcKI f'rIP'ilE. c No - �.'5TT 1 49 LCCi_ ` � E • Aj ' �'sa �2 0'1 --i" "I J4 - - N Ile 1 (min) tA 1 3,9 Af-- ELEVATION SCHEDULE ¢� PROPOSED SITE PLAN I. INV. AT FOUNDATION �3 r 2.. INV. INTO SEPTIC TANK = 3(p SEWAGE SYSTEM DESIGN IN 3. INV. OUT OF SEPTIC TANK _ 1 ,60,60 04 a / MILD, . 4. 1NV. INTO DISTRIBUTION BOX = Mao SCALE: 111= ° D -]P,n, j9, 1978 5. INV. OUT OF DISTRIBUTION BOX = �3�• C-5(�,'j rj 6. .INV INTO SEEPAGE PIT = � ,Q0 CAPE COD SURVEY CONSULTANTS BOTTOM OF PIT = 129 00 ROUTE 132 HYANNIS,MASS. A DIVISION BO9TON SURVEY CONSULTANTS, INC. B. BOTTOM OF .STONE LAYER = COVERS TO BE WATERTIGHT AND SEPTIC SYSTEM PROFILE Flaherty Environmental Services P.O. Box 331 TOP OF FOUNDATION BROUGHTfiO WITHIN 6" OF FINAL GRADE EL. 102.0' EL. 100.0' not to ale) Harwich, MA 02645 2" PEASTONE OR INSP. PORT W I 3" OF GRADE 774.994. 1166, GEOTEXTILE EL. 500.0' CLEAN SAND FILTER FABRIC 4" CAST IRON or EQUIVALENT MIN. PITCH 1 4" PER FOOT 4" SCHEDULE 40 PVC PIPE VENT (IF REQ.) 4"SCHEDULE 40 PVC PIPE FLOW LINE •'•...• (first 2'to be level) T1 15'(z.o%) 5' 1% EL. 97.2' —�� —► ••;.••, L. EXIST. 10 �'. 14" 2 EL. EXIST. �97. EL.94.5' EL.96.7' L.9 ..53' 96.5' (0 005%SLOPEi G S BAFFLE H 20 Deox SOIL ABSORPTION SYSTEM CLEAN, DOUBLE- (2) TRENCHES 3'W X 331 X 2'D USING 5.0 " 1500 GALLON SEPTIC TANK 6"CRUSHED STONE OR WASHED 3" TO 1 1" STONE PERFORATED PIPE AND SURROUNDED (DATUM: ASSUMED) (EXISTING) MECHANICALLY COMPACTED 2 BY DOUBLE-WASHED a" TO 1 2" STONE EL. 89.5' BOTTOM OF TEST HOLE EL. 89.5' USGS ADJUSTMENT: N/A LOCATIONMAP !' GROUNDWATER ELEV: N/A Q' EXIST. L.P. N TH JV 16�0p, BENCHMARK: RaCe Ln• O TH 2 TOP OF FNDN O EL. 102.0' ~ '0' LOCUS V B/ackthor EXIST, S. LOT 467 ne Rd. 10 .20,000 SFf NTS �1N( � ECK EXISTING MAP 47 LOT 30 3 BR / DWELLING. � FLA E 32.7' 0. i FG! TES . NITAlk\ 100 � X OP DRIVEWAY DATE:7/>8/2020 REVISED: \ � � ,' \ LEGEND \ ,� SITE AND SEWAGE PLAN FOR \ B & B EXCAVATION INC./ -0 6 G 6 GAS LINE DAVZD HOLT W W W 44L WATER LINE - 57 JASPER ROAD = E E E EXIST. ELECTRIC > ., E 99 EXIST, CONTOURS SCALE • 1 �� - 3 0' MARSTONS MILLS, MA 99 PROP. CONTOURS �I�E kI�E UNDERGROUND UTIL. li REF-CCSC PLAN DATED 111811978 PAGE 1 OF 2 i • Al • .. .......................................................__ ......... .................................. ....._._.. ........... ............. ................................. ..........-... ................... ......... ..... ... ... ................_ ............... ..........-. ................ ............................. ............................................... _. ............................................. ......... ...............__ ............. .......... ...._ ....... .._................. GENERAL NOTES DESIGN CALCULATIONS Flaherty Environmental Services P. O . Box 331 1. ALL PRECAST COMPONENTS TO BE H-10 SYSTEM DETAIL Harwich, MA 02645 RATED UNLESS OTHERWISE SPECIFIED. NUMBER OFACTUAL BEDROOMS 3 774.994. 1166 ALL COMPONENTS WITH ANY ANTICIPATED VEHICULAR TRAFFIC TO BE H-20 RATED. GARBAGE DISPOSAL UNIT NO ❑BS. PORT 2. THE DESIGN OF THIS SYSTEM DOES NOT TOTAL ESTIMATED FLOW T ALLOW FOR THE USE OF A GARBAGE (110 GAL/BR/DAYX 3 BR) 330 GAL./DAY GRINDER. 3. MUNICIPAL WATER IS AVAILABLE. REQUIRED SEPTIC TANK CAPACITY 4. ALL CONSTRUCTION TO CONFORM WITH 330 GPD X 2= 660 GAL. 6 310 CMR 15.000 AND ALL OTHER APPLICABLE LOCAL, STATE AND FEDERAL SIZE OF SEPTIC TANK 1500 GAL. (EXISTING) � '�;'' `; ; '. :;- �'-`";; '-:: :::,•-`'•'�` ' :;':;;•,:,°`•` '�: ��I1r �1I1. �1I I.CODES AND REGULATIONS. 5. INSTALLER/CONTRACTOR TO REVIEW& SOIL CLASSIFICATION 1 I---- 33' VERIFY ALL ELEVATIONS AND DETAILS AND DESIGN PERCOLATION RATE <2 MIN./INCH REPORT ANY DISCREPANCIES TO — DESIGNER PRIOR TO CONSTRUCTION OR EFFLUENT LOADING RATE 0.74 GAL./DAY/FTC ASSUME ALL RESPONSIBILITY } 6. INSTALLER/CONTRACTOR IS RESPONSIBLE LEACHINGAREA 9' MIN, OF SOIL FOR MAINTAINING SAFE WORK AREA, BOTTOM: (3'X44)X2= 264FT2 2' PEAST❑NE OR FILTER FABRIC 2' VERIFYING ALL UTILITIES AND NOTIFYING SIDES: "DIG SAFE" (1-888-344-7233) 72 HOURS [(2'X 44)X 2+(2'X 3)X 2j X 2= 376 FTZ PRIOR TO CONSTRUCTION. TOTAL = 640 FTZ 7. ANY CHANGES TO OR DEVIATIONS FROM X 0.74= 473 GAL/DAY 3' THIS PLAN MUST BE APPROVED IN TRENCH END VIEW WRITING BY FLAHERTY ENVIRONMENTAL USE(2) TRENCHES OF PERFORATED PIPE SURROUNDED BY SERVICES AND LOCAL BOARD OF HEALTH. 4"TO 12"STONE, EACH TRENCH CONFIGURED AS 8. FINISH COVER OVER COMPONENTS IS NOT 3 WIDE X 44'L ONG AND 2'DEEP TO EXCEED 3'PER 310 CMR 15.000 UNLESS SHOWN PER PLAN. RESERVE LEACHING CAPACITY N/A 9. ALL ABANDONED SEPTIC SYSTEM (NTS) COMPONENTS TO BE PUMPED DRY AND FILLED WITH CLEAN SAND OR REMOVED AND REPLACED WITH CLEAN SAND. 10.ALL COMPONENTS TO BE PROVIDED WITH SOIL EVALUATION WATERTIGHT ACCESS PORTS WITHIN 6" OF �N(W FINISH GRADE. yam 11.ALL SEPTIC TANKS, DISTRIBUTION BOXES V a� AND PIPING TO BE INSTALLED TESTHOLE#1 TPT#20-142 TESTHOLE#2 TPT#20-142 7certify that on November 12,2002,l have passed Evaluator. David D.Flaherty Jr.,RS,REHS Evaluator. David D.Flaherty Jr.,RS,REHS the examination approved by the Department of FLA , WATERTIGHT, SE#2755 SE#2755 Environmental Protection and that the above analysis BOH Witness: Don Desmarais,RS BOH Witness. Dave Stanton,RS Date: July 15,2020 Date: July>5,2020 has been performed by me consistent with the 12.NO KNOWN WETLANDS OR WELLS WITHIN required training,expertise,and experience described 150 FEET OF PROPOSED LEACHING, in 310CMR 15.0M(2)." Q/STE� nn 13.THIS IS NOT A CERTIFIED PLOT PLAN AND rH->ECEv 100.0' 7H-2ELEV 100.0' �gNITAW r I �"� UNDER NO CIRCUMSTANCES IS THIS PLAN 0"-27" FILL 0"-27" FILL 6 TO BE USED FOR ZONING OR BUILDING PURPOSES. 14.LOT IS SHOWN AS ASSESSOR'S MAP 47 PARCEL 30 . 27"-126" C MS 2.5Y614 27"-120" C MS 2.5Y614 15. LOCUS PROPERTY'S PROPOSED SYSTEM MERC AT 58 APPEARS TO BE WITHIN AN AQUIFER SITE AND SEWAGE PLAN FOR PROTECTION DISTRICT(ZONE II). G.W.ELEV.WA G.W.ELEV WA B & B EXCAVATION INC./ DAVID HOLT BOTTOM TH-1 ELEV.89.5' BOTTOM TH-2 ELEV..9 0.0' 571ASPER ROAD MARSTONS MILLS, MA PAGE 2 OF 2 DATE:711612020 ............................... ............ .........__ _ ......_.._... .... ..._.... ._....... ... ... .... ............_ ....._....... ... ..._. ..........._ .. ............ ..... SOIL LOG 2';.PEASTONE� LOAM 9 FILL-- 12"MAX. _ .•fir-*"r- .-?r-- i/ T � ; w.om [_oA l?7 a I 0 411 C.I. ° DIST. BOX IIo °a°0 ../_(3..�S 124"MIN. PF /O'MIN. 1500 1000— GAL. GAL. PRECAST OR SEPTIC 6' 0� °°, BLOCK u ° 0 133 5 TANK ��°. ° ° ° SEEPAGE PIT ° ou S.W.Area= M.5F p p 4:To v Bob,Area = 19 0 D 20' MINIMUM — e'0 total =267 n.a� vdrl ` FOUNDfATIOL_N G'ftc !2G•S I hem-4 certify 1ifi h%&5bvcAum shown i I %:11 WASHED STONE l ereon was located 4do adz,al�r/c/6 yrVdy � *� Of r� on Pec W,1977anCl Con forms W/A Me zonln5 10 PERC. RATE % By4dws 75- wno><Barns1ab/�,1�'1ass, lead area re utr d� '98sF�w���GCrrinc�Br� TEST BY : -e2�a c •, •�rc.Tirs TOWN r'^"L 'NA.4 14,0 ZH OF M�ss� Leach o�rl'a�??'pvlr��o'- Z�ol S/C BACKHOE OPERATOR INSPECTOR: 3 a L•� t DANA cyGn TEST MADE ON W. �. 0 MCN.E'CHNIE A No. 17933 O N 1 F�,STE.R�pQ` J A S PE l �Np U jt\4 IX i Low 467 0,coa 44 EX h'/7y I 3-Bedra��� h ; Dwe If/n9 of M1 Q r` 7-t,- 141 !(o ff N ? t#t` _ q RENW.ICK N�' .. 0. t0� . t c A flu. 27654 O �g N.L `3 Area S ! r I eLEVATION SCHEDULE PROPOSED SITE PLAN P I. INV. AT `FOUNDATION = �310. �/ SEWAGE SYSTEM DESIGN d 2. 1 NV. INTO S.EPTIC .TANK = �p,2 IN r j�/ � 3. INV. OUT OF SEPTIC TANK !r /N%d / u MILLS, IS5 4. INV. INTO DI A�� $�DISTRIBUTION BOX = SCALE: I°=W. jpn, Jg, 1978 � C--%pl-D 5. 1 NV. OUT OF DISTRIBUTION BOX = �� 6. INV INTO SEEPAGE PIT = 00 r CAPE COD SURVEY CONSULTANTS p ROUTE 132 c �L7• HYANNIS 7 BOTTOM OF PIT r MASS._ g A DIVISION BOSTON SURVEY CONSULTANTS, INC, . B. BOTTOM OF STONE LAYER = ...•_ __ _.._._...-_... . __.___._-__ ___.__..__._ ...._.__..._.-._.__ -_-.____.__._.._._.__..__. _.._._..___ _.----_----_-_.__.____.__`__-----------..__-__ .._...__._ . _._ . - I 29111 SFF —14 All 10' 06 j M .w 6d!IfISMf f I J t, .f ly a , a , i •"jI, - I i I _ i ' 1 j E , J is j .-. . _ qt ! j. } 1 A f Ing 13AT R ! ! y'Fei r+ t-c.ig ��r.STi�4 l3Cd C�1'y'•s slot u t I Ulm Omov af 1 __ _..J�_..._ �-_._.. low_....__ ...... ..___...._ .___._ � _ --- i P� � r t j