HomeMy WebLinkAbout0069 JASPER ROAD - Health 69 Jasper Road
Marstons Mills
A= 047-029 -- ------ ----- — - - _______ _
1 _
a
TOWN OF BARNSTABLE
_ LOCATION ' Ofl IZ L SEWAGE#70/6 "Q L
VILLAGE dllC h-,145 W I ll ASSESSOR'S MAP&PARCEL Q V7 0.2 GI
INSTALLER'S NAME&PHONE NO. �r�j (+� 6 inQ <7V "177-017I
SEPTIC TANK CAPACITY p�7
',LEACHING FACILITY: (type) Zac 6U.7 nv '(size) lax T!S 4k
;1V0.OF BEDROOMS
OWNER 190 vt &I L aS
PERMIT DATE: COMPLIANCE DATE: 3
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
i
FURNISHED BY
Pad
*'1
I
TOWN OF BARNSTABLE �
LOCATION SEWAGE #
,,'MLAGE ASSESSOR'S MAP & LOT �2C]
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY I 1
LEACHING FACILITY: (type) (size)
ackyo�
NO. OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
- Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
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 _ _
%�'a/dsuru�,l 10•y`- =� rifrler P¢'?w.awra. ..
tl//1 M.TOl1f0g d/CB/tpW.�da 198 fR�N'N192Y9 .: .� TEST BY
�Nf��d9S. • .pypyn*sQ.�e7Sf _ � TOWN-INSPECTOR�`d71n.�
f 9ACWIOE OPERATOR P ?°A
II i' L _ TE$T:NAQE ON+ "f/1 r
JASPER. Rp >
44
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k
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. Qtic.Ft?P
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al
O SepficTank I".
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SCHEDULE POOP68ED SSITE�_.PL:AN
F.
- I35i5 r
' SEWAYE."SYSTEM DESIGN
IN
B Y
L`OiCATION SEWAGE PERMIT NO.:
tOA TM . Op
VILLAGE
12
INSTA LLER'S NAME & ADDRESS
B Ul*LDE R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED `�2/ �
1
JJ O
~V.
.�_•---z,,,,_� to,.
No. Fee
_ J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ftpliLation for Misposal *pstem Construction Permit
I Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) El Complete System ❑Individual Components
Location Address or Lot No.& as p e r J?e�9N�ame,Address,an d Tel.No.
Assessor's Map/Parcel `G�j, cj ' Q r .e
Installer's Name,Address,and Tel.No 4/7770/ esign ' Name,Address,and Tel.No.
?j9vCa r ti we Lor 's S o h
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building !/7 Q ts� No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 2 `41✓%
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 Co2oOd not to place the system in operation until a Certificate of
Compliance has been issued by this Board o
gn d Date '�40-
�—�
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No.&VE/42Date Issued
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
Z PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
application for 3Disposal-& stem Construction permit
1 p
Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.
O er's Name,Address,and Tel.No,
Assessor's Map/Parcel Ll — -.�j j U G r f V0 -e
` Installer's Name,Address,and Tel. 77 DesigneA Name,Address,and Tel.No.
X�G c f ✓1 �'�G3 �'-P e
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building /�eC)de tiT No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) gpd Design flow provided gpd
Plan Date Number of sheets Revision Date
Title -
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Coe d not to place the system in operation until a Certificate of
Compliance has been issued by this Board of aI
gn d Date
—� —�
Application Approved by e2J Date
Application Disapproved by Y v Date
for the following reasons
1
Permit No.Nzff_42Date Issued `.
-------------------------------------------------�; --------------------------- - , ------------------------------------
THE�COMMONWEALTHOF MASSACHUSETTS
BA ABLE,MASSACHUSETTS
urtlfiraff of Compliance
THIS IS TOCE CERTIFY,that the On-site Sewage Disposal system Constructed.(! ) Repaired( ) -Upgraded(Y )
Abandoned( )by ( o w)S E
X C'G
at q I G S Deg" (Rot has been construe a _ ace e
with the provisions of Title 5 and the for Disposal System Construction Permit No
Installer� s E Y �'� � "f i V►Gp Designer
#bedrooms Approved design flow,' ,r _? 1 y - , gpd
The issuance of is permit shall not be construed as a guarantee that the system wi 1 ctio signed.
Date 16 Inspector n r
-------------- --------
No. // ;` Fee
THE COMMONWEALTH OF MASSACHUSETTS:
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
]Disposal &- pstem Construction Vermit
Permission is hereby granted to Construct( ) Repair X
Upgrad ) Abandon( )
System located at G l 2 Fl / ,L,,.�
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.
i Provided:f on4,kucti n must be completed within three years of the date of this permit.
Date Approved by
f F32/04/2010/TH4 02:42 Fri FAX No. P. 001
Town of Barnstable
` T " Regulatory Services
(� Richard"V, Scali, Interim Director
l
MAW Public Health Division
�#D ' Thomas McKean,Director
200 Main Street,Hyannis,MA,02601
Office, 509-862-4644 Fax: .509-740-6304
Installer&Designer Certification Form
Date: SewaKW ge Permit# Assessor's MaplParcel
Designer: &I Installer:
Address: Address:
On date} (install was issued a permit to install a
r�er,)
septic system at Iw,/, based on a design drown bv-
address)
dated 11247 f(o
(desier) �f
I certifythat tie sit llll stem r of rented above a ep y v 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 system referenced above Was installed with major changes (i.e.
greater than 101 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 eorstruei a with the terms
of theroval letters(if applicable)
fl (Installer's Signature) 4 1�
Designer's Signature) —(Affm Designer E p• ere)
PLEASE RETURN TO BARN ABLE PUBLIC HEALTfr DIVISXON. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARINST.A.ULE PUBLIC HEALTH DMSION.
THANK YOU.
QASeptic\Designer CerEifieation Four Etev 8-14-13.doo
I
Town of Barnstable. P#
Department of Regulatory Services
�ar�B� :' • • Public Health Division race
i
,6 tee$ 200 Main Street,Hyannis MA 02601 j
1
Date Scheduled Ti. Fee Pd.
i
oil Suitahility Assessm'eni t,fog- Seyv e D osal
Performed By. Oa COAA AA Witnessed By: U'
j
LOCATION & GENERAL INFORMATION
Location Address J ��.� Owner's Name
Address /+71"F
Assessor's Map/P4rcel: !) 0 29 I Engineer's Name
/ So 8' 360 —3
NEW CON REPAIR
REPAIR Telephone# 3 1
Land Use ���a1l�+��'L Slopes(%) '/• Surface Stones
Distances from: Open Water Body rV ft Possible Wee Area ��rb ft Drinking Water Well ���G ft
j
btainage Way �D O ft Prope..rty Line �lO ft Other ft
SKETCH:($treet name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
�t�s ePa l V P14-7
1<Z7l)b
i
;
F j
• I 1/� •
Parent material(gedlOgic) AS')/ Depth to Bedrock
nding Water in Hole:' /NII i Weeping from Pit FACe
Depth to Groundwater.
Estimated Seasonal iRigh GroundwaterfA--
D&E ATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to 5011 m0tLfs7 it
Depth toiweeping from side of obs.hole: i in. Groundwater Adjustment
Index Well#� Reading Date: Index Well level Act.{:IetOr,, _4
Adj.froundwaterLevel,,
i
PERCOLATION TEST . Dater. Tit-.
Observation / I Time at 0" -. --
Hole#
,4' , lGi./� Time at G"
^�,
Depth of Perc
.-•-..------
Time(9„-611
Start Pre-soak Time.@
End Pre-soak
L 2ti�
Rate MinJInch
X Additional Testing Needed(Y/N)
Site Suitability Assessment: Site Passed Site Failed;
Original:.Public k.e$Ith Division Observation Hole Data To B e Completed on Back--
***If percola#6n testis to be condiacted within 1.00' of wetland,-you must first notify the
rior to beginning.
Barnstable C41iservation Division at least one (1)wedk p
�d �s
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
.Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders.
Consistenc %Gravel
14
I-f"-44'' 14 and G1s�
4 "-Of c
DEEP OBSERVATION HOLE LOG Hole# 7--
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
N . y q►2t AK�
441 1i4G�'' k14
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,3'o Gravel
DEEP OBSERVATION HOLE LOG Hole# tJ14
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency. ra 1
Flood Insurance Rate Map:
Above 500 year flood boundary No Yes
Within 500 year boundary No Yes .
Within 100 year flood boundary No— Yes
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 pervi s material7
Certification
I certify that on 16 A 9 (date)I have passed the soil evaluator examination approved by the
Department of Enviro mental Protection and that the above analysis was performed by me consistent with
the required tr ' 'ngg,^expertise and experience described in 3:10 CMR 15.017.
Signature V Date �7
Q:\.SEPTIC\PERCFORM.DOC
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
—
every page. Cityrrown State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important: A. General_ Information
When filling out
forms on the I computer,use 1. Inspector: U!
only the tab key
to move your Patrick M. O'Connell
cursor-do not Name of Inspector
use the return
key. Septic Inspection Services Co.
Company Name
189 Cammett Road
Company Address
Marstons Mills MA 02648
Citylrown State Zip Code
508.428.1779 SI 12855
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000). The system:
❑ Passes ❑ Conditionally Passes ® Fails
❑ Needs Further'Evaluation by the Local Approving Authority
cz-,�lk-�,()@
April 12, 2011 Job# 11-52
In pector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time. This inspection does not address how the system will perform in the future under
the same or different conditions of use.
l5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
� l
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage bisposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
❑ :I have not found.any information which i1ndirates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
every page. City/Town State Zip Code Date of Inspection
B. Certifications (cont.)
B) System Conditionally Passes (cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier, if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply;.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well".
Method used to determine distance:
This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No" to each of the following for all inspections:
Yes No
® El clogged
of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than day flow
t5ins•09/08 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 4 of 17
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills _MA 02648 April 12, 2011
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspoo! or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply
well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory, for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
® ❑ The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10;000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
El ❑F 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
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
15ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
r Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
every page. Cityrrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
Yes No
® ❑ Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
® ❑ Has the system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® El available
as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
® ❑ Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System (SAS)on the site has
been determined based on:
® ❑ Existing information. For example,.a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
w 69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
every page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents:
4
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
Sump pump? ❑ Yes ® No
Currently
Last date of occupancy: Occupied.
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow (seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title .5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12. 2011
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: Tank pumped 12/14/01 and 18 months ago.
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑- Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract (to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•09108 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known) and source of information:
30 Years
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 2
feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Septic Tank (locate on site plan):
1'
Depth below grade: feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 8.5' long x 5.2'wide- 1000 gal.
3"
Sludge depth:
15ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
every page. CityrFown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank (cont)
Distance from top of sludge to bottom of outlet tee or baffle
27"
2 Scum thickness
Distance from top of scum to top of outlet tee or baffle 6
Distance from bottom of scum to bottom of outlet tee or baffle
12"
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.):
Liquid level was found at bottom ofo outlet invert and baffles were intact. Observed solids on top of
baffle indicating hydraulic failure.
Grease Trap.(locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
15ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is required for Marstons Mills MA 02648 April 12, 2011
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of co-istruction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No
t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is Marstons Mills MA 02648 April 12, 2011
required for
every page. City(Town State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert Full
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.):
liquid level was found over pipes and had been to top of riser.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
15ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
F Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is Marstons Mills MA 02648 April 12, 2011
required for
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number:
One 6x6 pit.
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Area of SAS was probed, found soils to be saturated, system is in hydraulic failure. Leaching pit has
no effective leaching and is surcharged into d-box.
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
!Sins•09108 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is Marstons Mills MA 02648 April 12 2011
required for
State Zip Code Date of Inspection
every page. City/Town
D. System Information (cont.)
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
t5ins•09/08
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr _ --
Owner Owner's Name
information is Marstons Mills _ NSA.____ 02648__ April 12, 2011
required for ----- — State Zip Code Date of Inspection
every page. Cityrrown
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate
where public water supply enters the building. Check one of the boxes below:
❑ hand-sketch in the area below
❑ drawinq attached separately
36
Tank cover under 53 _
hatch in deck.
s
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is Marstons Mills MA 02648 April 12, 2011
required for
every page. Cityrrown State Zip Code Date of Inspection
D. System Infotmation (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
Estimated depth to high round water: N/A
P 9 9 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:
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•09/08 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
r Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
69 Jasper Road
Property Address
Douglas Tarr
Owner Owner's Name
information is Marstons Mills MA 02648 April 12, 2011
required for State Zip Code Date of Inspection
every page. City/Town
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17
t5ins-09/08
F
No.. ...........Y...... ss..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..._.....sl�a .-....... oF.-.-.. r - �i ..........................................
Applira tiun for UiupuuFal Workii Tantrnr#iun Errant
Application is hereby made for a Permit to Construct (vj or Repair ( ) an Individual Sewage Disposal
System at: 1.
41...... ....... 4 9 ---
f L anon Address ` or Lot No.
Owner Address
a ....................................Z... �._1� ................................. ..........................:� �.A.....................................................
Installer Address
d Type of Building Size Lot__W.400.........Sq. feet
U Dwelling—No. of Bedrooms--- _______________________________Expansion Attic ( ) Garbage GrinderPL4 (�)�
Other—Type of Building No. of persons____________________________ Showers — Cafeteria
Other fixtures ..................................
W Design Flow..............1,l ..................... pert6mi, per day. Total daily flow...............;-3�._-
___.._._.dons.
WSeptic Tank—Liquid capacityl-60D..gallons Length_/�__.a ._. Width--- Diameter________________ Depth____" ".--
x Disposal Trench—No..................:.. Width_o___._ii.._.___._._ Total Length.._._____y__.__r__ Total leaching area....................sq. ft.
Seepage Pit No-----i.............. Diameter...JD---0___._. Depth below inlet...�_'�_ .... Total leaching area...2.47_...sq. ft.
Z Other Distribution box (� Dosing tank
Percolation Test Results Performed b- ............................ Date__��?
aTest Pit No. 1 la_3_..____minutes per inch Depth of Test Pit......48....... Depth to ground water../VIZ............
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to grou . ......................
....----ic ...................••----•-•--•---•-•---•-----•------ .........o _P�Sk�.oE�Ytgs y-•-----....._.
O Description of Soil-••••• - `�� �9�------ - --------
U ........... .. _•------ - •••-- :..- .._ .�..�.. �......_ ��.._._—, WICK- -m -•------•
B.
LN
W -----••••----------------•...----•-•-•-•-•-••..._._..------•-....---------•-••-••••••••-•---•--•--•---...--•--•------.._._...._----•-----•--•-•••-••• v -----CHAPMAN—' -y ---•------
UNature of Repairs or Alterations—Answer when applicable______________________________________________ _A ._ - 1,--- ---------•
�Gf - ��o. -----------
Agreement: ,� N
The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sys rdance with
the provisions of iIT?rs 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.
jne .. --------------------------------------------------------------- ------ ----------------- ----
Date
Application Approved BY -- g - �P
.w Date
Application Disapproved for the following reasons:------•-----•----------•----------------------------------•--------------------------.._._..•-•-••-•--•••••-_.
.............................................................................................................................................................................................------_-•---
Date
Permit No.--••••-_____---- ...---------•-...----•--- Issued.... (......:bz 2
Date
No.- .04 ;2 --- FEs... ...._....�"...._
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........../own._...............OF......�„ i l"/7�i1G2 _/�------------....--••---------
Applirtttiun for Diipuutt1 Works Touotrnrtiun ramit
Application is hereby made for a Permit to Construct (i./) or Repair ( ) an Individual Sewage Disposal
System at: A 'J / q
f � .lG.r...jq ./................................... ............ .............................................................
Location Address or Lot No.
.; r .�. � ....... . ? ................9.t_jq.)(1Au-A..................................................
Owner Address
a ................................... JV................................. ...........................5 A.&- ......................................................
Installer Address
dType of Building Size Lot_20,?1� ......... feet
1-4 U Dwelling—No. of Bedrooms......... _______________________________Expansion Attic ( ) Garbage Grinder (r►-�-
14 Other—Type of Building No. of ersons____________________________ Showers — Cafeteria
QI yP g ------------------•--------- P ( ) ( )
0.1 Other fixtures _____••••--••••••••••••••-----•--..._
W Design Flow..............//jO......................gallons pets `Ow per day. Total daily flow...............33--................gallons.
WSeptic Tank—Liquid capacity/5'M__gallons Length4'0.=__V.'=___ Width_. Q."_. Diameter________________ Depth_4'_Q.._..
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No----_g............... Diameter...j0-D...... Depth below inlet... ,-F�."_..... Total leaching area._ 67....sq. ft.
Z Other Distribution box (<) Dosing tank ( )
a Percolation Test Results•' Performed by.�yC�!ftlYt�f't _ t�rlS�___________________________ Date.Jaa.11,1918........
1 Test Pit No. 1.11-l'......minutes per inch Depth of Test Pit______ . .._._... Depth to ground water.A.E.............
Test Pit No. 2................minutes per'. inch Depth of Test Pit.................... Depth to ground water........................
t� .....................
O Description of Soil...... -•_••-••••-- �.?.�........Mgsrq° ....._•....._..
---- - - ---------
x
.+� ...+.: - -:...�q-- -----------mar --------------
UNature of Repairs or Alterations=Answer when applicable______________________________ �__•-•CHAPNtAN•••
_._.... o _ N 7654
____________________________________________________________________________________________________________________________ .P.._. _
Agreement: °
The undersigned agrees to install the aforedescribed Individual Sewage Disposal ordance with
the provisions of TITI:E 5 of the State Sanitary Code— The undersigned further agrees not o place the system in
operation until a Certificate of Compliance has been sued by the board of health.
ned...... :.. . .................................................... .........................._....
Date
Application Approved By....... 4-•••-••--•-•............... .•--•�`" ' 1-��
• Date
Application Disapproved for the following reasons:_______•___________________________________________________________•____________..__....._..____.......__--•___
..........................................•-•---------------•---•----..........--._....----•--------------••--•-•--•----•-••-•--••••••••-•-••--•••••-•••-•••--•--•--••-•--•---•-•-••-•-•--••••-._.....--
Date
Permit No................................
.......................•--..._....--------------------- Issued........................................................
Date,`
t
THE COMMONWEALTH OF MASSACHUSETTS
`BOARD JO HEALTH
............n. tLt...G.i fi'.......OF...... . ...........
....
..........................
��ertif irtttle of (�unt��ittnr�e
THIS , T/i C RTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by - �f d= ............................... ---?�d_/'I-"..................................................................................................
Installer
has been installed in accordance with the provisions of T1G' , 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No ____!*k_f-------------------- dated------ :r?_>G.' , .................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..........................................-------------------------------------- Inspector....................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD O HEALTH
No. 2. ..... FEE... ................
Dilionsal urku �antrnrtion pamit
Permission is hereby granted................... t ®•f-•. -!•-'-••-•-•--•----•-•••-••-•••.....................................•••••--........._..--_-------_-.
to Construct or Repair ( ) an Individual Sewage Disposal System
at No................
�•&'=-----...7A-Sv0*,h,-ft-------A—t}------------------- r l t. ._. ............................................................
Street j! ��,
as shown on the application for Disposal Works Construction Perm' No_____ ___________ Dated....�.'__.:_.______.....__._____.-------
................ GLy' i��_._ - ------------------------------
Board
-•_______________________•_--__•_ Board of Health
DATE.--•-•----------------------•---•--------------
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS -
atthe_51tmc
airs i7U8� ��E�St 'Yc�( , %s /n�- ✓
tinder �F• .mow•. ,N
or� rt�r15 1Ki"ih. he Za»inj Leachaaelre�nrd �98sF.(h' 9 9 TEST sY °i�'.�`""•"' i
�>�' nsta61e1Mass. „ l nvr, = 2474ec . w„- ,.,.
TOWN INSPECIt »�Y.. +�
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SEWAGE.: SYSTEM DESIGN
e cOTl!` TANK . . I N
r isSbZlC7`l tlt' S W/t
17WhJa/A!ldSca ey Iot �taG.``Iti1Tts 6�f /n+;
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PROPOSED 3ITE PLAN
SOIL LOG
. �I�kIUJ.Y��1Jntif`�A[bviiiavdi �wVnW/A/•Ld�u,c
2';.PEAS;ONE -.LOAM B FILL 12 WAX. /
'-(.[,Ovi� I.VM l�'1••?
4%.1. DI$T. 1 . ' o` o� °pel
/O'MIN. 1500 � 24 MIN. .' 1.0.00— GAL. a o&I - _ v. .zl b
GAL.. I i .,°- PRECAST OR e °°e' I ;.g,vr.o� 4
SEPTIC 6'1/ ,, °. BLOCK ° o r e�^9• �30•0
TANK I,'• ° SEEPAGE PIT ° so
SAY,
189 $.F
°° eece �1�s 795F 0 p I A
I° ;° oo. rOfi! i7SF. n 0.'01
20 MINIMUM �:° °
FOUNDATION I �., c
I d V2 .I WASHED :STONE v,1a;rel*
I here cer�;� fhaf fl e�bw fk � shown
he►l on ryas locafed ran xkal fi�,/d.5�v0y I o ,. '��t+�; �ti►T� d 4
on Lt,20,1 77o7p,d:gr�r�ren� wJtfz. he Zonlny i ame/.Wre�r+are t B��:(w,thgar;6a�agrineas'er TEST BY / v >L�,•J<oas.N �. . H•r,Nf
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Mgss�C' I TEST:MADE ON
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a. ...IIAy JL,�:�.�t:y,,rHt I•,;,,"•i �r��w ......�.-.�..�...-! � J' Q O ' ., "�`'a
•..........,;y..,.r+ 9 i..�wnen,r,.•w, 1../ +...«.�+.,r.:,.•rrrwa,.r...e.,...e -._..�+,.�,.__.....-..__�,a�.' _.. _ ...�
ELEVATION SCHEDULE �.
PROPOSED SITE PLAN
,,.
L, . INV.. ,AT' FOUN XTIO.N
13511 s
SEWAGE.' SYSTEM DESIGN
2. .1Nv: INTO SEPTIC TANK = > IN
3. I NV. OUT OF SEPTIC TANK _'. ,�!'°!�� � Gl � �rJ 1 L.LS ASS•
4., INV. INTO .DISTRIBUTION BOX. J SCALE: Ill='� a ane 1$ , 19-m
At
5: 1 NV. OUT OF. DISTRIBUTION BOX
6: INV INTO SEEPAGE PIT CAPE ':COD SURVEY CONSULTANTS
ROUTE 132
7. BOTTOM OF PIT HYANNI.S,.MASS.
- - A DIVISION BOSTON SURVEY CO�NSULTANTB, INC. _
8. $9TTOM OF STONE LAYER. _
LEGEND x MARSTONS MILLS
PROPOSED CONTOUR 97.4
® PROPOSED SPOT GRADE
--98 -- EXISTING CONTOUR �Q /
+ 96.52 EXISTING SPOT GRADE / RACE, LANE
W— EXISTING WATER SERVICE LOC
�
TEST PIT
k
SCALE: 1"=20'
s c- 0 ,
"- TH-1 TH-2 /e
TO
A O 5h \ 5 98.3
G
�, EXIST. ,000G LOT 469 c�
_0- _ SEPTIC TANK v LOCUS MAP
\ � O (accessible for pumping) J
LOCUS INFORMATION
x 98.7 LP � G� PLAN REF: LCP 30751-1 SH.3
x 98.3 TITLE REF: CTF# 113779
PARCEL
LOT 468ky16 Q��'`� ZONING: I RFMAP 47 PAR. 29
' FLOOD ZONE: "X"
� COMMUNITY PANEL: 25001CO541J DATED:07/16/14
SEPTIC SYSTEM
_ --s REPAIR PLAN
LOCATED AT:
#6 9 69 JASPER- ROAD
s� \
x98.6 '� MARSTONS MILLS, MA.
V, B.M.= 100.0 I TOF= 100.7 ,
'' COR BLHD ` �� PREPARED FOR
s� �°� _ `�,,, G DOUGLAS & KATHLEEN
t.W TARR
F� 98.5 JANUARY 27, 2016
or �ss9cy
DA REN M. s
i N 1 0
LOT 467
AN I TA
MEYER & SONS, INC.
.. \ �•`� P.O. BOX 981
GRAPHIC SCALE h`��� \ EAST SANDWICH, MA. 02537.
20 0 10 20 40 so y (508)360 3311 FAX: (774)413-9468
r �Q meyerandsonsinc@gmail.com
IN FEET ) \P
1 inch = 20 ft. J SHEET 1 OF 2 J#1789
TOP NOTE: PLACE MAGNETIC MARKING TAPE OVER ALL COVERS
FOUNDATELEION BRING ALL COVERS TO WITHIN 3" OF FINISH GRADE
,(Existing) FINISHED GRADE (98.0)
100.7 �F.G.EL: 99.0 F.G.EL: 98.5 F.G. EL: 98.0
A � MAINTAIN 2% MIN SLOPE OVER LEACHING AREA
a
Q 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2"
F.G.EL: 98.28 STONE OR FILTER FABRIC
DOUBLE WASHED STONE
A 6" 4" SCH 40 PVC
" ®®IMI®- O ®®®®
A: 10 I 14 s @ S= 1% (MIN.) ®®®®®®®®®®®
TEES ARE TO BE INV.95.'40 F
:Q 4" SCH 40 PVC 2 E F. DEPTH ®®®®®®®®®®®
INV.96.95
INV.95.20 4' 2 X 8.5' 4'
GAS PROPOSED DB-3
EXISTING OUTLET BAFFLE EFFECTIVE LENGTH = 25'
.; .•. . DISTRIBUTION BOX
INV. 97.20 mt (1-120) INV. ELEV.= 94.0
EXISTING 1 ,000 GALLON SEPTIC TANK
GAS BAFFLE TO BE INSTALLED ON ����` OF Mgssq BREAKOUT
OUTLET TEE AS MANUFACTURED BY �`` D M Sys
ELEV.= 95.0 ELEV.- 95.0
TUF-TITE, ZABEL, OR EQUAL TOP CONC.
Y .. ..
NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING Q. 1140 INV. ELEV.= 94.0 •E38
12
PIPE INVERTS PRIOR TO CONSTRUCTION ®®®®®
2) D-BOX SHALL BE SET LEVEL AND TRUE TO R£�/ � ®®®®®®®
GRADE ON A MECHANICALLY COMPACTED SIX Sq \P� BOTTOM EL.= 92.0 ®®®®®®®
INCH CRUSHED STONE BASE, AS SPECIFIED IN NI TAR 3.75' 5 FT. 3.75'
310 CMR 15.221(2) 1
3) REPLACE EXISTING 1,000 GALLON SEPTIC TANK SEPARATION 6.30 FT. EFFECTIVE WIDTH = 12.5'
WITH GALLON SEPTIC TANK IF FAILED, SEPTIC SYSTEM PROFILE
DAMAGEDED,, NOT H2O LOADING, OR UNDERSIZED. SOIL ABSORPTION SYSTEM (SECTION)
4) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL: 85.70
GAS BAFFLE AS REQUIRED (500 GALLON H2O LEACH CHAMBER)
GENERAL NOTES:
SOIL LOGS P#: 14935 DESIGN CRITERIA
1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL NUMBER OF BEDROOMS: 3 BEDROOOM
BOARD OF HEALTH AND THE DESIGN ENGINEER. DATE: JANUARY 19, 2016
SOIL TEXTURAL CLASS: CLASS I (0.74 GPD/SF)
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614 DESIGN PERCOLATION RATE: <2 MIN/IN
LOCAL RULES AND REGULATIONS. WITNESS: DAVE STANTON, BARNSTABLE HEALTH _
GAILY FLOW: 110 G.P.D. X 3 BR - DESIGN FLOW: 33� G.P.D.
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE TP- 1 Elev. TP-2 Depth GARBAGE GRINDER: NO (not designed for garbage grinder) , o
DESIGN ENGINEER. Elev. De Pth
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 97.70 0" 97.70 0" SEPTIC TANK: 330 gpd x 200% = 660 gpd, USE EXISTING 1,000 GAL. SEPTIC TANK
FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
FILL
ENGINEER BEFORE CONSTRUCTION CONTINUES. FILL
5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 96.95 g" 96.95 9" LEACHING AREA REQUIRED: (330) = 445.94 S.F.
6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF A LOAMY SAND A LOAMY SAND .74
1OYR 3/2
THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF tOYR 3/2 i '
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 96.54 14" 96.54 14" USE TWO (2) 500 GALLON PRECAST H2O LEACH CHAMBERS W/ 4
7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. B LOAMY SAND B LOAMY SAND STONE ON ENDS & 3.75' STONE ON SIDES: 25' L x 12.5' W x 2'D
8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 1OYR 6/8 1OYR 6/8 BOTTOM AREA: 25 x 12.5= 312.5 SF
TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR.
94.03 44" 94.03 44"
9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE C � C SIDE AREA: (25 + 12.5) X 2 X 2 = 150 SF
THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
CONSTRUCTION. SANID ��/ Mao TOTAL SQUARE FEET PROVIDED = 462 vs. 445.94 REQ'D
10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5.
2.5Y 6/4 � 2.5Y 6/4 DESIGN FLOW PROVIDED: 0.74(462 S.F.) = 342.25 G.P.D. vs. 330 G.P.D. req'd
11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION
12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 85.70 144" 85.70 144" PROPOSED SEPTIC SYSTEM UPGRADE PLAN
AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY
13. NO PRIVATE WELLS WITHIN 100' OF PROPOSED LEACHING. PERC RATE <2 MIN/IN. (-Cl- HORIZON) 69 JASPER ROAD, M. MILLS, MA
14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. NO GROUNDWATER OBSERVED
15. ALL PIPING TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPECIFIED) Prepared for: Tarr
Engineering and Survey by: SCALE DRAWN DATE
• 1, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 MEYER&SONS,INC. N.T.S. DMM 01/27/16
to conduct soil evaluations and that the above analysis has been performed b me consistent with the PO BOX 961
P y
requirements of 310 CMR 15.017. I further certify that 1 have passed the Soil Evol. Exam in October, 1999. E4STSANDw1CH,MA02537 REV. DATE CHECKED SHEET NO.
508-362-2922 DMM 2 o f 2
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ELEVATION SCHEDULE
PROPOSED SITE PLAN
1. INV. AT FOUNDATION = a
SEWAGE SYSTEM DESISRI
2. INV. INTO SEPTIC TANK = 135:1 IN
3. INV. OUT OF SEPTIC TANK _ 135,5[� 14A (.IN,, �LLS
1t
4. INV. INTO DISTRIBUTION BOX SCALE: 111=Zr Jan > 19-11a k
5. INV. OUT OF DISTRIBUTION BOX •
+ 6. INV INTO SEEPAGE PIT = 134° 3 CAPE COD SURVEY CONSULTANTS
x ROUTE 132
7" BOTTOM OF PIT t2S. HYANNIS,MASS. ,
A DIVISION BOSTON SURVEY CONSULTANTS, INC. '
B. BOTTOM OF STONE- LA•Y•Y-ER =