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0105 JONES ROAD - Health
105 0JONES MARSTONS MILLS , ,A _947�045_LOT 452 h r� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,..'' 105 Jones Road Property Address Deborah Packard Owner Owner's Name ; information is arsons Mills, Ma. required for every M 02648 4/23/2015 � page. City/Town State Zip Code Date of Inspection,'q, ram~. Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector key to move your cursor-do not Raymond Dumas use the return Name of Inspector key. Dumas Landscape Const. t A Company Name 564 Old Stage Rd. Company Address Centerville Ma. 02632 Cityrrown State 508-778-0249 S1437 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 4/23/2015 Inspe is si nature 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. 109 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 105 Jones Road M Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: 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•3113 Title 5 Official hmpection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page. City/town State Zip Code Date-of Inspection B. Certification (cont.) ❑ Pump Chamber pumpstalarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cunt.): ❑ 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-3113 Tile 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 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than Y day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ 0 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 well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components,excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 I t5ins•3113 Title 5 Offictal Inspection Forth:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page. CitylTown State Zip Code Date of Inspection D. System Information Description: 1000 gallon tank, D-box and 5-500 gallon chambers as per plan on record datedl1/6/2000 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: 2014 54000 gallons 2013 64000 gallons Sump pump? ❑ Yes ® No Last date of occupancy: Occupied now Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 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 105 Jones Road Property Address Deborah Packard Owner Owner's Name information.is required for every Marstons Mills, Ma. 02648 4/23/2015 page. City/Town 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: No Pump records available from Barnstable Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 f Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 105 Jones Road Property Address Deborah Packard Owner Owner's Name information requ'ired for every Marstons Mills, Ma. 02648 4/23/2015 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: System upgrade Nov. 2000 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 34 inches below top of foundation feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 20 ft from pipe feet Comments (on condition of joints,venting, evidence of leakage, etc.): all good Septic Tank(locate on site plan): Depth below grade: 12 inches 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: 1000 gallon Sludge depth: 6 inches t5ins•3113 Title 5 Official Uspedion Form:Subsurface Sewage Disposal System-Page 9 of 17 r- Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System► Form -Not for Voluntary Assessments 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is Marston Mills, Ma. 02648 4/23/2015 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cont) Distance from top 9 of sludge to bottom of outlet tee or baffle 34 inches Scum thickness 6 inches Distance from top of scum to top of outlet tee or baffle 4 inches Distance from bottom of scum to bottom of outlet tee or baffle 14 inches How were dimensions determined? dip stick ruler Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I recommend pump soon and every 2-3 years Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Tdle 5 Official Inspedion 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 y 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 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.): Inlet and outlet tees good no evidence of leakage Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora kv, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is Marstons Mills Ma. 02648 4/23/2015 required for every page_ Citylrown 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 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 Level, no carryover or evidence of leakage liquid at bottom of outlet inverts inspected by camera from outlet tee on septic tank Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan,excavation not required): If SAS not located, explain why: as per plans on record t5ins•3/13 Title 5 Official Inspection Form:,Subsurface Sewage Disposal System•Page 12 of 17 f Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page- City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5-500 gallon chambers ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Precast Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): All good Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ® No t5ins•3113 Tdle 5 Official Inspection Forth: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 y 105 Jones Road Property Address Deborah Packard Owner Owner's Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cost.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): all good Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Fonn:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth -Not for Voluntary Assessments wM ,. 105 Jones Road Property Address Deborah Packard Owner Owners Name information is required for every Marstons Mills, Ma. 02648 4/23/2015 page. City/Town State Zip Code Date of Inspection D. System Information (coat.) . Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Asa Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments I-J" F105 Jones Road Property Address Deborah Packard Owner Owner's Name information is Marstons Mills, Ma. 02648 4/23/2015 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 50 ft 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: 11/6/2015 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: Plans on record no water at ten ft as per plan ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: from plan datedl 1/6/2015 Index well sdw 253 adj. level 55.55 Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3113 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 105 Jones Road Property Address Deborah Packard Owner Owner's Name information' required Marstons Mills, Ma. 02648 4/23/2015 page, Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Assessing As-Built Cards http://www.to%vnofbamstable.us[Assessing(HMdisplayasp?ntap... T'OR2,TnOF�BARNS£ABLE LOCAL /05 TPA e S SEWAGE# 7le' *7,9-f S 14/1%/5 �ASSMOR'S MAP&LOTkZ--&r rS INSTALLER'S NAW E&PHONE NO.IP, .d s fIZ-a ZrP0 SEPTIC TANK CAPACITY lL�'D �Jcc.ag X,��.//r LEACHING FACILITY:(type).'r-023P TM& Ch -. (siu) r X l�X NO.OFBEDROOMS---.:K— BUILDER OR OWNER L��avrt�An/^Iel TTy PFRNIITDATE://- L—00 COMPLIANCE DATE Separation Distance Between the: Ma:nmum Adjusted Gtaundwater Table and Bottom of 14acb Facility Feet Private Wa cr Supply WeL and L=hmg Facilky (IfM wells exist on site or within 200 feu of lewbq facility) Fect Edge of Wetland ad Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by f X/�' a F.X v t�? Yr ( l t. s L of 1 4116/15 6:45 AM No. � � / Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipp iration for j0tzpo$ar *potem Com6truction 3pCrmtt Application for a Permit to Construct(V/)"Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot.No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel � �� �i� pv� po-' f Installer's Name,Address,and Tel. o. 160i_13A-O 1;,so Designer's Name,Address and Tel.No.S'D 8-8k7—S/Cj 76' 11 PO60K IS 3cr Nr{o . rhress. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Ito gallons per day. Calculated daily flow MYy gallons. Plan Date //A./QZ_ Number of sheets Revision Date Title Size of Septic Tank /00Q Type of S.A.S. 5.Ae— Pla m Description of Soil Nature of Repairs or Alterations(Answer when applicable) E .X r crz� P « Gae 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 Certifi- cate of Compliance has been issued by this Board of Health. Signed Date_/J2 7 Application Approved by Date/,Vr ;ZZrr) Application Disapproved for the following reasons Permit No. -2�,az%- _7 2 C Date Issued 9 � TOWN OF BARNSTABLE r LOCATION 49S ✓'a"ye I- SEWAGE # ©o" VILLAGE 01"S Tp;y S /1 ASSESSOR'S MAP & LOT�'7- 6 -�45 INSTALLER'S NAME&PHONE NO.1! SEPTIC TANK CAPACITY �kG I LEACHING FACILITY: (type) (size) X I� X� NO. OF BEDROOMS BUILDER OR OWNER &Z414- ,-0d Ant ZIP TTy Us/hr1�/ r PERMITDATE: COMPLIANCE DATE:- 'O/ Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well 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 a. within 300 feet of leaching facility) Feet L Furnished by E- Cam•, � �, ��, � .y o No. / b✓ °^" Fee D THE-COMMONWEALTH OF MASSACHUSETTS Entered in computer: s ' PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pprication for Misspozar 6pgtem Construction permit Application for a Permit to Construct(V)Repair( )Upgrade( )Abandon( ) ❑Complete System O Individual Components Location Address or Lot No. --q., Owner's Name,Address and Tel.No. /US" XV-14.$ QA.!h cc%A�l,!k^ A u,s y t: -0 (3'�tz C1,1,W,c.-"x Assessor's Map/Parcel A -to�` /$'501 a rt a,.\ 13c�i Inpstaller's Name,Address,and Tel o. ,Sl��'eaz-COS 3o Designer's Name,Address and Tel.No. re)7-$ ram—Iq 7,5 PO 604 t S 3 k N t-(u.,,�.�.-w.e, iyi ti s s, l qcf 20, #- !?o Type of Building: Dwelling No.of Bedrooms _ Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) { Other Fixtures Design Flow //U gallons per day. Calculated daily flow h/`/U gallons. Plan Date //lam aU Number of sheets Revision Date Title Size of Septic Tank /OOC, <;` ' Type of S.A.S. Description of Soil i Nature of Repairs or Alterations(Answer when applicable) E .X i (J.-Po" Q Y , 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 Certifi- cate of Compliance has been issued liy thnis card of Health. /� r Signed L � Q,-g. 0'. IL, Date /) 7 oZj Application Approved by _ Date " Application Disapproved for the following reasons Permit No. � �' �1 Date Issued I7" dZi'� ----------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTY,ihat the On-site Sewag Disposal stem Constructed( )Repaired( )Upgraded Abandoned( by " / �, at / � r' hasebeen constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N7, "7Yd9 dated /;;F, Installer Designer �A A— (i NO The issuance of this erg'mtsh 1 not be construed as,a guarantee that thesst i-1 fu -c s h +si ned Date Inspector . . I No Fee " Fee THE COMMONWEALTH OF MASSACHUSETTS y PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS—., Migpooar 6potem Construction hermit... Permission is hereby granted to C�o_%§tyuct( )Repair( )Up gr de System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this e it. Approved Date: � ""' b� i TOWN OF BARNSTABLE If L--OCATI'ON 495 TP Ve S 14ww' SEWAGE # LAGE/� s- �`��Sy ���� � ASSESSOR'S MAP & LOT�C/�� INSTALLER'S NAME&PHONE NO. If, SEPTIC TANK CAPACITY /*0 LEACHING FACILITY: (type) �Oyli v�i�i C�i.,��s z (size) ��X �� X NO.OF BEDROOMS__ BUILDER OR OWNER j W-,A/ 6 T>"v �✓/j?r1� PERMITDATE: COMPLIANCE DATE: 0 O/ Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r- Town of Barnstable P# Department of Health,Safety,and Environmental Services Public Health Division Date ( -42 � 367 Main Street,Hyannis MA 02601 4 eewaereeU& MAW OrE ►�� Date Scheduled Time %o�� Fee Pd. 100 Soil Suitability Assessment for Sewage Disposal Performed By: Cw ra/fin 4 . Witnessed By: LOCATION &`GENERAL INFORMATION Location Address /0j;--jV 4e,S Owner's Name A-4r>7b✓f.5 inydy Address g,sn•�r.,o.> ,5 ,A4e-Z4,~,41 oases 3. Assessor's Map/Parcel: ~P YJ, 4 v T 115' F..neineer's Name Ca/V/yam iT �Qy/ram% NEW CONSTRUCTION REPAIR _z Telephone# _jjg—fff V9 35— Land Use La w,7 Slopes(%) O-3 !%o Surface Stones f e&I Distances from: Open Water Body N/JR ft Possible Wet Area A/_�ft Drinking Water Well A**1,4 ft Drainage Way NZ19 ft Property Line 30 r ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 155,3? i •� V �1 4aa / t r'6ur � M F / Soo Parent material(geologic) i2p77r/asf� �4ii! t j -epv7bo r Depth to Bedrock N/A de rrs Depth to Groundwater: Standing Water in Hole: ,U/r¢ Weeping from Pit Face N//J Estimated Seasonal High Groundwater ✓�O ��°�` 6rDdNLluxt7�G/' Coy 7bW-Huc� DETERMINATION FOR S ASONAL HIGH WATIt'TABLP, Method Used: afDY.y�uf Depth Observed standing in obs.hole: R'J4JR in. Depth to soil mottles: in. Depth to weeping from side of obs.,hole: 6Y4 in. Groundwater Adjustment ft. Index Well#5 &I Reading Date:ry Index Well level_ .S./ Adj.factor 57:�5 Adj.Groundwater Level_070-,5— PERCOLATION TEST: Dat 4. Observation # 6 Hole# / Time av" G,"go oar Depth of Perc SS' Time at Jr ;30 V o� Start Pre-soak Time @ Time End Pre-soak i Rate Min./Inch Site Suitability Assessment: Site Passed V, Site Failed: Additional Testing Needed(Y/N) J/ `original: Public Health Division Observation Hole Data To Be Completed on Back—� Copy: Applicant DEEP OBSERVATION HOLE LOG Hole:## Depth from _ Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel) o -6 �0 4 y /0 ye'/a mil— C e q A�Y�l fie.✓ Gob/e3 'T`tl 5D/arJ C CoV�e,SasyW DEEP OBSERVATION HOLE LOG Hole#- Depth from Suii i iurizol+ i c ,I r„tor I C iil I Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° Gravel) E n ' 'DEEP.OBSERVATION MOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°o Gravel) .DEEP OBSERVATIONROLE LOG '` " Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° Gravel) Flood Insurance Rate Man: 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? �lre 5 Jf not,what is the depth of naturally occurring pervious material? 'Certification I certify that on oc7, /995 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature _ __� _ Date /J�oo LOCATION , SEWAGE PERMIT NO. - VILLAGE INSTA LLER'S NAME & ADDRESS BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED �� 7 � �` ! \ ,�f �� � � � �' �'�� �' �, `� � . �-� {`_� yam` � � �, �� � r G� FEB -:?�.� No........... . .. ......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN......O F.........BARNS TAB LF Appliratinn for Disposal Works Tonstrnrtion Prrmit Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal System at: Jones Road, Marston Mills Lot 452 .....---•--•-•--................................................................................. --•--•---••••------•--•--•----•---..........-•----•-••-----.................................---••- Location-Address or t No. : ............. -� ........... _l`1.111.-'.1h.!.5..�'....�c7f?�.�.._.... f!1�c�1 ................................................ W pw�e;� ��Address v'y( , a ....•••.............•---.....--- .....1 ........................................ ............................................. ................................................. Installer Address dType of Building A),0iL sA. r-T , no A Size Lot.....2 2 t 9.5..1.......Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building .... No. of persons............................ Showers — Cafeteria a Other fixtures ------------------------------------------••-- W Design Flow.....................55......._._....._..gallons per person per day. Total daily flow..................`�:330...............gallons. WSeptic Tank—Liquid capacity.lQ.Q Qgallons Length$..'..-6"... Width.'.-.1.Q"Diameter--------\�..._. Depth5.'..-.4..... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No......... Diameter.........1Q...... Depth below inlet........6.......... Total leaching area---2.6.7.......sq. ft. Z Other Distribution box (X) Dosing tank ( ) Percolation Test Results Performed by..Cape...GS2d....S..Ur.vey..CC?x1aLi1,tantDate...April...2.6......1.9-78 aTest Pit No. 1...... ........minutes per inch Depth of Test Pit......12........ Depth,to ground water-----n.QZ1p.......... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' •-••••••-•--••-•-------•-•-••--••-•••-•••••........................••••••--•...........----•-----•-..................................... O Description of soil........0-0 .5 wood loam-,--..0..5.:-2•,_5...subsc ,l,__•2_.5--12.t.Q..san• x •• ........ .............. ........ 9C' R01 ........................... ...................................•---•----.................---•---•------•---............--•--.......---------•-•-----•--•-••......•------- a ..........f.......... U Nature of Repairs or Alterations—Answer when applicable................................................................ sa_.:._..DA.y{©R.... y ------------•-----•------- -----------------•-----------•---•-----------------•---...............-----------•---•--•----.........--••••----•-•-•----••••--•--.. ��Ns:27_ O Agreement: i T The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in a Sd the provisions of TI ITI TIL 5 of the State Sanitary Code—The undersigned further agrees not to place the in operation until a Certificate of Compliance has been issued by the board of health. Signed �•. . •. A- Date Application Approved By.......... y 1 •. .. . Car ` Z _ `���� Date Application Disapproved for the following reasons--------------------------------------------------------•--------•---------........--•...---••---•........-•-•-- --•--•-•-----------------------------------------------------------------------•--------....------.......••------•••--•••-••••-••••. Date PermitNo......................................................... Issued........................................ ...... Date C J No....... Fim.......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN.....0 F BARNSTABLE ... ...................... ............... ......!.......................................................................... Applirafton for Disposal Works Tonstrurtion "trutit Application is hereby made for a Permit to Construct (X ) or,.Repair an Individual Sewage!rDisposal �system at: T-t Jones Road, Marston Mills Lot 452 ....................................... I.................................. ..............................................1WR............................................ Location-Address or 0 ................................................. ............. i CRv4; j V-r Address .............................Y....... ....�WXC.r......................................... ................................ ............................................... % )C/ Address Type of Building fkyllij) - 54.L 71� 1> Size Lot.....22,95-7......Sq. feet U <� Dwelling—No. 0 edrooms .... .... ... Garbage Grinder.....................Expansion Attic ( ) 44 Other—Type of Building ............................ No. of persons........................_... Showers Cafeteria 134 Other fixtures ......................................................I............................. ............................................... C4 0�,;�_� ---------------- --- Design Flow............ .......5-5..................gall er person per day. Total daily flow......................33.0...............gallons. 9 Septic Tank—Liquid capacity.1.0-0.0.gallofis Length3°.-.6...... Widths.'._,jG!!Diameter................ Depth5l.-V... Disposal Trench—No..................... Width............._...... Total Length..................... Total leaching.Aerea....................sq. f t. Seepage Pit No..*..... ------------ Diameter........1.0...... Depth below inlet.......6.1........ Total leaching area..26.7.......sq. ft. Z Other Distribution box (X Dosing tank Percolation Test Results Performed by.Cap.e..Cad...S"Urvey...Ccn�s.ultanti)ate..April'---26.,.-..1.9-7.8 Test- Pit No. I.....R........minutes,per inch Depth of Test Pit......12........ Depth to ground water....norIP......... 44 Test Pit No. 2................minutes per inch Depth of Test Pit............._..._.. Depth to ground water........................ ...6.... ....................................................................... 0 Description of Soil........0 W1� .........?�..... ....Q_.5=Z_5 ................ ................................................................................................................................................................. ................. U W - - ROBERT yus ................. ..............................................................................................................................w................... . ..... .......... ......... U Nature of Repairs or Alterations—Answer when applicable.......................................................11.......... � DAYt --- ..............................................................................................................................................................I..... .... .... _�2 3 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in a L the provisions of TI TILE 5 of the State Sanitary Code—The undersigned further agrees not to place t operation until a Certificate of Compliance has been issued by the board of health. aSign .4 . . ..................................... ................................ Date .... ..... Application Approved By......................................................................... ..................... ........7........ Date Application Disapproved for the following reasons:................................................................................................................ .........................................................................................................................................................................7............................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ '.. :::....OF..... ...... .............................. �rr#ifirtt#r of f�nm�littnrr - THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (k-) or Repaired by.........................................A.......- ................................................................................................................................... Installer at................................ Z)...............;-"N e7.� ;-y _j.... ...............-j)...........A4.... .. ............................. r of T� Sanitary Cpde as 4-scrib d i th has been installed in accordance with the provisions of e State Sa 't !D (I in e 0� application for Disposal Works Construction Permit No .... .... ------- .... dated--- ....................... ----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL4UNCTION SATISFACTORY. DATE................................................................................ Inspector.....1............................................................................... THE COMMONWEALTH OF MASSACHUSETTS U91 BOARD OFAYEALTH ..... 23'ed ......... .....OF............. ........................... No.....:. FEE........................ Disposal Ends To ' tnution Orrmit Permission is hereby granted............)Z_..._37a.. ; ................................................................................... ......... to Construct or Repair an Individual Sewage Disposal System at No. . ...4-/.xt.-L............. . L,4� - . ............... ...../4------ ---------------------------------------------------- treet as shown on the application for Disposal Works Constructi rmi ................................ ......................................................... ...... ................................... 'Board of Heal DATE.......................... ................................................... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS s SOLID PVC, S=0.010 RISER TO 12" BELOWTYP. 2- LAYEROF 1/8" - 1/2" DOUBLE GRADE } ( ) WASHED STONE ABOVE GALLEYS RISER TO 12" BELOW SOIL TEST LOG DESIGN CRITERIA: GRADE (TIP.) P-9873 1 SOLID PVC, FIRST 2' TO BE LEVEL REST AT S=0.005 DEPTH HORIZON DESIGN FLOW. GRADE = EL. 100.25 4 BEDROOMS AT 110 GPD = 440 GPD 0" EXISTING SEPTIC TANK = 1,000 GALLONS -- -- -""--- NO GARBAGE DISPOSAL o o LOAMY SAND Ap TOWN WATER 2 1OYR2/2 4 5 PROVIDE INLET TEE 3. 42.5' 3, 611 SIZE OF LEACH FIELD REQUIRED: OR BAFFLE (IF S>O.OB) LOAMY SAND Bw DESIGN PERC RATE: 2 MIN/INCH PROVIDE FLOW LEVELLORS cR• sroNE crz SIDNE O YR5/6 REQ'D AREA = 44O/0.74 = 586.7 S.F. EX. SEPTIC TANK ON OUTLET PIPES ON ENW ON ENDS 25" AREA PROVIDED: PROVIDE GAS BAFFLE g MEDIUM TO AA = ((8.5'x5)+3'+3'+1) (5.2'+3'+3'+i) = 603.9 S.F. PROPOSED SEPTIC SYSTEM - PROFILE COARSE SAND EFFEC77VE LENGTH =NOT TO SCALE W/GRAVEL & Cl EFFECTIVE WIDTH= 11.2'S� FEW COBBLES NOTES FOR SEPTIC TANKS: 2.5Y6/4 50" 1. INLET TEE SHALL EXTEND A MIN. OF 10" BELOW THE FLOW LINE. 2. OUTLET TEE SHALL BE PROVIDED PER THE TABLE BELOW. MEDIUM TO COARSE C2 LIQUID DEPTH IN SEP77C TANK DEPTH OF OUTLET TEE BELOW FLOW LINE SAND 4 FEET 14 INCHES 2.5Y6/3 ESTIMATED HIGH GROUNDWATER CALCULA 77ON 5 FEET 19 INCHES (USGS/CCC METHOD) 6 FEET 24 INCHES INDEX WELL: # SOW-253 ZONE. B 7 FEET 29 INCHES 120" DATE OF READING: 9.125100 DEPTH TO GROUNDWATER: 51.15 8 FEET 34 INCHES SOIL TEST CONDUCTED ON 10/31/D0 GROUNDWATER LEVEL ADJUSTMENT.- 5.3' SO CAEST C J. UCT ED P.E. AND ACTUAL GROUNDWATER LEVEL ® SITE: EL= 50.251 WITNESSED BY BDONSTABLE B N ESTIMATED (MAX) HIGH GROUNDWATER LEVEL: EL= 55.55 SYSTEM COMPONENTS* ELEVATIONS** AGENT DONNA MIORANDI NO GROUNDWATER AT 10' (EL. 90.25) PER USGS MAP, SAS AT EL. 100.00f ABOVE MEAN SEA LEVEL 1. TOP OF FOUNDATION .......................................... 100.65 PERC RATE S2 MIN/INCH AT 43"-55" PER GROUNDWATER CONTOUR MAP (1995), G.W. AT EL. 50.00 (MSL) 100.00 - 50.00 = 50.00' TO GROUNDWATER 2. INVERT OF PIPE AT FOUNDATION ....................... 97.40 100.25 (ASSUMED GRADE AT SAS) - 50.00' = 50.25 (G.W EL.) 3. INVERT OF PIPE AT SEPTIC TANK INLET ............ 97.28 jj MIN. 3" TOPSOIL FILL (FREE OF TOPSOIL 4. INVERT OF PIPE AT SEPTIC TANK OUTLET ......... 97.11 ORGANIC MATERIAL & �\ BOULDERS, IN COMPLIANCE ' / REVISIONS: 5. INVERT OF PIPE AT D-BOX INLET ..................... 96.78 \ \\ WITH 310 CMR 15.255(3)), / \ \\ 6. INVERT OF PIPE AT D-BOX OUTLET .................. 96.61 // COMPACT TO 90% DRY � DENSITY 2" LAYER OF 1/8-1 2" \ 7. INLET TO 500 GALLON GALLEY ........................... 96.51 DOUBLE WASHED STONE Tl TLE: SEPTIC SYSTEM REPAIR DESIGN / •:• /\ 105 JONES ROAD, MARSTONS MILLS, MA 8. BOTTOM OF 500 GALLON GALLEY ...................... 94.51 j\ ... 7 / 819 OWNER: EDWARD & BETTY OSMUN 9. BOTTOM OF AGGREGATE ...................................... 94.51 \(>20' ABOVE MAX. ADJUSADJUSTED HJGH GROUNDWATER) /\ ' '.• 3' 5.2' 3' � /Xx\\ �F 18 SOLOMON POND RD., E. SANDWICH, MA 02537 *LOCATED ON SECTION & PROFILE ��► �� CJ ENGINEERING CAROLYN 449 ROUTE 130, SUITE 13 3/4-1 1/2" DOUBLE "BENCHMARK = TOP OF FOUNDATION - 100.65 (ASSUMED) �/ . WASHED STONE /\ J. SANDWICH,. MA 02563 SEE SHEET 1 OF 2 / •. j• DOYLE (508) 888-49 75 No.3M1 SHOULD UNSUITABLE MATERIAL BE ENCOUNTERED BELOW EL. 96.51 //\\/\\/\\/\/\�j\\/�\/\�/\\/\\/\�j\\j\\/\\/\\ 100 MAP; 47 PARCEL- IT 45 SHALL BE REMOVED & REPLACED WITH A 5' OVERDIG PER TITLE ' - L DATE: 11/06/00 SCALE: AS NOTED 5 REGULATIONS. SECTION A A NOT TO SCALE DWG CJ182/105JONES2.DWG SHEET 2 OF 2 1 i LOCUS: SITE PLAN IS FOR SEP77C SYSTEM UPGRADE ONLY AND GENERAL NOTES: SHOULD NOT BE CONSIDERED A PROPERTY LINE SURVEY OR CERTIFIED PLOT PLAN, 1. THE SYSTEM COMPONENTS AND CONSTRUCTION a ti SHALL BE 1N ACCORDANCE WITH THE STATE OF SITE CROOKED CARTWAY MASSACHUSETTS SANITARY CODE TITLE 5, AND LOCAL Sa° BOARD OF HEALTH REGULATIONS. DELL A MILLRACE FIVE 500—GALLON PRECAST CONCRETE 4 2. CONTRACTOR SHALL N077FY DIG—SAFE PRIOR TO RA L GALLEYS, $'6" X 5'2" EACH, WITH Q 3' CRUSHED STONE AROUND CONSTRUCTION AND BE RESPONSIBLE FOR ALL UNDERGROUND UTILITIES. h ELMWOOD DR. EXISTING LEACHING PIT TO BE 3. CONTRACTOR SHALL VERIFY PIPE INVERTS AND y CAMEL an. ABANDONED PER TITLE 5 LOCATION OF SYSTEM COMPONENTS PRIOR TO STOCKADE STK FND CONSTRUCTION. GRIST MILL PATH FENCE � sz 4. ELEVATIONS ARE BASED ON BENCHMARK AS SHOWN. Z FLEETvoDD RD. EXISTING D—BOX TO BE PEBBLE PATH ABANDONED PER TITLE 5 5. PIPING SHALL BE SCHEDULE 40 PVC. QQ•� EMERALD LA. TURTLEBACK RD. SA# BOSUNS ESS LA 6. SYSTEM COMPONENTS.SHALL MEET H-10 LOADING ABLE WAY STOCKADE UNLESS OTHERWISE SPECIFIED OR H-20 LOADING Q� EDA ROSE LA. �'`' FENCE UNDER DRIVEWAYS. OSE LA. •��'O ,poi i REFERENCE: BARNSTABLE REGISTRY OF DEEDS PLAN 5� � 1 ,. --� 7. CONTRACTOR SHALL WATER TEST D—BOX FOR L.C.C. 30751 1, SHEET 3 OF 4 LEVELNESS. _b �y / 8. ANY SIGNIFICANT ALTERA71ONS OF THIS DESIGN SHALL BE APPROVED IN WRITING BY THE ENGINEER AND BOARD U. OF HEALTH. 9. DISTURBED AREAS SHALL BE RETURNED TO PRE— AONSTRUCTION CONDITION, I.E. LOAM & SEED LAWN CB/DH FND \ \ LEGEND: LOT WA TER BOUNDARY c GAS DECK `�GPI E;c ELECTRIC, CABLE TV STOCKADE r TELEPHONE \ ` ��`�. Q,j,P�' 15 EXISTING/PROPOSED CONTOURS FENCE '\ �.\ / Jp �� I \ LIMITS OF OVERDIG �.\ ,�p5 10` J ------------ LIMITS OF LEACH FIELD STOCKADE TREE/ /` \ /FENCE P-9873 TEST PIT, LOCATION & NUMBER / ,o \ BULKHEAD LAMP POST �10 `.�\I , / CATCH BASIN REVISIONS: T/TLE: SEP77C SYSTEM REPAIR DESIGN 105 JOKES ROAD, MARSTONS MILLS, MA STOCKADE FENCE '$ \ \ ,�� QQ OWNER: EDWARD & BETTY OSMUN WITH GATE \ \ \ QP �d 18 SOLOMON POND RD., E. SANDWICH, MA 02539 FENICE RE Of CJ ENGINEERING CAROLYN 449 ROUTE 130, SUITE J. SANDWICH MA 13 02563 0 30 60 ,O KYLE (508) 888-4975 No.34531 MAP: 47 PARCEL: 45 o Gf E�CB/DH FND I �E SCALE: 1 30' 10�A ����'�` ` DATE: 11106100 SCALE: AS SHOWN "= DWG NO.:CJ182/105JONESI.DWG SHEET 1 OF 2 .SOIL LOG ► >�UICR\VAnr� Kar/I/s.c�i�Uptyn �0yirT x } je 2••.PEASTONE LOAM & FILL——- T�2°NlAr%T�s f tJ'gp �- Ts t ° 0 0 .So. /z?Z 1� DIS T. BOX I.° .° ,• °0 /d�IN. 1000 O24"MOIN.a ° a pP.AG �Il•Z s I° . ° 1000— GAL. a oo� T�sr GAL. I o PRECAST OR SEPTIC 6 1� o. ° BLOCK °a 0 0( ys TANK l 14 . o . SEEPAGE PIT I • i� it,. • ° o ° 0 I CSG EL �. poo ° 0 ° 20' MINIMUM oo &° FOUNDATION 1 % WASHED STONE ' ; ELEVATION SKETCH ; r` 10'. PtpC. RATE s ��-� z�./,.f,I�C/✓ SCALE: 1"= 4' TEST BY crr✓.!>�-��/✓P��c TOWN INSPECTOR: %re-jefeLn7Z " BACKHOE OPERATOR : #t TEST MADE ON :-- ' ., �• RCSE -7 1 V LEACH I KI G � SPIT ` 3 OUT T ! -�• '�• U1ST'TZ1�'JS'iOh4 BOX"'' �10000 GAS — ' -s c Gt*d`. e�.r�..��/ Tit► T ( ! SUPTX.TA Ai . . 1AI ,•s1`+C.'7`V A'3�.. tw""'.�a-..tas •.�(1 4CG/�'1'' Gi/V j ` V, a-7'0 �-.�►'�- �`ca�..vcs 3Y- .,e'!�t+�S �� 3 �SE,pt a� �i►r4C" ?ea's�.7�✓ �ar�?' ��,�.es.�/st,�sc�.�f f '�\ faW�:`I.-t N C� � - w '' 1 ! IZ9. 2 DIHSiGN4 FLOW * 3 Bopm x i to 6 LIB /DAy=330 Gat-/DAy LeACNING ApEA. CAPACITY: > 188.a x 23 cJ.ISFI DAY 4•�1{,Al�/DAY $If�WAt- .• f � , TTGM 78•Soc 1 or, i�DR�- 78_5 j4T A,l_ LE'AC H I N(n CAP, GAJ.l DAY r . . - �` ���� �► c; t�a ELEVATION SCHEDULE t31 N PROPOSED SITE PLAN OBE I. INV. AT FOUNDATION or ROBERT °yam SEWAGE SYSTEM xDESIGN ;'�+ DAYLOR Ll 2. 'INV. INTO S.EPTIC TANK = � � F, I N t No, 201CIB r- ' 1c -.1 cc 4 y c� DAYLOR \r�ST;P/jam 3. 1 NV. OUT OF SEPTIC TANK = 128. N: 2174J t' •� .� \�, .Q mac); r.•Y'.e�S7-ra--lam ,���G$ r:.✓.•°�".S' �J �tl�.')�'�• : 4. INV. INTO DISTRIBUTION BOX = LF nG SCALE I"==" 'i-�.` , 19 5. INV. OUT OF DISTRIBUTION BOX = 27 q C 6. 11jV INTO SEEPAGE PIT CAPE COD SURVEY,; CONSULTANTS ROUTE 132 Z BOTTOM OF PIT HYANNIS,MASS. A DIVISION BOSTON SURVEY CONSULTANTS, INC. ' B. 90 TOM OF STONE LAYER = 21, 09 I'